Tuesday, December 30, 2014

The Next Big Thing in Healthcare?

CNN recently published an article discussing the related concepts of Concierge Medicine, Private Physicians and Direct Pay Practices. A few notable excerpts appear below:

Many doctors shy away from the term "concierge" because it connotes that it's for an exclusive club. They are not practicing "wealth care," as a few of those interviewed termed it. Instead, these doctors are increasingly positioning themselves as health care providers for middle class Americans who value wellness.
"Patients have made a decision to invest $4 to $5 bucks a day in their health," said Bret Jorgensen, CEO of MDVIP, a concierge doctor network. The company has 230,000 members, ranging from chief executives to teachers, who pay their doctors an annual fee of about $1,700 a year, on average, on top of their insurance co-payments.
Concierge doctors argue that they save patients money by reducing their need to go to specialists and hospitals. "Patients who join have better control of chronic medical issues. That $100 a month is paid back relatively quickly," said Dr. Matthew Priddy, who also serves as President of the American Academy of Private Physicians.

Tuesday, December 16, 2014

FHIcommunications Expands Digital Portfolio with New Title

Florida Health Industry's Week in Review Launched DEC 8, 2014

Week in Review will be distributed every Monday. WIR is quick read and summarizes the top headlines of the previous week nationally (What Happened). FHIcommunications editors provide the analysis portion (Why it Matters).

Jeff Herschler, Founder of FHIcommunications stated:
“We are very excited about the new title and believe it will round out our current list of titles (Specialty Focus, Updates in Pediatrics, FHIweekly and Game Changers). WIR will further our mission of Informing, Connecting and Engaging Florida's healthcare community.”

You can view the inaugural issue of the publication here>> http://conta.cc/1BrgUMl

Saturday, November 29, 2014

Healthcare Roundtable Examines Professional Liability

With the premise that:

Repeal of Florida's 2003 tort reform law as well as innovations in medical technology necessitate a re-evaluation of risk management strategies. Meanwhile the transformation of healthcare delivery brought on by the ACA, the HITECH Act and health industry economics creates potential new Medical Malpractice liabilities.

The most recent installment of the Healthcare Roundtable was held at Imperial Club in Aventura. Guest speakers were:
  • Matt Gracey, CEO, Danna-Gracey
  • Michael A. Petruccelli, JD, Partner, Fann & Petruccelli
  • Alexandru Visan, MD, CEO & Co-Founder, Executive Cortex Consulting

We are seeing an explosion of risk in the (physician) extender world. There is a lot going on behind the scenes among insurers and risk managers as to how to properly manage this risk.
-Matt Gracey

When you are seeing new patients, who have not had a standing physician-patient relationship, coming to you via the ACA, you have to look at each one as a potential plaintiff.
-Michael Petruccelli

Telemedicine can help address the physician shortage. We don't have to be there to see patients anymore. We should allow telemedicine to fulfill its role. We should allow automation to fulfill its role.
-Alexandru Visan, MD

We see some remarkable things down here (in S. FL).  Average per member, per year expense for a Medicare patient is just shy of $9k (nationally).  In Palm Beach county it's $15k. In Miami it's $19k.
-Lanny Pauley 

The event was Moderated by Lanny Pauley, COO, Neuroscience Consultants and Closing Remarks wereprovided by Jeff Kramer, CPA, Partner, Goldstein Schechter Koch.

Sponsors were Danna-Gracey, Goldstein Schechter Koch and VidaCare Plus.

Tuesday, November 11, 2014

Florida Specialists Featured in List of Top Doctors

Becker's Hospital Review recently released their 100 physician leaders of hospital and health systems 2014. 

Florida doctors who made the list include:
  • David J. Bailey, MD, MBA, a Pediatric Gastroenterologist, President and CEO of Nemours, Jacksonville
  • M. Narendra Kini, MD, a Pediatrician, President and CEO of Miami Children's Hospital
  • Mack Reavis, MD, a Pathologist, President and CMO of Lakeland Regional Medical Center
  • Patrick Taylor, MD, an Emergency Medicine specialist, President and CEO of Holy Cross Hospital, Fort Lauderdale
  • Allen S. Weiss, MD, A specialist in Rheumatology and Geriatrics, President and CEO of NCH Healthcare System, Naples
To view the entire list including physician BIOs, click HERE.

