September 28, 2012
Volume 56, Issue 39

Public Wants More Control, More Choice, Less Government in Health Care

Health care leaders are accustomed to hearing that "change is coming," but when that message comes from Scott Rasmussen, a highly-respected pollster best-known for sharing keen political insights, it carries a new sense of urgency. Sweeping change will hit every aspect of health care, according to Rasmussen, who presented at the WHA 2012 Summit held September 21 in Madison.

"It’s not just about what is happening in Wisconsin’s health care industry," according to Rasmussen, best-selling author and president of Rasmussen Reports. "The health care industry is going to change more than you can imagine. A decade from now it will be financed differently, patients will be interacting with you differently and your jobs will be different."

People recognize that lifestyle choices have a greater affect on their health than medical care, but people can’t agree on what the role of government should be in rewarding—or penalizing—unhealthy lifestyles. While people believe that insurance companies should offer a discount to subscribers that have a healthy lifestyle, they are at the same time, paying a smaller share of their disposable income toward health care than people did 50 years ago.

Rasmussen said 82 percent of the voters believe that if your company provides health insurance, you should be able to use that money to buy a policy that works for you. However, if they find a less expensive policy, they believe they should be able to ‘keep the change.’

"When people around the country hear about the ‘exploding cost of health care,’ they are not personally seeing it," Rasmussen said. "Government agencies are seeing it, insurance companies and employers are seeing it, but most people are not feeling it in their own pocket."

As people become more responsible for the cost of care, they will also demand more control over their choices. This will trigger transformational change in the industry. Rasmussen predicts that less care will occur in hospitals and clinics and more will be done at home, which will change the relationship between patient and care provider.

"If you figure out where public opinion is going, you will see what the end result is going to be in health care and the right policies and right choices are going to fall into place that will give individuals the maximum amount of control over their own health," Rasmussen said.

On the political scene, Rasmussen said the presidential race continues to be too close to call. While President Obama "got a good bounce" out of the Democratic convention, according to Rasmussen, the Republicans are more engaged. Rasmussen said Wisconsin is one of eight pivotal states for Obama and Romney in the upcoming election. Meanwhile, control of the senate could hang on the results in four toss-up states—Wisconsin, Virginia, Connecticut and Massachusetts.

Rasmussen noted that in a presidential election, the most important number to watch is the President’s job approval rating because that is a rough estimate of the percentage of votes the President will garner on Election Day. For three years, President Obama’s job approval rating has been, on average, 47 percent. And the biggest driver of the approval rating is no surprise, the economy. Only 16 percent of the public believes that today’s children will be better off than their parents. In the 1930’s, 37 percent thought the next generation would be better off.

"The public is ready to make thoughtful changes in programs, but it will take a leader to articulate that and when you go through change, it is a painful process," Rasmussen said. "There will be turmoil and anger as we go through these changes."

On Medicare, Rasmussen said only 40 percent of people under 40 think Medicare is a good deal for them. They like the concept, but they don’t like the way the system is working today. While the public largely opposes the health reform law, they recognize that change is needed, but they have no idea how to change the system.

"People are getting the sense that the health care debate is not about them—it is just about who sets the rules and how you get paid for it," according to Rasmussen. "They don’t want government or insurance companies to make choices for them. They are looking for a new, different process."

To help their communities cope with the rapid change that is ahead in health care, Rasmussen encouraged hospitals to remain patient-centered and "give a lot of thought to how you actually can help your patients improve their health."

Top of page (9/28/12)

WHA Medicaid Reengineering Group Reconvenes
Group Tackles Complexity of Medicaid Expansion

The WHA Medicaid Reengineering Group (MRG) was reconvened and met at WHA September 25, led by Chair Nick Desien, CEO of Ministry Health. The group, which is comprised of member CEOs and CFOs, was created in 2011 to study various aspects of the Wisconsin Medicaid program. Under its ongoing charge, the MRG is taking on the complex issues around Medicaid expansion in Wisconsin. The group’s goal is to develop recommendations related to ACA implementation in Wisconsin, and in keeping with the WHA Medicaid principles of maintaining Medicaid as a safety net for Wisconsin’s vulnerable citizens.

"The Supreme Court decision has caused a number of unanswered questions, yet policy makers are going to be grappling with how to structure the Medicaid program in Wisconsin in the face of this uncertainty," said Desien. "We want to be proactive in our approach to understanding the policy questions and coming up with ideas and input."

In its previous work, the MRG developed over 47 recommendations for reforming the Medicaid program. At this meeting, members reviewed the WHA Medicaid Guiding Principles, and the MRG policy assumptions. These policy assumptions guided its work in the past and members agreed they are still relevant today. The policy principles are:

Joanne Alig, senior vice president for policy and research at WHA, walked the MRG through WHA’s current analysis of the Supreme Court’s ruling on Medicaid expansion. The ruling makes optional the health care reform law’s requirement to expand eligibility to anyone with income below 133 percent of the federal poverty level. In Wisconsin the key population group that would be affected by this provision is adults without dependent children (the "childless adults"). Alig said it ultimately boils down to policy questions about what income threshold should be used to determine eligibility for Medicaid for all population groups and whether subsidized coverage through an exchange or the Basic Health Plan provide better alternatives.

"We are carefully considering Wisconsin’s choices and their implications on providers, recipients, the state and the overall cost shift to employers," said WHA Executive Vice President Eric Borgerding. "We are fortunate in this state that our members are engaged and willing to commit their time to these issues."

The MRG is currently scheduled to meet three times through the end of November.

Top of page (9/28/12)

Political Action Fundraising Campaign Surpasses $200k Mark!

Totals to the 2012 Wisconsin hospitals state political action funds fundraising campaign surpassed $200,000 this week, raising $206,746 to date. More than $12,000 has been raised in the last two weeks from 31 more individuals, putting the total number of participants at 339, and 50 of them are members of the Platinum Club contributing $1,500 or more to the 2012 campaign.

The 2012 campaign continues its strong pace, $38,000 ahead of last year at this time and nearly $13,000 ahead of the 2010 record breaking year. The campaign is at 83 percent of the goal to raise $250,000 by year’s end, which if achieved, would be the highest total ever raised in a single campaign year, a long way from the $60,000 record raised back in 2001, just over ten years ago.

