July 31, 2015
Volume 59, Issue 30

U.S. House Ways & Means Committee Activity
DSH, IME, Site Neutral Bills Introduced; WHA Comments on Rural Issues

It was a busy week for the U.S. Ways & Means Committee which held a hearing on rural health and released a series of legislation designed to reform the Medicare program.

Ways & Means Republicans Introduce Medicare Reform Bills

On July 29, committee Republicans released four bills they believe will help move Medicare reforms forward. The Wisconsin Hospital Association (WHA) will analyze the legislative bill text as it is released and will provide updates in future Valued Voice newsletters. A general summary of the bills follow:

A fourth bill was also introduced by Ways & Means Health Subcommittee Chairman Kevin Brady (R-TX) and Health Subcommittee Member Ron Kind (D-WI), entitled, “Medicare Post-Acute Care Value-Based Purchasing Act of 2015 (HR 3298).” The legislation would establish a value-based purchasing program in four post-acute care settings—home health agencies, skilled-nursing facilities, inpatient-rehabilitation facilities and long-term care hospitals. Under this program, providers will be rated on one metric--Medicare spending per beneficiary.

Ways & Means Health Subcommittee Rural Hearing

On July 28, the Subcommittee on Health held a hearing entitled, “Rural Health Disparities Created by Medicare Regulations.” WHA submitted a statement to the Committee on this hearing. Read WHA’s statement at http://www.wha.org/pdf/2015WHAWaysMeansWrittenTestimony7-28.pdf.

In its statement, WHA highlighted key Medicare policies that are creating problems in rural PPS and critical access hospitals (CAH), and recommended the Committee do the following:

WHA also highlighted the advances made by rural hospitals and CAHs with respect to quality improvement and value through participating in WHA programs such as Partners for Patients and CheckPoint, among others.

“Wisconsin hospitals have a strong and long-standing commitment to collaboration and the pursuit of high-value care—high-quality, cost-efficient care. This pursuit is shared by all of Wisconsin’s facilities, regardless of size,” the WHA statement read. “WHA and our hospitals stand at the ready to assist Congress and CMS in developing approaches that continue moving Medicare further along the health care value continuum while still recognizing the unique roles rural PPS and critical access hospitals play throughout our state and much of the country.”  

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Observation “Notice Act” Moves to President for Signature

The U.S. Senate passed July 29 by unanimous consent legislation known as the Notice Act--The Notice of Observation, Treatment and Implication for Care Eligibility Act (HR 876). The legislation was overwhelming approved by the U.S. House of Representatives in March and now moves to the President for his signature.

Under the Notice Act, hospitals, including critical access hospitals, must provide written and oral notice to Medicare beneficiaries in outpatient observation for more than 24 hours. Notice is required within 36 hours or at discharge, whichever is sooner. In general, notification would need to:

The legislation will take effect one year after enactment.  

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Physician Licensure Compact, Diversity Top WHA Workforce Council Agenda

The demographic changes in Wisconsin’s population require hospitals and health systems to attract and keep a more diverse workforce. Currently, nurses are predominately white and female in Wisconsin. However, the diversity of the patient population along with the competition to attract younger workers will mean hospitals and health systems will increasingly need to build a more culturally and ethnically diverse population.

Aliah Berman, director of diversity and inclusion for Aurora Health Care, shared her expertise in this field with the members of the WHA Council on Workforce at their July 30 meeting in Madison. Berman led council members in a discussion that examined the current status of diversity efforts within Wisconsin hospitals, and she described some of the programs and efforts that have been successful in not just attracting, but in retaining, a more diverse health care team.

“Wisconsin hospitals serve a diverse population, so they want to have employees in their own workforce reflect the diversity in the community,” according to Steven Rush, WHA vice president, workforce and clinical practice. “Although many different aspects of diversity are of concern for Wisconsin hospitals, the under-representation of certain ethnicities in our workforce is an area of focus.”

Rush added that specific to nursing, men continue to be under represented in nursing, comprising only 6 percent of Wisconsin’s registered nurses.

WHA Senior Vice President for Government Relations Kyle O’Brien updated the Council on the recently-enacted biennial state budget, which included key WHA priorities such as an ongoing Medicaid Disproportionate Share Hospital (DSH) program and a budget that funds the cost-to-continue in Medicaid without hospital or physician cuts. O’Brien previewed activity expected in the fall legislative session, including a proactive agenda by WHA to pass a bill joining the Interstate Physician Licensure Compact and legislation to implement behavioral health pilot programs in Medicaid.  The Council discussed how the Physician Licensure Compact would work in Wisconsin and how the bill could make it easier and more streamlined for physicians to become licensed in the state.

