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Wisconsin Health News
A group of Republican lawmakers plan to introduce a $3.5 million package of bills next session aimed at improving rural healthcare.
The bills, part of the Rural Wisconsin Initiative, would address projected workforce shortages by expanding training programs for healthcare professionals and wellness programs in rural areas.
“We know that medical professionals who have exposure to rotations in rural areas are more likely to stay in those areas,” Rep. Romaine Quinn, R-Rice Lake, said in a statement. “These bills will help ensure that we build on that reputation by encouraging young healthcare professionals to live, work and train in our rural communities.
One of the proposals would provide $250,000 annually over the next biennium to the Wisconsin Rural Physician Residency Assistance Program. The funding is aimed at OB-GYN and mental health residencies in northern Wisconsin,according to the lawmakers.
They also propose the creation of a $250,000 annual grant program that would be available to hospitals and other entities that form training consortia focused on allied health professionals like radiographers, physical therapists, nutritionists and others.
The lawmakers also encourage hospitals to partner with educational institutions to support advance practice clinicians. The package would establish a $750,000 annual grant program for establishing clinical training infrastructure in rural communities.
And the package would create a grant program to encourage the development of wellness facilities and programs in underserved areas. Grants would be limited to $250,000, and the state would award at least two to recipients that provide matching funds.
An additional $100,000 annual grant would go to the Wisconsin Hospital Association Foundation to increase participation by rural hospitals in quality improvement activities. And lawmakers are looking at legislation that will identify future workforce gaps through collecting better workforce data.
“Many rural areas of Wisconsin are facing increasing challenges as they strive to deliver high-quality, accessible healthcare, including attracting and retaining highly skilled healthcare professionals,” WHA CEO Eric Borgerding said in a statement. “Healthcare is a key factor in economic development across the state and is critically important for rural areas.”
“The best way to ensure access is to have these professionals trained in the same rural environments where they will practice,” said George Quinn, Wisconsin Council on Medical Education and Workforce executive director, in a statement.
Tim Size, executive director at the Rural Wisconsin Health Cooperative, said the package would accelerate what’s already happening in rural communities and expand best practices across the state.
“It’s seed money to help the development, help the expansion,” Size said, calling the initiative a “very important next step.”
He noted that health is only part of the Wisconsin Rural Initiative.
“The health of the community – education, jobs – you can’t separate them out,” he said. “It doesn’t any good to have great healthcare if there’s no jobs or education. We need all these pieces to be working together.”
Wisconsin Health News
Aurora Health Care has ended its partnership with the UW Cancer Center at ProHealth Care, representatives of the organizations confirmed Tuesday.
The three health systems, part of the statewide health network AboutHealth, were all collaborators on the cancer center in Pewaukee.
But Aurora spokeswoman Tami Kou said, “We discovered limitations and determined that our patients would be best served at their current locations.”
The split was first reported by the Milwaukee Business Journal late Monday.
Kou pointed toward other collaborations between ProHealth Care, including Aurora providing remote intensive care unit monitoring services for ProHealth Care’s Waukesha Memorial Hospital and Oconomowoc Memorial Hospital, which it started doing in June.
“While ProHealth Care and Aurora Health Care are working together in a number of ways, the two organizations mutually decided last year to maintain separate cancer programs in Waukesha County,” said Jeff Squire, chief corporate affairs officer at ProHealth Care.
UW Heath didn’t play a role in the decision, according to spokeswoman Lisa Brunette. She said Aurora’s decision to leave the cancer center wouldn’t have an impact on UW Health working with Aurora on pediatric cancer services in northeast Wisconsin.
Wisconsin hospitals provided $918 million in uncompensated healthcare services to their patients in fiscal year 2015, a decrease of 29.8 percent from FY 2014, according to a new report from the Wisconsin Hospital Association.
The 149 hospitals included in the report provided $434.7 million in charity care and incurred $483.3 million in bad debt in FY 2015.
General medical surgical hospitals reported a 31.1 percent decrease in uncompensated care, while specialty facilities reported an increase of 19.1 percent.
Total uncompensated care declined to 1.9 percent of total gross patient revenue in FY 2015 from 3 percent the previous year.
The Wisconsin Hospital Association attributed the decline to the expansion of health insurance coverage under the federal health reform law. They also noted they’ve seen an increase in losses from Medicaid.
Wisconsin hospitals receive 65 percent of what it costs to provide care for patients enrolled through Medicaid, according to Brian Potter, WHA senior vice president. Losses increased to more than $1 billion in fiscal year 2015, up from $899 million the previous year.
Medicare losses also increased to more than $1.64 billion, an increase of $160 million from the previous year, according to Potter.
“As the population continues to age and new enrollees are added to the Medicare program, the impact of the underpayments will become more pronounced,” he said.
Potter also noted that hospitals reinvest in communities by working with community partners to address unmet health needs.
“Hospitals help create healthier communities, and ensure that people are able to participate fully in employment opportunities and care for their families,” he said in a statement. “Without the assistance of hospitals and health systems, services for this segment of our society would remain scarce and in many instances, local government entities would be responsible for meeting this need.”
Milwaukee hospitals accounted for about 26.2 percent, roughly $240.1 million, of overall uncompensated care in the state. Of the 149 hospitals in the report, 52 delivered more than $5 million in uncompensated care during FY 2015.
Hospitals provided uncompensated care to 1.6 million patients in FY 2015.
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The chair of the state’s Medical Examining Board said last week that he expects doctors should be able to obtain a license under the interstate licensure compact in January.
“We want to be issuing the first licenses by Jan. 1,” said Dr. Kenneth Simons, who called it a conservative timeline. Simons serves as one of the state’s commissioners for the group developing the compact.
