November 15, 2013
Volume 57, Issue 46

Gov. Walker to Call Special Session to Delay Medicaid and HIRSP Changes
WHA hails "good decision," urges swift bipartisan passage

On Thursday, November 14, Governor Scott Walker called for a delay in transitioning current Medicaid recipients into the Exchange from January 1 to April 1. Governor Walker also announced a three-month extension for the state’s Health Insurance Risk-Sharing Program (HIRSP). Without the extension, the HIRSP program would sunset December 31, 2013.

"The Governor has made a good decision in the face of the exchange’s ongoing problems. The delay keeps the Medicaid program we have today in place and unchanged through the first three months of 2014, allowing more time for the exchange to improve," WHA President Steve Brenton said. "We’ll continue to work closely with our members, the Department of Health Services, the Walker Administration, the State Legislature and the federal government to reach the goal of reducing the number of uninsured in Wisconsin."

The Governor’s press release made clear that he is not backing away from the Medicaid program changes he has supported—expanding Medicaid for childless adults with income below the poverty line while moving adults with income above the poverty line off the Medicaid rolls. However, a delay is needed to better help "smooth the transition" to exchange coverage for 77,000 people who would otherwise lose Medicaid coverage January 1.

"We have been concerned about the exchange’s functionality since February, and those concerns have proven valid," said WHA Executive Vice President Eric Borgerding. "We commend the Governor for taking this action and urge swift, bipartisan passage of the legislation. In the meantime and throughout the delay, WHA and our members will keep working with the Walker Administration, our community health partners and other stakeholders to continue robust education and outreach efforts so that on April 1, as many people as possible will transition to coverage through either the exchange or Medicaid."

In addition to calling on the federal government to fix the problems with the health insurance exchange website, Governor Walker called on President Obama to open up the entire insurance market to allow consumers who are eligible for subsidies to use them to purchase any qualified health plan in the private market, not just those listed on the exchange. According to the Administration, this will provide consumers with more choice.

The Governor is calling the Legislature into special session to enact needed statutory changes to implement the delays. There are also other moving parts to the proposal that may need federal approval. WHA will continue to monitor the details of the legislation and the state and federal processes.

Top of page (11/15/13)

WHA Praises Wisconsin State Assembly for Passing Mental Health Bills
Mental Health Care Coordination Bill among those passed

On November 12, the Wisconsin Hospital Association (WHA) praised the Wisconsin State Assembly for passing a series of bipartisan bills developed through the Speaker’s Task Force on Mental Health.

"Wisconsin’s behavioral health care system is facing serious challenges. Identifying tangible problems and finding solutions to help remove barriers to a more modern, accessible, integrated and consistent mental health system for Wisconsin is one of WHA’s top priorities," according to WHA Executive Vice President Eric Borgerding. "We want to thank members of the Assembly who supported these important reforms that will help improve outcomes for individuals with mental illness."

WHA was particularly pleased with one of the hallmark proposals passed by the Assembly that came from the Speaker’s Task Force on Mental Health: the Mental Health Care Coordination Bill.

"While the views and treatment of mental illness have evolved, our laws have not kept pace with that change. WHA is very pleased to see the Assembly’s bipartisan passage of the Mental Health Care Coordination Bill," said Borgerding. "This bill removes barriers to care coordination for individuals with mental illness that do not exist for physical illnesses."

Other key WHA proposals and WHA-supported proposals to the Speaker’s Task Force that passed by the Assembly include:

The Speaker’s Task Force on Mental Health bills will now move to the Senate for consideration. WHA appreciates the leadership of Speaker Robin Vos, and the Task Force co-chairs, Rep. Eric Severson and Rep. Sandy Pasch, on these important reforms.

Links to the bills and WHA testimony and memos on the bills passed by the Assembly can be found at:

Top of page (11/15/13)

The Countdown Begins - Political Action Campaign at 87 Percent

With just 45 days left until the close of the year, totals to the 2013 Wisconsin Hospitals Conduit and State Political Action Funds campaign continue to climb. In the last two weeks, an additional $22,000 was raised from 21 more participants. In the next month and a half, the campaign needs to raise $35,000 by the end of the year to meet the $260,000 goal.

While still behind last year’s pace, the gap is closing, and whereas the 2013 Campaign was down nearly $30,000 from 2012 totals just two weeks ago, the campaign is currently behind $14,000 from the 2012 pace.

So far 326 individuals have joined the campaign, contributing almost $225,000. Individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. Thank you to the 2013 contributors to date who are listed on pages 8-9. They are listed alphabetically by contribution amount category. The next publication of the contributor list will be in the November 29 edition of The Valued Voice.

For more information, contact Jodi Bloch at 608-217-9508 or Jenny Boese at 608-274-1820.

