The ACHE Board of Governors is calling for applications to serve as Regent-at-Large in District 3, beginning in March 2022. Regents-at-Large serve as advisors to the Regents of their assigned district in fostering greater diversity in chapter and ACHE leadership. They also collaborate with ACHE elected leaders and staff to develop and implement programs to facilitate greater diversity.
All ACHE Fellows in District 3 are eligible. The goal of the Board of Governors in appointing Regents-at-Large is to diversify the Council of Regents. The purpose of the Regent-at-Large is to promote diversity in the governance of ACHE with respect to race, ethnicity, gender, religion, age, sexual orientation or disability.
For further details, please visit the Call for Nominations page. The deadline for applications is Monday, Sept. 20.
Author: editorwisconsin
LDP Site Visit with Executives from Froedtert & Medical College of Wisconsin
Our Leadership Development Program (LDP) spent an impactful day of learning with influential healthcare executives at Froedtert Health and the Medical College of Wisconsin in a virtual site visit with virtual tours last week, and gained valuable insights from inspiring leaders including: Froedtert President and CEO Cathy Jacobson, Mark Behl, Matthew Rehmann, Erika Smith, Andrew Dresang and Amanda Wisth from Froedtert Health; and MCW President and CEO Dr. John Raymond, Dr. Jose Franco, Lisa Henk, Christina Ellis, Nate Filzen and Richard Katschke from the Medical College of Wisconsin.
Members of LDP cohort XII participating include co-hosts Jenny Nikolai and Alyssa Graffy, plus Sandra Elsen, Maria Mejia Franco, Kyle Landry, Brayden Longnecker, Jason Mattern, Mary Rueth, Melissa Schlimgen and Zach Ziesemer, and LDP co-chair Kathleen Olewinski plus LDP alum Betsy Folbrecht and FHE student mentee Jai Lor.
Fall Education Plans
After careful consideration, the ACHE-WI leadership and Annual Conference Committee have decided to change to virtual. As the surge of COVID-19 expands throughout the country and healthcare organizations continue working through the ongoing pandemic, ACHE-WI feels that an in-person gathering would not be responsible at this time.
While the opportunity to gather as a healthcare community will be missed, the ACHE-WI Chapter plans to offer an inspiring and informative keynote presentation, F2F educational sessions, presentations from our Premier Sponsors, Annual Meeting & Awards Ceremony, and the opportunity to network this fall.
The content for the Annual Conference will be offered through the fall. The kickoff education sessions will be held on September 20, along with a free chapter social. Please watch your email and LinkedIn for notifications about future events. View all upcoming events.
FACHE Spotlight: Laura Bubla, FACHE
Where were you at in your career when you joined ACHE?
I was in the middle of my healthcare career and advanced into a more senior level leader position. I was influenced by my one up to become a member of ACHE in 2016, when career planning for what was to be my next 5 to 10 year plan.
Where are you now in your career?
Serving my organization and community in a market leader role. Connecting and collaborating to ensure that healthcare services are available and sustainable. Growing and ensuring that not only do we have the workforce needed to care for our patients, but mentoring our next leaders.
How has ACHE been valuable to your career progression?
The network and connections made during my time with ACHE are irreplaceable! The content experts and amount of knowledge within the members is priceless. There have been many educational components and ability to learn from each other that I have applied to my day to day challenges.
Who has been the most influential person in your career?
This is a tough one… there have been a few individuals that have influenced my career path in different ways. I have had one up leaders that ensured that I exceeded the expectations and inspired me to grow in my career, but I would say my upbringing guided my career. My parents instilled a foundation of integrity, hard work, dedication, compassion, and excellence in who I am (or strive to be).
What advice would you give someone aspiring to be in a role similar to yours?
The old saying of “when one door closes another opens”, it’s true! Opportunities are in the least expected places, you just have to say “yes”. Take on projects that are out of your comfort zone, ask for help, learn and grow in all that you do.
Tell me about your dream vacation.
My dream vacation, memory making with my husband and kids. A beautiful white sandy beach, good book, umbrella drink, the sound of waves crashing, my kids laughing and getting along, no laundry or meal planning, limited internet service, and no email or meeting alerts! There are so many beautiful islands/beaches that I would love to see nationally and internationally. A girl can dream!
A Lack of Density Does Not Equal a Lack of Need: How Rural Health Has Largely Gone Overlooked
Shared by: EUA
In the Fall of 2018, one of my best friends proposed we embark on the ultimate weekend. One of his corporate partners invited him to a private event at Lambeau Field that included drinks, dinner and a tour with Packer Legend LeRoy Butler; following we made the roughly 70-mile trip to my family’s Northwoods cabin to fish before returning to Green Bay for the game on Sunday. The event at Lambeau was incredible, but it was the next morning that I remember the most. After breakfast, my friend calmly asked me where the nearest hospital was. He was experiencing chest pain and the closest hospital was nearly 45 minutes away. Knowing that calling an ambulance to our remote area would take considerable time, I chose to drive him to a rural hospital I knew was operated by a larger system with a renowned cardiology center. Thankfully, we arrived at the rural hospital and he began receiving treatment in time and transferred to the larger center to have a stent inserted into his 95% blocked artery. The following day, we watched the game from my living room instead of Lambeau Field.
