October 23, 2015
Volume 59, Issue 42

Fee Schedule Off the Table in Worker’s Compensation Advisory Committee Negotiations
Labor reps propose directed care pilot; Management and Labor agree on several other proposed policy changes 

On October 21, 2015, the Worker’s Compensation Advisory Committee (WCAC) met for about 13 hours to negotiate several proposed changes to the Wisconsin Worker’s Compensation Program, absent a fee schedule or other medical cost management mechanism. 

At the beginning of the meeting, the Management representatives announced they were withdrawing their proposal for a fee schedule and/or medical cost management council. Jeffrey Beiriger, speaking on behalf of the Management representatives, indicated that opposition to the fee schedule last year resulted in the entire proposal being dismissed. Beiriger said it would be “irresponsible not to recognize that other policy changes are important and need to advance.” Beiriger made it clear, however, that the discussion is delayed for this session, but is still an important issue for them. 

Joanne Alig, WHA senior vice president for policy & research, said WHA is pleased that a fee schedule or a variation of a fee schedule is not part of the proposal this year. “We wholeheartedly continue to oppose any policy that would artificially set prices, as that does nothing to reduce the underlying cost of the program and instead complicates an already complex system,” she said. 

Directed Care Pilot Proposed: Labor and Management Not in Agreement
The Labor members of the WCAC proposed a directed care pilot program that would limit choices of providers for employees who are injured on the job. As the project was a fairly new concept, Labor agreed to draft language separate from the rest of the agreed-to provisions, and Management agreed to consider the proposed language further. Labor and Management did not agree to include this pilot project in the agreed-to proposal at this time. 

As described at the meeting, the pilot would apply to a limited group of workers in highway and other heavy construction, with employers who have a contract with the Department of Transportation, and employees who are part of a bargaining unit. The program would sunset after five years. The bargaining unit and employer would agree on the terms of the directed care. Data on the outcomes of the pilot would be gathered and submitted annually to the WCAC for evaluation. The Management members of the WCAC indicated they prefer a broader take on directed care, applying it to all injured workers. 

Agreement Reached on Several Policies
In the end, several policies were agreed upon. The Department of Workforce Development (DWD) is working to put these agreed-to policies into a proposed bill draft that will be reviewed by the WCAC at their next meeting in November. Once the language in the bill has been agreed to by the Council, it is expected to be forwarded to the Legislature for consideration. 

Policies that were agreed upon by the full Committee include: There were several other changes that were agreed to as well. For a full list of the provisions, see WHA’s summary at: www.wha.org/pdf/WHASummary-WCAC10-21-15.pdf.

Related News: Worker’s Comp Bill Circulated in State Legislature
In related news, on October 22, State Rep. John Spiros (R-Marshfield), Rep. Dan Knodl (R-Germantown) and Sen. Duey Stroebel (R-Saukville) circulated draft legislation, not yet introduced, that would make various changes to Wisconsin’s Worker’s Compensation law. Most notably, the draft does not include a fee schedule or medical cost management council, but does include two provisions related to directed care in the program. WHA is currently analyzing these policy provisions to determine their potential impact for providers. The bill can be found at www.wha.org/pdf/LRB1786.pdf

Top of page (10/23/15)

Key Senate Committee Hears Physician Licensure Compact Bill
Hartberg: Aging physician workforce could create access challenges

The Senate Health and Human Services Committee met October 22 to take public testimony on legislation adopting the Interstate Medical Licensure Compact in Wisconsin, an initiative that would create an expedited process for pre-qualified physicians licensed in other states to receive a Wisconsin medical license. The legislation, Senate Bill 196, authored by Sen. Sheila Harsdorf (R-River Falls) and Rep. Nancy VanderMeer (R-Tomah), would enact a licensure Compact that has so far been adopted by Iowa, Illinois and Minnesota along with eight other states throughout the country. 

Gundersen Boscobel Area Hospital and Clinics CEO David Hartberg and WHA General Counsel Matthew Stanford testified in favor of the legislation during the Committee meeting. Hartberg, who testified for the first time in front of a state legislative committee, provided the Committee with first-hand knowledge of what this legislation might mean for the community that his hospital serves.

“The average age of a practicing physician in our organization is 63 years old, so we will be needing to recruit additional physicians to my community very soon to replace a retiring physician workforce,” said Hartberg. “The Compact will allow us to more quickly license physicians who we successfully recruit to our community from another state.”

Hartberg also discussed the challenges of recruiting physicians to rural Wisconsin, citing studies that indicate only five percent of graduating medical students wish to practice in communities of less than 10,000 people.

Stanford went on to testify about provisions in the Compact legislation, citing the voluntary nature of the proposal and the taxpayer protections that exist in the bill. SB 196 would require that any costs to participate in the Compact must be borne by those physicians choosing to be licensed through the Compact process.

Senate Health and Human Services Committee Chair Sen. Leah Vukmir (R-Wauwatosa), discussed some concerns that she has had with the legislation. To accommodate for those concerns, Vukmir announced in the public hearing that she has introduced an amendment to the bill that would make three changes to the legislation. The first would require that any rules established by the Compact Commission must be given to the Joint Committee on Finance in a report. The second change would require that the two Compact Commission members representing Wisconsin receive Senate confirmation, instead of simply being chosen by the Medical Examining Board. The final provision of the amendment would require that the Compact be reviewed by the Legislature within four years of the effective date of the bill.

