September 15, 2006
Volume 50, Issue 35

Public Policy Council Meets: Medicaid Director Kevin Hayden Featured Speaker


The WHA Public Policy Council was convened by Chairman David Olson this week and heard important updates regarding Medicaid, health care reform, the PAC and conduit and the HEAT program. Featured speaker for the September 12 meeting was new Division of Health Care Financing Director Kevin Hayden.

Hayden was eager to speak to the Council and begin forging relationships with WHA during his first months as Director. He began by providing insight into his role and that of his staff, numbering roughly 700, in overseeing the state’s largest payer program, Medicaid. Hayden praised the work of his staff, saying that he was greatly impressed by how deep their expertise is on issues. He also mentioned that one of his roles as director is to manage relationships—state-federal relationships and state-county relationships.

Hayden provided insight into the depth and impact of the Medicaid program on Wisconsin. Based on his many years of private sector experience, he has definite ideas about how the Medicaid program can be made more efficient and cost-effective. Hayden is well aware of the chronic problems caused by poor provider payments and is eager to try and address that issue as well.

Though Hayden has been in the health care field for years, serving as president and CAO of Dean Health Systems for the past ten years, he indicated he still had a big learning curve in order to get up to speed on the minutiae and details of administering the Medicaid program. He looks forward to working closely with WHA and its members to constructively address many of the challenges facing the massive program.

The Council then heard from Senior Vice President Eric Borgerding, and Joe Kachelski, vice president, WHA Information Center, regarding several health care reform proposals currently percolating. They reviewed the "Miller-Benedict" proposal, the "Decker-Musser" proposal and provided an extensive analysis of Wisconsin Health Plan, which was developed by David Reimer and offered in the Legislature by Reps. Curt Gielow and John Richards.

Jodi Bloch, vice president of government relations, provided the Council with an update on the 2006 Wisconsin Hospitals PAC/Conduit campaign, highlighting that individuals affiliated with hospitals across the state have contributed over $160,000 to date. That is roughly 86 percent of the campaign’s $185,000 goal. Bloch also provided insight into the November elections, focusing on the several competitive open seats in the Assembly.

Jenny Boese, vice president of external relations & member advocacy, provided the Council with a summary of HEAT grassroots activities in 2006 and a look forward to 2007. She indicated that in 2006, hospitals and HEAT members had at least 1,200 legislative contacts with legislators and over 345 face-to-face meetings on major issues of importance, such as restoring a medical liability cap, defeating the Taxpayer Protection Amendment and supporting a dental access rule. She highlighted that several 2006 HEAT program goals have already been achieved as well as plans for 2007.

For more detailed information on any of the matters discussed, contact Eric Borgerding at 608-274-1820.

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Political Action Spotlight: 95 New Individual Contributors In the Last Month Help Push the Campaign over $160,000

With 560 individuals affiliated with 70 hospitals, and almost 100 new contributors in the last month, the campaign has raised to date over $160,000. This accounts for over 86 percent of the 2006 fundraising campaign’s $185,000 monetary goal.

"During the last month, not only did the number of new contributors increase by a large number, but all contributions totaled almost an additional $30,000," explained WHA Vice President, Government Affairs Jodi Bloch. "Another month like this and we will meet the fundraising campaign’s goal of raising more than $185,000 in 2006."

Persons who have contributed this year are listed at the end of this Valued Voice by name and their affiliated organization. If you are a contributor, check to see if your name is listed. Contributors are listed by amount categories and in the order the contribution was received. The next publication of contributors in Valued Voice will be in the October 20 edition.

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

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WHA Continues Its Activities to Improve Wage Index Reporting

WHA is again pleased to announce that it will work with RC Healthcare on our wage index improvement project. WHA has been partnering with RC Healthcare for the past several years and have achieved excellent results on improving Wisconsin wage indices, which has a major impact on Medicare reimbursement for PPS hospitals. The results of on-site and remote wage index reviews performed by RC Healthcare on data used in determining the 2007 wage index will benefit Wisconsin hospitals by over $10 million.

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

Through two rounds of occupational mix survey submissions, RC Healthcare shared experiences among hospitals interpreting the survey and worked to increase hospitals’ average hourly wages by as much as 1.5 percent through recommending the reclassification of Nurse’s Aides from "All Other" for appropriate categories. Similarly, they reviewed hospital’s detailed survey documentation to identify RNs whom could be classified to "All Other" based upon the survey instructions to report only RNs in specific cost centers.

