October 11, 2013
Volume 57, Issue 41

Gov. Tells WHA Board: State Committed to Making Medicaid-to-Exchange Transition Work

While Governor Scott Walker is aware of the problems that have dogged the health insurance exchange website since it opened October 1, he remains optimistic that the bugs will be worked out soon.

"Any time you roll out a new website you are going to have challenges," according to Walker, who noted that a workable exchange is needed to ensure a smooth transition for residents he wants to move from Medicaid to private coverage.

Speaking at the WHA Board meeting October 10 in Madison, the Governor noted his larger concerns with the ACA but indicated the need to make the insurance exchange work regardless of the political environment. "We are literally helping people make the transition to private overage. We want it to work," Walker said. "We appreciate the help we have received from those of you in this room and from hospitals all across the state."

The Governor said DHS has notified all those who will be transitioned from Medicaid, and extensive follow up is planned to help them connect to the exchange. "We are committed to insuring people who were previously on Medicaid," the Governor said. "We put time and resources into making that happen, and that won’t stop January 1. We are committed to this for the long term."

Wisconsin’s high-quality health care is a competitive advantage for economic development, a topic that is high on the Governor’s agenda. "We need to remember that the quality of our health care is an asset to our people and to our employers," Walker said. "It is part of our infrastructure."

The Governor reiterated his support for creating new and expanding current graduate medical education (GME) programs, as well as assuring that there are opportunities for people to complete two and four-year health professional education programs.

The Governor said he appreciates WHA’s leadership on Worker’s Compensation, noting his recent productive meeting with WHA Board members and staff to discuss possible program reforms in light of legislative interest in passing an initiative this year.

The Governor also spoke briefly on the idea of moving state government employees to a self-insured plan, noting that he needs significant data before he can make an informed decision. As the fiduciary agent of the taxpayers of the state, the Governor said he is obligated to look at the state’s current health insurance system because it is such a large part of the state budget. He promised that any decision will be made based on multiple factors because of the impact it has on state employees, health care providers and local insurance markets. He invited WHA members to provide feedback and suggestions to him on the issue.

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Legislation Addressing Jandre Decision Passes Senate Committee
Key WHA legislative priority moves to Senate floor for a vote

The Senate Judiciary and Labor Committee approved companion bills this week addressing key concerns with the Wisconsin Supreme Court’s Jandre decision, the case in which the jury found a physician had non-negligently diagnosed the patient but breached her duty to obtain the patient’s informed consent by not informing the patient about alternate modes of treatment for conditions that were not part of the diagnosis. The Jandre decision left physicians in the difficult position of not knowing how much information is enough, and raising concerns about whether they would need to provide information about conditions the physician has ruled out, which in some cases might be many.

After the vote, WHA Vice President of Government Relations Kyle O’Brien noted, "The Jandre decision, if left unaddressed, could lead to overutilization of tests, increased health care costs, unnecessary angst for patients as well as potential risks associated with unnecessary tests. We appreciate Sen. Grothman’s and the Committee’s action to address this issue."

The companion bills, AB 139/SB 137, would establish the "reasonable physician standard." This standard would require a physician to provide information that a reasonable physician in the same or similar medical specialty would know and disclose under the same circumstances. The legislation also directly addresses the Jandre decision by making it clear that a negligent diagnosis claim is separate from an informed consent claim.

The amended bills were recommended for adoption by the Senate Committee on a 3-2 party-line vote, with Republican members voting in favor of the legislation. This bill is expected to reach the floor of the State Senate next week and then return to the Assembly for final concurrence.

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Speaker’s Mental Health Task Force Releases Final Report
Report Includes Key WHA Recommendations

The Speaker’s Task Force on Mental Health concluded its work October 9, finalizing a report containing more than 30 specific recommendations to address mental health issues in Wisconsin. Many recommendations include statutory changes that will be drafted into bills for the Legislature to consider this fall.

"The recommendations will hopefully eliminate barriers to treatment and improve coordination of care," said Speaker Robin Vos (R-Rochester). "I want to thank Task Force Chair Rep. Erik Severson (R-Osceola) and Vice-Chair Rep. Sandy Pasch (D-Shorewood) for their leadership on this important issue affecting families across Wisconsin."