Thursday, October 23, 2014

Healthcare Roundtable Announces 2nd Fall Program

Join Us...

Tues., November 18, 2014 | 7:30-9:30 am

Imperial Club, Aventura

As the Healthcare Roundtable addresses...
Professional Liability in the New Health Age

Repeal of Florida’s 2003 tort reform law as well as innovations in medical technology necessitate a re-evaluation of risk management strategies.  

Meanwhile the transformation of healthcare delivery brought on by the ACA, the HITECH Act and health industry economics creates potential new Medical Malpractice liabilities.

Guest Speakers include:

Matt Gracey
, CEO, Danna-Gracey

Michael A. Petruccelli, JD, Partner, Fann & Petruccelli

Alexandru Visan, MD, CEO & Co-Founder, Executive Cortex Consulting

Alicia Robles de la Lama, JD, CHC, LHRM, General Counsel, Chief Compliance Officer, Gastro Health

Moderated by:  Lanny Pauley, COO, Neuroscience Consultants

Register/Learn More>>

Tuesday, October 7, 2014

Good News, Bad News for Medical Specialists

Ellie Rizzo reports in Becker's ASC Review on the Top 25 Highest Paid Physician Specialties for 2014, (This analysis is based on Medcape's recent survey; the same author reported on the top specialists earlier this year using BLS data which applies different metrics). Regarding the Mescape report, there are no surprises among the Top 5:

1. Orthopedics - $413,000 (2 percent increase)
2. Cardiology - $351,000 (2 percent decrease)
3. Urology - $348,000 (2 percent increase)
4. Gastroenterology - $348,000 (2 percent increase)
5. Radiology - $340,000 (2 percent decrease)

Meanwhile, Kathy McCoy details some challenges ahead for some of these very same specialists in a recent article entitled CMS Puts Away the Carrot and Brandishes the Stick.  According to Ms. McCoy, physicians face potential Medicare income loss of 9% due to PQRS and Value Based Modifier Program reductions plus Meaningful Use penalties. This translates to reductions in Medicare reimbursements of over $20,000 for an average Cardiologist and over $10,000 for a Gastroenterologist in 2017.

Tuesday, September 23, 2014

Healthcare Mergers: Cutting Waste or Creating Monopolies?

An excellent article, written by John Tozzi, appeared in Bloomberg Businessweek recently. Mr. Tozzi addresses an apparent paradox in current health policy, stating:
"To cut costs, healthcare providers are linking family practices and specialists with hospitals, rehabilitation centers, and outpatient clinics. The hope is that consolidating services will eliminate redundancies, reduce waste, and improve patient outcomes by making it easier for medical professionals to coordinate care-all objectives of the Affordable Care Act."

However, this "...is creating health systems so big they can dictate prices."
Anyone who took Principles of Economics knows that market power leads to pricing power. An equally important doctrine is this: Achieving scale lowers costs. For current health policy to work in lowering our national healthcare bill, regulators need to make sure that large health systems don't pocket these savings by overcharging. In other words, our health system appears to be evolving toward a network of heavily regulated monopolies akin to our electricity providers (FPL, Con Edison, JEA, Duke Energy etc.).

HERE to read the entire article.

Saturday, September 6, 2014

CMS’ Final Rule for Meaningful Use in 2014 Offers Providers Flexibility

By Kathy McCoy

CMS approved the proposed rule to ease the Meaningful Use obstacles faced by many providers on August 29, giving providers assurance that they can use EHRs that have been certified under the 2011 Edition, a combination of the 2011 and 2014 Editions, or the 2014 Edition of certified electronic health record technology (CEHRT) for 2014.

