This week, a budget conference committee agreed to modifications that reconciled the different versions of the state budget passed by the Senate and Assembly earlier this month. Both houses are required to pass an identical budget bill before it can be forwarded to Governor Doyle for his consideration, including possible vetoes.

Late last night (June 25), the Democratic-controlled Senate on a required up or down vote approved the conference committee bill by a 17-15 margin. The Assembly is expected to take up the measure today.

Members of the conference committee for the Senate included Senate Majority Leader Russ Decker (D-Weston), Joint Finance Committee Co-Chair Mark Miller (D-Monona) and Minority Leader Scott Fitzgerald (R-Juneau). Members for the Assembly were Speaker Mike Sheridan (D-Janesville), Mary Hubler (D-Rice Lake) and Minority Leader Jeff Fitzgerald (R-Horicon).

Pressure has steadily increased to quickly pass the budget because of a June 29 federal deadline that looms for implementation of changes to the hospital assessment that were included in the budget. At issue are millions of additional federal dollars the state would qualify to use for increased Medicaid expenditures and hospital payments if the budget passes and in effect the changes are made by the deadline.

The budget needs to be signed by Governor Doyle by Monday, June 29 to secure the federal dollars.

Improvements to medical records language lost

Troubling language related to access to medical records and the fees that can be charged for copies of medical records that was improved during Senate budget deliberations was removed by the conference committee. WHA continues to lobby for their complete elimination from the budget.

As previously reported, a late-night amendment put in the budget bill several weeks ago makes massive changes to Wisconsin law relating to copies of medical records. The language sets the allowable fees that can be charged for copies of medical records below the cost of making the copies, includes no provision for future price increases and includes language that conflicts with state privacy laws and federal HIPAA regulations.

The language would also require health care providers using electronic medical records (EMR) to provide electronic copies well below the cost of generating the copies. This policy change is based on simplistic and uninformed assumptions that generating copies from electronic medical records is without cost.

WHA is joined by other health care providers, medical record copy service providers and leading e-health industry experts, including Wisconsin’s own Epic Corporation, who have asked Governor Doyle to veto this provision in its entirety from the budget.

WHA asks you to contact Governor Doyle immediately to urge his veto of all provisions relating to copies of medical records. Email Governor Doyle at WHA’s Email Your Legislator: www.wha.org/speakUp/emailLegislator.aspx or call Governor Doyle’s office at: 608-266-1212.

Wisconsin’s Rep. David Obey and Minnesota’s Rep. Betty McCollum are leading the effort on a dear colleague letter urging that the current Medicare geographic disparity be addressed in any health care reform legislation. The letter will be sent to House leadership as well as the chairs and ranking members of the three committees crafting health care reform legislation. To date, Wisconsin’s Tammy Baldwin and Tom Petri are also co-signers of this letter.

"It is our strong belief that geographic payment inequities must be resolved for health care reform to be successful and for Medicare to achieve long-term sustainability," the letter reads. "We represent states in which quality of care exceeds the national average and per-beneficiary fee-for-service Medicare costs are substantially lower than the national average, reducing overall Medicare costs. Our low-cost, high-quality states are setting the national standard for Medicare, yet we are penalized by the current Medicare reimbursement formula."

In addition to AHRQ’s quality rankings, which put Wisconsin at the top in providing quality health care, the Dartmouth Atlas Health Study has also ranked Wisconsin communities as some of the most efficient and low-cost in the country when caring for Medicare patients. Studies indicate that integrated delivery system models could save Medicare upwards of $100 billion a year. For these reasons, WHA has advocated that the current quantity over outcomes payment formulas must be replaced with an appropriate outcomes-quality-value based proposition.

"WHA thanks Rep. Obey for his efforts to address the current inequity in Medicare reimbursement among states and to incentivize high-quality, efficient care," said WHA President Steve Brenton. "We strongly agree that quality and value must be brought into the Medicare reimbursement equation."