All individual contributors are listed in The Valued Voice by name and affiliated organization on a regular basis. Thank you to the 2012 contributors to date who are listed on pages 12-13. Contributors are listed alphabetically by contribution amount category. The next publication of the contributor list will be in the October 12 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
Appleby, Jane Aurora Health Care
Arendt, Kathleen Aspirus Wausau Hospital
Ashenhurst, Karla Ministry Health Care
Bair, Barbara St. Clare Hospital & Health Services
Beglinger, Joan St. Mary's Hospital
Bell, Kristine Aspirus Wausau Hospital
Bernklau, Robert Aspirus Wausau Hospital
Biros, Marilyn SSM Health Care-Wisconsin
Bliven, David Aspirus Wausau Hospital
Bosio, David Aspirus Wausau Hospital
Boson, Ann Ministry Saint Joseph's Hospital
Bowers, Laura SSM Health Care-Wisconsin
Brenholt, Craig St. Joseph's Hospital
Brenton, Andrew Wisconsin Hospital Association
Buettner, Susan Aurora Health Care
Burgener, Jean Aspirus Wausau Hospital
Buss, Diane St. Mary's Hospital
Bychinski, Paul Aspirus Wausau Hospital
Calhoun, William Mercy Medical Center
Carlson, Peter Aurora Psychiatric Hospital
Censky, Bill Holy Family Memorial
Cieslak Duchek, Mary Aurora Health Care
Clark, Julie St. Joseph's Hospital
Clesceri, Maryann Aurora Health Care
Coil, Joseph St. Clare Hospital & Health Services
Cox, Tamarah Aspirus Wausau Hospital
Culotta, Jennifer St. Clare Hospital & Health Services
Cummings, Mike Aurora Health Care
Dahl, James Fort HealthCare
Dalebroux, Steve St. Mary's Hospital
Danner, Forrest Aspirus Wausau Hospital
Davis, Leslie Aurora Health Care
DeRosa, Jody St. Mary's Janesville Hospital
Dettman, Amy Bellin Hospital
Dietrich, Dean Aspirus Wausau Hospital
Dodd, Petra Aspirus Wausau Hospital
Drengler, Kathryn Aspirus Wausau Hospital
Dufek, Nancy Memorial Medical Center - Ashland
Dux, Larry Community Memorial Hospital
Elliott, Roger St. Joseph's Hospital
Entenmann, Kim St. Joseph's Hospital
Fabich, Robb Aspirus, Inc.
Facey, Alice St. Clare Hospital & Health Services
Fielding, Laura Holy Family Memorial
Francaviglia, Stephen Aurora Health Care
Freimund, Rooney Bay Area Medical Center
Fuchs, Thomas St. Joseph's Hospital
Gajeski, Lynn St. Vincent Hospital
Garavet, Scott Aspirus Wausau Hospital
Garibaldi, Isabelle Wheaton Franciscan Healthcare - All Saints
Garvey, Gale St. Mary's Hospital
Gates, John Aurora Health Care
Giedd, Janice St. Joseph's Hospital
Govier, Mary Holy Family Memorial
Grady, Raymond Aurora Health Care
Granger, Lorna ProHealth Care, Inc.
Gresham, James Wheaton Franciscan Healthcare
Groskreutz, Kevin St. Joseph's Hospital
Grundstrom, David Flambeau Hospital
Gulan, Maria Aspirus Wausau Hospital
Halida, Cheryl St. Joseph's Hospital
Hamilton, Mark
Hattem, Marita Aspirus Wausau Hospital
Hedrington, Brian Sacred Heart Hospital
Heinzen, James Aurora Medical Center in Hartford
Hieb, Laura Bellin Hospital
Hill, Nick St. Joseph's Hospital
Hinker, Jennifer Aspirus Wausau Hospital
Hinton, George Aurora Sinai Medical Center
Hockers, Sara Holy Family Memorial
Hoege, Beverly Reedsburg Area Medical Center
Holub, Gregory Ministry Door County Medical Center
Huber, Mark Aurora Health Care
Hueller, Julie Wheaton Franciscan Healthcare
Huemmer, Paul St. Mary's Hospital
Irwin, Ron Aurora Health Care
Jelle, Laura St. Clare Hospital & Health Services
Jensema, Christine HSHS-Eastern Wisconsin Division
Jensen, Russell St. Mary's Hospital
Johnas, Nancy Aspirus Wausau Hospital
Johnson, George Reedsburg Area Medical Center
Jones, Mary Meriter Hospital
Karow, Deborah Ministry Health Care's Howard Young Medical Center
Keene, Kaaron Memorial Health Center
Kelsey Foley, Kathy Aspirus Wausau Hospital
Kempen, Jacob Aspirus Wausau Hospital
Kepchar, Dennis Ministry Health Care
King, Steve St. Mary's Hospital
Kingston, Mary Beth Aurora Health Care
Klay, Lois St. Joseph's Hospital
Klein, Richard Aurora Health Care
Klein, Tim Holy Family Memorial
Kleinschmidt, Sherry Aspirus Wausau Hospital
Koch, Doug Aurora Health Care
Kocourek, Cathie Aurora Medical Center in Two Rivers
Koss, Gail Aspirus, Inc.
Krause, Carolyn Meriter Hospital
Lachecki, Therese Memorial Medical Center - Ashland
Lambrecht, Randy Aurora Health Care
Lampman, Sandra St. Mary's Hospital
Larson, William St. Joseph's Hospital
Leonard, Mary Kay St. Mary's Hospital
Lewandowski, Terri Ministry Our Lady of Victory Hospital
Logemann, Tim Aspirus Wausau Hospital
Lucas, Roger Aspirus Wausau Hospital
Ludgin, Richard Aurora Health Care
Lynch, Sue Mayo Health System - Franciscan Healthcare
Marcouiller, Don Memorial Medical Center - Ashland
Margan, Rob Wisconsin Hospital Association
Maroney, Lisa
Mason, Paul Wheaton Franciscan Healthcare - All Saints
Maurer, Mary Holy Family Memorial
McMeans, Scott Holy Family Memorial
Meicher, John St. Mary's Hospital
Merline, Karen
Merrick, Marianne St. Mary's Hospital
Mohr, Carol Sacred Heart Hospital
Moon-Mogush, Cindy Aurora Health Care
Moss, Kenneth Meriter Hospital
Murphy, Thomas Aurora Health Care
Neeno, Joan St. Mary's Janesville Hospital
Nelson, Dean St. Mary's Hospital
Nevers, Rick Aspirus, Inc.
Nguyen, Juliet Sacred Heart Hospital
Norbin Killoran, Carrie Aurora Health Care
Norton, Marcella Aspirus Wausau Hospital
O'Hara, Tiffanie Wisconsin Hospital Association
Ojala, Theresa St. Mary's Hospital
Olson, Bonnie Sacred Heart Hospital
Olson, Christine Aurora Medical Center in Kenosha
Olson, Keri St. Clare Hospital & Health Services
Ose, Peggy Riverview Hospital Association
Peck, Lori Memorial Health Center
Peiffer, Susan Sacred Heart Hospital
Pempek, Kalynn Aspirus Wausau Hospital
Penczykowski, James St. Mary's Hospital
Pennebecker, Allen Ministry Saint Michael's Hospital
Pirsig-Anderson, Jane Aurora Health Care
Platt-Gibson, Melanie St. Clare Hospital & Health Services
Prunty, Brian Aspirus Wausau Hospital
Quinn, George Wisconsin Hospital Association
Reinke, Mary Meriter Hospital
Reynolds, Kristen Aurora Health Care
Richbourg, Mary Sacred Heart Hospital
Rocheleau, John Bellin Hospital
Roethle, Linda Bellin Hospital
Roundy, Ann Columbus Community Hospital
Rozenfeld, Jonathan St. Mary's Hospital
Rubenzer, Deanne St. Joseph's Hospital
Rudolph, Wade Sacred Heart Hospital
Rueber, Joel Aspirus, Inc.
Samuelson, Bonnie Aspirus Wausau Hospital
Sanicola, Suzanne Columbia St. Mary's Columbia Hospital
Saunaitis, Tamara Meriter Hospital
Schaetzl, Ron St. Clare Hospital & Health Services
Schraufnagel, Patricia Memorial Medical Center - Ashland
Schwartz, Mary St. Clare Hospital & Health Services
Scinto, Jeanne Aspirus Wausau Hospital
Sczygelski, Sidney Aspirus Wausau Hospital
Sender, Jon
Sheehan, Heather Hayward Area Memorial Hospital and Nursing Home
Sio, Tim Wheaton Franciscan Healthcare - All Saints
Slomczewski, Constance Wheaton Franciscan Healthcare - All Saints
Stapelfeldt, Kimberly Aurora Medical Center in Hartford
Statz, Darrell Rural Wisconsin Health Cooperative
Steevens, Alan St. Clare Hospital & Health Services
