With an Executive Order aimed at federal agencies that provide coverage to nearly one in every four Americans with health insurance, President Bush this week took a major step forward in providing consumers with easy-to-use information about the quality and price of their health care. The information will enable consumers to make informed choices among doctors and hospitals, and it will help support doctors and hospitals that deliver high-quality care and avoid unnecessary health care costs, creating opportunities to improve care and lower its costs.

The Executive Order directs agencies that administer or support health insurance programs to take steps that will result in more complete and open information for consumers. The President said he hopes the federal action will be followed by similar commitments in the private sector, and in state and local government. He directed Health and Human Services Secretary Mike Leavitt to work collaboratively with the health care sector to ensure that information provided to consumers is reliable and accurate.

The steps required by the Order include sharing information about the quality of care delivered by doctors and hospitals, as well as the prices paid to these providers. The Order also requires agencies and their health care contractors to promote the use of interoperable health information technology products, so that data can be easily shared. In addition, it requires agencies to offer insurance options that reward consumers who exercise choice among health providers based on value and quality of care.

President Bush said the Executive Order is a first step in a larger plan to provide open health quality and price information for all American consumers. He invited other employers to make similar commitments on behalf of their employees, including major private employers, and state and local governments. And he pledged that the Administration will work with health care providers as well as labor unions, the insurance industry and others to support a reliable and comprehensive system of health quality and price information.

"People deserve to know what their health care costs, how good it is, and the choices available to them," HHS Secretary Mike Leavitt said. "The President’s action today is a major step forward in giving consumers easy-to-use information about the quality and price of their health care. This is fundamental to achieving a health care system that delivers good value."

Secretary Leavitt said the effort will begin with information available now and will grow in volume and sophistication over time. The goal of the President’s initiative is to strengthen and build on these efforts and ultimately present consumers with information in a single, easy-to-use spreadsheet format. Ultimately, under the President’s plan, local information on the quality and cost of care for most Americans will be available from the collaboration of health care providers, public and private payers, and other stakeholders in different regions of the country. The collaboration by providers and payers will create an unprecedented broad and reliable foundation of information on the quality and price of services delivered by each health care provider.

WHA President Steve Brenton applauded the Administration’s Executive Order noting, "Wisconsin’s current private sector initiatives align well with the President’s public policy objectives. Initiatives like WHA’s CheckPoint and PricePoint Web sites and the WCHQ performance measurement reports are viewed nationally as private sector programs that others should emulate."

The MHA Group, a division of the AMN HealthCare Services, Inc., has put together a group of national health care leaders to address the growing problem of nurse and physician shortages. 

"Nationally, we still do not have a consensus on whether there is a physician shortage. Some critics question it, but the reality is we have parts of the country that are experiencing very real shortages of physicians. You can argue whether it is a shortage or maldistribution, but for the patient who is waiting 24 hours in an emergency department to receive care in our cities, it is very real," said Kurt Mosley, vice president of business development at the MHA Group. Mosley recently experienced a long wait to receive orthopedic care after breaking an ankle.

"It doesn’t matter it you have insurance or not, there are areas of the country where there are longs waits to see primary care physicians and specialists," Mosley added.

The new council, which includes MHA and AMN Healthcare executives, is seeking to bring awareness and perspective to the physician supply situation.

According to Richard "Buz" Cooper, MD and Linda Aiken, PhD, RN, co-chairs of the newly created Council on Physician and Nurse Supply, the U.S. may lack as many as 200,000 physicians and 800,000 nurses by the year 2020.  "By training more doctors and nurses now," they said, "it may be possible to avert long waiting times for routine health care and remedy the understaffing of hospitals."

Research funding for the Council is being provided by AMN Healthcare®, the nation’s largest health care staffing organization, and the parent of The MHA Group of companies.  The MHA Group, which includes Merritt, Hawkins & Associates, Staff Care, Inc., and Med Travelers, is a "Corporate Champion" of the Wisconsin Hospital Association.

The Council is based in the University of Pennsylvania’s Consortium for Health Workforce Research and Policy, a joint program of the Schools of Nursing and Medicine and the Leonard Davis Institute of Health Economics. 