Several weeks ago Wisconsin Senators Herb Kohl and Russ Feingold led a similar effort in the Senate on a dear colleague letter.

Wisconsin Medicare providers are nationally recognized as leaders in providing high-quality health care at a low cost that saves taxpayer dollars. Earlier this month, the Washington Post reported that if all hospital systems operated like those in La Crosse, Wisconsin, patients around the country would receive better medical care that costs patients, insurers, and the government less.

I am working with my colleagues in the Senate to pass legislation providing guaranteed, affordable, high-quality health care for all Americans. One of my priorities for this legislation is to ensure states, hospitals and other Medicare providers are rewarded when they provide high-quality and efficient care. We have to shift to a performance-based Medicare reimbursement system that takes into account quality of care, not quantity of care.

To move Congress toward this performance-based system, I led a bipartisan group of senators, including Senator Kohl (D-WI), in asking the Senate Finance Committee—which is developing health reform legislation—to protect high-performing states like Wisconsin from unnecessary cuts to Medicare reimbursement. The best providers should be rewarded, not punished, for providing superior care.

We also asked that any bonus or incentive payments tied to progress on quality benchmarks also take into account the high efficiency regions that have already met quality benchmarks. This would ensure equitable reimbursement for their efforts and help address a history of Medicare underpayments to Wisconsin.

As we make this shift to a performance-based Medicare reimbursement system, Congress and the Obama Administration can learn a lot from Wisconsin’s leadership in integrating and coordinating delivery of care. Our state provides better care while spending about $1,200 less per patient than the national average. Wisconsin’s integrated Medicare system and aggressive quality controls provide Medicare beneficiaries better care for lower costs than most other states.

Studies show that moving to a coordinated, integrated delivery system could save Medicare more than $100 billion a year. I strongly support efforts in Congress to use strong performing health systems, many of which are in Wisconsin, as a model for all Medicare providers. President Obama took the same approach when he said about high performing health systems that "we need to learn from their successes and replicate those best practices across our country." In fact, on his recent visit to Green Bay, he complimented Wisconsin in its achievements in this area.

As the health care debate continues, I will continue using the strength of integrated hospitals in Wisconsin to demonstrate how health care reform can be done right—using them as a model for the entire nation and rewarding our high performing providers.

Health care is front page news as talk of reform at the federal level sweeps the nation. Meanwhile, state legislators are working feverishly to complete what has been one of the most challenging budgets in recent memory. With so much at stake, Wisconsin health care leaders are keeping a watchful eye on a multitude of issues and proposals. Discussion at the WHA Board meeting June 25 in Madison reflected collective concern about what the future will mean for patients and communities.

In a detailed legislative report to the Board, WHA Executive Vice President Eric Borgerding described the current situation in Madison as several key health issues are in play. Predicting that late nights at the capitol won’t end soon, Borgerding said the newly-formed Conference Committee, comprised of three members from each house, has started meeting to work out differences between the budget versions passed by the House and Senate. The pressure is on to pass the state budget by June 29 or Wisconsin risks losing $74 million in federal Medicaid matching funds generated by the increase in the 2009 hospital assessment.

Throughout the budget deliberations, the hospital assessment has remained intact, as approved by the WHA Board. Also noteworthy is the fact that funding to expand Medicaid to uninsured childless adults is hinged to the formula currently in the assessment legislation. Borgerding said a deal on the budget is expected soon.

The major health care issues in the budget include:

Joint and several liability – After damaging changes were proposed to joint and several liability and other tort statutes, Borgerding happily reported that neither version of the state budget includes these proposals.

Medical record copy fees – It’s the perennial issue in the State Capitol. This session, a damaging proposal included in the budget redefines patient representative and who can access medical records at a reduced fee and mandates that providers with EHR provide information at little cost. The proposal is now in the Conference Committee and is being heavily lobbied by WHA.

Department of Regulation and Licensing – On a positive note, the Governor’s budget included 15 new FTEs and created a new bureau within DRL to focus on physician and other health care provider licensing needs. Eight of the positions remain in the budget.