Contributors ranging from $1 to $499
Allen, Patricia Columbia St. Mary's, Inc.
Ambs, Kathleen St. Mary's Janesville Hospital
Anderson, Phil Sacred Heart Hospital
Andritsch, Stacie Wheaton Franciscan Healthcare
Appleby, Jane Aurora Health Care
Bagnall, Andrew St. Nicholas Hospital
Bair, Barbara St. Clare Hospital & Health Services
Ballentine, Anne Wheaton Franciscan Healthcare
Baltzer, David Memorial Medical Center - Neillsville
Bayer, Tom St. Vincent Hospital
Bergmann, Ann Spooner Health System
Block, Jeffrey Monroe Clinic
Bloom, Deborah Sacred Heart Hospital
Boson, Ann Ministry Saint Joseph's Hospital
Bowman, Andrew Sacred Heart Hospital
Breeser, Bryan Aurora Medical Center Summit
Brenholt, Craig St. Joseph's Hospital
Brennan, Karen St. Mary's Hospital
Brenny, Terrence Stoughton Hospital Association
Brenton, Andrew Wisconsin Hospital Association
Burgener, Jean Aspirus Wausau Hospital
Buss, Diane St. Mary's Hospital
Campau, Patricia Columbia St. Mary's, Inc.
Capelli, A.J. Aurora Health Care
Cardinal, Lori Agnesian HealthCare
Casey, Candy Columbia Center
Censky, Bill Holy Family Memorial
Clark, Renee Fort HealthCare
Collins, Sherry Wisconsin Hospital Association
Coniff, Barbara St. Mary's Hospital Medical Center
Connors, Lawrence St. Mary's Hospital Medical Center
Cormier, Laura Bellin Hospital
Culotta, Jennifer St. Clare Hospital & Health Services
Dahl, James Fort HealthCare
Dalebroux, Steve St. Mary's Hospital
Danner, Forrest Aspirus Wausau Hospital
Dearth, Charles Monroe Clinic
Dietrich, Dean Aspirus Wausau Hospital
DeMars, Nancy Sacred Heart Hospital
Drengler, Kathryn Aspirus Wausau Hospital
Dux, Larry Froedtert & MCW Community Memorial Hospital campus
Dwyer, Maxine St. Mary's Hospital
Feldhausen, Mary St. Vincent Hospital
Ferrigno, Sandra St. Mary's Hospital
Fielding, Laura Holy Family Memorial
Folstad, John Sacred Heart Hospital
Fox, Stephen Aspirus Wausau Hospital
Fry, William Columbia St. Mary's, Inc.
Furlong, Marian Hudson Hospital & Clinics
Gagnon, Annette HSHS-Eastern Wisconsin Division
Gajeski, Lynn St. Vincent Hospital
Gansemer, Sheila Wheaton Franciscan Healthcare
Garvey, Gale St. Mary's Hospital
Gille, Larry St. Vincent Hospital
Granger, Lorna Aurora Health Care
Gresham, James Wheaton Franciscan Healthcare
Gruber, Richard Mercy Hospital and Trauma Center
Grundstrom, David Flambeau Hospital
Guffey, Kerra Meriter Hospital
Gulan, Maria Aspirus Wausau Hospital
Gullicksrud, Lynn Sacred Heart Hospital
Hafeman, Paula St. Vincent Hospital
Halida, Cheryl St. Joseph's Hospital
Hamilton, Mark
Hansen, Karen Memorial Medical Center - Ashland
Hardy, Shawntera Hudson Hospital & Clinics
Hattem, Marita Aspirus Wausau Hospital
Helgeson, Jason HSHS-Eastern Wisconsin Division
Henricks, William Rogers Memorial Hospital
Hieb, Laura Bellin Hospital
Hockers, Sara Holy Family Memorial
Hockin, Jennifer Aspirus, Inc.
Hofer, John Bay Area Medical Center
Hueller, Julie Wheaton Franciscan Healthcare
Hupf, Angela Memorial Health Center
Jelle, Laura St. Clare Hospital & Health Services
Jensema, Christine HSHS-Eastern Wisconsin Division
Jensen, Russell St. Mary's Hospital
Johnson, Charles St. Mary's Hospital
Johnson, Kimberly Sacred Heart Hospital
Josue, Sherry St. Mary's Hospital
Karuschak, Michael Amery Regional Medical Center
Keene, Kaaron Memorial Health Center
Kelsey Foley, Kathy Aspirus Wausau Hospital
Kempen, Jacob Aspirus Wausau Hospital
King, Peggy Memorial Health Center
King, Steve St. Mary's Hospital
Klay, Chris St. Joseph's Hospital
Klay, Lois St. Joseph's Hospital
Klein, Tim Holy Family Memorial
Knutzen, Barbara Agnesian HealthCare
Kocourek, Cathie Aurora Medical Center in Two Rivers
Krueger, Kari St. Mary's Janesville Hospital
Lambrecht, Randy Aurora Health Care
Lange, George Westgate Medical Group, CSMCP
Larson, William St. Joseph's Hospital
Lentz, Darrell Aspirus, Inc.
Leonard, Mary Kay St. Mary's Hospital
Lepien, Troy St. Mary's Hospital
Lucas, Roger Aspirus Wausau Hospital
LuCore, Patricia Sacred Heart Hospital
Luehring, Sally St. Vincent Hospital
Lynch, Sue Mayo Health System - Franciscan Healthcare
Maroney, Lisa
Martin, Nancy Ministry Saint Michael's Hospital
Maurer, Mary Holy Family Memorial
McCarthy, Steven Southwest Health Center
McManmon, Kristin St. Mary's Hospital
McMeans, Scott Holy Family Memorial
Meicher, John St. Mary's Hospital
Needham, Jean Westfields Hospital
Neikirk, Jon Froedtert & The Medical College of Wisconsin
Nevers, Rick Aspirus, Inc.
Nguyen, Juliet Sacred Heart Hospital
Nicklaus, Todd Aspirus, Inc.
O'Brien, Laura