When asked if WHA would support Vukmir’s amendment, Stanford said “We are supportive of the amendment to the extent that the bill moves forward and is enacted this year.”

Top of page (10/23/15)

Guest Column: Support for the Interstate Medical Licensure Compact
By State Senator Howard Marklein (R-Spring Green)

The Interstate Medical Licensure Compact is a new, voluntary licensing option by which physicians who wish to practice in multiple states would be eligible for an expedited licensing process in participating states. Under the U.S. Constitution, states are able to enact their own compacts for shared interests while retaining individual state authority over licensing and regulation of professions. Iowa, Illinois and Minnesota are among the 11 states that have already enacted the Compact into law.

Participation in this Compact would be strictly voluntary for physicians. State medical boards would continue to retain authority over licensing and discipline of physicians in their own states. In Wisconsin, the Interstate Medical Licensure Compact has received broad support from the medical community, including hospitals, physicians and clinics.

This proposal would be especially beneficial for physicians in Wisconsin because 10,391 of these physicians are licensed in multiple states, which is a higher proportion than the national average. By streamlining the licensure process, Wisconsin can continue to attract high-quality physicians. This compact would give them the flexibility to practice in multiple states while giving the opportunity for physicians in other states to practice in Wisconsin. 

The vast majority of the 17th Senate District is rural. The Senate District I represent is one of the largest in the State of Wisconsin, with all or parts of nine counties. The southern part of the district borders Iowa and Illinois and runs to the top of Juneau County. It is critical that my constituents in these nine counties receive the health care they need, given the rural nature of our communities. This benefits my constituents, who may see doctors who are licensed to practice in Iowa, Illinois and Wisconsin. It can be difficult attracting young physicians to rural areas to practice medicine. I want to make it easy for our rural hospitals to recruit physicians from other states.

Assembly Bill 253 boasts a broad range of bipartisan support, with 77 legislators that have signed onto the bill. The bill has passed the State Assembly by an overwhelming margin of 95-1. It awaits action by the State Senate. I hope to see our House act on it very soon. Wisconsin can be a leader in health care by being one of the first 12 states to enact this important compact. I support this legislation and ask my colleagues in the Senate to do the same.

Howard Marklein is the State Senator for the 17th Senate District of Wisconsin. He represents all of Lafayette, Grant, Juneau and Richland Counties and parts of Sauk, Iowa, Green, Monroe and Vernon Counties.

Top of page (10/23/15)

Wisconsin Hospitals State PAC & Conduit Campaign Update
$53,000 Left to Reach 2015 Goal

Over the last two weeks, the 2015 Wisconsin Hospitals State PAC and Conduit Campaign has added 13 contributors and raised an additional $17,000 to bring the campaign’s total to $217,356. The Campaign is now at 80 percent of the annual goal to raise $270,300 by year’s end.

The average contribution is $805. So far 270 individuals have joined together to support this year’s annual campaign. Thank you to those who are listed on page 12 by name and affiliated organization by contribution amount category. The next publication of the contributor list will be in the November 6 edition of The Valued Voice

