Friday, December 13, 2013

CNN Contributor Offers Passionate, Flawed Commentary

Written by Tara Pihn

Entitled The Healthcare Reality the Conservatives Ignore, Paul Waldman offers a zealous critique of Republicans and their health policy in a recent CNN opinion piece. 

He correctly points at that, with regard to the ACA, "...most Republicans are barely bothering to offer an alternative". 

He is further on point when he states:

"It wasn't government that gave us nearly 50 million uninsured Americans and denials for pre-existing conditions. It wasn't government that gave us the yearly and lifetime caps on insurance coverage that have sent so many people into bankruptcy when they've faced a serious illness or accident. It wasn't government that gave us 'rescissions', where your insurance company cancels your policy if you get sick."

However this piece is deeply flawed and probably didn't deserve to be published.  The author goes on to conclude that "It was the free market" that created our currently mediocre health system.  Even a cursory glance at the health industry in the US reveals that it is far from a "Free Market".  If it was, I have no doubt it would be brutally efficient. 

He goes on to fawn over Europe's various socialized and semi-socialized health systems.

So called "Health Policy Experts" need to have an understanding of the fundamentals of Economics. It also would be refreshing if a Progressive could suggest a uniquely American solution instead of simply imitating Europe, a region struggling under economic stagnation, stalled productivity, unfunded entitlements and burdensome national debts. 

Wednesday, November 27, 2013

Hospitals May Be Closing in the "New Health Age"

In an era of healthcare reform, the industry can achieve higher quality care and better outcomes for patients by closing and consolidating low-volume hospitals, according to an article by Robert Pearl, MD, a contributor to Forbes.

Dr. Pearl offers an intriguing thesis as well as a fascinating historical account of American hospitals. 
 
Read More>> 

Thursday, November 14, 2013

2013 Physician Workforce Annual Report

Florida's DOH released its 2013 Physician Workforce Annual Report earlier this month. For anyone interested in healthcare economics and health policy, it makes for a fascinating read. Here are a few salient points:

Of the state's licensed physicians, 43,406 (69.7%) are actively practicing in Florida.

Nearly two-thirds (26,778 or 61.7%) of the actively practicing physicians are age 50 or older.

Of the state's active physicians, 14,502 (33.4%) are practicing in primary care (family medicine, internal medicine, and pediatrics).

Of Florida's licensed and practicing physicians, 32,219 (74.2%) are males and 11,185 (25.8%) are females.

According to the Association of American Medical Colleges' (AAMC) 2011 State Physician Workforce Data Book, Florida ranks 5th in states with the greatest number of active physicians over age 60. Looking at the age distribution of Florida's physician workforce, 13,283 (30.6%) are age 60 and older and 13,495 (31.1%) are between ages 50-59. It is notable that only 5,040 (11.6%) are under 40 and 11,586 (26.7%) are between ages 40-49.

The full report can be viewed HERE.

Thursday, October 24, 2013

Tenet Facilities Receive Awards

Palm Beach Gardens Medical Center (owned and operated by Tenet) recently accepted the Get With The Guidelines-Heart Failure Gold Plus Quality Achievement Award from the American Heart Association. The recognition signifies that Palm Beach Gardens Medical Center has treated its heart failure patients according to the guidelines of care recommended by the American Heart Association/American College of Cardiology.

The American Heart Association's Get With The Guidelines program is a quality improvement initiative that provides hospital staff with tools that follow proven evidence-based guidelines and procedures in caring for heart failure patients to improve outcomes, prevent future hospitalizations and prolong life.

"We are proud that the American Heart Association is recognizing Palm Beach Gardens Medical Center for our achievements in their Get With The Guidelines program," said Larry Coomes, CEO of Palm Beach Gardens Medical Center. "Get With The Guidelines gives our professionals the tools and reports they need to help them effectively treat our coronary heart disease and heart failure patients."  

St. Mary's Medical Center in West Palm Beach, another Tenet property, also received the award as well as an accolade for Stroke Gold Plus Quality Achievement.

Tenet operates ten hospitals in South Florida:  5 in Palm Beach County, 1 in Broward and 4 in Miami-Dade.   

Read more HERE and HERE.

Thursday, October 10, 2013

Healthcare Roundtable Series Continues with November Event

FHIcommunications presents…

NPs, PAs, Scope of Practice and the Looming Physician Shortage

Tues., Nov 12 | 7:30-9:30 am

Vi at Aventura

Early Registration Ends October 18.

