Independent public opinion pollster Scott Rasmussen will deliver the keynote presentation at the 2012 WHA Leadership Summit September 21 at the Marriott Hotel in Madison. Rasmussen will review the latest public opinion data on the November 2012 elections, as well as a perspective on public attitudes toward health care and the political environment.

A pollster since 1994 and frequent guest of major media outlets, Rasmussen is the founder and president of Rasmussen Reports, one of the nation’s premier sources for public opinion information.

The WHA Leadership Summit is a one-day event focused on sharing examples of innovative and bold leadership, sharing actionable strategies, and gaining valuable insight on ways that Wisconsin can continue to be a national leader in providing high quality, high value and affordable health care in Wisconsin.

CEOs, administrators, vice presidents, CFOs, nurse executives, physician executives, department and service line managers and board of trustee members should register today at: http://events.SignUp4.com/12LeadershipSummit0921.

A block of rooms is being held at the Marriott Madison West Hotel for the evening of September 20. Reservations in the WHA block can be made by calling 888-745-2032 or 608-831-2000 before August 31.

I’m an unabashed fan of Wisconsin Congressman Paul Ryan. Paul is smart, energetic, charismatic and a "big idea" guy when it comes to health care. Other than Ron Kind (D-La Crosse), who shares many of those attributes, no one in our current delegation has shown a greater interest in supporting measures that will truly transform health care by rewarding VALUE—a dynamic that is essential if we are to successfully move away from a delivery system framed by fee-for-service (FFS) payments to payment designed to incent delivery with a population health focus.

I also conceptually support Congressman Ryan’s call for transforming Medicare from the broken status quo model to a defined contribution that will engage tomorrow’s seniors as thoughtful consumers. And the fact that Ryan has attracted a few Democrats to the cause should not go unnoticed. In fact, former Bill Clinton Chief of Staff Erskine Bowles, whom Obama appointed to head a budget deficit reduction commission, has called the plan "sensible, honest, and serious."

If done right, defined contribution could be particularly good for providers (and beneficiaries) in low spending and high quality states like Wisconsin. Integrated provider organizations, either through their own health plans or with commercial plan junior partners, would be especially well-positioned to market themselves directly to future Medicare beneficiaries. The key will be to successfully manage risk by taking a more population health-oriented delivery approach and better coordinating care. Contrast this to the alternative vision of a 15-member Board (IPAB) empowered to arbitrarily reduce provider payments (and ONLY provider payments) in order to balance Medicare spending with available revenue.

The next 80 days or so will see some, but probably not enough, serious discussion about Medicare’s future. Unfortunately, we will hear way too much hyper hysteria and falsehoods that will be rightly labeled "pants on fire" by media fact-checkers. The wild claims will be aimed at scaring seniors (none of whom are actually affected by the Ryan plan) into voting against the GOP ticket on November 6. And they may be successful.

But remember this: 1) Medicare is already broken and unsustainable. The SGR (doc payment formula) is a case in point, as was the scheme that recently jacked up MASSACHUSETTS’ hospital payments by over eight percent, paid for by hospital cuts in the rest of the country. 2) Major new Medicare cuts are inevitable—as is an annual global spending cap. 3) The choices as to how 1 and 2 will be addressed are limited. It is a very short list.

From a big picture perspective, the November choice comes down to: The FFS status quo run by IPAB—or—Medicare largely paid for and delivered via a defined contribution. The latter, if consistent with the bipartisan Ryan/Wyden proposal, would include a "traditional" Medicare option.

Go ahead and determine on your own which option best aligns (or could align) with WHA’s reform principles (www.wha.org/Data/Sites/1/pdf/accessprinciples.pdf). Let me know what you think.

Steve Brenton
President

WHA announced that 23 hospitals will participate in Wisconsin’s second Transforming Care at the Bedside (TCAB) initiative. Lead by the Wisconsin Hospital Association and supported by Wisconsin’s statewide participation in an Aligning Forces for Quality (AF4Q) grant, 25 hospital units from 23 Wisconsin hospitals will begin an 18-month improvement strategy. The initiative will formally begin with a kick-off event at the end of September, but will begin immediately doing pre-work and data collection for that meeting.

TCAB is an innovative model that calls for nurses to lead unit and hospital-wide team efforts to improve the quality and safety of patient care. It focuses on nurses’ creativity, teamwork and focus on patients.

Participating hospitals/units are:

"The beauty of TCAB is that quality becomes practical in the hands of bedside nurses who are given the tools to conduct small tests of change, then adapt, adopt, or abandon those tests until an innovation becomes a new way of doing things," according to Judy Warmuth, WHA vice president, workforce.

The 25 TCAB units are also charged with spreading their improvement strategies to the entire hospital.

In Wisconsin, Aligning Forces for Quality is a joint project by the Wisconsin Collaborative for Healthcare Quality, Wisconsin Hospital Association, and other organizations. It is funded by RWJF.

