WHA this year is again working with RC Healthcare on our wage index improvement project. This is a major WHA commitment aimed at helping hospitals accurately report data in their cost reports, which is used to calculate the hospital wage index, a key component of Medicare payment for PPS hospitals. WHA has been partnering with RC Healthcare for the past several years and has achieved excellent results.

The results of on-site and remote wage index reviews performed by RC Healthcare on data used in determining the 2009 wage index will benefit Wisconsin hospitals by several million dollars.

Among RC Healthcare’s findings—outlined below—are revisions to initial filings consistent with what they have been reviewing in the WHA annual wage index seminars:

• Several hospitals reported 27 payroll periods in the fiscal year, understating their average hourly wage increases by 3.8 percent.
• RC Healthcare identified millions of dollars in unreported or understated home office expense, and hundreds of thousands of hours for removal due to reconciliations, error corrections, on-call, and PTO buyback.
• RC documented Contract Part A physician expense in a number of hospitals and added wage related costs through G/L review and FTE allocation of physician departments.
• RC worked with hospitals to defend and support fiscal intermediary (FI) audits and worked with hospitals to draft an appeal to CMS following a denial by the Fiscal Intermediary.

With WHA staff oversight, RC Healthcare also helps hospitals prepare the occupational mix survey, which is another adjustment factor used to modify Medicare PPS rates. Through several rounds of occupational mix survey submissions, RC Healthcare shared experiences among hospitals interpreting the survey and worked to increase hospitals’ average hourly wages by as much as 1.5 percent through recommending the reclassification of Nurse’s Aides from "All Other" for appropriate categories. Similarly, they reviewed hospitals’ detailed survey documentation to identify RNs that could be classified to "All Other" based upon the survey instructions to report only RNs in specific cost centers.

WHA will be offering a wage index education session later this year. Members can attend in person or call in to participate. RC Healthcare is spending much more time doing hospital visits and making individual phone calls to facilities working on wage index reporting issues. Therefore, the education session will be more directed toward those who have not participated in the education sessions before, or would like a refresher on the S-3 worksheet and how it impacts the wage index. More information will be sent to hospitals in the coming weeks.

If you have questions about WHA’s Wage Index Improvement Project, contact Brian Potter at WHA at bpotter@wha.org or 608-274-1820.

Despite the loss of Brett Favre, big things are still happening in Green Bay this fall—most importantly, the WHA 2008 Annual Convention! Make your plans now to attend this year’s Annual Convention September 17-19 at the KI Convention Center and the adjoining Hotel Sierra (formerly Regency Suites) in downtown Green Bay.

If you plan to attend, call 800-236-3330 today to make your room reservation, as the cut-off date for the group room rate is Friday, August 22.

This year’s convention is the perfect opportunity for you, your hospital senior staff, and your Board of Trustee members to network together and with colleagues from around the state, and discuss your thoughts on the future of health care. This year’s convention agenda has several very important and timely topics for you, your staff and your trustees, including:

• A keynote session presented by internationally-known health care futurist Ian Morrison, sharing his insight on the future of health care and how the health care provider’s playing field will change, particularly following the 2008 elections.
• A CEO reactor panel will share their thoughts on the future of health care and the keynote presenter’s message, moderated by Leo Brideau, CEO of Columbia-St. Mary’s, and chair of WHA’s Task Force on Access and Coverage.
• A plenary session focused on AHA’s Health for Life reform initiative, presented by AHA Chair, and Wisconsin’s own, Bill Petasnick.
• A closing session focused on leadership, presented by Major General David Rubenstein, Deputy Surgeon General for the U.S. Army and 2008-2009 Chairman of ACHE.

In conjunction with WHA, Aspirus Wausau Hospital and Aurora Health Care Metro and Kettle Moraine Regions have collaborated in the development of a forum focusing on nursing-driven quality outcomes and related leadership topics.

This is your last chance to register for the September 9 conference, entitled "Over the River and Through the Woods: Excellence in Wisconsin Nursing." Conference registrations are due by August 21. Hotel reservations at the Howard Johnson Inn in Wausau must be made by August 29 in order to receive the group rate of $53. Call 800-928-7281 and request a room in group block #2043.

