January 5, 2018

Volume 62-Issue 1

Judge Dismisses 340B Lawsuit as Premature; Fight Not Over

Opposing 340B legislation pending in Congress

On December 29, 2017, a federal judge dismissed a lawsuit filed by the American Hospital Association (AHA), the Association of American Medical Colleges (AAMC) and America’s Essential Hospitals over a Centers for Medicare & Medicaid Services (CMS) policy cutting 340B payments to certain hospitals. The court ruled the lawsuit was premature since the cuts had yet to take effect. The court did not rule on the merits of the claim, leaving open the option of refiling the lawsuit once cuts go into effect. The cuts took effect January 1, 2018.

“We are disappointed in the court’s initial decision,” said Wisconsin Hospital Association President/CEO Eric Borgerding. “However, we will continue to support our member hospitals and our national counterparts as we move forward together in protecting this essential program.”

In December, WHA joined 31 other hospital associations across the country in an amicus brief in support of the AHA’s position on AHA v. Hargan.

On the legislative front, U.S. Reps. McKinley (R-WV) and Thompson (D-CA) introduced legislation in late 2017 to stop the CMS cuts from going into effect. That legislation, HR 4392, is supported by WHA. It currently has 167 cosponsors, including four bipartisan members of Wisconsin’s delegation: Reps. Kind, Moore, Pocan, and Gallagher.

“WHA appreciates the broad bipartisan support in Congress for the 340B program and, in particular, for HR 4392,” said Borgerding. “We urge Congress to support this bill and to halt the 340B cuts as the court case continues to unfold.”

On the other side of this issue is legislation supported by the pharmaceutical industry, HR 4710, introduced by U.S. Reps. Bucshon (R-IN) and Collins (R-NY). The bill would initiate a two-year moratorium on certain new 340B-covered entities (and child sites) as well as require multiple new reporting requirements. WHA opposes this legislation as overly burdensome and restrictive.

Top of page (1/5/18)

DHS Announces New Grants to Support Graduate Medical Education

Grant program a key WHA policy initiative to increase physician workforce

A new round of state grant funding totaling more than $2.9 million to support development of three new residency programs and eight new resident positions in current programs was awarded this week by the Wisconsin Department of Health Services (DHS). The new round of grants builds upon over $22 million in new funding and matching private investment in graduate medical education (GME) enabled by the creation of the DHS Graduate Medical Education Program first established in the 2013-15 state budget and expanded in the 2017-19 state budget. Developed by and a key state budget priority for WHA, the previous awards from the program have created seven new residency programs on track to train at least 79 new residents in Wisconsin.

“It is rewarding to see the DHS grant program, a public policy solution created, championed and now grown by WHA, moving forward toward fulfillment of all of our mutual objectives of expanding GME in critical shortage areas,” said Eric Borgerding, WHA president/CEO. “WHA looks forward to continuing to work with our members, DHS, legislators and the governor as we pursue our standing agenda to expand GME in Wisconsin.”

DHS announced new three-year grants to support development of new GME programs at:

  • Ascension St. Michael’s Hospital, Stevens Point – Family Medicine
  • Health Sisters Health System (HSHS) St. Mary’s Hospital Medical Center, Green Bay – Family Medicine
  • The Medical College of Wisconsin, Milwaukee – Addiction Psychiatry Fellowship

Existing accredited GME programs receiving new funding for new resident positions for the length of the residency are:

  • Gundersen Lutheran Medical Center Family Medicine Resident Training Program
  • SSM Health Monroe Clinic Hospital Rural Family Medicine Resident Training Program
  • The Medical College of Wisconsin Central Psychiatry Resident Training Program
  • University of Wisconsin-Madison Addiction Medicine Fellowship Program

“Based on current data, we know that Wisconsin faces a significant physician shortage in the near future due to a number of factors, including an aging population, increases in chronic diseases and retiring physicians,” Gov. Scott Walker said. “Our investments in expansion of GME programs help ensure that we can meet this challenge. This year, we also increased our investments in addiction medicine and addiction psychiatry to address the opioid crisis by supporting new fellowships in these specialties.”

“DHS applauds the hard work demonstrated by these successful applicants, including creating partnerships with rural facilities for new clinical training opportunities,” DHS Secretary Linda Seemeyer said. “We know that this training coupled with residents who have prior or existing ties to Wisconsin significantly increases the likelihood that resident physicians will establish their practices in these or similar rural areas.”

Top of page (1/5/18)

WI Hospitals State PAC & Conduit Surpasses Fundraising Goal!

340 individuals contributed in 2017; disbursements top $225,000

The Wisconsin Hospitals State PAC & Conduit surged past its aggressive $312,500 fundraising goal in late December on the way to hitting a record-setting total of $317,569. A total of 340 individuals contributed in 2017 to propel the campaign forward. What were a few of the year-end stats for 2017?