The Council members plan to continue discussion and work in addressing diversity in the hospital workforce. It was suggested that tools and action steps developed by the American Hospital Association serve as the framework for WHA’s efforts. See http://www.diversityconnection.org/diversityconnection/homepage/index.jsp.  

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Regional Health Care Coalitions Build on Wisconsin’s Emergency Prep Success

On July 1, the Department of Health Services (DHS) formally inaugurated seven regional healthcare coalitions (HCCs) to provide for a more interdisciplinary, coordinated approach to prepare for natural and health emergencies. The HCC model will assist in coordinating regional health care plans for large-scale disasters, monitoring and managing resources, streamlining information flow, and promoting uniform messaging within and across regions. In addition, there will be closer coordination among the various disciplines that participate in emergency preparedness work, including hospitals, trauma, public health and emergency management. An “HCC” is a group of health care, public health and public safety organizations that have come together to prepare for, respond to, and recover from disasters and other adverse events in the community.

At its first meeting earlier this month, the HCC Advisory Group convened to play a leadership role in advising DHS and the regional HCCs on program matters. This meeting set the tone for a strong start to the HCC model of health emergency preparedness. State Health Officer Karen McKeown welcomed the Advisory Group and encouraged members to succeed on their important mission of bolstering Wisconsin’s health emergency preparedness infrastructure. She noted that the HCC Advisory Group builds on the collaborative partnerships that the Wisconsin Healthcare Emergency Preparedness Program (WHEPP) has fostered over the years. Members of the Advisory Group also welcomed the hiring of a new State Trauma Coordinator, Julie Forcier, as well as a new DHS medical advisor, Jon Meiman, MD.

The regional HCCs cover the same geographic areas as the WHEPP regions. Each regional HCC has its own staff and a separate governance structure. To find the HCC coordinator, medical advisor, and RTAC coordinator for your hospital’s region, visit www.wha.org/data/sites/1/emergencyprep/RegionalHCCStaffContacts.xlsx

“Hospitals have always been central to a community’s ability to respond to a disaster, and hospitals will continue to play a central role in HCCs,” according to Andrew Brenton, WHA assistant general counsel and WHA’s liaison to the HCC. “WHA will play an important role in providing communications and expertise to the HCC Advisory Group to ensure that our members are informed of education and support opportunities offered by the HCCs.”

The WHEPP program, administered by DHS in partnership with WHA and other stakeholders, was developed in 2002 to bolster the state’s disaster/emergency response. If you have any questions regarding emergency preparedness or health care coalitions, contact, Andrew Brenton, WHA assistant general counsel at 608-274-1820 or abrenton@wha.org, or visit: www.wha.org/HealthcareCoalitions.aspx.

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WHA 2015 Nominating Awards Committee to Meet in Early September

Nominations are now being accepted for WHA’s annual Distinguished Service Award and Trustee Award. These important awards recognize those who display leadership, dedication and professionalism to their community or the Association. You may know someone in your region, in your hospital or on your Board of Directors who deserves such an honor. You now have an opportunity to nominate them for one of these annual awards:

Information on these two awards can be found on the WHA website at www.wha.org/award-program-information.aspx.

The Nominating Committee will also make recommendations on new WHA Board Members. WHA members interested in being considered for an At-Large WHA Board seat or the Chair-Elect position should contact either WHA President Eric Borgerding at eborgerding@wha.org or WHA Nominating Committee Chair Ed Harding at eharding@bamc.org.

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WHA Offers “Listening for a Change” Workshop: Crucial Conversations                      

One key component to effectively lead change is the ability to have crucial conversations with colleagues. The role of an informal leader requires a set of communication skills that we do not learn in school.  WHA is pleased to offer “Listening for a Change,” a two-day communication skills workshop at Glacier Canyon Lodge Conference Center in Wisconsin Dells, August 26-27.

“Our work with nurse leaders and managers indicates there is a need to learn skills that facilitate supportive, interpersonal communication,” according to Kelly Court, WHA chief quality officer. “This workshop exposes our members to a different type of learning experience, one that is experiential and focused on skill development.”

This is a high-quality, ‘hands-on’, small group learning that will embed several key skills that can be applied universally – no matter the topic or the focus of the conversation.  There are limited spaces left in the Listening for a Change communication skills workshop. The workshop is limited to two staff per hospital.

The workshop facilitators, Kathy Germann and Denise Jess, have been teaching audiences including professionals in health care, law enforcement, education, government and the corporate sector. They each operate their own business and choose to collaborate on their specialties, including diversity/inclusivity, conflict transformation, facilitation, team development and communication skills.

The fee is $300 per person. WHA has reserved rooms at Glacier Canyon at a discounted price. For more information and to register: http://events.SignUp4.net/ListeningforaChange0826-27.

