August 21, 2009
Volume 53, Issue 33
The national health reform dialogue continued this past week in Wisconsin as WHA staff and health care leaders met with key media at editorial boards meetings in Appleton, Eau Claire, Milwaukee and Green Bay. While members of Congress continue to gather local input at what have been rather contentious town hall meetings, editors and reporters were interested to know how various proposals in Washington would play out in Wisconsin.
In Milwaukee, questions were raised about cost, coverage and what has surfaced as one of the more politically-charged ideas—end-of-life discussions with patients and their families. In an editorial that followed a meeting with editors at the Milwaukee Journal Sentinel, the paper opined:
"Lawmakers are declaring dead a provision that would allow health consumers to voluntarily get advice on end-of-life directives. They also are saying that a public health care option is now expendable.
First, the end-of-life directives. Talk to health care experts, and they will tell you that such directives are necessary in making sure that a person’s last days go according to wishes. But this morphed into “death panels” and “pulling the plug on grandma” - fictions thoroughly debunked. And it didn’t matter.”
In Appleton, WHA President Steve Brenton was joined by Dean Gruner, MD, president and CEO, ThedaCare and Dan Neufelder, president and CEO, Affinity Health System. At that meeting, Brenton said bad debt has increased 20 percent over the past year.
"For some patients, their insurance covers most of the care costs, with the exception of a $1,000 deductible, and it’s that $1,000 they’re having a hard time with," he said.
Gruner, Neufelder and Brenton said they believe a public option health plan will harm a system already dealing with rising costs and limited access. They told the Post Crescent a public option could lead to providers receiving lower payments to cover costs of care. Despite the bleak outlook, they believe disaster can be averted if Congress and President Barack Obama will allow industry experts to develop a plan to fix the system, which lawmakers could later consider.
How hospitals are reimbursed, particularly through Medicare and other government programs, should be based on performance or providing quality care at low cost, the Fox Cities health executives said. Gruner said ThedaCare’s collaborative care model, which took nearly two years to develop, has reduced costs by 28 percent and reduced length of stay in the hospital by 25 percent.
"But doing that made us an outsider on the Medicare database," he said. "The result of reducing our cost meant Medicare reduced our reimbursement by $1,000 per admission. The system needs to reward people (for) doing the right thing."
Advanced technology and patient-centered care that reduce length of stay have improved efficiency, but as Gruner noted, the payment system fails to reward it. Obama has acknowledged these initiatives should be rewarded, according to Neufelder.
"We’re still in a pursuit of excellence and that means doing the right thing for the patient even though you could get more money if you did something in an inefficient way," he said.
During an editorial board visit with the Eau Claire Leader Telegram, Randall Linton, MD, Luther Midelfort president and chief executive, made the point that variations in health care delivery and payment cannot be ignored.
"Medicare, as most traditional insurance does, pays for doing things not based on the quality and the outcomes," he said Wednesday. "The more you do, the more you get paid. That’s a perverse incentive that does not directly get to the issue of how you control cost."
Regarding payment for health care, Medicare payment rates to Wisconsin hospitals already are inadequate and Linton called paying for all health care under a similar method "untenable."
"We already know Medicare is going broke," he said.
Also this week the Wisconsin Hospitals Issue Advocacy Council, Inc. (WHIAC), a 501(C)(4) organized to promote, develop, and encourage the distribution of information about Wisconsin’s health care climate and the importance of enabling high quality health care, released its second in a series of radio ads aimed at educating the public about national health care reform and its impact on Wisconsin. The radio message focuses on the many strengths of Wisconsin’s health care system.
"As the President and Congress push health reform on a massive scale, access to some of the best health care in the nation continues to be provided right here in Wisconsin," the narrator says. Later the ad points out that "While Congress rushes to overhaul our nation’s health care, they need to support what is working well in America’s Heartland."
The ad concludes by urging listeners to contact their congressperson and urge them to "use Wisconsin as a model for national health care reform."
The ad, titled "Top Notch Care," ran this week on radio stations across the state. WHA has posted the audio version of both ads on its Web site at www.wha.org.
WHA has more editorial board meetings scheduled over the next few weeks.
WHA/HEAT Hosts Call: "All Eyes on Health Care"In its ongoing commitment to provide up-to-date legislative information, WHA and its grassroots program, HEAT, held a conference call August 19 entitled, "All Eyes on Health Care: A Look At Issues Pending in Congress and Madison." More than 135 individuals listened in as featured presenter WHA President Steve Brenton discussed health care reform legislation pending in Washington, DC.
During his presentation, Brenton laid out several issues of contention in health care reform, the political dynamics in play, how the public is impacting health care reform through town hall meetings, and several messages WHA has been delivering to Wisconsin’s Members of Congress.
With respect to contentious policy issues, Brenton highlighted "the big three:" a public plan option; an employer and/or individual mandate; and the cost of funding health care reform. He also discussed the differing dynamics between the U.S. Senate and the U.S. House. In the Senate, a group of six bipartisan Senators are attempting to craft reform legislation. In the House, an intra-party dynamic has surfaced, pitting the liberal wing of the Democratic caucus, who firmly believe in a public plan option, against the moderate/Blue Dog contingent who are expressing reservations, especially with the overall cost of reform.
In terms of messages WHA has been delivering, Brenton highlighted the following:
WHA Executive Vice President Eric Borgerding closed the conference call with an update on implementation of the recently enacted state budget bill.
Political Action Spotlight: Fundraising Campaign Surpasses $132,000The Wisconsin Hospitals State PAC and Conduit Fundraising Campaign has raised $132,557, or 63 percent of its $213,000 goal for the year. That is down about 17 percent from this same time last year, but the campaign’s momentum seems to be increasing, as nearly $20,000 in contributions from 52 additional individuals has been raised in the last three weeks.