Stelzer, Jason St. Clare Hospital & Health Services
Stewart, Jeff Children's Hospital and Health System
Strasser, Kathy Aspirus, Inc.
Sullivan, Anne Memorial Medical Center - Ashland
Tapper, Joy Milwaukee Health Care Partnership
Teigen, Seth St. Mary's Hospital
Thornton, Eric St. Mary's Janesville Hospital
Thurmer, DeAnn Waupun Memorial Hospital
Tobin, Susan Aspirus Wausau Hospital
Turner, Sally Aurora Health Care
Tuttle, Kathryn Memorial Medical Center - Ashland
Voelker, Thomas Aspirus Wausau Hospital
Walker, Troy St. Clare Hospital & Health Services
Wanless, Kathy Aspirus Wausau Hospital
Watts, Susan St. Vincent Hospital
Wojciechowski, Gary Aspirus Wausau Hospital
Woleske, Chris Bellin Psychiatric Center
Worrick, Gerald Ministry Door County Medical Center
Wymelenberg, Tracy Aurora Health Care
Wysocki, Scott St. Clare Hospital & Health Services
Zaher, Beth
Zaverl, Kimberly Froedtert Health
Zeller, Brad Hayward Area Memorial Hospital and Nursing Home
Contributors ranging from $500 to $999
Arca, Marjorie Children's Hospital and Health System
Bard, Jeffrey Aurora Health Care
Bonin, Christopher Aurora Health Care
Borgerding, Dana
Brooks, Alenia Aurora Health Care
Brophy, Michael Aurora Health Care
Bukowski, Cathy Ministry Eagle River Memorial Hospital
Bultema, Janice
Carlson, Dan Bay Area Medical Center
Chess, Eva Aurora Health Care
Chumbley, Bud Aspirus, Inc.
Clough, Sheila Ministry Eagle River Memorial Hospital
Dietsche, James Bellin Hospital
Eckels, Timothy Hospital Sisters Health System
Ewing, Thomas Aurora Health Care
Fields, Mary Aurora Health Care
Garcia-Thomas, Cristy Aurora Health Care
Guffey, Kerra Meriter Hospital
Hart, Shelly Aurora Health Care
Heifetz, Michael SSM Health Care-Wisconsin
Houlahan, Beth
Huettl, Patricia Holy Family Memorial
Hyland, Carol Agnesian HealthCare
Jacobson, Terry St. Mary's Hospital of Superior
Joyner, Ken Bay Area Medical Center
Just, Lisa Aurora Medical Center in Hartford
Kellar, Richard Aurora West Allis Medical Center
Kerwin, George Bellin Hospital
Klimisch, Ronald Aspirus Wausau Hospital
Larson, Margaret Mercy Medical Center
Lentz, Darrell Aspirus, Inc.
Lewis, Gordon Burnett Medical Center
Mantei, Mary Jo Bay Area Medical Center
May, Carol Sauk Prairie Memorial Hospital
McDonald, Brian Aurora Health Care
McKennie, Randall Aurora St. Luke's Medical Center
McNally, Maureen Froedtert Health
Miller, Jim Children's Hospital and Health System
Nelson, Dave SSM Health Care-Wisconsin
Nelson, James Fort HealthCare
Potts, Dennis Aurora Health Care
Richards, Theresa Ministry Saint Joseph's Hospital
Rickelman, Debbie WHA Information Center
Roberts, Paula Children's Hospital and Health System
Samitt, Craig Dean Health
Schafer, Michael Spooner Health System
Selberg, Heidi HSHS-Eastern Wisconsin Division
Shabino, Charles Wisconsin Hospital Association
Skowlund, Kathleen Aurora Health Care-South Region
Stuart, Philip Tomah Memorial Hospital
Swanson, Kerry St. Mary's Janesville Hospital
Talley, Barbara St. Clare Hospital & Health Services
Taplin Statz, Linda SSM Health Care-Wisconsin
Trenschel, Robert Aurora Health Care
VanCourt, Bernie Bay Area Medical Center
Wilk, Leonard Aurora Medical Center in Grafton
Zenk, Ann Ministry Saint Mary's Hospital
Zorbini, John Aurora Health Care
Contributors ranging from $1,000 to $1,499
Anderson, Sandy St. Clare Hospital & Health Services
Bablitch, Steve Aurora Health Care
Bailet, Jeffrey Aurora Health Care
Banaszynski, Gregory Aurora Health Care
Bedwell, Elizabeth Children's Hospital of Wisconsin
Britton, Gregory Beloit Health System
Buck, Catherine Froedtert Health
Byrne, Frank St. Mary's Hospital
Canter, Richard Wheaton Franciscan Healthcare
Court, Kelly Wisconsin Hospital Association
Deich, Faye Sacred Heart Hospital
Falvey, Patrick Aurora Health Care
Fischer, Edwin Fort HealthCare
Francis, Jeff Ministry Health Care
Frank, Jennifer Wisconsin Hospital Association
Garcia, Dawn St. Joseph's Hospital
Gunn, Veronica Children's Hospital and Health System
Gutzeit, Michael Children's Hospital and Health System
Herzog, Mark Holy Family Memorial
Hilt, Monica Ministry Saint Mary's Hospital
Hymans, Daniel Memorial Medical Center - Ashland
Johnson, Charles St. Mary's Hospital
Kelch, Elaine
Kosanovich, John Watertown Regional Medical Center
Lappin, Michael Aurora Health Care
Loftus, Philip Aurora Health Care
Mattes, Dan Wheaton Franciscan Healthcare
Mohorek, Ronald Ministry Health Care
Niemer, Margaret Children's Hospital and Health System
Peterson, Douglas Chippewa Valley Hospital
Radoszewski, Pat Children's Hospital and Health System
Reynolds, Sheila Children's Hospital and Health System
Ricci, Anthony Aurora Memorial Hospital of Burlington
Robertstad, John ProHealth Care - Oconomowoc Memorial Hospital
Roller, Rachel Aurora Health Care
Russell, John Columbus Community Hospital
Sanders, Robert Children's Hospital and Health System
Size, Pat
Tempelis, Eric Gundersen Lutheran Health System
Uhing, Michael Children's Hospital of Wisconsin
Westrick, Paul Columbia St. Mary's Columbia Hospital
Wolf, Edward Lakeview Medical Center
Contributors ranging from $1,500 to $1,999
Alig, Joanne Wisconsin Hospital Association
Barney, Steven SSM Health Care-Wisconsin
Bloch, Jodi Wisconsin Hospital Association
Boese, Jennifer Wisconsin Hospital Association
Clapp, Nicole Grant Regional Health Center
Coffman, Joan St. Joseph's Hospital
Eichman, Cynthia Ministry Our Lady of Victory Hospital
Geboy, Scott Hall, Render, Killian, Heath & Lyman
Gorelick, Marc Children's Hospital and Health System
Grasmick, Mary Kay Wisconsin Hospital Association
Hahn, Brad Aurora Health Care
Harding, Edward Bay Area Medical Center
Levin, Jeremy Rural Wisconsin Health Cooperative
Maciver, Carolyn Aurora Health Care
Meyer, Daniel Aurora BayCare Medical Center in Green Bay
Natzke, Ryan Marshfield Clinic
O'Brien, Mary Aurora St. Luke's Medical Center
Postler-Slattery, Diane Aspirus Wausau Hospital
Potter, Brian Wisconsin Hospital Association
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.
Duncan, Robert Children's Hospital and Health System
Erwin, Duane Aspirus, Inc.
Jacobson, Catherine Froedtert Health
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
Merline, Paul Wisconsin Hospital Association
Mettner, Michelle Children's Hospital and Health System
Neufelder, Daniel Affinity Health System
Normington, Jeremy Moundview Memorial Hospital & Clinics
Oliverio, John Wheaton Franciscan Healthcare
Pandl, Therese HSHS-Eastern Wisconsin Division
Sanders, Michael Monroe Clinic
Sexton, William Prairie du Chien Memorial Hospital
Starmann-Harrison, Mary Hospital Sisters Health System
Taylor, Mark Columbia St. Mary's, Inc.
Woodward, James Meriter Hospital
Contributors ranging from $3,000 to $4,999
Borgerding, Eric Wisconsin Hospital Association
Fish, David Hospital Sisters Health System
Turkal, Nick Aurora Health Care
Contributors $5,000 and above
Bjork, Tanya
Brenton, Stephen Wisconsin Hospital Association
Size, Tim Rural Wisconsin Health Cooperative
Tyre, Scott Capitol Navigators, Inc

