July 11, 2014
Volume 57, Issue 28

WHA Sponsors WisconsinEye Candidate Interviews
WisEye election coverage 2014 features hundreds of interviews, full election coverage

Wisconsin’s primary elections are only a month away—August 12—with the general election taking place November 4. To help educate the public on the hundreds of candidates running for office statewide, WisconsinEye, our state’s version of C-SPAN, is conducting interviews with every candidate running for office this election cycle. To help support this important public service of WisconsinEye, the Wisconsin Hospital Association is sponsoring WisconsinEye’s 2014 candidate interviews.

"Over the next several months, you will hear candidates share their views on many important issues, including health care. I encourage you to listen carefully and participate in those discussions," WHA Executive Vice President Eric Borgerding says in a taped introduction featured in WisEye’s Campaign 2014 coverage. "For over 90 years, WHA has been an advocate for sound health care policy, and that is why today we are proud to sponsor WisconsinEye’s candidate interviews and election coverage."

The WisconsinEye interviews include statewide races, Congressional races and state legislative races, with new candidate interviews added on a near-daily basis. WisconsinEye is a statewide, non-partisan, non-profit, independent television network devoted to covering state government and civic activities throughout Wisconsin.

Watch for more health care-focused WHA-Wisconsin Eye partnerships in the near future.

Learn more and watch the candidate interviews by logging onto WisconsinEye’s "Campaign 2014" portal at: www.wiseye.org/Programming/Campaign2014.aspx.

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Political Action Fundraising Campaign Climbs to $139K
30 more participants joined in last two weeks

The Wisconsin Hospitals Conduit and State PAC annual campaign so far has raised $138,745 from 187 individuals. This puts the 2014 campaign at 52 percent of the goal to raise $265,000 by the end of the year.

Individuals are contributing an average of $741, which is the same as last year, but the number of participants so far in 2014 is up by 42 people from last year. This year’s campaign is outpacing both the 2013 campaign ($107,000) and the last election year campaign in 2012 ($114,000) in all areas including dollars raised, number of participants and Platinum Club members.

Of the total contributors so far, 53 are members of the Platinum Club who have contributed $1,500 or more to the 2014 campaign vs. 42 members at this same time last year.

Individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. Thank you to the 2014 contributors to date who are listed on page 7. Contributors are listed alphabetically by contribution amount category. The next publication of the contributor list will be in the July 25 edition of The Valued Voice. For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

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Register Now for WHA’s Reproduction Health Law Manual Webinar

WHA will continue its months-long complimentary webinar series on July 24 from 12-1:30 p.m. with a presentation of the WHA Reproduction Manual. This webinar will address the legal issues related to reproduction, including contraception, the human papillomavirus vaccine, sterilization and surrogacy.

WHA members are encouraged to register for this webinar as well as any or all of the other webinars in the series. To register or for more information about each of the remaining webinars, go to http://events.SignUp4.net/HealthLawManual. Attorneys in attendance may earn CLE credit.

This webinar will be presented by Kerry Moskol and Jennifer Hennessy of the law firm of Quarles & Brady.

The Health Law Manuals are available for WHA members to view and download at www.wha.org/healthLawManual.aspx. WHA members who would like access to the manuals should contact webmaster@wha.org to request a username and password.

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CMS Releases 2015 Outpatient PPS Proposed Rule

Last week, the Centers for Medicare & Medicaid Services (CMS) released the 2015 outpatient prospective payment system (PPS) proposed rule. Some of the highlights in the rule are below.

Payment Update: The proposed rule includes a market basket update of 2.7 percent, as well as a productivity reduction of 0.4 percentage points and an additional reduction of 0.2 percentage points, as required by the Affordable Care Act (ACA). This results in a proposed market basket update for CY 2015 of 2.1 percent for those hospitals that publicly report data on 22 quality measures. For hospitals that do not report, the update would be 0.1 percent.

