Wednesday, December 27, 2017

The GOP Tax Bill Repeals Obamacare's Individual Mandate

The unpopular individual mandate, which requires most Americans (other than those who qualify for a hardship exemption) to carry a minimum level of health coverage, has been repealed by the new Republican tax bill. Passed by both houses of Congress, the bill will be signed into law by President Trump.
Read more in the current issue of Week in Review>>

Wednesday, December 13, 2017

U.S. healthcare spending growth slowed in 2016

According to Reuters, in a Dec. 06 2017 article, "Growth in healthcare spending in the United States slowed in 2016 following two years of expansion under the Affordable Care Act, a government health agency reported on Wednesday."
Read more in the current issue of Week in Review>>

Thursday, November 30, 2017

Physicians must embrace the business side of medicine

Davis Liu, MD asserts, in a KevinMD post dated November 26, 2017, that the "issue lies in the false dichotomy...often create<d> by asking whether physicians or business people should ultimately be responsible for hospital care."

Read more in the current issue of Week in Review>>

Monday, November 6, 2017

Why Doctors Should Unionize

"Hospital administrators easily manipulated physicians, treating them as if they were hired hands. Insurance companies were dealing with them as if they were employees. Government programs...controlled key aspects of doctors' work, told them how much they would be paid, and what procedures they would be paid for," according to Dr. Sanford A. Marcus, a surgeon in private practice who formed the Union of American Physicians and Dentists (UAPD).

Read more in the current issue of Week in Review>>

Monday, October 23, 2017

Healthcare Roundtable announces November event

Trustbridge presents...
Palliative Care Roundtable
A live panel discussion featuring some of South Florida's leading hospice and elder care experts, this will be the third annual event.

Tues., Nov. 14, 2017 | 7:30-9:30 am

Five Star Premier Residences
Hollywood, FL


Monday, October 9, 2017

Cancer and obesity

A Centers for Disease Control & Prevention (CDC) post dated 10/3/17 examines the relationship between cancer and obesity:

Overweight and obesity are associated with at least 13 different types of cancer. These cancers make up 40% of all cancers diagnosed. About 2 in 3 occur in adults 50-74 years old. Most types of these cancers associated with overweight and obesity increased from 2005-2014. More than half of Americans don't know that overweight and obesity can increase their risk for cancer. Many things are associated with cancer, but avoiding tobacco use and keeping a healthy weight are among the most important things people can do to lower their risk of getting cancer.
Read more in the current issue of Week in Review>>

Monday, September 25, 2017

Many Questions Remain as Investigators Examine Broward Nursing Home Deaths

Police say a ninth person has died nearly a week after the evacuation of a Florida nursing home that Hurricane Irma left without air conditioning. 

The Rehabilitation Center at Hollywood Hills has been in business for over 30 years. It was acquired by Hollywood Property Investments in 2015 (an affiliate of South Miami-based Larkin Community Hospital). Jorge Carballo, MBA, NHA is the Administrator and the Director of Nursing is Maria Colon, RN, BSN. Attorney Gary Matzner is the facility's legal counsel. The facility is located directly across the street from Memorial Regional Hospital
The Florida Department of Health stated, "The tragic and senseless loss at Hollywood Hills Rehabilitation Center is the subject of a criminal homicide investigation by law enforcement." The legal guardian of one resident is suing the facility for negligence and reckless indifference, claiming that Hollywood Hills didn't take the proper precautions to protect their most vulnerable patients. The public relations firm representing the hospital said that multiple calls and requests for assistance were placed to Florida emergency services and utility companies after the air conditioning and electrical supply were rendered inert by Irma. Florida officials have suspended the license of the nursing home. Home officials say they used coolers, fans, ice and other means to cool the patients. When FPL workers arrived at the nursing home after the patients died, it took them approximately 20 minutes to get the center's power back up and running.
Read more in the current issue of Week in Review>>

Monday, August 28, 2017

8 ways to fix the Affordable Care Act

Gienna Shaw, in an August 23, 2017 post:

In this special report,  FierceHealthcare's editors-experts on the business of healthcare who cover hospitals, health systems, physician practices, insurance companies, health information technology and healthcare finance every day-outline some of the ideas, programs and reforms that hold the most potential to heal the nation's healthcare system. 