Ban on mandatory overtime – No legislative proposals have moved forward, but WHA staff is prepared if interest resumes on this issue after the budget is completed.

Provider Order for Life Sustaining Treatment (POLST) – WHA is working with the Wisconsin Medical Society on legislation that would allow the use of the POLST document in Wisconsin. Borgerding said the proposal has bipartisan backing. Borgerding warned that it will not be without some controversy, but the benefits to both families and health care providers to have these orders have been demonstrated across the state and when in place, POLST has been shown to reduce end-of-life costs and reduce stress on family members.

Update on assessment and increased payments – Following Borgerding’s report, WHA Senior Vice President George Quinn provided a detailed review of the hospital assessment to date, noting that WHA continues to closely monitor the process and will participate in a reconciliation process with the Department of Health Services as soon as data becomes available.

Federal health reform proposals continue to create headlines and potential headaches as well as opportunities. WHA President Steve Brenton said health reform had been moving near warp-speed until Congress was grounded by the financial analysis from the Congressional Budget Office that showed costs of specific legislation to be in the trillions.

When Brenton presented an overview of what was on the horizon relative to health reform at the April Board meeting, he predicted that consensus would explode around three key issues: the public plan alternative; mandated coverage, and who would pay and how. Over the past three weeks, the discussion moved from global pronouncements on how it could work to detailed plans.

The Senate Health, Education, Labor and Pensions Committee introduced a proposal with an open-ended government alternative set to compete with commercial plans that would be open to anyone, not just those in small groups or those financially or medically vulnerable. With payments set in the plan at Medicare plus 10 percent, Brenton said commercial insurers would be unable to compete, with significant societal and provider consequences, as it would trigger a mass migration from private plans to the public plan. Similar legislation was introduced in the Senate.

President Barack Obama seems to be waiting for the congressional process to produce a consensus plan that he can support. The Senate Finance Committee will also have a plan that is expected to narrow the public plan alternative to those that are uninsured or that work for small employers. The American Hospital Association says it could support a narrowly-defined public option.

It is an absolute certainty there will be a coverage mandate of some sort, Brenton said. The issue is will it be an individual mandate, or will it be an employer mandate or a combination of the two? The House and Senate have a combination mandate, but is it a mandate to Lexus or Ford coverage? Will there be government subsidies for those that cannot afford the premium?

Wisconsin is a high quality, low cost Medicare provider. That fact is being promoted by the Wisconsin congressional delegation and Obama himself when he was in Green Bay recently. Regional variations in Medicare program costs are large. Thought is being given to encouraging the Medicare program to reward providers financially on the basis of efficiency or outcomes with new money, rather than through a payment system that is redistributive in nature.

Brenton noted that WHA is working closely with the Wisconsin congressional delegation to encourage them to seek incentives that reward, or at least do not cut, high quality, low cost states. Brenton acknowledged the highly-visible work of the Wisconsin congressional delegation in touting the value that Wisconsin providers bring to the Medicare program. He added that WHA is working with a number of similarly-situated states to build a coalition that would support value-based incentives backed with new money.

At the request of a Board member who said he is frequently asked questions on the federal health reform proposals, Brenton said WHA staff would develop talking points around this issue and send them to member hospitals.

Minnesota-licensed physicians now have the ability to practice in Wisconsin effective August 1 thanks to the efforts of WHA’s Judy Warmuth, vice president of workforce. Brenton thanked Warmuth for her work and said she did an "extremely effective job" working with the Medical Examining Board and the Office of the Commissioner of Insurance in Wisconsin.

In other actions, the Board approved a change to the WHA Bylaws that would allow for a virtual annual business meeting.

Dana Richardson, WHA vice president, quality, asked for Board input as she described the AHA "Hospitals in Pursuit of Excellence." The agenda is designed to lower health care costs nationally. Many of the efforts in the AHA plan align closely with work already in progress in Wisconsin including the use of surgical checklists, reducing central line infections and MRSA, reducing adverse drug events for high hazard medications, and reducing pressure ulcers.

