At the Wisconsin Hospital Association (WHA) Board of Directors meeting on Dec. 14 at the WHA Headquarters in Madison, WHA President and CEO Eric Borgerding reviewed the association’s 2023 goals and outcomes highlighting its policy and advocacy work and member engagement throughout the year. Borgerding called special attention to the coverage WHA’s 2023 Workforce Report received with lawmakers and the media, policy progress made in post-acute care, like establishing a next-of-kin priority legislation and ongoing advocacy tactics that have thus far stopped state-level hospital price transparency legislation.
Borgerding reviewed WHA’s 2023-2025 State Budget advocacy and emphasized working hand-in-hand with members “to deliver one of the best state budgets for health care in recent memory.” He also recognized Rep. Mark Born (R-Beaver Dam), WHA 2023 Health Care Advocate of the Year, for championing hospitals in the state budget.
Borgerding thanked members for their strong engagement with WHA in 2023 participating in advocacy trips to Washington, D. C., participating in WHA’s grassroots program HEAT and returning to Madison for WHA’s first in-person Advocacy Day since 2019.
WHA Board Chair, CEO of Vernon Memorial Hospital David Hartberg, also recognized WHA’s 2023 accomplishments specifically calling out WHA’s messaging campaign,
Stronger Hospitals, Stronger Communities, which sought to reinforce the important role hospitals play in their communities and “the association’s strong advocacy work in the state budget that brough much-need health care funding to our hospitals and health systems.”
The WHA Board was pleased to welcome Wisconsin Department of Health Services (DHS) Deputy Secretary Deb Standridge to present the recently released study of the long-term care system in Wisconsin, which was prepared for DHS by the consulting firm Baker Tilly.
DHS Deputy Secretary Deb Standridge presented at WHA’s Dec. 14, 2023 board of directors meeting.
Standridge outlined some of the limitations of the study, including that the effect of the historic rate increases for nursing homes over the last several years is still unknown. Standridge summarized the key findings of the study, which underscored the existing challenges associated with care transitions that lead to delayed discharges from hospitals. The report found that the state lacks appropriate placement options for the increasing number of complex patients, adding to the estimated 5-7% of hospital days that are excess days due to delayed discharges, which Standridge said she believes is a low estimate. The report noted the excess days result in delayed surgeries, pressure on emergency departments and staff burnout, among other concerns.
Standridge discussed the nursing home bed cap that was established in the early 1980s and the regional and specialty bed shortages. Adding to the capacity challenges, the report found that the state will need more than 12,000 additional assisted living facility beds by 2027. Standridge cited the report’s findings that the discharge delays are also related to Medicaid application process issues, guardianship challenges and the increasing demand for post-acute care.
Standridge emphasized the need for both the private and public sectors to invest in and support the long-term care workforce, such as through staff pooling, expanding telehealth and remote patient monitoring, and adopting other labor-saving technologies. Board members thanked Standridge for DHS’s support of the “grow your own” training grants.
Board members discussed local units of government reducing or eliminating behavioral health and post-acute care services even though the demand is intensifying, and local governments received large increases in shared revenue from the state. Standridge discussed the need for accountability and DHS’s plan to bring the interested parties together to work on solutions.
Borgerding thanked Standridge for the overview and agreed, “There must be accountability in both the public and private sectors. Organizations are too often walking away from the challenges, putting the onus on their community hospitals to find workable options.”
AHA Deploying Communications Strategies to Combat Negative Rhetoric
The American Hospital Association (AHA) Senior Vice President of Communications Alicia Mitchell joined the meeting virtually to share insights on the messaging campaigns AHA is deploying to combat negative rhetoric toward hospitals at the national level. Mitchell described, “While polling shows high favorability among the public toward hospitals, many outside groups are attacking hospitals to advance their own agendas.”
The AHA, along with The Coalition to Protect America’s Health care of which AHA is a founding member, have ramped up communications and fundraising for paid advertising, video production and research. They have compiled resources to assist hospitals and health systems tell their stories and push back in their own local markets. Mitchell encouraged board members to engage by amplifying AHA and coalition messaging.
WHA Staff Updates Board on State and Federal Advocacy, Quality Initiatives
WHA Senior Vice President of Government Relations Kyle O’Brien updated the WHA Board on the association’s continued advocacy to push back against legislation that would create duplicative state-level regulations on hospitals related to hospital price transparency. O’Brien stated that besides lobbying and in-district meetings with lawmakers, WHA is publicly responding (see
Borgerding: Hospital price transparency critics omit facts) to opinion pieces that are inaccurately portraying hospital compliance with federal price transparency regulations.
O’Brien also discussed WHA’s response to digital ads being put up in legislative districts by Patient Rights Advocate and Wisconsin Manufacturers & Commerce (WMC) in a
Nov. 20, 2023 memo to the state Legislature. In the memo, WHA lays out a clear counter to incorrect claims that hospitals are not compliant with federal price transparency regulations.
O’Brien also updated the Board on various pieces of legislation from WHA’s proactive agenda that are making their way through the legislative process right now. These bills include a reform to the state’s graduate medical education grant program and a bill that directs state health officials to pursue a waiver of the federal Medicaid institute for mental disease exception. O’Brien said both pieces of legislation are expected to finally pass the Assembly and Senate in early 2024.
WHA Vice President of Federal and State Relations Jon Hoelter gave a brief update on activity at the federal level. On Dec. 11, the U.S. House of Representatives passed legislation that WHA has been focusing its advocacy efforts against all year that would require site-neutral payments for drug administration services furnished at off-campus hospital outpatient departments. Hoelter said the good news is that the Senate has not yet passed any legislation that contains similar cuts to hospitals, so WHA’s advocacy efforts will now shift focus to the Senate, hoping to prevent such legislation from becoming law.
WHA Chief Quality Officer Nadine Allen reviewed the quality improvement team’s accomplishments from 2023, including the increased engagement from members on quality initiatives, the launch of a member recognition quality and patient safety awards program, enhancements to the CheckPoint website and the increased amount of external funding secured for future initiatives (a 31% growth over 2022). The team will continue to support improving measures that are publicly reported by CMS as part of the CMS Star Ratings and Value-Based Purchasing programs.
In 2023, the WHA Information Center (WHAIC) proudly celebrated their 20th anniversary marking a successful year as a trusted partner of the State. A significant accomplishment was the complete rewrite of the 20-year-old data collection tool, WIPop, enhancing the user experience. Logins are streamlined across applications, providing a seamless experience for users. Data quality saw improvements in enhanced payer detail differentiation and expanded race, ethnicity, and language data collection. WHAIC launched the WHA Member Directory app and collaborated on a psychiatric bed locator tool, adding checklists and dashboards. The inaugural WHA-WisHHRA Salary Survey was successful with 123 hospital participants. Privacy and security remains paramount, culminating in a successful security risk assessment. Looking ahead to 2024, WHAIC plans to rewrite WHAIC Survey Applications, roll out year two of the salary survey, and explore incorporating data science, AI and predictive analytics into their tools and analytics. WHAIC is committed to supporting WHA and our members in every possible way.