The 2009 Campaign also aims to increase the number of individual contributors by 10 percent, increasing the total number of contributors to 660 people. To date, 305 individuals have contributed on average $435 to either the Wisconsin Hospitals State PAC or Conduit.
Individual contributors are listed below by name and affiliated organization. Contributors are listed alphabetically by contribution category. The next list will be published in the September 4 edition of The Valued Voice. For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.
Contributions ranging from $1 - $249
Adams, Daniel Memorial Medical Center - Ashland
Albers, Kirstin Meriter Hospital
Albert, Matthew St. Mary’s Hospital
Ambs, Kathleen St. Mary’s Hospital
Anderson, Mark Sacred Heart Hospital
Annala, Shannon Aspirus Wausau Hospital
Arendt, Kathleen Aspirus Wausau Hospital
Axelsen, Kathern Sacred Heart Hospital
Banaszynski, Gregory Aurora Health Care
Barkovich, Catherine Sacred Heart Hospital
Bauer, David Sacred Heart Hospital
Beckler, Rick Sacred Heart Hospital
Beglinger, Joan St. Mary’s Hospital
Bernklau, Robert Memorial Health Center
Bliven, David Aspirus Wausau Hospital
Block, Jennifer Sacred Heart Hospital
Bloom, Deborah Sacred Heart Hospital
Bosio, David Aspirus Wausau Hospital
Boson, Ann Saint Joseph’s Hospital
Bowe, Cynthia Sacred Heart Hospital
Bowman, Andrew Sacred Heart Hospital
Bradley, Connie Columbia St. Mary’s Columbia Hospital
Braun, James Flambeau Hospital
Brenholt, Craig St. Mary’s Hospital
Brenholt, Mary St. Mary’s Hospital
Brennan, Karen St. Mary’s Hospital
Brisch, Joe Holy Family Memorial Medical Center
Brown, John St. Mary’s Hospital
Brueggeman, Mary St. Joseph’s Community Health Services
Bryans, Richard Sacred Heart Hospital
Burgener, Jean Aspirus Wausau Hospital
Burtch, Sue Aspirus Wausau Hospital
Buss, Diane St. Mary’s Hospital
Campbell-Kelz, Nancy Aspirus Wausau Hospital
Carlson, Carol Sacred Heart Hospital
Casey, Karen Columbia Center
Censky, Bill Holy Family Memorial Medical Center
Chartier, Jacklyn Aspirus Wausau Hospital
Christensen, Leslie St. Mary’s Hospital
Coblentz, Kathy Jo St. Joseph’s Community Health Services
Cohen, Joan Aspirus Wausau Hospital
Colby, Daniel Mercy Health System
Collins, Sherry Wisconsin Hospital Association
Cox, Tamarah Aspirus Wausau Hospital
Culotta, Jennifer St. Clare Hospital and Health Services
Dalebroux, Steve St. Mary’s Hospital
Danzinger, Marcia Sacred Heart Hospital
Davis, Kathleen Children’s Hospital of Wisconsin
Decker, Dawn Aspirus Wausau Hospital
DeMars, Nancy Sacred Heart Hospital
Derks, Darla Sacred Heart Hospital
Dettman, Amy Bellin Memorial Hospital
DeWitt, Pamela St. Joseph’s Community Health Services
Diemer, Peggy Aspirus Wausau Hospital
Dietsch, Teresa St. Clare Hospital and Health Services
Dittrich, Peggy Memorial Health Center
Dorpat, Denice Aspirus Wausau Hospital
Draxler, Deborah Aspirus Wausau Hospital
Dryden, Shawn Sacred Heart Hospital
Duda, Carrie Wheaton Franciscan Healthcare - All Saints
Dwyer, Amy Sacred Heart Hospital
Dwyer, Maxine St. Mary’s Hospital
Ellis, Nancy Aspirus Wausau Hospital
Erickson, Susan Meriter Hospital
Eskridge, Melissa Sacred Heart Hospital
Facey, Alice St. Clare Hospital and Health Services
Fedorov, Emilie St. Mary’s Hospital
Feldhausen, Mary St. Vincent Hospital
Folstad, John Sacred Heart Hospital
Gahagan, Marsha St. Mary’s Hospital
Galfano, Victor Sacred Heart Hospital
Gantner, Sue Aspirus Wausau Hospital
Garavet, Scott Aspirus Wausau Hospital
Garcia, Dawn Sacred Heart Hospital
Garvey, Gale St. Mary’s Hospital
Gengler, Tim Aspirus Wausau Hospital
Goffinet, Jo St. Mary’s Hospital
Grohskopf, Kevin St. Clare Hospital and Health Services
Gulan, Maria Aspirus Wausau Hospital
Gullicksrud, Lynn Sacred Heart Hospital
Haggerty, Peggy Columbus Community Hospital
Halberg, Carole St. Mary’s Hospital
Halberslaben, Holly St. Mary’s Hospital
Harter, Ellen Aspirus Wausau Hospital
Hassemer, Robert Sacred Heart Hospital
Hedrington, Brian Sacred Heart Hospital
Herbert, William Meriter Hospital
Hieb, Laura Bellin Memorial Hospital
Hinton, George Aurora Sinai Medical Center
Hinz, Russ Aurora Health Care
Hoege, Beverly Reedsburg Area Medical Center
Holmes, Sheri Aspirus Wausau Hospital
Hueller, Julie Wheaton Franciscan - Milwaukee
Huemmer, Paul St. Mary’s Hospital
Jelle, Laura St. Clare Hospital and Health Services
Johnson, Kimberly Sacred Heart Hospital
Jones, Mary Meriter Hospital
Jones, Tom St. Joseph’s Community Health Services
Kaiser, Ann Sacred Heart Hospital