WHA will be offering a wage index education session this year in Madison on October 5. Members can attend in person or call in to participate. RC Healthcare is spending much more time doing hospital visits and making individual phone calls to facilities working on wage index reporting issues. Therefore, the education session is more directed towards those who have not participated in the education sessions before, or would like a refresher on the S-3 worksheet and how it impacts the wage index.

If you have questions about WHA’s Wage Index Improvement Project, please contact Brian Potter at WHA.

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President’s Column - Senate Finance Committee

At a Capitol Hill hearing Wednesday, September 13, Senate Finance Committee members pressed hospitals to justify their tax-exempt status and specifically raised questions about community benefits provided by not-for-profit hospitals. Committee Chair Senator Chuck Grassley (R-Iowa) noted that while he does not recommend legislative action at this time, he continues to believe that the "substantial" tax breaks need to be scrutinized by government.

"Hospitals do more to assist the poor, sick, elderly and infirm than any other entity in the health care sector," testified Kevin Lofton, chair-elect of the American Hospital Association (AHA) and CEO of Catholic Health Initiatives, a Denver-based system. Lofton noted the role that hospitals, as safety net providers of last resort, play in delivering uncompensated care and significant community services provided to promote the public’s health and well-being. "Quite simply, America’s hospitals are the backbone of the communities they serve," Lofton said.

The September 13 hearing was the latest development in a yearlong investigation the Senate Finance Committee has conducted on a number of issues associated with charitable activities and billing and collection practices of not-for-profit hospitals. In response to the Congressional scrutiny, AHA’s Board passed a resolution earlier this year calling on hospitals to provide free care to uninsured patients below 100 percent of the federal poverty level and specific financial assistance to patients who are between 100-200 percent of the poverty level. AHA has also called upon the nation’s hospitals to voluntarily report community benefits using uniform definitions that largely align with guidelines developed by the Catholic Health Association and VHA.

WHA will release a statewide report on community benefits in October. The report will quantify community benefits and showcase dozens of specific community benefit stories that will be helpful in demonstrating the good work that hospitals are doing to fulfill their missions. Click here for another example of WHA efforts to share our special message with the public.

Steve Brenton
President

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WHA Provides Medicare Reimbursement Rule Analysis on the WHA Website

The WHA website section on Finance and Data offers information on a variety of topics as well as an emphasis on the Medicare payment rules. These rules along with other information regarding Medicare payment systems can be found for inpatient, outpatient, home health, rehab, inpatient psych, long-term care hospitals, skilled nursing facilities and the physician fee schedule on the website.

Summaries of many of the Medicare reimbursement rules that have come out in the past several weeks can be now found on the WHA website at http://www.wha.org/financeAndData/default.aspx.

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Grassroots Spotlight: Legislators Like Their Hospitals!

The number of elected officials heading off to their local hospitals for a visit continues to increase. This week HEAT was alerted to even more hospitals scheduling visits with their elected officials. 

Upcoming Visits: Cong. Ron Kind at the WHA West Central Region Annual Trustee Forum; Sen. Mark Miller at Columbus Community Hospital; Rep. Jason Fields at Aurora Sinai; Rep. Mike Sheridan at Mercy

Sacred Heart Hospital in Eau Claire hosted local legislators, State Sen. Ron Brown and State Rep. Rob Kreibich, at its facility this week. During the visit Sen. Brown discussed with hospital staff the importance of a "consumer driven approach" in order to reduce health care costs, citing examples like co-op care which can assist with individuals and small businesses with pooling coverage. He added that health care saving accounts and transparency/reporting are both important for the future of health care as well. Both issues have been supported by WHA.

"I think consumer driven health care is the way to go," said Brown. "We need to look at absolutely everything; there are no bad ideas. In the fire service I learned: Listen, learn and lead."

Brown also commented that the recent restoration of a cap on non-economic damages was important in order to prevent the loss of physicians in Wisconsin.

In his comments, Rep. Kreibich complimented Sacred Heart Hospital and regional providers for increasing access to health care services in western Wisconsin. Rep. Kreibich noted three things he views as cost drivers in health care that can contribute to a crisis: defensive medicine, cost shifting and an aging population that will place an increasing burden on Medicaid.

"We’re at a crossroad in the Legislature on health care issues," said Kreibich. "But one thing I’ve learned in my 14 years is that we don’t have all the answers. Thankfully, there’s no shortage of ideas out there [from our constituents]."