State Rep. Joan Ballweg (R-Markesan) visited Moundview Memorial Hospital & Clinics in Friendship and visited with its managers and supervisors on August 10. Ballweg is the new state representative for central and southern portions of Adams County following redistricting.

"Representative Ballweg is well versed on rural health issues as she previously served on the governing board of a critical access hospital in Waupun," noted Jeremy Normington, CEO at Moundview. "During her visit we educated her on the health needs of Adams County, Moundview’s history and the services we offer. We also discussed current and future challenges for Moundview including federal and state budget cuts, health care reform, and the impending physician shortage in Wisconsin."

Ballweg shared a recent story about a personal experience she had with a family member at a Wisconsin hospital, noting that health care in our state is "excellent." She spoke very positively about the Wisconsin Hospital Association and stated that she has worked well with the Association since becoming a legislator. Ballweg also demonstrated an understanding of key health care issues and of the many challenges that are particular to rural health in the state. She is very engaged in workforce development and higher education, both of which will benefit health care in Wisconsin.

"We enjoyed our visit with Representative Ballweg," said Normington. "It was a good opportunity to build a relationship with our new legislator and discuss with her the issues we are facing which will help her to make informed decisions on behalf of our hospital and community."

State Rep. Kathy Bernier (R-Chippewa Falls) recently visited Ministry Our Lady of Victory Hospital (OLVH). Bernier was hosted by OLVH president Cindy Eichman. She toured the hospital and met with hospital leaders.

Due to redistricting, Rep. Bernier now represents two critical access hospitals, including OLVH, and hospital staff was able to provide insight into the importance of small, critical access hospitals in rural Wisconsin communities. In addition, the group discussed other important issues like Medicaid funding.

Hospitals and first responders participate on a regular basis in regional training exercises to prepare for the unimaginable. Last October, the Wisconsin Hospital Emergency Preparedness Program (WHEPP), in conjunction with the Urban Area Security Initiative through the Department of Homeland Security, sponsored a national tactical emergency medical specialists (TEMS) training program. Held at the Summerfest grounds in Milwaukee, the exercise brought 40 members of law enforcement agencies together with emergency medicine professionals from across Wisconsin to learn how medics can respond with SWAT teams and render lifesaving critical care on the scene of an active shooter.

On Sunday, August 5 their training was put to the test. A mutual aid call was placed that alerted multiple emergency medical service personnel, including police, fire and EMS, to the situation that was unfolding at the Sikh Temple of Wisconsin in Oak Creek. At the same time, a WiTrac alert was sent to 33 hospitals and other response partners in southeastern Wisconsin. Oak Creek’s TEMS unit was first on the scene, with Milwaukee’s TEMS unit responding as a back-up, when a lone gunman took the lives of six people, and his own, and severely injured four others, including a police officer. Both the Oak Creek and Milwaukee TEMS units had participated in the first WHEPP-sponsored TEMS training in Milwaukee last fall.

Elizabeth Corneliuson, RN, MS, a WHEPP project manager, said WHEPP continues to fund TEMS training through Waukesha County Technical College. TEMS courses have been held in Superior and Madison, along with a course later this month in Wausau. Courses are scheduled in La Crosse and Green Bay later this year.

"The TEMS training was essential in preparing our first responders for the dangerous situation they faced at the Sikh Temple," according to Corneliuson. "We had practiced a TEMS response to an active shooter scenario on a regional basis to ensure that if there was ever an incident with mass casualties, as was the case in the theater shooting in Colorado this summer, we could respond at the scene and provide treatment to the injured as quickly and safely as possible on a regional basis."

In a letter submitted to the Milwaukee Journal, Lynn Schubert, manager of facilities safety at Aurora Health Care, and chair of WHEPP Region 7, said:

Froedtert Health has appointed Allen Ericson as president of St. Joseph’s Hospital, West Bend, and chief operating officer of the Community Hospital Division of Froedtert Health. In these positions Ericson will lead St. Joseph’s Community Hospital, West Bend, and oversee daily operations of the Froedtert Health Community Hospital Division, which includes St. Joseph’s Hospital and Community Memorial Hospital, Menomonee Falls. He will join the health system in early September.

Ericson has served as senior vice president and chief operating officer of Catholic Medical Center, Manchester, NH for the past seven years. Catholic Medical Center is a 330-bed facility in the largest city in New Hampshire.

Ericson succeeds David Olson, who is serving as interim president of St. Joseph’s. Olson joined Froedtert Health in fall 2011 as the system’s chief strategy officer.

Ericson earned a master’s of business administration from Widener University in Chester, Pennsylvania, and a bachelor’s in economics from Rutgers University, Camden, New Jersey. He’s also a fellow of the American College of Healthcare Executives.

Fear of a bill should never prevent a patient from seeking care at a Wisconsin hospital. Wisconsin hospital charity care programs provided $232 million to more than 700 patients each day last year. The stories that follow illustrate the deep commitment and continuing concern that hospitals have to their patients to ensure they receive the care they need regardless of their ability to pay.

