July 29, 2011
Volume 55, Issue 29

Rhoades Tells WHA Board Health Exchange Could Eliminate Medicaid Eligibility Errors
Exchange could improve speed, accuracy

Wisconsin is establishing what could become a national model for setting up a health insurance exchange that utilizes the free market to connect consumers with available coverage options, according to Department of Health Services Deputy Secretary Kitty Rhoades. The exchange could also eliminate Medicaid eligibility errors.

"We hope the exchange will eliminate Medicaid eligibility errors. People will know in real time when they use the exchange whether they are eligible for Medicaid—not 45 days after they apply and costs are incurred," Rhoades added.

Rhoades, speaking at the WHA Board Planning Session July 21, said DHS is still determining the impact health reform will have on Wisconsin. However, the Department is moving forward on implementation of a health insurance exchange.

"Since the rules for establishing a health exchange are undefined at this point, we can use the early innovator money to bring in the concept of free market health care," according to Rhoades. "Medicaid eligibility will be folded into the exchange. When someone comes to the health exchange, it will determine what they’re eligible for, whether that is a subsidy, Medicaid or a private sector plan."

Medicaid, she said, should be the plan of last—not first—resort.

Rhoades said DHS hopes to build a Medicaid benchmark plan that will remain the same across all the plans. For example, as a family’s situation changes, or they move from Medicaid to a subsidized policy in the exchange, their providers won’t change. It will not make the government plan better than what else is out there, according to Rhoades, and the entire family will be covered by the same plan.

The exchange, according to Rhoades, is not set up to compete or replace the private health insurers. It will serve more as an education tool so people will know what they are qualified for, and it will help them find the right coverage.

In comments on the state budget, Rhoades noted that in the 12 years she served in the state Legislature, never did "real" state (general purpose revenue) dollars go into the Medicaid program. GPR builds a stable base and creates sustainability. While the Department still has to find $350 million in Medicaid cuts, Rhoades sees it as an opportunity to identify and control health care cost drivers.

"We found that across-the-board cuts are not the answer," Rhoades said.

Rhoades also noted that DHS was pleased to receive the recommendations provided by WHA’s Medicaid Reengineering Group. Rhoades said she was impressed by the level of engagement from groups that genuinely want to want to work with the Department to identify efficiencies, reforms and better ways of meeting the needs of enrollees.

"When we’re facing a $1.8 billion Medicaid shortfall, we knew right away that we could not come up with a solution by ourselves," Rhoades admitted. "If we do it TO you, it will be wrong. If you work WITH us, we can get it right. So that is what we are doing."

Rhodes praised DHS Secretary Dennis Smith, and said he has been able to jump start many projects in the Department because of his experience with the Centers for Medicare and Medicaid Services.

"He knows and understands health care," according to Rhoades. "Secretary Smith has been instrumental in helping Wisconsin maintain its position as one of the most innovative states in the country."

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Register Now for 2011 WHA Annual Convention

Leaders in the health care industry must constantly be looking toward tomorrow’s health care, anticipating and planning for the changes to come. At this year’s WHA Annual Convention, scheduled September 14-16 at the Grand Geneva Resort in Lake Geneva, hospital leaders will have the opportunity to do just that.

The Annual Convention offers the opportunity to network with colleagues, focus on the key issues facing health care leaders today and discuss options to tackle those issues through a variety of plenary and concurrent sessions. Health care leaders can register for the 2011 Annual Convention at http://events.SignUp4.com/Annual2011.

If you plan to attend the convention, make sure to reserve a hotel room at the Grand Geneva before August 24 to take advantage of the convention group rate. You can make a reservation by calling 800-558-3417 and requesting a room in the WHA room block.

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Rep. Duffy Meets Virtually with District Hospital CEOs, Discusses Federal Debt Ceiling Negotiations
Duffy to Boehner: "Please help me keep our promise to rural hospitals."

