December 5, 2014
Volume 57, Issue 39
· 35 Hospitals Identified as Ebola Treatment Centers
Cong. Sean Duffy Leads Bipartisan
Register Today for WHA 2015
Physician Leadership Development Conference
Wisconsin Health News Panel Focuses
on Hospital, Health System Partnerships
WHA Webinar Series Focuses on Hot
Topics for Hospital HR
WHA Provides Testimony on
Wisconsin’s Safe Haven Law
CMS Issues Final Rule on Medicaid
DSH Payment Uninsured Definition
Support Statewide Health Care
Initiatives with Contribution to WHA Foundation
Opportunity to Transform Ambulatory
Member News: Crossing Rivers Health
to Receive Wisconsin Forward Award
Hospitals Identified as Ebola Treatment Centers
Froedtert, UW Hospitals and Clinics, Children’s Hospital among those named
Wisconsin health systems were among the 35 hospitals identified December 2 by
the Department of Health and Human Services (HHS) as Ebola treatment centers. In
addition, as part of a tiered-hospital strategy, the Centers for Disease Control
and Prevention (CDC) released interim guidance for states and hospitals to use
as they identify and confirm Ebola treatment centers and interim guidance to use
as they identify Ebola assessment hospitals.
is served by hospitals and health systems dedicated to caring for all those in
need, and being there at times when needs are greatest,” said WHA Executive
Vice President Eric Borgerding. “There’s a lot more to being a designated
treatment facility than simply agreeing to be one. It takes tremendous
preparation from dedicated caregivers and engaged leaders willing to take on
this role, and Froedtert, UW and Children’s are some of the finest examples of
Wisconsin hospitals’ commitment to care and service.”
& The Medical College of Wisconsin Froedtert Hospital campus, Milwaukee; UW
Hospitals and Clinics, Madison; and Children’s Hospital, Milwaukee are among
the 35 hospitals with 53 treatment beds located in 12 states and Washington,
D.C. Additional facilities are expected to be added in the next several weeks.
More than 80 percent of returning travelers from Ebola-stricken countries live
within 200 miles of an Ebola treatment center, HHS said.
The announcements were part of an update from the White House on the government’s efforts to respond to Ebola and the need for immediate, additional funding to support these efforts. In a statement, AHA President and CEO Rich Umbdenstock said, “America’s hospitals are investing enormous time and resources to enhance our country’s readiness for the new and real threat of Ebola,” and he reiterated the AHA’s request for “Congress to approve at least $500 million in funds to help hospitals better prepare to win the battle against Ebola.” (See AHA Politico ad at www.aha.org/content/14/141202-aha-ad.pdf)
hospitals continue to prepare for the possibility of encountering a patient
suspected of Ebola. In the event Ebola is diagnosed in the state, the Wisconsin
Department of Health Services will work with partners and the three designated
health systems to care for patients, ensuring that each patient receives the
best care while protecting health care workers and the general public.
CDC’s advisory at www.advisory.com/daily-briefing/2014/12/02/cdc-names-35-hospitals-as-designated-ebola-centers.
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Sean Duffy Leads Bipartisan Letter
Urges President not to cut rural hospital reimbursement
Rep. Sean Duffy (WI-07) led a bipartisan letter with 45 other Members of
Congress in support of rural hospitals. In a letter delivered to President Obama,
the group asked the President to refrain from including arbitrary cuts to
critical access hospitals (CAHs) in his upcoming budget request.
President has previously included proposals reducing Medicare reimbursement for
CAHs and removing the “critical access” designation for any hospital within
10 miles of another hospital.
respect to these two proposals, the letter reads:
play an important role in our communities by providing access to primary,
emergency and acute care services…We believe these savings are overstated, as
patients will still need to seek care at other facilities…indiscriminate cuts
to CAHs, similar to those included in previous budgets, are not the answer.”
expressed appreciation to Rep. Duffy for leading this letter and thanked other
Wisconsin House Members—U.S. Reps Kind, Ribble and Pocan—for signing on as
small, rural citical access hospitals continue to be an important part of the
health care fabric of our state,” said WHA Executive Vice President Eric
Borgerding. “WHA thanks Rep. Duffy for his leadership on this letter and
appreciates all those who continue to champion the cause of rural hospitals.”
the full, signed House letter at: www.wha.org/pdf/2014CAHtoObama11-14.pdf
Rep. Duffy’s press release at:
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Today for WHA 2015 Physician Leadership Development Conference
March 13-14, 2015 in Kohler
leaders must represent both clinical and managerial interests, which is the
focus each year ot the WHA Physician Leadership Development Conference. The
annual conference benefits both new and seasoned physician leaders, and focuses
on important and practical leadership skills that help physician leaders move
beyond their clinical training and take a new approach to managerial
decision-making and problem solving.
