May 27, 2016
Volume 60, Issue 21
U.S. House Ways & Means Committee Amends Hospital Package
On May 24, the U.S. House Ways & Means Committee amended legislation it introduced last week, the Helping Hospitals Improve Patient Care Act/HR 5273, to provide more flexibility for certain hospital outpatient department (HOPD) projects caught up in a prohibition enacted last year under the Bipartisan Budget Act of 2015 (BBA 2015).
The BBA 2015 banned new off-campus provider-based HOPDs from using Medicareís Outpatient Prospective Payment System (OPPS) beginning in 2017. The law was enacted so quickly that projects across the country well under construction but not yet able to bill under the OPPS were no longer able to use this entire Medicare reimbursement system. Congress has been working since that time to craft a targeted fix to address these "mid-build" situations.
One of the original exemption pathways under HR 5273 included a multi-part process for an HOPD to fulfill. One of the requirements under that process was for the HOPD to attest by July 1, 2016 in order to be exempted. The amended legislation extended that attestation deadline to December 31, 2016 or 60 days after the legislationís enactment. In order to pay for this legislation, prospective payment system hospitals will see an additional, small reduction to the coding offset increase they were to have received in their Fiscal Year 2018 market-basket.
In addition to this HOPD fix, the legislation contains other provisions of interest. Among those are changes to the hospital readmission reduction program in order to address socioeconomic status. This provision would initially require the Centers for Medicare & Medicaid Services (CMS) to make an adjustment based on the proportion of a hospitalís dually-eligible Medicare and Medicaid patients. CMS may modify risk adjustments in the future. Another provision in this legislation is Speaker Paul Ryanís bill requiring CMS to study and report on how the inpatient and outpatient hospital codes for similar services can be cross-walked. The basis of this provision was Ryanís original bill, HR 3291.
If you have questions, contact Jenny Boese, WHA vice president, federal affairs & advocacy, at 608-268-1816 or email@example.com.
Top of page (5/27/16)
A few weeks ago, the WHA Information Center (WHAIC) launched a new tool designed to help WHA hospitals and health systems gain crucial insights into areas such as population health, utilization, patient access, geographic distribution and market share.
The tool, called "Kaavio," allows WHA hospital and health system users to analyze and visualize Wisconsin discharge data. With Kaavio, users can easily interact with the Wisconsin discharge data applying filters, refining parameters and adding criteria. The changes are instantly reflected in the data. Kaavio presents the data in meaningful graphics that allow users to detect patterns, trends, outliers and relationships that can help users make important decisions.
One feature now available is "Quick Reports." Quick Reports are dashboards that, with just a few clicks, can answer specific questions.
Quick Reports can show:
Kaavio is available to WHA hospitals and health systems that purchase data at the relational data set level for no additional fee through 2016. Kaavio can also be enhanced with the purchase of the "Other Hospital Outpatient Data" (ancillary services information).
Within Kaavio, users can analyze the data for hospitals and free-standing ambulatory surgery centers and compare them to other facilities. They can create custom dashboards with filters for categories such as primary diagnosis category, principal procedure category, MS-DRG, primary payer, patient ZIP code and facility.
To learn more about Kaavio and how to access the new tool, go to the WHA Information Center website, www.whainfocenter.com, or contact Brian Competente at firstname.lastname@example.org.
WHAIC is dedicated to collecting, analyzing and disseminating complete, accurate and timely data and reports about charges, utilization, quality and efficiency provided by Wisconsin hospitals, ambulatory surgery centers and other health care providers.
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As of May 26, the 2016 Wisconsin Hospitals State PAC & Conduit topped the $120,000 mark with contributions from almost 130 individuals.
"The Wisconsin Hospitals State PAC & Conduit campaign is off to a great start," said WHA 2016 Advocacy Committee Chair Therese Pandl. "We want to reach our goal of raising $300,000 so together we can help support candidates of both parties who value hospitals and health systems in Wisconsin. I am asking everyone who cares about health care in our state to support our industry in this important way."
The 2016 fundraising campaign is based on the calendar year, which means that since the start of this year, more than $5,600 has come in, on average, each week. The 2016 campaign will need to continue at this pace or better to meet the $300,000 goal by yearís end. While $300,000 is an aggressive goal, it is a reachable goal when everyone pitches in. In this pivotal election year, remember that elections matter, and participation is important.