This week hospital executives in U.S. House of Representative Sean Duffy’s district met with Duffy via videoconference at Ministry St. Joseph’s Hospital in Marshfield. Duffy was required to be in DC during continuing debt ceiling/deficit reduction negotiations but was able to virtually participate in this important meeting with CEOs to discuss the impact of potential Medicare and Medicaid cuts on hospitals and area communities. The meeting was coordinated by WHA and is part of WHA’s grassroots campaign to push back against the proposed health care cuts.

"I have let my leadership know my concerns with the impact on rural hospitals," said Rep. Duffy referring to federal debt ceiling negotiations. "I am well aware of your concerns on funding issues, and I am on your side."

In fact, shortly after this meeting, Rep. Duffy reiterated his support for rural hospitals in a letter to House Speaker John Boehner (see full text of letter on page 3). "I believe the proposal to trim from the budgets of rural critical access hospitals would cause more harm than good," Rep. Duffy’s letter read.

"The rural hospitals I represent are already experiencing an extremely challenging fiscal environment. We require them to care for those who cannot afford to pay for medical care themselves, and yet, when the bill comes, the federal government pays less than what it actually costs to treat Medicare and Medicaid patients….Please help me keep our promise to rural hospitals. They cannot afford to sacrifice much more than they already have."

Area hospital CEOs participated in the virtual meeting to share concerns with Rep. Duffy over federal proposals that could impact Medicare and Medicaid reimbursement levels. While other proposals have included cuts of $100 billion or more to hospital reimbursements, Rep. Duffy pointed out that the House proposal he voted for, "cut, cap and balance," did not include any Medicare cuts.

"The reason we are talking about cuts is because they will impact our hospital, jobs and our community," said Ministry St. Joseph’s President Brian Kief. "We’ve brought in a consultant and one of the things they told us was that from a supply chain perspective, we are already best practice in the nation. We don’t have a lot of room left to trim."

Rep. Duffy indicated his support for structural system reforms including choice, competition and premium support models, but not for provider cuts.

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Federal Deficit: CEOs Continue To Talk Medicare/Medicaid Cuts in Local Papers

Across the state, hospital executives are continuing to write to their local papers to express concern over Medicare and Medicaid cuts being discussed in federal debt ceiling/deficit reduction talks in Washington, DC. We wanted to make sure you saw excerpts of what they are saying in their letters to the editor…

Cuts will hurt hospitals, health
President Barack Obama and congressional leaders are working to reach agreement on a deal that would raise the federal debt ceiling. As negotiations drag on, time is running short, and action is needed to avoid a debt crisis. The looming deadline has drawn additional attention to the nation’s significant debt and deficit spending. Policy-makers are looking for ways to reduce the debt and deficit, and federal spending cuts are expected. Unfortunately, some of the proposals under consideration include dramatic cuts to crucial health programs. Over $100 billion in Medicaid and Medicare cuts may be on the table, including significant cuts to graduate medical education programs. Graduate medical education funding provides critical support for programs that train tomorrow’s physicians. With projected physician shortages looming, this funding is essential. If we cannot train tomorrow’s health care providers, how can we assure that care will be available when it is needed?

William D. Petasnick, CEO, Froedtert Health, in the Milwaukee Journal Sentinel

Cuts to hospital care must be reconsidered
I understand the budget crisis and the need for shared sacrifice, but to put this into context it’s important to remember that hospitals are already facing billions in payment reductions from other federal policies. Congress and the federal government cannot continue to view reductions to hospital care as a solution. These do not constitute reform and will not address the underlying cost drivers in our system. Ultimately, reductions will exacerbate cost-shifting onto employers and others. Despite declining reimbursements; however, hospitals continue to proactively innovate to deliver some of the highest quality, cost-effective care in the nation.