During the question/answer portion of the visit, an employee asked how constituents should contact legislators so their voices could be heard. Both legislators agreed that writing letters and following up with a phone call worked best. They went on to add that when a legislator receives five letters, that is a big deal. They cautioned, however, that form letters are not considered effective and are generally ignored.

Hosting legislators is a staple grassroots activity and provides an excellent way of building positive hospital-legislative relationships. Not only does it allow for relationship building but it also allows for hospital employees to learn first-hand about how health care issues fared in the Legislature. A legislative visit can also include a tour of the facility and/or separate meetings with other key hospital staff on issues of interest.

If your hospital will be hosting a legislator, please let the HEAT program know by contacting Jenny Boese at 608-268-1816 or jboese@wha.org .

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Campaign Spotlight -- Senate District 31

Senator Ron Brown v. Challenger Kathleen Vinehout

District Description: The 31st Senate District in Northwestern Wisconsin stretches east to west from Pierce County to Jackson and Monroe Counties and south from Trempeleau County to the north including the southern third of Eau Claire and Dunn counties. The district includes parts of the city of Eau Claire.

District Hospitals: Black River Memorial Hospital, Chippewa Valley Hospital & Oakview Care Center, Franciscan Skemp Healthcare-Arcadia & Sparta Campuses, Oak Leaf Surgical Center, Osseo Area Hospital & Nursing Home, Sacred Heart Hospital, Eau Claire, Tomah Memorial Hospital, Tri-County Memorial Hospital, Whitehall and the Veteran Affairs Medical Center, Tomah.

Candidate Profiles: Ron Brown is a member of the Republican Party. He resides in Eau Claire. He was elected to the State Senate in 2002 and is a current member of the Committee on Health Children, Families, Aging and Long Term Care and the Committee on Agriculture and Insurance. Ron served in the Air Force and was the former fire chief of the City of Eau Claire.

Kathleen Vinehout is a Democrat. She is a farmer from Buffalo County. Kathleen and her husband have been farming since the early ‘90s. Prior to farming Kathleen worked as a nurse, quality assurance specialist and medical educator and worked in a hospital and a home health agency settings. She was also a professor teaching in the area of public health and health administration at the University of Illinois, Springfield.

Candidate Survey Results: Candidates’ answers to selected abbreviated questions from WHA’s 2006 candidate survey appear below. To view the entire survey for this or any other race, contact Eric Borgerding or Jodi Bloch 608-274-1820.

Wisconsin’s Medicaid and BadgerCare programs pay hospitals about 49 cents for every $1 dollar it costs hospitals to care for these patients. In 2005, this resulted in $550 million of unpaid costs that were shifted to the private sector. Known as the "Hidden Health Care Tax," this level of cost-shifting due to un-funded government programs contributes to rising health insurance premiums. The situation is much the same for Wisconsin’s nursing homes, many of which are owned/subsidized by hospitals. Would you support the state budgeting additional funds to pay hospitals and nursing homes more adequately and to reduce the "Hidden Health Care Tax" on Wisconsin employers?

Brown: YES, Vinehout: YES. "We need comprehensive reform in how we pay for health care. We must eliminate the need for cost shifting by raising reimbursement rates for Medicaid and Badgercare to adequate levels. We also need to raise long term care rates to adequate levels. Our current reimbursement rate for Medicaid patients penalizes those who provide care to our most vulnerable citizens. This is unacceptable."

Under current law, employee contributions to employer-provided health insurance are exempt from state and federal income tax. However, Wisconsin is one of a handful of states that does not allow a state income tax deduction for contributions to a Health Savings Account (HSA). A bill to accomplish this was passed three times by the Legislature, and vetoed each time by Governor Doyle. Do you support allowing individuals to deduct contributions to HSAs from their state income taxes (estimated cost $4.5 million in 2006)? Brown: YES; Vinehout: "Health savings accounts could be a part of comprehensive reform. The problems they create must be resolved in the organization of the delivery system. At this time I do not support additional tax breaks for those making contributions.

It is anticipated that legislation could be introduced again this session that mandates nurse-to-patient ratios in hospitals (i.e., 1 nurse for X number of patients). Would you support legislation mandating patient staffing ratios? Brown: NO;

Vinehout: "I would support establishment of minimum nurse to patient staffing ratios."

In the past, legislation was introduced that would have required hospitals to obtain government approval for new construction, renovation or expansion projects and major new equipment purchases. This legislation failed. Should state government approve hospital decisions about the purchase of state-of-the-art equipment and construction of new facilities?