Take a look at the first 2016 contributor list on page 7 to see who is on the list. Make sure your name is not left off of future lists by making your personal contribution today at
www.whconduit.com or by contacting WHAís Jenny Boese at 608-268-1816 or email@example.com, or Nora Statsick at 608-239-4535 or firstname.lastname@example.org. Be part of the success story by contributing to the Wisconsin Hospitals State PAC and Conduit today.
|Contributors ranging from $1 to $499|
|Bayer, Tom||HSHS St. Vincent Hospital|
|Boese, June||Wheaton Franciscan - All Saints|
|Braddock, Jonathan||ISG Advisors, LLC|
|Carlson, Peter||Aurora Psychiatric Hospital|
|Clementi, Bridget||Children's Hospital of Wisconsin|
|Coffman, Joan||HSHS St. Joseph's Hospital|
|Collins, Sherry||Wisconsin Hospital Association|
|Coopman, Dianne||SSM - St. Mary's Janesville Hospital|
|Davis, Brett||Aspirus, Inc.|
|Dux, Larry||Froedtert & MCW Community Memorial Hospital campus|
|Ewald, Sandra||Aurora Health Care|
|Ferrigno, Sandra||SSM - St. Mary's Hospital|
|Grabow, Peter||Mayo Health System -Franciscan Healthcare LaCrosse|
|Grasmick, Michael||Wisconsin Hospital Association|
|Groskreutz, Kevin||HSHS St. Joseph's Hospital|
|Gustafson, Sara||UW Hospitals and Clinics|
|Hamilton, Mark||UW Hospitals and Clinics|
|Harrington, Kathleen||Mayo Health System - Eau Claire|
|Hartberg, David||Gundersen - Boscobel Area Hospital and Clinics|
|Heaney, Dwight||Fort HealthCare|
|Kaiser, Ann||HSHS Sacred Heart Hospital|
|Kantos, Craig||ThedaCare Medical Center - Waupaca|
|Kirsch, Jennifer||Gundersen Health System|
|Klay, Chris||HSHS St. Joseph's Hospital|
|Kruse, Joe||Mayo Health System -Franciscan Healthcare LaCrosse|
|Lynch, Sue||Mayo Health System -Franciscan Healthcare LaCrosse|
|Meicher, John||SSM - St. Mary's Hospital|
|Nicklaus, Todd||Aspirus, Inc.|
|Pearson, Jane||SSM - St. Mary's Janesville Hospital|
|Prise, Eric||Tomah Memorial Hospital|
|Revnew, Dorothy||ProHealth Care - Oconomowoc Memorial Hospital|
|Roller, Rachel||Aurora Health Care|
|Schaetzl, Ron||SSM - St. Clare Hospital & Health Services|
|Selle, Ginger||SSM - St. Clare Hospital & Health Services|
|Stapelfeldt, Kimberly||Aurora Medical Center - Washington County|
|Statz, Darrell||Rural Wisconsin Health Cooperative|
|Stelzer, Jason||SSM - St. Clare Hospital & Health Services|
|Swanson, Kaitlin||HSHS Eastern Wisconsin Division|
|Thornton, Eric||SSM - St. Mary's Janesville Hospital|
|Walker, Troy||SSM - St. Clare Hospital & Health Services|
|Whitinger, Margaret||Agnesian HealthCare|
|Wysocki, Scott||SSM - St. Clare Hospital & Health Services|
|Contributors ranging from $500 to $999|
|Behl, Kevin||Columbia St. Mary's Hospital - Milwaukee|
|DeGroot, Dan||HSHS St. Clare Memorial Hospital|
|Dexter, Donn||Mayo Health System - Eau Claire|
|Doeringsfeld, Jean||Wisconsin Hospital Association|
|Jensema, Christine||HSHS Eastern Wisconsin Division|
|King, Steve||SSM - St. Mary's Hospital|
|Lange, George||Columbia St. Mary's Hospital - Milwaukee|
|Larson, Margaret||Affinity Health - Mercy Medical Center|
|Mulder, Doris||Beloit Health System|
|Nelson, James||Fort HealthCare|
|Oland, Charisse||Rusk County Memorial Hospital|
|Peterson, Douglas||Chippewa Valley Hospital|
|Reardon, Brian||Hospital Sisters Health System|
|Roesler, Bruce||The Richland Hospital|
|Roundy, Ann||Columbus Community Hospital|
|Rude, Nels||The Kammer Group|
|Selberg, Heidi||HSHS Eastern Wisconsin Division|
|Shabino, Charles||Wisconsin Hospital Association|
|Stuart, Philip||Tomah Memorial Hospital|
|Swanson, Kerry||SSM - St. Mary's Janesville Hospital|