  • Over $6,107 was raised, on average, each week in 2017.
  • Contributors gave an average of $934 each.
  • Club Level giving continued growing in 2017 with 85 individuals giving at one of the three levels:
    • Leaders Circle ($5,000+) – 6 individuals contributed at this level.
    • Platinum Club ($3,000-$4,999) – 21 individuals contributed at this level. This is up 6 contributors over 2016.
    • Gold Club ($1,500-$2,999) – 58 individuals contributed at this level. This is up 9 contributors over 2016
  • In 2017, 70 new contributors came on board.
  • In a non-election year, over $225,000 was still disbursed to candidate campaigns, both Democrats and Republicans.

“Thank you, again, to everyone who contributed in 2017. Your generosity and commitment to political advocacy is greatly appreciated,” said WHA President/CEO Eric Borgerding. “Additionally, thank you to the many Wisconsin Hospitals Conduit contributors who disbursed hundreds of thousands of dollars in this non-election year. Your commitment helps keep Wisconsin health care moving forward.”

See the final list of 2017 Wisconsin Hospitals State PAC & Conduit contributors below.

Contributors ranging from $1 to $499
Anderson, Eric Aspirus, Inc.
Anderson, Marty Marshfield Clinic
Bagnall, Andrew HSHS - St. Nicholas Hospital
Bauman, Jan Divine Savior Healthcare
Bea, Javon Mercyhealth 
Bengtson, Carolyn Mercyhealth Hospital & Trauma Center - Janesville
Benning, Joanna Mercyhealth 
Benz, Betsy Aurora Medical Center- Two Rivers
Bortner, Barbara Mercyhealth Hospital & Trauma Center - Janesville
Breen, Melissa Marshfield Clinic
Brenner, Holly Agnesian HealthCare
Burch, Todd Aspirus Riverview Hospital & Clinics
Busch, Rebecca Spooner Health System
Brice, Kaitlin HSHS - Eastern Wisconsin Division
Byrne, Frank SSM - St. Mary's Hospital
Cahoy, Jim WHA Information Center
Cameron, Kelli Mercyhealth Hospital & Trauma Center - Janesville
Carr, Alistair WHA Information Center
Clark, Julie HSHS - St. Joseph's Hospital
Cliffe, Elizabeth Ascension Wisconsin
Collins, Sherry Wisconsin Hospital Association
Cook, John Mercyhealth Hospital & Trauma Center - Janesville
Competente, Brian WHA Information Center
Cranley, Patrick Mercyhealth Hospital & Trauma Center - Janesville
Danner, Forrest Aspirus Clinics
Decker, Michael Divine Savior Healthcare
Derks, Jenny Affinity Health - Calumet Medical Center
Dettman, Amy Bellin Hospital
Dorsey, John Mercyhealth Hospital & Medical Center - Walworth
Dresang, Andrew Froedtert Health
Drone, Kim Wisconsin Hospital Association
Dux, Larry Froedtert & MCW Community Memorial Hospital campus
Gordon, Edwards Marshfield Clinic
Ferrigno, Sandra SSM - St. Mary's Hospital
Fielding, Laura Holy Family Memorial, Inc.
Foley, Kathy Kelsey Aspirus
Folstad, John HSHS - Sacred Heart Hospital
Franzen, Kimberly HSHS - St. Vincent Hospital
Garibaldi, Isabelle Watertown Regional Medical Center
Goelzer, Mark Mercyhealth Hospital & Trauma Center - Janesville
Groskreutz, Kevin HSHS - St. Joseph's Hospital
Halida, Cheryl HSHS - St. Joseph's Hospital
Hall, Jennifer Mercyhealth Hospital & Trauma Center - Janesville
Hallatt, Jeni Mercyhealth Hospital & Medical Center - Walworth
Hanson-Mays, Joan Black River Memorial Hospital
Harris, Kathleen Ascension Mercy Medical Center
Hart, William Columbia St. Mary's Hospital - Milwaukee
Hermel, Cindy Aspirus Wausau Hospital
Hieb, Laura Bellin Hospital
Helgeson, Jason HSHS - Eastern Wisconsin Division
Hendrix, Jamie Columbus Community Hospital
Hill, Juliet HSHS - Sacred Heart Hospital
Hinner, William Ascension St. Clare's Hospital
Jensen, Tom Mercyhealth 
Johnson, Kimberly HSHS - Sacred Heart Hospital
Kaufmann, Marilyn Holy Family Memorial, Inc.
Kempen, Jacob Aspirus Wausau Hospital
Klay, Chris HSHS - St. Joseph's Hospital
Kluth, Doreen HSHS - St. Vincent Hospital
Koebke, Troy Bellin Hospital
Kruse, Joe Mayo Clinic Health System - Franciscan Healthcare
Layman, Ben SSM - St. Mary's Janesville Hospital
Lerch, Shawn Sauk Prairie Healthcare
Lippert, Michele Mercyhealth Hospital & Trauma Center - Janesville
Luehring, Sally HSHS - St. Vincent Hospital
Lux, Teresa Froedtert & MCW Community Memorial Hospital campus
Lynch, Sue Mayo Clinic Health System - Franciscan Healthcare
Malone, Virginia SSM - St. Mary's Hospital
Manning, Bradley Meriter - UnityPoint Health
Mannix, Peter HSHS - St. Clare Memorial Hospital
Manley, Paula Prevea Health/Hospital Sisters Health System
Margan, Rob Wisconsin Hospital Association
Markgraf, Janelle Aspirus Langlade Hospital
Maurer, Mary Holy Family Memorial, Inc.
McCawley, Thomas Beloit Health System
McMeans, Scott Aurora BayCare Medical Center 
Meicher, John SSM - St. Mary's Hospital
Mercer, Carla Reedsburg Area Medical Center
Miller, Thomas Children's Hospital of Wisconsin
Mirasola, Tony WHA Information Center
Nagle, Dan WHA Information Center
Nevers, Rick Aspirus Medford Hospital & Clinics, Inc.
Nicklaus, Todd Aspirus, Inc.
O'Brien, Colleen Bellin Health System
O'Connell, Kevin Aspirus Wausau Hospital
O'Keefe, James Mile Bluff Medical Center
Page, Alison Western Wisconsin Health
Parker, Bessant Aspirus Langlade Hospital
Pavelec-Marti, Cheryl Ascension St. Michael's Hospital
Peck, Lori Aspirus, Inc.
Peiffer, Susan HSHS - Sacred Heart Hospital
Pempek, Kalynn Aspirus, Inc.
Penovich, Carrie Aurora Medical Center - Two Rivers
Pinske, Heather SSM - St. Mary's Hospital
Potempa, Debra Mercyhealth 
Prunty, Brian Aspirus
Quackenboss, Tatum HSHS - St. Vincent Hospital
Revnew, Dorothy ProHealth Care - Oconomowoc Memorial Hospital
Riddle, Roberta Rusk County Memorial Hospital
Ripsch, Sue Mercyhealth 
Risley-Gray, Ruth Aspirus, Inc.
Roethle, Linda Bellin Hospital
Rude, Nels The Kammer Group
Rudquist, Debra Amery Hospital & Clinic
Rumpf, Michael Fort HealthCare
Schaetzl, Ron SSM - St. Clare Hospital & Health Services
Schattschneider, Tami Agnesian - Ripon Medical Center
Schrieber, Sue Mercyhealth 
Selle, Ginger SSM - St. Clare Hospital & Health Services
Sheehan, Heather Hayward Area Memorial Hospital and Nursing Home
Smith, Robert Aspirus Wausau Hospital
Stamas, Peter Ascension St. Clare's Hospital
Strasser, Kathy Aspirus, Inc.
Statz, Darrell Rural Wisconsin Health Cooperative
Staudenmayer, Suzanne WHA Information Center
Stelzer, Jason SSM - St. Clare Hospital & Health Services
Stephens, Brian Door County Medical Center
Tandberg, Ann HSHS - St. Joseph's Hospital
Tapper, Joy Milwaukee Health Care Partnership
Telega, Craig Marshfield Clinic
Thompson, Mark SSM Health - Wisconsin
Thompson, Mark Aurora Health Care
Thorton, Eric SSM - St. Mary's Janesville Hospital
Tincher, Pat Aspirus Langlade Hospital
Trinkner, Steve WHA Information Center
Van den Heuvel, Paul Mercyhealth 
VanStraten, Randy Bellin Hospital
Waldoch, Timothy Columbia St. Mary's, Inc.
Walker, Troy SSM - St. Clare Hospital & Health Services
Walters, Robert Mercyhealth 
Werkheiser, Cindy Monroe Clinic
Westbrook, Diane River Falls Area Hospital
Wetenkamp, Vicki Holy Family Memorial, Inc.
Wilczek, Teri Marshfield Clinic
Wymelenberg, Tracy Aurora Health Care
Wysocki, Scott SSM - St. Clare Hospital & Health Services
Yarbrough, Ruth Mercyhealth 