Twelve of the recommendations in the final report were initiated by the Wisconsin Hospital Association (WHA) and WHA’s Mental Health Task Force. Key WHA-initiated recommendations include enactment of the Mental Health Care Coordination Bill to eliminate barriers to better coordination of care for individuals with mental illness, creating formal mechanisms for family members and health care providers to pursue an emergency detention, and hastening study of redesigning Wisconsin’s county-based mental health care system to a regional system better supported by state rather than county funding.

"Wisconsin’s behavioral health care system is facing serious challenges and finding solutions is a top Wisconsin Hospital Association priority," said WHA Executive Vice President Eric Borgerding. "For nearly two years, our team has worked diligently to build bipartisan support for targeted behavioral health reforms. WHA is quite pleased to see the breadth and depth of reforms, including enacting the Mental Health Care Coordination legislation that the Task Force has recommended."

The report finalized this week concluded the work the Task Force started in February. The Task Force held five public hearings across Wisconsin and heard testimony from over 70 individuals and organizations.

"At every single hearing, whether it was rural Polk County or Milwaukee’s urban center, access to care was the primary concern for mental health consumers, advocates, and providers," said Rep. Severson. "The Task Force recommendations not only increase access to care through some truly innovative means, but also help eliminate barriers to care, improve coordination of care and work to reduce the stigma that often accompanies mental health diagnoses."

"It is long overdue that we have a genuine, evidence-based discussion regarding how we can most effectively provide services and treatment to individuals living with mental illness," said Rep. Pasch. "I am proud to have helped facilitate these discussions through a number of avenues both before entering office and as a State Representative, the most recent within my capacity as vice-chair of this Speaker’s Task Force on Mental Health."

Moving forward, WHA will continue to work with legislators as these bi-partisan recommendations become bills and move through the legislative process. A copy of the Task Force’s final report and copies of WHA’s recommendations and testimony to the Task Force can be found on the mental health section of WHA’s website (www.wha.org/mentalhealth.aspx).

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Brenton Outlines Payment Cuts as Hospitals Remain the Medicare Piñata

The news out of Washington has been anything but good as the government shut-down and Congressional gridlock drags on. WHA President Steve Brenton enumerated the more than $4 billion in cuts that will impact Wisconsin hospitals and health systems over the next decade. He told WHA Board members October 10 that he fears there could be more cuts.

"Hospitals and health systems are already making difficult decisions reflective of those numbers," Brenton said. "Congress does not recognize the magnitude of the cuts they have already made and are now considering for the future."

Brenton said hospital reimbursement remains extremely vulnerable in the current environment as Congress grapples with the federal budget crisis and looming fiscal deadlines, while issues such as the physician payment fix remain unresolved. Brenton warned that cuts to graduate medical education, Medicare bad debt reimbursement, as well as site neutral proposals affecting hospital payments on outpatient services, and PPS coding offsets could all be reopened as Congress hunts for cash to shore up the federal budget.

"Hospitals have become the Medicare piñata in Washington," according to Brenton.

WHA has found an ally in its Congressional delegation as it fights to preserve the critical access hospital (CAH) designation and protect all hospitals from more cuts. Former WHA Chair Mike Schafer, CEO, Spooner Health System, participated in a DC "fly-in" led by WHA and the Rural Wisconsin Health Cooperative in late July. He was impressed with the support he saw in Washington.

"It was obvious when we went to DC that our Congressional delegation was well-versed on our issues. That doesn’t happen without the leadership that we have in this room and with WHA staff," Schafer noted.

Brenton said WHA will continue its full-scale federal advocacy efforts by hosting town hall meetings, sponsoring webinars, and by activating members of the HEAT program to contact their legislators. WHA and hospital leaders will be in Washington, DC October 29 to meet with members of Wisconsin’s Congressional Delegation about the importance of Wisconsin’s high-value, high-quality health care. If you are interested in joining this trip, contact WHA’s Jenny Boese at 608-268-1816 or jboese@wha.org.

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WHA Marks Progress Toward 2013 Advocacy Goals

While things in Washington came to a crashing halt this month, WHA Executive Vice President Eric Borgerding reported good progress is being made in Madison on several of the Association’s key goals for 2013.