Kenneth R. Buser, President & CEO, Wheaton Franciscan Healthcare-All Saints, in the Racine Journal Times

Proposed cuts have negative impact
As you may have heard through the news and most recently...multiple proposals are under debate in Washington, D.C., that would severely cut Medicaid and Medicare payments, affecting billions of Americans depending on these for their health care needs. I wanted to share the most recent information with you as we partner in your health care in our community. Collectively, the Wisconsin Hospital Association (WHA) and I asked our U.S. Senators, Herb Kohl and Ron Johnson, and Congressman Tom Petri to oppose these federal cuts to these programs. The recession still is part of the reality for a lot of us. In Manitowoc County, health care providers are a big economic engine, providing nearly $2 million in charity care and more than $200 million in economic impact in this community. These cuts will undermine this and drastically affect our community, economy and employers. The proposed cuts will negatively impact employers. This is a time for serious collaboration to protect our viability. In spite of these declining reimbursements, Holy Family Memorial has continually focused on innovation and improvement to be flexible in recognizing and delivering the highest quality of care to Manitowoc County. Dr. Steven Driggers, our chief medical officer, and I were recently appointed to a WHA committee on quality improvement to address the future of health care and continue to stay on top of future trends. You can get involved in the future of our healthcare in Manitowoc County by calling your member of Congress at (866) 887-CARE.

Mark Herzog, President & CEO, Holy Family Memorial in the Manitowoc Herald Times

Medicare payment cuts a bad solution
Simply cutting Medicare and Medicaid payments to doctors and hospitals is not a viable, long-term solution to the rising costs of health care. That response simply shifts costs from one payer to another. When Medicare and Medicaid pay less for health care, private sector employers and employees bear the cost. . . At ThedaCare, we’ve been redesigning care to deliver better quality at lower cost for 20 years. Studies are showing that Medicare costs per beneficiary in the counties we serve are among the lowest in the United States. If more people in the United States received the kind of care we deliver at ThedaCare, our nation could save billions. Reform in Medicare and Medicaid should focus on value — the quality of the care delivered in relationship to its cost. Cutting payments to hospitals is an easy, short-sighted response. We urge members of Congress to adopt a long-term solution that requires better care delivery, and pays for it.

Dean Gruner, Chief Executive Officer, ThedaCare, in the Appleton Post Crescent

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In Letter to Boehner, Duffy Supports Rural Hospitals

The following letter sent by Rep. Sean Duffy to House Speaker John Boehner July 27 is a direct result of efforts by local hospitals to relay concerns regarding potential Medicare/Medicaid cuts in debt ceiling/deficit negotiations. This past week hospital executives met virtually with Rep. Duffy at Ministry St. Joseph’s Hospital in Marshfield. Duffy has also met with other hospitals, including Wausau Aspirus and St. Joseph’s Hospital-Chippewa Falls. These efforts are part of WHA’s aggressive grassroots campaign.

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WHA Board Recognizes Quinn at Planning Session

After a long and distinguished career in health care finance, WHA Senior Vice President George Quinn announced his retirement. With more than 16 years of service to the Association, Quinn was recognized for his contributions to Wisconsin’s health care industry by the WHA Board at their annual Planning Session held July 21 in Green Lake.

Quinn served as WHA’s vice president of finance from 1978 through 1982 and rejoined the Association in 1999 as a senior vice president. His responsibilities at WHA were focused on health care finance policy, health reform, cost and payment issues, as well as quality. Most notably, Quinn has authored three landmark reports on Wisconsin’s physician workforce, focusing on the future supply. Quinn will continue in a consulting capacity to co-lead WHA’s work in this area with WHA Senior Medical Advisor Chuck Shabino, MD.

Over his career, Quinn also served in senior financial management positions for DeanCare HMO and Physicians Plus Insurance Company, director of operations with Affiliated University Physicians, and senior manager for Ernst & Young, management consultants.

"George Quinn has been a valuable resource for WHA members and staff. His knowledge of our industry, his guidance on policy issues and his keen understanding of health care finance have been assets to WHA for more than a decade," according to WHA President Steve Brenton. "We are very pleased that he will continue to work with us on the physician workforce issue, at the same time, respecting the fact that he should enjoy his retirement with his wife Connie in the years ahead. We thank him for his service and wish him well in the future."