For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

Contributors Ranging from $1 - $499  
Aittama, Craig Ministry - St. Michael's Hospital
Alstad, Nancy Fort HealthCare
Anderson, Phil Sacred Heart Hospital
Appleby, Jane Aurora Health Care
Ballentine, Anne Wheaton Franciscan Healthcare
Bayer, Tom St. Vincent Hospital
Bard, Jeffrey Aurora Medical Center - Oshkosh
Bisterfeldt, Joan Wheaton Franciscan Healthcare
Bollig, Dale SSM - St. Mary's Hospital
Brenny, Terrence Stoughton Hospital
Brisch, Donald Holy Family Memorial
Bunten, Sherry Aspirus Langlade Hospital
Cardinal, Lori Agnesian HealthCare
Carlson, Dan Aurora - Bay Area Medical Center
Carter, Shane Aurora Medical Center - Oshkosh
Clark, Julie HSHS - St. Joseph's Hospital
Clark, Renee Fort HealthCare
Cliffe Kucharski, Elizabeth Wheaton Franciscan Healthcare
Collins, Sherry Wisconsin Hospital Association
Colman, Gerard Aurora Health Care
Coniff, Barbara HSHS - St. Mary's Hospital Medical Center
Coopman, Dianne St. Mary's Janesville Hospital
Cormier, Laura Bellin Hospital
Culotta, Jennifer St. Clare Hospital & Health Svcs
Curran-Meuli, Jane Holy Family Memorial
Danner, Forrest Aspirus Wausau Hospital
Davidson, Lisa Wisconsin Primary Health Care Association
Dettman, Amy Bellin Hospital
Donlon, Marcia Holy Family Memorial
Dube, Troy Chippewa Valley Hospital
Dux, Larry Froedtert & MCW Community Mem. Hosp
Dwyer, Maxine SSM - St. Mary's Hospital
Evans, Kim Bellin Hospital
Feeney, John Community Health Network, Inc.
Fielding, Laura Holy Family Memorial
Freitag, Vanessa                       Our Lady of Victory Hospital
Gagnon, Annette HSHS - Eastern Wisconsin Division
Grundstrom, David Ministry - Flambeau Hospital
Gullicksrud, Lynn Sacred Heart Hospital
Gutsch, Mike Cumberland Healthcare
Hafeman, Paula St. Vincent Hospital
Halida, Cheryl HSHS - St. Joseph's Hospital
Hamilton, Mark UW Hospitals and Clinics
Harasim, Edward Wheaton Franciscan Healthcare
Harrington, Kathleen Mayo Health System - Eau Claire
Helgeson, Jason HSHS - Eastern Wisconsin Division
Hernandez, Terri HSHS - St. Joseph's Hospital
Herzog, Sarah Wheaton Franciscan Healthcare
Hofer, John Bay Area Medical Center
Jelle, Laura St. Clare Hospital & Health Services
Kaufmann, Marilyn Holy Family Memorial
Kelsey Foley, Kathy Aspirus Wausau Hospital
Kempen, Jacob Aspirus Wausau Hospital
Klay, Chris HSHS - St. Joseph's Hospital
Klay, Lois HSHS - St. Joseph's Hospital
Knutzen, Barbara Agnesian HealthCare
Koebke, Troy Bellin Hospital
Krueger, Kari St. Mary's Janesville Hospital
LaBarge, Margie Ministry Health Care
Lampman, Sandra St. Mary's Hospital
Leschke, John Mercy Medical Center
Lynch, Sue Mayo Health System - Franciscan HC
Maurer, Mary Holy Family Memorial
Mays, Laura Stoughton Hospital Association
McArdle, PeggyAnn Agnesian HealthCare
McMeans, Scott Holy Family Memorial
Mercer, Carla Reedsburg Area Medical Center
Merrick, Marianne SSM - St. Mary's Hospital
Miller, Thomas Children's Hospital of Wisconsin
Nevers, Rick Aspirus, Inc.
Nicklaus, Todd Aspirus, Inc.
O'Hara, Tiffanie Sundial Software
Olson, Bonnie Sacred Heart Hospital
Ordinans, Karen Children's Hospital of Wisconsin
Ostrander, Gail HSHS - Eastern Wisconsin Division
Palecek, Steve HSHS - St. Joseph's Hospital
Peck, Lori Aspirus, Inc.
Peiffer, Susan Sacred Heart Hospital
Pempek, Kalynn Aspirus Wausau Hospital
Penovich, Carrie Aurora Medical Center - Two Rivers
Pritchard, Paul Prevea Health/HSHS
Radke, Chad Aspirus Wausau Hospital
Range, Bonnie Holy Family Memorial
Revnew, Dorothy ProHealth Care - Oconomowoc Memorial Hospital
Richman, Tim Affinity Health - Calumet Medical Center
Riddle, Roberta Rusk County Memorial Hospital
Rocheleau, John Bellin Health
Roethle, Linda Bellin Memorial Hospital
Roundy, Ann Columbus Community Hospital
Rudquist, Debra Amery Hospital & Clinic
Schaetzl, Ron SSM - St. Clare Hospital & Health Services
Schneider, David Aspirus Langlade Hospital
Schubring, Randy Mayo Health System - Eau Claire
Sciuti, Jennifer Aurora Health Care
Selle, Ginger St. Clare Hospital & Health Services
Sio, Tim Wheaton Franciscan - All Saints
Statz, Darrell Rural Wisconsin Health Cooperative
Stelzer, Jason St. Clare Hospital & Health Services
Strasser, Kathy Aspirus, Inc.
Strobel, Victoria Marshfield Clinic
Swanson, Kaitlin HSHS - Eastern WI Division
Tandberg, Ann HSHS - St. Joseph's Hospital
Tapper, Joy Milwaukee Health Care Partnership
Theiler, Brian Gundersen Tri-County Hospitals & Clinics 
Thornton, Eric SSM - St. Mary's Janesville Hospital
Van Abel, Lois Bellin Hospital
Vergos, Katherine Agnesian - Ripon Medical Center
Voelker, Thomas Aspirus Wausau Hospital
Waldoch, Timothy Columbia St. Mary's Inc.
Walker, Troy St. Clare Hospital & Health Services
Werkheiser, Cindy Monroe Clinic
Wheeler, Susan St. Nicholas Hospital
Whitinger, Margaret Agnesian HealthCare
Wipperfurth, Kay Fort HealthCare
Wold, Gwen Amery Regional Medical Center
Contributors Ranging from $500 - $999
Anderson, Layton Ministry - St. Joseph's Hospital
Bagnall, Andrew St. Nicholas Hospital
Bailet, Jeffrey Aurora Health Care
Deich, Faye HSHS - Sacred Heart Hospital
Dexter, Donn Mayo Health System - Eau Claire
Dicus-Johnson, Coreen Wheaton Franciscan Healthcare
Dietsche, James Bellin Hospital
Dolohanty, Naomi Aurora Health Care
Ericson, Allen Froedtert & MCW HSHS - St. Joseph's Hospital Campus
Frangesch, Wayne Wheaton Franciscan Healthcare
Freimund, Rooney Bay Area Medical Center
Furlong, Marian Hudson Hospital & Clinics
Golanowski, Marie Aurora St. Luke’s Medical Center
Graul, Mark Children’s Hospital of Wisconsin
Gullingsrud, Tim Hayward Area Memorial Hospital & Nursing Home
Gustafson, Andy SSM Health Care-Wisconsin
Hanson, Gail Aurora Health Care
Heaney, Dwight Fort HealthCare 
Jablonski, James Children's Hospital of Wisconsin
Jacobson, Terry St. Mary’s Hospital of Superior
Jensema, Christine HSHS-Eastern Wisconsin Division