Saturday, September 14, 2013

Traditional Approach vs. Integrated Model of Care

Traditional  Approach
vs.
Integrated MOC
No Population Health Improvement Plan and no Individual HIP required

Reimbursement not aligned or coordinated


Comprehensive PHIP and IHIP required to be kept up-to-date

Alignment of reimbursements, incentives,  coordinated across benefit plans and across care continuum

No comprehensive population health action plan

Integrated MOC with detailed goals, critical path algorithms strictly adhered to an backed up by CME

No mechanism for health assessment within 14 days of assignment

Mandated to belong to a MCO with 100% 14 day assessment requirement culminating with an IHIP
May or may not belong to a MCO

Telephonic assessment identifies this enrollee as a priority for face-to-face health assessment

No mechanism for health assessment, prioritization

F-2-F assessment performed by licensed professional

Enrollee utilizes ER for fall and broken hip; multiple illnesses due to exposure

ER considerably more expensive then taking Model of Care preventive measures outside the allopathic model

Enrollee identified as depressed, along with typical chronic symptoms associated with this population; Home needs to be repaired and refitted in order to protect enrollee from the elements; Also bathroom needs remodeling to accommodate enrollee and prevent hip fracture or worse; 56 year, unemployed, obese, non-ambulatory son found living in garage behind house

MCO reacts to over utilization of ER over time

Son utilizes ER over 100 times because that was the only way to receive services

Son enrolled in Medicaid program; Employed  as mother’s caregiver under directed care benefits at a savings;  A line installed between house and son’s domicile as quick fix  for purposes of ambulation and hygiene

Traditional scenario:
Costs quadruple in last moments of life-not to mention multiple ER, hospital, nursing home visits scenarios; Totally unsatisfactory to all parties involved in the healthcare transaction

Triple aim achievement unlikely

Avoidance of traditional scenario:
Son employed as mom’s caregiver at lower cost, allowing her to remain at home at lower cost; More satisfaction for all concerned in this healthcare transaction

Triple aim achievement within sight


Friday, September 6, 2013

October 8th Healthcare RoundTable Announces Panel

Tues., Oct 8 | 7:30-9:30 am

Imperial Club, Aventura

Moderator: 
Bimal Shah, CLU, ChFC, CASL | President, Rajparth Advisory Group

Guest Speakers:


Click HERE to play video.   REGISTER

Sponsor: 

Monday, August 19, 2013

The Integrated Model of Care: Seven Hurdles To Achieving The Triple Aim (Part 1)


Ladies and gentleman what I'm about to reveal in this article may be shocking to you, horrifying to some, and totally captivating to others.  Regardless of your reaction, everyone involved in the healthcare transaction has to answer the questions for themselves. We can no longer afford to sit quietly on the sideline doing nothing, because at the present time the U.S. healthcare system is economically unsustainable and on the verge of collapse. Moreover, the Accountable Care Act (ACA) has begun to mutate the very DNA of how healthcare is delivered and reimbursed in this country. Our objective here is to inform and suggest  a basic strategy to facilitate achievement of the triple aim. One thing we can all agree on is improved quality, increased satisfaction and reduced costs are generally good aspirations for our healthcare system.


Read Part 2 HERE.
Read Part 3 HERE.
Read Part 4 HERE.
Read Part 5 HERE.
Read Part 6 HERE.

Sunday, July 21, 2013

Healthcare RoundTable Oct 8 Program

FHIcommunications presents…

A Healthcare Roundtable Series Event

Chronic Disease Management
A constant drain on our nation’s physical and financial health, properly managing persistent ailments presents both a challenge and an opportunity.  Along with end-of-life care, it’s a key driver of healthcare inflation.  Taming it is paramount and one of the core goals of the Affordable Care Act. The AMA recently defined obesity as a disease.  Meanwhile, CMS is considering paying primary-care physicians for complex chronic care management services of Medicare patients without an in-person patient visit.  ACO's and Medical Homes are becoming reality as each day passes. So reimbursements models are obviously evolving to meet the needs of the population and providers who welcome and prepare for this change stand to profit.  Those who don't get ready stand to lose as at-risk contracting becomes ubiquitous. 


How can your practice benefit from this paradigm shift in health services delivery?

Tues., Oct 8 | 7:30-9:30 am

Imperial Club, Aventura

Moderator: 
Bimal Shah, CLU, ChFC, CASL
President, Rajparth Advisory Group


Click HERE to view the video. 