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Federal Medicaid EHR Incentive Program to Begin in August

On July 27, the Department of Health Services (DHS) released two separate Forward Health Updates that provide guidance on implementation of the federal Medicaid EHR Incentive Program. Guidance for hospitals can be found at https://www.forwardhealth.wi.gov/kw/pdf/2011-39.pdf, and guidance for physicians can be found at https://www.forwardhealth.wi.gov/kw/pdf/2011-40.pdf. Look for additional guidance and FAQs from DHS and WHA in the coming weeks.

Key information in the Forward Health Update for hospitals includes:

Additional information about the Medicaid EHR Incentive Program and the Medicare EHR Incentive Program, including the Forward Health Update, can be found on WHA’s Web site at www.wha.org/toolKit/EHR.pdf.

For additional information or questions, please WHA’s Matthew Stanford at mstanford@wha.org or 608-274-1820.

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Brenton Shares "The Good, the Bad and Ugly" Aspects of Health Reform

Health reform may have taken a back seat to the debate over the debt ceiling and the federal deficit, but Wisconsin hospitals continue to prepare for its arrival.

Speaking at the WHA Board Planning Session July 21, WHA President Steve Brenton said health reform implementation is a top priority for the Association and that WHA has fine-tuned its advocacy efforts to: focus on Medicare payments that reward value; weigh in on the proposed accountable care organization regulations; and engage in issues related to care coordination and payment reform. In addition, WHA has been working closely with the Walker Administration as it establishes an insurance exchange.

Brenton said WHA has sponsored Webinars, written white papers, and published "Valued Voice" articles aimed at keeping the members informed as Congress, CMS and policy makers weave their way through the 2400-page health reform bill.

While the federal health reform bill is a massive document, Brenton said key themes emerge that he likes to categorize as, the good, the bad and ugly.

The Good:

The Bad:

The Ugly:

Brenton said hospitals have reduced costs by implementing lean management principles, increased quality by participating in statewide collaboratives, and improved the health of their own workforce through wellness initiatives that many have shared with local employers.

"The good news is Wisconsin hospitals are not waiting for health reform to make changes that will enable them to deliver on their mission to improve the health of the communities they serve," Brenton said.

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WHA Board Recognizes WCMEW Chair Getto at Board Planning Session

Carl Getto, MD, chair of the Wisconsin Council on Medical Education and Workforce (WCMEW), was recognized by the WHA Board July 21 in Green Lake for his leadership role on physician workforce issues. Getto, who is senior vice president for medical affairs at UW Hospitals and Clinics and associate dean for hospital affairs and professor of psychiatry at the UW School of Medicine and Public Health, announced he will leave UWSMPH to join the regional medical center ("The Med") affiliated with the University of Tennessee (UT) in Memphis as executive vice president and chief medical officer.

WHA first suggested creating a body similar to WCMEW in its 2004 physician workforce report. The Council would "monitor, predict and recommend activities to maintain an adequate supply of physicians for Wisconsin," according to the report. Formed later that year, Getto has chaired WCMEW since its inception.

"Carl has provided strong leadership and valuable guidance as chair of WCMEW," said WHA President Steve Brenton. "We appreciate his commitment to helping us address the challenge of ensuring that Wisconsin has an adequate physician workforce in the future. We wish him well in his new role in Tennessee."

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Economic Uncertainty, Health Reform Trigger Change in Wisconsin Hospitals

A panel of senior leaders shared what they are doing in their health systems to prepare for the challenge of health reform. The focus of many of their efforts is to achieve the "triple aim" of reducing costs, improving health outcomes, and improving population health.

Participating on the panel were Bill Sexton, CEO, Prairie du Chien Memorial Hospital; Ed Harding, President/CEO, Bay Area Medical Center; Nick Desien, President/CEO, Ministry Health Care; Nick Turkal, MD, President/CEO, Aurora Health Care; and Dan Neufelder, President/CEO, Affinity Health System.