O'Hara, Tiffanie Wisconsin Hospital Association
O'Keefe, Robert
Oland, Charisse Rusk County Memorial Hospital and Nursing Home
Olson, Bonnie Sacred Heart Hospital
Ose, Peggy Riverview Hospital Association
Ostrander, Gail HSHS-Eastern Wisconsin Division
Ott, Virginia St. Joseph's Hospital
Palecek, Steve St. Joseph's Hospital
Pavelec-Marti, Cheryl Ministry Saint Michael's Hospital
Peck, Lori Memorial Health Center
Peiffer, Susan Sacred Heart Hospital
Pempek, Kalynn Aspirus Wausau Hospital
Penczykowski, James St. Mary's Hospital
Pinske, Heather St. Mary's Hospital
Reinke, Mary Meriter Hospital
Reising, Chris Aspirus, Inc.
Rocheleau, John Bellin Hospital
Roundy, Ann Columbus Community Hospital
Sanicola, Suzanne Columbia St. Mary's Columbia Hospital
Schaetzl, Ron St. Clare Hospital & Health Services
Schmitz, Bonnie Agnesian HealthCare
Schneider, David Langlade Hospital - An Aspirus Partner
Schubring, Randy Mayo Health System - Eau Claire
Scieszinski, Robert Ministry Door County Medical Center
Scinto, Jeanne Aspirus Wausau Hospital
Sheehan, Heather Hayward Area Memorial Hospital and Nursing Home
Sio, Tim Wheaton Franciscan Healthcare - All Saints
Slomczewski, Constance Wheaton Franciscan Healthcare - All Saints
Smith, Brian Aspirus, Inc.
Statz, Darrell Rural Wisconsin Health Cooperative
Stelzer, Jason St. Clare Hospital & Health Services
Strasser, Kathy Aspirus, Inc.
Swanson, Becky Sacred Heart Hospital
Tandberg, Ann St. Joseph's Hospital
Taylor, Steve Beloit Health System
Teigen, Seth St. Mary's Hospital
Theiler, Brian Gundersen Tri-County Hospital and Clinics
Thornton, Eric St. Mary's Janesville Hospital
Tuttle, Kathryn Memorial Medical Center - Ashland
Vergos, Katherine Ripon Medical Center
Voelker, Thomas Aspirus Wausau Hospital
Waldoch, Timothy Columbia St. Mary's, Inc.
Walker, Troy St. Clare Hospital & Health Services
Westrick, Paul Columbia St. Mary's Columbia Hospital
Wheeler, Susan St. Nicholas Hospital
White-Jacobs, Mary Beth Black River Memorial Hospital
Whitinger, Margaret Agnesian HealthCare
Wilke, Julie Monroe Clinic
Wipperfurth, Kay Fort HealthCare
Woleske, Chris Bellin Psychiatric Center
Wymelenberg, Tracy Aurora Health Care
Wysocki, Scott St. Clare Hospital & Health Services
Yaron, Rachel Ministry Saint Clare's Hospital
Contributors ranging from $500 to $999
Anderson, Rhonda Columbia St. Mary's Milwaukee Hospital
Ashenhurst, Karla Ministry Health Care
Bablitch, Steve Aurora Health Care
Behl, Kevin Columbia St. Mary's Milwaukee Hospital
Boecker, Ron Wheaton Franciscan Healthcare
Bukowski, Cathy Ministry Health Care
Bultema, Janice
Busch, Rebecca Spooner Health System
Carlson, Dan Bay Area Medical Center
Chumbley, Clyde ProHealth Care, Inc.
Deich, Faye Sacred Heart Hospital
Dewitt, Jocelyn
Dicus-Johnson, Coreen Wheaton Franciscan Healthcare
Dietsche, James Bellin Hospital
Dolohanty, Naomi Aurora Health Care
Dube, Troy Chippewa Valley Hospital
Eckels, Timothy Hospital Sisters Health System
Frangesch, Wayne Wheaton Franciscan Healthcare
Freimund, Rooney Bay Area Medical Center
Griffin, Gregory ElderSpan Management
Hartberg, David Gundersen Boscobel Area Hospital and Clinics
Hinner, William Ministry Saint Clare's Hospital
Houlahan, Beth
Hyland, Carol Agnesian HealthCare
Jacobson, Terry St. Mary's Hospital of Superior
Johnson, Kenneth St. Mary's Hospital Medical Center
Joyner, Ken Bay Area Medical Center
Kellar, Richard Aurora West Allis Medical Center
Krueger, Mary Ministry Saint Clare's Hospital
Larson, Margaret Mercy Medical Center
Lewis, Gordon Burnett Medical Center
Logemann, Cari Aspirus, Inc.
Mantei, Mary Jo Bay Area Medical Center
May, Carol Sauk Prairie Memorial Hospital
McCarthy, Bruce Columbia St. Mary's, Inc.
McNally, Maureen Froedtert & The Medical College of Wisconsin
Mueller, Joan Mayo Health System - Franciscan Healthcare
Mugan, James Agnesian HealthCare
Mulder, Doris Beloit Health System
Natzke, Kristin
Nelson, James Fort HealthCare
Ouimet, Mary Wheaton Franciscan Healthcare - All Saints
Pollard, Dennis Froedtert & The Medical College
Quinn, George Wisconsin Hospital Association
Richards, Theresa Ministry Saint Joseph's Hospital
Richardson, Todd Aspirus, Inc.
Rickelman, Debbie WHA Information Center
Rocole, Theresa Wheaton Franciscan Healthcare
Rohrbach, Dan Southwest Health Center
Rouzer, Cindy Spooner Health System
Sczygelski, Sidney Aspirus Wausau Hospital
Selberg, Heidi HSHS-Eastern Wisconsin Division
Shabino, Charles Wisconsin Hospital Association
Simaras, James Wheaton Franciscan Healthcare
Smith, Gregory Wheaton Franciscan Healthcare
