Marotta Warns of Tough Times Ahead. Speak Up: Advocacy Toolkit in Packet. Obey Pushes House to Approve Medicare Stopgap Funding

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Noel Welch
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February 7, 2003 Volume 47, Issue 6 Marotta Warns of Tough Times Ahead As introduction of Governor Doyle s biennial budget looms ahead (February 18), this week Department of Administration Secretary

1 February 7, 2003 Volume 47, Issue 6 Marotta Warns of Tough Times Ahead As introduction of Governor Doyle s biennial budget looms ahead (February 18), this week Department of Administration Secretary Marc Marotta sounded the alarm bells on Medicaid. As reported in WisPolitics earlier this week, Marotta said, In order to balance this budget we will have to make some cuts in that (medical assistance) area....that will be something that we are going to have to address but at the same time making sure we protect the most vulnerable, try to make sure seniors are taken care of, try to make sure there are affordable drugs there and also to try and make sure we maximize what we get from the federal government to support those programs here. We have ranked very near the bottom in terms of states and the support they have gotten from the federal government. There will be some reductions in that area no question about it but we hope to make sure we are still providing the basic services we need to provide. For the past several weeks WHA staff and members have been communicating with the Doyle administration and expressing concerns over deep cuts in the Medicaid program and funding for medical education. Last week WHA s Steve Brenton and Eric Borgerding, Mary Starmann-Harrison and Tim Size, met with Secretary Marotta regarding several issues, including Medicaid, workforce funding and WHA s quality reporting project. Brenton and Borgerding will join other health care providers for a briefing by the governor before his budget is introduced on February 18. Obey Pushes House to Approve Medicare Stopgap Funding Continued on page 2 Rep. Dave Obey (D-7th CD) pushed the House of Representatives to approve Medicare payments to rural and small urban hospitals, increase home health payments and to stop a planned cut in payments to physicians as part of the short-term budget fix being negotiated between the House and the Senate. The increase in payments provides $79.7.million to hospitals, $19.2 million for rural home health agencies and stops the 4.4% cut in physician payments scheduled to take effect March 1. The measure was defeated on a party line vote of That vote does not mean the issue is dead as GOP leadership continue to fashion a larger budget compromise. The provisions are part of the omnibus budget package that was passed by the Senate and is part of overall negotiations to complete the legislative work for the fiscal year 2003 budget. Continued on page 2 Speak Up: Advocacy Toolkit in Packet By now, I hope you have visited the redesigned WHA Web site You can easily see that advocacy is at the forefront of WHA s focus and programming. An essential part of advocacy is taking the time to talk to elected officials about meeting the health care needs of our patients and our communities. The legislative process can seem daunting, but to make it easier and user friendly, WHA developed the Grassroots Toolkit. The toolkit is designed to give you, your staff, volunteers and trustees essential information that will help facilitate contacts with elected officials. Using this toolkit, along with the latest information and position papers on the Web site and the Speak Up section, you have all the tools you need in one spot to make rapid, quality contacts with state and federal legislators. The toolkit is in the packet and is available on the WHA Web site, or you can contact Ann Lucas, alucas@wha.org for additional copies and for assistance in developing your grassroots advocacy team. Jerry Worrick --WHA Chair Board Chair: Gerald Worrick Door County Memorial Hospital Editor: Mary Kay Grasmick, V.P. Communications - mgrasmick@wha.org 5721 Odana Rd P.O. Box Madison, WI P ( ) F ( ) wha.org