Speaking at the October 10 WHA Board meeting, Borgerding said the worker’s compensation program is receiving attention in the capitol, a fact noted by the Governor in his remarks at the meeting (see story above). Rep. Dan Knodl, (R-Germantown), who was a leader in driving reforms in the unemployment insurance program, is now engaged in the worker’s compensation issue. The proposal from the Worker’s Compensation Advisory Council to the Legislature is expected at the end of this year.

Legislation that would address issues created by the Wisconsin Supreme Court decision in the Jandre case passed the Senate Judiciary Committee this week, a positive move for an issue that has been a high priority for WHA. The bill is expected to be on the Senate floor and return to the Assembly floor later this month. (See story above.)

Several of WHA’s key recommendations were included in the final report of the Speaker’s Mental Health Task Force, chaired by Rep. Erik Severson (R-Star Prairie), including a recommendation to enact "HIPAA Harmonization for Mental Health Care Coordination" legislation to remove barriers to mental health care coordination. A WHA Task Force identified several complex problems associated with the delivery of mental health service. The inclusion of WHA’s recommendations marks major progress toward addressing those issues. Many recommendations in the Task Force report include statutory changes that will be drafted into bills for the Legislature to consider this fall. (See story above.)

The Governor and the Legislature have identified the modernization of the state’s hospital regulations as a priority, calling them outdated, duplicative and confusing for health care administrators because of contradictory state and federal regulations. WHA’s proposal to address the issue by adopting the Medicare conditions of participation as the state regulatory standards for hospitals is currently being drafted as legislation.

"A key priority for WHA is to see the state’s regulatory codes modernized," Borgerding said. "We appreciate the support we’ve seen in the capitol on this important issue, and we are optimistic that we will continue to make progress."

WHA identified the physician shortage as a major issue facing Wisconsin. Unabated, the lack of physicians would hinder access to care in many areas of Wisconsin. One solution to keep physicians in Wisconsin is to create more residency positions, a high priority for WHA in 2013. This year, WHA continued to make progress on this front with a boost from the Governor, who included GME funding in the state budget. Borgerding said the funding has two components, one to be used for existing residency programs, and another to create new programs. WHA is sponsoring a GME conference October 24. The deans of both of Wisconsin’s medical schools will present along with several hospitals, health systems and residency program managers.

Lastly, Borgerding updated the Board on the BadgerCare waiver for childless adults, which expires December 31, 2013. DHS submitted a waiver to the federal Department of Health and Human Services (DHHS) August 9 that would make childless adults with income up to 100 percent of the FPL eligible for Medicaid, if the waiver is approved.

Enrollment Issues Persist

Joanne Alig, WHA senior vice president, policy and research, reviewed the problems that have plagued the health insurance exchange website. Alig told Board members that so far, very few people in Wisconsin have successfully enrolled in the online exchange. Open enrollment is October 1 – March 31; to have coverage start January 1, enrollees must sign up by December 15.

Board members discussed the fact that having an exchange that is not working adds to the uncertainty that hospitals have felt given the changes in the Medicaid program due to take place January 1. Alig said the WHA Enrollment Action Council, co-chaired by Board members Therese Pandl, HSHS, and Mark Taylor, Columbia St. Mary’s, has been meeting since July about enrollment issues. WHA continues to monitor the situation.

WHA Board Approves Association 2014 Budget

WHA Board Chair Dan Neufelder and Brian Potter, WHA senior vice president, presented the 2014 WHA budget as forwarded for approval by the WHA Budget Committee. The budget includes funding for work on key advocacy objectives including health care reform, reimbursement, physician workforce and quality initiatives. After discussion, the Board approved the 2014 WHA budget as submitted.

Nominating Committee Report

Nominating Committee Chair Sandy Anderson presented the slate of WHA Board nominees, which was approved by the Board. (See story on page 3)

Council Reports

Workforce Development – Judy Warmuth, WHA. The Wisconsin Technical College System has asked for WHA’s assistance for help in creating more clinical placements. Their greatest need is for learning experiences for students in the health information technology program. Hospitals have indicated that implementation of electronic medical records has created learning needs for their own employees, resulting in fewer student placements. Clinical placements are also needed in the medical laboratory technician and nursing programs. The Council also heard about important changes to the Unemployment Insurance program.