Sommers, Craig St. Mary's Hospital
Stuart, Philip Tomah Memorial Hospital
Swanson, Kerry St. Mary's Janesville Hospital
Thurmer, DeAnn Waupun Memorial Hospital
Van Meeteren, Bob Reedsburg Area Medical Center
VanCourt, Bernie Bay Area Medical Center
White, Pamela Mayo Health System - Eau Claire
Zenk, Ann Ministry Saint Mary's Hospital
Zorbini, John Aurora Health Care
Contributors ranging from $1,000 to $1,499
Bedwell, Elizabeth Children's Hospital of Wisconsin
Borgerding, Dana
Britton, Gregory Beloit Health System
Dexter, Donn Mayo Health System - Eau Claire
Gullingsrud, Tim Hayward Area Memorial Hospital and Nursing Home
Gutzeit, Michael Children's Hospital of Wisconsin
Hart, Shelly Aurora Health Care
Heifetz, Michael SSM Health Care-Wisconsin
Herzog, Sarah Wheaton Franciscan Healthcare
Huettl, Patricia Holy Family Memorial
Hymans, Daniel Memorial Medical Center - Ashland
Kosanovich, John Watertown Regional Medical Center
Lappin, Michael Aurora Health Care
Lewis, Jonathan St. Mary's Hospital
Martin, Jeff Ministry Saint Michael's Hospital
McKevett, Timothy Beloit Health System
Mohorek, Ronald Ministry Health Care
Natzke, Ryan Marshfield Clinic
Nauman, Michael Children's Hospital of Wisconsin
Nelson, Dave HSHS-Western Wisconsin Division
Rakowski, Mark Children's Hospital of Wisconsin
Reynolds, Sheila Children's Hospital of Wisconsin
Robertstad, John ProHealth Care - Oconomowoc Memorial Hospital
Roller, Rachel Aurora Health Care
Russell, John Columbus Community Hospital
Sanders, Robert Children's Hospital of Wisconsin
Schafer, Michael Spooner Health System
Sohn, Jonathan Wheaton Franciscan Healthcare
Spooner, Allan Columbia St. Mary's Milwaukee Hospital
Standridge, Debra Wheaton Franciscan Healthcare
Wolf, Edward Lakeview Medical Center
Worrick, Gerald Ministry Door County Medical Center
Contributors ranging from $1,500 to $1,999
Alig, Joanne Wisconsin Hospital Association
Anderson, Sandy St. Clare Hospital & Health Services
Bloch, Jodi Wisconsin Hospital Association
Boese, Jennifer Wisconsin Hospital Association
Byrne, Frank St. Mary's Hospital
Canter, Richard Wheaton Franciscan Healthcare
Clapp, Nicole Grant Regional Health Center
Coffman, Joan St. Joseph's Hospital
Court, Kelly Wisconsin Hospital Association
Eichman, Cynthia Ministry Our Lady of Victory Hospital
Francis, Jeff Ministry Health Care
Frank, Jennifer Wisconsin Hospital Association
Geboy, Scott Hall, Render, Killian, Heath & Lyman
Grasmick, Mary Kay Wisconsin Hospital Association
Harding, Edward Bay Area Medical Center
Heywood, Matthew Aspirus, Inc.
Hilt, Monica Ministry Saint Mary's Hospital
Khare, Smriti Children's Hospital of Wisconsin
Lepore, Michael Wheaton Franciscan Healthcare
Levin, Jeremy Rural Wisconsin Health Cooperative
Mattes, Dan Wheaton Franciscan Healthcare
Meyer, Daniel Aurora BayCare Medical Center in Green Bay
Millermaier, Edward Bellin Hospital
Olson, David Froedtert & The Medical College
Potter, Brian Wisconsin Hospital Association
Sanders, Michael Monroe Clinic
Sexton, William Prairie du Chien Memorial Hospital
Stanford, Matthew Wisconsin Hospital Association
Wallace, Michael Fort HealthCare
Warmuth, Judith Wisconsin Hospital Association
Contributors ranging from $2,000 to $2,999
Brenton, Mary E.
Desien, Nicholas Ministry Health Care
Duncan, Robert Children's Hospital of Wisconsin
Gage, Weldon Children's Hospital of Wisconsin
Herzog, Mark Holy Family Memorial
Jacobson, Catherine Froedtert & The Medical College
Kachelski, Joe Wisconsin Statewide Health Information Network
Katen-Bahensky, Donna
Kief, Brian Ministry Saint Joseph's Hospital
Leitch, Laura Wisconsin Hospital Association
Little, Steven Agnesian HealthCare
Manas, Julie Sacred Heart Hospital
Mettner, Michelle Children's Hospital of Wisconsin
Neufelder, Daniel Ministry Health Care
Normington, Jeremy Moundview Memorial Hospital & Clinics
O'Brien, Kyle Wisconsin Hospital Association
Oliverio, John Wheaton Franciscan Healthcare
Pandl, Therese HSHS-Eastern Wisconsin Division
Potts, Dennis Aurora St. Luke's Medical Center
Starmann-Harrison, Mary Hospital Sisters Health System
Taylor, Mark Columbia St. Mary's, Inc.
Troy, Peggy Children's Hospital of Wisconsin
Woodward, James Meriter Hospital
Contributors ranging from $3,000 to $4,999
Borgerding, Eric Wisconsin Hospital Association
Kammer, Peter The Kammer Group
Turkal, Nick Aurora Health Care
Contributors $5,000 and above
Brenton, Stephen Wisconsin Hospital Association
Kerwin, George Bellin Hospital
Size, Tim Rural Wisconsin Health Cooperative
Tyre, Scott Capitol Navigators, Inc