This a must-read for anyone interested in U.S. health policy.

Monday, August 14, 2017

Remarkable Increases in Alcohol Use

Bridget F. Grant, PhD, S. Patricia Chou, PhD, Tulshi D. Saha, PhD, et al report on American alcohol use in an August 9, 2017 JAMA Psychiatry post. The authors studied 12-month prevalence of alcohol use, high-risk drinking, and DSM-IV alcohol use disorder between 2001-2002 and 2012-2013. According to the authors:

In this study of data from face-to-face interviews conducted in 2 nationally representative surveys of U.S. adults, including the National Epidemiologic Survey on Alcohol and Related Conditions and the National Epidemiologic Survey on Alcohol and Related Conditions III, 12-month alcohol use (up 11.2%), high-risk drinking (up 29.9%), and DSM-IV alcohol use disorder (up 49.4%) increased for the total U.S. population and, with few exceptions, across socio-demographic subgroups.

Read more in the current issue of Week in Review>>

Monday, July 31, 2017

FDA Targets Nicotine in Cigarettes

Matt Egan, reporting for CNN on 7.28.17:

The FDA said it will consider a plan to cut the amount of nicotine in cigarettes to "non-addictive" levels. The agency said it may also regulate "kid-appealing flavors" in e-cigarettes and cigars and wants to encourage "new products that may be less dangerous than cigarettes."

Cigarettes are the "only legal consumer product that, when used as intended, will kill half of all long-term users," FDA Commissioner Scott Gottlieb said in a statement.

Read more in the current issue of Week in Review>>

Thursday, July 13, 2017

CDC: Despite recent declines, opioid prescribing is still high and inconsistent across the US

The CDC, in a July 6, 2017 Vital Signs post, reports:
  • Providers in the highest prescribing counties prescribed 6 times more opioids per person than the lowest prescribing counties in 2015.
  • Half of US counties had a decrease in the amount of opioids (morphine milligram equivalents aka MME) prescribed per person from 2010 to 2015.
  • The MME prescribed per person in 2015 was about 3 times as high as in 1999.
Read more in the current issue of Week in Review>>

Monday, June 26, 2017

Trump Signs VA Reform Bill

Barnini Chakraborty, in a June 23, 2017 Fox News post, reports:
President Trump on Friday signed Veterans Affairs reform legislation meant to protect whistleblowers while making it easier to fire problematic employees at the department... The Department of Veterans Affairs Accountability and Whistleblower Protection Act passed by Congress earlier this month streamlines the process to remove, demote, or suspend VA employees for poor performance or misconduct. In addition, it authorizes the VA secretary to recoup any bonuses awarded to employees who have acted improperly.
The bill enjoyed broad bi-partisan support and fulfilled a Trump campaign promise. The ongoing VA debacle is a cautionary tale for proponents of a single payer system.

Read more in the current issue of Week in Review>>

Monday, June 12, 2017

FDA Approves First Generic Truvada in U.S.

Robert Lowes delivers news from the FDA on June 09, 2017:
The U.S. Food and Drug Administration (FDA) has approved the first generic version of emtricitabine/tenofovir disoproxil (Truvada, Gilead Sciences) to both treat and prevent HIV infections in this country, the agency announced today.
The list price for Gilead Science's Truvada is roughly $1500 for a month's regimen of one pill per day, or about $18,000 a year, although health insurance and patient-assistance programs knock down the price considerably. Generic versions of Truvada in other countries cost as little as $70 a year, according to Mitchell Warren, executive director of AVAC, an international organization that promotes HIV prevention.

