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1 May 4, 2012 Volume 56, Issue 18 Wisconsin Medicaid Waiver Provisions Approved Last Friday, April 27, the Department of Health Services (DHS) received final approval from the federal government to move forward with certain aspects of its Medicaid reform proposals. DHS plans to implement the changes beginning July 1. The policies approved by the Centers for Medicare and Medicaid Services (CMS) are expected to result in about 17,000 adults being disenrolled from the program. The changes were proposed as part of an overall reform package intended to help balance the Medicaid program budget. Heading into the biennium, Wisconsin faced a $1.8 billion Medicaid deficit, which was partially offset by the infusion of nearly $1.3 million in state GPR funds added through Wisconsin Act 32, the biennial budget. We don t like everything that s been proposed, and we re not through the woods yet, there is still a lingering deficit, said WHA s Executive Vice President Eric Borgerding. But, if someone had told me a year ago that today SeniorCare would be intact, FamilyCare would be intact, provider reimbursements holding largely steady, Guest Column (continued on page 10) Meeting Child Health Needs By Karen Ordinans, Executive Director, Children s Health Alliance of Wisconsin Children s Health Alliance of Wisconsin was founded to ensure all children are healthy, safe and able to thrive. We recognize all hospitals are working in their communities to identify the health needs of children and adults. The Alliance is a resource that can help you achieve your medical mission, address the needs of kids and make a difference in your Karen Ordinans communities. I look forward to presenting additional information about our key initiatives at upcoming WHA regional meetings, but until then, here is a short preview of what the Alliance can offer your organization: Asthma: Over 111,000 Wisconsin children live with asthma, and children aged 0-4 years exhibit the highest rates of asthma (continued on page 7) New Legislator Profile: Rep. Kathy Bernier (R-Chippewa Falls) A series of interviews with newly-elected legislators, by Mary Kay Grasmick, editor Rep. Bernier arrived at the State Capitol as a new legislator, but one with 12 years of experience as Chippewa County Clerk and a familiarity with some of the key health issues facing Wisconsin communities. Rep. Kathy Bernier Bernier understands the value that good health care brings to the community. Good health care is just as important of a component to job growth and business development as good education is to businesses that are locating to our area, Bernier said. Hospitals play a role in economic development. We are fortunate in the Chippewa Valley to have excellent health care available. Bernier believes that individuals must take more responsibility for their own health, and while she believes that some people don t have the ability to cost share in the Medicaid program, those that do, should. (continued on page 7) Board Chair: Sandy Anderson, President, St. Clare Hospital, Baraboo Editor: Mary Kay Grasmick, VP Communications - mgrasmick@wha.org 5510 Research Park Drive P.O. Box Madison, WI P ( ) F ( )

2 Influenza Policies, Population Health, GME Topics at WHA MPA Council Meeting The WHA Medical and Professional Affairs Council met May 3 in Madison. Council member Bruce Van Cleave, MD, executive vice president and chief medical officer at Aurora Health Care, discussed the health system s experience with their new requirement that all employees must receive the influenza vaccination as a condition of employment. With the policy in place, Aurora vaccinated 97.7 percent of the 30,000 health care workers they employ. The largest barriers to vaccination cited by health care workers are based on misinformation and inconvenience, according to Van Cleave, two factors that the health system addressed in their employee vaccination program. Chuck Shabino, MD; Bruce Van Cleave, MD Van Cleave said since Aurora hosts clinical rotations and residency training, they worked directly with the respective schools to ensure that students were vaccinated as a condition of working in their hospitals. Aurora will modify their employee vaccination timeline this year to start earlier and end it sooner to avoid the holidays. Karen Timberlake is director of the University of Wisconsin Population Health Institute. She briefed the Council on the Institute s work related to the County Health Rankings project ( which started nearly 10 years ago in Wisconsin and now covers more than 3,000 counties in the United States. Population health is a relatively new way to describe a broad area of programs and Karen Timberlake policies aimed at looking at all the factors that comprise health in a community. These include factors within the control of individual, such as behavior, and those outside of it, such as social and economic conditions. (continued on page 8) WHA Expresses Significant Concerns on Stage 2 EHR Meaningful Use Rule On May 4, WHA submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the proposed rule for Stage 2 meaningful use of