Sue’s story

"Without this program there’s a good chance I’d be dead," said Sue Heins, a respiratory therapist who faced a respiratory crisis of her own when she was diagnosed with lung cancer. The program that had such an impact on her life is ThedaCare’s "Caring Hearts."

Sue is a mom who had to quit working to care for her disabled son. When she developed shortness of breath, her training told her that she needed to see a pulmonologist. The tests at a Green Bay clinic cost $6,000, and when she was unable to make payments, the pulmonologist would no longer see her. She didn’t qualify for state or federal programs. So she waited.

Several months later, Sue’s shortness of breath returned—so severely that she came to the Shawano Medical Center (SMC) emergency department. It was at SMC that she learned about the ThedaCare Caring Hearts Program. Caring Hearts is the "payer of last resort" for patients who meet income guidelines. It allows ThedaCare hospitals and clinics to provide care for patients who have no other way to pay for services.

Sue was hospitalized several times. In April, a surgeon at Appleton Medical Center removed a baseball-sized tumor and a section of her lung. She started chemotherapy. Sue knows that she is only in the beginning of her survival journey, but she believes that without this program, that journey would never have begun. Sue wrote about her experience:

"I am so very grateful, as without these services I truly would not be alive today. I continue to use this at AMC for chemotherapy that may save my life and at the least buy me some time. I have also had to come to ER at Shawano for issues regarding chemotherapy…"

Sue added that professional fees by the pathologist and radiologists have also been waived or reduced, and the staff is working with her to reduce the cost of medications.

Sue has also discovered that the gift of "Caring Hearts" is more than just a financial one.

"I have been treated as if I was the most important of patients at both AMC and SMC, even though I do not have insurance. It can be both humiliating and embarrassing when you do not have a means to pay for services that you need so badly. I have never been made to feel that way at your hospitals. At your hospitals you would never know the difference between my care and the care of someone fortunate enough to have great insurance," Sue wrote.

Sue now faces other medical complications that resulted from her cancer. She continues to receive care at ThedaCare hospitals and clinics.

"I have my son to take care of," Sue said.

Support for those who cannot afford to pay their medical bills

As part of Allina Hospitals & Clinics, River Falls Area Hospital is committed to providing high-quality medical care regardless of one’s ability to pay. Toward that end, staff at the hospital helps connect patients with the wide range of services Allina offers for patients and their families who cannot afford to pay their medical bills.

In addition to these defined programs, we know that there are times when patients experience catastrophic events that put them in devastating financial positions. In these special circumstances, staff works with these patients to determine how to best support them financially.

What stress can do

A 49-year-old female from Walworth County came into the Emergency Department at Aurora Lakeland Medical Center for extreme vomiting, abdominal pain, persistent reflux, severe heartburn and fever. Tests revealed that she had multiple problems within her intestinal tract. She was diagnosed with colon diverticulitis, intestinal abscess, paralytic ileus, esophageal reflux and anemia NOS, requiring immediate surgery.

The patient, a single mother who lives with her 22-year-old disabled son, was unemployed and uninsured. Her most valuable asset, her home, was in the process of foreclosure. As her son’s primary caretaker, her only source of income is his Social Security Supplemental Income.

Financial Counselor Tom Grenell met the patient in her room to provide resources and options. Tom provided her with the Aurora Helping Hand Patient Financial Assistance Program application. The patient needed a wound vacuum-assisted closure machine upon discharge from the hospital in order to heal completely. This device is used to treat chronic, difficult-to-heal wounds. Tom had to deal directly with the supplier to order it, which required signatures from Wound Care Specialist Suzie, as well as the patient’s primary doctor.

Tom was determined to relieve some of the stress for this patient. Within a few days, Tom received positive news that he was able to deliver to her. Although her hospital bills totaled $70,164, she was approved for a 100 percent discount through the Aurora Helping Hand Patient Financial Assistance Program.

Patients grateful for Community Care

Memorial Health Center’s Community Care program is devoted to providing compassionate health care services of the highest quality to people who cannot afford them otherwise.

Here are two of the many thank-you notes sent by grateful Community Care recipients to Memorial Health Center in the past year:

"Mary & Whom It May Concern:

Thank you so much for helping us out. This is just what we needed to get back on track. Thanks for letting us know about this program and everyone’s generosity. We greatly appreciate it!"

"To Erin and Others at the Community Care Program, Memorial Health Center:

We just wanted to say a big THANK YOU for the ways that you have seen and understood our financial situation, and been as generous as to completely forgive our bill. I am a bit at a loss for how to adequately express how much this has meant to us. Thank you for your compassion. We also feel so grateful for the care that our daughter received while she was there. In those moments of stress it was so good to know we could trust the doctors, nurses and staff at Memorial to take good care of her.

So, with gratitude and humility, we thank you! May God bless you ALL and continue to help you serve those who come through your doors!"

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

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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