Contributors ranging from $500 to $999
Alstad, Nancy Fort HealthCare
Bayer, Tom HSHS - St. Vincent Hospital
Braun, James Flambeau Hospital
Brenny, Terrence Stoughton Hospital Association
Brophy, Michael Aurora Health Care
Carlson, Peter Aurora Psychiatric Hospital
Cormier, Laura Bellin Hospital
Cottrell, Michael HSHS
Curran-Meuli, Jane Holy Family Memorial, Inc.
DeGroot, Dan HSHS - St. Clare Memorial Hospital
Dexter, Donn Mayo Clinic Health System - Eau Claire
Edwards, Gordon Marshfield Clinic
Elfner, Christopher Bellin Health System
Elkins, Kelly Ascension/Columbia St. Mary's
Fitzpatrick, Carrie Aurora Health Care
Francaviglia, Stephen Aurora Health Care
Francisco, Margo SSM - St. Mary's Hospital
Geboy, Scott Hall, Render, Killian, Heath & Lyman
Gille, Larry HSHS - St. Vincent Hospital
Graf, John Watertown Regional Medical Center
Griffin, Gregory  
Gutsch, Mike Cumberland Healthcare
Hartberg, David Gundersen - Boscobel Area Hospital and Clinics
Heaney, Dwight Fort HealthCare
Herbst, Amy Children's Hospital of Wisconsin
Herzog, Sarah Ascension/Wheaton Franciscan Healthcare
Jensema, Christine HSHS - Eastern Wisconsin Division
Johnas, Lora HSHS - Sacred Heart Hospital
Just, Lisa Aurora Memorial Hospital of Burlington
Keddington, Richard Watertown Regional Medical Center
Kersten, Juliet Children's Hospital of Wisconsin
Kingston, Mary Beth Aurora Health Care
Kneiser, Patti Froedtert & The Medical College of Wisconsin
Larson, Margaret Ascension Mercy Medical Center
Lentz, Darrell Aspirus Wausau Hospital
Logemann, Cari Aspirus, Inc.
McDonald, Brian Aurora Health Care
McMeans, Scott Aurora BayCare Medical Center - Green Bay
McNally, Maureen Froedtert & The Medical College of Wisconsin
Miller, Brent Marshfield Clinic
Myers, Karen Stoughton Hospital Association
Nelson, Meg Children's Hospital of Wisconsin
Nelson, James Fort HealthCare
O'Brien, Colleen Bellin Health System
Ordinans, Karen Children's Hospital of Wisconsin
Pearson, Jane SSM - St. Mary's Janesville Hospital
Peterson, Douglas Chippewa Valley Hospital
Pfaff, Marion Marshfield Medical Center
Quinn, George Wisconsin Hospital Association
Richardson, Todd Aspirus
Richman, Tim Ascension/Wheaton Franciscan Healthcare
Rocole, Theresa Ascension/Wheaton Franciscan Healthcare
Roesler, Bruce The Richland Hospital
Roundy, Ann Columbus Community Hospital
Rislov, Amy Aurora Health Care
Rutkowski, Jennifer Grant Regional Health Center
Schnedler, Lisa Upland Hills Health
Sczygelski, Sidney Aspirus, Inc.
Shabino, Charles Wisconsin Hospital Association
Sprecher, Lon  
Statsick, Nora Wisconsin Hospital Association
Strasser, Kathy Aspirus, Inc.
Stuart, Philip Tomah Memorial Hospital
Van Meeteren, Bob Reedsburg Area Medical Center
Vergos, Katherine Agnesian - St. Agnes Hospital