I’ve had the privilege of delivering architecture and planning services to the Healthcare industry for the past 25 years in a variety of communities. In my personal life as well as my career, I have witnessed the impact different payment models can have on communities and developed a passion for understanding how the built environment can connect the delivery of care to diverse populations, while being financially sustainable, efficient and effective. Accessibility, adequacy and affordability of healthcare continue to be three primary concerns for Americans.[1] Having worked for facilities in rural and urban areas, I’ve noticed the disparity of the various payment models regulated by Health and Human Services (HHS) as well as the impact the Affordable Care Act has had on both demographics. Though the 2010 legislation has come with challenges for all healthcare providers, I’ve observed that rural communities have an even greater uphill battle that is often not considered. Factors such as longer travel distances, difficulties in attracting medical talent at all levels and various socio-economic realities present real barriers for rural health facilities to strike the balance between delivering appropriate services to their unique populations, while also being financially sustainable.
To meet the needs of this rural population, this provider is undergoing a phased approach of first
expanding a clinic with an ED, and then expanding to include inpatient to make a full-scale rural hospital.
An Alarming Trend in Rural Health
According to the National Health Council, rural areas cover over 90 percent of the nation’s land area but contain somewhere around 20% percent of the total population (about 60 million).[2] This underserved and remote population has gone unnoticed for far too long. The challenges for rural health have been pretty much the same for many years with realities like higher poverty rates, large numbers of uninsured people and older adults with chronic health problems, in addition to heightened exposure to environmental hazards. Despite enhanced payment models for some rural hospitals over the last 20 years, in a February 24, 2020 article [3] cited that 120 facilities have closed in the 10 years prior, accounting for 7% of the 1,844 rural hospitals at that time.[4] Forbes also claimed that 1 in 4 rural hospitals were at risk of closure—an especially shocking number considering this was prior to the pandemic. Fortunately, this alarming trend has started to drive increased attention from policy makers and advocates in recent years. The article also cited that 120 facilities have closed in the 10 years prior, accounting for 7% of the 1,844 rural hospitals at that time. Forbes claimed that 1 in 4 rural hospitals were at risk of closure—an especially shocking number considering this was prior to the pandemic. Fortunately, this alarming trend has started to drive increased attention from policy makers and advocates in recent years—but not enough yet.
To demonstrate the disparity in attention between communities, we can look to the COVID-19 pandemic as a recent example. Since the beginning of COVID, health reform conversations and data on the effects of this health emergency have been primary focused on urban areas. However, a recent study on rural health in the Western states confirms the importance of increased focus on rural healthcare facilities.[5] The research indicates that the effects of the COVID-19 pandemic on rural populations have been severe, with significant negative impacts on unemployment, overall life satisfaction, mental health, and economic outlook, and that rural recovery policies risk being informed by anecdotal or urban-centric information.
Legislative Measures for Rural Health
Although far from receiving the attention and resources needed, there has been some traction in congress for improving rural health. The Rural Emergency Acute Care Act (REACH) has been around in various forms since 2015 in an attempt to provide relief, but it did not address two important areas: reimbursement around telehealth and the promotion of partnerships between rural hospitals and their closest larger health systems. So, it ended up serving as more of a springboard than a solution.
On December 21, 2020, legislation on year-end COVID-19 relief [6] was approved by Congress, establishing Rural Emergency Hospitals (REHs) as a new Medicare provider type effective January 1, 2023. REHs—defined as providers that furnish certain outpatient hospital services in rural areas, including emergency department services—will be reimbursed at a rate 5% higher than the otherwise-applicable payment under the Medicare Outpatient Prospective Payment System (OPPS). This enhanced reimbursement will undoubtedly provide major financial relief for many struggling hospitals.
Facilities wanting to enroll as REHs will need to meet certain requirements and conditions placed by the Centers for Medicare & Medicaid Services (CMS). According to the act, REHs are required to:
- Not provide acute care inpatient services (beds);
- Not exceed an annual per patient length of stay of 24 hours;
- Have a transfer agreement in place with a Level I or II trauma center;
- Maintain a staffed emergency department, including staffing 24/7 by a physician, nurse practitioner, clinical nurse specialist or physician assistant;
- Meet CAH-equivalent Conditions of Participation (COPs) for emergency services;
- Meet applicable state licensing requirements.