Establishing Comprehensive Ambulatory Payment Classifications (APCs): In the CY 2014 outpatient PPS final rule, CMS created a number of comprehensive ambulatory payment classifications (APCs), which package an expanded number of related items and services into a single payment for a comprehensive primary service under the outpatient PPS. Specifically, in the CY 2014 final rule, CMS created 29 comprehensive APCs, which were to replace the 29 existing device-dependent APCs, to pay for high-cost device-dependent services using a single payment for the entire outpatient hospital stay. However, CMS delayed implementation of this policy until CY 2015 to provide CMS and hospitals with more time to evaluate and refine the policy.

In this CY 2015 proposed rule, CMS reaffirms its plan to implement comprehensive APCs but proposes certain modifications. Under these changes, CMS proposes a total of 28 comprehensive APCs for 2015.

Packaging Proposals: CMS proposes to conditionally package the costs of certain ancillary services into the primary service with which they are furnished. Under conditional packaging, however, when these ancillary services are furnished by themselves, CMS would make a separate payment for them. For the initial application of this policy in CY 2015, the agency would package ancillary services that have a geometric mean cost of less than or equal to $100. CMS proposes to exclude from this ancillary services packaging policy preventive services, certain psychiatry and counseling-related services and very low-cost drug administration services. In a separate proposal, CMS would designate prosthetic supplies, which are currently paid under the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule, as covered outpatient department services payable under the outpatient PPS and package them into the surgical procedure APC with which they are billed.

Area Wage Index Update: CMS proposes to use the final FY 2015 inpatient PPS wage index as the wage index for the CY 2015 outpatient PPS. Therefore, as with the FY 2015 inpatient PPS wage index, the CY 2015 outpatient PPS wage index will be based on the most recent labor market areas that were issued by the Office of Management and Budget (OMB) on Feb. 28, 2013 in OMB Bulletin No. 13-01 and include an updated list of core-based statistical areas (CBSAs) that reflect the OMB’s 2010 standards and 2010 Census data.

CMS proposes to apply the same wage index transition periods to the outpatient PPS as it proposed for the inpatient PPS. These transitions would be applicable to all hospitals that experience negative impacts due to the proposed implementation of the new CBSAs. The agency indicates that these transition periods are consistent with the transition period it implemented in the FY 2005 inpatient PPS rulemaking process when CMS updated the areas to reflect 2000 Census data.

Outpatient Quality Reporting (OQR) Program: CMS proposes to add one new measure to the OQR for CY 2017—Facility seven-day risk-standardized hospital visit rate after outpatient colonoscopy. This measure includes all-cause, unplanned hospital admissions, ED visits and observation stays within seven days of a colonoscopy procedure. The measure is not yet endorsed by the National Quality Forum, and was only conditionally supported by the Measure Applications Partnership. CMS proposes to use the same quantitative criteria for assessing "topped out" measure performance as it uses in the hospital value-based purchasing (VBP) program, and recently proposed for the hospital inpatient quality reporting (IQR) program. Using these new criteria, CMS proposes to remove three "topped out" measures from the OQR program for CY 2017—a cardiac care measure and two perioperative antibiotic prophylaxis measures. CMS also proposes to change from required to voluntary reporting a cataract surgery measure assessing improvement in patients’ visual function within 90 days. CMS had already suspended this measure from reporting in March 2014 due to data collection issues. In addition, CMS would update the OQR data validation process and formal data correction process.

For future payment determinations, CMS is considering expanding current measure areas to include electronic clinical quality measures. One electronic clinical quality measure currently included in the OQR Program is OP-18: median time from ED arrival to ED departure for discharged ED patients. CMS states a belief that health information exchanges (HIEs) and the use of certified electronic health records (EHRs) can effectively and efficiently help providers improve internal care delivery practices, support management of patient care across the continuum, and support the reporting of electronically-specified clinical quality measures (eCQMs). CMS also states that it recognizes that considerable work needs to be done by measure owners and health information technology developers and implementers to make this possible.