Follow this link to register:

https://fhihealthcareroundtableseriesoct2013.eventbrite.com

Thursday, July 11, 2013

Several FL facilities involved in huge DOJ Settlement

Fifty-five hospitals located throughout twenty-one states have agreed to pay the United States a total of more than $34 million to settle allegations that the health care facilities submitted false claims to Medicare for kyphoplasty procedures, the Justice Department announced July 2. Kyphoplasty is a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis.
 
In many cases, kyphoplasty can be performed safely and effectively as an outpatient procedure without any need for a more costly hospital admission. The settlements announced today resolve allegations that the settling hospitals frequently billed Medicare for kyphoplasty procedures on a more costly inpatient basis, rather than an outpatient basis, in order to increase their Medicare billings.
 
The following Florida hospitals were involved in the settlement:
  • Mount Sinai Medical Center, Miami Beach has agreed to pay $1,846,194.00.
  • Twenty-three hospitals affiliated with HCA Inc., Nashville, TN, have agreed to pay a total of $7,145,842.72. These include: Aventura Hospital & Medical Center (Aventura); Capital Regional Medical Center (Tallahassee); Doctors Hospital of Sarasota (Sarasota,); Fawcett Memorial Hospital (Port Charlotte); Fort Walton Beach Medical Center (Fort Walton Beach); JFK Medical Center (Atlantis); North Florida Regional Medical Center (Gainesville); Southwest Florida Regional Medical Center (Fort Myers); St. Lucie Medical Center (Port Saint Lucie).
  • Four hospitals affiliated with Morton Plant Mease BayCare Health System, Clearwater, have agreed to pay a total of $2,378,325.45. These include: Morton Plant Hospital (Clearwater); Morton Plant North Bay Hospital (New Port Richey); Mease Dunedin Hospital (Dunedin); and Mease Countryside Hospital (Safety Harbor).
The claims resolved by these settlements are allegations only, and there has been no determination of liability.
 
 

Thursday, June 27, 2013

AMA Adopts New Policies on Second Day of Voting at Annual Meeting

The American Medical Association (AMA) voted June 18 during its Annual Meeting to adopt the following new policies on emerging issues in public health and science:
  • Opposition to Genetic Discrimination
  • Support of Public Access to Genetic Data
  • Pharmacy Compounding Safety
  • Opposition to the Lifetime Ban on Blood Donations for Gay Men 
  • HIV Treatment as Prevention
  • Obesity as a Disease
  • Banning Marketing/Sale of Energy Drinks to Kids
  • Health Risks of Sitting
  • Permitting Sunscreen in Schools
  • Exam Room Computing & Patient-Physician Interactions

Source:  American Medical Association
 

Monday, June 10, 2013

Asset Protection Q & A

Q.
What are the dangers of simply hiding my assets - perhaps in some offshore jurisdiction - and not revealing these assets to my creditor?

A.
That's a common mistake. One must never confuse secrecy or concealing assets with asset protection, though to discourage lawsuits, financial privacy can sometimes be helpful. A judgment creditor can compel you to disclose your finances under oath.

You can't then rely on secrecy. Once under oath you must truthfully disclose your assets. It's perjury to lie to conceal your assets. You want honest protection. With a good plan you can fully disclose your assets, confident that they'll stay creditor-proof. A judgment creditor is entitled to full and honest answers about your present and past assets.

Source: 
The Presser Law Firm

Friday, May 17, 2013

Healthcare Roundtable Series Announces June Program

As the healthcare industry rapidly transforms an unsustainable economic model, traditional Group Practices face formidable challenges.   Coping with payers, government regulators, payment reform and technology demands leaves too little time for patients.  And those clinging to traditional goals, strategies, structure and processes face a dim future. From immediate cash flow concerns to long-term capital budgets, Group Practices must elevate their financial acumen to thrive in the new health age.

Join us Tuesday, June 4th from 7:30-9:30 a.m. as we explore....

Group Practice Finance

We've assembled a mix of successful "in the trenches" practitioners and healthcare experts to educate and inform medical professionals seeking to exploit new opportunities.
 