Kersten, Juliet Children's Hospital of Wisconsin
Kingston, Mary Beth Aurora Health Care
Kirsch, Jennifer Gundersen Health System
Korom, Nancy Children's Hospital of Wisconsin
Kostroski, Sharon Ministry - St. Joseph's Hospital
Lange, George Westgate Medical Group, CSMCP
Larson, Margaret Mercy Medical Center
Latta, Richard Godfrey & Kahn, SC 
Lindberg, Steve Mayo Clinic Health System - Red Cedar
May, Carol Sauk Prairie Memorial Hospital
McNally, Maureen Froedtert & MCW
Mohorek, Ronald Ministry Health Care
Mulder, Doris Beloit Health System 
Nelson, James Fort HealthCare
O’Day, Thomas Godfrey & Kahn, SC
Oland, Charisse Rusk County Memorial Hospital
Ose, Peggy Riverview Hospital Association 
Peterson, Douglas Chippewa Valley Hospital
Pollard, Dennis Froedtert & The Medical College of Wisconsin
Quinn, George Wisconsin Hospital Association
Reardon, Brian Hospital Sisters Health System
Richards, Theresa Ministry - St. Joseph's Hospital
Rocole, Theresa Wheaton Franciscan Healthcare
Roesler, Bruce The Richland Hospital
Rohrbach, Dan Southwest Health Center
Rozenfeld, Jon St. Mary’s Hospital - Madison
Rude, Nels The Kammer Group
Sczygelski, Sidney Aspirus Wausau Hospital
Seitz, Verna ProHealth Care, Inc.
Selberg, Heidi HSHS-Eastern Wisconsin Division
Shabino, Charles Wisconsin Hospital Association
Shorter, Tom Godfrey & Kahn, SC
Simaras, Jim Wheaton Franciscan Healthcare
Sisney, Mary Children's Hospital of Wisconsin
Smith, Gregory Wheaton Franciscan Healthcare
Stern, Robert Wheaton Franciscan Healthcare
Stuart, Philip Tomah Memorial Hospital
Teigen, Seth St. Mary’s Hospital 
Thurmer, DeAnn Waupun Memorial Hospital
Van Court, Bernie Bay Area Medical Center
Van Meeteren, Bob Reedsburg Area Medical Center
Yaron, Rachel Ministry St. Clare’s Hospital
Zenk, Ann Ministry St. Mary’s Hospital
Contributors Ranging from $1,000 - $1,499
Ashenhurst, Karla Ministry Health Care
Bagemihl, Katherine Froedtert & The Medical College of Wisconsin
Bedwell, Elizabeth Children's Hospital of Wisconsin
Bloch, Jodi Wisconsin Hospital Association
Brenton, Andrew Wisconsin Hospital Association 
Connors, Larry St. Mary's & St. Vincent Hospital
Cullen-Schultz, Jeannie JP Cullen & Sons
Geboy, Scott Hall, Render, Killian, Heath & Lyman
Geraghty, Tricia Children's Hospital of Wisconsin
Gorelick, Marc Children's Hospital of Wisconsin
Gunn, Veronica Children's Hospital of Wisconsin
Gutzeit, Michael Children's Hospital of Wisconsin
Just, Lisa Aurora Health Care-South Region
Killoran, Carrie Aurora Health Care
Lentz, Darrell Aspirus Wausau Hospital
Lewis, Jonathan St. Mary's Hospital 
McCawley, Thomas Beloit Health System
McGowan, Kathryne Aspirus, Inc.
Punzenberger, Lindsay Children’s Hospital of Wisconsin 
Radoszewksi, Pat Children's Hospital of Wisconsin
Rakowski, Mark Children's Hospital of Wisconsin
Reynolds, Sheila Children’s Hospital of Wisconsin 
Rickelman, Debbie WHA Information Center
Robertstad, John ProHealth Care - Oconomowoc Memorial Hospital
Roller, Rachel Aurora Health Care
Rush, Steven Wisconsin Hospital Association
Sanders, Robert Children's Hospital of Wisconsin
Sato, Thomas Children’s Hospital of Wisconsin
Schafer, Michael Spooner Health System
Schmidt, Cheryl Affinity Health - St. Elizabeth Hospital
Shanahan, Thomas Children's Hospital of Wisconsin
Swanson, Kerry St. Mary’s Janesville Hospital
White-Jacobs, Mary Beth          Black River Memorial Hospital
Wolf, Edward Lakeview Medical Center
Contributors Ranging from $1,500 - $1,999
Boese, Jennifer Wisconsin Hospital Association 
Clapp, Nicole Grant Regional Health Center 
Coffman, Joan HSHS - St. Joseph's Hospital
Court, Kelly Wisconsin Hospital Association 
Decker, Michael Divine Savior Healthcare 
Dotson, Jason Beloit Health System
Frank, Jennifer Wisconsin Hospital Association 
Grasmick, Mary Kay Wisconsin Hospital Association 
Heywood, Matthew Aspirus, Inc.
Harding, Edward Bay Area Medical Center
McKevett, Timothy Beloit Health System
Natzke, Ryan Marshfield Clinic 
Nauman, Michael Children's Hospital of Wisconsin
Olson, David Froedtert & The Medical College of Wisconsin
Russell, John Columbus Community Hospital 
Schulze, Connie Ministry Health Care 
Sexton, William Crossing Rivers Health Medical Center
Sheehan, John UW Hospitals and Clinics
Wallace, Michael Fort HealthCare
Contributors Ranging from $2,000 - $2,999
Alig, Joanne Wisconsin Hospital Association
Anderson, Sandy St. Clare Hospital & Health Svcs
Duncan, Robert Children's Hospital & Health System
Herzog, Mark Holy Family Memorial
Hilt, Monica St. Elizabeth Hospital
Kachelski, Joe WI Statewide Health Info Network 
Kief, Brian Ministry - St. Joseph's Hospital
Leitch, Laura Hall Render
Levin, Jeremy Rural Wisconsin Health Cooperative 
Lewis, Gordon Burnett Medical Center 
Meyer, Daniel Aurora BayCare Medical Ctr Green Bay
Oliverio, John Wheaton Franciscan Healthcare
Pandl, Therese HSHS-Eastern Wisconsin Division
Potter, Brian Wisconsin Hospital Association
Potts, Dennis Aurora St. Luke’s Medical Center
Sanders, Michael Monroe Clinic 
Sliwinski, Ron UW Hospitals and Clinics
Stanford, Matthew Wisconsin Hospital Association
Troy, Peggy Children’s Hospital of Wisconsin
Contributors Ranging from $3,000 - $4,999
Boatwright, Damond SSM Health Care-Wisconsin
Jacobson, Catherine Froedtert & The MCW 
Kammer, Peter The Kammer Group
Kerwin, George Bellin Hospital
Little, Steve Agnesian Health Care
Mettner, Michelle Children’s Hospital of Wisconsin 
Neufelder, Dan Ministry Health Care
Normington, Jeremy Mercy Medical Center
O’Brien, Kyle Wisconsin Hospital Association
Standridge, Deb Wheaton Franciscan Healthcare
Starmann-Harrison, Mary  Hospital Sisters Health System
Turkal, Nick Aurora Health Care
Contributors Ranging from $5,000+
Borgerding, Eric & Dana   Wisconsin Hospital Association
Brenton, Stephen Wisconsin Hospital Association
Size, Tim Rural Wisconsin Health Cooperative
Tyre, Scott Capitol Navigators, Inc.