Richardson said Wisconsin hospitals have taken advantage of the opportunity to participate in statewide improvement collaboratives. Through the American Recovery and Reinvestment Act, the Centers for Disease Control are offering grant opportunities through the state health departments that will help put certain infection control measures in effect. The funding can be used to develop statewide plans and reporting systems along with providing funding for specific improvement collaboratives. WHA is currently working with DHS on the grant application.

Council Meeting Reports

Medical and Professional Affairs – Richardson said following up on a Board resolution regarding non-billing for nine adverse events, the Council reviewed the events at their last meeting to see if they were still on track. She said the Council will continue to review this issue. Also at the last meeting, the Wisconsin Medical Society reviewed a new CME process that gives physicians medical education credits for their work on quality improvement projects. This would include the time they spend on quality improvement collaboratives and internal quality improvement projects.

Just days after Wisconsin basked in the national spotlight of a Presidential visit that lauded the state as a benchmark for provider-based performance excellence, Wisconsin hospitals face unprecedented Medicare payments cuts that would create a level of red ink that would make the recent economic downturn look like "the good old days."

No one should be lulled into believing that these proposals, that could cut Wisconsin hospitals’ payments by as much as $4 billion over the next decade, are "not serious." Not only are they serious, but they seem to have become the preferred way to finance coverage expansion in every specific proposal currently before Congress.

The bottom line here is that legislation introduced to date fails to contain even one serious initiative that would reward value and efficiently delivered outcomes—the very performance heralded by President Obama in Green Bay earlier this month. Without question, cuts of this magnitude will destroy the infrastructure that Wisconsin delivery organizations have fashioned that advances the high performance they are producing.

The chart below describes the Medicare cuts that are in play and the ten-year impact of each proposal. The total red ink is undoubtedly worse than described here due to the fact that Medicare Advantage payments are not included. We also have not modeled CAH impacts due to uncertainty as to the dynamics of these proposals. But CAHs will be caught up in this…bet on it.

House Leadership Proposal: Productivity/Market Basket Updates: Wisconsin estimated share of $140 Billion National Estimate

Obama Administration Proposal: 75% Reduction in DSH based on yearly Wisconsin $85 Million Medicare DSH Payments and Medicaid Federal DSH Allotment

Obama Administration Proposal: Bundling adjustment based on Wisconsin share of $17.8 Billion National Estimate

Obama and House Leadership Proposals: Reduction for readmissions based on Wisconsin share of $8.4 Billion National Estimate

Obama Administration Proposal: Hospital payment linked to quality adjustment based on Wisconsin share of $12 Billion National Estimate

2010 IPPS Proposed Rule: Behavioral Offset reduction projected for 10 years

2010 IPPS Proposed Rule: IME reduction projected for 10 years

WHA submitted comments this week to the Office of the National Coordinator for Health Information Technology (ONCHIT) regarding the Health Information Technology (HIT) Policy Committee’s recently released recommendations on "meaningful use" of HIT. The definition of "meaningful use" is extremely important. Only hospitals that meet the definition of a meaningful user of a certified electronic medical record can receive the billions of dollars available in HIT incentive payments under the American Recovery & Reinvestment Act (ARRA). Further, hospitals not considered to be meaningful users by 2015 will begin to see Medicare payment penalties.

The HIT Policy Committee recommended that the definition of meaningful use be staged over five years. One set of requirements would be required to be a meaningful use in 2011, with additional requirements added in 2013 and 2015. However, the Committee recommended that many of the most challenging requirements be met beginning in 2011.

Among other provisions, the HIT Policy Committee recommended that a "meaningful user" would be required to:

• Exchange key clinical information among providers of care.
• Use computerized provider order entry (CPOE) for all order types.
• Report various quality, safety, patient satisfaction, and epidemiological measures.
• Electronically submit various information to public health and others.
• Fully comply with HIPAA.
• Provide patients access to a personal health record populated with data from an electronic health record.

