February 2024
President's Report
Turning Data into Action
Conversations about healthcare value and health equity are nearly everywhere, however, few organizations have figured out how to do something about it. With our unparalleled access to health care data and incredible statewide collaboration, WCHQ is uniquely positioned to transform information into meaningful outcomes. This capability was on full display at our recent event connecting healthcare value with health equity. It was incredible to hear real examples of organizations that have made a difference and are willing to share the prescription for change with others.
I left inspired by the stories of success and affirmed in the knowledge that Wisconsin is fortunate to have a unique data asset that allows us to do much more than talk about a problem. Our member health systems are committed to providing granular data that allow us to truly understand the risks affecting our communities. They are also committed working with trusted community partners who can advocate for actual patients.
This year, as we celebrate our 20th year of existence, WCHQ remains committed to its overall mission to improve the value of health care for all. Over the past 20 years, we have seen incredible improvement in health care quality across our state and region. Today, we focus on making sure every patient achieves equitable care and outcomes.
SPOTLIGHT: 20 Years of Measuring and Improvement: Controlling High Blood Pressure
As WCHQ celebrates its 20th anniversary, we review the results achieved over that time. In celebration of American Heart Month, we examine Blood Pressure (Hypertension) Control.
Blood Pressure Control was among the very first measures WCHQ publicly reported, due to its prevalent role in mortality and preventability. In 2021, the CDC found that hypertension was a primary or contributing cause of 691,095 deaths and is associated with more than $131 billion annually.
Since we began our work on improving hypertension, WCHQ members have seen dramatic improvement. In 2005, WCHQ members achieved 59.8% blood pressure control in a population of and increased to 82.8% control for 506,969 patients in 2015. From 2015 through 2019, WCHQ members maintained a control rate near or above 84% while continuing to see increasing volumes of patients with hypertension (658,650 patients in 2019). The dedication WCHQ members have shown towards this measure have resulted in control rates that exceed the national averages by 12% - 49%.
Like most measures, blood pressure control was impacted by the COVID-19 pandemic. For those still able to report data during 2020, WCHQ members saw blood pressure control rates dip to under 80% (reporting for 582,863 patients). Today, much like the early years of the measure, the control rate for WCHQ members is back on an upward trend. In June of 2023, 82.7% of 559,327 patients with hypertension were in good control.
In an effort to help members look at blood pressure control through different lenses, WCHQ measures blood pressure control for patients with diabetes, patients with Ischemic Vascular Disease (IVD), and most recently for patients with obesity. WCHQ members perform slightly better on the blood pressure control measures for patients with diabetes, obesity, or IVD than on the general blood pressure control measure for all patients with hypertension, consistently achieving at least 84% in good blood pressure control for the more specialized measures.
Member Profile
In recognition of the WCHQ 20th anniversary in 2024, we are planning a member profile each month.
Member Name: Children’s Wisconsin Oral Health
Member Background: Children’s Wisconsin Oral Health Program is a founding member of the WCHQ Oral Health Collaborative started in 2019 and is part of Children’s Wisconsin.
Number of Providers: 8 pediatric dental residents, 14 oral health practitioners (pediatric dentists, general dentists, an oral surgeon, orthodontists) and 5 dental hygienists.
Current Goals: “A current goal is to track emergency department visits looking at two patient populations,” said Pam Fraser, Director of Oral Health Services. “One population is children who are established patients who present to the emergency department for preventable dental issues. We are looking to determine what we could do differently to decrease these visits by identifying need sooner and/or shifting them into the more appropriate dental clinic setting. The other population is children 3 years of age or less and ensuring that they have appropriate follow up dental care and establish a dental home. For all of those we serve, their opinion of our service and experience is important to relationship building and establishing trust. To that end, patient and family experience through validated surveys in ongoing across all of the locations and an important measure of our overall quality.”
WCHQ Engagement: Children’s Wisconsin has two staff who participate in monthly and annual WCHQ Oral Health Collaborative Meetings; Dr. Lori Barbeau, DDS, Medical Director Children’s Dental Center and Pamela Fraser, MSM Director of Oral Health Services.
How WCHQ has impacted the care at Children's: “Establishing goals and outcomes is critical to providing the best and safest care and improving access,” said Dr. Lori Barbeau. “WCHQ supports that tenet and challenges us to think about quality and improvement is a larger and more holistic way. WCHQ has allowed us to partner with others to learn from their experience and contribute to establishing goals as a standard of care.”
Children's Oral Health Recognized in February
February is Children’s Oral Health Awareness Month - an occasion dedicated to recognizing the pivotal role of oral health in the overall well-being of children. Oral health often receives less emphasis than other pediatric concerns yet, neglecting the oral health of children can have enduring repercussions on their overall health and quality of life.
Early childhood is particularly crucial to establish the foundation for a lifetime of good oral health. Good oral health is tied to better academic achievements, improved self-esteem and self-confidence and the ability to more fully engage with others. Conversely, poor oral health results in dental disease that causes discomfort and pain and hinders a child's ability to eat, speak, and concentrate in school.