Karow, Deborah Aspirus Wausau Hospital
Kempen, Jacob Aspirus Wausau Hospital
Krueger, Pamela Aspirus Wausau Hospital
Kuehni-Flanagan, Tracy Sacred Heart Hospital
Lachecki, Therese Memorial Medical Center - Ashland
Lang, Susan Aspirus Wausau Hospital
Larson, Piper Sacred Heart Hospital
Leonard, Mary Kay St. Mary’s Hospital
Lerch, Shawn Columbus Community Hospital
Lien, Kristine Sacred Heart Hospital
Logemann, Tim Aspirus Wausau Hospital
Lopas, Mary Door County Memorial Hospital
Lorenz, Bruce Aspirus Wausau Hospital
Lucas, Roger Aspirus Wausau Hospital
LuCore, Patricia Sacred Heart Hospital
Lunde, Pam Columbus Community Hospital
Mackey, Theresa Sacred Heart Hospital
Marcouiller, Don Memorial Medical Center - Ashland
Marquardt, Amy Columbia St. Mary’s Columbia Hospital
Marsch, Jean St. Vincent Hospital
Mason, Paul Wheaton Franciscan Healthcare - All Saints
McKay, Jean Sacred Heart Hospital
McKenzie, Paula St. Mary’s Hospital
Meicher, John St. Mary’s Hospital
Merwald, Alfred Aspirus Wausau Hospital
Mickelson, Ronald St. Clare Hospital and Health Services
Miloszewicz, Angela Wisconsin Hospital Association
Mohr, Carol Sacred Heart Hospital
Morauske, Michelle WHA Financial Solutions, Inc.
Mourey, Gerald Aspirus Wausau Hospital
Mueller, Bonita St. Mary’s Hospital
Mulder, Doris Beloit Memorial Hospital
Ness, Nita Sacred Heart Hospital
Nohelty, Peter Sacred Heart Hospital
Ohrmundt, Joel Aspirus Wausau Hospital
Olson, Keri St. Clare Hospital and Health Services
Onsager, Sandra St. Mary’s Hospital
Osen, John Aspirus Wausau Hospital
Padilla, Gilbert Sacred Heart Hospital
Palecek, Steve Sacred Heart Hospital
Peck, Lori Memorial Health Center
Peickert, Barbara Hayward Area Memorial Hospital and Nursing Home
Peiffer, Susan Sacred Heart Hospital
Pengra, Mary Sacred Heart Hospital
Peters, Kenneth Bellin Memorial Hospital
Peterson, Brenda Sacred Heart Hospital
Peterson, Lawrence St. Mary’s Hospital
Pielhop, Judy Sacred Heart Hospital
Pinske, Heather St. Mary’s Hospital
Piper, Barbara Sacred Heart Hospital
Pittenger, Jeannie Sacred Heart Hospital
Plaisance, Christopher Aspirus Wausau Hospital
Powell, Stacey Sacred Heart Hospital
Preston, Mark Sacred Heart Hospital
Probst, Paula Sacred Heart Hospital
Prunty, Brian Aspirus Wausau Hospital
Quade, Steve Door County Memorial Hospital
Rasmussen, Sheri WHA Financial Solutions, Inc.
Reding, Rick Aspirus Wausau Hospital
Richbourg, Mary Sacred Heart Hospital
Rocole, Theresa Wheaton Franciscan Healthcare - All Saints
Rosenberger, Herb ProHealth Care
Rounds, Thomas St. Mary’s Hospital
Roundy, Ann Columbus Community Hospital
Rudolph, Wade Sacred Heart Hospital
Schade, Randy Aspirus Wausau Hospital
Schneck, Judy Sacred Heart Hospital
Schraufnagel, Patricia Memorial Medical Center - Ashland
Schweitzer, Susan Columbus Community Hospital
Scinto, Jeanne Aspirus Wausau Hospital
Segerstrom, Amy Sacred Heart Hospital
Selberg, Heidi St. Mary’s Hospital Medical Center
Sergey, Mark Sacred Heart Hospital
Sheehan, Heather Hayward Area Memorial Hospital and Nursing Home
Skulan-Balmer, Anna Sacred Heart Hospital
Smith, Julie Sacred Heart Hospital
Sorenson, Heather Sacred Heart Hospital
Sorenson, Jim Sacred Heart Hospital
Soward, Cindy Sacred Heart Hospital
Sparks, Steven St. Mary’s Hospital
Spindler, Greg Sacred Heart Hospital
Sprengeler, John Sacred Heart Hospital
Stone, Stacy Sacred Heart Hospital
Storing, Sandy Sacred Heart Hospital
Stranberg, Kevin Memorial Medical Center - Ashland
Sullivan, Anne Memorial Medical Center - Ashland
Swanson, Becky Sacred Heart Hospital
Swanson, Kerry SSM Health Care-Wisconsin
Tandberg, Christine Sacred Heart Hospital
Todd, Jeffrey Aspirus Wausau Hospital
Tryba, Jennifer Aspirus Wausau Hospital
Tuttle, Kathryn Memorial Medical Center - Ashland
VanDeVoort, John Sacred Heart Hospital
Verploegh, Alan Aspirus Wausau Hospital
Voelker, Thomas Aspirus Wausau Hospital
Vogler, Linda Sacred Heart Hospital
Voigt, Yolanda Aspirus Wausau Hospital
Walker, Troy St. Clare Hospital and Health Services
Wanserski, James Aspirus Wausau Hospital
White, Bridget St. Mary’s Hospital
Whiteaker, Les Memorial Medical Center - Ashland
Wilson, Deanna Upland Hills Health
Winckler, Carol Sacred Heart Hospital
Wojciechowski, Gary Aspirus Wausau Hospital
Worthing, Kelli Sacred Heart Hospital
Wrobel, Roberta Sacred Heart Hospital
Zeller, Brad Hayward Area Memorial Hospital and Nursing Home
Zemaitis, Tom Sacred Heart Hospital
Contributions ranging from $250 - $499
Abitz, John WHA Financial Solutions, Inc.