The Panel:
 
Eris Thomas, MBA
CEO, Coral Gables Executive Physicians
 
Bimal Shah, CLU, ChFC, CASL
President, Rajparth Advisory Group
 
Jonathan Katz, MBA
CEO, Oros Risk Solutions
 
Denise Schepis 
Healthcare Business Banker, VP, PNC Bank
 
Moderator:
Alexandru Visan, MD, MBA
University of Miami Dept of Anesthesiology & President, Executive Cortex Consulting
 
Sponsors:
  •    Rajparth Advisory Group, LLC
  •     Oros Risk Solutions
  •     PNC Bank
 
Host:
Park Shore Pharmacon
600 Ansin Boulevard
Hallandale Beach, FL 33009

Friday, May 3, 2013

FICPA Healthcare Conference Draws Large Crowd with Provocative, Timely Program

With all the changes in healthcare, the Florida Institute of CPAs had plenty of topics to cover in their annual Health Care Industry Conference held in Orlando on April 25 and 26.  Close to 300 CPAs, Practice/Facility Administrators, Managed Care Executives, Attorneys, Bankers, Physicians and other professionals attended the meetings at Disney's Yacht Club Resort to expand their health industry knowledge and earn continuing education credits.  The event featured nationally renowned speakers and nineteen sponsors  

The conference addressed many provocative and timely healthcare topics including...

Friday, April 19, 2013

Business as Usual in the Fee-for-Service, Government Payer World

A New Jersey Cardiologist recently admitted to a long-running health care fraud that cost insurers millions. 

This is a cautionary tale for Florida clinicians running high volume practices, insurers, taxpayers and healthcare reformers. It's also a sobering reminder of the massive flaws inherent in the Fee-for-Service, Government/Managed Care Payer business model.  

According to an article posted April 10 at NJ.com, Dr. Jose Katz maintained a sprawling cardiology practice that included two companies and five medical offices in northern New Jersey and New York. Authorities say he ran his illicit business from 2005-2012. Posing as a successful multi-site physician practice, Dr. Katz was in fact running a Medicare mill. He appeared in Federal Court, in Newark, the same day the NJ.com article was posted.

The author of the article, Jason Grant, reports further that:

By ordering essentially the same battery of diagnostic tests for nearly all his patients, regardless of their symptoms, and by dishing out a slew of false diagnoses, authorities say, Katz rung up large - and fraudulent - bills with the Medicare Part B program as well as Medicaid, Empire Blue Cross Blue Shield, Aetna and other insurers.

Appearing in federal court in Newark today, Katz, 68, of Closter, admitted to bilking the government health programs and private insurers out of more than $19 million over seven years. He also pleaded guilty to conspiracy to commit health care fraud and making false claims to the Social Security Administration in connection with a no-show office position given to his wife.

Under his plea agreement, Katz, the founder, CEO, and sole equity-holder of Cardio-Med Services LLC in New Jersey and Comprehensive Healthcare & Medical Services LLC in New York, faces 57 to 87 months in prison.

Officials called the health care fraud the largest ever by a single practitioner in the tri-state area.

Click
here to see the full story from NJ.com.

Friday, April 5, 2013

Docs Weigh In on Future of Medicine

Deloitte just released their 2013 Survey of U.S. Physicians and the results reveal important attitudes and beliefs among practicing physicians.

For example, 38% of physicians believe the ACA is "A Step in the Wrong Direction." This is down from last year (44%) but continues to be ominously high as we head into the final stages of implementation of the new law.  Without physician buy-in, it's hard to imagine the ACA truly reforming healthcare.  On a positive note, physicians uniformly agree that "Patient relationships" and "Protecting and promoting the health of individuals" are the most satisfying aspects of practicing medicine.

The study also illustrates the differences in the opinions and convictions among various categories of doctors.

For example, among physicians dissatisfied with the practice of medicine, PCPs and Non-Surgical Specialists agree that "less time with each patient" is the chief grievance.  Meanwhile Surgical Specialists list their primary complaint as "long hours/work weeks".  Non-Surgical Specialists (67%) and Surgical Specialists (63%) are more likely to be satisfied with the practice of medicine than PCPs (59%).

Despite all the talk about payment reform, fee-for-service is still firmly entrenched in our healthcare system. The majority (73 percent) of physicians do not work in a setting that provides gain-sharing or an incentives program; only three in 10 do so.  Pay-for-performance is more prevalent in the primary care setting.  PCPs (37 percent) are significantly more likely to participate in such a program than Non-Surgical (25 percent) or Surgical Specialists (23 percent).

There were 613 completed surveys and the margin of error is +/- 3.89 percent at the .95 confidence level according to Deloitte.

Friday, March 22, 2013

Wheels of Justice: Biogenesis Investigation, First Reported by Miami New Times, is “In the Hands of the MLB and DOH” (Gulp!)