"We’re seeing the most pressing access problems hitting the rural areas and inner cities. The bad news is that it is going to get worse before it gets better," Mosley said.

The Council will monitor data and act as an advocate for change, advising legislators and others on ways that the supply of nurses and physicians can be altered to meet the public’s needs.  Its goals are to bring objectivity to the study of physician and nurse supply and to shape public policy.  It is the only multidisciplinary organization in the nation dedicated exclusively to addressing issues of nurse and physician supply. 

Those interested in joining or supporting the Council may contact Kurt Mosley at 469-524-1446, or Stephanie Godwin, manager of business development for the MHA Group, at 469-524-1635.

For 25 years, WHA Financial Solutions, Inc. has been dedicated to delivering innovative products and services to members of the Wisconsin Hospital Association (WHA). While the organization has gone through significant changes over the years, one thing has not changed—their mission to provide value to WHA members by being the resource to ensure that hospital insurance and benefit needs are met.

During the last 25 years, WHA Financial Solutions has grown from an organization staffed by a single person, to a staff with an average of 18 years of experience in consulting and planning who are all current with industry regulations and changes, treasury department rulings, and market trends.

So, too, has WHA Financial Solutions’ service to hospitals grown since its modest beginnings, and today WHA Financial Solutions serves 86 clients. To better serve hospitals, WHA Financial Solutions has cultivated relationships with insurance carriers so they can be actively involved in designing programs that deliver outstanding plan benefits at the best rates. These relationships have allowed Financial Solutions to become better problem solvers – should that need arise.

In addition to carrier relationships developed over 25 years, WHA Financial Solutions has recently formed strategic partners with Kunkel, Bounds & Associates and MHA Insurance because of their expertise in group health and professional liability and their commitment to Wisconsin health care organizations. WHA Financial Solutions has also expanded the products and services available to its clients through its membership in NFP Benefits, a national partnership of 155 benefit firms, which offers powerful technology systems, broad information resources and an expansive network of intellectual capital and negotiating power.

Perhaps most significant over the last 25 years has been WHA Financial Solutions’ continued support of WHA and its efforts that help hospitals accomplish their missions of providing high quality, accessible, affordable health care in their communities. WHA Financial Solutions looks forward to another 25 years of providing support and services to Wisconsin Hospitals to help them further those missions.

Over the course of the last week, individual contributors have donated over $10,000 to the political action fundraising campaign. 481 individuals affiliated with 66 hospitals have raised to date nearly $143,000, accounting for over 77 percent of the 2006 fundraising campaign’s $185,000 monetary goal.

"The campaign is still short more than $40,000 towards the goal, but there are many individuals who have yet to participate who contributed in previous years," explained WHA’s Vice President of Government Affairs Jodi Bloch. Only ten more individuals have contributed so far this year over 2005 totals for the same time period.

Persons contributing this year have been and will continue to be published in The Valued Voice on a monthly basis. Contributors are listed by amount categories and in the order the contribution was received. The next publication of contributors in The Valued Voice will be in the September 15th edition.

For more information, contact Jenny Boese or Jodi Bloch at 608-274-1820.

A letter dated August 18, 2006, from the Antitrust Division of the U.S. Department of Justice to the South Carolina Department of Health and Environmental Control (DHEC) requested that it have an opportunity to address the policy implications of DHEC using South Carolina’s certificate of need law to prohibit new competitive entry into hospital markets.

According to the Antitrust Division’s letter, the DHEC’s action "raises significant policy issues for hospital competition in South Carolina." The letter further states, "The Antitrust Division and the Federal Trade Commission (FTC) have studied the benefits that competition among health care providers brings to patients and payers, and we recently published a report on this subject after a series of hearings: Improving Health Care: A Dose of Competition (July 2004)….In that report, ch.8, sec. I, we described harmful effects that CON laws can have on competition in health care markets."

The FTC and DOJ report referred to states, "The Agencies believe that CON programs can pose serious competitive concerns that generally outweigh CON programs’ purported economic benefits. Where CON programs are intended to control health care costs, there is considerable evidence that they can actually drive up prices by fostering anticompetitive barriers to entry."

Both the Department of Justice letter and the portion of the report referred to in the letter can be found at www.wha.org/legalAndRegulatory/DOJCONletter8-25-06.pdf.