Working with the chief information officers at various Wisconsin hospitals and systems, WHA crafted its comments in a letter. That comment letter raises the following issues:

• While objectives recommended by the HIT Policy Committee are laudable, these should be long-term policy goals not front-loaded all at once beginning 2011.
• The definition of "meaningful use" as written is overly aggressive and will work contrary to the overarching goals of widespread HIT adoption.
• Concern there may not be an adequate health IT workforce supply to meet an aggressive timeline for nationwide adoption of interoperable EMRs that have all of the capabilities outlined in the recommendations.
• Concern that some of the technologies required to meet the objectives and measures are not fully mature and are not standardized.
• Concern that the definition of "meaningful use" is being used to achieve Medicare payment reforms when achieving routine use of an EMR in a patient care setting should be the primary goal of these regulations.
• Concern that Wisconsin’s small, rural Critical Access Hospitals will find it especially difficult to meet the high threshold for compliance set by these meaningful use recommendations.

The recommendations made by ONCHIT’s HIT Policy Committee are the first step in a process that will ultimately require promulgation of federal rules defining requirements for "meaningful use" of a certified electronic medical record. A proposed rule is expected to be published by the Secretary of HHS in late 2009, with promulgation of a final rule in early 2010. Look for further articles in The Valued Voice as important criteria for the HIT incentive payments progresses.

Read the HIT Policy Committee’s Meaningful Use Matrix and Preamble online at:

http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113_872719_0_0_18/Meaningful%20Use%20Matrix.pdf.

Read WHA’s comment letter online at: www.wha.org/healthit/whacomment6-26-09.pdf.

This week WHA wrote each of Wisconsin’s Members of Congress on several workforce bills—HR 2273 and S. 1031—that include provisions mandating nurse-to-patient staffing ratios.

WHA’s letter outlined four main reasons it opposes legislatively-mandated nurse staffing ratios. Those are:

1. Evidence shows staffing ratios will not provide better patient outcomes.
2. Evidence shows staffing ratios will increase the cost to provide care.
3. Ratios have very significant shortcomings.
4. Wisconsin already provides great care at reasonable cost and our hospitals are committed to continual evidence-based improvement.

Instead of ratios, WHA expressed support for evidence-based approaches that look at relevant research to develop best practices for staffing. One such approach is from the Wisconsin Organization of Nurse Executives (W-ONE). In their report, Guiding Principles in Determining Appropriate Nurse Staffing: Standards of Practice for Acute Care in the State of Wisconsin, they reviewed the relevant research to date on nurse staffing and set guiding principles for determining appropriate nurse staffing. Access this document online at: www.w-one.org/uploads/NurseStaffing_WONE_2005.pdf.

WHA will continue to advocate in favor of evidence-based approaches and against legislatively-prescribed mandates on important workforce issues.

Vernon Memorial Healthcare CEO Garith Steiner has spent his career recruiting physicians to Viroqua. He knows one of the characteristics to look for when attracting a physician to practice in a rural area is whether they grew up in a similar setting. So when daughter Megan voiced an interest in medical school, Dad was only too happy to connect her to the Wisconsin Academy for Rural Medicine (WARM), a program within the University of Wisconsin School of Medicine and Public Health that admits students to medical school that are likely to practice medicine in rural Wisconsin.

Steiner promotes the WARM program in his community among high school and college-aged students. Building awareness of the program drives up the number of applicants. There are still parts of the state that have not had an applicant to the WARM program (www.wha.org/workforce/warm2-09.pdf). Steiner has a few words of advice.

"I try to personally talk to high school counselors, science teachers, and community leaders to make them aware of the WARM program so we can promote the program to students that are likely to consider medicine as a career," Steiner said. "My wife, Julie, and I are very proud that Megan was accepted into the program. She’s a dedicated student, and could have applied and probably been accepted into other programs, but she chose to stay in Wisconsin and enter the WARM. She’ll be a great ambassador for the program."