Contributors ranging from $1,000 to $1,499
Bard, Jeffrey Aurora Medical Center - Oshkosh
Bedwell, Elizabeth Children's Hospital of Wisconsin
Brenton, Andrew Wisconsin Hospital Association
Buck, Catherine Froedtert & The Medical College of Wisconsin
Cadieux, Marc Children's Hospital of Wisconsin
Dietsche, James Bellin Hospital
Doty, Kelsie UW Health
Ericson, Allen Froedtert & MCW St. Joseph's Hospital Campus
Falvey, Patrick Aurora Health Care
Fields, Mary Aurora Health Care
Foley, John Aurora Health Care
Furlong, Marian Hudson Hospital & Clinics
Garcia-Thomas, Cristy Aurora Health Care
Geraghty, Tricia Children's Hospital of Wisconsin
Grebe, Michael Aurora Health Care
Gunn, Veronica Children's Hospital of Wisconsin
Gustafson, Andy & Sara SSM Health
Gutzeit, Michael Children's Hospital of Wisconsin
Hafeman, Paula HSHS - Eastern Wisconsin Division
Jacobson, Terry St. Mary's Hospital of Superior
Jelle, Laura SSM - St. Clare Hospital & Health Services
Kadlec, Mark SSM Health
Katt, Jeff Aurora Health Care
Kulick, Dr. Steven ProHealth Care, Inc.
Lewis, Jonathan SSM - St. Mary's Hospital
McGrail, Michael Aspirus, Inc.
Miller, Kimberly Beaver Dam Community Hospitals
Mugan, James Agnesian HealthCare
Muzi, Titus Aurora Health Care
Nelson, David HSHS - Sacred Heart Hospital
Nelson, Meg Children's Hospital of Wisconsin
Newcomer, Peter UW Health
Norell, Brett Holy Family Memorial, Inc.
Pollard, Dennis Froedtert Health
Punzenberger, Lindsay Children's Hospital of Wisconsin
Reardon, Brian Hospital Sisters Health System
Reding, Dr. Douglas Ascension Wisconsin
Robertstad, John ProHealth Care - Oconomowoc Memorial Hospital
Rohrbach, Dan Southwest Health Center
Roller, Rachel Aurora Health Care
Sahajpal, Ajay Aurora Health Care
Sanders, Robert Children's Hospital of Wisconsin
Schafer, Michael Spooner Health System
Siddalingaiah, Vasanth Aurora Health Care
Sohn, Jonathan Ascension Wisconsin
Tector, Leslie Children's Hospital of Wisconsin
Ter Horst, Thomas SSM Health
Thota, Venkata Aurora Health Care
Veldhouse, Paul Children's Hospital of Wisconsin
Voelker, Dr. Thomas Aspirus Riverview Hospital & Clinics
Wolf, Edward Marshfield Clinic

