April’s WHA headlines:

1. Nearly 700 RSVP’d for Advocacy Day
2. CMS promotes coverage with texting service
3. 3 new Wisconsin ACOs
4. Medicaid waiver changes
5. Why patient satisfaction and quality don’t always line up

Each month, in addition to marketing and communications posts, we will be exploring new issues impacting Wisconsin’s hospitals and health systems. In partnership and orientation with the Wisconsin Hospital Association (WHA), this blog will feature headlines and hot topic issues concerning Wisconsin hospitals, clinics and organizations. Here, you’ll read about information on new legislation, hospital measurement and performance initiatives and the tools and resources you need to understand and manage today’s current, complex and controversial health care issues. We look forward to bringing you this information!

1. Nearly 700 RSVP’d for Advocacy Day in Madison

On April 24, nearly 700 Wisconsin hospital employees, trustees and volunteers will come together to talk personally with their legislators by taking part in WHA’s Annual Advocacy Day at Monona Terrace in Madison.

WHA’s Advocacy Day is an annual legislative event designed to motivate, involve and educate health care employees, volunteers and trustees on health-related issues and grassroots advocacy opportunities.

Eric Borgerding, WHA executive vice president said in a recent video this event is more than just a showing of support. “Advocacy Day allows health care leaders to talk personally with policymakers and legislators on the most important issues affecting your hospital right now,” said Borgerding.

There is no fee but participants must register to attend Advocacy Day. WHA encourages and invites hospital CEOs, CFOs, managers, nurse executives, public relations professionals, WHPRMS members, volunteers, trustees, WHA HEAT grassroots members, Partners of WHA members, WHA corporate members, and other hospital staff interested in helping to shape the future of health care in Wisconsin communities to attend.

To register, CLICK HERE.

CMS to promote health coverage through texting service for new moms

In February, The Centers for Medicaid and Medicaid Services (CMS) partnered with a new text messaging service to promote health information and enrollment in Medicaid and the Children’s Health Insurance Program to pregnant women and new mothers. The free Text4Baby service provides health information over mobile devices.

Marilyn Tavenner, CMS acting administrator, said in a recent article, “Text4Baby users will be alerted to the availability of health insurance options, and we are encouraging our partners and other organizations working to help get children enrolled in health coverage to make sure that new moms know how to sign up with Text4Baby for all kinds of health tips and reminders.”

Three new ACOs in Medicare Shared Savings Program

On April 10, The Centers for Medicare and Medicaid Services announced it had selected 27 new health organizations to participate in its Accountable Care Organization (ACO) program, the Medicare Shared Savings program, including one organization in Milwaukee.

Three Wisconsin health systems and one physician group now participate in federal ACO models.

The Accountable Care Coalition of Southeast Wisconsin, LLC formed in partnership between Independent Physician Network, Inc. (IPN) and Collaborative Health Systems (CHS). CHS will partner with seven other organizations in other states as well, and will provide various administrative services, including care coordination, analytics and reporting, and technology. IPN was established in 1984 and has grown to include more than 900 member physicians who serve more than 130,000 patients in southeastern Wisconsin. This ACO is expected to serve 10,000 beneficiaries.

CMS received a lot of negative feedback from the ACO rules it first proposed last year. To address some of the criticism and concerns, the agency created two other ACO models in addition to the Medicare Shared Savings Program.

Earlier this year, CMS announced the participants in the Pioneer ACOs and two of those are in Wisconsin: Allina Hospitals and Clinics and Bellin-ThedaCare Healthcare Partners. The Pioneer ACO was an option for organizations with experience offering coordinated, patient-centered care, and operating in ACO-like arrangements. In the first two performance years, the entity will receive a fee-for-service payment, but it will have higher levels of reward and risk than in the Shared Savings program. In year three, these hospitals have to show savings over the first two years. They are then eligible for a “population-based” payment model. This would then replace some or all of the ACO’s fee-for-service payments with a prospective monthly payment. Pioneers also had the opportunity to suggest alternative payment arrangements in their applications.

What is the advance payment program?

This program is available for ACOs and includes only critical care hospitals and/or Medicare low-volume rural hospitals and that have less than $80 million in total annual revenue. These ACOs will receive advanced payments to help offset their up-front costs. These payments would have to be paid back to the federal government from any savings generated by the program. No Wisconsin hospitals were chosen at this time.

For more information, CLICK HERE.

DHS wants to modify its modified changes to the Medicaid waiver

In March, The Department of Health Services (DHS) announced it is looking to further modify its Medicaid waiver. DHS wants to implement sliding scale premiums from 3% to 9.5% of household income for nondisabled, non-pregnant adults making between 133 and 400% of the federal poverty level.

The department originally went for a 5% flat premium for families above 150% of the poverty level. But after negotiations with CMS, it changed that to a sliding scale premium starting at 3% of income for adults making 133% of the federal poverty level up to 6% for adults at 200%. They also removed children from the mix and backed down on plans to eliminate the Transitional Medical Assistance (TMA) Program.

Secretary Dennis Smith noted in a letter to the state’s budget committee (via Wisconsin Health News) that because a TMA case may be eligible at income levels exceeding 200% federal poverty level, we propose to adjust the sliding premium scale upward.

Study finds patient satisfaction and quality don’t always line up

Hospitals with consistently low performance measure rankings also received a thumbs down in patient satisfaction, according to a study published online April 10 in Circulation: Cardiovascular Quality and Outcomes. Authors of the study say that without understanding the factors that contribute to poor performance, value-based initiatives may make problems at these hospitals worse and impact care in a negative way.

Researchers at University of Iowa Hospitals and Clinics and colleagues looked at Hospital Compare 2006 to 2008 data for acute myocardial infarction and heart failure process measures, as well as Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) 2008 data to compare hospitals. Low-performing hospitals tended to have fewer beds, fewer nurses per patient and were more likely rural hospitals in the South.

Makes sense, right? A low performing hospital would have low patient satisfaction. But the study also found that 61% of patients (at a cardiac hospital) said they would recommend a low performance hospital. In addition, nearly 40 percent of the low-performing heart failure hospitals were in the top half of patient satisfaction ratings, and 40 percent of the top-performing hospitals were in the bottom half.

If hospitals and health organizations can learn to better understand the factors associated with poor performance (such as organizational values and communication as well as their community benefit and patient options) there could be a better match up between quality and patient satisfaction scores.

As marketers and communicators, it’s our job to understand that our patients consider many different factors when making decisions about or surveying our hospital.

To read the full study, CLICK HERE.

Feel free to connect Trish Skram on my Facebook page at Trish Skram “PR Gal” or on LinkedIn.