|Van Meeteren, Bob||Reedsburg Area Medical Center|
|Wessels, Bill||Aspirus, Inc.|
|Wolf, Edward||Lakeview Medical Center|
|Worrick, Gerald||Ministry - Door County Medical Center|
|Contributors ranging from $1,000 to $1,499|
|Anderson, Sandy||Ministry Health Care|
|Brenton, Andrew||Wisconsin Hospital Association|
|Brussow, Julie||Marshfield Clinic|
|Dietsche, James||Bellin Hospital|
|Graebner, David||Aurora Sheboygan Memorial Medical Center|
|Hafeman, Paula||HSHS St. Vincent Hospital|
|Hanus, Andrew||Aurora Health Care|
|Jacobson, Terry||St. Mary's Hospital of Superior|
|Jelle, Laura||SSM - St. Clare Hospital & Health Services|
|Just, Lisa||Aurora Health Care - South Region|
|Levin, Jeremy||Rural Wisconsin Health Cooperative|
|Lindberg, Steve||Mayo Health System - Red Cedar|
|Miller, Kim||Beaver Dam Community Hospital|
|Pollard, Dennis||Froedtert & MCW Community Memorial Hospital campus|
|Punzenberger, Lindsay||Children's Hospital of Wisconsin|
|Rush, Steven||Wisconsin Hospital Association|
|Sanders, Robert||Children's Hospital of Wisconsin|
|Schafer, Michael||Spooner Health System|
|Teigen, Seth||SSM Health Care of Wisconsin|
|White-Jacobs, Mary Beth||Black River Memorial Hospital|
|Contributors ranging from $1,500 to $1,999|
|Bloch, Jodi||Children's Hospital of Wisconsin|
|Clapp, Nicole||Grant Regional Health Center|
|Court, Kelly||Wisconsin Hospital Association|
|Frank, Jennifer||Wisconsin Hospital Association|
|Grasmick, Mary Kay||Wisconsin Hospital Association|
|Gullingsrud, Tim||Hayward Area Memorial Hospital and Nursing Home|
|Hilt, Monica||Ministry Health Care/St. Elizabeth Hospital|
|Lewis, Gordon||Burnett Medical Center|
|McKevett, Timothy||Beloit Health System|
|Russell, John||Columbus Community Hospital|
|Sheehan, John||UW Health American Center|
|Stanford, Matthew||Wisconsin Hospital Association|
|Schulze, Connie||Ministry Health Care|
|Contributors ranging from $2,000 to $2,999|
|Alig, Joanne||Wisconsin Hospital Association|
|Boese, Jennifer||Wisconsin Hospital Association|
|Kachelski, Joe||Wisconsin Statewide Health Information Network|
|Lappin, Michael||Aurora Health Care|
|Leitch, Laura||Hall Render|
|Mettner, Michelle||Children's Hospital of Wisconsin|
|Meyer, Daniel||Aurora BayCare Medical Center|
|Natzke, Ryan||Marshfield Clinic|
|Potter, Brian||Wisconsin Hospital Association|
|Starmann-Harrison, Mary||Hospital Sisters Health System|
|Steines, Sara||Children's Hospital of Wisconsin|
|Wallace, Michael||Fort HealthCare|
|Contributors ranging from $3,000 to $4,999|
|Boatwright, Damond||SSM Health Care of Wisconsin|
|Jacobson, Catherine||Froedtert & The Medical College of Wisconsin|
|Neufelder, Daniel||Ministry Health Care|
|O'Brien, Kyle||Wisconsin Hospital Association|
|Pandl, Therese||HSHS Eastern Wisconsin Division|
|Standridge, Debra||Wheaton Franciscan Healthcare|
|Turkal, Nick||Aurora Health Care|
|Contributors ranging from $5,000 to $9,999|
|Borgerding, Eric & Dana||Wisconsin Hospital Association|
|Brenton, Stephen||Wisconsin Hospital Association|
|Kerwin, George||Bellin Hospital|
|Size, Tim||Rural Wisconsin Health Cooperative|
|Troy, Peggy||Children's Hospital of Wisconsin|
|Tyre, Scott||Capitol Navigators, Inc.|
Guest Column: Keeping Your Organizationís Retirement Plan on Track
Top of page (5/27/16)
An annual review of your hospital or health systemís retirement plan not only helps you set and manage plan expectations, it may also help your plan meet certain nondiscrimination and regulatory standards. Use contribution and participant rates to help analyze how well the plan works and whether any changes might be beneficial.