Contributors ranging from $1,500 to $1,999 - Gold Club
Anderson, Andy Aurora Health Care
Anderson, Sandy Ascension Ministry Health Care 
Bakkum, Kyle Vernon Memorial Healthcare
Barth, Andrew Aspirus Langlade Hospital
Brussow, Julie Security Health Plan
Clapp, Nicole Grant Regional Health Center
Coffman, Joan HSHS - St. Joseph's Hospital
Colman, Gerard Aurora Health Care
Court, Kelly Wisconsin Hospital Association
Doeringsfeld, Jean WHA Information Center
Frank, Jennifer Wisconsin Hospital Association
Grasmick, Mary Kay Wisconsin Hospital Association
Gustafson, Sara UW Health
Gullingsrud, Tim Hayward Area Memorial Hospital and Nursing Home
Harding, Edward Bay Area Medical Center
Heywood, Matthew Aspirus, Inc.
Hilt, Monica Ascension St. Elizabeth Hospital
Hogan, Denis Bellin Health System
Jensen, Jerard Marshfield Clinic
Kluesner, Kevin Ascension Wisconsin
Levin, Jeremy Rural Wisconsin Health Cooperative
Lewis, Gordon Burnett Medical Center
Lindberg, Steve Mayo Clinic Health System - Red Cedar
McKevett, Timothy Beloit Health System
Newson, Reggie Ascension Wisconsin
Oland, Charisse Rusk County Memorial Hospital
Rose, Laura Wisconsin Hospital Association
Rozenfeld, Jonathan SSM - St. Mary's Hospital
Sanders, Michael Monroe Clinic
Sexton, William Crossing Rivers Health Medical Center
Sheehan, John UW Health - The American Center
Teigen, Seth Ascension Wisconsin
Telega, Craig Marshfield Clinic Health System
Turney, Dr. Sue Marshfield Clinic Health System
White-Jacobs, Mary Beth Black River Memorial Hospital
Woleske, Chris Bellin Hospital
Zenk, Ann Wisconsin Hospital Association

Contributors ranging from $2,000 to $2,999 - Gold Club
Bahr, Jeffery Aurora Health Care
Bloch, Jodi Children's Hospital of Wisconsin
Bolt, Elizabeth UW Health
Dallman, Michael University of WI Hospital and Clinics
Faure, Bruce Aurora Health Care
Flannery, Bob UW Health
Hanson, Gail Aurora Health Care
Hanus, Andrew Aurora Health Care
Heisler, John Aspirus Wausau Hospital
Herzog, Mark Holy Family Memorial, Inc.
Kachelski, Joe Wisconsin Statewide Health Information Network
Kaplan, Alan UW Health
Khare, Smriti Children's Hospital of Wisconsin
Lappin, Michael Aurora Health Care
Leitch, Laura Wisconsin Hospital Association
Manas, Julie HSHS - Sacred Heart Hospital
Natzke, Ryan Marshfield Clinic
Norbin Killoran, Carrie Aurora Health Care
Potts, Dennis Aurora St. Luke's Medical Center
Robaidek, Jay UW Health
Russell, John Columbus Community Hospital
Schulze, Connie UW Health
Turney, Dr. Sue Marshfield Clinic Health System

Contributors ranging from $3,000 to $4,999 - Platinum Club
Alig, Joanne Wisconsin Hospital Association
Andersen, Travis Ascension Wisconsin 
Boatwright, Damond SSM Health
Boese, Jennifer Wisconsin Hospital Association
Duncan, Robert Children's Hospital of Wisconsin
Jacobson, Catherine Froedtert & The Medical College of Wisconsin
Kammer, Peter The Kammer Group
Kerwin, George Bellin Hospital
Little, Steven Agnesian HealthCare
Meyer, Daniel Aurora BayCare Medical Center 
Normington, Jeremy Ascension North Central Region 
O'Brien, Kyle & Laura Wisconsin Hospital Association
Pandl, Therese HSHS - St. Clare Memorial Hospital
Potter, Brian Wisconsin Hospital Association
Sherry, Bernie Ascension Wisconsin
Simons, Preston Aurora Health Care
Standridge, Debra Ascension Wisconsin
Stanford, Matthew Wisconsin Hospital Association
Starmann-Harrison, Mary Hospital Sisters Health System
Tyre, Scott Capitol Navigators, Inc
Wallace, Michael Fort HealthCare

Contributors ranging from $5,000 to $9,999 - Leaders Circle
Borgerding, Eric & Dana Wisconsin Hospital Association
Brenton, Stephen Wisconsin Hospital Association
Mettner, Michelle Children's Hospital of Wisconsin
Size, Tim Rural Wisconsin Health Cooperative
Troy, Peggy & Ron Children's Hospital of Wisconsin
Turkal, Nick Aurora Health Care

Top of page (1/5/18)

President’s Column: Despite Uncertainty in Washington, WI Health Care Steadily Leads the Nation

This column is reprinted from the Wisconsin Bankers Association’s 2018 Wisconsin Economic Report.