electronic health records. In addition, WHA provided a model comment letter to Wisconsin hospital information services directors, quality directors, and hospital lobbyists on May 2. In the comment letter, WHA expresses support for the goal of the electronic health record (EHR) incentive programs: accelerating adoption and use of EHRs to improve health care by providing financial support. However, the letter expresses concerns that the program is not poised to meet that goal. Given the experience to date in Stage 1, WHA is concerned that elements of the proposed rule for Stage 2 would stand in the way of a successful program to support widespread adoption by all hospitals, WHA wrote. Many of the proposals put regulatory requirements ahead of actual experience with these technologies an approach that will likely have unintended consequences. Based on data from various surveys and input from Wisconsin hospital CEOs, CIOs, quality improvement executives, and others, we are concerned that despite a high rate of EHR adoption in Wisconsin as measured by multiple metrics, the vast majority of Wisconsin hospitals almost 90 percent have not yet met Stage 1, due to both the high bar set and market factors, such as accelerating costs and limited vendor capacity, states WHA s letter. Wisconsin s stage 1 attestation rate is very similar to the experience of hospitals across the nation. (continued on page 8) The Valued Voice -- Page /4/12

3 Guest Column A Place We are Not Coming Back From With or without PPACA, Wisconsin health systems moving forward with value driven reform By Eric Borgerding, WHA Executive Vice President Nearly five years ago, WHA sponsored a full-page ad in major Wisconsin dailies congratulating our members for helping Wisconsin achieve the top spot in the AHRQ quality rankings. Our message then was: Congratulations to the leaders and caregivers at Wisconsin s hospitals for your tireless pursuit of excellence in patient care. Improving health care quality and value is health care reform. Fast forward to March 25, 2011, and this statement by then WHA Board Chair Nick Turkal in an interview with the Milwaukee Business Journal: All the dialogue and all the debate has pushed the (health care) industry in a way that it is not going to come back from changes around value-based reimbursement are coming, regardless of what happens in D.C., and I think for businesses and consumers that s a good thing. One year later, WHA sent a letter to several leading Wisconsin business organizations to engage them in the health care quality discussion: Improving quality and achieving better outcomes not only benefits our patients, but also helps create a more attractive Wisconsin business climate. High quality health care can make Wisconsin a more competitive place for employers to locate or expand. In many parts of the country, talk by the health care community of quality, accountability, measuring performance, shifting from generating volume to focusing on outcomes, or the notion of VALUEbased payment would be considered foolhardy, risky or worse. But not in Wisconsin. Jump ahead to March 27, 2012, the day ordinary people tuned-in to the U.S. Supreme Court to hear oral arguments that sent shockwaves through the political and health care worlds and made even the staunchest supporters of PPACA pessimistically speculate on prospects for real health care reform. But not in Wisconsin. While the multi-level ramifications of the Court s coming decisions on PPACA will be massive, Wisconsin is indeed already heading to a place it is not going to come back from. With or without PPACA, Wisconsin providers, and many payers, are moving down the road to value-driven health care reform and we need to keep our foot on the gas pedal. The focus on quality and value is being hastened, if not dictated, by the combined forces of federal deficit reduction and the need for health care cost containment in the context of employer labor costs in the globally competitive environment. Increasingly engaged payers, coupled with integrated systems of providers aligned toward a common goal producing higher quality, better outcomes and greater value for employer and employee health care dollars will continue pushing Wisconsin forward and set us apart from many other parts of the country with or without PPACA. Here s why: Wisconsin is the home of national leaders and pioneering organizations in the quality and value movement. Dr. John Toussaint, founder of the ThedaCare Center for Healthcare Value, John Torinus, former CEO of Serigraph, Inc., the Wisconsin Health Information Organization (WHIO) and a host of other Wisconsin business and health care leaders and organizations have been catalysts, and continue to push both providers and payers to seek superior quality and value and accelerate the pace of change. (continued on page 9) The Valued Voice -- Page /4/12