Overview of the September 2014 Meaningful Use Final Rule

  1. Stage 2 of the Meaningful Use incentive program will be extended through 2016
  2. Stage 3 will begin in 2017 for providers who first became meaningful users of electronic health records in 2011, 2012 or 2013
  3. Maintains the 3 month (quarterly for Medicare) reporting period
  4. Allows eligible providers to use any of the following options to meet Meaningful Use in 2014:
    1.  2011 edition certified electronic health record technology (CEHRT),
    2. a combination of 2011 and 2014 edition CEHRT
    3. 2014 CEHRT to report Stage 1 objectives
    4. 2014 CEHRT to report Stage 2 objectives
  5. Eligible professionals (EPs) must use the 2014 edition CEHRT in 2015
  6. The 2015 reporting period for EPs is the full calendar year
None of the flexibility rules above have changed when comparing the May 2014 proposed rule to the September 2014 final rule, but CMS has clarified several issues that caused concern for many in the medical community.

Among the issues that were unclear in the proposed rule were:

1.     When CMS said that the alternatives were available only for those providers that “could not fully implement” 2014 certified EHRs, what does “fully implement” mean?
In the Final Rule, CMS provided this definition: “A provider's ability to fully implement all of the functionality of 2014 Edition CEHRT may be limited by the availability and timing of product installation, deployment of new processes and workflows, and employee training.”

2.     What about that “transitions of care” objective that was not feasible for most providers due to a lack of ability on the part of other providers?
CMS has also clarified their position on the “transitions of care” objective in the final rule: “…the sending provider may experience significant difficulty meeting the 10 percent threshold, despite the referring provider’s ability to send the electronic document, if the intermediary or the recipient of the transition or referral is experiencing delays in the ability to fully implement 2014 Edition CEHRT. 

We acknowledge referring providers may not be able to meet the summary of care measure in 2014, if receiving providers they frequently work with have not upgraded to 2014 Edition CEHRT.”

CMS reinforces that providers not able to meet the transition / summary of care measure may attest to Stage 1 and they remind the provider to retain documentation that they were unable to meet the measure’s 10% threshold.

2014 Participation Options
A useful chart provided by the industry publication EHR Intelligence, based on information from CMS, outlines the options for eligible providers.

CEHRT Flexibility Resources
To help the public understand the final rule’s changes to 2014 participation, CMS has developed the following resources:
•  CEHRT Interactive Decision Tool – providers answer a few questions about their current stage of meaningful use and Edition of EHR certification, and the tool displays the corresponding 2014 options.
• 2014 CEHRT Flexibility Chart – chart provides a visual overview of CEHRT participation options for 2014.
• 2014 CEHRT Rule Quick Guide – guide provides corresponding resources based on the option a provider chooses to participate in the EHR Incentive Programs in 2014.

No changes to proposed rule, despite requests

Although many public comments signaled that a significant number of stakeholders would have preferred additional changes, CMS approved the proposed rule without any significant changes. One of the items at issue for many providers was the requirement to report for 12 months in 2015; a number of industry groups proposed changing the reporting period to the 90 days required in 2014.

“CHIME is deeply disappointed in the decision made by CMS and ONC to require 365 days of EHR reporting in 2015,” said Russell Branzell, President and CEO of The College of Healthcare Information Management Executives (CHIME) in a press release. “This single provision has severely muted the positive impacts of this final rule. Further, it has all but ensured that industry struggles will continue well beyond 2014.”

Another requirement to remember for 2015 is that a 2014 certified EHR will be required to attest next year. If you are looking for an EHR, it’s best to select one that is already 2014 certified to insure that you will be able to attest in 2015.

For more information on Meaningful Use, see:

Kathy McCoy, MBA, is Director, Content Marketing, for HealthFusion’s MediTouch® EHR & Practice Management Software. She can be reached at kmccoy@HealthFusion.com

Monday, August 25, 2014

Monday, August 18, 2014

Healthcare Roundtable Announces Venue for Fall Program

Entitled Women in Healthcare:  Healers and Leaders, the event will take place Tuesday, Sept 30, 2014 from 7:30-9:30 am at Park Shore Pharmacon in Hallandale Beach.

In concert with Women in Medicine Month, this provocative and timely panel discussion will focus on the rapid growth of female doctors in the American health system. In 1849, Elizabeth Blackwell became the first woman to receive a medical degree in the U.S. Today, half of medical students and a third of practicing physicians are women (source: San Francisco Medical Society). 