Megan graduated from Luther College in Decorah, Iowa with a major in biology. She learned about the WARM program from Dad, and knew right away it was the right choice. Her goal is to become a primary care physician and practice in rural Wisconsin.

According to Megan, "My interest in rural medicine stems from being born and raised in a rural community. I’ve come to appreciate small town life and look forward to establishing and maintaining relationships with my patients and contributing to the community."

The Wisconsin Academy for Rural Medicine is about to begin its third year. The first group of WARM students will begin their clinical training in Marshfield and Rice Lake, according to WARM Director Byron Crouse, MD.

"It is truly exciting to see their passion and commitment to rural Wisconsin. We are looking to admit 25 students in 2010 representing our full implementation of WARM," Crouse said. "My thanks to the hospital administrators and other rural contacts that have encouraged applicants from your communities to apply to WARM. I look forward to the day they complete their training and enter practice in your communities to meet the health care needs of rural Wisconsin."

For more information about WARM, visit www.med.wisc.edu/warm. A list of the newly-admitted WARM students and their hometowns is below.

Gabe Berendes, La Crosse
Marcus Bickford, Wautoma
Ben Brusch, Arbor Vitae
Amanda Carlson, Wentworth
Edward Dunbar, Tomah and Dodgeville
Tracy Hansen, Allenton
Christopher Johnson, Amery
Michelle (Ellie) Kosmalski, Rosholt
David Kumar, Rice Lake
Jessica Novak, Antigo
David Lee Rebedew, Fond du Lac
Katherine Reimer, Eagle River
Joshua Schulist, Rosholt
Jenna Sebranek, Richland Center
Megan Steiner, Viroqua
Ian Stormont, Monroe
Joshua Taylor , Reedsburg
Jaida Temperly, Hazel Green

Jill Hanson recently joined WHA as a quality coordinator. Hanson brings with her more than 10 years of quality improvement experience in both the health care and insurance settings. Most recently, she was employed at Dean Health Systems as a clinical quality project manager. Prior to that, she worked at Dean Health Plan as a quality improvement data coordinator. Hanson will serve as the state coordinator for the CUSP:STOP BSI Initiative and will work on other projects under the Aligning Forces for Quality Program.

"As the focus on performance improvement ratchets up at the state and national level, Jill’s knowledge and experience will be a valuable resource for all Wisconsin hospitals," according to Dana Richardson, WHA vice president, quality initiatives.

Hanson received her Bachelor of Science degree from UW-Green Bay and is a certified six sigma green belt.

Now is the time to honor one of your hospital’s community health projects by nominating it for a 2009 Global Vision Community Partnership Award presented by the WHA Foundation.

Nominations must be received no later than 5 p.m. on July 15, 2009. The final call for nominations for the 2009 Award is included in this week’s packet.

Any WHA member can nominate a community health project. The project must have been in existence for a minimum of two years and must be a collaborative or partnership project that includes a WHA member hospital and an organization(s) within the community.

The Award will be presented at the WHA Annual Convention September 24, 2009. Nominations are due July 15, 2009. Nomination forms can also be found on the WHA Web site at www.wha.org.

For more information about the Award, contact Jennifer Frank at jfrank@wha.org or 608-274-1820.

CMS has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC). The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent a gap in Medicare payments. The fax may have the CMS logo and/or the contractor logo to enhance the appearance of authenticity.

Mike Schmidt, president of Ministry Health Care’s Saint Joseph’s Hospital in Marshfield, announced his plans to retire in January 2010. Schmidt began his 25-year career at Saint Joseph’s in 1984 as vice president of finance and chief financial officer. In 1989 he was named executive vice president of finance. After several years of responsibility for the financial performance of the organization, Schmidt was named president in 1993. He has held that post since that time.

Under Schmidt’s leadership, Saint Joseph’s Hospital has achieved many milestones.