Review these 10 items to make sure your hospital or health systemís retirement plan stays on track.
Address the compliance, governance, and fiduciary issues of your hospital or health systemís retirement plan proactively so your plan maintains peak condition.
About ISG Advisors
As WHAís Premier Partner, ISG Advisors goes above and beyond to help hospitals balance employee needs with the cost of employee benefits. Through strategic planning, professional services, and technology based solutions, ISG can help reduce benefit costs, increase efficiency, and improve employee satisfactionóbringing your employee benefits program to new heights in quality and performance.
Securities & Investment Advisory Services offered through VSR Financial Services, Inc., a Registered Investment Adviser and Member FINRA and SIPC. ISG Advisors is not owned or controlled by VSR Financial Services, Inc.
Learn more at www.isg-advisors.com/wha.html.
Top of page (5/27/16)
Recently Wisconsinís Congressional Delegation signed onto two bipartisan "Dear Colleague" letters sent to the Centers for Medicare & Medicaid Services (CMS). Those letters urge CMS to provide flexibility in implementing a policy related to new off-campus hospital outpatient departments (HOPDs).
The new policy was included in the Bipartisan Budget Act of 2015 (BBA) and prohibited use of the Outpatient Prospective Payment System (OPPS) by new HOPDs. However, for HOPDs currently in existence, BBA 2015 included several grandfathering provisions. CMS is now developing regulation implementing this new policy going forward.
The "Dear Colleague" letters by Congress to CMS focus on key issues of interest, such as providing flexibility for currently grandfathered HOPDs so they are able to relocate, rebuild, change services, among various situations, and not be at risk of losing their grandfathered status.
"The Wisconsin Hospital Association thanks Wisconsinís membersóSenators Baldwin and Johnson; and Representatives Duffy, Grothman, Kind, Moore, Pocan, Ribble and Sensenbrennerófor signing onto these letters," said WHA President/CEO Eric Borgerding. "We appreciate our Delegation understanding the importance of crafting implementation policies that do not inhibit access to care or disadvantage Wisconsinís high-value hospitals and health systems."
Fifty-one Senators, including Wisconsin Sens. Tammy Baldwin and Ron Johnson, signed onto the U.S. Senate letter, which was led by Sen. Rob Portman of Ohio and Sen. Chuck Schumer of New York. In the U.S. House, 235 members, including all of Wisconsinís House members (except for Speaker Ryan due to his leadership role), signed onto the U.S. House letter, which was led by Rep. Devin Nunes of California and Rep. Joseph Crowley of New York.
Read the Senate letter at: www.aha.org/advocacy-issues/letter/2016/160519-senate-hopd-dearcolleague.pdf.
Read the House letter at: www.aha.org/content/16/160524-cms-congress-sec603hopd.pdf.
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On May 24, the Senate Committee on Health and Human Services held an informational hearing on a proposal, 2015 Senate Bill 762 (SB 762) (see at http://docs.legis.wisconsin.gov/2015/related/proposals/sb762.pdf), to create an additional certification for chiropractors that would, among other things, allow prescribing of medications and administration of anesthesia under the direction of a physician. The new certification, known in the legislation as a Primary Spinal Care Practitioner (PSCP), would allow the PSCPs to practice "spinal medicine" after completing an additional 60 hours of instruction and 500 clinical rotation hours beyond their chiropractic training.
Wisconsinís two professional chiropractic groups, the Wisconsin Chiropractic Association (WCA) and the Chiropractic Society of Wisconsin (CSW), had differing views on the proposal. The WCA said the proposal would be a more "patient-centered" care delivery model by giving a chiropractor trained as a PSCP "all the tools that are necessary to be the primary caregiver for spine care." WCA President Rod Lefler said the proposal would "reduce the seven to nine different providers that are needed and make the referral process more simple" for someone suffering with back pain.
The Chiropractic Society of Wisconsin testified with "100 percent opposition" to the proposal, stating that the majority of chiropractors in Wisconsin oppose the concept of adding prescribing authority and that the educational component included in SB 762 is "grossly inadequate and creates a public safety concern." The CSW stated that their position against the legislation is in alignment with "all recognized and established national and state chiropractic institutions and organizations" who do not support adding prescribing authority for chiropractors.