Top of page (10/23/15)

Senate Passes Behavioral Health Legislation with Unanimous Vote
Senate Bill 293 receives 30-0 vote in State Senate, moves to Assembly

Legislation enacting two Medicaid behavioral health pilot programs and a mental health bed tracking system passed the floor of the State Senate this week on a unanimous, 30-0 vote. The legislation, which was introduced October 9, moved quickly through the Senate Health and Human Services Committee and was passed by the Senate October 20. The legislation has 72 co-sponsors.

Following the Senate vote, WHA President/CEO Eric Borgerding released a statement applauding the bipartisan action of the Senate. 

“Senate Bill 293 will demonstrate the roles Wisconsin hospitals and health systems can have in better managing physical health, behavioral health and social services for Medicaid patients with significant behavioral health needs,” said Borgerding. “We commend the Wisconsin State Senate for today’s unanimous adoption of this bipartisan legislation.”

The legislation was authored by Sens. Leah Vukmir (R-Wauwatosa) and Janet Bewley (D-Ashland) and Reps. Mary Czaja (R-Irma) and Deb Kolste (D-Janesville). In testimony before the Senate Health and Human Services Committee, lead author Czaja told the Committee the bill is a “three-part initiative that seeks to better coordinate mental health services and to improve outcomes for Wisconsin Medicaid patients who are suffering from mental illness.”

Senate Bill 293 has now been sent to the State Assembly and awaits action in that chamber. WHA continues to work with Rep. Paul Tittl (R-Manitowoc), chair of the Committee on Mental Health Reform, to schedule a public hearing on this legislation in the Assembly.

See a copy of Senate Bill 293.

Top of page (10/23/15)

Nygren Amends HOPE Legislation with WHA-Backed Changes
Health Committee recommends passage

In a meeting of the Assembly Health Committee October 22, lawmakers took up and adopted amendments introduced by Rep. John Nygren that would make various changes to his Heroin, Opiate, Prevention and Education (HOPE) package of legislation. The amendments were all adopted on a unanimous vote by Republicans and Democrats on the Committee.

The policy in this HOPE package that has garnered the most attention from WHA members is the requirement in Assembly Bill 364 for practitioners to check the Prescription Drug Monitoring Program (PDMP) before prescribing a monitored drug to a patient. Some of the most notable changes in the amendment to the bill include:

WHA has worked very closely with Nygren and his staff to make these changes over the past several weeks. Most importantly, WHA requested from Nygren that the PDMP must be operational and able to share information directly with electronic health records systems before any mandate is in effect for prescribers. This policy recommendation was a product of conversations between the WHA Physician Leaders Council with Nygren and WHA staff earlier this year, along with subsequent discussions between WHA government relations staff and Nygren’s office.

“WHA’s Physician Leaders Council played a critical role in making these important changes to the PDMP bill,” said Eric Borgerding, WHA president/CEO. “Their insight and leadership in expressing to Rep. Nygren how important it is to ensure that the new PDMP is interoperable with physician EHRs was clearly a significant catalyst for his amendments to the bill.” 

WHA’s government relations team was also appreciative of Nygren’s willingness to sunset the prescriber mandate provision three years after the mandate becomes effective. Nygren believed that his policy was going to be used to force exposure to the PDMP for those prescribers who had not previously used the PDMP, but did not want the mandate to exist in perpetuity. His hope is that prescribers see value in the information being provided and that the PDMP is functioning well enough to efficiently provide information directly to prescribers.