Top of page (9/28/12)

Twenty-one Hospitals Attend WHA-Led TCAB Learning Session

Nearly 150 nurses and clinicians gathered in Wisconsin Dells to launch the second Transforming Care at the Bedside (TCAB) initiative. Led by the Wisconsin Hospital Association, 23 hospital units representing 21 hospitals participated in a two-day TCAB education session designed to give caregivers the tools, and the inspiration, to improve care at the bedside by engaging all employees in patient-centered process improvement. WHA’s Stephanie Sobczak, quality manager, and Judy Warmuth, vice president of workforce, facilitated with assistance from Betsy Lee, director, Indiana Patient Safety Center, Indiana Hospital Association. The keynote presentation and leadership luncheon was provided by Lynn Cote, nurse manager from Southern Maine Medical Center, which just completed a three-year TCAB collaborative with Aligning Forces for Quality.

TCAB is an innovative quality improvement model that calls for nurses to lead unit and hospital-wide team efforts to improve the quality and safety of patient care.

"The beauty of TCAB is that quality becomes practical in the hands of bedside nurses who are given the tools to conduct small tests of change, then adapt, adopt, or abandon those tests until an innovation becomes a new way of doing things," according to Judy Warmuth, WHA vice president, workforce.

The 23 TCAB units are also charged with spreading their improvement strategies to the entire hospital.

The participants in the two-day TCAB event learned how to motivate and engage frontline staff to rethink how they do their work. The teams were asked to come up with a new idea that would lead to better patient care, and then they were given an opportunity to share that improvement with the larger audience by performing a short skit. There were more teams volunteering to share than there was time left in the day. That eagerness to collaborate is a hallmark of Wisconsin’s quality efforts.

"We can be very proud of the fact that once our hospitals find a way to improve the quality and safety of the care, they are more than willing to share—and even to teach—it to others," according to Sobczak. This best practice sharing was facilitated by presentations from WHA member hospitals who participated in the initial TCAB cohort. Front line nurses from Boscobel, Beloit Memorial, Reedsburg, and Froedtert Community Memorial hospitals shared their experiences and lessons learned in several aspects of the TCAB work.

Don’t miss the photos taken during the TCAB launch, including a group photo of every hospital team there, at:

Top of page (9/28/12)

President’s Column: Ryan Explains Harsh Reality to AARP

The headlines last week focused on the boos Paul Ryan received when he addressed the AARP, the self-styled seniors’ lobby. But as so often occurs, the mainstream media conveniently ignored the real story, which was that the Republican vice presidential nominee was modestly rewarded for telling some hard truths by actually receiving some applause.

The Wisconsin Congressman deserves credit merely for showing up at an organization that portrays itself as nonpartisan but whose leadership is hardly that. Just last week, WSJ opinion writer Kimberley Strassel reported ( on a long email trail showing how AARP officials aided the White House in passing the ACA. And at the AARP convention, CEO Barry Rand used his opening remarks to defend the ACA, including the taking of $716 billion from Medicare (providers), an action that does nothing to improve the long-term finances of the program.

Ryan showed up with his message that Medicare is on a path to bankruptcy if it isn’t reformed. His statements didn’t go over well with some in the crowd who tipped their political bent by booing and heckling.

Largely unreported, however, was the applause Ryan received. That came in response to his criticism of the ACA’s Independent Payment Advisory Board, the 15 "unaccountable bureaucrats" empowered to make cuts to Medicare providers that Ryan said will "jeopardize access to care." As a reminder, the payment board is largely shielded from Congressional review precisely so it can ration care with little oversight. Even some ACA supporters admit discomfort with the scheme.

The Wisconsin Congressman was also cheered for his promise that his Medicare premium-support reform would "force insurance companies to compete against each other to better serve seniors, with more help for the poor and the sick...."