year’s conference will include a full-day session focused on the tools,
techniques and skills to not just manage but lead strategic innovation and
change within your organization, presented by William “Marty” Martin, PsyD,
one of this event’s most popular faculty. In addition, the half-day session,
presented by Barry Silbaugh, MD, will focus on moving a perspective and skill
set from that of a physician working autonomously to leading a team and
influencing others to change. Both Martin and Silbaugh are faculty from the
American Association for Physician Leadership (formerly the American College of
Registration is now open for the tenth annual “WHA Physician Leadership Development Conference,” scheduled Friday, March 13 and Saturday, March 14 at The American Club in Kohler. Information and registration are available at http://events.SignUp4.net/15PLD. The conference brochure is included in this week’s packet. As a reminder, the special room rate is only available until February 19 or until the room block fills (which it does quickly each year), so make your hotel reservations today.
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Health News Panel Focuses on Hospital, Health System Partnershi ps
mergers, strategic alliances and quality partnerships, Wisconsin hospitals and
health systems are increasingly teaming up. At a December 2 Wisconsin Health
News briefing, a panel of experts helped explain what’s driving these new
agreements and what the ultimate impact will be on the state’s health care
included Greg Devine, CEO, abouthealthTM; Damond Boatwright, regional
president/CEO, SSM Healthcare of Wisconsin; and Peter Pruessing, CEO, Integrated
Health Network of Wisconsin.
noted what health care experts have known for a long time—that the Wisconsin
health care market is different from most others and provides high-quality care.
Nevertheless, the growing number of alliances is a nationwide trend.
driven partly by the desire to achieve scale and have a large population base,
new affiliations are also driven by the need for affordability for consumers.
do we make health care more affordable?...It is very hard to do that unless you
have most of the components that drive the cost of care under single ownership
or a very well-defined affiliated partnership,” Boatwright said. “A lot of
hospitals and health systems are merging, affiliating and partnering with one
another to try to find that ‘secret sauce’ to affordability.”
asked if all of these mergers and acquisitions will decrease competition and
actually raise prices, panelists responded that there is still competition, but
an enhanced level of competition. Providers can have their own business plans
and compete with each other while collaborating.
Competition gets all the attention and collaboration doesn’t get enough
attention,” said Pruessing. “These things can coexist, and they can create
value together.” He noted that
clinical integration, data and analytics, and a care model are all components of
Integrated Health Network’s collaborative strategy.
the CEO of the newly-announced abouthealthTM, Devine noted the groups
are still in the early stages of working together, but they believe that scale
matters for affordability and efficiency.
focus is about the patient. It’s not just about the work we do for them in
their health plans or benefit coverage… we are looking at how we can address
individuals’ health but also things that are not just traditional health
delivery in the way we commonly consider that,” Devine said.
goal is to also improve access to advancing technology and clinical research,
which benefits everyone.
each of the panelists views working with insurance companies a bit
differently—some collaborate while others own insurance companies—all agreed
that partnerships between care providers and insurers can help drive value.
general concern about the mergers and collaborations on the impact of rural
health care providers was discussed, with panelists commenting on the continued
need for rural hospitals and providers as essential for access.
the end, health care is local,” said Boatwright.
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WHA Webinar Series Focuses on Hot Topics for Hospital HR
in January, WHA is offering members a three-part webinar series addressing
timely and relevant labor and employment issues for all health care providers.
The individual webinar sessions will address three important labor and
employment issues, each presented by attorneys from the labor and employment
practice of Reinhart Boerner Van Deuren s.c., a corporate member of WHA.
will be held January 23, February 20 and March 20, each focusing on three
descriptions of each topic covered in the sessions, as well as online
registration, can be found at: http://events.SignUp4.net/2015LaborEmployWebSeries.
care human resources professionals, hospital and health system in-house counsel
and others interested in learning more about these important labor and
employment issues should plan to participate. Attendees are encouraged to
participate in this webinar series as a team, to gather and learn together
through one, low-cost registration. While attendees are encouraged to attend all
three sessions, the option exists to register for individual sessions as well.