Top of page (11/15/13)

WHA and Member Physicians Testify Against Bill that Bars Employers from Requiring Flu Shots
Bill "erodes the safety and health of Wisconsin residents"

Physicians from two of Wisconsin’s largest health systems joined WHA and many other health care organizations in opposing Assembly Bill 247, which would limit an employer’s ability to enact policies that protect patient and employee health.

If enacted, AB 247 would prohibit employers from requiring employees to be immunized against influenza as a condition of employment. It would also prohibit employers from requiring employees to wear a mask if they are not immunized.

Speaking before the Assembly Health Committee November 13 hearing in Madison, Bruce Van Cleave, MD, chief clinical officer at Aurora Health Care, stated, quite simply, vaccinations keep our patients safer.

"We need to create the safest place that we can for our patients. That is our responsibility," Van Cleave said. "Caregivers can be healthy carriers of influenza and expose patients to the disease. Getting a flu vaccination is one of the most effective ways to help prevent unnecessary deaths and stem the spread of this preventable disease."

David Smith, MD, vice president of patient experience & care management at Aurora Health Care, said Aurora adopted the "condition of employment" strategy in 2011 as a proven and acceptable intervention to reach nearly universal influenza protection of patients.

"As a result (of the policy), for each of the past three years including 2013, 98 percent of Aurora’s 30,048 employees have received influenza vaccine," Smith said. "Aurora has proven that we can effectively protect our patients from unnecessary exposure to the influenza virus with little disruption to our employees. This bill seeks to erode the safety and health of Wisconsin residents."

Smith asked the Health Committee members to "seek ways to improve the health of our communities, rather than restrict it through legislation such as AB 247."