See a copy of the amendment to AB 364. The legislation is now ready to be voted on by the full State Assembly.

Top of page (10/23/15)

Grassroots Spotlight: Children’s Hospital of Wisconsin Hosts Area Legislators

This month, State Sen. Nikiya Harris Dodd and U.S. Rep. Gwen Moore each toured Children’s Hospital of Wisconsin inpatient units and met with community service leaders about Children’s work in foster care, social services and community navigators. 

Top of page (10/23/15)

Medical Examining Board Unexpectedly Advances Telemedicine Rule
WHA: Additional stakeholder input needed on rule

The Wisconsin Medical Examining Board (MEB) unexpectedly and with little discussion approved new draft rule language governing physician use of telemedicine services at its meeting on October 22. The action begins the rule promulgation process that will include review by the Governor’s Office, the appropriate standing committees in the Legislature and the Joint Committee on Review of Administrative Rules. The draft language was largely based on language recently enacted by the Iowa Medical Board.

WHA Vice President for Workforce & Clinical Practice Steve Rush provided the only public comment to the MEB on the draft rule language. Rush informed the MEB that very few stakeholders have reviewed the draft language and expressed concern that the draft language had only been made available a few days before the meeting.

Rush further commented to the MEB that WHA will work with the WHA Telemedicine Task Force to provide further comment to the MEB, the Department of Safety and Professional Services and the Governor’s Office about the proposed rules.

“Many Wisconsin hospitals and clinics are already successfully utilizing telemedicine services to provide high quality and more accessible health care in communities throughout Wisconsin,” said Rush. “Wisconsin needs to carefully review this rule to ensure it does not disrupt or unnecessarily add to the costs of providing telemedicine services to Wisconsin patients and communities.”

A copy of the draft rule language can be found at www.wha.org/pdf/TelemedicineMED24draft.pdf.

Top of page (10/23/15)

Health Care Jobs Important To Community, Kures Tells WHA Workforce Council

Workforce development and economic development are often seen as two separate entities rather than two sides of the same coin, according to Matt Kures, community development specialist with the University of Wisconsin-Extension’s Center of Community and Economic Development. Kures presented “Demographic and Economic Trends Influencing Wisconsin’s Future Workforce” to the WHA Council on Workforce Development at their October 22 meeting in Madison. 

Kures presentation centered on a theme of how understanding and applying Wisconsin demographics can serve as a powerful tool in addressing current and future workforce demands. 

“I am beginning to see that key stakeholders in Wisconsin understand that one cannot speak about workforce and at the same time not talk about economic development, and vice versa,” according to Kures. Health care jobs, in particular, are an important part of a community’s economic vitality, he added. High-demand, high-paying jobs requiring a college degree are often absent in rural communities that lack health care jobs. Hospitals and health systems in rural areas, however, offer careers for those who have advanced degrees.

Kures addressed a myth that Wisconsin is experiencing a “brain drain”; that is, individuals with college degrees are leaving the state. Kures stated, “When compared to other states, Wisconsin is not experiencing a ‘brain drain,’ rather, Wisconsin is experiencing a lack of ‘brain gain.’” He explained that data reveals Wisconsin is unable to attract college-prepared individuals from out-of-state to relocate within our state borders. This impacts health care more than other major employers, such as manufacturing, because a higher percentage of jobs in health care require formal education. Kures said the focus should be on why our net in-migration rate, or “brain gain” is not keeping pace with our net out-migration rate, or “brain drain.” Kures shared that the workforce needs of health care are unique in Wisconsin because of this imbalance. 

“If you look at the job sectors that have large need, such as manufacturing, those are the same jobs that often do not require a college education. Health care jobs for the most part do. So this ‘brain gain’ issue is especially relevant for hospitals and health care employers,” according to Kures.

Top of page (10/23/15)

Rush Appointed to Workforce Development Board of South Central WI

Steve Rush, WHA vice president for workforce and clinical practice, has been appointed to the Board of Directors of the Workforce Development Board of South Central WI (WDB). WDB Executive Director Pat Schramm, along with Dane County Executive Joe Parisi, asked Rush to join the board for an initial two-year term beginning in November, 2015. Schramm said she recommended Rush for his “outstanding achievements in health care workforce issues” and that he would “be a great asset” to the WDB organization.

The Workforce Development Board of South Central Wisconsin is led by a board of directors, chosen to represent the diverse groups involved with workforce and economic development issues and challenges. Their leadership team is comprised of experts in workforce development, economic development, training, education, public policy, human resources, business management and strategic development. The Board brings their expertise and targets investments to effectively align the needs of job seekers and employers. A focus on collaboration drives well-rounded, strategic solutions for a better local economy.

Top of page (10/23/15)

Nordin to Lead New Mayo Clinic Family Medicine Residency Program in NW WI 

Terri Nordin, MD, has been named director of the new Mayo Clinic Family Medicine Residency Program in northwest Wisconsin.

Nordin will lead the Mayo Clinic Family Medicine Residency Program planned to open in July 2017 with the first class graduating in 2020. She will work with other Mayo Clinic physicians and staff in and around Eau Claire to recruit and train high-caliber residents who exhibit commitment to patient-centered care, excellence, compassion and integrity. During the course of their three-year training, the physician residents will see patients at Mayo Clinic Health System sites in Eau Claire, as well as in rural sites in the Barron, Bloomer, Menomonie and Osseo areas. Mayo Clinic also is collaborating with HSHS Sacred Heart Hospital and Marshfield Clinic for residents to receive training at their facilities.