Ministry Health Care President and CEO Nick Desien noted, "Mike’s career with Saint Joseph’s Hospital has spanned 25 years, and he has been an outstanding leader for both the hospital and Ministry Health Care. We can all be proud of what we have accomplished under his leadership."

"Mike has been an outstanding leader for our organization and central Wisconsin communities," stated Michael Kryda, MD, and CEO for Saint Joseph’s Hospital. "His tenure with the organization has helped to create a world class hospital that serves the health care needs of central and northern Wisconsin."

Schmidt will continue in his role through the remainder of the year and assist with the leadership transition at the hospital.

The Friends of St. Joseph’s Hospital’s 6th Annual Farm Family Event, "Sustaining Working Lands and the Future of Farming," on March 30 was a huge success.

McDonald Hall was filled to capacity with 63 Chippewa County farmers in attendance. Staff offered free blood pressure screenings and a screen for prostate cancer to eight individuals. Nine local businesses (listed below) and the Agriculture Advancement Fund at the Community Foundation of Chippewa County sponsored the event.

Richard Stadelman, executive director of Wisconsin Towns Association, was the keynote speaker, discussing the Sustaining Working Lands Initiative and the Comprehensive Planning Law in Wisconsin. Stadelman serves as an attorney and lobbyist for the Wisconsin Towns Association and has participated in several state planning committees including the DATCP Livestock Facility Siting Committee and most currently the DATCP Working Lands Steering Committee. Todd Schrankel, Kohel Power Equipment, Chippewa Falls, gave an overview of the new GPS technology used in precision farming.

The Friends of St. Joseph’s Hospital hosts Farm Family Day on an annual basis. Carl Cronquest, chair of the Friends of St. Joseph’s Hospital’s Farm Committee and lifelong Chippewa County farmer, promotes the event as a way to reach out to rural farmers.

"Our goal is to offer free information on a current topic in farming as well as promote health, through screenings and education," said Cronquest.

Sponsoring businesses: Agri-Tech/River Country Co-op; Chippewa County Farm Bureau; Common Sense Ag Service of Bloomer; Falls Farm Automation; Kohel Power Equipment; Rural Mutual Insurance; Thaler Oil Company, Inc.; Wisconsin Farmers Union; Farm & Fleet

Obesity and lack of exercise can contribute to lifelong health problems for people of all ages. In line with Ripon Medical Center’s (RMC) mission to improve the health status of the entire community, RMC initiated a "Focus on Wellness."

The first new activity—"Lighten Your Load"—was launched January 24. Knowing that weight loss is easier when you share the experience with others, the eight week weight loss program encouraged area residents to register, either individually or as teams, and receive assistance and information from RMC health professionals.

Danelle Phillips, community outreach coordinator at RMC, said the purpose of "Lighten Your Load" was not just for the participants in the weight loss challenge.

"The kick-off of the ‘Lighten Your Load’ weight loss challenge was also the kick-off event for a much broader, ‘Focus on Wellness,’ initiative at RMC, according to Phillips. "We know obesity is one of Wisconsin’s top health concerns and we wanted to help people get off on the right foot for the New Year by developing a supportive environment in the community that would promote healthy lifestyles."

Community members were encouraged to participate in the weigh-in day festivities, whether or not they were participating in the challenge. RMC health care professionals Dr. Patricia E. Sias of the RMC Primary Care Services clinic, and RMC Nurse Practitioner Rene Bodary offered free blood pressure screenings and body mass index (BMI) checks. Participants in the day’s activities could talk with RMC staff members about exercise, nutrition and diet needs.

Twenty-two teams participated in the weight loss challenge. After eight weeks, the individual who achieved the greatest weight loss shed an astonishing 49 pounds, which was 18.2 percent of his body weight. The teams lost a combined weight of 928 pounds. The team finishing first was "Mid-life Crisis," which lost a total of 110 pounds or 12.28 percent of their combined body weight.

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

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