Read more in the current issue of Week in Review>>

Thursday, May 25, 2017

Proton pump inhibitors implicated in chronic kidney disease

Sydney Lupkin & Pauline Bartolone | KHN

Recent research has linked the proton pump inhibitors, or PPIs, to serious side effects, including chronic kidney disease, and recently filed lawsuits allege, among other things, that the manufacturers should have known of their potential harms. The risk of chronic kidney disease is as much as 50 percent higher in people who've taken the drug compared with those who've not - although no causative link has been proven and manufacturers insist they are safe.

Read More

Senate Introduces 2 New Healthcare Bills PLUS Is Physician Shortage a Myth?

New Senate bills aim to boost Medicaid addiction treatment access and lift the ban on the creation and expansion of physician-owned hospitals. Meanwhile a new study discredits the commonly held belief that the U.S. is headed for a shortage of physicians.

Read more in the current issue of Week in Review>>

Monday, May 8, 2017

Chronic Disease Management - Non-Pharma Approach for Better Outcomes

It’s no secret that cardiovascular disease, hypertension and metabolic disorder are among the top chronic conditions in the U.S. today ( The Western diet of carbohydrate rich, processed foods combined with sedentary lifestyles are major drivers of these diseases. Cigarette smoking, excessive alcohol consumption and obesity are also significant risk factors (  Health spending in the U.S. is currently approaching 20% of GDP and growing (The Fiscal Times). Thus, properly preventing, delaying and/or managing chronic conditions is critical for the long term health and wealth of our nation.

Despite lip service to diet, exercise and  life style modifications to address chronic disease, many practitioners are quick to reach for the prescription pad ( And why not? It's tough to persuade patients to eat right, workout, quit smoking and reign in alcohol consumption. Furthermore, a lot of the medications used to treat chronic conditions are inexpensive, effective  and widely considered safe.

However, these various drugs are not a panacea. First, although generally considered safe, many of these drugs are associated with significant Adverse Affects (AEs) ( and Second, meeting lipid profile guidelines and controlling blood pressure and blood sugar naturally (i.e. via diet and exercise) intuitively seems more healthful than artificially (i.e. via prescription meds). Western medicine appears to be in agreement with that intuitive conclusion. For example, the almost universally embraced Framingham Risk tool examines various data points to assess ten year risk of a cardiac event. In order to earn a low risk rating, a patient needs to have a systolic BP of less than 130 mm Hg. If the patient's BP is being treated with medicines, the risk increases even if the below 130 mm Hg benchmark is achieved. Finally, a patient who relies on prescription medications might be more likely to avoid important lifestyle changes. E.G. If my blood cholesterol is fine on the statin, why lose weight? If my blood pressure is under control with the lisinopril, why quit smoking?

Chronic inflammation and poor gut health are both implicated as major contributors to chronic disease ( and JAMA). Meanwhile an anti-inflammatory diet ( combined with a sensible exercise program can simultaneously address chronic conditions synergistically and deliver a host of additional health benefits with no AEs. A diet of healthy fats, lean protein and lots of fruit and vegetables united with exercise (30 minutes a day, five days a week, balanced between aerobic and anaerobic activity) will naturally reduce systemic inflammation and restore gut health ( and and WebMD). Anti-inflammatory supplements and probiotics can complement the diet/exercise treatment plan. Benefits include improved cardiovascular health (better lipid profile and reduced blood pressure), improved gastrointestinal function, reduced cancer risk as well as improved metabolic and sexual function. Such a treatment plan promotes healthy weight, reduces tobacco and alcohol cravings, lessens joint pain and supports restful sleep and general well-being.

Not every patient has the determination necessary to adopt a disciplined diet and exercise program. And not all patients will be able to completely restore their health without prescription medications. But a huge segment of our population could transform their health without drugs. Most of the remainder could benefit by relying on lower dosages of fewer medicines. Both healthcare practitioners and patients can prosper by adopting diet and exercise as a first line of defense against chronic disease.