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WHA Board Considers Physician Workforce Report at Annual Planning Session
Report provides recommendations, options for increasing physician supply

As the physician supply continues to lag behind the demand for their services, it is clear that Wisconsin’s health care leaders want to take action now to avert what many believe will be a shortage of historic proportion in Wisconsin within the next couple of decades.

At the 2011 WHA Board Planning Session held July 21 in Green Lake, the Board reviewed a WHA draft report that asserts Wisconsin will need an additional 100 new physicians each year to keep pace with demand.

The report was presented to the Board by WHA’s George Quinn and Chuck Shabino, MD. The report provides evidence-based projections of physician supply and demand in Wisconsin, evaluates potential options for meeting the anticipated demand, and recommends options for policy makers to pursue.

In his introductory comments, WHA President Steve Brenton said, "Shaping our health care future helps us to shape our own destiny. From the recent member survey, we focused on initiatives that rose to the top – high among those were two issues: physician workforce shortage and health care reform implementation."

Brenton added that in the past, the discussions that transpire at the Board Planning session have helped set the direction and policy for the successful implementation of initiatives that address the Association’s highest priorities.

WHA Chair-elect Sandy Anderson, president of St. Clare Hospital in Baraboo, led the Planning Session. Anderson, who has been instrumental in the development and operation of a rural residency program in her own hospital, commented that while in the past the concern was "who will care for our patients" the conversation must now be more inclusive to be one of "who will care for our communities?" Anderson emphasized that health care extends well beyond the hospital campus and physicians play a critical role not only in clinical care, but also in the broader issue of improving population health.

The Board reviewed the recommendations outlined in the report, considered the options that are now available and new ones proposed in the report that could help address the physician shortage, and provided valuable feedback. One of the primary concerns moving forward is how to create more opportunities for residencies and clinical experiences in Wisconsin.

WHA Chair Nick Turkal, MD, commented that while many hospitals are now expending their own resources to fund residencies and clinical training opportunities, those efforts and more will be necessary in the future as federal resources become minimal or cease to exist to fund medical education.

Turkal suggested that an inventory be taken of residency and clinical training programs that are available in Wisconsin now to ensure that sufficient opportunities are available in the future to attract and retain medical students and physicians-in-training in Wisconsin.

Moving forward, Brenton said staff will incorporate the ideas and recommendations that were discussed at the Board Planning Session into a draft of a final WHA report. The Board also asked that WHA staff meet with stakeholders to get additional feedback. Brenton said staff will present their findings at the October Board meeting in Madison.

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WCMEW Reviews Preliminary WHA Physician Workforce Report

As the Wisconsin Council on Medical Education considered the draft WHA physician workforce report, it was clear that it will encourage a lively debate among stakeholders on just how the challenge of ensuring Wisconsin has enough physicians will be met. While the WCMEW members of Council raised questions about how best to proceed, there was consensus that aggressive action must be taken to avert a statewide crisis. And soon…for every year that no action is taken, the shortage of physicians becomes more acute.

All members agreed that the report, presented by WHA’s George Quinn and Chuck Shabino, MD, provided a good outline of the workforce issues, while offering options and opportunities that could be available to address the shortage. The necessity to grow the physician workforce is evident as health reform combined with an aging population could fuel the demand for medical care.

At what would be his last meeting as WCMEW Chair (see related story page 7), Carl Getto, MD, praised the report for being what he called one of the best reports of its kind he has seen in recent years. WCMEW will meet in October to further discuss the report.

In other action, WHA’s Judy Warmuth reported that the Medical Examining Board turned down a proposal that would have increased the number of physician assistants that a physician could supervise from the current two to five.

Rebecca Thompson, director of the Wisconsin Medical Society Foundation, said the Society is seeking more opportunities to place medical students in summer internships in Wisconsin hospitals. WHA staff agreed to help by promoting the internships among its members in future issues of The Valued Voice.