Attendees will meet five remarkable female physicians.  They will share their stories of the challenges overcome and comment on the opportunities that lie ahead as women in medicine make their mark on the industry.

Proceeds to benefit The Breast Cancer Research Foundation.  Tickets are free; continental breakfast included.  Recommended donation is $20 per attendee.  Seating strictly limited to 35 guests. 


Tuesday, July 22, 2014

Alcohol-Related Liver Damage

According to a recent article by Brigid Duffy in the July 2014 issue of  Gastroenterology & Endoscopy News and citing Center for Disease Control and Prevention (CDC) statistics:
  • Alcohol abuse accounted for an estimated 88,000 deaths in the United States each year between 2006 and 2010.
  • This abuse amounted to  $224 billion in economic costs in 2006 alone.
As said by the article, the CDC found that only one in six adults, including binge drinkers, reported ever discussing alcohol consumption with a health professional. 

Gastroenterology & Endoscopy News recruited a lineup of hepatologists and gastroenterologists to share their experiences in treating alcohol-related liver damage.  

Follow the link below to view the panel discussion.

Friday, July 11, 2014

Analysts Forecast Future of Hospitals

A terrific article was published earlier this week examining the economics of the hospital industry.  Authored by attorneys at McDermott Will & Emery and consultants at Juniper Advisory, it compares the hospital business to other industries and forecasts big changes driven by the Affordable Care Act.  You can view it HERE

Sunday, June 22, 2014

Republicans Continue ACA Onslaught

According to a recent post on Modern Healthcare, entitled Obamacare legal battle threatens subsidies for millions, ACA opponents are exploiting a drafting error in the Senate bill that eventually became the law.
The article states that "If the cases reach the high court, legal observers believe it is possible the conservative majority led by Chief Justice John Roberts would find the premium subsidies illegal, crippling the law's insurance expansion".
There is no hidden agenda here. The Republican hate the ACA. They believe it is a government overreach that is not in the best interest of the people or physicians. They will continue to attack the law at every opportunity.

Friday, June 6, 2014

SFHHA Releases Program for Upcoming Event

The South Florida Hospital & Healthcare Association has finalized its program for the June 19-20 Healthcare Summit to be held at the Signature Grand, Davie. This year's theme is Quantity & Quality, Cost & Benefit: How to get what we pay for!

As is customary, the event will kick off Thursday evening with a Summit Registration & Exhibit Hall Networking Opportunity. Friday morning will feature a Plenary Panel Discussion entitled Lessons from Medicaid Debate, Reform & Implementation.  Morning breakout sessions followed by luncheon with exhibitors and afternoon breakouts will round out the day.  

States SFHHA President Linda Quick: "Timely topics!  Superb speakers!  Great networking!"

Click HERE to learn more.  

Friday, May 23, 2014

Meet the Panel: June 3rd Healthcare Roundtable

In today’s rapidly changing healthcare marketplace, some doctors have elevated their game and adopted an entrepreneurial mindset to leverage their physician credentials.  In this panel discussion, you will learn from…
  • a doctor who is succeeding in the delivery of an innovative diagnostic test,
  • another who has built his busy practice by embracing, instead of vilifying, managed care,
  •  a third who built a large group (50 + physicians) practice, and continues to lead it today,
  •  another who participated in the Medicare Shared Savings Program, and profited,
  •  and a fifth who has  successfully implemented cutting-edge surgical procedures
Click HERE for full BIOs

Physician Entrepreneurs

Tues. June 3 | 7:30-9:30 am | Vi at Aventura

Complimentary Registration Available to Qualified Healthcare PROs | Space is Limited 

Friday, May 2, 2014

June Healthcare Roundtable Panelists Announced

The latest headlines focus on the ACA, EHR, Population Health, ICD-10, Expanded NP Scope of Practice, Physician Payment Reform, Payer and Health System Consolidation.

As the American health system enters a new health age, physicians appear to be losing power, prestige and income as their skills are commoditized and non-practitioners increasingly control decision making and budgets.