Abrams, K. Scott Beaver Dam Community Hospitals
Allison Stonebraker, Pat Children’s Hospital of Wisconsin
Andersen, Travis St. Elizabeth Hospital
Ayers, Mandy Wisconsin Hospital Association
Baker, Chris St. Mary’s Hospital
Biros, Marilyn SSM Health Care-Wisconsin
Calhoun, William Affinity Health System
Carlson, Dan Bay Area Medical Center
Clapp, Nicole Grant Regional Health Center
Clough, Sheila Howard Young Medical Center
Conwell, Lisa WHA Financial Solutions, Inc.
Curran, Joan Gundersen Lutheran Medical Center
Danner, Forrest Aspirus Wausau Hospital
Deich, Faye Sacred Heart Hospital
Dietrich, Dean Aspirus Wausau Hospital
Drengler, Kathryn Aspirus Wausau Hospital
Erickson, Robert Aspirus Wausau Hospital
Erickson, William Sacred Heart-St. Mary’s Hospitals
Furlong, Marian Hudson Hospital
Geiss, Peter ProHealth Care
Gruber, Richard Mercy Health System
Grundstrom, David Flambeau Hospital
Guffey, Kerra Meriter Hospital
Gutsch, Mike Southwest Health Center
Hattem, Marita Aspirus Wausau Hospital
Hessert, Peter Aspirus Wausau Hospital
Hilt, Monica Sacred Heart-St. Mary’s Hospitals
Hofer, John Bay Area Medical Center
Huettl, Patty Sacred Heart Hospital
Jensen, Russell St. Mary’s Hospital
Johnson, Charles St. Mary’s Hospital
Keene, Kaaron Memorial Health Center
Kehrberg, Mark Affinity Health System
Kostroski, Sharon Saint Joseph’s Hospital
Mantei, Mary Jo Bay Area Medical Center
Marciano, Karol Columbia St. Mary’s Milwaukee Hospital
May, Carol Sauk Prairie Memorial Hospital
McCoic, Kristie St. Joseph’s Community Health Services
McKevett, Timothy Beloit Memorial Hospital
Merline, Karen
Miller, Kimberly Beaver Dam Community Hospitals
Nelson, James Fort HealthCare
Nevers, Rick Aspirus Wausau Hospital
Nick, Mary Meriter Hospital
Oberholtzer, Curt Bay Area Medical Center
Olkowski, Leland Aspirus Wausau Hospital
Olson, Gregory Memorial Health Center
Penczykowski, James St. Mary’s Hospital
Pinekenstein, Barbara ProHealth Care-Oconomowoc Memorial
Pollard, Dennis Community Memorial Hospital
Roberts, Phillip Columbus Community Hospital
Ross, Forrest WHA Financial Solutions, Inc.
Rowe, Jeanne Aspirus Wausau Hospital
Rozenfeld, Jonathan St. Mary’s Hospital
Sanicola, Suzanne Columbia St. Mary’s Columbia Hospital
Schroeder, Larry Sauk Prairie Memorial Hospital
Schulz, Janet ProHealth Care
Sczygelski, Sidney Aspirus Wausau Hospital
Shapiro, David Columbia St. Mary’s Columbia Hospital
Spieckerman, Jill Sacred Heart-St. Mary’s Hospitals
Staffileno, Gerri Columbia St. Mary’s Ozaukee Hospital
Stout, Johni WHA Financial Solutions, Inc.
Stuart, Philip Tomah Memorial Hospital
Swiderski, Julie Wheaton Franciscan - Milwaukee
Taplin Statz, Linda SSM Health Care-Wisconsin
Tarantino, Jennifer Aurora Health Care
Van Meeteren, Bob Reedsburg Area Medical Center
VanCourt, Bernie Bay Area Medical Center
Voss, Mark Aspirus Wausau Hospital
Worrick, Gerald Door County Memorial Hospital
Yunk, Dennis Agnesian HealthCare
Contributions ranging from $500 - $999
Anderson, Sandy St. Clare Hospital and Health Services
Bayer, Tom St. Vincent Hospital
Borgerding, Dana
Braddock, Michelle WHA Financial Solutions, Inc.