Public Policy – Eric Borgerding, WHA. Rep. Erik Severson (R-Star Prairie), chair of the Speaker’s Task Force on Mental Health and the Assembly Committee on Health spoke at the Council meeting on issues related to mental health, modernizing hospital regulations and on the role of government in health care. The Council will meet November 5 and Congressman Reid Ribble will be the guest.

Finance and Payment - Steve Little, Chair. The Council was briefed on developments on the worker’s compensation issue, ICD-10 readiness, and exchange enrollment assistance.

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WHA Board Approves Nominating Committee Recommendations

The Nominating Committee presented their recommendations to the WHA Board October 10. The Board voted and approved the Nominating Committee recommendations. The following individuals will serve on the WHA Board effective January 1, 2014.

Mike Sanders
(2nd term)
President/CEO, Monroe Clinic, Monroe

James Woodward
(2nd term)
President/CEO, Meriter Hospital, Madison

Robert Van Meeteren
(1st term)
President, Reedsburg Area Medical Center, Reedsburg

Dan Mattes
(Filling unexpired term)
President, Wheaton Franciscan Healthcare-St. Francis, Inc.– Milwaukee, & Wheaton Franciscan Healthcare-Franklin

Peggy Ose
(2nd term)
VP, Patient Services, Riverview Hospital Association, Wisconsin Rapids

Monica Hilt
(Filling unexpired term)
Chief Executive Officer, Northern Region, Howard Young Health Care, Inc., Woodruff

Packerland Region voted and approved the following individual to represent the Packerland Region on the WHA Board of Directors.

Daniel Meyer
(1st term)
Chief Administrative Officer, Aurora BayCare Medical Center, Green Bay

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Grassroots Spotlight: Cumberland Hosts Senator Jauch and Rep. Smith
Discuss critical importance of rural hospitals in Northwestern Wisconsin

On September 24, Senator Bob Jauch (D-Poplar) and State Representative Steven Smith (D-Shell Lake) visited Cumberland Healthcare to tour the hospital, talk with hospital leaders and governing board members, and to learn how current legislative proposals could impact small town hospitals like Cumberland.

"Cumberland Healthcare, along with the school system, is the heart and soul of this community. It is very important to have this facility in Cumberland as it serves a vital role, not only as a major employer, but serving the needs of the community as well," said Sen. Jauch during the visit. "Rural health care is very important for our small towns, not only in Wisconsin but across the nation."

In providing an overview of current health care challenges and issues facing rural hospitals, Cumberland Healthcare CEO Mike Gutsch discussed an August 2013 report from the federal Health and Human Services’ Office of Inspector General (OIG), which recommended significant changes to how the Medicare program pays small, rural hospitals like Cumberland.

The OIG report’s recommendation, if approved by Congress, would conservatively impact more than 800 small hospitals nationally, including Cumberland Healthcare, by eliminating their "critical access hospital" status. This designation was created many years ago to protect access to care in rural communities.

In response, Sen. Jauch said, "We have made great strides in providing excellent health care in the state of Wisconsin, and I believe if this recommendation moves forward, it will just set us up for failure. I strongly oppose this recommendation and feel that there is another way to figure out the budget."

Rep. Smith also expressed his opposition to the OIG recommendation. "Seeing firsthand the importance that this hospital plays within our community, I wholeheartedly believe that the OIG recommendation is a flawed way of addressing budgeting concerns. We cannot stand by and just watch a facility that is critical to Northwestern Wisconsin be harmed by bureaucratic paper shuffling. Together we have to do whatever is necessary to provide rural healthcare access, not just here but throughout Wisconsin," stated Rep. Smith.

The legislators had an opportunity for questions and answers, after which they toured the hospital.

"We are very fortunate to have both Sen. Jauch and Rep. Smith take time out of their busy schedules to meet with us. We were able talk to them about our challenges as a rural healthcare provider along with giving greater insight into the impact of Cumberland Healthcare on this community. Both legislators have a strong interest in local health care, and I thank them greatly for their time," Gutsch said.

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Grassroots Spotlight: Neillsville City Council Passes Resolution In Support of Hospital
Opposes OIG recommendation on CAH designation

In response to the misguided federal Office of Inspector General (OIG) report regarding critical access hospital designation, the City of Neillsville Common Council passed a resolution recognizing Memorial Medical Center and the critical role it plays in the local community.