4 Grassroots Spotlight St. Mary s Janesville Hospital Hosts Wisconsin DSPS Secretary Ross Wisconsin Department of Safety and Professional Services (DSPS) Secretary Dave Ross recently visited St. Mary s Janesville Hospital. During his time at the facility, Ross was hosted by hospital President Kerry Swanson and met with employees across the spectrum of care delivery. St. Mary s Janesville Hospital appreciates the opportunity to meet and discuss issues with Secretary Ross, said Swanson. We are pleased by his agency s efforts to streamline and improve departmental processes impacting licensed professionals in Wisconsin. St. Mary s Janesville Hospital President Kerry Swanson with WI DSPS Secretary Dave Ross. Sec. Ross met with roughly 20 clinicians, managers, doctors, nurses, social workers and others during his time at the hospital. Worker s Compensation Audit Committee Begins Work to Audit Certified Databases Providers concerned about inaccurate or incomplete data The Worker s Compensation Advisory Council s (WCAC) Audit Committee, newly established as part of this biennium s agreed to bill (see 10/14/11Valued Voice article at valued_voice/vv pdf), met this week to begin work on auditing the certified Health Cost Fee databases. The Worker s Compensation program uses the certified databases during the reasonablenessof-fee dispute process when a provider appeals a payment received from a Worker s Compensation carrier. The carriers use the certified databases to determine the maximum allowable fee for health care services provided to injured workers. Health care providers cannot access the databases and are concerned that the black boxes are based on inaccurate or incomplete data. The recent Worker s Compensation legislation (2012 Wis. Act 183) reduced the maximum fee for a health care service from 1.4 to 1.2 standard deviations above the mean charge for that service. Under the legislation, the maximum fee will be increased to 1.3 standard deviations above the mean charge if the Department of Workforce Development (DWD) does not begin to audit the certified databases by November 1, During its initial meeting, the WCAC audit committee learned about the DWD s certification process for the databases, discussed potential shortcomings with that process identified by staff and committee members, and began to discuss the scope of the audit. There are currently five certified databases; a copy of the certification application is available on the WHA website at legal/certificationhealthcostfeedatabase.pdf. The committee will meet again on May 21 and June 19, intending to submit audit recommendations to the WCAC by June 26. The Valued Voice -- Page /4/12

5 Joplin Tornado Provides Valuable Disaster Preparedness Lessons The stories recounted haunting images in the aftermath of a tornado that hit St. John s Regional Medical Center in Joplin, Missouri on May 22, In a video prepared by Mercy Health System, St. John s nurses described diving under hospital beds with newborn babies in their arms to protect them, while ER physicians said they used their own bodies to shield their patients as powerful winds hit the hospital and blew out windows and doors. Nurses took their shoes off and put them on the feet of ambulatory patients to protect their patients feet from the broken glass and sharp debris that littered the way out during the evacuation. Rated as an EF5 tornado (on a 6 point scale), the tornado demolished the hospital and left it without power and water. Hospital staff worked frantically to evacuate patients to surrounding hospitals, which quickly became overwhelmed themselves as St. John s patients arrived just as the injured throughout the community sought medical help. On May 1 and 2, the Wisconsin Hospital Emergency Preparedness Program (WHEPP), in coordination with the Wisconsin Hospital Association, sponsored hospital public information officer seminars in Madison and in Wausau. David Morris, who is the public information officer at St. John s Regional Medical Center, was one of two presenters, and he discussed St. John s response and shared lessons learned. We had just implemented electronic medical records on May 1, which proved invaluable to patient care following the tornado, Morris said. Our health system was able to print out the patients records and give our caregivers hard copies of the records in a relatively short period of time, which was critical to our ability to continue to care for our patients. David Morris A few days after the tornado, the hospital functioned out of a tent. After that, a small hospital was assembled using component parts, which look like trailers. Just eight months after the tornado destroyed it, the hospital began serving patients in a modular-constructed hospital that will be in place until the new hospital is completed. Gerard Braud, an expert in media issues and crisis communications, followed Morris s presentation with hands-on crisis communications training. Braud walked participants through a number of crisis scenarios and emphasized the Gerard Braud importance of maintaining control of the message. He advised communicators to use social media strategically and sparingly during a crisis, and to bridge all social media back to the hospital or health system website as the main source of information. The Valued Voice -- Page /4/12

