THE VALUED VOICE

The WHA Physician Leaders Council meeting on Sept. 22 featured discussion of topics including WHA’s physician leader education programming, emerging insurance denial trends impacting patient care, continuing skilled nursing facility (SNF) availability challenges for hospitals, provider licensure delays, hospital impacts of the Fort McCoy Afghan populations, Wisconsin Medical Examining Board rulemaking and the latest COVID-related issues impacting Wisconsin.
 
The meeting was kicked off by new WHA Physician Leaders Council Chair William Melms, M.D., chief medical officer for Marshfield Clinic Health System. 
 
Council members shared and discussed concerns about rising insurance denials for inpatient services and transfers to sub-acute facilities, as well as an insurance practice called “white bagging.” WHA Senior Vice President of Public Policy Joanne Alig discussed the significant safety concerns that white bagging poses for patients with conditions such as cancer, multiple sclerosis, Crohn’s disease or other conditions for which the patient’s medication needs to be administered by a clinician. According to a recent report from Vizient, 83% of hospitals surveyed said that specialty medications delivered to them for patient administration through this process did not arrive on time, and another 66% of hospitals said that they have received the wrong dose.
 
Finding skilled nursing facility placement for patients ready to be discharged from the hospital continued to be a significant concern for chief medical officers on the council, particularly as hospitals manage hospital capacity during the current COVID surge. WHA staff highlighted WHA’s post-acute care advocacy work, and council members shared some local efforts to manage hospital capacity.
 
WHA Senior Vice President of Workforce and Clinical Practice Ann Zenk discussed recurring challenges that hospitals continue to experience related to processes for health care providers seeking to become newly licensed in Wisconsin. Zenk highlighted recent interactions and communications with the Wisconsin Department of Safety and Professional Services (DSPS) that have resulted in a new commitment by the department to prioritize health care provider licenses.
 
Zenk then outlined the strategies WHA is pursuing to sustain the long-term strength of the state’s health care workforce, including making 2010 Wisconsin Act 10 licensure provisions more visible to applicants and employers, working with DSPS on a software conversion to streamline health care licensure and creating better connection and understanding of the licensure challenges between DSPS and WHA members. 
 
Council members also shared current impacts on hospital capacity related to the arrival of over 13,000 Afghan refugees currently housed at Fort McCoy. Zenk discussed WHA’s regular meetings with federal and state officials focusing on coordination and capacity of medical care for the refugees currently housed at Fort McCoy. 
 
WHA General Counsel Matthew Stanford provided an update on a rulemaking effort at the Wisconsin Medical Examining Board to require an additional chaperone for certain sensitive medical examinations. The council shared concerns that such a requirement would exacerbate current health care workforce shortages, add new unnecessary and unreimbursed expenses to clinics and other facilities and lead to fewer examinations of sensitive areas, resulting in less complete examinations. One physician leader expressing such concerns said, “We need to keep on top of this issue.”
 
Lastly, Stanford and WHA Vice President of Education and Marketing Leigh Ann Larson sought input from the council on future WHA physician leader education programming. A particular focus was on the WHA Physician Leadership Development Conference, which because of COVID precautions, shifted entirely to a virtual format for 2021. 
 
To help guide future plans for the WHA Physician Leadership Development Conference and other WHA physician-focused education, council members discussed their thoughts on virtual versus in-person education programs for physician leaders, and what elements of WHA’s physician leader focused education provide the greatest value to members.