In a related story, reports published this month have indicated that Stuart Levine, former vice chairman of the Illinois Health Facilities Planning Board which reviews CON requests for hospitals in Illinois, is cooperating with a federal investigation into corruption in the Illinois state government. Levine and others were indicted last year, charged in a multimillion-dollar scheme in which kickbacks were demanded for hospital CON approvals.

WHA member survey results from earlier this spring found members indicating a high level of satisfaction in the overall value they are receiving from their WHA membership. In fact, 96 percent of respondents rated WHA membership either an excellent or good value. That ranking is a "Top 3" score among recently surveyed state hospital associations across the nation.

WHA’s overall performance was ranked as either excellent or good by 98 percent of members. In fact, 59 percent of survey respondents ranked WHA performance as excellent. That score was 28 percent in 2003, thus representing a significant improvement over the past three years.

Importantly, 97 percent of responding members believe that WHA is effectively representing the diverse interests of its member hospitals and health systems. That’s an extremely high overall score and the fact that two-thirds of survey respondents said that WHA represents their interests "very effectively" is gratifying. As a trade association with a diverse membership, balancing member priorities, effectively communicating those priorities and advancing an advocacy agenda that maximizes member support is crucial for success. Member survey results indicate that member satisfaction with current WHA performance has established a strong foundation for that future success.

WHA staff and WHA board members are certainly pleased with the 2006 member survey findings. Those results create a benchmark for the future that will motivate us to maintain the high level of member satisfaction that has helped shape WHA’s recent performance.

Steve Brenton
President

The annual WHA membership meeting will be held on September 28, 2006, at the Grand Geneva Resort in Lake Geneva at 8:15 a.m. immediately preceding the WHA Annual Convention. Each WHA member with voting rights should ensure that a person eligible to vote on behalf of the member attends this important meeting.

At the meeting, in addition to electing WHA officers, WHA members will be asked to approve an amendment to the WHA bylaws creating an Audit and Investment Committee. The WHA Board requested the creation of this committee that will assist the Board in discharging the Board’s fiduciary responsibilities. The WHA Board is requesting that the membership approve the amendment.

The majority of physicians coming out of training have been contacted 50 times or more about job opportunities by potential employers, and some have received over 100 job solicitations, according to a new survey conducted by Merritt, Hawkins & Associates (MHA), a national physician search firm based in Irving, Texas. (MHA is a WHA "Corporate Champion.")

The survey asked 285 physicians about to complete their training how many times they had been contacted by potential employers seeking to recruit them during the course of their residencies. Fifty-two percent said that they had received 50 or more job solicitations during the course of their training, while 79 percent said they had received 26 or more job solicitations. Sixteen percent said they had received over 100 job solicitations, while only four percent said they had received 10 or fewer job solicitations.

According to MHA, a national physician shortage is responsible for the large number of job solicitations directed at new doctors. The number of new physicians being trained in the United States has remained flat for over 20 years while the general population has become both larger and, on average, older, driving the need for doctors upward. As a result, newly trained physicians in almost all specialties are in high demand.

The survey conveys some bad news for rural areas, which traditionally have had a hard time attracting newly trained physicians. Virtually none of the new doctors surveyed would prefer to practice in communities of 25,000 or fewer. Over 80 percent of those surveyed would prefer to practice in communities of 100,000 or more. Only 8 percent of new doctors expressed a preference to work independently in solo practice settings. The great majority would prefer to be employed by medical groups or hospitals.

"These survey results confirm that our job of attracting new medical graduates to rural areas is becoming more difficult," said George Quinn, WHA senior vice president, "making the role of the Wisconsin Council on Medical Education and Workforce increasingly important."

A summary of Merritt, Hawkins & Associates’ 2006 Survey of Final Year Medical Residents can be accessed at www.merritthawkins.com or by calling (800) 876-0500.

Make your plans now to attend WHA’s 2006 Annual Convention on September 27-29 at the Grand Geneva Resort in Lake Geneva.

This year’s convention kicks off with Joe Flower offering an amazing examination of some of the newest technologies affecting health care, from genomics, bioinformatics and nanotechnology to the latest in robotics and imaging, and will discuss what they mean for the future of health care.