6 Call for Nominations: 2012 Global Vision Community Partnership Award Nominations due to WHA Foundation by July 13 Honor one of your hospital s community health projects by nominating it for a 2012 Global Vision Community Partnership Award, presented by the WHA Foundation. This competitive grant award is presented to a community health initiative that successfully addresses a documented community health need. The Award, launched by the WHA Foundation in 1993, seeks to recognize and support ongoing projects that support community health. Any WHA hospital member can nominate a community health project. The project must have been in existence for a minimum of two years and must be a collaborative or partnership project that includes a WHA member hospital and an organization(s) within the community. The official call for nominations for the 2012 Award is included in this week s packet. Nominations are due July 13, Nomination forms can also be found on the WHA website at For more information about the Award, contact Jennifer Frank at jfrank@wha.org or Helping Others Motivates, Inspires Health Care Employees WHA recognizes 36 hospital employees for dedication to patients The Wisconsin Hospital Association Health Care Employee Pride Program this week recognized 36 individuals for their dedication to their career, service to patients in their hospitals and their contribution to meeting the health care needs of their community. Each person honored submitted an essay describing why they entered the health profession. The reasons they gave were deeply personal and reveal the type of individual that seeks a health career. The employees essays are reflective of the commitment that our health care workers have to going above and beyond the call of duty to care for their patients, says Judy Warmuth, vice president, workforce development. From their writings, we learn why individuals chose a career in health care and we can begin to understand what makes health care as a career different and more rewarding than other choices these talented employees could have made, said Warmuth. WHA has sponsored this program for ten years, and I never cease to be impressed by the individuals who take the time to express what it means to them to work in this field. Health care today offers people an opportunity to work in a high-tech, yet high-touch, environment. By showcasing the personal stories of health care employees, we are able to share the rewards of choosing a career serving others, according to WHA President Steve Brenton. The essays may be viewed at A list of this year s honored employees is on page 11. The Valued Voice -- Page /4/12

7 Guest Column (cont d. from page 1) Meeting Child Health Needs hospitalization. The Alliance offers the Asthma Focused Follow-up Program for primary care providers to better manage asthma patients; the Asthma Care Fax program a partnership with pharmacists; and is working with Medicaid officials on discrepancies in asthma services provided by HMOs. Dental: Last year hospitals statewide spent $7 million on emergency room care related to dental, and less than 20 percent of the Medicaid population saw a dentist. The Alliance has leveraged funding to expand school-based sealant programs serving over 30,000 children and guided communities in organizing dental resources. Grief and bereavement: The Alliance manages the Infant Death Center and provides resources to families who unexpectedly experience the death of an infant and professionals working with families. This complements hospital Resolve Through Sharing (RTS) programs. Injury prevention and death review: The Alliance is promoting consistent messaging on safe sleep practices for parents, caregivers and professional staff. Teaching sheets, sample internal hospital policy and messaging materials are available for replication. We have built more than 40 local child death review teams statewide to identify common risk factors and guide communities in implementing strategies to prevent future deaths. We also are developing a Fetal Infant Mortality Review Program, with hospitals as critical partners. Reach Out and Read Wisconsin: Thirty-four percent of American children start kindergarten without the skills they need to learn to read. Reach Out and Read Wisconsin partners with doctors to prescribe books and encourage families to read together. The Alliance is assisting 77 current programs and working to secure book support to expand new programs statewide. As we move to a population management health care system, it is crucial to focus on prevention. Hospital systems and health care providers are key partners in ensuring kids are healthy, safe and able to thrive, and we are eager to work with you. Let us be a resource. Visit our website at Continued from page 1... New Legislator Profile: Rep. Kathy Bernier (R-Chippewa Falls) I think patients are better off when we participate more in our own health care financially, Bernier said. There are a host of ways that cost sharing could be used (in BadgerCare) that would make people have more responsibility for managing their own health care. With a background in public health, Bernier also applauded hospitals for their work in improving and protecting the health of their communities. Bernier is particularly supportive of hospitals working with those in the public health arena on issues related to emergency preparedness. Bernier encourages her constituents to contact her. Constituent input is invaluable. When I have a chance to talk to people one on one meet with real people who have real concerns they give me good suggestions for legislation that people in the legislative arena may not even think of, according to Bernier. I think that legislators in general are getting the clue that we need to think outside the box, change business as usual, because what we have done thus far is not sustainable. Average, every day people are the ones who often have the best ideas, Bernier said. The Valued Voice -- Page /4/12