As critically noted in the Wall Street Journal a few days ago, "The press corps like to whine that politicians duck the ‘hard choices,’ but when a politician doesn’t duck, they quickly call it politically foolish. That’s what they’re now doing on Medicare, repeating the spin that seniors oppose reform even as the polls show Republicans doing better on the issue than is usually the case."

Medicare spending can’t continue on its current course, and one difference in this campaign is that Congressman Ryan is willing to say just that. As observed in this space previously, there are only two choices for transforming Medicare—moving toward a defined contribution approach—or—propping up a broken down FFS status quo with an "independent" board empowered to further whack providers.

Steve Brenton,

Top of page (9/28/12)

HHS Director Munson Discusses Health Insurance Exchange, Medicaid Expansion

On Friday, September 21, WHA staff attended a forum held by Senators Jon Erpenbach and Jon Richards in the State Capitol on the implementation of the Affordable Care Act in Wisconsin. The featured speaker was Kenneth Munson, Region V director of the U.S. Department of Health and Human Services (HHS). Munson previously held positions in Wisconsin, including deputy secretary for the Department of Health Services under Governor Doyle.

The two main topics covered at the forum were the health insurance exchanges and Medicaid expansion. On the exchanges, Munson laid out the timeline for a state to choose to operate its own exchange. Long-term, exchanges must be operational beginning October 2013 when enrollment into health plans in the exchanges is expected to begin. In the near-term, states must submit a "blueprint" to HHS by November 16 describing the steps taken thus far to develop an exchange and future steps toward implementation. If the state has not submitted the blueprint by the November 16 deadline, federal government officials will assume the state is not implementing an exchange and will take steps to implement a federally-run exchange instead. Munson said that 12 Governors have sent letters to HHS declaring their intention to operate a state exchange.

Given the number of states—including Wisconsin—that are waiting for the November elections before deciding on exchange implementation, some questioned whether the federal government is considering extending the timelines for exchange implementation. Munson said that HHS currently has no plans to relax the current deadlines, the requirement that exchanges be implemented for 2014 is in the law, and HHS could not, through rule, modify the deadlines.

Although Governor Walker halted work on the exchange in Wisconsin pending the November elections, the Administration had made some progress on implementation prior to that decision, and had spent federal grant funds of approximately $2 million on exchange planning. In response to a question, Munson said that there has been no determination that those funds would have to be returned.

Munson also discussed the Essential Health Benefits (EHB) package, which is the minimum set of benefits that must be offered in the individual and small group markets beginning in 2014. HHS is asking that states select an EHB by the end of September, although there is no official deadline for states to decide. Munson said that about 30 states have been working on determining the EHB. States can choose their EHB from one of ten existing plans in the market. If the state does not elect an EHB from one of the ten, the default selection will be largest (by enrollment) small group market plan in the state.

On Medicaid, Munson said that there is no deadline for a state to decide whether or not to expand. In Wisconsin, the "expansion population" generally refers to adults without dependent children ("childless adults"). Although states are eligible for a higher match for this population, the match rate in Wisconsin is still uncertain, and he indicated there has been no determination yet for Wisconsin. Moreover, some have indicated an interest in possibly expanding Medicaid for smaller groups of individuals with a lower income level than is provided for in the health care reform law. Munson indicated there was no answer yet from HHS on whether states can expand coverage for individuals with income up to the poverty line and still be eligible for a higher match. WHA reconvened its Medicaid Reengineering Group September 25 (see article on page 1) to discuss these issues as part of its overall deliberations on Medicaid expansion.

Top of page (9/28/12)

WHA Comments on Proposed Rules Implementing PPACA Requirements
Additional requirements for tax-exempt hospitals

The Wisconsin Hospital Association submitted comments September 24 to the Internal Revenue Service in response to proposed regulations issued by the U.S. Department of Treasury and the IRS to implement, in part, the additional obligations for tax-exempt hospitals as a result of the Patient Protection and Affordable Care Act of 2010. The obligations include that each hospital maintain a financial assistance policy and an emergency medical care policy, limit amounts charged to individuals determined to be eligible under the a facility’s financial assistance policy, and refrain from taking extraordinary collections actions until the facility has made reasonable efforts to determine an individual’s eligibility under the financial assistance policy.

In its letter, WHA emphasized that the Wisconsin hospital community fully supports the goals of the new statutory requirements. WHA, however, expressed concern about the proposed rule’s lack of flexibility and its oftentimes administratively inefficient standards that would apply regardless of the circumstances. While the Treasury’s stated objective was to balance the patient protection goals of the statute with the efficient administration and operation of hospitals, WHA wrote that the proposed rules do not achieve the balance. WHA is concerned that the proposed regulations consist of extremely detailed and prescriptive requirements that do not provide hospitals with the flexibility to use the most efficient and effective means to meet the new requirements in their communities.

WHA asked the agencies to work with the hospital community to address the identified issues as they work to finalize the rules. A copy of the WHA comment letter is available at:

Top of page (9/28/12)

Grassroots Spotlight: Sen. Moulton Visits Ministry Saint Joseph’s Hospital, Marshfield
Redistricting places hospital in Moulton’s district

On September 13, State Senator Terry Moulton (R-Chippewa Falls) visited Ministry Saint Joseph’s Hospital in Marshfield. Under new district boundaries, the medical campus moves into Senator Moulton’s district.

"Senator Moulton, having a background in health care, fully understands the challenges we face, particularly Medicaid reimbursement issues," said hospital President/CEO Brian Kief. "He also appreciates that Ministry Saint Joseph’s Hospital is serving a critical need for the patients and families we serve."

As this is the first time representing the medical campus, Moulton had an extensive visit with the hospital team, including the following agenda:

The Senator was impressed by the scope of services offered on the medical campus.

During his visit, Sen. Moulton was also able to learn more about the hospital and its commitment to the community. The group also discussed important legislative issues facing hospitals, such as Medicaid and concerns with the LogistiCare program.

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Reminder: WHA to Lead, Participate in November 29 AHA DC Fly-In

The Wisconsin Hospital Association will staff and lead a group of Wisconsin hospital representatives November 29 for the upcoming American Hospital Association (AHA) Washington, DC Capitol Hill fly-in.

"We have an excellent group assembled already who will travel to DC to make the case known that reimbursement cuts are of significant concern to Wisconsin’s high value, integrated hospitals and health care systems," said WHA Executive Vice President Eric Borgerding. "I would encourage other leaders to consider the trip as a continuation of our ongoing efforts to protect hospital care."

Details on the AHA trips can be found at:

If you are interested in participating in the November 29 Washington, DC fly-in, please contact WHA’s Jenny Boese at or 608-268-1816.