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WHA, PSW Sponsor Quality Improvement “Boot Camp”

Focus on improving transitions of care and eliminating medication errors

WHA and the Pharmacy Society of Wisconsin (PSW) are collaborating to offer a three-part webinar boot-camp series designed to improve transitions of care and reduce medication errors. The sessions will help hospitals learn how best to leverage pharmacy resources to reduce readmissions. All WHA member hospital staff are welcome to participate. Details are below:

    Boot Camp Webinar One:
    September 22 from 12:00-1:00: Pharmacy Involvement in Transition of Care Services at Discharge
   --Registration and Event Address: https://whaquality.webex.com/whaquality/onstage/g.php?MTID=efd138aa7bf7753c98beba19521c4c733

    Boot Camp Webinar Two:
    September 29 from 12:00-1:00: Pharmacy Involvement in Discharge Medication Education and Reconciliation: A Business Plan for Action
   --Registration and Event Address: https://whaquality.webex.com/whaquality/onstage/g.php?MTID=e36b6931d6b94527168d7566388387b1f

    Boot Camp Webinar Three:
    October 6 from 12:00-1:00:  Best Practices: Enhancing Transition of Care Communication
   --Registration and Event Address: https://whaquality.webex.com/whaquality/onstage/g.php?MTID=e20201a7776300be6a5bf372f5602d340  

For more information, contact Tom Kaster at 608-268-1813 or tkaster@wha.org.


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Member News: CHW-Fox Valley Names Franckowiak Executive Director

Debbie Franckowiak, PhD, MBA/HCA, has been selected to serve as executive director for Children’s Hospital of Wisconsin in Neenah. Franckowiak, who has been serving in this interim role since April, will manage all aspects of patient care delivery, fiscal administration, performance improvement, utilization review and professional development at Children’s Hospital of Wisconsin-Fox Valley.

Together with the hospital’s medical directors, she will participate in the development and implementation of hospital goals, objectives, policies, procedures and programs in accordance with its mission and vision.

Before joining Children’s, Franckowiak served as project coordinator - health science specialist for Michael E. DeBakey VAMC in Houston, director of clinical operations for Oconomowoc Memorial Hospital, and prior to that, chief clinical services officer with Aurora Health Care.   

Franckowiak earned her Bachelor of Science in health science from the University of Wisconsin – Milwaukee and a Master of Business/healthcare administration from the University of Phoenix. Most recently, she earned her PhD in industrial organizational psychology from Walden University.

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Member News: Scott Rathgaber, MD, Named Gundersen CEO

Gundersen Health System announced Scott Rathgaber, MD, AGAF, is the organization’s next chief executive officer. Rathgaber will begin his new role in September.

Since 2012, Rathgaber, a native of Indiana, has served as medical vice president of Gundersen’s hospital operations, neurosciences, general surgery, anesthesiology, emergency services, occupational health services and pharmacy.

Rathgaber has cared for patients in gastroenterology and hepatology at Gundersen since 1998. In addition to serving as section chief of Gundersen gastroenterology  from 2005 to 2011, Rathgaber served on the Gundersen Board of Governors from 2010 to 2012.

Rathgaber received his medical degree from the Indiana University Medical Center. He completed an internal medicine residency at the University of Minnesota before returning to the Indiana University Medical Center for a gastroenterology fellowship. He is board-certified in gastroenterology and is a fellow of the American Gastroenterological Association and member of the American College of Gastroenterology. He has authored, or co-authored 14 publications in peer-reviewed journals.

Current CEO, Jeff Thompson, MD, will remain with Gundersen to assist Rathgaber during a period of transition.

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AP Clinician Hospitalist Program Webinar Series Launches August 5

On August 5, the first of a three-part, complimentary webinar series focused on the use of advanced practice clinicians (APCs) in hospitalist programs will be offered for WHA hospital and corporate members. There is no fee to participate, but pre-registration is required.

This first session will focus on the various legal parameters relevant to an APC hospitalist program and challenges hospitals face when considering use of APCs as hospitalists. It will include the interplay between state and federal hospital regulations, the scope of practice laws, reimbursement requirements and relevant accreditation.

Session two is scheduled September 2, and will focus on various APC hospitalist structures that can be implemented in CAHs or PPS hospitals, as well as provide an overview of the regulatory risks involved in these programs and propose strategies to mitigate the risks. The final session, scheduled for October 6, will describe practical steps hospitals need to take to implement an APC hospitalist program, including a discussion of bylaw considerations, privileging documents, co-signature timeframes, and policies and procedures.

Complete descriptions of the three sessions and online registration can be found at: http://events.SignUp4.net/2015APHospWebSeries.

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