At the time of this writing, the US Senate has just passed the American Rescue Plan [7]. The Senate version provides $8.5 billion for rural hospitals and facilities for healthcare-related expenses and lost revenues attributable to the COVID-19 pandemic. This is another positive sign the federal government is taking action to help our rural population and healthcare providers.
To minimize operating costs, this new construction rural hospital incorporated a geothermal system
to achieve payback in less than five years.
What Will the Future Hold for Rural Health
There are still a lot of open questions and the next two years will surely be filled with lively discussion and debate as CMS digs deeper into detailing future rulemaking and guidance while rural communities grapple with potential changes to their local healthcare system. Questions will be raised, such as: how will local jobs be affected? Will people adapt to only receiving primary and emergency care close to home with travel required for surgery and other complex procedures? With more flexible work models and the cost of living in urban areas rising, will younger populations move to rural areas post-pandemic, thereby increasing the need for resources? Will hospitals that recently closed be able to reopen as REHs? Rural communities and healthcare providers will need to have a broader dialog surrounding these issues soon.
The idea of bed-less hospitals may seem unconventional but has been around for years. One of my hospital clients in Maryland underwent a pilot program to relocate and convert an outdated hospital into a bed-less Freestanding Medical Facility (FMF), given its proximity to another licensed bed facility. There was considerable concern in the community that they were losing their hospital and access to comprehensive care, while absorbing the additional costs associated with an ambulance ride should they need to be transferred after stabilization. Some speculated that people might make the longer drive to a hospital with beds at the risk of not arriving in time to be kept alive. The facts in this case were just the opposite. The project data proved that residents would get better care and at a better price point than if they had kept their original facility—and that was without an enhanced reimbursement. Rural America is finally getting some of the financial relief and attention it has needed for so long, but it still has a long way to go. Rural Emergency Hospitals, like the one that saved my friend’s life, are a viable option for many communities. Hopefully after January 1, 2023, even more lives will be saved as more facilities are able to meet their populations’ healthcare needs and remain fiscally healthy themselves.
Originally Published in CREJ Health Care & Senior Housing Quarterly
Citations
[1] National Health Council, Accessibility, Adequacy & Affordability of Health Care for Patients During & After the COVID-19 Emergency. Nationalhealthcouncil.org, April 16, 2020. https://nationalhealthcouncil.org/accessibility-adequacy-affordability-of-health-care-for-patients-during-after-the-covid-19-emergency/
[2] National Health Council, Accessibility, Adequacy & Affordability of Health Care for Patients During & After the COVID-19 Emergency. Nationalhealthcouncil.org, April 16, 2020. https://nationalhealthcouncil.org/accessibility-adequacy-affordability-of-health-care-for-patients-during-after-the-covid-19-emergency/
[3] Clary Estes. “1 in 4 Rural Hospitals Are at Risk of Closure and the Problem Is Getting Worse.” Forbes. Forbes.com, February 4, 2020. https://www.forbes.com/sites/claryestes/2020/02/24/1-4-rural-hospitals-are-at-risk-of-closure-and-the-problem-is-getting-worse/?sh=74c6c5601bc0
[4] Clary Estes. “1 in 4 Rural Hospitals Are at Risk of Closure and the Problem Is Getting Worse.” Forbes. Forbes.com, February 4, 2020. https://www.forbes.com/sites/claryestes/2020/02/24/1-4-rural-hospitals-are-at-risk-of-closure-and-the-problem-is-getting-worse/?sh=74c6c5601bc0
[5] Proceedings of the National Academy of Sciences of the United States of America (PNAS). “Impacts of the COVID-19 on Rural America.” Edited by Douglas S. Massey, Princeton University, Princeton, NJ, and approved November 25, 2020. https://www.pnas.org/content/118/1/2019378118
[6] Emily J. Cook, Sandra M. DiVarco, Caroline Reigart. “Congress Establishes New Medicare Provider Category for Reimbursement for Rural Emergency Hospitals.” The National Law Review. March 22, 2021, Volume XI, Number 81. January 5, 2021. https://www.natlawreview.com/article/congress-establishes-new-medicare-provider-category-and-reimbursement-rural
[7] McGuireWoods, LLP. “U.S. Senate Passes American Rescue Plan – 10 Key Updates for Healthcare Providers.” March 9, 2021. https://www.jdsupra.com/legalnews/u-s-senate-passes-american-rescue-plan-4036718/
Ed Anderson, MBA, EDAC
Colorado Real Estate Journal Health Care & Senior Living Quarterly
ACHE Leadership Development Program Highlights Site Visit with Navvis Healthcare and SSM Health
Members of ACHE-WI Leadership Development Program (LDP) cohort XII were joined by leaders from Navvis Healthcare and SSM Health for a site visit co-hosted by Melissa Schlimgen and Brayden Longnecker with their respective organizations on July 22, 2021.