Brown: NO; Vinehout: NO. "State mandated planning will likely be an issue in statewide reform discussions. Rather than add complex new layers of bureaucracy, I prefer an approach that would provide incentives, through reimbursement structures, to create or expand certain services – like primary care and community outreach."

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Campaign Spotlight -- Assembly District 80

Representative Brett Davis v. Challenger Janis Ringhand

District Description:
 The 80th Assembly District south of Madison stretches west to east from New Glarus to Evansville and north to south from Oregon to Monroe and Brodhead.

District Hospital:
 The Monroe Clinic

Candidate Profiles:
 Brett is a Republican first elected to the Assembly in 2004. He currently serves on the Assembly Medicaid Reform Committee. He resides in Oregon with his family. Prior to being elected to the Legislature, Brett worked for Secretary Thompson as a health policy advisor and for Sen. Joe Leibham as his chief of staff.

Janis is a Democrat and a lifelong resident of Evansville where she resides with her family. She has served as the Mayor of Evansville, Alderwoman and City Council President.

Candidate Survey Results:
 Candidates’ answers to selected abbreviated questions from WHA’s 2006 candidate survey appear below. Candidate Ringhand did not return the survey. To view the entire survey for this or any other race, contact Eric Borgerding or Jodi Bloch 608-274-1820.

Wisconsin’s Medicaid and BadgerCare programs pay hospitals about 49 cents for every $1 dollar it costs hospitals to care for these patients. In 2005, this resulted in $550 million of unpaid costs that were shifted to the private sector. Known as the "Hidden Health Care Tax," this level of cost-shifting due to un-funded government programs contributes to rising health insurance premiums. The situation is much the same for Wisconsin’s nursing homes, many of which are owned/subsidized by hospitals Would you support the state budgeting additional funds to pay hospitals and nursing homes more adequately and to reduce the "Hidden Health Care Tax" on Wisconsin employers?

Davis: "I will continue to work for funding MA’s cost to continue and then look for ways to reduce the ‘hidden health care tax.’"

Under current law, employee contributions to employer-provided health insurance are exempt from state and federal income tax. However, Wisconsin is one of a handful of states that does not allow a state income tax deduction for contributions to a Health Savings Account (HSA). A bill to accomplish this was passed three times by the Legislature, and vetoed each time by Governor Doyle. Do you support allowing individuals to deduct contributions to HSAs from their state income taxes (estimated cost $4.5 million in 2006)?

Davis: YES

It is anticipated that legislation could be introduced again this session that mandates nurse-to-patient ratios in hospitals (i.e., 1 nurse for X number of patients). Would you support legislation mandating patient staffing ratios?

Davis: NO

In the past, legislation was introduced that would have required hospitals to obtain government approval for new construction, renovation or expansion projects and major new equipment purchases. This legislation failed. Should state government approve hospital decisions about the purchase of state-of-the-art equipment and construction of new facilities?

Davis: NO

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Connecting with Our Communities: Stories From Our Hospitals

Fort HealthCare and Watertown Area Health Services
 Rock River Free Clinic, Jefferson, Wisconsin

The free clinic concept grew out of an assessed need to provide care for individuals with limited financial means and without health insurance. The needs assessment surveyed individuals regarding insurance coverage for health and dental services and access to care. Research was supplemented by subjective assessments of Public Health Nurses who were seeing many individuals who could not get health care.

Ms. Scott, Ann Lynch, RN, BSN, and Barb Dehnert, all of Jefferson County Health Department (JCHD) convened the first monthly Free Clinic Feasibility Committee meeting in February 2002. Present were community individuals, groups and medical providers similarly interested in the feasibility of a free clinic. Representatives from Fort HealthCare and Watertown Area Health Services were at the table from the beginning and were vital to the success of the clinic.

The Clinic’s mission is "To provide access to free health services through volunteer health professionals dedicated to caring for low income and uninsured individuals."

In June 2002, the Jefferson County Building and Grounds Committee offered the lower level clinic area of the Health Department at no charge. The County continues to provide utilities and maintenance at no cost.

The Clinic treats patients with these illnesses and more:

Eligible patients are those uninsured and with income at 200 percent of poverty level or less.

Fort HealthCare provides a diabetic educator to Clinic patients. By December 2005, 30 patients had completed four sessions that include diabetes basics, monitoring, glucose control strategies, diet, exercise, foot care and goal setting.