2 Continued from page 1: Marotta Warns of Tough Times Ahead It seems this administration will try hard to shield MA from cuts, but it will be a difficult task in the face of a $3.2 billion deficit, said Eric Borgerding. After the budget is introduced on February 18, our lobbying focus will shift to the Joint Committee on Finance and that s when we will also start to kick-in with our grassroots effort. Borgerding said. WHA s April 8 Advocacy Day program in Madison could be one of the most important ones ever. Marotta said job cuts at agencies will be done as humanely as possible but that the cuts would be unprecedented. Said Marotta: I think that by looking at people who are on the verge of retirement, hopefully they will have some incentives to move into retirement, as well as looking at vacancies. There are a fair amount of vacancies right now....our hope is to try and not fill vacancies, so we would eliminate positions that are currently vacant. Sometimes that doesn t always match up with needs, though, so that is the issue. Continued from page 1: Obey Pushes House to Approve Medicare Stopgap Funding I made an effort to give Wisconsin a better deal on Medicare reimbursement. We would have increased the rural hospital reimbursement rate and avoided the 4.4% cut in the payments that Medicare makes to doctors and patients, said Obey. We know the Wisconsin delegation is supportive of increasing Wisconsin s share of Medicaid reimbursements, said Steve Brenton, WHA President. We applaud Congressman Obey s effort which makes a real difference to many of our hospitals, home health providers and physicians. Reports from Washington as we go to press indicate the House may complete its work by Monday, February 10 and move to a floor vote by the end of next week. If not, Sen. Ted Stevens (R-Alaska) has suggested he will move for a continuing resolution for the balance of the fiscal year, and stop trying to pass this omnibus bill. Jensen Joins WHA Government Relations Team WHA is pleased to announce that Jodi Jensen will become newest member of the WHA Government Relations team. Jensen will serve as the Vice President of Government Relations starting Monday, February 10. Jensen comes to WHA from Alliant Energy, where she served over four years as Manager of Public Affairs. Prior to that, Jensen was a policy advisor to Assembly Majority Leader and Joint Finance Committee Vice Chair Steve Foti (R-Oconomowoc). Jodi is a veteran Capitol lobbyist and will be a great addition to our team, said WHA Senior Vice President Eric Borgerding. She comes from the complex, consumer focused and heavily-regulated world of utilities, an issue sphere that is in many ways similar to health care. She will hit the ground running and have an immediate impact for us. Jensen graduated Cum Laude from the University of Wisconsin Law School in 1995 and holds a BA in Journalism and Sociology from UW-Madison. The Valued Voice -- Page /7/2003

President s Message Earlier this week, the American Hospital Association (AHA) cautiously praised the Bush Administration s health care budget recommendations, noting that the budget blueprint

3 President s Message Earlier this week, the American Hospital Association (AHA) cautiously praised the Bush Administration s health care budget recommendations, noting that the budget blueprint appears to have rejected specific cuts to the Medicare program. That commentary, based on budget narratives as opposed to real numbers, may have been premature. Reports now filtering out of Washington, D.C. suggest that the Administration s Medicare reform plan will propose fixing the flawed physician fee schedule (at a cost of as much as $40 billion over the next decade) by slashing Medicare payment to other providers, including hospitals, by a nearly equal magnitude. While specific details have yet to emerge, the Administration may adopt many of the fiscal 2004 payment recommendations proposed in January by the Medicare Payment Advisory Commission (MedPAC). MedPAC recommendations will be well represented in the so-called reform proposal according to an anonymous Administration official. Physician organizations are already praising the Bush Administration s tilt toward fixing physician payment problems. With today s action, President Bush acknowledges that America s seniors should not pay for the government s mistakes, according to the American Medical Association in a February 3 statement. But other provider groups appear to be confused by the fact that the absence of specific provider payment cut initiatives in the Bush Administration budget narrative may actually emerge as unacceptable payment cuts when the actual budget proposals are released. Unfortunately, what this all means is that in addition to playing offense this year on much needed Medicare payment equity and adequacy issues WHA and other groups and organizations may also need to champion the position of first do no harm as a necessary theme to defeat new cuts. Steve Brenton President That commentary, based on budget narratives as opposed to real numbers, may have been premature. SPEAK UP! Plan to Attend WHA Advocacy Day April 8 Bring Employees, Trustees, and Volunteers: Registration is in the Packet and on the Web site Make plans now to attend WHA s Advocacy Day April 8 in Madison. We can, and we do, make a difference when we speak with a unified voice for hospitals. We proved it in the last legislative session, and this year we will be back at it again. The timing couldn t be better. The legislative committees will be considering the budget and other issues important to hospitals. Armed with up-to-the-minute information and briefings from political experts, you ll be well prepared to trek to the Dome and meet with your legislator. Advocacy Day is a key event for Wisconsin hospitals. It is an opportunity to improve our grassroots effectiveness, while learning about the issues that will shape the future of health care delivery in Wisconsin. Gov. Jim Doyle has been invited to speak, and a number of legislators will share their perspectives on health care issues. In the afternoon, WHA government relations staff will hold an issue briefing preceding member visits with their legislators. WHA will schedule the visits for member hospitals to ensure that we meet with as many legislators as possible on April 8. Again this year, WHA will present an Advocacy Award to the hospital that has demonstrated a keen understanding of and dedication to grassroots advocacy. Last year, the Blue Dog Express from St. Joseph s Hospital in Chippewa Falls took the prize. Tthis year the competition will be keen as more and more hospitals gear up for and participate in the legislative process. Registration materials are in the packet and on the Web site. For more information contact Jennifer Frank or at jfrank@wha.org or contact Bridget Gifford at or at bgifford@wha.org.. The Valued Voice -- Page 3 --2/7/2003