Monday, April 24, 2017

FICPA Holds Health Care Industry Conference in Orlando

Health care is a profession under constant change, especially under a new administration. New rules and regulations are introduced with regularity. What can you do to keep pace with this ever-evolving industry? Attendees of the 2017 FICPA Health Care Industry Conference addressed these issues and more. The event was held at the Caribe Royale in Orlando April 20 and 21.

The program featured a morning Keynote Address entitled Information Security: Threats, Attack Vectors and Solutions, led by Robert E. Anderson Jr., Managing Director of Navigant Consulting, Inc. Breakout topics included Physician Independence in an Environment of Growing Complexity, New Revenue Opportunities, Learning From the Past: Regulatory and Transactional Lessons Learned in Healthcare Deals and Building a Personal Brand in Health Care. There was also a Luncheon Presentation focused on the Post Election World for the Health Care Industry, an afternoon Keynote Address called Value as a Driver of Provider Payment and an Expert Panel discussing The Impact of the Presidential Election on Strategy and Alternative Payment Systems.

Sponsors included:
  • South Florida Hospital News & Healthcare Report
  • American Express
  • Carr, Riggs & Ingram, LLC
  • PNC Health Care
  • FHIcommunications
  • Gregory, Sharer & Stuart, CPAs
  • J.P. Morgan
  • Ernst and Young, LLP
  • Fifth Third Bank
  • Healthcare Financial Management Association - Florida Chapter
  • Memorial Healthcare System
  • Moore Stephens Lovelace CPAs & Advisors
  • Navigant Consulting, Inc.
  • Pinnacle Healthcare Consulting
  • Vaco
  • Winthrop Resources
The FICPA has unique conference sponsorship opportunities available that can help increase visibility and exposure of services and products. Conference sponsorship options include table-top exhibits and exclusive sponsorship of lunch, breakfast and/or breaks.

For more information on how to become a sponsor for a future conference, please contact the FICPA at (800) 342-3197, (850) 224-2727 or

Monday, April 10, 2017

23andMe Receives FDA Nod

According to an news release dated 4.6.17:

The U.S. Food and Drug Administration (FDA) today allowed marketing of 23andMe Personal Genome Service Genetic Health Risk (GHR) tests for 10 diseases or conditions. These are the first direct-to-consumer (DTC) tests authorized by the FDA that provide information on an individual's genetic predisposition to certain medical diseases or conditions, which may help to make decisions about lifestyle choices or to inform discussions with a health care professional.                                 

Read more in the current issue of Week in Review>>

Monday, March 27, 2017

House Cancels AHCA Vote

Ben Mathis-Lilley reporting for Slate on 3/24/17:

A day after Donald Trump demanded that Republican House leaders hold a Friday vote on the flailing American Health Care Act (AHCA) Obamacare replacement bill-and hours after he reportedly repeated his demand in a meeting with House Speaker Paul Ryan-the AHCA has been pulled from consideration and will not be voted on.

According to a CNN opinion piece, by  Dean Obeidallah, published this morning:

Donald Trump may just have achieved another first -- but this isn't one he will like. He may be on the verge of becoming the first president to be considered a "lame duck" within the first two months of his presidency.

Even Fox News admitted the result was a major setback for Republicans, labeling Trump's compromise healthcare bill Mission Impossible

Read more in the current issue of Week in Review>>

Monday, March 13, 2017

Increasing evidence that sugar-sweetened beverage taxes work

In a post by Aaron E. Carroll, MD, MS on Academy Health:
I have written before about soda bans, and why I think they're somewhat misguided. There were loopholes to get around them, they arbitrarily focused on some size beverages, and they were somewhat haphazardly enforced. But I left myself open to the idea of a soda tax - which seems less forceful - and a number of governments have attempted them.