Keeping employees trained appropriately and their skills and competencies up-to-date is a constant challenge for hospitals and health care providers. Add on the expenses associated with developing curriculum and the difficulty of scheduling, and it’s easy to understand why health care providers are looking for alternatives to traditional training. careLearning.com is available to WHA hospital members as a simple, affordable way to keep their employees up-to-date on mandatory training, as well as regulatory and policy issues.

careLearning is a non-profit e-learning company operated by state hospital associations nationwide, including WHA and the American Hospital Association. careLearning offers cost-effective Web-based education, as well as the ability to track both live and online education. The careLearning services include:

• Mandatory Education—including a set of 14 Health and Safety Compliance courses with complete recordkeeping and reporting functions. These courses use cost-effective interactive, multimedia training to help comply with Joint Commission and OSHA requirements
• Competencies—to address either core or discipline-specific education
• Continuing Education—credit toward licensure or various types of certification
• Hospital Specific Private Courses—the ability to include courses that are written and produced by your organization for sole use of your organization on the careLearning Learner Management System
• Webinars—where participants with a common interest learn from one another
• Nursing Education—self-paced, interactive, and cost effective CNE any time, on any computer with Internet access capability

If you have questions or would like to try any of the online courses at no charge, contact Jennifer Frank at jfrank@wha.org or at 608-274-1820.

Solving the nation’s health care "crisis" (aka: Health Reform) for most voters has absolutely nothing to do with improving access and coverage for the uninsured. As recently revealed in a major Kaiser Family Foundation Tracking Poll, Health Reform for most voters either means concern about health insurance affordability—or—a strong sense that we are spending too much on health care…probably meaning that public spending on Medicare and Medicaid is soaking up resources that could otherwise be spent in other areas…or on reducing taxes.

The fact that only one in five Americans looks at Health Reform from a "coverage for all" viewpoint is a sobering reality check for politicos and health policy wonks who generally focus on coverage universality and access improvements—both of which require significant funding and infrastructure investments. But the public appetite for new spending is not deeply felt.

The greatest opportunity for the provider community to address this strong voter sentiment for reducing the rising costs of health insurance premiums can be answered by support for: 1) performance improvement achieved via the investment and implementation of IT-based solutions; 2) advancing the measurement and public reporting of quality and safety process and outcomes agenda; and 3) collaborating with employers to improve the health status of employees and their families (discussed last week in my column).

Provider advocates must also continue efforts to advocate for access and coverage improvements. But, failure to lead on the cost issue is a lost opportunity.

Steve Brenton
President

The Wisconsin Hospital Association is committed to providing our members with timely, high quality resources on a variety of issues. Training and educating our members on legislation and grassroots is no exception. WHA provides a wide range of resources that are immediately available to you and your hospitals. Whether your facility is new to grassroots or is full of grassroots all-stars, there’s something here for everyone.

Hospital leaders are individuals of influence, and this workshop provides in-depth training to leverage that influence in the legislative arena. The workshop was initially presented in 2007 with overwhelming success. In 2008, WHA will bring this workshop directly to your hospital and its leadership team. The two-hour workshop includes a legislative update and grassroots training.

HEAT (Hospitals Education & Advocacy Team) Grassroots Program

WHA’s grassroots advocacy efforts, through the Hospitals Education & Advocacy Team (HEAT), are part of the reason WHA is so well respected by Wisconsin legislators—because Wisconsin hospitals have thousands of individuals across the state who tell their legislators how they feel on important issues. If your employees, trustees and volunteers are not engaged with the legislative process, they need to be. The HEAT program is the place to start. HEAT is free and is designed to help you positively impact the legislative process. Add your hospital’s voice to this statewide program. Membership materials are available via hard copy, PDF or online at www.wha.org/speakUp/heat.aspx.

Guide to Grassroots Advocacy Handbook

Learn the fundamentals of grassroots advocacy and how to become a positive force for change through HEAT’s Guide to Grassroots Advocacy Handbook. Chapters in the book include how to communicate with legislators, understanding the legislative process, how to host a legislator at your hospital and more. Individual chapters or the entire publication are available to you by request and can be sent in hardcopy format or PDF.