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Cong. Tom Petri at WHA Hospital Listening Session

Several dozen hospital leaders and WHA HEAT advocates representing hospitals in the 6th Congressional District attended a WHA Hospital Listening Session with U.S. Rep. Tom Petri (R-WI 6th) hosted by Holy Family Memorial Hospital in Manitowoc. The Hospital Listening Session was an opportunity for hospital advocates to hear personally from Cong. Petri about health care issues pending in Congress and to ask important questions.

During the listening session attendees discussed issues including Wisconsin’s high value health care and efforts at reforming health care’s payment model, to which Cong. Petri said, "We in Wisconsin are on the cutting edge of health care in a lot of areas. We are trying to manage the transformation of health care." He went on to describe the great efforts by Wisconsin hospitals, saying, "This institution and a lot of others are on the forefront of working to manage cost and quality."

In looking to the future, participants raised the issue of the physician shortages and referenced the WHA report on the subject along with the hospital field’s ongoing work in the area. The group discussed the flawed Medicare physician reimbursement formula (SGR), impending cuts under the sequester process and the burden of the Recovery Auditor Contractor program. With respect to the latter, one attendee indicated their hospital had recently copied 20,000 pages of records to comply with the RAC auditor request. Cong. Petri expressed his willingness to help.

The WHA Hospital Listening Sessions along with the WHA Telephone Town Halls have been a mainstay over the past year as a means for WHA to educate and motivate hospitals on important issues. 2012 events held to date include:

Additional events are in progress so watch The Valued Voice for details in the coming weeks and months. Contact WHA’s Jenny Boese with questions at or 608-268-1816.

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Buser Receives WHA 2012 Distinguished Service Award

Ken Buser, president of Wheaton Franciscan Healthcare’s south market, received the Wisconsin Hospital Association’s 2012 Distinguished Service Award for his service to the hospital, community and to the Association. WHA President Steve Brenton presented the award to Buser at a ceremony during the WHA Summit held September 21 in Madison.

Buser has been a valuable resource to and active in the Wisconsin Hospital Association. He served on the Board from 2001-2009 and was Chair of the Board in 2008 in addition to his participation on or leadership of numerous committees since 2004.

"Ken’s passion for serving others has been an inspiration to everyone who has had the pleasure to know him and to work with him," according to Brenton. "His leadership, vision and guidance have helped not only his own health care system to prepare for the future, but he has also shared his considerable talents unselfishly with the entire health care industry. I am personally honored to know Ken both as a friend and as a health care leader."

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Soldiers Bring Value, Community Commitment to Health Care Workforce
WHA signs Employer Support of Guards and Reserves Statement at 2012 Summit

Speaking at the WHA 2012 Summit, Colonel Leah Moore told the nearly 200 attendees that less than one percent of the U.S. population joins the military forces, but their education, commitment to community, and leadership set them apart. Moore spoke passionately about the benefits to hospitals that hiring guards, reservists and former soldiers has on the workforce.

"Soldiers are hard working, good humored, goal oriented, and community driven," Moore said. "Many have joined to serve a purpose greater than just themselves." Col. Moore summarized a few of the professional licenses that are extremely valuable in the health care workforce, which include:

Advanced Individual Training (AIT) – For those in the medical arena, this phase of training can last anywhere from 6 to 52 weeks. Several of these programs, upon successful completion earn a Soldier a nationally-recognized certificate and/or licensure in the following areas.

In his introduction of Col. Moore and Tim Flatley, executive director the Employer-Sponsored Guard and Reserve Program (ESGR), WHA President Steve Brenton noted that a majority of WHA’s members have signed the ESGR support statement.

On a related subject, the ESGR will host an employer seminar November 8 at North Central Technical College in Wausau. For more information, go to

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Hafeman Named WONE Nurse Leader of the Year

Paula Hafeman, RN, MSN, FACHE received the Wisconsin Organization of Nurse Executives (WONE) 2012 Nurse Leader of the Year Award at WHA’s Leadership Summit September 21. Hafeman is chief nursing officer of St. Vincent Hospital and St. Mary’s Medical Center in Green Bay.

Hafeman has been a member of WONE for 12 years, serving on the Board of Directors for the past eight. She was the WONE president in 2010-2011. She currently chairs the Nurse Leadership Academy and developed the WONE Nurse Leader Succession Planning Toolkit.

Hafeman is a highly-respected chief nursing officer who has made nursing leadership, mentoring and succession planning a focus throughout her career. She is currently a mentor to several aspiring nursing leaders, assisted with her organization’s own nursing leadership development program, and has always had a succession plan in place for someone to follow in her footsteps. Under her guidance, three hospitals with differing cultures were brought together to form one successful Professional Nursing Practice Council, with the mission of standardizing nursing practice across the hospitals.

In support of her nomination, Therese Pandl, president, HSHS Eastern Wisconsin Division, said, "Paula is an exceptional nursing leader dedicated to advancing safe, quality, patient-centered care through the professional practice of nursing. She is a strong and passionate leader of nurses and health care."

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Marcouiller, Barth Receive WHA 2012 Trustee Awards

Two Wisconsin hospital trustees were honored recently by the Wisconsin Hospital Association. Memorial Medical Center (Ashland) Board member Donald Marcouiller and Memorial Medical Center (Neillsville) Board member Bob Barth are the recipients of the Wisconsin Hospital Association 2012 Trustee awards. The annual award goes to health care trustees that have made an exemplary commitment to the community.

Don Marcouiller first joined the board of Memorial Medical Center, Ashland, in 1981. In 1992, he assumed his first leadership position within the Board as treasurer and later on served as Board chair. This current term will be his last.

Marcouiller helped initiate the planning for Memorial Medical Center, Ashland, to transition to a critical access hospital. Finally, as the former campus administrator for Wisconsin Indianhead Technical College, he worked tirelessly to see that programs were available locally to ensure properly-trained health care professionals in northwest Wisconsin.

Bob Barth was asked to join the Memorial Medical Center, Neillsville Board in 1981, by then-president Walter ("Buster") Brown, and became Board president in the early 90s. He then left the board when his term finished. He was later asked by then CEO Glen Grady to fill a vacant position on the Board. After serving several years, Barth then reassumed the role of Board president, tallying his total tenure of service to the board at 30 years.

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Neufelder, Teigen Receive ACHE Regent Awards

Daniel Neufelder, FACHE, received the 2012 ACHE Regent’s Senior-Level Healthcare Executive Award, and Seth Teigen, MHA, RT(R), received the 2012 ACHE Regent’s Early Career Healthcare Executive Award. The awards were presented at WHA’s Leadership Summit September 21 in Madison.

Neufelder is the current senior vice president of hospital operations for Ministry Health Care and president of Affinity Health System. In this capacity, he leads the 15 Ministry hospitals and is responsible for Affinity Health System, a regional integrated delivery system of three hospitals, the 300-provider Affinity Medical Group, and the 133,000-member Network Health Plan. He joined Ministry and Affinity in 2006 as president/CEO of Affinity. He assumed his current leadership position earlier this year.