Buerstatte, Gary ProHealth Care
Bukowski, Cathy Our Lady of Victory Hospital
Butler, John St. Mary’s Hospital
Callies, Julie WHA Information Center
Canter, Richard Wheaton Franciscan Healthcare
Desien, Nicholas Ministry Health Care
Dietsche, James Bellin Memorial Hospital
Eddy, Lee Anne Children’s Hospital of Wisconsin
Fish, David St. Joseph’s Hospital
Frank, Jennifer Wisconsin Hospital Association
Geboy, Scott Hall, Render, Killian, Heath & Lyman
Gutzeit, Michael Children’s Hospital of Wisconsin
Harding, Edward Columbus Community Hospital
Heifetz, Michael SSM Health Care-Wisconsin
Huber, Mark Aurora Health Care
Hymans, Daniel Memorial Medical Center - Ashland
Kersten, Juliet Children’s Hospital of Wisconsin
Kerwin, George Bellin Memorial Hospital
Klawiter, Anne Southwest Health Center
Klimisch, Ronald Aspirus Wausau Hospital
Korom, Nancy Children’s Hospital of Wisconsin
Levin, Jeremy Rural Wisconsin Health Cooperative
Merline, Paul Wisconsin Hospital Association
Miller, Jim Children’s Hospital and Health System
Mlynarek, Robert ProHealth Care-Waukesha Memorial
Neufelder, Daniel Affinity Health System
Petonic, Mary Frances Meriter Hospital
Postler-Slattery, Diane Aspirus Wausau Hospital
Potter, Brian Wisconsin Hospital Association
Radoszewski, Pat Children’s Hospital of Wisconsin
Richards, Theresa Saint Joseph’s Hospital
Ronstrom, Stephen Sacred Heart Hospital
Sachdeva, Ramesh Children’s Hospital of Wisconsin
Schafer, Michael Spooner Health System
Shabino, Charles Wisconsin Hospital Association
Ship, Mark Children’s Hospital of Wisconsin
Siebecker, William Aspirus Wausau Hospital
Stine, Stephen Aspirus Wausau Hospital
Wallace, Michael Fort HealthCare
Wolf, Edward Lakeview Medical Center
Woodward, Jim Meriter Hospital
Contributions ranging from $1,000 - $1,999
Bazan, Bill Wisconsin Hospital Association
Birkenstock, Timothy Children’s Hospital of Wisconsin
Bloch, Jodi Wisconsin Hospital Association
Boese, Jennifer Wisconsin Hospital Association
Braddock, Jonathan WHA Financial Solutions, Inc.
Brideau, Leo Columbia St. Mary’s Columbia Hospital
Britton, Gregory Beloit Memorial Hospital
Byrne, Frank St. Mary’s Hospital
Chapin, Rocklon St. Mary’s/Duluth Clinic Health System
Christensen, Cinthia Children’s Hospital of Wisconsin
Duncan, Larry Children’s Hospital of Wisconsin
Dunigan, Thomas Children’s Hospital of Wisconsin
Eichman, Cynthia Our Lady of Victory Hospital
Erwin, Duane Aspirus Wausau Hospital
Gazzana, Thomas Children’s Hospital of Wisconsin
Grasmick, Mary Kay Wisconsin Hospital Association
Kachelski, Joe WHA Information Center
Karuschak, Michael Amery Regional Medical Center
Kosanovich, John Watertown Memorial Hospital
Kryda, Michael Saint Joseph’s Hospital
Leitch, Laura Wisconsin Hospital Association
Loftus, Philip Aurora Health Care
Mettner, Michelle Children’s Hospital of Wisconsin
Morgan, Dwight Aurora Health Care
Munson, Kenneth Children’s Hospital of Wisconsin
Niemer, Margaret Children’s Hospital of Wisconsin
O’Brien, Mary Aurora St. Luke’s Medical Center
Oldham, Keith Children’s Hospital of Wisconsin
Olson, David Bay Area Medical Center
Olson, Edward ProHealth Care-Waukesha Memorial
Reynolds, Sheila Children’s Hospital of Wisconsin
Richardson, Dana Wisconsin Hospital Association
Robertstad, John ProHealth Care-Oconomowoc Memorial
Roller, Rachel Aurora Health Care
Sanders, Robert Children’s Hospital of Wisconsin
Stanford, Matthew Wisconsin Hospital Association
Titus, Rexford ProHealth Care
Troy, Peggy Children’s Hospital and Health System
Turkal, Nick Aurora Health Care
Warmuth, Judith Wisconsin Hospital Association
Welch, Kimberly Aurora Health Care
Westrick, Paul Columbia St. Mary’s Milwaukee Hospital
Contributions ranging from $2,000 - $2,999
Brenton, Mary E.
Buser, Kenneth Wheaton Franciscan Healthcare - All Saints
Fale, Robert Agnesian HealthCare
Katen-Bahensky, Donna
Oliverio, John Wheaton Franciscan Healthcare
Quinn, George Wisconsin Hospital Association
Starmann-Harrison, Mary SSM Health Care-Wisconsin
Tyre, Scott Capitol Navigators, Inc
Contributions $3,000 and up
Borgerding, Eric Wisconsin Hospital Association
Brenton, Stephen Wisconsin Hospital Association
Size, Tim Rural Wisconsin Health Cooperative
HHS Issues HIPAA Rule on Breach NotificationThe U.S. Department of Health and Human Services (HHS) has issued an interim final rule governing notification of breaches of unsecured protected health information by HIPAA-covered entities and business associates. The rule can be found at http://hhs.gov/ocr/privacy. The development and promulgation of this rule was required by the American Recovery and Reinvestment Act signed into law earlier this year.
The HHS rule requires hospitals and other HIPAA-covered entities to promptly notify affected individuals in instances of a data "breach," which is defined in the rule. Prompt notification to HHS and the media is required when a breach affects more than 500 individuals, while breaches involving fewer individuals must be annually reported to HHS. The rule also addresses breach notifications that business associates must make to affected covered entities.
Notably, HHS indicates that not all violations of HIPAA constitute a "breach." Rather, a violation of HIPAA is only a "breach" if the violation "poses a significant risk of financial, reputational, or other harm to the individual." Thus, to determine whether a breach has occurred, a covered entity will need to perform a risk assessment to determine if there is a significant risk of harm to the individual as a result of the impermissible use or disclosure, according to HHS. Within its supplementary information, HHS provides a number of factors and examples to consider when performing the risk assessment.
In addition, the rule provides three exclusions from the definition of breach: (i) certain circumstances involving unintentional access to or use of protected health information by a member of a covered entity’s or business associate’s workforce when acting in good faith and within his or her scope of authority, (ii)certain inadvertent disclosures from one person authorized to access personal health information to another person authorized to access protected health information if both individuals are at the same covered entity, business associate or organized health care arrangement, and (iii) certain disclosures where the covered entity or business associate has a good faith belief that an unauthorized person to whom a disclosure was made would not reasonably have been able to retain such information.