The regular volunteer support of area physicians, nurses, social workers, interpreters and other health professionals help the Clinic meet the needs of patients. The volunteers include many from Fort Memorial Hospital and Watertown Memorial Hospital.

The Clinic has an annual operating budget of approximately $42,000. One half is provided by United Way; the remainder from private donations.

The Rock River Free Clinic’s Annual Report for 2005 shows that Fort HealthCare’s donated value of X-ray and lab tests was $41,979. Watertown Area Health Services donated $43,589 for similar services.

Clinic activity is a strong indicator of achievement regarding how well the Clinic meets the needs of medically indigent individuals.

Year Visits
2003 1,294
2004 1,811
2005 1,885

Patient success stories are also indicative of the clinic’s value to the medically indigent. Two stories follow.

A patient with active tuberculosis received daily observed therapy from Public Health Nurses who also assisted him with obtaining food, medical care and rent money. He completed treatment and is tuberculosis free. All his contacts received TB skin tests and follow-up by the Health Department.

A young woman presented with abdominal pain. She had been seen in the local ER with a negative gall bladder ultrasound. At a Thursday evening clinic, Dr. Gehred referred her to surgeon Dr. Kontny who saw her Friday and determined she needed immediate gall bladder surgery. Dr. Gehred did her pre-operative clearance exam in Dr. Kontny’s office. She had successful surgery the next morning at Fort Memorial Hospital.

Hudson Hospital, Hudson
Crash Course

"Jacci was an awesome light in my life -- curious, tenacious, passionate and funny. Her laughter was contagious." These are the words spoken by a mother in remembrance of her 17-year-old daughter killed in a drunken driving car accident on prom night. Although a staged performance, part of this year’s Mock Crash event held April 26, these words are just the type parents don’t want to have to say.

Back in 2003, out of concern for prom safety, Hudson High School parent advisory board and Lori Poppe, board member and Hudson Hospital employee at the time, suggested that the community host a Mock Crash event as other schools had done. Because it was so successful, and an outstanding example of community collaboration in support of the high school, Hudson Hospital once again supported this year’s event.

"A picture is worth a thousand words" and nothing is more powerful to a young, impressionable mind. Hosting such an event, just a few nights before prom, is an attempt to make a lasting impression upon viewers. Hudson High School, Hudson Hospital, emergency services and local businesses teamed up to give students a "crash course" on the consequences of drunken and careless driving.

The day’s event unfolded with 1,000 Hudson High School onlookers in attendance. Alerted by a frantic 911 call (student actors), Hudson police, fire and ambulance personnel responded to a mock head-on collision staged in a parking lot across the street from the high school. Tarps were removed from two mangled cars revealing "bloodied" teenagers inside, as well as a girl who had been "thrown" from one of the vehicles. Students were intrigued by the number of emergency personnel involved in responding to a car accident with injuries and death--police, fire, paramedics, Life Link medical transport helicopter, which carried off the most critical passenger, Jacci, St. Croix County Medical Examiner, and the local funeral home. They were also amazed at how long it took to free victims from the wreckage.

Once back in the school gym, the setting changed to a hospital emergency room. Hudson Hospital’s trauma team demonstrated the efforts needed to try and save Jacci’s life had the trauma been real. Trauma team members included two emergency room physicians, a nurse, respiratory therapist, and trauma coordinator, Lynn Nelson. Lynn is responsible for community education on trauma prevention and a committee member for this year’s Mock Crash event. "Mock Crash is just one example of our community involvement. Everyone volunteers their time in addition to service and material donations, which are all needed to make this event happen. The use of actual emergency room equipment lends credibility to the re-enactment," said Lynn. A flat line monitor and removal of sterile gloves indicated to the audience that Jacci had died. Her funeral was emotionally moving, with Jacci’s real mother delivering the eulogy. The court proceedings that followed provided a serious look at the legal consequences of drunk driving. And, in conclusion, students’ questions and concerns were addressed by the panel of experts who had assisted throughout the day.

Organizers of Mock Crash hope they have impressed upon students the importance of making positive choices when it comes to drinking and driving, wearing seatbelts, and riding with people under the influence. Upper classmen thought it was a pretty powerful presentation. One student later remarked how he thought about the presentation on prom night and took the car keys from an intoxicated friend. Another remarked on how her group of friends chose not to drink and drive that night. And yet another girl reported calling her parents for a ride home when her boyfriend, who wasn’t going to drink – got drunk. Younger students, who aren’t driving yet, couldn’t relate to it as well, but that’s the reason for an event repeat every three years.