James H. Conway, MD, FAAP, testifying on behalf of the Wisconsin Public Health Association and UW Health, said since UW Health implemented an employee influenza mandate, there has been a "dramatic" impact on outbreaks.

"Physicians are sworn to ‘do no harm’ and we work with highly vulnerable patients," Conway said. "By vaccinating our employees, we build a cocoon around our patients. The influenza vaccination is not perfect, but it is the best tool we have now to fight this disease."

Testifying against the bill on behalf of the Wisconsin Hospital Association, Chief Quality Officer Kelly Court said hospitals and health systems must have the ability to determine and implement an approach to prevent the spread of influenza that is effective in their work environment.

"We believe this flexibility is critical for the safety of patients and to maintain the high standard of quality and safety that is expected, and delivered, in Wisconsin," Court said.

Renee O’ Day, assistant deputy secretary at the Department of Health Services (DHS) explained that health care personnel flu vaccination rate is one of seven different measures included in the Medicaid hospital pay-for-performance program that affects all hospitals. O’Day also explained that even if the bill became law, hospitals would still need to comply with federal requirements for reporting flu vaccinations rates, and that the measure could become a component of the CMS pay-for-performance program in the future. She added that AB 247 "could potentially prevent many hospitals from successful participation in pay-for-performance goals, which were designed to enhance health care value delivered with the citizens’ tax dollars."

Other organizations that submitted testimony in opposition to the bill included the State of Wisconsin Department of Veterans Affairs, which now requires all Veteran’s Home employees to be immunized or wear a mask during the flu season.

See Channel 3000 coverage of the hearing at

Top of page (11/15/13)

Worker’s Compensation Council Continues to Push Fee Schedule
Provider alternative "more balanced…than 1970’s era government price controls"

The Worker’s Compensation Advisory Council (WCAC) continues to negotiate this legislative session’s bill that would amend the current Worker’s Compensation system. That bill, once approved by the WCAC, becomes law only if approved by the Legislature and signed by the Governor. The WCAC, which includes five representatives of organized labor and five representatives of management, appears poised to propose a fee schedule for reimbursing health care services provided to injured workers under the program. The health care provider liaisons to the WCAC, who include representatives of WHA, the Wisconsin Medical Society, and the Wisconsin Chiropractic and Physical Therapy Associations, have conveyed to the WCAC and the Legislature their members’ ardent opposition to a fee schedule for the Worker’s Compensation program.

Prior to the meeting, WHA, with the Society, WCA, and WPTA, provided the Council with a package of health care cost containment strategies developed and supported by their members, and briefed both labor and management representatives on the proposals. The provider proposals recognize the strengths of the current system and aim to preserve those strengths while encouraging improved administrative efficiencies within the program. In other words, the proposals would reduce costs by reducing costs. A copy of the provider proposal is available at

After the meeting, WHA Executive Vice President Eric Borgerding said, "Wisconsin’s hospitals and health systems are always striving to improve, and bring greater efficiency to the processes we work within. WHA and our members support measured reforms that encourage greater efficiency in the Worker’s Compensation system, including changes to an administrative apparatus that are long overdue and that can be accompanied by commensurate discounts from charges for health care services." Borgerding emphasized, "This is a far more innovative, balanced and creative approach than 1970s-era government price controls and fee schedules that are controversial and have, at best, a mixed track record in other states."

The WCAC meets again December 3, 2013, to continue negotiations on this session’s legislation.

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Dan Mattes, President of WFHC, Dies

Dan Mattes, 46, president of Wheaton Franciscan Healthcare’s facilities in southeastern Wisconsin, died November 8.

Mattes joined Wheaton Franciscan in 1992. He headed the organization’s hospitals in Franklin, St. Francis Hospital in Milwaukee and the Midwest Orthopedic Specialty Hospital in Franklin.

"I considered Dan to be a member of my family, and his death is a monumental loss for Wheaton Franciscan Healthcare and all those who personally knew and loved him," John Oliverio, president and chief executive officer, said.

The Dan Mattes Scholarship Fund is being established and will go toward a graduate of Greendale High School each year.

Mattes had recently been appointed to serve on the Wisconsin Hospital Association’s Board of Directors.

"Dan was committed to not only serving his community through his work at Wheaton, but he shared his vision broadly with his health care colleagues statewide as well. He was a talented, committed and skillful leader," said WHA President Steve Brenton. "We extend our deepest sympathy to his family, friends and to his colleagues at Wheaton Franciscan at this very difficult time."

In addition to his wife, Kristin, Mattes is survived by four children—Amanda, Jessica, Sarah and Luke.

Top of page (11/15/13)

Less Than 900 in Wisconsin Enroll in Exchange Health Plan
HHS releases state by state numbers

The first report released by the federal Department of Health and Human Services (HHS) on exchange enrollment shows that only 877 Wisconsin residents signed up for coverage during the first month of open enrollment on the state’s federally-facilitated health insurance exchange. Nationwide, in states with a federally-facilitated exchange, just 26,794 people have enrolled. The report does not indicate whether those enrollees have paid their first premium.