8 Continued from page 2... Flu Policies, Population Health, GME Topics at MPA Meeting Timberlake said the Population Health Institute and WHA have been working together in the development of tools and resources that hospitals will find helpful as they work on community health needs assessments. WHA continues to lead a statewide effort dedicated to ensuring that Wisconsin has an adequate supply of physicians to meet the present and future demand. Chuck Shabino, WHA senior medical advisor, told Council members that the WHA Graduate Medical Education (GME) Task Force has been gathering information that will be used to develop a concept paper that will be useful in facilitating a statewide dialogue on the issue. A recent WHA survey of hospital and health system CEOs on the subject of GME found two-thirds of the respondents either were or are now involved with medical student training or residencies. For those responding in the negative, the reason most often given was a lack of physician support. The benefits of having GME in their community that CEOs most often cited were growing the physician workforce and enhancing their relationships with their current medical staff. WHA also surveyed residency program directors and found that only half of the respondents believe that their program receives the appropriate level of interest from Wisconsin s medical school graduates. The key issues that must be addressed are the perceived barriers to expanding the programs which include financial support, clinical volumes, and lack of support from faculty at the medical schools. WHA Senior Vice President and General Counsel Laura Leitch provided the Council with an update on proposed changes to MED 8, the administrative rule that regulates physician assistant (PA) practice. Leitch sought feedback from the Council concerning the PA supervision ratio, the definition of supervision, and other issues. Continued from page 2... WHA Expresses Concerns on Stage 2 EHR Meaningful Use Rule Drawn from input from WHA s HIT Task Force, the results of WHA s stage 2 meaningful use survey, other member input, and the American Hospital Association s comment letter efforts, WHA s comment letter focuses on major concerns and recommendations relating to: The flawed clinical quality measure scheme which has largely failed to automate the generation of accurate, valid, and useable clinical quality measures The proposed timing and staging of meaningful use Stage 2 An unfeasible patient portal requirement that ties hospital incentives and penalties to decisions made by patients Overly aggressive and burdensome proposed Stage 2 requirements, including a summary of care measure that disincentivizes health care integration and accountable care organization-like efforts An accelerated timing of the Medicare payment penalties for PPS hospitals WHA also submitted a letter May 4 to the Office of the National Coordinator for Health Information Technology (ONC) on the related EHR certification proposed rule. In addition to meeting the meaningful use requirements, hospitals must meet the EHR certification requirements to receive the EHR incentive payments and avoid future penalties. That letter encourages ONC to set EHR vendor requirements to test and accurately generate the meaningful use quality measures. The letter also comments on health information exchange and summary of care technical requirements, and discourages ONC from requiring that all hospitals use the SNOMED nomenclature for problem lists by WHA s comment letters and additional information about the Stage 2 meaningful use proposed rules, including a summary PowerPoint, can be found at If you have any questions or comments on the proposed rules, contact Matthew Stanford at mstanford@wha.org or The Valued Voice -- Page /4/12