Bright Light Shines on South Florida’s Sleazy Anti-Aging "Specialists"

The story first broke in late January with the Miami New Times story about the Coral Gables based Anti-Aging clinic and it’s All-Star list of athlete clients (click HERE to read it).  Anthony Bosch, son of medical doctor Pedro Bosch, was the owner of Biogenesis. Anthony Bosch allegedly posed as a licensed physician and supplied steroids and other drugs illegally while controlling this business entity called Biogenesis of America, LLC.  Biogenesis is listed on Yelp as a weight-loss center located at 1390 S. Dixie Highway.  This isn’t the first time the Bosch family has been associated with illicit performance enhancing drugs…
 
…So who was writing the prescriptions for Anthony's patients?  After all Tony is not a real doctor; an actual physician would have to be complicit for the scheme to work.  So far we don't know.  For the record Dr. Bosch vehemently denies writing the 'scripts.  Here is Dr. Bosch’s denial published January 30 on Business Wire (courtesy Reuters).

As if the narrative wasn’t fascinating enough (although admittedly anther black-eye for Florida’s medical community), it got even more interesting when, last week, Sports Illustrated picked up Miami New Times Editor Chuck Strouse’s rambling and erratic explanation for why he wouldn’t share his assets/sources for an MLB investigation.  He then dropped this bombshell:

…there is a hitherto-unreported Florida Department of Health criminal probe into clinic director Anthony Bosch.

"We're going after Tony Bosch," says a source from the State Department of Health. "He's the target."

Friday, March 8, 2013

Healthcare Roundtable Continues with April 9 Program

Title Sponsor

The next Healthcare Roundtable event, entitled
Practice Formation/Re-Formation 2014

will be held at Imperial Club, Aventura

Tuesday, April 9, 7:30-9:30 a.m.   

The Panel thus far is:

  • Brian Polner, MD
  • Sandra Greenblatt, MBA, JD
  • Ira Agatstein, MD
  • Lanny Pauley 
Moderated by Brian Foster, MBA 
 
Click HERE to learn more.  

Healthcare Roundtable Events are produced by FHIcommunications.

Friday, February 22, 2013

Florida Facilities Make Becker's List of 36 GI & Endoscopy-Driven Surgery Centers to Know

Three Florida ASC's made the list that you "...cannot pay to be selected for...":
  • Barkley Surgicenter (Fort Myers, FL)
  • Fleming Island Surgery Center (Orange Park, FL)
  • Jacksonville Center for Endoscopy (Jacksonville, FL)
The state of Texas contributed four to the list while California boasted three. New York (all in NYC) and Pennsylvania also had three on the list while Georgia, Michigan and New Jersey each contributed two to the roll.

Click HERE to see the full report.
 

Friday, February 8, 2013

FHIcommunications Enters Into Content Sharing Contract with Fierce

FHIcommunications, a digital publishing company based in Coral Gables,  FL has entered into a content exchange agreement with Fierce Healthcare, a digital publishing company based in Washington, D.C.  “I was delighted when Lindsey Wagner at Fierce Markets contacted me about this opportunity,” stated Jeff Herschler the owner and founder of FHIcommunications.   “This gives us access to great editorial from their talented team of journalists and allows us to broaden our coverage and better serve our readers.   Meanwhile, our contributors and sponsors now have the potential to reach their 80,000+ daily subscribers,” he added. 

Friday, January 25, 2013

Study: Efficacy of Surgical Crisis Check Lists is Demonstrated

According to an article published recently on the New England Journal of Medicine website "...checklist use was associated with significant improvement in the management of operating-room crises. These findings suggest that checklists for use during operating-room crises have the potential to improve surgical care."

The study was simulation based and a total of 17 operating-room teams participated in 106 simulated surgical-crisis scenarios.  Operating-room teams from three institutions (one academic medical center and two community hospitals) participated. 

The authors included three General Surgeons, two Anesthesiologists, a Neurosurgeon, a Hematologist/Oncologist, a Diagnostic Radiologist and an Emergency Medicine Specialist.  The study was funded by the Agency for Healthcare Research and Quality.
 
Read More>>>

Friday, January 11, 2013

Finding a Path through the Maze: Medicare Provider Re-Validation


Tuesday, January 29, 2013  7:00-9:00 a.m. 

Panelists

  • Benjamin Frosch
  • Gary Matzner, Esq.
Venue:
Mount Sinai Medical Center Aventura

For details, including online registration, click HERE.


presented by...

A Healthcare Roundtable Series Event