The low enrollment numbers reflect the initial and ongoing problems with the exchange website that have caused significant concern and frustration for those seeking insurance coverage, as well as hospital and health system staff assisting patients with coverage options. The data covers the October 1 through November 2 time period.

The HHS report shows that 19,098 applications were completed in Wisconsin for 34,678 people. Of those, 22,038 individuals have been deemed eligible to enroll in an exchange plan, and 8,911 have been determined eligible for financial assistance for enrolling in an exchange plan. In addition, 10,736 have been deemed eligible for Medicaid.

In other exchange news this week, President Obama announced new guidance to insurers that would allow them to continue coverage that would otherwise be terminated or cancelled. This new guidance comes after the Administration was criticized when consumers began receiving letters cancelling their previous insurance policies because the policies didn’t meet the requirements of the Affordable Care Act. Under the guidance, health insurance coverage in the individual or small group market that is renewed for a benefit year starting between January 1, 2014, and October 1, 2014, will not have to comply with certain market reforms including guaranteed issue and new premium rating requirements. Insurers and other health care experts are assessing the ramifications of this new option.

Top of page (11/15/13)

WHA Submits Comments on Congressional SGR Proposal
Unless addressed, 25 percent cut scheduled to take effect December 31

Unless Congress can find a solution to the sustainable growth rate (SGR), an impending 25 percent cut to physician payments under Medicare is scheduled to go into effect December 31. While Congress has historically used short-term "patches" to stave off cuts, Congress has increasingly been focused on finding a permanent solution. One potential option is a complete repeal of the SGR.

On November 12 the Wisconsin Hospital Association submitted comments to both the U.S. Senate Finance Committee and the U.S. House of Representatives Ways & Means Committee in response to their recently-released SGR Repeal and Medicare Physician Payment Reform Discussion Draft.

"With respect to reforming the Medicare program, we have been national leaders in driving the volume versus value equation in Medicare payment reform, including supporting a full repeal of the SGR. We are very encouraged to see the significant, bipartisan work on this issue by many in Congress, including your Committees," the letter began.

WHA expressed support for the proposal’s full repeal of Medicare’s failed SGR formula and for the draft’s commitment to move toward value-based payments in Medicare. One example of the latter would be the consolidation of several programs into one "Value-Based Performance Payment Program" (VBP). At the same time, WHA expressed caution regarding the VBP program, including its lack of specificity and impact on rural and other shortage areas. Additionally, WHA, as it has consistently done, urged that the VBP include a national benchmark.

"With moving Medicare toward value and quality…[w]e strongly encourage you to use a national benchmark in the VBP. High-value providers have already demonstrated better outcomes and more efficient care and they should not be forced to compete against similar high-value providers. Doing so, in essence, penalizes those of us who have already committed to the value proposition."

One of the most significant problem areas for WHA with the proposal is its lack of a funding mechanism. Currently the estimates for a full SGR repeal begin at $140 billion.

"WHA has strong concerns hospital payments will be targeted to pay for the SGR repeal. This is troubling on multiple fronts, including it is arbitrary and will disproportionately impact high value and highly integrated states like Wisconsin…Additionally[, for] Wisconsin, we estimate our hospitals and systems are already seeing what will amount to close to $4 billion in payment reductions over 10 years due to multiple laws, including two recent SGR patches."

Read the full letter online at:

Read the "discussion draft" at:

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David Nash, MD to Focus on Effect of Quality & Safety Movement on Physicians at WHA’s 2014 Physician Leadership Development Conference
March 14-15, 2014, at The American Club, Kohler

David Nash, MD, internationally recognized for his work in quality outcomes management, medical staff development and quality improvement, will lead day one of the two-day, annual WHA Physician Leadership Development Conference, scheduled March 14-15, 2014 at The American Club in Kohler. Online registration is now open for the 2014 event at

During the full-day session, Nash will focus on the history of the quality and safety movement, with special attention to its current connection to health reform and its effect on physicians. He will also discuss the key measures developed for health reform and compare and contrast those measures that promote the goals of the Institute for Medicine. He will also discuss strategies for physician leaders to support a culture of quality improvement, and how they can engage their physician colleagues in supporting a culture where quality improvement is the expectation.

Nash is a professor of health policy and the founding dean for the Jefferson School of Population Health (JSPH) at Thomas Jefferson University in Philadelphia. JSPH offers Masters programs in public health, health care quality and safety, health policy, and applied health economics; as well as a doctoral program in population health science. Nash is also a board-certified internist, and has repeatedly been named to Modern Healthcare’s list of Most Powerful Persons in Healthcare. He is the principal faculty member for quality of care programming for the American College of Physician Executives (ACPE) and leads the academic joint venture between JSPH and ACPE.