The Mayo Clinic Family Medicine Residency Program is one of six locations that received funding from a grant program administrated by the Department of Health Services, which was backed by WHA. 

The grant program will provide $3.3 million over three years to hospitals to create new medical residencies for physicians so they are able to complete their training in rural or underserved areas of the state. 

“Hospitals assume a huge responsibility and commit human and financial capital to create the infrastructure necessary to educate and train new physicians for Wisconsin,” according to WHA President/CEO Eric Borgerding. “The grants boost these efforts by providing the support these organizations need to build much-needed new residency programs.” 

Gov. Scott Walker included funding for the new residency programs in the 2013-2015 biennial budget; a move that was supported by research from, and strongly backed by, WHA.

“Our goal is to provide an exceptional family medicine training program that will attract high-quality residents to northwest Wisconsin,” says Dr. Nordin. “Many residents choose to stay and practice within the geographic area where they train, and we hope this program will help meet the immediate and future primary care needs here in Wisconsin.”

The northwest Wisconsin program will accommodate as many as 15 residents, five per year over the three-year residency. The program would continue to graduate five residents each year who are equipped to provide full-spectrum care to patients of any age.

Top of page (10/23/15)

Register Now: WCMEW Team-Based Care Summit on November 12

The Wisconsin Council on Medical Education and Workforce (WCMEW) is hosting a one-day event focused on designing and advancing team-based care. Team-Based Care Summit 2015: Transforming Concepts into Reality will be held November 12 in Appleton. Register now at http://events.SignUp4.net/15TBC1112.

The Summit will begin with an opening keynote session focused on improving population health through team-based care. A plenary session will examine payer perspectives on team-based care. Breakout sessions will focus on using metrics as a guide for team-based care; provide a how-to guide to managing workflows, protocols and team member roles; ways to leverage learners in existing or developing teams; and measuring the outcomes of a team’s impact. 

Registration is now open for this event. For information, including the day’s agenda, visit: http://events.SignUp4.net/15TBC1112. Registration questions can be directed to Jenna Hanson at jenna.hanson@wha.org or at 608-274-1820.

Top of page (10/23/15)

WHA Member Forum: Nov 11 Webinar Will Focus on New Meaningful Use

WHA will host a members-only webinar aimed at hospital leaders that will focus on the new EHR meaningful use final rules released in October. 

The Centers for Medicare & Medicaid Services (CMS) released a joint rule October 6, 2015, that finalizes proposals made in two separate 2015 proposed rules regarding the meaningful use requirements of the EHR Incentive Program. While the joint rule provides some flexibility for hospitals and physicians in 2015 and 2016, other aspects of the joint rule raise the bar for provider performance as early as 2015.

This complimentary webinar will be held Wednesday, November 11, at 10:00 a.m. The discussion will cover important provisions of the joint rule, highlighting new compliance provisions for meaningful use “modified Stage 2” (2015 through 2017) and meaningful use “Stage 3” (beginning in 2018). While there is no fee to participate, pre-registration is required. Sign-up information, as well as more information about this webinar, may be found at http://events.SignUp4.net/15MeaningfulUseWebinar. This webinar is intended for and limited to staff of WHA members only, as a benefit of membership.

For more information contact Andrew Brenton, WHA assistant general counsel, at 608-274-1820 or abrenton@wha.org.

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WHA/PSW Boot Camp Focused on Care Transitions, Medication Errors

In late September through early October, the Wisconsin Hospital Association (WHA) and the Pharmacy Society of Wisconsin (PSW) hosted a three-part webinar Boot Camp series designed to improve transitions of care and reduce medication errors. The sessions were designed to help health systems learn new strategies for incorporating pharmacy department representatives into key transitional moments with patients.

“We know that pharmacists are well positioned to take the lead in reducing adverse drug events throughout a patient’s stay in the hospital and as they transition to their next provider of care,” according to PSW Vice President of Professional & Educational Affairs Sarah Sorum. “Interventions made by pharmacists, particularly at transitions of care, have been shown to improve patient care and safety and decrease costs. PSW would like to thank the Wisconsin Hospital Association and their members for their collaboration.” 

The sessions were hosted by WHA and facilitated by members of the PSW Practice Advancement Leadership Team, representing health systems across Wisconsin. The PSW Practice Advancement Leadership Team is a collaboration of the pharmacy directors from five Wisconsin health systems (Aurora Health Care, Froedtert & The Medical College of Wisconsin, Ministry St. Joseph’s Hospital in Marshfield, UW Health, and the William S. Middleton VA Hospital in Madison) and their post-graduate pharmacy administration residents. The group of residents represent some of the nation’s top pharmacy school graduates.

Wisconsin hospitals have been working on improving adverse drug events, medication reconciliation and transitions of care through the WHA Partners for Patients improvement collaborative for the last three years. The ideas, research and perspectives provided by the PSW Practice Advance leadership team lay out the frame work for incorporating the invaluable knowledge that pharmacy professionals have regarding patient safety into everyday hospital transitions. 

“This has been a great collaboration, and we look forward to continuing this relationship in future improvement work,” said WHA Quality Coordinator Tom Kaster.