4 Hospital Week: May 11-17, 2003 Theme: Bringing the Power of Care to the Community Information packets are in the mail to AHA member hospitals. If you do not receive a packet by mid-february, contact THA-Bells Select at The AHA is continuing its relationship with the Texas Hospital Association to distribute Hospital Week material. Program Provides Tools to Write Grants That Produce Results Whether you re a novice or experienced grant writer, attending WHA s educational seminar Grant Writing 101 and Beyond will sharpen your skills and improve your understanding of the grant making process. Learn from those who know - the workshop presenters write, review and award grants regularly. Additionally, learn about grant opportunities at both the federal and state level to help improve health funding for Wisconsin communities. Ultimately, attendees will leave this workshop armed with the knowledge to prepare more competitive grant proposals. The seminar will be held on March 19 from 9 am to 3 pm at Hotel Mead in Wisconsin Rapids. A brochure and registration form are included in this week s packet and on the Web site at On-line registration for this program is also now available on the WHA Web site. This program is co-sponsored by the Wisconsin Hospital Association, the Wisconsin Office of Rural Health, Wisconsin Primary Health Care Association, and the Rural Wisconsin Health Cooperative. For more information on the program content, contact Jennifer Frank at or at jfrank@wha.org. For registration questions, contact Bridget Gifford at or at bgifford@wha.org. Education Offered on Chargemaster Maintenance Remember to mark your calendar for the 2003 Challenges for Chargemaster Maintenance education seminar scheduled for March 11 in Stevens Point. This program focuses on updating your chargemaster for the 2003 reporting requirements, new APC strategies, and new chargemaster opportunities to keep you in the know for CPT and HCPCS coding revisions. This is a must-attend event for chargemaster/apc coordinators, coding staff and for all those with responsibility for charge generation processes. The seminar will be held on March 11 from 9 am to 4 pm at Holiday Inn in Stevens Point. A brochure and on-line registration are now available on the web site at The American Health Information Management Association (AHIMA) has approved this seminar for six (6) continuing education hours. For more information on the program content, contact Jennifer Frank at or at jfrank@wha.org. For registration questions, contact Bridget Gifford at or at bgifford@wha.org. The Valued Voice -- Page /7/2003

5 Major Changes Coming to JCAHO Accreditation Process Upcoming changes to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation process, effective January 1, 2004, were the focus of two recent education seminars hosted by WHA. Following are key changes that will be occurring in the JCAHO accreditation process, according to Mark Crafton, JCAHO s Director of State Relations. All of the current JCAHO standards have undergone an extensive review. Standards that are not currently scored or are scored elsewhere will be eliminated. This will reduce the current 1,352 standards down to 508. The 2004 standards will have a new format that removes the intent statement if the statement is not scored, and instead provides a rationale. There will be no new standards added. The Organization Self-Assessment process will be required for all organizations that are scheduled for an on-site survey in July 2005 and beyond. The Organization Self-Assessment survey will be available 15 months after the previous on-site review date and must be completed within three months. This survey will be available for data entry on the web. The survey process will be modified to focus on the issues most relevant to patient safety and quality of care for each health care organization being surveyed. The Priority Focus Process will use pre-survey data from JCAHO (QMS, ORYX core measures), data supplied by the health care organization (e-application, self assessment survey), and publicly available data (MedPar) to determine focus areas. The on-site survey will now follow the Tracer Methodology instead of the ICE method. This approach traces a number of patients through an organization s entire health care process. There will be a single survey process for complex organizations defined as those that currently use standards from at least two JCAHO accreditation manuals. These organizations will now have one survey that is customized to their areas of accreditation. This will replace the tailored survey. The post survey scoring process will change to a three-point scale. There will be no health care organization or public access to the actual scores. The surveyor will leave a final report on-site, so organizations will no longer have to wait for the report. Each standard will be either compliant or not compliant. The health care organization will have 30 days to send evidence of standards compliance for all standards identified as not compliant. During this 30 day time period, the health care organization maintains its current accreditation status. If no evidence of standards compliance is submitted within the 30 days, the organization will move to a Provisional Accreditation status. This status replaces the category Accredited with Recommendations for Improvement and can be disclosed. The final accreditation decision will be made after JCAHO receives and approves the evidence of standards compliance and measure of success. To obtain the Accredited status, 100% of the standards must be in compliance. The presentation used for the recent seminars, as well as a wealth of other information about the Shared Visions-New Pathways changes, can be viewed on the JCAHO web site through the following link: You can contact Mark Crafton of JCAHO ( or mcrafton@jcaho.org) or Dana Richardson of WHA ( or drichardson@wha.org) for questions not addressed by the JCAHO web site. A video about the upcoming changes and highlighting the new tracer methodology will be available from JCAHO in late February. Watch for more information from WHA on how to access this helpful tool. Additionally, WHA is considering repeating this seminar later in 2003, based on member need. If your organization may be interested in attending, please contact Jennifer Frank of WHA at or jfrank@wha.org. The Valued Voice -- Page /7/2003