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AHIMA Releases Top 10 List: Phase 2 – ICD-10 Implementation Preparation
Time Frame: First Quarter 2011-Second Quarter 2013

The implementation date for ICD-10 has been established as October 1, 2013 and CMS has reiterated that the date will not be delayed (www.cms.gov/ICD10/Downloads?ICD-10MythsandFacts.pdf). This is a wide-reaching regulation that impacts financial and clinical systems and operations throughout health care, payer and vendor organizations. In early 2011, Phase 1 of the ICD-10 Implementation Plan should have come to a close in organizations, and Phase 2, ICD-10 preparation should have begun. It is important to note that ICD-10, 5010 and meaningful use implementation are not mutually exclusive; it is critical to work on all of these projects simultaneously as they are integrated and support each other. AHIMA and other associations recommend that organizations do not dedicate exclusive time and resources to completing 5010 and meaningful use and then expect to start working on ICD-10 afterwards, because the implementation of ICD-10 requires as much time as possible to complete all steps in each of the four phases by 2013.

The Top 10 List: Phase ICD-10 outlines tasks to help facilitate this process. Senior management should take an active leadership role in this project by offering direction through a steering committee and allocating resources with those involved in ICD-10 implementation. The steps are to continue impact assessment and initiate resolution, continue to evaluate the effect on data analysis, monitor business associate readiness (including payers, providers, system vendors, and electronic data interchange trading partners), implement the training/education plan identified during the impact assessment, update and reassess the project, continue to assess clinical documentation practices, review the potential reimbursement impact during transition, develop risk mitigation strategies to minimize transition problems and maximize opportunities for successful transition, develop a strategic plan to prevent decreased coding productivity and accuracy and expand the ICD-10 communication plan.

More detailed information on each step listed above is available at www.ahima.org/downloads/pdfs/resources/checklist.pdf.

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Transforming Care at the Bedside Site Visits Continue

WHA’s Judy Warmuth, vice president, workforce, has been conducting site visits at the 18 medical-surgical nursing units participating in the Transforming Care at the Bedside project (TCAB). The major purpose of a site visit is to ensure that each team has successfully launched TCAB on their unit, but it is also an opportunity for TCAB site to ask for assistance and learn about initiatives from other participating units. Last week visits were made to Stoughton Hospital and Prairie du Chien Hospital.

EMR installation at Stoughton Hospital delayed the beginning of TCAB activities at until May, but they have been very busy since that time. The team has implemented an ‘all about me’ project which introduces the patient and his or her interests to staff as they enter the room. Health unit coordinators are interviewing patients for that project. The TCAB team has had discussions about the relationship between TCAB and their shared governance model and handed one project off to their unit council. Next, they plan to improve dietary tray delivery.

The TCAB team at Prairie du Chien held a "snorkel" and has over 200 ideas from that event. They have reorganized storage rooms and supply spaces in patient rooms. Largest goal and project is bedside report. They have done small trials and have made a video to demonstrate how they would like a report completed.

The number of creative workplace projects, ideas and solutions reported at these site visits is amazing. Site visits continue to prove that the TCAB teams are showcasing their actions and making progress on the quest to improve care at the bedside.

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Two Wisconsin Health System Leaders Named to AHA Board of Trustees

Former WHA Chair Mary Starmann-Harrison, president/CEO of Hospital Sisters Health System, which has five hospitals in Wisconsin, and Donna Katen-Bahensky, president/CEO of the University of Wisconsin Hospitals and Clinics in Madison, were among eight new board members elected to the AHA Board of Trustees for terms beginning January1. The Board of Trustees is the policy-making body of the AHA and has ultimate authority for the governance and management of its direction and finances.

"These two health executives both have a clear understanding of the changing nature of our industry and will be knowledgeable contributors to discussions that will lay the groundwork for AHA’s federal advocacy efforts," according to WHA President Steve Brenton. "We are very pleased that Wisconsin will be well represented on the AHA Board, and we look forward to having this connection."

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Last Chance for Hospitals to Register for Concealed Carry Webinar

WHA is holding a webinar to provide hospitals with an overview of the new concealed carry law on Wednesday, August 3, from 12:00 to 12:30 PM. To attend the webinar you must register at http://events.SignUp4.com/ConcealCarry.