"Whereas Memorial Medical Center…has a long history of providing vital services for the health and wellbeing to the citizens of Neillsville and Clark County, Wisconsin and surrounding areas…"

"Now, therefore, be it resolved that the City of Neillsville Common Council supports the continuation of Critical Access Hospital Necessary Provider status for Memorial Medical Center in its current definition and implementation."

The resolution was passed on September 24, 2013.

WHA thanks Memorial Medical Center and Administrator & CEO David Baltzer for their local leadership on this issue.

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WHA TCAB Project Unlocks Power of Frontline Staff to Accelerate Improvement
Hospital clinical leaders see value, results in TCAB participation

Patient care starts at the bedside, so it only makes sense that quality improvement efforts should begin with frontline nurses. The WHA Transforming Care at the Bedside (TCAB) project is engaging nurses and frontline staff to improve the quality and safety of patient care on medical and surgical units, intensive care, and long-term care units in hospitals.

More than 150 front-line and nurse leaders gathered in Wisconsin Dells late last month to share their TCAB experiences at the WHA TCAB Mid-Point Event and to learn from one another how to improve patient care. The Mid-Point event is a key step in the process as TCAB units are asked to bring their best work to showcase for their peers. To add fun and friendly competition to the conference, the TCAB units were asked to present their best practice to align with the conference theme: national parks. See photos of all the participating teams here: https://www.facebook.com/media/set/?set=a.10151802933223666.1073741834.172480133665&type=1.

Deb Potempa, chief nursing officer, Mercy Health System, Janesville, has enrolled teams in both TCAB cohorts sponsored by WHA to date. Potempa said collaboration among hospitals speeds improvement and energizes the teams. She shares the benefits of working with WHA on TCAB in this short video: http://youtu.be/pSg8aBhVx4k.

"The pace of change in hospitals isn’t slowing down anytime soon," according to Stephanie Sobczak, WHA quality improvement manager. "Hospitals with staff that can adapt quickly to the changing health care environment while maintaining excellent patient care will have a competitive advantage." TCAB also serves to engage staff at a deeper level by tapping into their creativity and problem solving skills, which impacts turnover. "More engaged staff is more likely to stay with the hospital for the long term," Sobczak said.

The 24 units representing 22 hospitals are working to improve performance on several measures at once, while engaging their colleagues in improvement projects and practicing newly-learned skills. TCAB also provides an excellent opportunity for front-line staff to exhibit leadership among their peers. WHA will launch their third TCAB cohort in March 2014. For information, contact Judy Warmuth or Stephanie Sobczak at jwarmuth@wha.org or ssobczak@wha.org.

The Aligning Forces for Quality: Transforming Care at the Bedside Collaborative (TCAB Collaborative) is an initiative of the Robert Wood Johnson Foundation. WHA receives funding support for TCAB through the Aligning Forces for Quality collaborative supported by the Robert Wood Johnson Foundation, through a grant to the Wisconsin Collaborative for Healthcare Quality. In Wisconsin, Aligning Forces for Quality is a joint project of the WCHQ, WHA, and other organizations.

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Partners Mark 60th Anniversary

Honoring 60 years of volunteer "partnership" with Wisconsin hospitals, close to 400 hospital volunteers gathered for the Partners of WHA Annual Convention in Wisconsin Dells October 7-10. One of the highlights each year of the convention is the hospital leadership panel discussion. This year’s panelists included Marita Hattem of Aspirus, Inc.; Terry Jacobson of Essentia Health St. Mary’s Hospital-Superior; David Grundstrom of Flambeau Hospital, Park Falls; Dr. Timothy Johnson of Mayo Clinic Health System – Franciscan Healthcare, La Crosse; and Steve Brenton, WHA. The panel was moderated by WHA’s Eric Borgerding.

The panelists addressed key topics of the day, including implementation of the Affordable Care Act and the status of the newly-launched federal health insurance "marketplace." Panelists provided insight into what these transitions mean for Wisconsin communities, both large and small. The panelists discussed issues surrounding payment system reform, such as how to move the country forward with paying for volume to paying for value. With the value equation—high-quality, cost-effective care—a cornerstone of Wisconsin’s health care system, panelists told attendees that Wisconsin is well positioned for a system that pays for value, but the challenge will be moving the rest of the nation forward in this regard.

