From WisPolitics.com/WisBusiness.com …
— The chair of the Senate Health Committee today questioned the value of providing tax credits to incentivize graduate nursing clinical placements after various stakeholders proposed the idea during an informational hearing.
Sen. Rachael Cabral-Guevara, R-Fox Crossing, convened today’s committee hearing after hearing about numerous graduate nurse practitioner students struggling to find clinical placements, both in Wisconsin and nationally.
“What is happening is, student after student is asked to find clinical placement spots, and they are not able to find these spots,” she said. “I have students contacting me that are dropping out of the program; I have students that are one, two, three semesters sometimes not being able to find a spot.”
In some cases, students are being directed to contact third-party organizations that charge thousands of dollars per semester to match them with a supervisory preceptor, Cabral-Guevara said.
“This is ridiculous,” she said. “I feel that if a school is asking students to find these hours, then they should be assisting.”
Gina Dennik-Champion, executive director of the Wisconsin Nursing Association, today noted serving as a preceptor takes a lot of time. Their responsibilities include observing students and providing feedback, completing official evaluations and communicating with nursing faculty.
“All of those common barriers that we hear … the scheduling constraints, insufficient organizational recognition, inconsistent financial support,” she said, also pointing to differing requirements between programs as an issue.
The association has backed a tax credit for nurses who serve as preceptors for students, Dennik-Champion said.
“We do have the data to show what tax incentives, a tax credit does,” she said. “It incentivizes participation, especially if the amount that’s available for a tax credit will catch the ears and the eyes and maybe the checking account … it enhances education and training.”
Meanwhile, UW-Milwaukee School of Nursing Dean Kim Litwack noted the university has committed to finding preceptors for its students, and it turns away students if it’s not able to place them in a clinical preceptor.
“It becomes a challenge, how do you make that balancing act where we want to meet workforce needs but we also have to meet our ethical obligations to students?” she said today.
Litwack referenced the possibility of tax credits as an immediate solution, noting 25 states currently provide tax credits for preceptors — though just 18 of those are for nurse practitioners.
“We have to find a way to incentivize that,” she said. “We need those nurse practitioners, we need them desperately for primary care, even more desperately for psychiatric mental health, and that’s one of the hardest ones to find preceptors for.”
Cabral-Guevara noted even with a tax credit in place, many restrictions are placed on nurse practitioners for taking on students. In response to her concern, Litwack called for greater coordination between academic and practice partnerships.
“Many of our providers in both nurse practitioners and physicians are incentivized to bring up their volume, and if their volume decreases because they’ve got students, the tax credit offsets that a little bit, but you have to have an organization that’s willing to do it,” Litwack said.
Still, Cabral-Guevara said tax credits are only helpful “if we have nurse practitioners that can actually take students,” and that needs to be addressed somehow.
“I know everybody has brought up tax credits, but I challenge it a little,” she said, adding, “There are many nurse practitioners or people to precept that would do it without getting a tax credit. I mean, they’ve been doing it already, and I think that they would. So would a little tax credit actually incentivize that? I’m not completely sure.”
She argued tax credits wouldn’t address the broader issues driving this trend, questioning if facilities aren’t making enough spots andproposed if schools are taking on too many students to be able to place them all.
— A recent poll from the American Cancer Society Cancer Action Network found 81% of likely voters in Wisconsin say it’s important that all Americans should have access to nearby, affordable cancer screening regardless of health insurance.
Of that percentage, 54% said it’s extremely important and 27% said it’s very important, according to a polling memo distributed today.
The poll also found 64% of likely voters said they’d be more likely to vote for an official who was “a leader in ensuring healthcare is affordable and accessible,” while 57% said they’d be more likely to vote for an official who advocates for access to Medicaid insurance coverage.
And while 59% of respondents said they’re concerned about young people in their community using tobacco products, 63% said they support increasing tobacco taxes and using the revenue for prevention programs. The poll also found 67% would be less likely to elect someone who had gotten large donations from tobacco companies.
Sara Sahli, the group’s Wisconsin government relations director, notes more than 42,000 Wisconsin residents are expected to be diagnosed with cancer this year.
“Cancer touches everyone and voters want cancer issues to be a top priority this election season,” she said in today’s release.
The poll was conducted for the group by Lake Research Partners and the Tarrance Group for its national Cancer Votes campaign. It was done between June 30 and July 12 through phone interviews and text messages with links to the online survey, reaching 518 likely voters in the state. The margin of error was plus or minus 4.2 percentage points.
See the release below.
— State health officials have identified two more measles cases in Grant County, bringing the number of cases in the southwestern Wisconsin outbreak to 36 confirmed and three probable.
The state Department of Health Services today announced the new cases are related to confirmed cases in Lafayette and Iowa counties. DHS has previously said infections among residents who haven’t traveled recently indicates the virus is spreading within the state.
Local and state-level public health responses are ongoing, as officials seek to identify and inform those who may have been exposed. DHS says it still hasn’t identified any public exposure locations.
As of today, Wisconsin has now had 41 total measles cases so far this year, the state’s measles dashboard shows. Of that number, 40 were among unvaccinated people, and two have resulted in hospitalization.
See the release below.
— Prices across dozens of hospitals in Wisconsin were “consistently and substantially higher” than prices for the same services in Illinois, a report from a UW-Madison think tank found.
The Center for Research on the Wisconsin Economy recently issued a report comparing prices between 70 hospitals in Illinois and 60 in Wisconsin based on commercial negotiated-rate data.
It covers dozens of health systems, assessing “high-spend” inpatient services for UnitedHealthcare and the “Blue plan,” Anthem Blue Cross in Wisconsin.
Authors found hospital prices in Wisconsin are about 26% higher than in Illinois, noting the finding “holds under multiple analytic approaches.” This suggests the difference isn’t driven by differences in the mix of patients, services or insurers, or by hospital type, the report found.
“Within the Advocate Health system, which operates on both sides of the border under common ownership, Wisconsin hospitals are still paid about 23 percent more than their Illinois counterparts,” authors wrote. “And the premium is strikingly uniform across the Blue plan and UnitedHealthcare, which independently land within half a percentage point of each other for inpatient care.”
Meanwhile, the Wisconsin Hospital Association is criticizing the report, noting the lack of citations and data to back up findings “makes it impossible to verify” the authors’ claims.
“A study that ignores entire groups of hospitals, does not identify the hospitals included in its sample, disregards entire categories of procedures, and compares prices using only two group health plans that have a combined 90.1% market share in Illinois compared to 22.6% in Wisconsin has obvious flaws,” the group said in an emailed statement.
The report points to structural differences as an explanation for the trend authors found, including provider market concentration, system-level consolidation and the “strategic positioning” of major health systems in the state. It points to the widespread use of “percent-of-change” contracting in Wisconsin as particularly important.
Under this model, a hospital is paid a fixed share of its billed charges, rather than a pre-set dollar amount. This results in the effective price being linked to a price database that “the hospital sets unilaterally and can raise over time,” authors wrote.
It’s much more widely used in Wisconsin than in Illinois, per the report.
“The concentration of such contracts in Wisconsin is consistent with the strong provider bargaining position that a consolidated hospital market confers; and because these contracts give hospitals a standing mechanism to raise realized prices, they may help entrench the very premium this report documents,” authors wrote.
The report was authored by Prof. Anthony T. Lo Sasso, a member of UW-Madison’s La Follette School of Public Affairs, and Ike Brannon, president of the consulting firm Capital Policy Analytics.
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