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On the Healthcare Purchasing Path
By: Dr. Dean Gruner | Post-Crescent | October 17, 2015

It’s an interesting and inexact path in the health care purchasing world right now. No one knows that better than our business customers. As we talk with them and listen to what they’re experiencing, what they’re facing and how they’re navigating forward to do well by their employees, we continually deepen our understanding of the employer purchasing market and what we need to do to both lead and respond.

What are our customers telling us lately? I talked with our ThedaCare At Work team and was heartened to hear about some shifts in business thinking and purchasing decisions around health care, and concerned by some of the trends businesses continue to face. Here’s a snapshot of what they shared with me.

Cost-shifting may be nearing its peak. While employers continue to look for ways for employees to participate in the costs of health care—a trend that’s been occurring for many years—they are increasingly aware of the risks and downside of this approach. Although high deductible health plans, and increased co-pays and out-of-pocket costs are still typical, more and more employers are realizing this trajectory has a ceiling. They’re exploring other ideas. 

New payment models intrigue employers. Employers are becoming educated about alternative payment models as they look to increase predictability around costs. And, they understand that moving into those spaces requires a close partnership with us. We’re doing more consulting to help employers manage their costs. We’re getting questions about bundled payments for procedures like joint replacement. We’re being asked what we can do to lower costs and improve quality. 

Employees are behaving differently. With the advent of health apps, social media prompts and personal fitness activity trackers, people are taking their health more seriously. At an individual level, more and more employees want to improve their health, believe they can do it, see change in others, and are changing their own behaviors to make it happen. What’s more, they’re bringing this new attitude and approach to work. 

Worksite health care options are growing. Today’s health care market is less about one-size-fits-all, and more about what meets the needs of my workforce? Employers are answering that question by opening onsite clinics, engaging health coaches, launching wellness programs and more. They’re empowering employees to partner in improving their own health. 

Narrow networks aren’t what they used to be. As employers look for high-quality providers who are skilled at managing costs, they’re anxious about being forced into a narrow network of providers. The good news is that the narrow networks of today are not the narrow networks of the 1990s. Thanks to the alignment of high-quality, lower-cost systems—like AboutHealth, of which ThedaCare is one member among eight—employers can provide access to doctors, clinics and hospitals in towns and cities across the state. That’s actually a remarkably broad network!

What can employers take away from these insights? First, there are many available options. The marketplace continues to change quickly. Keep working with your broker to understand how you can get access to all the high-quality, low-cost options you need. Then, don’t be afraid to pick up the phone and connect with us. More than ever before, we’re innovating, adapting and responding to meet individual employer needs.

The way forward will continue to change and require innovation from us all. Let’s keep talking as we walk this path together.

Find at: www.postcrescent.com/story/money/2015/10/17/healthcare-purchasing-path/73985516.

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Health Literacy Month: Removing Barriers to Understanding

October is Health Literacy Month. Being sick or getting injured is bad enough without additional stress from not understanding what’s wrong and if it can be fixed. What better way is there to provide patient-centered care than making sure when they leave, patients are confident knowing what they need to do and why?

That is what health literacy is all about. 

Wisconsin health care providers are making changes, and improvements, in how they communicate with patients. It is not possible to tell by looking who has low health literacy—the best approach is that of universal precautions. Just as in the clinical setting, universal precautions in health literacy means taking action to minimize risk for everyone. Communicate in a way that is understandable by all. Evidence shows even highly literate people prefer simple communications. 

According to Wisconsin Health Literacy, nine of ten adults have difficulty understanding health information, and three of ten really struggle. They have trouble completing health forms, communicating symptoms, managing chronic illness or navigating health care. These patients are more frequently readmitted to the hospital because they don’t take medications properly or understand how to follow self-care instructions. People with low health literacy have poorer health knowledge, increased hospital and emergency department visits, and higher health care costs. Sadly, more are also likely to die. 

Health literacy is about removing barriers to successful communication. It begins with awareness and continues with training and practice of techniques proven to make a difference. Health Literacy practices are quick and inexpensive to implement. They are more effective ways to communicate so everyone can understand and act on critical health information and services.

For more information, contact Steve Sparks, director, Wisconsin Health Literacy, at 608-257-1655 or visit WisconsinHealthLiteracy.org.

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New System Standardizes Patient Tagging, Tracking in Mass Casualty Situation 

A triage tagging system that is internationally and nationally known has been adopted in neighboring states and was introduced to the Northeast Wisconsin Regional Trauma Advisory Board (RTAC) in 2011. The RTAC took up a project to implement a common triage tagging system within seven Northeastern counties with support from what was then referred to as Region 3 Wisconsin Hospital Emergency Preparedness Program (WHEPP). The triage tag format was presented during an initiative to update the START/JUMP SMART triage protocol methods. The triage tagging system supports, but does not alter, the triage protocol but provides a clear and recognizable display of patient condition in good weather or bad, day or night. The new tagging system allows attending medical staff to change triage color code display back and forth as patient conduction changes and documents the patient’s personal and medical condition. Importantly, the tag system includes bar coding. This will easily adapt to and work with the coming statewide electronic patient tracking system that will be initiated this year by the Wisconsin Department of Health Services (DHS). 

The new tagging system will be used by approximately 70 EMS agencies and first responder vehicles. Ten hospital emergency departments located in northeast Wisconsin have received training on the tagging system. This common tagging system will be a patient care and tracking cornerstone for the Northeast Wisconsin Healthcare Emergency Response Coalition into the future.

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