The hybrid visit began with a Navvis overview and review of Navvis markets, impacts and outcomes. This was followed by an interactive Navvis showcase with Nicole Amling, SVP, Head of Human Resources; Dr. Aman Chawla, SVP and Medical Director of Practice Optimization; Chuck Eberl, Chief Strategy Officer; Dr. Miles Snowden, Chief Growth Officer and EVP of Physician Strategy; and Courtney Fortner, Chief Operations Officer. Leaders joined the group for a panel discussion, and then a practice optimization deep dive followed by Q&A.
The afternoon site visit kicked off with an SSM Health Wisconsin overview by Joyce Zweifel, MBA, FACHE. The group then met with an administrator panel from SSM Health Dean Medical Group, for an engaging discussion with Ben Jarvis, MHSA, Administrator, Surgical Operations; Diona Sheehan, MAPC, Administrator, Clinical Services; Steve Wilkes, MS, PT, Administrator, Clinical Operations; and Tanya Kroll, MBA, Administrator, Women’s Health and Digestive Health. The afternoon continued with an overview of Pharmacy and PBM Operations, with Brent Eberle, MBA, RPh, Senior Vice President & Chief Pharmacy Officer, Navitus; and Mo Kharbat, MBA, BPharm, RPh, BCPS, Regional Vice President, Pharmacy Services, SSM WI. The day was capped off with a tour of St. Mary’s Hospital, led by Craig Sommers, MHA, Vice President of Operations.
Members of LDP cohort XII include co-hosts Melissa Schlimgen and Brayden Longnecker, plus Alyssa Graffy, Jenny Nikolai, Maria Mejia Franco, Sandra Elsen, Zach Ziesemer, Mary Rueth, Jason Mattern and Kyle Landry.
New Coffee with the College Podcast: Public Policy Issues Facing Health Care
On this episode of Coffee with the College, our host Janet Schulz discusses some public policy issues facing health care with Marshfield Clinic Health System’s Ryan Natzke, Chief External Affairs Officer and Brad Wolters, Director of Federal Government Relations. Ryan and Brad give insight into how industry knowledge, building coalitions and a good story go a long way in creating legislative change. Later, they dive into the current state of policy efforts to increase patient access to care throughout Wisconsin. We hope you enjoy!
Listen now!
ACHE Leadership Development Program – Mayo Clinic Health System Site Visit Spotlight
On June 24, 2021, our latest cohort of the ACHE Leadership development program kicked off one of their first site visits as a team. The effort was led by Sandra Elsen, MBA, Sr. Health Systems Engineer, in the Management Engineering and Consulting Department as part of the SW WI Mayo Clinic Health System.
The team took an exemplary and globally known system, and a highly motivated group of early careerists, and tackled some of the most pressing topics affecting all health systems nationally. Some of the highlights included culture work, a deep dive on Mayo’s clinic leadership model, women in leadership, and a closer look at management, engineering, and consulting as a service.
The impactful work did not end there, with the team tackling a master visioning exercise, and even engaging in some leadership through medical improv. Special thanks to the team for their commitment to excellence and for leading such a world-class site visit!
ACHE Board of Governors Call for Applications
Applications are now being accepted for the ACHE Board of Governors. As you know, these roles are an essential part of ACHE governance and help ensure the ongoing strength of ACHE as an organization. We encourage you to consider your interest in these roles.
ACHE’s 2021–2022 Nominating Committee is calling for applications for service beginning in 2022. ACHE Fellows are eligible for any of the Governor and Chairman-Elect vacancies. Those interested in pursuing applications should review the call for nominations and candidate guidelines.
Applications to serve and self-nominations must be submitted electronically to jnolan@ache.org by July 15. All correspondence should be addressed to Heather J. Rohan, FACHE, chair, Nominating Committee, c/o Julie Nolan, American College of Healthcare Executives, 300 S. Riverside Plaza, Ste. 1900, Chicago, IL 60606-6698. If you have any questions, please contact Julie Nolan at (312) 424-9367 or jnolan@ache.org.
Latest Coffee with the College Podcast Featuring Seth Teigen, FACHE, Chief Executive Officer at Providence Mission Hospital in Mission Viejo
How do you respond when a senior executive in your organization asks you, “what do you want to be when you grow up?” Do you risk sounding too ambitious and reply with “I want YOUR job”? Do you sidestep and risk a label of “lacks direction” by saying you’re taking it one step at a time?
Today, we explore how the answer to this question was critical to the career of Seth Teigen, Chief Executive Officer at Providence Mission Hospital in Mission Viejo, California. Seth takes us on his career journey, including a story about one of his worst decisions as a new leader, and how an experienced executive advised him never to make a similar mistake again! He also talks about work-life balance, taking advantage of stretch assignments, and how ACHE impacted his professional growth. We hope you enjoy!