6 Updates to the Wisconsin UB-92 Billing Manual Now Available Adding value through well-advised financial solutions. Updates to the Wisconsin UB-92 Billing Manual have been finalized for 2002 and the update supplements and/or revised manuals are now available through WHA Financial Solutions, Inc. As an annual member benefit, a copy of the update supplement has already been sent to each WHA member chief financial officer. Additional supplements or full manuals can be ordered through the WHA Financial Solutions web site at The Wisconsin State Uniform Billing Committee (SUBC) is responsible for the contents of the Wisconsin UB-92 Manual. This committee, which is comprised of a broad cross section of payers and providers, has reviewed the National Uniform Billing Committee revisions to the UB-92, as well as state-specific requirements, in order to update the Wisconsin UB-92 Manual. SUBC makes manual updates at the end of a calendar year. It is important that payers and providers doing business in Wisconsin or any other states who have United Government Services as their fiscal intermediary follow the Wisconsin UB-92 manual requirements. For information on ordering 2002 updates or full manuals, contact Lisa Marcinkus at or via lmarcinkus@wha.org. For UB-92 technical issues, contact Brian Potter at or bpotter@wha.org. Member News Hoover Resigns from Orthopaedic Hospital of Wisconsin David Hoover, CEO, Orthopaedic Hospital of Wisconsin in Glendale, has resigned effective the end of February. He has accepted a position with National Surgical Hospitals in Chicago where he will help develop and operate physician-owned surgical specialty hospitals for that system. Hoover has been a member of the WHA Public Policy Council and HFS 124 Rewrite Task Force. Mueller Chief Operations Officer for Roger s Oconomowoc Campus Paul Mueller, MSW, who most recently served as V.P. of Marketing at Rogers Memorial Hospital, has accepted the Chief Operations Officer position for Roger s Oconomowoc campus. He will oversee all aspects of the Oconomowoc hospital s operations, which includes inpatient, partial and residential treatment programs for children, adolescents, adults and older adults. Pinzer Joins the Media Relations Team of Aurora Health Care for the Metro Region Steven C. Pinzer has joined the media relations team of Aurora Health Care for the Metro Region. As part of the Business and Market Development Department, he will oversee the region s media and community relations efforts and will be headquartered at St. Luke s Medical Center in Milwaukee. Position Available Sauk Prairie Memorial Hospital and Clinics is seeking a Human Resource Director to manage the human resources, education and employee health departments. This position is responsible for recruitment, benefits, payroll, employee health and education. Must be able to advise and counsel directors and supervisors regarding employee relations issues, ensure compliance with applicable state and federal regulations, provide strategic short and long term planning and establish ongoing policies and procedures in accordance with state and federal agencies. A bachelor s degree in human resources, 10 years health care human resource experience (hospital preferred), and five years of management experience required. Send resume along with salary requirements to: Sauk Prairie Memorial Hospital & Clinics, Human Resources, 80 First Street, Prairie du Sac, WI 53578, Fax , careers@spmh.org Web site: The Valued Voice -- Page /7/2003

Joint Finance Takes First Crack at Medicaid Budget Sen. Olsen, others pose tough questions on cigarette tax, provider payments and cost shifting

April 1, 2005 Volume 49, Issue 13 Joint Finance Takes First Crack at Medicaid Budget Sen. Olsen, others pose tough questions on cigarette tax, provider payments and cost shifting On Wednesday, March 30,