August 12, 2016 Volume 60, Issue 32 WHA Sponsors WisconsinEye Candidate Interviews WisEye Election Coverage 2016 features hundreds of interviews, full election coverage With the primary results in, the field has now narrowed and Wisconsin’s November 8 general election is just three months away. To help educate the public on the candidates running for office statewide, WisconsinEye, our state’s version of C-SPAN, has launched a free video player providing the state’s most extensive coverage of Wisconsin legislative races. To help support this important public service of WisconsinEye, the Wisconsin Hospital Association (WHA) is sponsoring WisconsinEye’s 2016 candidate interviews. Watch the interviews here: www.wiseye.org “For nearly 100 years, WHA has been an advocate of high- quality health care in Wisconsin. Decisions are made every day in the state capitol that affect how many doctors and nurses we will have, about public policy that affects access to our high-quality care and whether the state will transfer the cost of government health care programs onto families and employers,” WHA President/CEO Eric Borgerding says in a recorded introduction posted on the online player. “It’s important WHA President/CEO Eric Borgerding provides that we know where the candidates stand on important issues a sponsor message on wiseye.org such as health care. That is why WHA is proud to sponsor WisconsinEye’s coverage and interviews with all candidates for elected office.” (To watch Borgerding’s intro, go to www.wiseye.org/mp4stream/SPN/SPN_160717_WHA%202.mp4.) (continued on page 6) Primary Elections Set Stage for State and Federal Races Marquette Law School Poll: Clinton 46%, Trump 36%; Feingold 49%, Johnson 43% Candidates in select congressional and state legislative districts across Wisconsin faced off in a primary August 9 to represent their party in the upcoming November general election. Meanwhile, the Marquette University Law School released its latest poll results following the Democratic and Republican national conventions. Details on this latest poll and a recap of the primary results are below. Congress - Wisconsin In the state’s most competitive Congressional primary, the 8th Congressional District to replace retiring Rep. Reid Ribble—Mike Gallagher, a former adviser to Gov. Scott Walker, garnered nearly 75 percent of Republican primary voters. Gallagher will now face off in the general election against his Democratic opponent, Outagamie County Executive and former state Assembly Majority Leader Tom Nelson in the November 8 contest. Wisconsin State Senate In the state Senate, two Republicans faced off in the 18th Senate District to replace retiring Sen. (continued on page 6) Board Chair: Mike Wallace, President/CEO, Fort HealthCare Editor: Mary Kay Grasmick, VP Communications - [email protected] 5510 Research Park Drive P.O. Box 259038 Madison, WI 53725-9038 P (608.274.1820) F (608.274.8554) www.wha.org Political Action Spotlight WI Hospitals State PAC & Conduit Campaign Tops $200,000 Full contributor list to run in August 19 Valued Voice With the primaries now behind us, the 2016 Wisconsin Hospitals State PAC & Conduit campaign moves into the general election with over $200,000 of its $300,000 goal. This puts the 2016 campaign at over 67 percent of its aggressive $300,000 goal for this year. A total of 235 individuals have contributed to date, which is up 32 contributors from this same time last year. “As WHA Advocacy Committee chair, I strongly encourage everyone to consider participating in the 2016 Wisconsin Hospitals State PAC and Conduit campaign,” said Therese Pandl. “This is an extremely important election year, and as individuals we can collectively come together and make a difference in who will be making policy in Madison next year.” In this pivotal year, remember that elections matter and participation is important. “As a health care leader, I believe it is my personal obligation to get involved in the advocacy process, and that includes our political process,” said John Russell. “I believe a contribution to the Wisconsin Hospitals State PAC and Conduit is an important way for individuals to support candidates for state office who value the role of hospitals and health systems in Wisconsin.” The next contributor list for the 2016 campaign will run in the August 19 edition of WHA’s Valued Voice newsletter. Make sure you are on the list by making your contribution today at www.whconduit.com or by contacting Jenny Boese at 608-268-1816 or [email protected] or Nora Statsick at 608-239-4535 or [email protected]. WHA to Lead September 13 Washington DC Fly-in Topics: Medicare, HOPD The Wisconsin Hospital Association will staff and lead a group of Wisconsin hospital representatives to Washington, DC September 13 in conjunction with the American Hospital Association (AHA) Capitol Hill fly-in. Key topics to be discussed include the need to legislatively