Space on the webinar is limited. If multiple individuals from your hospital wish to participate in this webinar, please arrange to call in to the webinar using a single phone line.

WHA has also created a summary of key aspects of the law as well as model signage that hospitals may choose to use or modify. The summary and model signage can be found at: www.wha.org/SummaryKeyIssuesConcealedCarryAct7-11.pdf and www.wha.org/NoWeaponsPoster.ppt.

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Milwaukee Health Care Partnership Receives National Recognition
Partnership Wins the AHA NOVA Award

The Milwaukee Health Care Partnership (MHCP) has received this year’s American Hospital Association’s (AHA) NOVA Award for its hospital-led efforts to improve community health. One of only five health care collaboratives being honored for making a difference in the lives of the most vulnerable in their communities, the partnership was recognized July 19 at the Health Forum / AHA’s Leadership Summit in San Diego.

Since 2007, the Milwaukee Health Care Partnership has brought together health care providers, government agencies and community organizations to increase access to quality health care, improve health outcomes and reduce disparities in Milwaukee’s low-income and uninsured populations. Founded by the CEOs of Aurora Health Care, Children’s Hospital and Health System, Columbia St. Mary’s, Froedtert Health and Wheaton Franciscan Healthcare, the MHCP now includes the executive leadership of the Medical College of Wisconsin, the four Federally Qualified Health Centers in Milwaukee, the State of Wisconsin Department of Health Services, the Milwaukee County Department of Health and Human Services, and the City of Milwaukee Health Department.

With a focus on ensuring health care coverage, improving access to health care providers and services, and enhancing care coordination for Milwaukee’s vulnerable populations, the MHCP is helping to improve health while reducing the total cost of care to patients, providers and payers. "The partnership demonstrates that working together is essential," says William D. Petasnick, CEO of Froedtert Health and MHCP board chair. "A single health system can’t do it alone, but the partnership is able to tackle complex issues because we have all the right stakeholders at the table."

An example of the partnership’s success is its emergency department care coordination work, where emergency department patients without primary care physicians are connected to a Federally Qualified Health Center (FQHC) for ongoing care. A massive effort involving physicians, social workers, case managers and administrators across 10 emergency departments and four FQHCs, the program provides each patient with a follow-up appointment and real-time information sharing among their care providers. Aided by the Wisconsin Health Information Exchange, ED physicians utilize a web-based tool to communicate with each other and the community clinics to coordinate and improve care for low income and uninsured patients.

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Wisconsin Hospitals Community Benefits: Acute, Chronic and Communicable Disease Prevention and Control

Hospitals are well aware of the critical role they have in protecting public health. Whether it is working with public health agencies to develop protocols and responses to pandemic flu outbreaks, teaching children proper hand-washing techniques or educating people about how to live with chronic conditions, Wisconsin hospitals partner with key stakeholders to improve the health status of their communities.

Free seminar helps Allis find the right treatment

Gary Allis was just about out of options. The 67-year-old had been dealing with atrial fibrillation (a-fib) for more than five years and all the treatments and medications he tried to treat the condition were unsuccessful.

A-fib is a common heart condition where a faulty electrical impulse causes the heart to beat irregularly and greatly increases a person’s risk for stroke. While the condition doesn’t pose an immediate risk to people who have it, Allis was growing tired of always waiting for the next episode to happen.

"When you have a-fib, there’s always something looming and you never knew when the next episode would hit," he said. "I have five daughters and seven grandkids, but when they visited I couldn’t even play with them because I’d have to go lie down in bed when an episode hit."

Thinking he had exhausted all the treatment options available near his home in northern Wisconsin, Allis was prepared to try just about anything, including travel to Ohio, one of few places in the country to offer a progressive surgical treatment called minimally-invasive Maze, or mini-Maze. The procedure is performed by fewer than 50 physicians in the country, so Allis figured such a procedure wouldn’t be available close to home.