The 2015 outpatient PPS proposed rule will be published in the July 14 Federal Register. WHA is working on a more detailed analysis of the rule, which will be coming out in the next couple of weeks. All completed PPS rule summaries can be found on the WHA website at www.wha.org/medicare.aspx. WHA will also be preparing hospital-specific analysis on the fiscal impact of the 2015 Outpatient PPS proposed rule in the next few weeks. Hospital-specific reports can be obtained on the WHA member portal at http://members.wha.org/Home.aspx.

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Wisconsin Hospitals Launch Statewide TeamSTEPPS Collaborative

Wisconsin hospitals continue to demonstrate their ongoing commitment to quality improvement and patient safety. Most recently, 24 hospital managers and senior leaders attended the TeamSTEPPS Master Training Course at the National Conference held in Minneapolis, Minnesota (http://teamstepps.ahrq.gov). Wisconsin had one of the largest showings of any state at the event. The Wisconsin Hospital Association will work with these individuals over the next six months to help them implement what they learned at the conference and then share that knowledge statewide.

TeamSTEPPS is a comprehensive safety culture program developed by the Agency for Healthcare Research & Quality (AHRQ) and the Department of Defense, which aims to improve the ability of teams within an organization to respond quickly and effectively to numerous patient safety situations. Early adoption of TeamSTEPPS has been successful because the program is a research-based curriculum that is highly adaptable to the needs of any health care institution.

The 24 individuals who attended the master training course received information on the fundamentals of the program and learned from the experiences of hospitals that previously implemented TeamSTEPPS. Topics covered ranged from the basics of team structure and communication to more complex topics such as change management, situation monitoring and effective evaluation. The tools from TeamSTEPPS are easy to use, adaptable to any setting, and provide the fundamentals to growing a strong team.

"I am excited to introduce this into our organization to improve communication through the use of the TeamSTEPPS tools. It will enable a focus on safety using a systematic method of communication, while eliminating the fear to speak up," said Katie Spiegel of Langlade Hospital – An Aspirus Partner, who attended all three days of the training.

Tom Kaster and Travis Dollak, two of WHA’s improvement advisors, also attended the program.

In summarizing the event, Dollak said, "TeamSTEPPS will provide an opportunity for our hospitals to customize and implement some new tools that they can apply to their unique situations. I am confident this will spread quickly because Wisconsin hospitals are so collaborative. If it works well and improves patient care and safety, our hospitals will quickly share it."

The next step, according to Kaster, is for WHA to host a mini-collaborative or develop an advisory board to determine how to involve more hospitals in TeamSTEPPS.

"We plan to leverage the knowledge that we have gained to the benefit of all our member hospitals to continue to strengthen Wisconsin’s culture of patient safety," Kaster said.

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Front-Line Nurses Find Success in TCAB

The success of Transforming Care at the Bedside (TCAB) transcends all generations of nursing to create a positive culture for change. Jodi Johnson, WHA vice president, workforce and clinical practice, completed her first round of TCAB site visits to Wisconsin hospitals.

"I continue to be impressed by the progress the TCAB teams have made in implementing innovations that enhance patient-focused care," says Johnson. "These sometimes small changes can make a big difference in the quality of patient care."

Mercy Hospital and Trauma Center in Janesville proudly showcased the team of nurses with 15-plus years of experience who are leading the TCAB team on the specialty care unit. Currently the team is working on a project related to decentralizing nursing supplies. By decentralizing or reorganizing into a few areas throughout the nursing unit, it has improved efficiency so nurses are spending more time at the patient’s bedside instead of seeking supplies. The culture at Mercy is one of interest because the more experienced nurses are leading the change and the newer nurses are following their lead. This display of synergy between nursing generations is promoting success in the specialty care unit.