Eric Borgerding

2017 was another year of outstanding performance from Wisconsin’s health care system. The highly regarded Agency for Healthcare Research and Quality (AHRQ) ranked Wisconsin health care #1 in the country. This was one of several studies last year that applauded the performance of Wisconsin health care, including having the highest quality rural hospitals, being one of the best states for physicians, the best state for nurses and the best provider-owned health plans in the country.

While these accolades are noteworthy, more remarkable is Wisconsin’s sustained performance. Last year’s top AHRQ ranking was laudable, but even more impressive is that in the 11 years these rankings have been released, Wisconsin has never shown worse than seventh (#1 three times, #2 four times). Our top-ranked health care also delivers downstream benefits for Wisconsin businesses. In times of severe labor shortages, every day on the job matters, and Wisconsin leads the nation in returning injured workers back to their jobs, back to productivity.

Wisconsin’s health care has been so good for so long that most people take it for granted. However, a recent WHA poll of our member hospital and health system leaders, those in part responsible for sustaining that excellence, revealed growing concern over the instability of the insurance market and its impact in Wisconsin.

In my column last year, I said repealing Obamacare, which seemed a certainty in the wake of the election, would prove easier said than done… and it has. Love or hate it, nearly a quarter million Wisconsinites get health insurance from the Obamacare exchange (and probably three times that number are happy their kids, parents, or friends have that coverage). Since Obamacare went into effect in 2014, Wisconsin’s uninsured rate, now at 5.7 percent, has been nearly cut in half. That’s the good news. At the same time, insurance premiums on the exchanges have been steadily rising, indeed spiking in 2018 by an average of 36 percent in Wisconsin. Generous federal subsidies mean most exchange enrollees won’t feel these increases, but those subsidies cost money and Uncle Sam is picking up the growing tab.

One of the key ingredients for high-performing heath care systems is access to insurance coverage. It’s one of the reasons Wisconsin has performed so well for so long. But if Congress can’t deliver on its pledge to replace Obamacare, where does that leave us? The current system could limp along, crippled by incrementally dismantling its components which, absent a comprehensive replacement, will exacerbate both premium increases and taxpayer costs. And if the exchanges eventually fall apart (as some policymakers desire) with nothing to replace them, the ranks of uninsured could swell.

These are not armchair contemplations for Wisconsin health care leaders. As noted in our member survey, the fragmented state of Obamacare is one of the “keep you up at night” concerns most gripping health care today. Since becoming law in 2010, our members have been redesigning care systems and realigning resources within the policy and regulatory frameworks of Obamacare. Given a relative level of stability, some semblance of certainty, Wisconsin health care leaders will not only adapt, but as the record shows, they will excel under any environment. After years of dealing with Dodd-Frank and its related regulatory upheavals, Wisconsin’s banking industry can certainly empathize with health care’s desire for stability and clarity.

Amidst unprecedented uncertainty one thing has, unfortunately, remained constant: the price-inflating dynamic of government “cost shifting.” To be sure, more insurance coverage has meant fewer unpaid medical bills and “uncompensated care” in hospitals has fallen along with our uninsured rate. But wiping out those gains are growing losses from government programs like Medicaid and Medicare.

Medicaid reimburses Wisconsin hospitals about 65 cents for every dollar they spend providing care; Medicare about 78 cents. Those pennies add up to about $2.8 billion/year in unpaid costs (not charges) that must be shifted to everyone else. According to the Greater Milwaukee Business Foundation on Health, below cost hospital reimbursement from these two programs accounts for about 31 percent of the price of hospital care for businesses in southeastern Wisconsin. It’s a phenomena WMC dubbed “the hidden health care tax” and adds billions to the health care spend for employers, workers, and families. For Medicaid alone the “hidden health care tax” now tops $1 billion annually, higher than any actual tax in Wisconsin, including the corporate income tax. The piecemeal disassembly of Obamacare won’t address that ongoing problem and could actually make it worse.

Eric Borgerding

Top of page (1/5/18)

Medicaid SSI Recipients Required to Enroll in HMOs in 2018

Under a change being implemented by the Department of Health Services (DHS), starting in January, Medicaid recipients age 19 and older who receive Medicaid because of a disability will be required to enroll in an HMO in order to receive health care services. This category of Medicaid is typically referred to as Medicaid-SSI to indicate these individuals are receiving supplemental security income because of a disability. 

In the past, Medicaid-SSI recipients could choose not to enroll in an HMO, with services paid for on a fee-for-service basis. Starting in January, these recipients will need to choose an HMO or will have an HMO chosen for them. The change will be effective at different times in 2018 for different regions of the state, and recipients will have to choose an HMO prior to the effective dates. The effective dates are:  

  • February 2018: Region 1 (North)
  • March 2018: Region 3 (West Central)
  • April 2018: Region 5 (Southeast)
  • May 2018: Region 6 (Milwaukee)
  • June 2018: Region 2 (Northeast)
  • June 2018: Region 4 (South Central)

According to DHS, there are eight HMOs that will participate in the program for Medicaid-SSI. Participation may vary by region, but include: Anthem Blue Cross Blue Shield; Care Wisconsin Health Plan; Group Health Cooperative of Eau Claire; Independent Care (ICare); Managed Health Services; Molina Healthcare; Network Health Plan; and United Healthcare Community Plan.