A variety of important and timely breakout session will be offered, including sessions focused on the next wave of physicians and pharmacists, union activity awareness, the pay-for-performance movement, and innovation in pricing transparency. Additionally, the results of Wisconsin’s first voluntary community benefits reporting initiative will be distributed and discussed.

Be sure to stay for Friday’s closing session by Dr. Lowell Catlett, a fascinating speaker who is sure to be the highlight of this year’s event. Catlett, a professor of economics, agriculture and genetic engineering for New Mexico State University, will discuss how affluence is segmenting the health care market, how the three major drivers in health care can affect strategic planning, and how innovative research can provide opportunities for the overall improvement of our health.

As a reminder, the cut-off for Grand Geneva Resort room reservations at the WHA group pricing is September 6. All convention and golf outing registrations are due to WHA by September 8.

Wisconsin Physical Therapy Association representatives Michele Thorman and Mike Edwards told the WHA Workforce Council this week that a new physical therapy program will be opening soon at the University of Wisconsin-Milwaukee. The program is currently accepting applicants for 2007. Thorman and Edwards said there is much interest in the career and the schools are receiving many more applicants than current programs can accommodate. Council members expressed concern about the Doctorate in Physical Therapy as the entry degree. All but one of the programs in Wisconsin have converted to this degree, which takes an additional two and one half to three years beyond a baccalaureate degree. The lengthier program creates much more debt load for the graduates.

Rep. Suzanne Jeskewitz (R-Menomonee Falls), chair of Speaker Gard’s Task Force on the Technical College System and member of the Assembly Committee on Colleges and Universities, joined the Council to talk about education and preparation of the health care workforce. She shared her particular passion about transfer of core courses within the UW system. Rep. Jeskewitz asked Council members to identify current educational issues for hospitals. The Council raised the following concerns: credit transfer, admission standards, faculty qualifications, and the cost of specialized RN and LPN programs from the Technical System. Rep. Jeskewitz invited members of the Council to contact her in the future with education related concerns and issues.

WHA Vice President of Workforce Development Judy Warmuth provided a state and national workforce update and assisted the group in prioritizing issues that would be addressed by the group in the coming year.

The WHA Foundation, Inc. Board of Directors has agreed to continue the health care career scholarship program at technical colleges throughout Wisconsin for the 2006-2007 school year.

"The technical colleges in Wisconsin are a major source of well-trained health care workers for our hospitals. The Foundation Board believes our scholarship program will continue to attract quality people to health care careers," said Joe Neidenbach, chair of the WHA Foundation.

The scholarship program offers two scholarships to each of the state’s 16 technical colleges. The unique twist to the WHA Foundation scholarship program is that, unlike most scholarships, it covers actual tuition and book expenses, up to $2,000, for the final semester of a two-year, health care-related degree program. The intention is to assist and encourage students to make that one final push toward graduation and a career in health care.

Since the inception of the WHA Foundation scholarship program in 2003, scholarships have been granted to 82 students from all 16 technical colleges, worth approximately $92,000. For students who received the scholarships, they were able to complete their education and join the health care workforce, many at WHA member hospitals.

Of the 82 scholarship recipients, 58 were pursuing associate degrees in nursing. Others were pursuing degrees in radiography, clinical laboratory, health information technology, respiratory care, occupational therapy, sonography and physical therapy.

On October 24, WHA will offer a two-part coding and billing seminar focused on the ICD-9 changes and the ICD-10 preparation. The morning program, "ICD-9-CM and DRG Update," will cover the extensive coding and DRG changes that will be implemented on October 1, 2006, and share examples of how these changes will impact your reimbursement.

The afternoon program "ICD-10-CM and ICD-10-PCS: How Do We Prepare?" provides a broad overview of the complex changes to both the diagnosis and procedure coding systems currently projected for implementation in 2010. The main focus of this session, however, will be to assist attendees in developing an implementation plan and setting the foundation needed for this change in their businesses. Now is the time to develop plans that will ensure a smooth transition to the new ICD-10 coding systems.