The WHA Physician Leadership Development Conference benefits both new and seasoned physician leaders, and each year, focuses on important and practical leadership skills that help physician leaders to move beyond their clinical training and take a new approach to managerial decision-making and problem solving. To learn more about this year’s conference agenda, including the Saturday session, led by Dr. Tim Keogh and focused on building the communication skills physician leaders need to gain influence, promote cooperation and engage top performers, visit:

A discounted fee is available to those registering by January 15. Additionally, a "host" registration option is available for senior-level hospital representatives (non-physicians) who accompany one or more of their physicians to the conference but do not need CME credit. ACPE is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. ACPE designates this live activity for a maximum of 12 AMA PRA Category 1 Credits.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.

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Support Quality & Workforce Initiatives with WHA Foundation Contribution

Each year, the WHA Foundation supports a variety of initiatives that have statewide impact on health care in the areas of workforce development, quality and patient safety and community collaboration. In 2013, those initiatives included development of the BSN completion program website,, scholarships for technical college students in health-related programs, as well as support for the Transforming Care at the Bedside (TCAB) gathering, allowing participants an in-person opportunity to network and share best practices.

In order to continue to support initiatives like these and others in 2014, the WHA Foundation has officially kicked off its annual fundraising campaign, asking WHA hospital members to consider supporting the WHA Foundation by making a contribution this fall.

Funds raised in the current campaign will be used to continue some of its most successful and long-standing initiatives, including the Global Vision Community Partnership Awards, and they will give the Foundation the opportunity to consider new initiatives in 2014.

Each WHA hospital member executive has received a direct appeal for the fundraising effort. A contribution form is included in this week’s packet for anyone who would like to make an individual contribution or one on behalf of your hospital. For more information on the WHA Foundation’s annual fundraising campaign, contact Jennifer Frank at 608-274-1820 or

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Wisconsin Hospitals Community Benefits – Charity Care

Fear of a bill should never prevent a patient from seeking care at a Wisconsin hospital. Wisconsin hospital charity care programs provided $232 million to more than 700 patients each day last year. The stories that follow illustrate the deep commitment and continuing concern that hospitals have to their patients to ensure they receive the care they need regardless of their ability to pay.

Community Care lends a helping hand to a person in need

Deanna Hintz is like a lot Americans today – struggling to make ends meet. When she needed immediate surgery for a hernia, she did not know how she was going to afford it.

Deanna already knew that she has developed a hernia, but her doctor assured her that she did not need to seek medical attention immediately. But a week after Thanksgiving, her symptoms significantly worsened. It was bothering her so much that she decided to go the Wheaton Franciscan – Elmbrook Emergency Department. After she arrived, her physician gave her two options – to go back home and schedule surgery or have the procedure performed immediately. She chose to have the surgery immediately.

Deanna was concerned about how she was going to pay for this procedure. She works a seasonal part-time position as a bus driver and lives on an $800 a month income. She barely has enough funds to cover her existing bills. "The bills were more than what I make in a year," expressed Deanna. On top of that, she was unsure of how much her insurance from work would cover.

While recovering from her condition, Deanna talked with a Financial Counselor at Elmbrook about Community Care, Wheaton Franciscan Healthcare’s program offering financial assistance to those in need. Because Deanna qualified, Wheaton provided her services free of charge.

"It was like the weight was being lifted off my shoulders," said Deanna. "This is a true blessing."

Wheaton Franciscan – Elmbrook Memorial Campus, Brookfield

Financial counselors at Aurora Sinai go beyond the call of duty

Aurora Sinai Medical Center (ASMC) is one of only two essential safety-net hospitals remaining in Milwaukee for the city’s low-income neighborhoods. Patients visit the ASMC emergency department who are homeless, uninsured, unemployed, and suffering from ailments that have gone untreated because they believe their inability to pay precludes their ability to seek help. Often financial counselors at ASMC receive calls and visits from patients requesting help for paying medical expenses. Sometimes the need goes beyond paying their medical bills, as it did for one particular young woman with no family to support her.

The young woman arrived one cold, winter morning in the office of an ASMC financial counselor. She was pregnant and applied for an Aurora Helping Hand Patient Financial Assistance Program application to receive medical services she required for her pregnancy.

While talking with the young woman, the financial counselor noticed that she was not wearing shoes that were proper for the winter weather in Wisconsin. The counselor immediately went through her personal items and found a pair of her own shoes for the young woman to try on. The woman left the counselor’s office not only being approved for Helping Hand Financial Assistance, but with a new, slightly used pair of shoes and the comfort of knowing that someone truly cared about her personal well-being.

Aurora Sinai Medical Center, Milwaukee

Submit community benefit stories to Mary Kay Grasmick, editor, at

Read more about hospitals connecting with their communities at

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