Health Committee Leaders, WHA Host Capitol Briefing on Health Care Quality

WHA members explain how they improve care, reduce costs, improve patient outcomes

September 15, 2017

Three innovative programs that are improving patient care and reducing health care costs in Wisconsin were shared at a briefing hosted by WHA in the State Capitol September 14. More than 40 legislators and members of their staff attended the session. State Rep. Joe Sanfelippo, chair of the Assembly Health Committee, led a bipartisan group of Health Committee leaders who encouraged lawmakers and staff to attend this briefing by WHA. Sanfelippo, WHA’s 2017 Health Care Advocate of the Year, provided introductory remarks at the briefing. 

“Over the past few years, with all the distractions we have had with Obamacare and everything, it is easy to get caught up in that and forget about what we have here in the state of Wisconsin,” Sanfelippo said. “This presentation is going to remind us what great hospitals and hospital systems we have in our state, and the level of health care that our citizens get is above and beyond what many of the country get to experience. I am excited to be part of this presentation.” 

WHA President/CEO Eric Borgerding said quality health care is an economic advantage for Wisconsin.

“We need to understand what high-quality care means for Wisconsin. Of course, it means better outcomes for patients, better care for patients and their families, but it also has an impact on our economy, economic development and employers locating to our state,” Borgerding said. “That is why it is important to have good public policy in place that supports quality improvement and population health.”

WHA Chief Quality Officer Kelly Court described how hospitals and health systems are using data and analytics created by the WHA Information Center to identify patient populations who are at higher risk for certain diseases or conditions. WHA’s staff works closely with individual hospitals and health systems to advance their quality improvement activities by using data and creating networks that allow hospitals to share best practices.

Court cited two key pieces of WHA-supported legislation that have advanced quality improvement in recent years. The Quality Improvement Act added legal protections to information shared between hospitals that is used for quality improvement purposes, and the Data Modernization Act provides the WHA Information Center with the ability to assess patient condition information at a more precise and accurate geographic level, which is critical for health care data users, such as hospitals, who are preparing population health strategies in the communities they serve.

Hospitals are working beyond their walls, according to Laura Rose, WHA vice president, policy development. She described WHA’s work in the area of developing policy initiatives aimed at improving the ability of hospitals and health systems to provide or locate post-acute care for their patients.

“We know there are patients who are ready to be discharged from the hospital, but have waited in the hospital for as long as 45 days for placement in an appropriate skilled nursing facility,” Rose said.

Three health systems presented at the briefing. Lois Van Abel from Bellin Health Care in Green Bay, described Bellin Health’s “Next Generation” accountable care organization’s work that has improved quality and the patient experience while reducing costs. Bellin and ThedaCare participated in the Pioneer ACO program, and over three years saved the Centers for Medicare and Medicaid Services $14 million in Medicare costs.

“It requires a lot of coordination to achieve those savings—work we do not get paid for,” according to Abel. “We basically never ‘discharge’ a patient, instead we ‘transition’ them to a new setting and work closely with partners in that community to coordinate care.”

Engaging patients in their own care and connecting them to a medical home is critically important in controlling costs and improving care for those who are high utilizers of emergency department services. Robert Marrs, Aurora Health Care, said high utilizers account for 25 percent of health care services. The problem is how to deliver health care to those who need it most and have multiple other issues that are usually outside of the scope of the hospital to solve.

Marrs said Aurora Sinai developed a program called “Coverage to Care” where social workers receive coaching in behavioral health and do what he described as “forensic care planning.” They determine the usage patterns of these complex, high users of health care, then they connect them to a medical home and the social services to stabilize the patient not only medically, but also ensure they can lead a healthier, more productive life. Marrs credited the bipartisan HIPAA Harmonization Act, championed by WHA in 2013, as a public policy that has strengthened the ability for providers to communicate with each other and make Coverage to Care more successful.

Ascension-St. Joseph’s Hospital, also in Milwaukee, has also implemented a program called “Transitions in Care” that connects patients to a medical home and reduces ER visits.

Linda Puccini said St. Joseph’s has one of the busiest ERs in the state, with more than 85,000 visits every year. Their goal was to reduce non-urgent ER visits by providing patients with education and resources, and connect patients to a primary care physician.

“We built a relationship with the patient, even going with them to their first doctor’s visit if they were nervous about it,” Puccini said.

More than half of the patients enrolled in their care program were enrolled in Medicaid and 14 percent were uninsured. The program was successful in not only reducing ER visits, but also reduced readmissions and revealed social needs of the patients, which the hospital accounted for in their care plans.

Borgerding said hospitals’ and health systems’ efforts to improve the quality of care are also lowering the cost of care, and ensuring patients are able to resume their daily activities, return to work sooner and have better outcomes from the care they receive.

“It’s care that is proven to work,” Borgerding said. “That is why Wisconsin’s health care is an economic advantage to our employers, a benefit to their employees and a factor in moving our state to a higher level of wellness.”  

This story originally appeared in the September 15, 2017 edition of WHA Newsletter