For providers, the change is important as Medicaid-SSI recipients previously were likely enrolled in Medicaid fee-for-service and would have been able to choose their provider. Under an HMO, the recipient will have access only to the providers enrolled with the Medicaid HMO that is participating in SSI. Providers would need to have contracts in place with the Medicaid SSI HMOs to continue serving these patients. 

More information about these changes can be found on the DHS website at: www.dhs.wisconsin.gov/medicaid/hmo-2018chng.htm. In addition, DHS is planning several public hearings. Starting in January, these hearings will be held in areas in the Northern Region of the state. Current planned hearings are: 

  • Wednesday, January 10, 2018: Region 1 (North), Marathon County
    1:30 - 3:30 p.m. or 5 - 7 p.m.
    Northcentral Technical College, 1000 W. Campus Dr., Wausau, WI 54401
  • Wednesday, January 10, 2018: Region 1 (North), Iron County
    1:30 - 3:30 p.m. or 5 - 7 p.m.
    Iron County Human Services, 300 Taconite St., Suite 201, Hurley, WI 54534
  • Wednesday, January 10, 2018: Region 1 (North), Douglas County
    1:30 - 3:30 p.m. or 5 - 7 p.m.
    Government Center, 1316 N. 14th St., Suite 400, Superior, WI 54880
  • Wednesday, January 10, 2018: Region 1 (North), Shawano County
    1:30 - 3:30 p.m.
    Shawano County Department of Human Services 
    607 E. Elizabeth St., Lundmark Room, Shawano, WI 54166
  • Wednesday, January 10, 2018: Region 1 (North), Dunn County
    1:30 - 3:30 p.m. or 5 - 7 p.m.
    Dunn County Community Services Building
    3001 US Highway 12 East, Room 54 (Basement), Menomonie, WI 54751
  • Wednesday, January 10, 2018: Region 1 (North), Oneida County
    1:30 - 3:30 p.m. or 5 - 7 p.m.
    The Human Service Center, 705 E. Timber Dr., 132 Rhinelander Room, Rhinelander, WI 54501
  • Tuesday, February 6, 2018: Region 3 (West Central), La Crosse County
    1:30 - 3:30 p.m. or 5 - 7 p.m.
    Onalaska Omni Center, 255 Riders Club Rd., Onalaska, WI 54650

Top of page (1/5/18)

WHA Webinar Focuses on New Enhanced Nurse Licensure Compact, January 16

On January 16, WHA will offer a WHA member forum webinar entitled “Enhanced Nurse Licensure Compact (eNLC): A Voluntary, Alternative & Expedited Process for Nurse Licensure,” which nurse leaders and human resources leaders will find informative.

This complimentary webinar will provide information on eligibility criteria for eNLC multistate licenses, which nurses who currently hold a multistate license will be grandfathered into the eNLC, and which states are members of the eNLC.

WHA presenters are Ann Zenk, vice president of workforce and clinical practice, and Andrew Brenton, assistant general counsel. They will provide details about how and when the eNLC will be implemented in Wisconsin.

This webinar is complimentary for WHA hospital and corporate members, but pre-registration is required. To register, visit: www.whareg4.org/eNLCWebinar. For content questions, contact Ann Zenk at 608-274-1820 or azenk@wha.org. For registration questions, contact Kayla Chatterton at kchatterton@wha.org or 608-274-1820.

Top of page (1/5/18)

Register Your Team Today for Advocacy Day 2018 – March 21 in Madison

Advocacy Day brochure cover

Make plans now to have an impact in Madison on March 21. Join WHA for Advocacy Day 2018, one of the best ways hospital employees, trustees and volunteers can make an important, visible impact in the state capitol.

You can register yourself and your team today at www.whareg4.org/2018AdvocacyDay.

As always, Advocacy Day 2018 will have a great line up of speakers, including morning keynote Mara Liasson, national political correspondent for NPR. In addition, Gov. Scott Walker has been invited to offer the luncheon address. The day will also include a legislative panel and an issues briefing for attendees who plan to visit their state legislator at the state capitol.

The afternoon of Advocacy Day is always a highlight as hundreds of attendees take what they’ve learned and meet with their legislators in the state capitol. Speaking up on behalf of your hospital by meeting with your legislators during Advocacy Day is essential in helping educate our elected officials on the issues that influence your hospital and health care in your community.

Make plans now to join over 1,000 of your peers from across the state at Advocacy Day 2018 on March 21. More information and online registration are available at www.whareg4.org/2018AdvocacyDay.

For Advocacy Day questions, contact Jenny Boese at 608-268-1816 or jboese@wha.org. For registration questions, contact Kayla Chatterton at kchatterton@wha.org or 608-274-1820.