The emergency room TCAB team at Wheaton Franciscan Healthcare in Franklin was very excited to share their accomplishments after only the first quarter of TCAB. The team’s projects had an overarching theme centered on communication. Signs were created to signify to staff that a procedure was in progress to prevent interruptions in the patient’s room. Implementation of bedside report has improved hand-off communication not only among the emergency department staff, but it is now extending to other units that are accepting ER transfers. The TCAB team feels that bedside report among nurses in different departments will allow for seamless care transitions for their patients.

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Last Call for Nominations: WHA Foundation’s 2014 Global Vision Award
Nominations due by July 15

Nominations for the 2014 Global Vision Community Partnership Award, presented by the WHA Foundation, are due by July 15, 2014. The official call for nominations for the 2014 Award is included in this week’s packet or can be found on the WHA website at www.wha.org/global-vision-comm-partnership.aspx.

The Award is a competitive grant presented to a community health initiative that successfully addresses a documented community health need. Any WHA hospital member can nominate a project that has been in existence for a minimum of two years and is a collaboration between the hospital and an organization within the community.

Launched by the WHA Foundation in 1993, the Award seeks to recognize ongoing projects that support community health. Honor one of your hospital’s community health projects by submitting a nomination today. For more information about the Award, contact Jennifer Frank at jfrank@wha.org or 608-274-1820.

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WHPRMS Annual Conference, September 24-26

The Wisconsin Healthcare Public Relations & Marketing Society (WHPRMS) is holding its 2014 Annual Conference September 24-26 at the Wilderness Resort in Wisconsin Dells. There will be an optional pre-conference workshop on how to embrace and operationalize digital marketing from two leading digital marketing experts. The conference kicks off Thursday morning with a presentation by Barbara Thompson, president/CEO of The Roberts Group, on how to identify and foster a solid work ethic in the health care workforce.

Additional conference topics include marketing to men, implementing a CRM initiative, health care marketing 101, how to successfully use data to take your business to the next level, using a brand compass, and presentations focusing on social media. The conference will conclude Friday morning with a presentation by Don Seymour, president, Don Seymour & Associates, covering health care trends and how to incorporate those trends into an organization’s strategic planning.

Public relations and marketing professionals from hospitals, clinics and other health care provider organizations throughout Wisconsin will want to register. You do not need to be a member of WHPRMS to attend this event.

The full agenda and registration information are at: http://whprms.org/annual-conference. Register by August 1 to receive the early bird discount. If you have questions, contact Nicole Barreau at educationchair@whprms.org or 608-265-1618.

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Member News: Andersen Named President/CEO of Columbia St. Mary’s

Ascension Health and Columbia St. Mary’s Health System announced that Travis Andersen has been named president and CEO of Columbia St. Mary’s Health System in Milwaukee. Andersen assumes the role previously held by Mark Taylor, who retired at the end of June. Andersen will begin his new responsibilities August 4, 2014.

Andersen comes to Columbia St. Mary’s Health System from Ministry Health Care, where he served as president of St. Elizabeth Hospital in Appleton and oversaw Calumet Medical Center, Chilton.

During Andersen’s tenure, St. Elizabeth Hospital showed strong results in clinical quality, patient experience, growth and physician and associate engagement.

Andersen came to Wisconsin in 2001, when he joined Affinity Health System (which became a wholly- owned ministry of Ministry Health Care in 2012), as director of business development. Prior to coming to Wisconsin, Andersen was an area manager with John Deere Health of Moline, IL where he had responsibility for 120,000 members of their health plan. Andersen earned his master’s in hospital and health administration from the University of Iowa.

Nick Desien, president/CEO of Ministry Health Care and the Ascension Health Ministry market leader for Wisconsin, said, "Travis has done an outstanding job of advancing St. Elizabeth Hospital. He has engaged and energized not only the organizations’ physicians, associates and boards but also the entire Appleton community. He is an excellent choice to lead Columbia St. Mary’s."

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