Customized Grassroots/Legislative Presentations

WHA staff is available to present at your facility. Presentations may include legislative issues update, grassroots education/training and more. Consider inviting WHA to present to your hospital leadership teams, boards of trustees or volunteers.

Ever wonder what a legislative hearing is like? This seven-minute video is your insider’s look—and you don’t even have to leave your office! Using footage of a "mock hearing" held during a session at the Wisconsin Organization of Nurse Executive’s Annual Meeting, nurse leaders show you what to do (and not to do) when testifying. WHA can discuss this video in conjunction with a presentation to your hospital or we will send it to you for use.

WHA’s premier grassroots event is Advocacy Day, bringing 600 hospital employees, trustees and volunteers from across Wisconsin to the State Capital to learn about important issues, participate in grassroots training and meet personally with legislators. It’s a fun and simple way to begin your grassroots involvement or to continue building those oh-so-important legislative relationships. Your hospitals won’t want to miss this yearly event. Mark your calendars for April 1, 2009 in Madison (no foolin’!).

Join dozens of your colleagues at the American Hospital Association’s Annual Meeting in Washington, DC. With so many Wisconsin hospital representatives in Washington, WHA uses this time to meet with Wisconsin’s Members of Congress. WHA provides issue briefings and members-only events to prepare our hospital leaders for these important Hill meetings. Each Hill meeting includes WHA staff. This important event takes place on April 26-29, 2009 in Washington, DC.

WHA is constantly looking for ways to increase and improve our grassroots offerings. If there is something you think would be useful, please let us know that as well. If you are interested in any of the resources listed above, contact WHA’s Jenny Boese at jboese@wha.org or 608-268-1816.

On a blustery November weekend, 16 women attended a special health-focused event in Weston, sponsored by Aspirus. Organized in partnership with the Wisconsin Rural Women’s Initiative, the event provided free health education and screenings to women who live on working family farms.

The women represent a population that struggles with a physically and emotionally demanding livelihood, and with high health insurance costs that often prevent them from accessing timely health care.

"I appreciate the fact that you sponsored the free health screenings," said one participant. "I have a few health issues, but didn’t want to go to my doctor because I have such a high deductible on my insurance."

Beyond the physical health care component of this event, women found true value in the camaraderie.

"This is the only opportunity I really get to take time for myself and get away," said another participant. "Connecting with other farm women is so important because there are not many in my community and most people do not understand or cannot relate to the problems we face."

Submit hospital community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Pharmacists from Aurora Pharmacies partnered with Metro Milwaukee Sewerage District and other community agencies to collect 3.5 tons of unused medication from more than 2,000 people at sites in Milwaukee, Ozaukee, Racine, and Washington Counties.

The May 2008 event was the third annual Medicine Collection Day. The event is held each year to help protect our rivers and Lake Michigan, prevent childhood poisonings and reduce substance abuse. The materials are destroyed in accordance to federal regulations.

Items collected included:

                                                Non-Controlled                 Controlled
                                                Substances                     Substances

Milwaukee County                     4,487 lbs                         36,831 (Pills, Patches & Bottles)
Ozaukee County                       1,022 lbs                         three 30-gallon drums
Racine County                             761 lbs                         50 lbs
Washington County                      743 lbs                         83 lbs

Additionally, Waukesha County collected thirteen 30-gallon barrels of non-controlled substances and two barrels of controlled substances.

The circumstances surrounding the birth of her first child weren’t exactly how she had planned them. But 17-year-old Jesse Pfliger of Menomonee Falls was able to successfully navigate her first pregnancy—thanks to the help of Community Memorial Hospital and the Pregnancy Support Connection.

The Pregnancy Support Connection, a non-profit organization based in Waukesha County, supports young mothers throughout their pregnancies and after their babies are born. In 2007, it helped 233 young women and girls. Community Memorial Hospital contributes by providing space, free of charge, for the Connection’s childbirth education classes, and by awarding the organization thousands of dollars in grants each year through the Community Outreach Steering Committee.

Jesse first heard about the Pregnancy Support Connection through a nurse practitioner at Community Memorial Hospital. Karen Villarreal, the Connection’s lead case manager, was Jesse’s main contact throughout her pregnancy. Karen visited Jesse at home once a month, offering her information on breastfeeding, healthy eating, exercise and car seat safety. After the baby was born, she brought her diapers and baby outfits.