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WHA Physician Leadership Development Conference

The American Club, Kohler *** March 9-10, 2018


Early Bird Registration: Register by January 15 to qualify
More information and online registration can be found at: http://cvent.com/d/ktql9j

Need hotel reservations? Contact The American Club at 855-209-5679 ASAP.

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WHA Legal Webinar Focuses on CPOE Regulatory Flexibility

On February 7, WHA is offering a WHA member forum webinar entitled “Update on Computerized Provider Order Entry (CPOE) Reporting Under Federal Payment Programs.” This complimentary webinar will review the current CPOE reporting requirements for hospitals and physicians under federal payment programs that require demonstration of meaningful use of electronic health record (EHR) technology: the Medicare and Medicaid EHR Incentive Programs for hospitals and physicians and the Merit-Based Incentive Payment System (MIPS) for physicians and other eligible clinicians. The webinar will explain, among other things, that hospitals and physicians are no longer required to report CPOE in order to avoid Medicare penalties.

This webinar, as well as the regulatory update that WHA recently published (see December 28, 2017, edition of The Valued Voice), is the result of discussions at the WHA Physician Leaders Council regarding physician time spent utilizing CPOE technology and confusion regarding regulatory requirements of CPOE usage under federal payment programs.

This complimentary webinar is open to all WHA hospital and corporate members, but pre-registration is required. An audio recording of the webinar will be available after the event, but you must pre-register to receive the recording. For more information and to register, go to www.whareg4.org/CPOEUpdate. For content questions, contact Andrew Brenton at 608-274-1820 or abrenton@wha.org. For registration questions, contact Kayla Chatterton at kchatterton@wha.org or 608-274-1820.

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Bellin Health and Northeast Wisconsin Technical College: Partnering to Improve Health, Save Costs

Wisconsin hospitals and health systems share a common mission to improve access to care. That is why they are forming partnerships with local employers to develop onsite services, making it easier for employees to meet with a physician, nurse or wellness coach. These partnerships are helping employers hold the line on health care costs, prevent workplace injuries and reduce worker’s compensation costs. All while creating a healthier community and with that, a healthier Wisconsin.

Over the next few weeks, the Wisconsin Hospital Association will share a series of articles that illustrate the innovative and effective programs being created in our state that are keeping employees, and their families, healthier.

Bellin Health logo

CAMPUS CARE, a collaboration between Northeast Wisconsin Technical College (NWTC) and Bellin Health, is bringing down health care spending for NWTC while giving employees and students easy-access options for care.

Through an onsite health and wellness center, NWTC employees can choose from many preventive and acute care options including treatment for chronic diseases like hypertension, high cholesterol and diabetes. They can also get immunizations, allergy treatments, complete physicals and blood drawn for certain tests.

Free services include treatment for infections, migraines, allergies, minor injury treatment and simple lab tests for things like mono, strep and pregnancy. Fitness and personal training, physical therapy, nutrition services as well as health coaching are all offered at the clinic. And for mental health, the Employee Assistance Program is there to help with issues that might not be as easy to define.

Valarie Wunderlich, director of benefits and compensation in NWTC’s Human Resources Department, says these free services help create a “culture of health and wellness,” with a long-term focus on better health through preventive action. For example, she points to the physical therapy option as a must for early intervention.

“If an employee has an ache and pain in the knee or back when running, they can go see a therapist at no cost,” she said. “They work with you on form, or maybe they need to do some therapy, but that could be preventing a bigger issue.”

She said 96 percent of their early preventive care is resolved in physical therapy, so there’s usually no need for orthopedic surgeries or expensive MRIs.

“We are saving costs by taking care of things early on,” she said.

Since the collaboration between NWTC and Bellin began in 2011, the clinic has been building out its offerings to cover areas of special concern.

At one point, NWTC made the decision to ramp up its physical therapy by bringing on a personal trainer, getting employees more active in hopes of preventing injuries. This was done because at the time, the number one category for medical claims was musculoskeletal.

Between 2015 and 2016, NWTC’s spend on musculoskeletal claims dropped from $1.5 million to $1 million—a big reduction, which Wunderlich says is at least partly due to efforts with personal training and therapy.

As well as keeping premium increases below average, the program has led to significant cost savings through direct preventive action, Wunderlich says. Partnering with Bellin means NWTC can examine employee data constantly to take strategic action. In 2013, NWTC was looking at its data and seeing a lot of people with heart issues. Bellin then offered a free heart calcium screening test, which normally costs about $50, for free to 52 individuals. Of that number, 18 needed further attention for issues like aortic aneurysms and others.

“Had it not been caught early, that would have been very expensive for the health plan and very expensive for the person,” she said.

The partnership also incentivizes employees to take their health into their own hands by offering a program in which premium costs are discounted for making health improvements through specific programs and activities. Wunderlich says this structure has led to a much higher rate of participation than other organizations in the area have been able to achieve with comparable programs.

“We want people to participate—if they’re focused on health, they will work on things they need to change,” she said.

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