9 Guest Column (cont d. from page 3) A Place We are Not Coming Back From Wisconsin has a strong presence of vertically integrated hospital and health systems, with employed physicians aligning towards a common goal better outcomes. According to the MGMA, in 2002 about 20 percent of U.S. physician practices were hospital-owned; in 2008 that figure was over 50 percent. At least two-thirds of Wisconsin s practicing physicians are employees of hospitals or growing integrated delivery systems. That means more and more care is happening under one roof and a shared philosophy facilitating coordination of and honing focus on patients and delivering better quality, better outcomes and, ultimately, better value for Wisconsin s health care dollars. Wisconsin s balanced and fair tort system attracts high quality physicians and staff: Wisconsin already struggles attracting and retaining the physicians and other high-level providers we need to meet demand for care. Our balanced medical malpractice system is an attribute that serves to attract good practitioners to our state. Wisconsin hospital and health systems have a long history of commitment to improving care: Wisconsin is a national leader in ongoing, measurable quality improvement. One recent example is WHA s Partners for Patients, which aims to improve Wisconsin hospitals already belowaverage readmission rates by another 20 percent. Hitting that target could save Wisconsin a quarter billion in health care costs annually Commitment to transparent reporting of results: Since 2005, WHA s CheckPoint program, the first of its kind in the nation, has been publicly reporting hospital quality indicators and is continuously updating its measures. In February, CheckPoint began reporting Wisconsin hospital infection rates. The Wisconsin Collaborative for Health Care Quality is also a pioneer in public reporting, bringing providers and payers together to develop and publicly report health care performance measures. Wisconsin is a leader in adopting electronic health records: In 2012, Wisconsin hospitals rank second in the nation in adoption of certified electronic health records (EHR) technology. Further, Wisconsin is ahead of nearly all of its Midwest neighbors in the adoption of more advanced EHRs. Wisconsin providers are developing accountable systems of care that improve quality, reduce costs and work at managing the populations in their service areas: Commercial reimbursement is changing: With or without Medicare-driven ACOs, the payment model in health care is moving away from unit pricing/fee-for-service and towards outcomes/total cost of care. There are several examples across the state of accountable care models in the private sector commercial market, outside of PPACA s Medicare-driven ACOs Aurora, Bellin/ThedaCare, Dean, Gundersen Lutheran, and Quality Health Solutions are a few examples. Wisconsin hospitals are reducing operating expenses through adoption of LEAN, Six Sigma and other efficiency initiatives. A 2011 study by Milliman and Mercer showed that from hospital operating expenses in SE Wisconsin increased by 17 percent compared to a 28 percent increase in the Hospital PPI and 37 percent increase in the CMS Hospital Market basket for the same period. Wisconsin hospital supply costs per discharge are now nearly 19 percent lower than the national median. (continued on page 10) The Valued Voice -- Page /4/12

10 Guest Column (cont d. from page 9) A Place We are Not Coming Back From Hospital commercial payments and prices are reflecting improvements in efficiency and quality. From , hospital commercial payments in SE Wisconsin increased 40 percent less than the Hospital CPI over the same period. Health care costs are a component of labor costs, and with over one-third of all Wisconsin jobs located in the seven county SE Wisconsin region, the impact on health care costs is significant. Annualized hospital rate increases are trending downward, declining from 7.4 percent in 2002 to 4.8 percent in 2012 What we said five years ago is even truer today improving health care quality and value is health care reform. Some in the health care and business community have been critical of the pace of change and refocus on quality and efficiency in health care. They are not wrong. With or without PPACA, Wisconsin must, and will, continue down the reform path. Few other states are as well positioned to succeed, if not thrive, in the emerging value dynamic A Wisconsin strength WHA believes can transform into competitive advantage. Stay tuned. Continued from page 1... Wisconsin Medicaid Waiver Provisions Approved cost-shifting minimized and nearly 99 percent of those covered by Medicaid still covered, I wouldn t have believed them. Yet that is essentially where Wisconsin stands today. The waiver approval comes after several months of negotiations in which the Department s original proposal had been scaled back so that the new policies could not be applied to children under the age of 18. Instead, the changes will affect non-pregnant, non-disabled adults with income above 133 percent of the federal poverty level ($30,657 for a family of four). As expected, the federal Centers for Medicare and Medicaid Services (CMS) approved a new level of premiums, based on a sliding scale, mirroring the premium provisions included in the federal health care reform law. In addition, under the waiver approval, DHS will change the way it determines if adults have access to employer-sponsored health insurance. An adult who has access to employer-sponsored insurance for which they pay a premium of less than 9.5 percent of their income are no longer eligible for the Medicaid program. CMS also approved eliminating retroactive eligibility for non-pregnant non-disabled adults. As a result, medical bills incurred