Prior to joining Affinity, Neufelder served for 12 years as the executive vice president and COO of Memorial Hospital of South Bend, Indiana. He has been active in professional organizations and has served in leadership capacities with ACHE and the Healthcare Financial Management Association (HFMA). He currently serves as the chair-elect of the Wisconsin Hospital Association Board of Directors and is part of the United Way Fox Cities Board of Directors. Neufelder is the recipient of the 1997 Young Healthcare Executive of the Year Award for Northern Indiana, is an ACHE Fellow and a Certified Public Accountant. He received his Bachelor’s degree from the University of Southern Indiana and his Master’s degree in business administration from the University of Indianapolis.

Seth Teigen has 11 years of health care experience and is currently the administrative director of medical imaging for St. Mary’s Hospital and Dean Health System in Madison, Wisconsin. He has held previous director positions overseeing a variety of ambulatory areas, including orthopedics, neurosciences, pain programming, GI services, physical medicine and rehab, and medical imaging. He was also a radiologic technologist for two Wisconsin hospitals.

Teigen serves on the Board of Directors for the Wisconsin Chapter of ACHE and is current chair of the communications committee. In addition, he is involved with the Madison Area Technical College Radiology Advisory Board, WHA’s HEAT program, ACHE Wisconsin Chapter’s Young Professional Network, United Way of Dane County, and the St. Mary’s Hospital Foundation.

Teigen holds a degree in radiologic technology from the University of Wisconsin Hospital, a bachelor of science degree in health arts, and a master of science degree in health care administration from the University of St. Francis in Joliet, Illinois. He will become a Fellow of ACHE in November 2012.

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Several Wisconsin Hospitals Featured in Rural GME News Article

The WHA physician workforce report identified the creation of more opportunity for in-state graduate medical education as a top priority in ensuring that Wisconsin has enough physicians. An article published by the Wisconsin State Journal on September 22, written by health care journalist David Wahlberg, focused on several hospitals that have received funding from the Wisconsin Rural Physicians Residency Assistance Program, based at the UW Department of Family Medicine. WHA supported the creation of the Wisconsin Rural Physician Residency Assistance Program, which provides grants for the expansion or creation of new rural resident rotations and training tracks.

The story is reprinted by permission.

Training programs aim to ease shortage of rural doctors

Six medical facilities in rural Wisconsin are looking at starting or expanding training programs for medical school graduates, which could ease a rural doctor shortage expected to grow in coming years.

"Physicians who spend a significant portion of their training time in rural areas are much more likely to practice rural," said Wilda Nilsestuen, coordinator of the Wisconsin Rural Physicians Residency Assistance Program, based at the UW Department of Family Medicine.

The program recently awarded its first grants to doctor training projects in Baraboo, Berlin, Chilton, Dodgeville, Lancaster and Monroe.

The effort is funded by a tax imposed on—and supported by—rural hospitals two years ago. The tax brings in federal money to help the hospitals and place more health care providers in rural areas.

About $750,000 is available each year to set up or pay for rural residencies, the years of specialized training generally required after medical school.

With the state facing an estimated shortage of 2,200 doctors by 2030, most in primary care and many in rural settings, authorities say more rural training is needed.

"We need to continue to develop the pipeline," said Nicole Clapp, chief executive officer of Grant Regional Medical Center in Lancaster.

Grant Regional is using a $35,000 grant to study becoming a rotation site for a residency. New doctors would get several weeks of exposure to primary care, emergency care, obstetrics, surgery and other services in Lancaster, Clapp said.

Similar grants were awarded to Calumet Medical Center in Chilton, Community Health Network in Berlin and Upland Hills Health Center in Dodgeville.

UW’s Baraboo Rural Training Track, the only rural-based family medicine residency program in Wisconsin, got $35,000 to redesign its women’s health curriculum. It is based at St. Clare Hospital in Baraboo.

Monroe Clinic received $150,000 to develop a fellowship in emergency medicine, and the Rural Wisconsin Health Cooperative got $150,000 to organize many of the activities.

Future grants could support further efforts at those facilities or new projects at other places, Nilsestuen said. "We’re hoping some of these sites are going to develop into rural training tracks," she said.

Meanwhile, the Medical College of Wisconsin in Milwaukee said in June it plans to set up campuses in Green Bay and central Wisconsin, with the first students to be admitted in 2015.

A plan to open the Wisconsin College of Osteopathic Medicine was hindered in February when the main backer, Wausau-based Aspirus health system, said it wasn’t viable.

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Upcoding vs. Correct Coding: An Unintended Consequence of EHR

Several recent articles in the media have raised the question of whether an unintended consequence of electronic health record (EHR) implementations is an increase in both facility and professional charges across the United States. On Monday, September 24, the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) sent a letter to five major hospital groups warning them not to use electronic health records to "game the system" and boost their revenues. The letter from HHS/DOJ came a few days after an article in the New York Times analyzing Medicare data that essentially inferred hospitals and physicians were using electronic health records to increase federal reimbursement by overstating the severity of the patients and the services they were providing.

The Association of Academic Health Centers sent a letter the following day to HHS and DOJ supporting concerns from the American Hospital Association (AHA) that the industry doesn’t have adequate guidelines on billing for the evaluation and management (E&M) codes—a set of codes developed and licensed for physician billing by the American Medical Association—the Current Procedural Terminology (CPT) codes. The codes were originally developed for use by physicians in 1992. Since 2000, CMS has required hospitals to file claims using these codes. The lack of hospital-specific codes, or guidelines for how hospitals should use physician codes, has left the system open to broad interpretation by hospitals.

During the 12 years that CMS has allowed hospitals to set their own billing policies for E&M codes, several organizations have proposed national guidelines. In 2002, the AHA and the American Health Information Management Association formed an expert panel to develop guidelines for hospital emergency room billing at the request of CMS. In 2003, the groups submitted detailed recommendations for a billing system for hospital ER services. The agency stated the AHA proposal was the "most appropriate and well-developed guidelines" available, yet the guidelines have not been implemented. Instead, CMS requires hospitals to develop their own guidelines using codes that were designed to bill physician services.

The AHA continues to push for guidelines. "We keep asking them to issue national guidelines," said Nelly Leon-Chisen, the association’s director of coding and classification. "We do it every year, and they don’t do anything about it."

The problem is magnified by the federal government’s campaign to convert the medical industry to electronic health records. In the rush to get the program off the ground, federal officials did not implement controls on billing software vendors to address the issue of medical fraud in simple terms referred to as "upcoding." The subjective nature of the coding process has left the medical industry and payers in continual conflict. Many physicians and billing experts claim that most practitioners charge too little when using paper.