In last month's Health Affairs, researchers report on the effects of a sugar-sweetened beverage tax that had been in place for two years. Mexico implemented the 1 peso per liter excise tax in the beginning of 2014. This was in response to their own obesity epidemic, where about 70% of adults and 30% of children were overweight or obese by 2012.
Read More>>

Monday, February 27, 2017

Healthcare Roundtable Announces Spring '17 Program

Good Genes. Healthy Choices. Luck. All are factors contributing to successful aging. But what’s the magic formula for beating the odds and living a long, healthful life?

Join us APR 4, 2017 at 7:30 am as we explore….

Successful Aging: Unlocking the Mystery of Quality Long Living

At this remarkable panel discussion, featuring renowned S. Florida geriatric and functional medicine specialists, you will meet true experts on successful aging. Learn from the best how to unravel the secret of winning the longevity battle. Apply these long-standing strategies to revitalize your patients, your loved ones and yourself.

Register/Learn more at

Monday, February 13, 2017

Senate Confirms Tom Price for HHS Post

Ted Barrett, in a CNN post dated Fri., February 10, 2017:

In a middle-of-the-night vote, the Senate confirmed Rep. Tom Price to be the next secretary of the Department of Health and Human Services.

The 52 to 47 vote was along party lines.

According to the article:

Democrats opposed Price, a Republican from Georgia, because he is a key architect of undoing the Affordable Care Act and has advocated making major changes to Medicare.
Republicans view Price, an orthopedic surgeon, as a champion of free market principles who will guide the repeal and replacement of Obamacare...

See related: 10 Things to Know About Tom Price

Read more in the current issue of Week in Review>>

Saturday, January 28, 2017

Medicare establishes 5 percent incentive for practices in the advance payment model under MACRA

Written by Accountable Care Options, LLP

The Centers for Medicare and Medicaid Services finalized rules for its payment program on Nov. 2. They affect practices in advanced alternative payment models, including accountable care organizations, or ACOs.

Practices can earn annual incentives up to 5 percent if they are in ACOs that accept a financial risk for excessive costs in return for a greater percentage of the savings generated. That category includes Medicare Shared Savings Tracks 2 and 3, Next Generation ACO models, Comprehensive ESRD Care Model, Comprehensive Primary Care Plus model and Oncology Care Model.

Practices that receive 25 percent of Medicare payments or see 20 percent of Medicare patients in 2017 through an advanced payment model are eligible to receive a 5 percent incentive payment in 2019.

The good news is that practices in those ACOs have most of the reporting work done for them. Physicians can focus their time and attention on delivering effective, efficient care. They will still need to attest what's called Advancing Care Information measures; they replace meaningful use.

The best way to score well in this area is to perform a security risk analysis - a HIPAA analysis of electronic health records. Evaluate the integrity of your system and the structures that house them. If you discover a security risk, then establish a plan and act on it.

To do well overall, a practice should align itself with an ACO that ranks in the 90th percentile or higher in quality and had a positive 2015 adjustment in the value modifier; the latter was based on measures of quality of care and cost containment.

Practices in the advanced payment model that efficiently treat specific cases and diseases and have also generated shared savings will also earn a positive adjustment. The incentive payment will be delivered directly to the practitioner.

Wednesday, January 11, 2017

We trained for this,' say doctors who treated shooting victims

George Richards & Susan Miller Degnan reporting for the Miami Herald on 1/6/17:

It was a somber scene at Fort Lauderdale's Broward Health Medical Center following the mass shooting at Fort Lauderdale-Hollywood International Airport on Friday afternoon, as dozens of reporters and camera crews crowded the entryways to the trauma center.

Victims of the shooting were brought to the hospital soon after the attack occurred at the Terminal 2 baggage claim...

Dr. Ralph Guarneri, the trauma surgeon on duty, said five gunshot victims came into the trauma center and two were undergoing surgery. All five, Guarneri said, were in stable condition.

Read more in the current issue of Week in Review>>