Some doctors however are bucking that trend. 

Join us…

Tues., June 3, 2014 | 7:30-9:30 am

Vi at Aventura

…for a provocative and informative panel discussion as we focus on…

Physician Entrepreneurs

A distinguished group of healthcare experts has been assembled to offer insight and enlightenment so providers can not only survive, but thrive.

Moderated by Bimal Shah, CLU, ChFC



For more information about this event and future programs including sponsorships, opportunities to join the panel, please contact Jeff Herschler at 305.299.3937 or JHerschler@me.com.   

Friday, April 18, 2014

NCQA Launches New PCMH Standards; Announces Deadline for 2011 PCMH Recognition

By Kathy McCoy, MBA | UpdatesInPediatrics.com Guest Blogger

The Patient-Centered Medical Home, a concept first introduced by the American Academy of Pediatrics (AAP) in 1967 but now adopted much more broadly, is developing as studies demonstrate the need for different requirements.

One of the recent changes includes new requirements issued by one of the leading accrediting bodies, the National Committee for Quality Assurance (NCQA), on March 24, 2014, for the 2014 PCMH recognition program. The new program is designed to:    
  • Align more closely with Meaningful Use Stage 2 requirements
  • Emphasize team-based care
  • Align quality improvement activities with the “triple aim” of improving the patient experience and population health and reducing per capita costs of health care
  • Put a care management focus on high need populations

If you were planning to apply for PCMH recognition under the NCQA 2011 version, you need to know that the last day to purchase the 2011 Survey tool is June 30, 2014, and the last day to submit the 2011 Survey Tool is March 31, 2015.

Even if you haven’t decided which version to use, you may want to purchase the 2011 Survey Tool before the deadline runs out on June 30, 2014, in order to maintain the flexibility of choosing which recognition program—2011 or 2014—you want to be recognized for.

New Standards

In announcing the new standards, NCQA said that “PCMH 2014 retains strengths of earlier NCQA standards, including alignment with contemporary federal requirements for ‘meaningful use’ of health information technology—now Meaningful Use Stage 2.”

Changes in the advantages and requirements of the new NCQA PCMH Recognition include:
      Integration of behavioral health –Practices are expected to collaborate with behavioral health care providers and to convey behavioral health care capabilities to patients.
      Care management focus on high-need populations – Practices are expected to address socioeconomic drivers of health and poorly controlled or complex conditions. Practices should also focus on the special needs of patients referred from the “medical neighborhood” of practices that surround and inform the medical home.
      Enhanced emphasis on team-based care – The new standards emphasize collaboration with patients as part of the care team and establish team-based care as a “must-pass” criterion for NCQA Recognition.
      Alignment of improvement efforts with the triple aim – Practices must show that they are working to improve across all three components of the triple aim: patient experience, cost and clinical quality.
      Sustained transformation – In keeping with the goal of continuous improvement, practices must show that they comply with NCQA standards over long periods.

Between March 24, 2014, and March 31, 2015, practices can submit either the PCMH 2011 Survey Tool or the new version’s survey tool. After March 31, 2015, only the new survey tool will be accepted. It is important to note that the most progressive software vendors may begin to support the new standard exclusively sometime later this year. We advise medical practices interested in PCMH to focus on using the 2014 standard beginning in the 4th quarter of 2014.
Whether you are submitting the 2011 Survey Tool or the PCMH 2014 survey tool, the best way to become recognized as an NCQA Medical Home is to use software that has been pre-validated and that is Meaningful Use Stage 2 certified.

PCMH Resources
·      Watch a free recorded webinar on The Patient-CenteredMedical Home: What You Need to Know
·      See a free infographicWhat is Patient-Centered Medical Home?
·      Download the PCMH 2014 standards free of charge via the NCQA website.
Kathy McCoy, MBA, is Director, Content Marketing, for HealthFusion, a leading provider of EHR and practice management software. She can be reached at: kmccoy@HealthFusion.com.

Friday, April 4, 2014

A Better Way to Think About Your Body

Written by Deepak Chopra, MD     

We desperately need a new model of the human body. Compliance with the standard model of prevention (moderate exercise, abstinence from alcohol and tobacco, a Mediterranean diet, and stress management) remains fitful and haphazard.