by these recipients up to three months prior to their becoming eligible will no longer be covered by the Medicaid program. WHA had opposed this provision, arguing that retroactive eligibility should be preserved for emergency situations and should not be eliminated until DHS implemented a real-time eligibility system. Otherwise, providers run the risk of not getting paid for services particularly emergency room services simply due to delays in patients becoming enrolled in Medicaid. Although WHA is pleased that the policy will not apply to pregnant women or children as first proposed, we remain concerned that this reduces reimbursements for providers when enrollment in Medicaid is caused by administrative delays, and we will monitor the implementation of this policy change. DHS continues to negotiate other aspects of its waiver requests with the federal government including medical home models and the alternative benchmark plan. Additional background information on DHS s proposed waiver reforms can be found on the WHA website at The Valued Voice -- Page /4/12

11 2012 Wisconsin Health Care Employee Pride Program Honorees Agnesian Healthcare/St. Agnes Hospital, Fond du Lac Janelle B. Baldwin, Lead Fitness Trainer Aspirus Wausau Hospital, Wausau Sue Ziebell, EVS Aide Aurora Medical Center in Grafton Laura Vande Boom, Registered Nurse Aurora Medical Center in Hartford Brenda Jochem, Administrative Assistant Sr. Aurora Medical Center in Oshkosh Amy Laridaen, Registered Nurse Aurora Medical Center Manitowoc County, Two Rivers Shirley A. Noffke, Patient Access Representative Beaver Dam Community Hospitals, Inc., Beaver Dam Patricia Van Buren, RN, Foot Clinic Nurse Bellin Hospital, Green Bay Holly Horkman, Registered Nurse Burnett Medical Center, Grantsburg Molly (Marlene) Olson, CNA Community Health Network, Berlin Mary Ann Nero, RN, Employee Health Nurse Divine Savior Healthcare, Portage Natashia Peschel, Respiratory Care Practitioner Holy Family Memorial, Manitowoc Sue Schmeichel, Registered Nurse Mayo Clinic Health System - Franciscan Healthcare in La Crosse Art Peek, Social Worker Memorial Health Center, Medford Mary Farning, Registered Nurse Memorial Medical Center, Neillsville Wendy Langreck, Physical Therapist Assistant Memorial Medical Center, Ashland Susan Wilhelm, RN - Perioperative Services Mercy Health System Corporation, Janesville Sue Kratz, Medical Transcriptionist Mile Bluff Medical Center, Mauston Bobbie Jo John, CNA Ministry Door County Medical Center, Sturgeon Bay Carol Moellenberndt, RN - Obstetrics Osceola Medical Center, Osceola Cole Pederson, Nutrition Services Cook Sacred Heart Hospital, Eau Claire Christine Tandberg, Environmental Services Technician Southwest Health Center, Platteville Sandy Andrews, Diabetes Educator St. Clare Hospital, Baraboo Darcy Jensen, Respiratory Therapist St. Croix Regional Medical Center, St. Croix Falls Amy Clark, Registered Nurse St. Joseph s Health Services - Gundersen Lutheran, Hillsboro Andrea Anderson, Physicians Assistant St. Joseph s Hospital, Chippewa Falls Tiffany Berg, Counselor St. Vincent Hospital, Green Bay Cindy Bunker, Planning Analyst Tomah Memorial Hospital, Tomah Theresa Schuh, Transcriptionist UW Health Partners Watertown Regional Medical Center, Watertown Pam Chadwick, Hospitality Associate UW Hospitals and Clinics, Madison Diana Hanson, Sr. Admin. Secretary VA Medical Center, Tomah Marcy E. Engebretson, MSN-ED, Registered Nurse Vernon Memorial Healthcare, Viroqua Kimberly Harter, Medical Laboratory Technician Wheaton Franciscan - St. Joseph, Inc., Milwaukee Crystal Sturm, Registered Nurse Wheaton Franciscan Healthcare - All Saints, Racine Kimberly K. Amason, RN, Registered Nurse Wheaton Franciscan Healthcare Franklin Rhonda Radandt, Emergency Dept. Tech II Wheaton Franciscan Healthcare - St. Francis, Inc., Milwaukee Nicole Winters, RN IV The Valued Voice -- Page /4/12

12 Wisconsin Hospitals Community Benefits Adequate and Appropriate Nutrition Nutrition counseling is an important aspect of the service that hospitals provide within their communities. Whether it is offering classes that focus on weight loss or promoting better health, or nutrition education for people who are diabetic, Wisconsin hospitals offer hundreds of free classes that stress the importance of a nutritional, well-balanced diet on overall health. Hospital employees also help deliver Meals on Wheels and they organize and participate in food drives to benefit local food pantries. Adding convenience to healthy eating When most people think of the food found in convenience stores, they don t think healthy. Gundersen Lutheran Health System has proven that s not always the case through a unique partnership with Kwik Trip, a corporation with more than 350 convenience stores in the Midwest. In 2010, Kwik Trip became a member of the Gundersen Lutheran 500 Club, a healthy eating program that helps people choose eating selections that are controlled in calories and fat. The program is coordinated by Gundersen Lutheran registered dietitians and recommended by physicians. Gundersen Lutheran recognized that to better the health of the community, the 500 Club needed