correct a change to off-campus provider-based hospital outpatient departments (HOPD) and problems for HOPDs with the Centers for Medicare & Medicaid Services proposed Outpatient Prospective Payment System rule. “The Wisconsin Hospital Association continues to urge Congress to fix issues it created last year under the Bipartisan Budget Act of 2015, which is negatively impacting certain HOPDs,” said WHA President/ CEO Eric Borgerding. “We are traveling to Washington, DC to make sure our Delegation continues to understand the urgency of correcting this issue in the fall.” WHA will schedule and coordinate all Hill meetings. If you are interested in participating in the September 13 Washington, DC fly-in, contact Jenny Boese, WHA vice president, federal affairs & advocacy, at [email protected] or 608-268-1816. Details on the AHA trip can be found at: https://www.surveymonkey.com/r/GHYDW77. The Valued Voice -- Page 2 -- 8/12/16 Register today for WHA Webinar Focused on MACRA On August 25, WHA is hosting a Member Forum webinar, “MACRA—Implementation of the Merit-based Incentive Payment System (MIPS).” This webinar will provide an overview of MIPS that is proposed in the new Medicare Access and CHIP Reauthorization Act (MACRA), scheduled to affect provider reimbursement beginning in 2019. Hospital quality managers, chief financial officers and chief medical officers are encouraged to participate. The one-hour complimentary webinar will include overviews of MACRA and MIPS; identify the providers to which MIPS applies; and discuss the MIPS measure categories, including quality, resource use, advancing care information and clinical quality improvement activities. Register today at: https://events.signup4.net/16MACRA-MIPS0801. This complimentary webinar is open to all WHA hospital and corporate members, but pre-registration is required. An audio recording of the webinar will be available after the event, but you must pre-register to receive the recording. Content questions can be directed to Kelly Court at [email protected]. Registration questions can be directed to Kayla Chatterton at [email protected]. CMS Final IPPS Rule for 2017 Issued The Centers for Medicare and Medicaid Services (CMS) has issued its inpatient prospective payment systems (IPPS) final rule for fiscal year 2017. The final rule will be published in the Federal Register August 22 and take effect October 1. WHA will provide a more detailed analysis soon, which can be found on the WHA website at www.wha.org/pps_inpatient.aspx. Here are some key points from the 2,434-page CMS final IPPS rule for 2017. • Under the final rule, acute care hospitals that report quality data and that are meaningful users of electronic health records (EHRs) will receive a 0.95 percent increase in Medicare operating rates. • Hospitals that do not submit quality data would lose a fourth of the market basket update (2.7 percent), and hospitals that are not meaningful users of EHRs will be subject to a three-fourths reduction of the market basket update in FY 2017. • CMS arrived at its proposed rate of 0.95 percent (again, which only would apply to hospitals that report quality data and attest to meaningful use) through the following updates: a positive 2.7 percent market basket update, a negative 0.3 percentage point update for a productivity adjustment, a negative 0.75 percentage point update for cuts under the Affordable Care Act, a negative 1.5 percentage point documentation and coding adjustment as part of the American Taxpayer Relief Act of 2012 and an increase of approximately 0.8 percentage points to remove the adjustment to offset the estimated costs of the two-midnight rule. • Under the two-midnight rule, which was introduced in the 2014 IPPS rule, CMS expected a decline in the number of long observation stays and an increase in the number of inpatient admissions. CMS proposed offsetting the cost through a 0.2 percent reduction in inpatient payments. The payment reduction was strongly opposed by WHA and others. In its FY 2017 rule, CMS removed this adjustment for FY 2017 and also its effects in FYs 2014 through 2016. “CMS believes the assumptions underlying the -0.2 percent adjustment were reasonable at the time they were made,” wrote CMS in the final rule. However, in light of the unique circumstances surrounding this adjustment, the agency decided to remove it. • CMS projects total medical spending on inpatient hospital services will increase by about $746 million in fiscal year 2017. • CMS did not allow Nantucket Cottage Hospital to adjust its wage rates, meaning the wage indices for other areas of the country won’t be negatively affected. (continued on page 4) The Valued Voice -- Page 3 -- 8/12/16 Continued from page 3 . CMS’ Final IPPS Rule for 2017 Issued • As part of the Affordable Care Act (ACA), Medicare disproportionate share hospital (DSH) payments will be reduced by 75 percent, or $49.9 billion, by 2019.