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2014 Updates for the Chargemaster Focus of November 19 Seminar

On November 19, WHA is offering "2014 Procedure Coding for Chargemasters," a one-day seminar focused on the 2014 reporting requirements, as well as CPT and HCPCS coding revisions and additions impacting the hospital Chargemaster. Discussions will focus on requirements with revisions required, as well as strategies for department staff education.

Back by popular demand, the November 19 seminar will be led by coding expert Glenda Schuler.

In addition, this program has prior approval of the American Academy of Professional Coders (AAPC) for 5.5 continuing education units.

Chargemaster/APC coordinators, chief financial officers, controllers, decision support managers, office managers, compliance auditors, coding staff, pharmacy directors, material managers/purchasing directors, and other directors and managers responsible for the charge generation process are encouraged to attend this event.

This seminar will be held at Glacier Canyon Lodge at the Wilderness Resort in Wisconsin Dells November 19. A brochure with registration form is included in this week’s packet, and online registration is available at http://events.SignUp4.com/13Chargemaster1119.

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MetaStar to host IHI Forum Satellite Broadcast in Madison Dec 10-11

MetaStar is hosting a satellite broadcast of the Institute for Healthcare Improvement’s (IHI) 25th annual National Forum on Quality Improvement in Health Care. This broadcast will be held December 10-11 at The Pyle Center, 702 Langdon Street in Madison. Anyone interested in attending can register here. The cost to attend is $95 and registration will close December 2, 2013. Spots are limited.

Presentations and the latest agenda can be accessed at www.ihi.org. Please note that due to many of the presentation materials not being available until just prior to the broadcast, or not at all, we will not be making hard copies available to attendees. You may print your own from the IHI website as they become available or bring a laptop to access presentation materials during the broadcast.

Continuing education credits will be available through IHI for those who attend the broadcast. Public parking is available in the Lake Street ramp.

Contact MetaStar’s Liz Menzer at (608) 274-1940, ext. 8206, or lmenzer@metastar.com for more information.

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Member News: Meriter Announces Affiliation with UnityPoint Health

Meriter Health Services announced October 10 that it has agreed to combine operations and become an affiliate of UnityPoint Health, a nationally-recognized, integrated health system headquartered in West Des Moines, IA.

"Like Meriter, UnityPoint Health has a culture of patient-focused care, community-minded spirit and high-quality, lower-cost health care," said Jim Woodward, president, Meriter Health Services. "In the affiliation, UnityPoint Health will provide resources to Meriter Health Services, supporting and enhancing the services provided to the community, including taking an ownership interest in Physicians Plus and providing clinical practice and management support to Meriter Medical Group."

The affiliation is pending state and federal regulatory approvals, which are anticipated later this year.

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Member News: Program that Reduces VA Hospital Readmissions Expanding

A program that has reduced hospital readmissions by a third for older patients at the William S. Middleton VA Hospital in Madison will be expanding to VA hospitals in Tomah and Iron Mountain, Michigan.

Coordinated transitional care—or C-TraC—involves nurses calling patients two to three days after discharge to check on their condition and review their medication regimen. After that, follow-up phone calls are made weekly for up to a month before patients resume care with their primary care provider. Nurses call patients older than 65 and those with dementia.

According to December 2012 research published in Health Affairs and authored by Dr. Amy Kind, a geriatrics researcher and professor at the University of Wisconsin School of Medicine and Public Health, C-TraC patients had one-third fewer readmissions after 30 days out of the hospital compared to older patients not in the program. It also saved $1,225 per patient over 18 months for a total savings of more than $700,000.

Kind said the C-TraC programs in Tomah and Iron Mountain will be launched in spring 2014 after transitional-care specialists are hired and trained. The program will be funded by a grant that could provide up to $1.5 million over three years. Up to 50 patients at each facility would qualify for C-Trac.

"We need to assess what kind of capacity they have in order to provide necessary care to the patients," Kind said. "The grant will pay for a full-time nurse, a full-time program assistant, and a part-time physician at each site."

Kind said the weekly phone calls are thorough and last an average of 36 minutes.

"Studies have shown that within a few days after discharge, patients are already taking their medications the wrong way and not the way they were prescribed in the hospital," according to Kind. "Patients who are called a couple of days after discharge may say over the phone they understand their plan and know what’s going on, but if you dig deeper and ask them what the plan is, half of them have trouble remembering it. Transitional care truly does the best job of helping patients take care of themselves."