A group of physicians from the Wisconsin Medical Society, the Wisconsin Academy of Family Physicians and the Wisconsin Society of Anesthesiologists testified in opposition to the bill. The Wisconsin Society of Anesthesiologists stated the bill contained "many very troubling proposals." Donn Dexter, MD, chief medical officer for the Wisconsin Medical Society and neurologist at Mayo Health System in Eau Claire testified against the legislation, saying the billís scope would be "incredibly ambiguous" and indicating that he believed the new certification was a "shortcut to being a physician."
Sen. Leah Vukmir, chair of the Committee, asked representatives from the Wisconsin Chiropractic Association if any other state has similar prescribing authority for chiropractors. Lefler testified that New Mexico and Oklahoma had limited prescribing authority for chiropractors, but he said Wisconsin has a "chance to lead the nation" and is the first state to "come to the table" with this type of proposal.
The Wisconsin Hospital Association has registered against SB 762.
The Legislature is adjourned for the 2015-16 legislation session, therefore SB 762 will not move forward this year.
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On August 17, WHA is offering the workshop "Re-Energizing Fall and Injury Prevention Practices," which will focus on the state of science specific to fall and injury prevention, shifts in regulatory guidelines, and best practice approaches to fall risk and injury reduction. Registration is now open at https://events.SignUp4.net/FallsInjuryPrevent0817.
This one-day workshop will be led by Patricia Quigley, PhD, nationally-renowned expert in clinical practice innovations in patient safety, nursing and rehabilitation designed to promote independence and safety. Quigley has a legacy of leadership in health care outcomes related to functional improvement, rehabilitation outcomes and continuum of care. She serves as the patient safety expert for fall and injury reduction to the Hospital Engagement Networks. Her leadership in falls risk and injury prevention research has resulted in redesign measurement of patient safety indicators for falls and fall injuries that link organizational, unit and patient-level variables that are relevant and evidence-based.
Quality and patient safety leaders, managers, front-line nursing staff and nursing leaders from hospitals and health systems will benefit most from participating in this workshop. Hospital staff are encouraged to attend as a team, as attendees will engage in group discussions of changes that can be made quickly and those that require added infrastructure and capacity. In addition, post-acute providers who partner with hospitals, including staff from assisted-living facilities, skilled nursing facilities and home health providers should consider attending this important event as well.
The workshop is scheduled August 17 at Glacier Canyon Lodge at The Wilderness Resort in Wisconsin Dells. There is a minimal registration fee to attend this workshop, thanks to funding provided by the Wisconsin Office of Rural Health. For questions about the workshopís content, contact Beth Dibbert at email@example.com or at 608-274-1820.
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On May 20, more than 125 hospital leaders, caregivers and patients came together to attend the WHA Symposium for Patient and Family Centered Care. The Symposium featured The Institute for Patient and Family Centered Care (IPFCC). The IPFCC is globally recognized as a leader in advancing the understanding and adoption of patient and family centric cultures. Throughout the day, participants learned topics ranging from how to get started with partnering with patients and families, to engaging patients and families in clinical interactions, to investigating the role that leaders play in developing a patient and family-centric culture. Attendees left with short and long-term goals to take back and implement at their local hospitals.
Patient and Family Care and Engagement has been a foundational initiative through the WHA Partners for Patients collaborative. The aim of the initiative has been to pool the existing resources within the state of Wisconsin to develop a strategy and structure for facilitating the spread of Patient and Family Centered Care and Engagement through education, consultation, collaboration, training and dedication. The results have been impressive. In two short years the number of Patient and Family Advisory Councils (PFAC) at member hospitals has more than tripled. A Patient and Family Advisory Council (PFAC) is an organized structured committee with the purpose of partnering patients and families with members of the health care team to provide guidance on how to improve the patient and family experience.
"PFACs are essential in helping guide hospitals to approach improvements with the patients and their families in mind. By engaging the patients and family members through advisory councils, hospitals have been able to improve quality and safety as well as increase efficiencies and reduce costs," according to Kelly Court, WHA chief quality officer.
To learn more about how WHA can support patient and family-centered care improvement efforts for member hospitals, contact Court at firstname.lastname@example.org.
Top of page (5/27/16)
The Wisconsin Collaborative for Healthcare Quality (WCHQ) is partnering with the Wisconsin Department of Health Services to host the third annual Statewide Quality Improvement Event focused on improving the quality of care and patient outcomes in Wisconsin. This event is designed for clinical, operational, quality, and executive leaders and staff from health systems, medical groups, hospitals and clinics. Other health care stakeholders are welcome to attend.
Additional information and registration are available at: http://onlinecommunity.wchq.org/event/SQIE2016.
Top of page (5/27/16)