Robert Tennant, a Washington lobbyist with the Medical Group Management Association, which represents large medical practices, said the software simply helps doctors pick the correct code. "With a paper-based system there’s a little bit of concern from providers that they don’t have sufficient documentation to support a particular coding level," he said. Electronic systems, however, can quickly retrieve a patient’s documented history. "I don’t use the term ‘upcode.’ I use ‘correct code.’ I see it more as physicians being reimbursed more appropriately for the work that they are doing," he said.

The HHS Agency for Healthcare Research and Quality, an advocate for electronic health records, supported that view when it wrote in September 2009 that [in a paper environment] physicians may choose billing codes that are too low. The agency suggested that converting to digital systems would enable physicians to bill higher fees, "translating into enhanced revenue."

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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.

Kate’s story

Struggling with severe diabetes and foot problems, Kate was able to maintain only a low-paying part-time job. One day, her leg pain became so unbearable that she went to the Huiras Family Community Health Center at Columbia St. Mary’s Ozaukee. Quick to realize what care Kate needed, the staff made an appointment with the financial counselor to apply for Community Care so she could receive specialty care and support for procedures. Given Kate’s part-time job status and recent inability to work, she met the financial standard.

A specialist diagnosed Kate with a Baker’s cyst. Most people do not develop severe complications from Baker’s cysts; when the cysts rupture, however, the leg becomes swollen and extremely painful. Unfortunately, Kate’s cyst had burst and she was barely able to walk.

Kate tried to continue working but had to reduce her hours drastically, as the discomfort from the cyst was unbearable. With Community Care funding, she was able to receive physical therapy to relieve the pain. After several sessions, the pain was better controlled, yet she was still unable to work. The funding supported Kate’s consultation with an orthopedic surgeon, who assessed her for surgical intervention.

Kate will continue to benefit from Community Care, as she is scheduled for surgery to repair the damaged area. With her continued commitment to healing, the skills of the surgeon and the financial support of Community Care, she expects to be able to return to work and independence.

Columbia St. Mary’s Hospital Ozaukee, Mequon

Step by step with a Helping Hand

A patient was transported to the emergency department and was admitted into Aurora Medical Center in Summit due to severe abdominal pain. The patient required emergency surgery to repair a hole in his bowel. The surgery was a success, but the patient was uninsured and had no way to pay for the operation. When Clarice Zess, Financial Counselor at Aurora Medical Center in Summit, learned of the patient’s situation, she immediately came to his aide.

"I met with him during his inpatient stay," said Clarice. She assessed his financial situation and began the application process for the BadgerCare Plus Core Plan." BadgerCare Plus Core Plan is insurance coverage under the Badger Care Medicaid program.

"Knowing that the current hospital stay would not be covered, we also completed the Aurora Helping Hand financial assistance application." Aurora’s Helping Hand program offers some level of discount for persons who are uninsured. The amount of discount received depends upon the patient’s adjusted income as compared with the U.S. Department of Health and Human Services Poverty Guidelines.

Clarice met with the patient numerous times to assist him step by step, which resulted in coverage under the BadgerCare Plus Core Plan. When the Aurora Helping Hand application was processed, the patient was given a 100 percent discount on his surgery and inpatient hospital stay. He also received complete support for three follow-up visits.

Clarice said, "He cried when I told him his care here had been covered. He was so relieved and could hardly believe it. This is just one example of several patients that I’ve helped. I am so proud to be able to offer such caring and supportive help through Aurora’s Helping Hand financial assistance program."

Aurora Medical Center in Summit

Back on pace

Sandy David stopped into the Froedtert & Medical College of Wisconsin Plank Road Clinic in 2002 for what she thought might be a case of pneumonia. A quick assessment and redirection to the emergency department revealed a much more serious diagnosis—congestive heart failure. Sandy had surgery within 24 hours, including the insertion of a pace maker, and for the next several years, she received routine care with excellent outcomes from her Medical College physicians. "I’ve chosen to get my care at Froedtert and the Medical College for a long time," says Sandy. "I wouldn’t go anywhere else!"

When the economy faltered though, Sandy lost her job as well as her health care coverage. And although she was able to find other full-time employment, it did not provide health benefits. Like so many others in the down economy, Sandy could not afford to purchase insurance on her own and hoped she could stay healthy until a job with health benefits came her way. She let routine medical check-ups lapse and only made essential visits to her cardiology team.

By October of 2010, Sandy wasn’t feeling up to par. She had little energy and suspected something was wrong. Her pacemaker reading that month verified that her aging pacemaker battery was not functioning properly, and had a very short time left. Sandy knew she would need another life-saving surgery, but initially declined due to the lack of medical insurance. With limited time left on her pacemaker and no insurance, her care providers feared time might tick away before she could afford the surgery for a new pacemaker.

Sandy’s care team immediately went to work on her behalf. They contacted the device manufacturer to see if a free or discounted pacemaker might be available, and they connected Sandy with a financial counselor at Froedtert Hospital to navigate the anticipated costs for another surgery. Froedtert’s patient financial services team determined that she qualified for a 69% discount for her care.

"I was relieved to learn that I was eligible for charity care," says Sandy. "There are not enough words to express my gratitude and appreciation!"

Sandy had her surgery in November 2010, and she is back on pace now, returning to work shortly after her surgery and able to cover the balance of her surgery costs. "I wouldn’t be here today if it weren’t for the overall care I received from Froedtert and the Medical College of Wisconsin. Everyone involved in my care made me feel important and that I was worth it."

Froedtert Hospital, Milwaukee

Caring Hearts program helps man diagnosed with cancer

"I’m sorry Joe, but we’ve got a problem."

Those words shattered Joe Nagan’s world on December 18, 2009. Over the telephone Nagan heard the diagnosis: cancer.

"At that moment, it’s worse than you can possibly imagine," said Nagan, 57, of Kaukauna.

He spent hours walking afterward, thinking about his family and business situations. On top of all that, he did not have health insurance. In fact, he was in the process of looking into health insurance, which led him to get a physical.

Nagan’s fears melted once he met Dr. Jeffrey Klingbeil of Fox Valley Surgical.

"The minute I met that guy, the minute he walked in the door, shook my hand, I felt a million times better," he said.

Nagan was also impressed to learn Klingbeil had already enlisted Dr. Nathan Munson and Dr. William Guenther.

"It was just amazing they were able to put all that information together in such a short period of time," he said.

Nagan worried about the expenses that would follow.

Enter ThedaCare’s Caring Hearts Financial Assistance Program, which covered $67,000 worth of medical bills.

Words cannot describe the surprise and relief he felt.

"It does show that the folks in the Fox Valley are concerned about folks who could use a little bit of help," he said. "We often talk about the Fox Valley and what a great place it is to live. People say that is lip service."

But he found that being on the receiving end of such care "levels the playing field."

"I don’t know how I could ever, ever thank the Caring Hearts organization for what they have done for me so that I can continue to do what I do," said Nagan.

ThedaCare, Appleton

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

Read more about hospitals connecting with their communities at

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