The rule also requires covered entities to comply with the administrative requirements of the HIPAA privacy rule with respect to breach notification requirements. These administrative requirements, for example, "require covered entities and business associates to develop and document policies and procedures, [and] train workforce members on and have sanctions for failure to comply with these policies and procedures."
The interim final rule will be published in the Federal Register in the coming days and will be effective 30 days following that publication day. However, to address concerns that it will "take covered entities and business associates time to implement the processes and procedures necessary to comply with [the rule]," HHS states in its supplementary information to the rule that it "will use [its] enforcement discretion to not impose sanctions for failure to provide the required notifications for breaches that are discovered before 180 days from the publication of this rule." HHS will be accepting comments on the rule during a 60-day comment period following publication.
Other HIT news
Unsecured Data Guidance - HHS updated its April 17 guidance specifying technologies and methodologies that would render protected health information unusable, unreadable, or indecipherable to unauthorized individuals – that is, the information is not considered "unsecured" for purposes of the breach notification rule. The new guidance discusses the April guidance’s relationship with the HIPAA security rule, access controls, redactions of information in paper records, and definitions of "data in motion," "data at rest," and "data in use." The new guidance is contained in supplementary information issued by HHS with the breach notification rule and can be found here: hhs.gov/ocr/privacy.
President’s Column: WHA Emphasizes Focus on Wisconsin as Part of Health Reform EffortWHA senior staff and members are urging the state’s Congressional Delegation to demand that national health reform efforts build upon what Wisconsin is already doing well. In a statewide radio campaign and at editorial board meetings in Milwaukee, Appleton, Eau Claire, Wausau, Green Bay, Racine and Madison, WHA members are emphasizing the fact that Wisconsin is a national leader in expanding coverage to vulnerable populations and improving quality and clinical performance.
Here’s an executive summary of our major talking points:
Steve Brenton
President
The Wisconsin Division of Quality Assurance (DQA) has provided hospitals with recent guidance concerning several important issues. Copies of the guidance are available on the WHA Web site at www.wha.org under the Legal and Regulatory tab.
St. Mary’s Hospital of Superior/Duluth Clinic-Superior (SMDC) was the site of an August 18 forum featuring U.S. Sen. Herb Kohl. More than 60 audience members from the Twin Ports and Douglas County had the opportunity to question the Senator and share their thoughts about health care reform.
"People like me can learn from people like you," Sen. Kohl said as he listened to constituent concerns. "We all want to do something about the cost of health care."
Spooner Health System CEO and WHA Board Chair Mike Schafer thanked Sen. Kohl for his visit and noted that "Wisconsin and Minnesota are leaders in quality health care."
Two Duluth Clinic physicians—Joe Bianco, MD, and Tom Russ, MD—had the chance to talk about issues that matter to them. Dr. Bianco, SMDC’s associate chief of regional and community clinics, and the Senator discussed the importance of promoting primary care and encouraging medical students to consider going into that discipline.
"Wherever I go, people yell at me and tell me why I’m wrong on health care…I’m not getting paid enough," Sen. Kohl said as listeners responded with laughter. "But I also get people like you who are quiet and respectful."
Grassroots Spotlight: Watertown Regional Medical Center Hosts Cong. Tom PetriPrior to a town hall meeting he held in Watertown, Cong. Tom Petri met with officials at UW Health Partners Watertown Regional Medical Center (WRMC) to seek input on proposed health reform and its implications for hospitals and local patients.
"Wisconsin hospitals deliver some of the lowest-cost, highest quality care in the nation," said WRMC President John Kosanovich. "Wisconsin currently ranks #1 in overall health care quality as measured by the federal Agency for Health Care Research and Quality, and has led the nation for several years. At the same time, Wisconsin has the second lowest percentage of people without health insurance. We urge lawmakers to use the Badger State as a model for health care reform."
During a tour of the medical center, Petri was also able to see firsthand how one local Wisconsin hospital is working to lower cost and improve quality. Hospital officials demonstrated the medical center’s electronic health record, which promotes seamless care by providing immediate availability of medical records from anywhere in the health system.
Petri echoed comments that health care consumers are looking for a balance between efficiency and high quality. "We should be moving more to empower consumers to drive health care cost controls by determining what they want to buy…,"he said.
Kosanovich voiced support for reforming the Medicare-type payment system. "Medicare rewards volume—not value," said Kosanovich. "While Wisconsin providers deliver some of the highest quality and lowest cost health care in the nation, Wisconsin is reimbursed on average $6,978 per enrollee, while high cost states like Florida receive nearly $9,500."
Hospital officials also indicated it will be important for health reform to address access to care, which will be a challenge given the shortage of physicians in the state. Cong. Petri thanked WRMC officials for their work, and acknowledged that health reform is an important topic for residents.
"Many are concerned about reform, the economy and how this will turn out in the end," he said. "All of these factors together are making people uncomfortable, and that is why you are seeing opposition and charged town hall meetings."
During a tour of the Emergency Room, Cong. Petri consulted with a neurologist at UW Health through the first-in-the-state Telestroke system, which uses telemedicine technology to connect critical patients at WRMC with stroke specialists at UW Health in Madison.
WRMC officials emphasized that prevention is an important aspect of health reform, sharing results of the company’s wellness program, which has helped the company to lower health care costs. While most employers are seeing double digit annual premium increases, the medical center was able to decrease premiums last year.
