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  • 4 Dec 2019 1:46 PM | Anonymous

    Wisconsin Hospital Associaiton, December 2, 2019

    Aging Population, Shrinking Workforce and Increased Regulations

    WHA Health Care Workforce Report Reveals Current Challenges, Suggests Solutions

    Facts and data detailed in WHA’s latest health care workforce report point to the continuation of concerning demographic, employment and regulatory trends in Wisconsin that could threaten access to care unless wise policy strategies are embraced.

    The 2019 Wisconsin Health Care Workforce Report is the 16th annual report designed to assist health care entities and elected policymakers in helping to maintain Wisconsin as a source for nation-leading high-quality, high-value health care. The report draws from national and state data and studies, reports from other associations and findings in the field to offer recommendations for action.

    Among the major challenges identified in this year’s report:

    • The escalating demands of an aging population – the population over age 75 will increase by 75% from 2017-2032, increasing the number of those requiring more intensive health care.
    • Increased competition over a shrinking workforce – the population under 18 will grow by only 3.5% from 2017-2032.
    • A rapidly changing environment – hospitals have moved from paper to electronic health records in just a decade, and 75% of hospitals now provide access through telemedicine. With rapid technology changes come challenges.
    • Increased regulatory demand – meeting regulatory demands requires 59 FTEs for an average-sized hospital; physicians and advanced practice clinicians devote more time to the electronic health record than they do face-to-face with patients.

    WHA’s 2019 Health Care Workforce Report provides a snapshot and future projections for Wisconsin’s health care labor force while describing the current environment affecting this workforce. WHA analysis, along with the expertise and experience of WHA member hospitals, offers potential solutions for health care leaders, educators and policymakers to achieve a workforce of highly skilled professionals serving patients as coordinated teams working across the continuum of care to the top of their training and experience supported by effective technology.

    Key among the recommendations: state and federal policymakers must weigh any proposed regulation against the expected benefit. Even regulations proposed for a seemingly-positive purpose can instead hinder hospital and health system efforts that reflect the unique needs of their communities. Wisconsin’s health care system has evolved throughout the state via different strategies – and usually in ways that are not the result of “one size fits all” regulations.

    The report is available on WHA’s website. 

  • 23 Sep 2019 9:46 AM | Anonymous

    Wisconsin hospitals earned $1.95 billion in net income in fiscal year 2018, around $280 million less than they did in 2017, according to a report published Friday by the Wisconsin Hospital Association.
     
    The net-income percentage fell from 9.8 percent to 8.3 percent during the period.
     
    Forty-one hospitals lost money in FY 2018, eight more than the prior year. Total hospital revenue was $23.4 billion, up about $1 billion from FY 2017.
     
    “It’s a tougher environment,” said Brian Potter, WHA chief financial officer. “Healthcare is not inexpensive, and so there’s a lot of pressure from all payers to try to reduce the costs.”
     
    Potter noted that net income has been trending down in the last couple of years. He cited Medicare cuts, which helped fund the Affordable Care Act's coverage expansion, as a big driver in the decline.
     
    He noted that they’re also seeing a larger portion of a hospital’s business coming from Medicare, given an aging population.
     
    Medicare accounted for 45.3 percent of patient revenue in FY 2018, up from 44.4 percent in the prior year. Meanwhile, commercial payments fell from 36.5 percent in FY2017 to 35.8 percent in FY2018. 
     
    “You’ve got Medicare, who’s paying worse than it has in the past, and you have more of your business now being in Medicare than in commercial, which commercial pays significantly better,” Potter said. “I think that payer mix component is really one of the big drivers.”
     
    Potter said planned further Medicare payment cuts will put more pressure on hospitals to do more on expenses to maintain a margin that allows them to continue operating.
     
    Operating margins are also declining at health systems, Potter said. The report noted that Wisconsin hospitals often provide the operating margin that allows health systems to support unprofitable services that are necessary for patients, like nursing homes, physician clinics and home healthcare.
     
    WHA also surveyed 19 of the state’s largest healthcare systems, comprising 104 hospitals. While the average operating margin for hospitals within the systems was 8.8 percent, the systems as a whole had margins averaging 3.6 percent.
     
    For FY 2017, WHA surveyed 18 of the state’s largest healthcare systems, representing 96 hospitals. The average operating margins for the hospitals and the health systems were 9.6 percent and 4.6 percent, respectively.
     
    A rise in uncompensated care has also played a role in decreasing margins, Potter said. Uncompensated care charges went up 7.6 percent in FY 2018 to $1.2 billion, according to a separate report from WHA. Charity care amounted to $590.2 million, while bad debt was at $633.4 million. 
     
    Part of the reason for the change could be rate increases, according to Potter.
     