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The Department of Health Services is requesting an increase of $452 million in general purpose revenue for Medicaid in its 2017-’19 biennial budget request to the Department of Administration.
Secretary Linda Seemeyer wrote in the request sent Thursday to DOA that the department’s budget request that the increase in Medicaid funding is based on projected enrollment, costs per enrollee and other factors.
“While still a significant amount of funding, this increase is small by historical standards,” Seemeyer wrote, noting that the last three biennial budgets increased state spending in the program by $650 million, $685 million and $1.6 billion respectively.
Seemeyer also noted they expect the program to be below budget in the current biennium, with more than $260 million GPR expected to lapse into the state’s general fund at the end of fiscal year 2017. That lapse is separate from the department’s request for an increase.
“These slowing Medicaid growth rates reflect the success of Governor Walker’s entitlement reforms, efforts to improve health outcomes through better care coordination and initiatives to identify and eliminate waste, fraud and abuse,” she wrote. “They also result from improved oversight of managed care contracts and reforms enacted by the governor and Legislature.”
Karen Timberlake, director of the University of Wisconsin Population Health Institute, is joining Michael Best Strategies as a senior advisor, according to a Wednesday statement.
Timberlake has served as director of the institute since 2011. She previously served as the Department of Health Services’ secretary.
She starts Oct. 10, according to Kanoe Riedel, a spokeswoman for Michael Best & Friedrich, the law firm affiliated with Michael Best Strategies.
But is healthcare something that can really be shopped for like other industries? What factors are patients most interested in when making decisions? How are payers and providers responding? What will it mean for healthcare costs?
Learn more at a Wisconsin Health News Panel Event, Tuesday, Oct. 4 at the Milwaukee Athletic Club.
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APPLETON – The federal government has released ratings of hospitals nationwide, but Wisconsin health care leaders say the numbers don’t necessarily add up.
The new Center for Medicare and Medicaid Services (CMS) ratings by the federal Department of Health and Human Services evaluate 64 quality measures up to five stars. Those measures address everything from patient satisfaction and mortality rates for common ailments that land patients in hospitals to infection rates for different types of procedures.
But are these measures helpful to consumers and patients in the Fox Valley? Buyer beware, hospital and physician groups say.
“I do think this is a good first step, but there are some real flaws,” said Donn Dexter, chief medical officer of the Wisconsin Medical Society, a physician advocacy group. “The playing field is null and equal, and the measurements aren’t always applied equally to all hospitals.”
In the Fox Valley, almost all of the hospitals received three-star or four-star ratings. St. Elizabeth Hospital in Appleton, Aurora Medical Center and Mercy Medical Center in Oshkosh, were four-star hospitals in the southern part of the Fox Valley. In the Green Bay area, Bellin Memorial Hospital and Aurora Baycare Medical Center also had four stars.
All seven medical centers affiliated with Appleton-based ThedaCare received three-star ratings. The seven medical centers are in Appleton, Berlin, Neenah, New London, Shawano, Waupaca and Wild Rose.
ThedaCare is supportive of ratings like these being publicly available, said CEO Dean Gruner in a statement to USA TODAY NETWORK-Wisconsin, citing other rankings from Wisconsin Collaborative for Healthcare Quality and the Wisconsin Health Information Organization.
“The CMS star rating is new and we will learn as we go,” he said. “We always use feedback to help us further improve the great work of our team members.”
Dexter said it’s important to be wary of the rankings though, depending on whether the information is from patients’ opinions or the medical center has a smaller number of patients.
“If your patient comes in and wants narcotics for pain, and you don’t give them narcotics because while it’s easy, it’s not appropriate and because you want to prevent them from being addicted, you can get a very adverse rating (for patient satisfaction),” Dexter said. “Even though, you did the right thing.”
Robert Batt, a University of Wisconsin-Madison business professor, said he liked how CMS included reporting from patients.
“Surveys tend to have people with extreme opinions, but even at that, it’s real data of real patients who were there and who can say something,” he said.
Hospitals could also have higher infection rates according to the CMS data after certain surgeries or ailments, for example, but only because they had one patient who received that surgery and subsequently got an infection, Dexter said.
A smaller rural hospital, often referred to as critical access hospitals, will also likely rank lower than a large hospital with research capabilities, like UW Health in Madison or Froedert in Milwaukee, he said.
“It’s just not the same thing and we have to understand that,” Dexter said. “Interpreting these rankings with a little skill takes time.”
Patients with chronic illnesses or conditions should not just evaluate the general measures, but look at specific measures for their condition, said Patrick Falvey, chief transformation officer at Aurora Health Care.
If a patient has heart issues, they should dive deeply into measures related to cardiovascular health, for example, Falvey said. But, if hospitals perform well overall on the general measures, hospitals likely have a “solid foundation” of medical practice.
Beyond individual hospitals, Wisconsin as a whole has higher rated hospitals than its counterparts nationwide. All but three hospitals statewide scored at least three stars or higher.
Officials with the Wisconsin Hospital Association said the group is happy that Wisconsin scored well on the ratings. Dexter had similar sentiments, saying Wisconsin is in a much better place overall compared to other states.
“However, we are concerned that the large number of different hospital ratings that exist and the complexity of how these ratings are calculated can cause confusion for health care consumers,” said Kelly Court, Wisconsin Hospital Association’s chief quality officer, in a statement to USA TODAY NETWORK-Wisconsin. “Hospitals are working hard to improve the quality of the most important services they provide, which may or may not be reflected in this new rating.”
Northeast Wisconsin CMS hospital ratings
Madeleine Behr: 920-996-7226, or mbehr@postcrescent.com; on Twitter @madeleinebehr
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