About a year ago, however, Allis received some information about a free a-fib seminar in Rhinelander presented by Aspirus surgeon John Johnkoski, M.D. Allis attended the seminar and discovered that Dr. Johnkoski offered the mini-Maze procedure in Wausau.

"After the seminar he wouldn’t stop talking, he was so excited," said Allis’ wife Ruth.

Shortly after the seminar, Allis made an initial appointment with Dr. Johnkoski, who determined that Allis was in fact a candidate for the procedure. In June, 2010, Allis underwent the mini-Maze procedure at Aspirus Wausau Hospital and is now off all medications and hasn’t had an a-fib episode in more than 11 months.

"I have my life back, and I’m not faced with any more worries because of a-fib," Allis said. "I was surprised I was able to get back to a normal life so quickly, and it’s relief not to have to take all those meds."

Aspirus Wausau Hospital

Could you pass the self-motivation, please?

George Quillen of Beloit is the ideal patient—the type of person that every doctor or educator would like to see. He listens, processes and then gets right to work changing his lifestyle. Three years ago, he participated in Beloit Health System’s nine-hour Diabetes Education Series, and now there’s no stopping him.

Beloit offers a variety of diabetes education opportunities. There is the Diabetes Self-Management Series, as well as two free diabetes education programs; a quarterly support group and a new pre-diabetes class. George was so extremely pleased with his class experience that he faithfully attends all of the free support groups. (He’s only missed one in three years.)

"I learn so much from the instructors, but also from other attendees," George admits. "I can’t tell you how learning about my chronic illness has changed my life. I’ve lost over 50 pounds, changed my diet, lowered my A1-C from 6.6 to 5.5 and feel great!" At 86, George sees a lot of his friends choosing to complain or take high quantities of medication, rather than change the way they eat or care for themselves. He tries to motivate others to attend the free support groups with him. "I want them to see there is something they can do!"

"I see many of those who live in senior housing with me lose their toes, feet or legs to the ravages of diabetes, but I don’t want that to happen to me," he explains. "I have developed a meal plan that gives me 45 carbs for breakfast and 65 carbs for lunch and dinner. I have 40-50 meals that are less than 300 calories. This way, I can stay within my parameters." George also walks several miles a day, uses a Theraband four times a week, cooks for himself, charts his blood sugar and blood pressure and converts his favorite recipes to a healthier version. (Oh yes, and he writes western novels and children’s books in his spare time…)

"I wish others could see there is something they can do to improve their health," he adds. ‘"I greatly thank the Beloit Health System diabetic educators and my doctor for letting me know how to manage my disease. It’s made a big, big difference!"

Now that’s motivation.

Beloit Health System

Community-based settings help people manage chronic high blood pressure

AB is one of the cheerful parishioners at Cross Lutheran Church in Milwaukee who regularly checked in with the Aurora parish nurse and the Bread of Healing Clinic located there. He is the type of person everyone turns to for everything from how to handle finances to gardening issues. He is known for his generous willingness to help individual members of the community.

Over the past year, AB’s blood pressure had been slowly rising, and the Aurora parish nurses who monitored him were persistent in reminding him to see a doctor about it.

But AB could not be persuaded. He responded, "I will increase my exercise and find ways to decrease my stress rather than see a doctor."

Despite his positive health behavior changes, AB continued to experience an increase in his blood pressure. Then last summer, AB told the parish nurse that he had a one-time episode of tiredness and shortness of breath that lasted about 15 minutes, which occurred after he started mowing the lawn. It passed quickly and did not recur.

The parish nurse was stern. She warned him that his body was signaling a red flag for him to immediately see a doctor, which he then agreed to do. The doctor ordered a stress test and discovered blockages of 70 percent to 99 percent in five vessels of the heart.

AB underwent surgery to correct the problem and is nearly back to his normal routine of actively helping the community. He told his parish nurse, "Thank you for staying on my case and helping me find the underlying problem. Without your constant concern and reminders, I would not have followed up on my high blood pressure."

Aurora Health Care, Milwaukee

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

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

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