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Provides Testimony on Wisconsin’s Safe Haven Law ction to mandate hospital procedures
State Tribal Relations Committee pauses on a
ction to mandate hospital procedures
special committee of the state Legislature met December 4 to consider
legislative options that would create additional responsibilities for hospital
staff that take in a child under Wisconsin’s Safe Haven Law. Wisconsin’s
Native American tribes have stated they believe hospitals should be required to
collect information about the tribal heritage of a mother and father of a
relinquished child at the time that child is being relinquished. The tribal
community has expressed frustration with the Safe Haven Law and have argued that
this tribal affiliation information is necessary to comply with the federal
Indian Child Welfare Act (ICWA).
a memo to the Committee, Joint Legislative Council staff outlined two separate
options to collect information about tribal children relinquished under
Wisconsin’s Safe Haven law. The first would require that a hospital employee
provide a packet to the parent (mother or father) that would include information
related to the anonymity and confidentiality provisions of Safe Haven as well as
an explanation of the benefits of tribal enrollment. The packet would also
include a form to provide information on tribal affiliation along with a
postage-paid envelope to return that form. This option would also require a
hospital staff person who receives a relinquished child to review the materials with the
parent and assist that parent in completing the forms.
provided written testimony to the Committee stating the difficulty that
hospitals would have in fulfilling this requirement for all children
relinquished under the law. The testimony said that a child can be relinquished
to any employee in the hospital and in any location in the hospital, making this
mandate difficult to implement. The testimony went on to say that “many
individuals within a hospital do not have the appropriate training to assist
parents with this activity and would not be comfortable providing this type of
assistance.” Finally, the testimony argued that this type of specific process
requirement should not be mandated in the state statutes.
second option would have required that a hospital collect information from an
expectant mother at admission about her tribal affiliation, along with
information on the father’s tribal affiliation. The option went on to require
that the hospitals must provide any information regarding tribal affiliation of
the mother or father to the county social services department.
Joint Legislative Council staff outlined some complications related to this
option in their memo, including their opinion that “it appears that HIPAA
would prohibit the use of admission information for this purpose.” WHA stated
its opposition to this proposed option and stated that this requirement would go
against the original intent of Wisconsin’s Safe Haven law.
this special committee produces draft legislation for consideration by the full
Legislature in the upcoming session. The chairman of the committee, Rep. Jeff
Mursau (R-Crivitz) stated that the committee was not ready to take action at
this meeting. The chairman encouraged the tribal community, hospitals and
counties to work together to further discuss the tribe’s concerns and
encouraged stakeholders to pursue non-legislative solutions.
copy of the testimony is available at www.wha.org/pdf/2014WHASafeHaven12-4.pdf.
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Issues Final Rule on Medicaid DSH Payment Uninsured Definition
Centers for Medicare & Medicaid Services (CMS) on November 28 issued the
final rule to define “uninsured” for purposes of calculating the Medicaid
hospital-specific disproportionate share hospital (DSH) payment limit. The final
rule takes effect December 31.
final rule is effective for DSH audits and reports submitted for state plan rate
year (SPRY) 2011 and after. All states are required to submit their 2011 SPRY
audit report to CMS by December 31. The rule amends the definition of
“uninsured” for purposes of calculating the hospital-specific DSH payment
limit, which is tied to a hospital’s Medicaid payment shortfall plus
uncompensated care costs.
Wisconsin’s Medicaid DSH program in the past provided limited funding directly
to hospitals, this biennium the state recognized the need for a more substantive
DSH program and provided DSH funding under a formula directly to hospitals
serving Medicaid patients. Even though the rule addresses the hospital-specific
DSH limit and hospitals are now subject to its requirements, it will have very
limited practical effect on Wisconsin hospitals because the amount of DSH
funding received by hospitals is far below the significant Medicaid shortfalls
they incur—$960 million across all hospitals in Wisconsin in 2013.
rule reverses a more restrictive definition for uninsured implemented by CMS in
2008. The amended definition expands the inclusion of the following costs for
purposes of calculating the DSH limit.
cost of inpatient and outpatient hospital services furnished to a Medicaid
patient who has exhausted applicable state coverage limits can be included in
calculating the Medicaid shortfall.
cost of hospital services for individuals who exhausted their insurance benefits
or reached lifetime insurance limits can be counted as uninsured costs. These
include costs for services not included in the individual’s benefit package,
but identified as covered benefits in the state Medicaid plan.
costs of inpatient and outpatient hospital services provided to individuals
covered under the Indian Health Services (IHS) can be counted as uninsured costs
if the services are provided by a non-IHS hospital and not through an IHS health
final rule reiterates previous CMS policy that certain costs are not allowed to
be counted for purposes of calculating the DSH limit. Those “unallowable”
costs include: bad debt, unpaid coinsurance and deductibles, and hospital-based
will provide further guidance to states, auditors and providers, and it has
instructed Medicaid DSH auditors to apply the new policy to the DSH audits for
SPRY 2011. The final rule can be found at https://www.federalregister.gov/articles/2014/12/03/2014-28424/medicaid-program-disproportionate-share-hospital-payments-uninsured-definition.