WHA Cautions "Sheer Volume" of Licensees Could Slow Down DRLWHA testified for the second time in the State Capitol on a bill that would require individuals that practice radiography to be licensed. Such a move would involve licensing more than 7,000 radiographers that are currently certified in Wisconsin, with a potential of licensing more than 10,000 individuals. This would make radiographers the third largest licensed group in the Department of Regulation and Licensing (DRL), just behind registered nurses and physicians in number.
At the Senate hearing on the bill, SB 184, WHA Vice President of Workforce Judy Warmuth provided testimony that centered on concern that the sheer volume of individuals requiring licensure, when added to the work surrounding creation of a new board and rules, would negatively impact the length of time now required to license other professionals and could affect the Department’s ability to conduct and complete complaint investigations.
In cooperation with WHA, the DRL has been working to improve the timeliness of all licensing processes. Progress has been made and WHA is pleased with changes the Department and its Boards have implemented to streamline requirements, alter staffing patterns, and review policies and procedures that lead to better service to professionals, health care facilities and ultimately, improve access and care to Wisconsin residents.
WHA cautioned that adding to the Department’s workload at this time may undo the progress that has been made to date. During each of the last three sessions, the Legislature has created new licensed groups and occupations. Statutes regulating the new groups have not always included or allocated the resources necessary to support them. The time and effort required to implement these statutory changes has competed with efforts to increase the speed of investigation and licensing of professionals now holding or seeking licenses. This session, legislation to license radiographers and dietitians has been introduced, as have changes to physical therapist and podiatrist licensure.
WHA’s Warmuth concluded her testimony by restating WHA’s belief in the importance of protecting the public, but also restated that timely investigation of complaints and timely licensure for new graduates also offers important protection. WHA asked that the latter not be sacrificed for the former. WHA requested that the Legislature not take actions that would undo the efforts and progress that has been made to date.
"We asked that licensure of new groups and occupations be done thoughtfully, state resources be used wisely, Department work processes be considered and the ability of the Department to serve existing customers and consumers be maintained," Warmuth said in her testimony.
Licensure bills for radiographers have now had hearings in both the Senate and Assembly. Committee action on both bills is expected in the next few weeks. If you have comments or thoughts on these bills, contact Judy Warmuth at jwarmuth@wha.org or 608-274-1820.
Member News: Wisconsin Hospital Brings Home the Silver for Heart, Stroke CareThe American Heart Association and American Stroke Association recently recognized hospitals for their success in using the Get With The Guidelines to improve their heart disease and stroke care. In the August 7 edition of The Valued Voice, we acknowledged the Wisconsin hospitals that made the list. Much to our disappointment, the American Heart Association failed to include Columbia St. Mary’s on their list of hospitals that reached the Silver Performance level. The Silver Performance Achievement award requires 85 percent achievement for 12 consecutive months. - Editor, The Valued Voice
DRL Secretary Shares Impaired Professionals Program Proposals at WHA Workforce Council MeetingConcerns about the current Impaired Professionals Programs (IPP) were the focus of a discussion between Secretary of the Department of Regulation and Licensing (DRL) Celia Jackson and members of the WHA Workforce Council at their August 14 meeting in Madison. Secretary Jackson and DRL staff member Sharon Henes discussed the Department’s role with licensed professionals impaired by drug or alcohol use.
A Task Force formed by Secretary Jackson was asked to review the current program, examine the way other states address the problem and make recommendations for improvements to Wisconsin’s program. The Secretary provided background, and then discussed the Task Force’s recommendations, seeking input and feedback from members of the Council. Clarifying the difference between voluntary participation in a program and disciplinary action by a licensing board was raised as an issue, as was ensuring that individuals are identified, held accountable for actions and offered treatment. The Secretary is in the process of seeking input from many groups, but plans to offer a program proposal as early as this fall.
New legislation in Illinois requires the use of acuity systems and public reporting of nurse staffing. WHA invited Pat Merryweather of the Illinois Hospital Association to present at the Council meeting on the collection of the information and the October public release of the data. The information will be available to the public from both the State of Illinois and the Illinois Hospital Association on two separate Web sites. The public will be able to view, by hospital and unit, planned staffing. Merryweather said the data indicates there is wide variation in staffing levels in Illinois hospitals. The public (and even other hospitals) response to these reports and to the variation is yet unknown. Illinois is now one of at least six states with a mandate to report nurse staffing while a small number of others do so on a voluntary basis.
The Council also discussed a number of legislative proposals currently in process and offered input and advice to WHA on these proposals, which included: monitoring physician dispensing, licensing of radiographers, prescriptive authority for psychologists, and licensing changes for dietitians, physical therapists and podiatrists.
The meeting concluded with a discussion of hospital preparation/guidance for severe staffing shortages related to epidemic infections. Council members whose hospitals have already addressed human resource issues that may emerge in case of a serious flu outbreak this year shared issues and policy strategies they are discussing and/or plan to put in place.
Register Today for 2009 WHA Annual ConventionThe 2009 WHA Annual 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. Make sure to register your team today, and make your hotel reservations at the Grand Geneva Resort by September 2 to take advantage of special WHA group pricing.
In these uncertain times, this year’s convention agenda will focus on some of the most important and timely topics, including:
For ACHE members, attendance at this year’s annual convention will include 4.5 Category I (ACHE education) credit hours, thanks to a partnership with the Wisconsin Chapter of ACHE. In addition, the annual convention agenda has been submitted or approved for a variety of other applicable continuing education credits.
The full conference brochure and online registration are now available at www.wha.org. For registration information/questions, contact Lisa Littel at 608-274-1820 or email
llittel@wha.org.Top of page
Wisconsin Chapter of ACHE and WHA Partner to Offer Category I Session
Even during this time of tightened belts and limited education and travel for many health care organizations, ACHE members have a need to continue obtaining credit for advancement and credentialing. To help, the Wisconsin Chapter of ACHE and WHA have teamed up to offer a 3 credit Category I seminar, to take place as part of the WHA Annual Convention this September.