    There was a $20.2 million increase in uncompensated care at cost, which was $436.8 million in FY 2018. That broke down to $209.1 million in charity care at cost and $227.7 million in bad debt at cost.
     
    The main reason for the increase is plan design changes, with patients having to bear a higher portion of their healthcare costs through deductibles, coinsurance and copayments, Potter said.
     
    ABC for Health Executive Director Bobby Peterson said “myopic policy decisions” by state and federal lawmakers have resulted in more people lacking medical coverage for needed care. He said expanding Medicaid and strong consumer protections could help.
     
    “Bad debt and uncompensated care expenses hurt the bottom line for patients and hospitals, especially people affected by health disparities," he said in a statement.

  • 8 Oct 2018 8:52 AM | Anonymous

    Ann Zenk, WHA Vice President, Workforce and Clinical Practice, presented a preview of WHA’s 2018 Annual Health Care Workforce Report for WHA’s Council on Workforce Development at their October 4 meeting. The workforce challenges highlighted in this year’s report include physician shortages in primary care, rapid growth in advanced practice clinician employment, and increased difficulty in finding entry-level workers. The report also explores rapid adoption of telemedicine and technology, as well as electronic health records affecting and impacted by regulatory burden, trends.

    “WHA created matching grant programs for graduate medical education, advanced practice clinicians, and allied health professionals to grow essential segments of Wisconsin’s health care workforce,” Zenk noted. “To meet the demands of a rapidly aging population and sustain the highquality health care our state expects and deserves, we also need to make sure all members of the health care team can work to the top of their skill, training, and experience, and we need to remove unnecessary regulatory burdens placed on health care providers.”​

    Read more here.

  • 26 Mar 2018 9:50 AM | Anonymous

    Nearly 1,000 people filled an exhibit hall at Madison’s Monona Terrace March 21 to attend WHA’s 2018 Advocacy Day and hear keynote addresses from Lieutenant Governor Rebecca Kleefisch and Mara Liasson, correspondent for NPR and contributor to Fox News Channel. Over half of the attendees also ventured up to the state capitol in Madison to meet with their state senator and representative on issues impacting Wisconsin’s hospitals, including Medicaid reimbursement and a proposal to implement a government fee schedule in Wisconsin’s worker’s compensation program.

    Bob Van Meeteren, WHA Board chair and president/CEO of Reedsburg Area Medical Center, welcomed attendees to Advocacy Day. “Every year that I’ve attended Advocacy Day, I am so impressed by the number of people who gather for this event and the passion you all have for your community hospitals, and this year is no different,” said Van Meeteren.

    To kick off Advocacy Day, Van Meeteren introduced a video message from Gov. Scott Walker, recorded in advance at the Governor’s residence in Madison. In his remarks, Walker thanked everyone in attendance for contributing to Wisconsin’s achievement as the best state in the country for high-quality health care.

    “On behalf of our citizens, I want to say thank you! We are so proud that our health care systems in Wisconsin are ranked number one in the nation for quality. That is so important to individuals and families all over the state, as our health is a top priority. It is also a great recruiting tool for top talent and new employers to the state,” said Walker.

    The Governor told the crowd he is “proud to have such a great working relationship with WHA staff and members,” and highlighted several accomplishments achieved by working together.

    “We’ve made major investments in Medicaid to keep our systems strong and to care for those in need. We even added more through the Disproportionate Share Hospital (DSH) program,” said Walker, referring to the last budget he signed into law, which increased Wisconsin’s DSH program by $25 million in state funds. The Governor went on to talk about additional investments in the state’s health care workforce, medical education campus expansion, eliminating the waiting period for children’s long-term care services and recent legislation—signed into law at Tomah Memorial Hospital—to create a reinsurance program in Wisconsin to help stabilize the individual health insurance market.

    “Together, we will continue to reinforce Wisconsin’s reputation as a national leader in health care. Thank you for your service to your system, your community and to our state.”

  • 23 Mar 2018 8:48 AM | Anonymous

    The WisHHRA Board of Directors reviewed a set of proposed changes to the bylaws at their February 7th meeting.  The primary change to the bylaws includes the elimination of regions within the governance structure, and replacing the regional directors on the board with at-large directors.  The board discussed the importance of having statewide representation on the board, and would continue to encourage geographic diversity in recruiting candidates for the board.
     
    At the same time, the change is intended to provide the board an opportunity to to also recruit for knowledge, skills, and abilities - in addition to geographic representation.  A variety of other changes to the bylaws are also suggested, which are primarily editorial.  A red-line version of the bylaws are posted here, and will be presented to the membership for approval at the annual meeting.  Please let us know if you have any questions or comments on the proposed bylaws changes.

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