Oral Health members of WCHQ monitor key metrics related to children's oral health and publicly report their findings. In January, WCHQ released updated results for the period ending June 30, 2023 compared to calendar year 2022.
WCHQ’s Oral Health Collaborative members have demonstrated commendable scores in caries risk assessment and topical fluoride application for high-risk children, underscoring their dedication to children’s oral health.
Dr. Lori Barbeau, Pediatric Dentist and Dental Director of Children's Wisconsin, said, “We have focused on maintaining their high rates by prioritizing efforts on medical and dental integration. One approach involves embedding dental hygienists in primary care clinics, while another aims to enhance the patient experience by ensuring families know how to access the oral health program and engage in treatment.”
Dr. Todd Thierer, Associate Dental Director at HealthPartners, emphasized his organization’s close collaboration between medical and dental providers. “Nearly all infants receive a dental assessment during their well-baby visits, with fluoride varnish application often administered by nurses or doctors, particularly for those at high risk of dental decay. This collaboration has helped bridge the gap between high-risk children and appropriate referrals to dental providers.”
As we observe Children's Oral Health Awareness Month, let's reaffirm our commitment to prioritizing dental care for our children.
If you are interested in learning more about the work WCHQ is doing in oral health, contact Jen Koberstein.
“The Impact of Disparities on Healthcare Value”
WCHQ Assembly Provides Actionable Information to Attendees
WCHQ’s first event of 2024 was a success, with 130 attendees committed to ensuring all people receive affordable healthcare and equitable outcomes. Attendees heard how WCHQ members, the Wisconsin Department of Health Services, and community organizations are addressing healthcare disparities and left with a commitment to work together to improve the health of Wisconsin.
Dr. Mark Lodes, Chief Medical Officer and Vice President at Froedtert Health and Medical College of Wisconsin and Abbey Harburn, MPH, Director of Analytics and Practice Transformation, set the stage for attendees, by sharing statistics about the cost of disparities in our state. Disparities associated with race/ethnicity and educational attainment are linked with high economic burden. The speakers noted that the according to a recent JAMA article, annual national economic burden of racial and ethnic health inequities is estimated at $421 billion to $451 billion, while the national economic burden of education-related health inequities is $940 billion to $978 billion.
Dr. Lodes asked the group to examine how their organizations are collecting and reporting data, establishing health equity key performance indicators, improving commitment to anti-racism behaviors and more. “If there is a subset of our population that is experiencing disparities, you are not delivering top quality care,” he said.
The event’s keynote speaker was Michelle Robinson, PhD, Director of the Office of Health Equity, Wisconsin Department of Health Services. Dr. Robinson encouraged the audience to examine the causes of disparities, for example, racism. “What drives racial distinctions is racism. Racism assigns value on the way people look or the color of their skin. In healthcare, the treatment of racism is a biologic fact. It contributes to health inequities.” In addition to addressing racism, Dr. Robinson shared actions being taking within our state government to remove health inequities, such as the formation of the Governor’s Health Equity Council and improving cultural responsiveness.
Other speakers included:
- Edmond Ramly, PhD, Associate Professor and Program Director at Indiana University School of Public Health. Dr. Ramly spoke about using data to measure disparities in Wisconsin to inform improvement. Looking at results over time allows organizations to understand the interventions and their impacts.
- WCHQ member Bellin Health representatives Jody Anderson, RN, BSN, MS, Population Health Lead; Nicole Acobe Luna, Community Resource Navigator and Christian Roovers, Health Educator, informed the group about Bellin Health’s efforts to reduce health disparities within the care relationships Bellin has with area employers. They showed attendees their concept built on Partnership, Community and Data Analytics. Combined, these three areas provided data about gaps, inform strategies for improvement, and strengthen community relationships.
- Molly Zemke, MPH and Dorain James, CRT represented the Asthma-Safe Homes Program from the Wisconsin Department of Health Services. Molly and Dorian shared how the program uses education, home visits and funds for home repairs to help patients who live with chronic asthma. In addition, they shared numerous examples of disparities among their clients, for example that most patients with “very poorly-controlled” asthma are among lowest-income group in our state. Dorian shared his expertise on building trust with the community to educate the clients he serves for sustained change.
The event showcased the power of partnership. Kathi Chady, RT(R)(M), Lead Mammographer and Laura Jacobson, BSN, RN, Breast Coordinator, both from Fort HealthCare teamed with John Drake and Julie Drake of the Jefferson ½ Mile ATV Club for the final presentation. The Jefferson ½ Mile ATV Club has started an annual event to fund a critical need for mammogram vouchers. This event has grown, raising more than $52,000 in 2023, allowing patients to obtain this critical screening for free. This partnership has been an incredible resource for Fort HealthCare’s service area in improving breast cancer screening rates for the under and uninsured population.