to be in the places where people go most often. In their service area, Kwik Trip is the most common convenience store with thousands of people stopping in every day. To make the greatest impact, a partnership with Kwik Trip was a must. The 500 Club specialist didn t ask Kwik Trip to change their entire menu. Instead, she worked with the existing menu, at times pairing items that wouldn t normally fit the 500 Club criteria with other items to create a healthier 500 Club meal. As Kwik Trip adds new items, they seek the Gundersen Lutheran 500 Cub specialist s input and make alterations as necessary so they have even more 500 Club items to offer customers. In all, Kwik Trip has more than three dozen items on the 500 Club menu, and that s not counting their fresh fruit and vegetable selections. In addition, Kwik Trip has clearly labelled the selections with the green 500 Club seal of approval so customers can easily identify and select 500 Club options. The program has had outstanding success in a short time. Kwik Trip debuted the 500 Club in about 20 stores in La Crosse County, Wis., where the corporation and Gundersen Lutheran are headquartered. They have plans to expand it to more than 30 stores in their regional area, and are considering taking the program company-wide. Since becoming a 500 Club member, Kwik Trip has seen their sales of healthier food items increase. Additional 500 Club members Along with Kwik Trip, the Gundersen Lutheran 500 Club program has achieved tremendous success at numerous food retailers throughout their Tri-state service region. The 500 Club is includes restaurants, grocery stores, vending companies, universities and school districts as members. There is no charge to the consumer or the food retailers who participate in the program. The 40-plus members include well-known names such as McDonald s restaurants. Members have reported 500 Club selections account for 10 to 15 percent of sales. Gundersen Lutheran Health System, La Crosse Fort HealthCare Slimdown Challenge sheds three tons plus Fort HealthCare recently challenged local workers to lose weight and improve their health by participating in the Slimdown Challenge. The 12-week challenge was open to employees of Fort Atkinson-based Fort HealthCare, Nasco, Spacesaver, Digi-Star, Cygnus Business Media and members of the Rock Lake Activity Center in Lake Mills. Eligible participants formed teams of four to six players, attended official weigh-ins and logged weights throughout the competition. The team with the highest percentage of weight loss at the end of 12 weeks won a $1,000 Visa gift card for each team member. The competition started with 182 teams and 962 players. When the challenge ended on April 9 at midnight, 685 participants completed the challenge by The Valued Voice -- 5/4/12 (continued on next page)

13 Wisconsin Hospitals Community Benefits (continued) weighing out. On average, each player lost about 10 pounds the equivalent of losing two full points on the BMI scale. The combined total weight loss was 6,504 pounds just over three and one-quarter tons. The Fab Four, a team from the Therapy & Sport program at Fort HealthCare was the winner. The team lost a combined percent of their body weight during the competition and dropped their total body mass index (BMI) from 33.6 to Heidi Pitzner, an obstetrics nurse at Fort Memorial Hospital was among the top ten in terms of body mass lost, having shed percent. I feel awesome with my results, she said. The support she had from her coworkers and Bridezilla teammates helped her to stay focused, and were, she said, her biggest asset. Exercise and a healthy diet were key. She attended a weekly cardio-kickboxing class and boot camp twice each week at the hospital. She also spent many hours exercising in the cardiac rehab department and stopped eating white carbohydrates while eating more fruits and vegetables. The biggest thing was watching portion sizes, she added. Her children helped, too, threatening to take pictures and send them to team members if she cheated. The Slimdown Challenge follows the very successful Rock the Walk Challenge, a step challenge that was open to select local employers in the fall of More than 600 people participated, walking 10,769 miles and averaging nearly 400,000 steps over six weeks. Fort HealthCare, Fort Atkinson SHS makes contribution to Washburn County Food Pantry Sue Adams, Director of the Washburn County Food Pantry, accepts a donation from Spooner Health System (SHS) employees Maggie Gada (L) and Cathy Parker (R). Maggie and Cathy along with Michelle Stone, Beth Novak and Sue Stariha worked together to organize a bake sale and jeans day at SHS to raise money for the local food pantry. Proceeds from the two events were matched by SHS and a total contribution of $650 was given to the Washburn County Food Pantry on February 28. The money will be used to purchase food items that will be made available to community members in need through the food pantry. Spooner Health System, Spooner Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org. Read more about hospitals connecting with their communities at The Valued Voice -- 5/4/12