Memorial Medical Center, Neillsville
 The Benefits of Living In Our Community; Patients Share Experiences

Like many farmers, Ronald was accustomed to working with aches and pains. One pain in particular, however, eventually brought him to the Emergency Room. He was having problems breathing, and although he feared the medical bill, Ronald and his wife knew his heart needed immediate attention. From the ER, Ronald was admitted to the hospital for several days. After consulting with physicians and running tests, he was discharged…with a hefty medical bill.

It was just an average day on the job for Tom. He punched in and was looking forward to punching out. Over lunch, a co-worker was talking about how he had his blood-sugar tested at a health fair booth, located in the break room. Tom knew about the health fair, but had not seriously considered going. Being in his twenties, he felt invincible. At the end of his shift, however, he decided to get checked. After all, it was free. Little did Tom know, his life was about to change due to diabetes.

Stories like Tom’s and Ronald’s occur every day. People avoid seeking medical care for different reasons, including finances, feeling healthy, transportation, and time. To overcome these barriers, Memorial Medical Center tries to provide solutions. We have a responsibility to improve the health of local communities, but more than that, to raise the overall health status of those we serve.

Ronald and his wife lived primarily on his Social Security and Medicare for health insurance. When Ronald received his medical bill in the mail, he made an appointment to speak with Amanda in Patient Financial Services.

"I just told her the truth…that I was going to need help paying the bill. And Amanda couldn’t have been nicer. We talked about the options, and we gave her whatever paperwork she requested. Two days later, Amanda called to say it was taken care of," recalls Ronald. "We can’t thank them enough, but we can share our experience."

According to Charlene Arneson, RN and Diabetic Educator, going beyond the walls of our facility and collaborating with employers is key to reaching people like Tom. "Young people don’t think about their health as much. Unless there is an injury, they often assume things are fine. After Tom was discharged from our hospital, he had to totally adjust his lifestyle so diabetes wouldn’t cut it short. He was that close. He’s doing great now, though. He’s proof that we’re making a difference," stated Arneson.

Real-life accounts like these and dollars-and-cents data are included in the Wisconsin Hospital Association’s first statewide Community Benefit Report, to be issued later this year. The report will categorize benefits in two main areas: charity care and government program underfunding.

Along with other Wisconsin hospitals, Memorial Medical Center’s initiatives continue to overcome obstacles, improving lives and making our community healthier.

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

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MetaStar Provides Tool for Reducing Payment Error Rates

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is an electronic data report containing hospital-specific data for 13 target areas-–specific DRGs and discharges that have been identified as at high risk for payment errors. The Hospital Payment Monitoring Program (HPMP) Quality Improvement Organization Support Center (QIOSC), which is the Texas Medical Foundation Health Quality Institute (TMF), develops the PEPPER under contract with the CMS. TMF provides all Quality Improvement Organizations (QIOs) such as MetaStar with hospital-specific-data for short-stay, acute-care inpatient PPS hospitals within their states quarterly. These data are intended to assist QIOs in their HPMP efforts to identify and prevent payment errors by working with inpatient PPS hospitals within their state. The overall goal of HPMP is to reduce the Medicare payment error rate within each state as well as nationally

MetaStar forwards the PEPPER to a hospital-designated contact on a quarterly basis. This contact is typically a compliance officer, utilization manager, HIM director, or CFO. MetaStar reports that only 67 percent of receiving hospitals actually open the Web-based reports within seven days. The disadvantage of not opening the reports is that the hospital will not be aware of statistical outliers in their Medicare discharge data, and therefore will not have the knowledge to take steps to reduce their payment error rates. Of note, is that the Office of Inspector General has the option to target for review hospitals that are at or above the 75th percentile, or below the 10th percentile for any indicator in the PEPPER.

Hospitals that would like further information about the PEPPER may contact Bill French, RHIA, CPHQ, MBA, vice president, eHealth strategies at MetaStar (608-441-8246, 800-362-2320, bfrench@metastar.com).

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Political Action Spotlight: 2006 Fundraising Campaign

Contributions Ranging from $1 - $249

Contributions Ranging from $250-$499

Contributions Ranging from $500 - $999

Contributions Ranging from $1,000-$1,999

Contributions Ranging from $2,000-$2,999

Contributions $3,000 and up

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