Kind said C-TraC is an extra step in making sure discharged hospital patients have proper control of their own health care.

"The traditional health care culture over the last 25 years has been to discharge the patient and just assume everything will be followed up appropriately," she said. "Yet, that assumption is false. It’s important for patients to communicate understanding of their health care."

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Wisconsin Hospitals Community Benefits - Social, Economic and Educational Factors that Influence Health

There is a strong association between social and economic factors and adverse health outcomes. Low socioeconomic status, including poverty, lack of education, and other factors are strong influences on health. Wisconsin hospitals are dedicating resources and developing programs to address these issues and improve the health status of those individuals that often cannot access even basic health services.

Su Salud Program delivers caring service to the Hispanic community

Wheaton Franciscan – St. Francis is reaching out to the Hispanic community by educating women on the importance of breast health and breast cancer prevention.

Funded in part by the Susan G. Komen Foundation, the Su Salud program provides breast health resources for Latina women in need. The program pairs an RN breast care coordinator with a community health worker to give groups of women brief presentations on breast health. The program also provides mammograms to women who may not be able to afford them.

Su Salud has made a tremendous impact on the life of Virginia Vallejo. After receiving a check-up provided by the program, it was discovered that there was a blockage in Virginia’s right breast. "I understood my health issue because the staff explained it to me very thoroughly," she said.

Su Salud also connected her to all the resources that she needed so she would not have to worry about navigating her way through health care, which can be confusing when there is a language barrier.

Fabiola De Chico helped Virginia by enrolling her in the Wisconsin Women’s Health Fund to cover the remaining cost of a galactogram that her government funded insurance did not.

"I am very grateful for the quality attention provided by the program," Virginia expressed.

Virginia was so pleased with the services she received that she is spreading the word throughout the community about Su Salud and the importance of receiving a mammogram every year.

"A lot of Latina women are afraid to seek help because of their citizenship status," she explained. "They are unaware that financial assistance exists." She has also talked about the importance of breast health to women in her family and at church and work. "I tell them that even if they don’t have symptoms, they should get a mammogram every year," she added.

Virginia says that her two daughters are her main motivation to stay healthy. "Sometimes it’s hard to remember to take care of myself," she said. "My daughters remind me to take care of my health."

Virginia’s daughters are her best friends and the ones she trusts the most. "They are the reason I live."

Virginia received a galactogram at Wheaton Franciscan Healthcare – St. Francis and is scheduled to see a surgeon to evaluate whether she’ll need surgery to remove the blockage.

"I am very grateful there are programs like this available," Virginia said. "It helps to educate women so they can make decisions that will prevent cancer and other serious breast issues."

Wheaton Franciscan Healthcare – St. Francis, Milwaukee

Phenomenal Women program addresses health disparities

Wheaton Franciscan Healthcare’s Phenomenal Women program is making it easier for low-income African American women like Willie Mae Washington to receive routine mammograms.

Funded in part through a grant from Susan G. Komen for the Cure to the Wheaton Franciscan – St. Joseph Foundation, the Phenomenal Women breast health program works to educate low-income African American women about breast cancer and the importance of consistent breast health care.

"White women are diagnosed with breast cancer at a higher rate, but African American women die more often," says Janine Tucker, a Community Health Worker who coordinates the Phenomenal Women program. "I want to be the person who gets out there and lets them know they are important."

Whether patients are underinsured, insured, pay a high deductible or co-pay, Tucker works with all to ensure they get their mammograms or screenings.

Thanks to Janine and the Phenomenal Women program, Willie Mae is receiving the breast care that she needs, including regular mammograms and follow-ups as appropriate. "I’ve had worried days about my family members with cancer," Willie Mae said. "One of the best things that Miss Janine did for me is to get me on schedule."

Since April 2012, Wheaton Franciscan – St. Joseph has held 12 breast health presentations, educated 325 women, and referred 226 women for mammograms. The program exceeded its goal of reaching 250 women and referring 175 women for mammograms. Wheaton Franciscan – St. Joseph Campus is also reaching out to the community through the Living Well with Diabetes Program which provides information and support for those with diabetes. The program began late March 2013.

Wheaton Franciscan – St. Joseph, Milwaukee

Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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