But the best part for Jesse was the education class. "It was perfect for me," she said. The classes are nontraditional and geared for a younger group. "The girls tend to feel more comfortable in these classes than they would if they were in a traditional childbirth class with all these couples," Karen said.

Jesse’s daughter Kira is now 20 months old. Though Kira wasn’t planned, she is definitely loved by both her mother and father. Jesse is working as a certified nursing assistant through a home health care company. "Life is really good right now," she said.

Effective treatment of diabetes must include self-management education. Ensuring high-quality education for patient self-care is one of the primary goals of Fort HealthCare’s Diabetes Education program. Rhonda Perdelwitz, RN, the Diabetes Education Coordinator for Fort HealthCare, states, "It is our goal to make sure people receive the best possible care, and that includes making sure the community is informed about ways to maintain good, long-term health for themselves and their families. We hope to raise awareness about the importance of maintaining a healthy lifestyle, and how to manage diabetes in the safest way possible." Perdelwitz noted that many people are not aware that they have diabetes, and they may first learn of it when they are treated for one of its life-threatening complications including heart disease, stroke, kidney disease, blindness, nerve disease or amputation.

The Fort HealthCare Diabetes Education department offers a number of free services to the community including a bi-monthly Diabetic Education Series featuring open discussion and an educational presentation, free blood glucose meters and meter reading instruction, educational programs at area schools, free diabetic education information at community health fairs or upon request, and improved access to diabetic education materials for the growing Hispanic community in the area.

The number of cases of diabetes diagnosed each year is increasing, and the Fort HealthCare Diabetes Education department strives to teach the community that many simple lifestyle changes can make living with diabetes more manageable, or greatly reduce the risk of ever being diagnosed with it. The Fort HealthCare Diabetic Education program educates dozens of people every regarding healthful food choices, lifestyle habits, and the importance of physical activity in daily life.

At some point in our lives, we all need a lift. In the Hudson area, more than 1,800 people a year get one. For $1, homebound, wheelchair bound, injured and others who can’t transport themselves enjoy a safe, friendly drive to their appointments at Hudson Hospital and health campus. And if that $1 is a problem – no big deal, they’ll do it for free.

"It really made a huge difference in my life," said Patti Brophy of Hudson. "It wasn’t just a taxi service. It was care and true concern."

Brophy spent the summer of 2004 slowly recovering from major neck surgery. She couldn’t drive, but needed to attend occupational therapy, speech therapy and physical therapy sessions at Hudson Hospital in order to get back on her feet again.

Two or three times a week, from May to September, friendly volunteer van drivers arrived at her door. They watched her progress from using a wheelchair, to a walker and finally a cane.

One of those volunteers was Richard Knutson, a retired 3M data processor, who has been serving as a driver for more than three years. He’s out and about in the van up to seven times a day. Like the other volunteer drivers, he not only transports people, he also delivers prescriptions to people who can’t get to the pharmacy (a free service), as well as picks up the mail for the hospital.

Sara Nemo, the hospital’s volunteer services manager, said drivers are carefully selected and undergo a background check and training.

Patients can schedule the van service when they make their appointment at the hospital or clinic. The driver will pick the patient up at home, and then bring him or her back home after the appointment. The van accommodates wheelchairs. The only requirements are that van riders live within a 15-minute drive from Hudson Hospital, and they are able to articulate to the driver the location of their appointment.

For van rider Brophy, the van service was much more than transportation: "They’d say ‘Wow! You’re doing great. You can do it!’ It was very motivating for me. I never imagined people would give like they gave."

At one point when she was homebound, she was unable to collect the mail from the mailbox at the end of her long driveway. A Hudson Hospital van driver happened to be there one day when her mail was delivered and recognized her plight. So the driver brought Brophy’s mail to her house until she was well enough to get it herself.

"You can just tell they are caring people," Brophy said. "They are different. They give of themselves because they want to. There’s a giving component there that makes them special."

Brophy now strives to touch people’s lives in a similar way. She works as a volunteer at Hudson Hospital. She finds the atmosphere of the hospital invigorating and healing: "I go home and think, ‘I’m a better person because I was at Hudson Hospital today.’"

Submit hospital community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

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