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Statewide Health Care Initiatives with Contribution to WHA Foundation
year, the WHA Foundation supports a variety of initiatives that have statewide
impact on health care in the areas of workforce development, quality and patient
safety and community collaboration. In 2014, those initiatives include the WHA/RWHC
Quality Residency Program, for which the WHA Foundation provided funding for
start-up expenses and five scholarships. The WHA Foundation also provided
financial support for the third cohort of the Transforming Care at the Bedside (TCAB)
initiative, as well as for maintenance of the BSN completion program website, http://BSN.WHA.org.
order to continue supporting initiatives like these and others in 2015, the WHA
Foundation has officially kicked off its annual fundraising campaign, asking WHA
hospital and corporate members to consider supporting the WHA Foundation by
making a contribution this month.
raised in the current campaign will be used to continue some of its most
successful and long-standing initiatives, including the Global Vision Community
Partnership Awards and the annual scholarships to graduating technical college
students in health-related programs, and give the Foundation the opportunity to
consider new initiatives for funding in 2015.
WHA hospital member executive has received a direct appeal for the fundraising
effort. A contribution form is included in this week’s packet, for anyone who
would like to make an individual contribution or one on behalf of your hospital.
For more information on the WHA Foundation’s annual fundraising campaign,
contact Jennifer Frank at 608-274-1820 or at email@example.com.
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Opportunity to Transform Ambulatory Practices
want to improve care for their patients and position their practices to thrive
in a pay-for-value system. A new national initiative aims to drive this
improvement and our patients, communities and health care providers will likely
be in a position to benefit.
The Centers for Medicare and Medicaid Innovations (CMMI) recently released two funding opportunity announcements (http://innovation.cms.gov/initiatives/Transforming-Clinical-Practices/) to support the Transforming Clinical Practice Initiative, which seeks to support 150,000 clinicians in their efforts to move through five stages of practice transformation.
transformation networks (PTNs) and support and alignment networks (SANs) will
work together to ensure clinicians will be able to sustain practice and care
improvements that will:
Improve health outcomes for patients;
Improve care coordination through connectivity;
Improve patient and staff satisfaction; and,
Improve efficiencies and reduce cost.
is partnering with MetaStar, Wisconsin Collaborative for Healthcare Quality,
Wisconsin Medical Society and other stakeholders to prepare an application to
become a PTN. In this role, the group will provide support to primary care and
specialty clinicians who would like to use their health information technology
to improve efficiency in their practice and to provide better coordination of
care for their patients. The PTN will help clinicians transform their practices
to thrive under new payment models and meet quantifiable improvement outcomes.
practice transformation network will be an excellent continuation of efforts in
our communities that have been successfully bringing providers and practices the
benefits of quality improvement, patient-centered care and health information
technology alignment. This initiative will provide additional resources that can
help Wisconsin providers leverage their own work and that of existing community
partners to continue to improve the quality, safety and value of health care
through practice transformation.
more information on the PTN and the support available to your practice, visit www.metastar.com/ptn or contact Kelly Court at firstname.lastname@example.org.
Physicians and advanced practice providers who are interested in this
opportunity are encouraged to complete the online Intent to Participate form by
December 15, 2015 for inclusion with the Wisconsin application.
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Member News: Crossing Rivers Health to Receive Wisconsin Forward Award
Prairie du Chien, will be honored at the Wisconsin Forward Award ceremony
December 10 at Monona Terrace in Madison, along with two other Wisconsin
Rivers Health will receive Proficiency recognition for 2014. Crossing Rivers
Health is non-profit 25-bed critical access hospital established in 1957 that
employs more than 330 health care professionals. Crossing Rivers Health provides
more than 60 services to fulfill the health care needs of communities across
Southwest Wisconsin and Northeast Iowa, including medical, surgical, obstetrics,
outpatient, rehabilitation and emergency services. Crossing Rivers Health
demonstrates the true meaning of service excellence as it strives to deliver
high-quality, personalized health care and education.
previously reported in The Valued Voice, Holy Family Memorial, Inc.
in Manitowoc will also receive Proficiency Recognition for 2014, and HSHS St.
Joseph’s Hospital in Chippewa Falls achieved the level of Excellence,
which is the highest achievement level an organization can earn.
Forward Award is Wisconsin’s premier recognition for workplace excellence
involving business, education, government, health care and manufacturing. The
program recognizes innovative, future-thinking organizations in their quest for
customer-focused quality and excellence in performance management. The Wisconsin
Forward Award is based on the Malcolm Baldrige National Quality Award for
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