Why? It's not for lack of information but lack of motivation.

Read More>>

Source:  Linked in Today

Friday, March 21, 2014

Medical Students in Action Prepare for Spring Trip

Medical Students in Action (MSA), a 501 (c) (3) non-profit charitable organization travels bi-yearly to the rural villages of the Dominican Republic, providing medical and dental care as well as public health education to the under served. The medical team is led by Steven E. Chavoustie, MD, FACOG, MSA of Miami and Donato Arguelles, MD, FACC of Coral Gables. The current mission departs for the DR on March 29th.

All medical/dental personnel volunteer their expertise and time. In their 10th year of operation, the medical and dental teams are comprised of volunteer doctors, medical students and Carrollton Sacred Heart students. The organization relies solely on charitable donations for their medical mission. All donations go to providing medicines and supplies to the people served.

Learn More>>

Friday, March 7, 2014

Boynton Beach-based ACO Concludes Contract Year; Results Announced

Last month, Accountable Care Options, a Boynton Beach-based ACO led by Rich Lucibella, announced the results from their first contract year.  You can view the story with press release link in the February 14th issue of Game Changers.  Both financial and quality outcomes were impressive.  I had a chance to catch up with Rich recently to gain some insights into how these goals were reached.

Monday, February 17, 2014

Statistics reveal trends for Specialists; Hospital Employment, Compensation

A recent NY Times article entitled Apprehensive, Many Doctors Shift to Jobs With Salaries cited several interesting statistics relating to physician specialists, hospitals and compensation including:

  • 50 percent of surgeons and 25 percent of surgical subspecialists - such as ophthalmologists and ear, nose and throat surgeons - are employees rather than independent, according to the American Medical Association.  
  • The base salaries of physicians who become employees are still related to the income they can generate, ranging from... $575,000 in cardiology to $663,000 in neurosurgery, according to Becker's Hospital Review, a trade publication.
  • The fraction of cardiologists employed by hospitals rose to 35 percent in 2012, up from 11 percent just five years earlier, according to the American College of Cardiology.
You can view the complete article HERE

Monday, February 3, 2014

Healthcare Roundtable Announces March Breakfast Program

Limited Resources, Unlimited Hope:  Addressing the Dual Diagnosis of Mental Illness and Substance Abuse

Tues., March 4 | 7:30-9:30 am

Park Shore, Pharmacon, Hallandale Beach  

Register/Learn More>>

Thursday, January 23, 2014

Mike Fernandez joins Scott campaign team

Governor Rick Scott announced on January 17, 2014 the appointment of Mike Fernandez as Finance Co-Chair. Mr. Fernandez joins Darlene Jordan as Finance Co-Chair, State Senator John Thrasher as Chairman, Tim Saler as Deputy Campaign Manager and Matt Moon as Communications Director on the campaign re-election staff. The hiring of Melissa Sellers as Campaign Manager was simultaneously announced.

Mr. Fernandez is a close friend of the Governor and leads Coral Gables based MBF Health Partners.   Mr. Fernandez is credited with creating, financing and/or growing many well known healthcare companies including Physicians Healthcare Plans, Inc, CarePlus Health Plans, Inc, Hospitalists of America, Navarro Discount Pharmacies and Simply Healthcare Plans. Mr. Fernandez currently serves on the board of directors of MEDNAX, Inc in addition to his chairmanship of MBF.

Friday, January 17, 2014

Jackson Health System CFO Honored with Financial Turnaround Award

Mark T. Knight, Executive VP and CFO of Jackson Health System, will be honored during the South Florida Business Journal's 2014 CFO Awards on January 22. Knight has been selected as the "Turnaround Deal of the Year Winner" for his role in Jackson's dramatic financial turnaround.

"Mark Knight has played a critical role in securing Jackson's future for generations to come," said Carlos A. Migoya, president and CEO of Jackson Health System. "He is an expert in his field who has worked tirelessly, maintaining a laser focus on Jackson's finances. We are proud to have him on our team."