The session, titled "Emerging Trends in Health Care: New Leadership for Real Challenges," will be presented by John Sena, one of ACHE’s most popular faculty. This session will occur during the WHA Annual Convention, on Thursday afternoon, September 24, from 1- 4:15 p.m. There are a variety of registration options to meet your budget, your schedule and your need for both Category I and II credit.
In addition to the Thursday afternoon seminar, on Friday, September 25 the Wisconsin Chapter of ACHE also invites you to attend the annual chapter breakfast and meeting highlighted by keynote speaker Dr. Thomas Dolan, ACHE’s president and CEO. Finally, a 1.5 credit Category I panel discussion, titled "Care for the Uninsured," will also occur on September 25, at the conclusion of the WHA Annual Convention. These Friday activities are all available at no cost to chapter members.
More information is available at www.ache-wi.org. Online registration for these activities is available on the WHA Web site at www.wha.org. For registration information or questions, contact Lisa Littel at 608-274-1820 or email
llittel@wha.org.Top of page
Community Benefits: Aurora St. Luke’s Medical Center, Milwaukee
Dia de la Mujer Latina
Under the direction of Dr. Judy Tjoe, Medical Director of Aurora’s Comprehensive Breast Care Centers, a team of Aurora physicians completed a record 98 free clinical breast exams at the 2nd Annual Dia de la Mujer Latina event on Saturday, Oct. 4, 2008 at Aurora Walker’s Point Community Clinic. As Dr. Tjoe explains:
For underserved minorities who have limited resources for preventive health care, basic clinical breast exams and annual screening mammography are low on their priority lists. Misleading cultural beliefs and language barriers compound the problem.
Yet, with the help of Aurora medical residents and nurses, we provided education, clinical breast exams and access to grant-funded programs offering affordable screening mammography and referrals for care, thus achieving three goals:In translation, Dia de la Mujer Latina means "Day of the Latin Woman." To celebrate and support Latinas who are at the center of their families’ health and well being, multiple community partners came together to provide a variety of health screenings, health education, food, fun and entertainment for the whole family.
Months of work and planning on the part of a coalition of local providers make Dia de la Mujer Latina possible. In addition to Dr. Tjoe and her team and Aurora Walker’s Point Community Clinic, those partners were the American Cancer Society, Wisconsin Well Woman Program Southeast Wisconsin, Wheaton’s Su Salud Breast Health Program, and CORE/El Centro, an Aurora-supported health and wellness center. Also participating in the planning and providing follow-up services were Planned Parenthood, Milwaukee Health Services, Sixteenth Street Community Clinic.
Community Benefits: Memorial Hospital of Lafayette County, DarlingtonThe "Wellness is the Weigh to Go" coalition of Lafayette County is making efforts to outreach men on health and wellness opportunities. This coalition consists of key personnel from Memorial Hospital of Lafayette County, Lafayette County Health Department, UW Extension and Medical Associates Clinics. The hospital works closely with the coalition to offer educational opportunities on heart and prostate health, as well as stroke prevention. In addition, health care professionals from the hospital and health department put their expertise to work in the community by offering health-related screenings and information in settings where men might not expect it.
The coalition distributed information on men’s health to the local Fire Departments, Lions Clubs and Sportsman’s clubs. In addition to the literature, the coalition gave the organizations an opportunity to offer the health screenings at their monthly meetings. The Darlington Lions club took the coalition up and reached a dozen or so members during a meeting with free blood pressure and blood sugar screenings, education on the early warning signs and symptoms of stroke, and an informal question and answer session with Dr. Matt Solverson, a local physician.
As the success of the health coalition continues to spread, more men in our community will make their own health and wellness a true priority.
Community Benefits: Monroe Clinic, MonroeThe greatest incidence of trauma injury and death occurs between the ages of 15 to 24. One way to help change this trend is to educate youth on how decisions they make affect everyone around them. For this reason, Monroe Clinic sponsored and organized the P.A.R.T.Y. program—Preventing Alcohol and Risk-Related Trauma in Youth—on April 22, 2009 at the Monroe High School auditorium. Students were shown the dangers of alcohol consumption and the consequences of poor decision-making—while being empowered to make informed, safe choices.
There were two separate presentations for students, each 40 minutes in length including a student skit, presentations by trauma and emergency department surgeons, Green County emergency medical services, police officers, firefighters, and a coroner. An excerpt from the Green County judge and the personal stories of individuals directly affected by their own poor choices, or the poor choices of others when it comes to alcohol and driving while under the influence were also shared. Mental health professionals from Monroe Clinic were on hand for students and attendees to speak with. The P.A.R.T.Y. presentation was intentionally scheduled roughly one week before Monroe High School’s prom in hopes of eliminating alcohol-related trauma among students.
To reinforce this message, a separate program for members of the community was held later that evening. The evening program included video highlights from the afternoon sessions and a panel of speakers to field questions from the audience.
This program is an effort to open the students’ eyes to the sweeping impact one bad decision can make. It shows students the whole process, which sometimes starts at a party and ends with a trip through the emergency room, rehabilitation center, coroner’s office or the judicial system. Our hope is that students will recognize the dangers of alcohol and avoid making decisions that could adversely affect them and everyone else around them.
The P.A.R.T.Y. program was developed in 1986, in Canada, to educate teens of the perils of risk-taking behavior and the tragic consequences that can occur because of drinking and driving, noncompliance to seat belt legislation, and other dangerous behaviors.
Submit hospital community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.