The session "ICD-9-CM and DRG Update" is scheduled from 9 a.m. to 12 p.m. on October 24 at the Clarion Suites, Madison. This seminar is designed for those with at least a basic knowledge of ICD-9-CM coding. The educational seminar "ICD-10-CM and ICD-10-PCS: How Do We Prepare?" is scheduled for October 24 from 1 p.m. to 4 p.m., also at the Clarion Suites, Madison. Coding staff, financial management, HIM coders, HIM managers, information systems personnel, medical staff, and senior managers are encouraged to attend one or both sessions.

St. Joseph’s Hospital, Chippewa Falls, has been involved in the treatment of alcohol and drug abuse since the 1940’s. In the 1970’s, the hospital built a freestanding facility dedicated to helping people once again discover freedom from chemical dependency. Through the years that treatment has involved inpatient and outpatient programs, programs for adults and adolescents, and programs for families. As times change, so do the addictions that have presented themselves to the L.E.Phillips-Libertas Treatment Center. In recent years, with alarming frequency, methamphetamine is the drug of choice. Meth has devastating effects on entire families, especially children of parents who are using and manufacturing the drug. Local law enforcement agencies can relate countless instances when meth is at the heart of astounding criminal activity. As communities in rural western and northern Wisconsin were being faced with a crisis, the L.E.Phillips-Libertas Treatment Center was creating a network of concerned community agencies to face, head-on, the battle against meth. One way this was accomplished was to sponsor a free community event that shared the latest information about the damages of meth, the proliferation of it in our area and what treatment sources were available to assist victims of this horrific drug. The most dramatic aspect of the community event were the stories shared with audiences by actual past users of meth. To say the least, their stories were startling and very compelling.

The meth community awareness event has been held two years. This past May, the second event was held at one of the high schools in Chippewa Falls and attracted 800 people from throughout the region. Families, professionals and a cross section of Chippewa Falls and surrounding communities attended free of charge. One community 30 miles from Chippewa Falls sent a bus filled with parents and youths to hear the message that meth destroys lives. Community agencies had displays set up and even a light meal was available to attendees, all free of charge. Media coverage was extensive, so for people who were not able to attend, the message was shared with them via print and electronic media over the following several days. The event is greatly embraced by our community and the value to our residents cannot be measured. Much support is shown within the community through donations of food, speaker time and space to accommodate such a huge audience. The third event is already being planned for next year.

The Flambeau Hospital and Marshfield Clinic "Living the Mission" program made over 100 "May Baskets" for mostly homebound area residents after hospital and clinic employees responded overwhelmingly to a call from the local aging unit about needed items for the elderly. The group filled baskets with numerous items, including playing cards, band-aids, notepads and toiletries. The "May Baskets" are a tradition in some cultures, celebrating the return of spring. This is the second year the group has led this program. Many of the people receiving the baskets were overwhelmed by the thoughtfulness and generosity of the employees. The "Living the Mission" group, made up of all hospital and clinic employees, follows the vision statement of the hospital and clinic: "To create healthier communities while improving the health and well being in the rural settings served."

Submit hospital community benefit stories to Mary Kay Grasmick, editor, mgrasmick@wha.org or call 608-274-1820.

There have recently been a number of questions from WHA members about Limited English Proficiency Patients and the use of interpreters for these patients and their families. The Wisconsin AHEC coordinates a statewide group, The Wisconsin Coalition for Linguistic Access to Healthcare (WCLAH), which is a good resource on this issue. The group has a Web site at www.wclah.org that offers information on standards for interpreters and lists educational offerings. The group also maintains a listserv where members can communicate on issues and share job postings. To join the listserv, contact Kirstin Siemering [siemering@wisc.edu] at AHEC. The group meets monthly, and the next meeting is Thursday, September 7, at the Health Sciences Learning Center on the UW Madison campus.

The Wisconsin Hospital Public Relations and Marketing Society (WHPRMS) will hold their fall conference October 4 - 6 at the Heidel House in Green Lake. Topics set to be covered at the conference include: small-town and niche media relations, selling your brand, effective media relations, strategic planning and thinking, and lessons learned from crisis communications. A registration form and brochure are in this week's packet, or go to www.whprms.org and click on the Services tab, then on Conferences/Workshops.

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