Editors: Ellen W. McKnight, M.D. | Erica Huffman, Executive Director
www.escambiacms.org
Bulletin MARCH/APRIL 2015 VOLUME 45, NO. 2
PRESIDENT’S MESSAGE In February I had the privilege of attending a leadership conference with world renowned leadership expert John C. Maxwell. While I was there, I met a physician from Nigeria. He came wanting to improve the public health of his country. He states that there is a battle between doctors, nurses and other parties for control of how healthcare is run in that country. Apparently, some problems in healthcare are universal no matter what country you call home. I talked with him about the challenges we face here in the United State and what we are trying to accomplish as physicians here in Florida through organized medicine. We are fighting with insurance carriers, politicians, and other providers who want to tell us how to practice medicine or to replace us with “cheaper” alternatives. We are struggling with potential changes in reimbursement based on our patient compliance or patient satisfaction scores that are not always reflective of quality patient care. However these changes are coming whether we like it or not. Fortunately, we have an answer to help us with these problems, and that is communication. We cannot overemphasize the importance of communication in healthcare. Everything you say, do, write or wear is communicating something. This includes words, tone of voice and body language. Understanding what and how you are communicating is even more essential for healthcare professionals because what we communicate - or don’t
CONTENTS communicate - can have a major impact on a patient’s life. We may like to think that patients should do what we tell them, because we know what is the best treatment based on our years of training and experience. But being right is not enough. We have to get them to buy into the treatment plan and then be compliant with the plan. Whether it is logical or not, patients will sometimes buy into the treatment plan based solely on whether they connected with the doctor. So the question presents itself, are you connecting with your patients? We know that it isn’t always possible to please everyone, but at least our patients should feel like they have been heard. When we have only a few minutes to see each patient, it is still good practice to make them feel important. How many of us have gone into a room and never sat down because we knew “it isn’t going to take long”. I’ve been guilty of that more than a few times myself. But there are studies showing that patients perceived a physician spent more time with them just because he or she sat down than when compared to a physician spending the same amount of time standing in the room. Another thing my patients and I noticed after computers were placed in all the rooms was that there was less face-to-face time and less eye contact. In order to make sure all the correct boxes are checked for meaningful use, we can sometimes get sidetracked clicking away instead of looking at the patient who is talking to us. It isn’t cont. on page 12
Page 3 - Announcements Page 4 - Membership Page 6 - Medical/Legal Page 10 - Practice Mgmt. Page 12 - President’s Message cont. Page 15 - In the Community
SAVE THE DATE Monday, April 13, 2015 Pensacola Wahoos Game Doctors Day Celebration Wednesday, May 6, 2015 Hilton Garden Inn Airport Boulevard Mini Health Vendor Fair Vendors: BBVA Compass Bank, Catalyst CRE, Dyken Wealth Strategies, Rick Lambert CFP ®, Financial Advisor Edward Jones, Safe Harbor Tax Advisory, Underwood Anderson & Associates, Inc., Saltmarsh Cleveland & Gund, Panhandle Medical Services, Plateful of Yum Tuesday, August 11, 2015 New World Landing Young Physicians Section Meeting | Speaker: Patricia Clark Social Sponsor: Edward Jones & FD Insurance Founded in 1973
RETURN SERVICE REQUESTED PRSRT STD U.S. POSTAGE PAID PERMIT #258 PENSACOLA, FL
Founded in 1873
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
1 | ECMS
ECMS | 2
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
8880 University Pkwy., Suite B Pensacola, FL 32514 Ph: 850-478-0706 x2 Fx: 850-474-9783 Email: info@escambiacms.org www.escambiacms.org
E.C.M.S. Bulletin
The Bulletin is a publication for and by the members of the Escambia County Medical Society. The Bulletin publishes six times a year: Jan/Feb, Mar/Apr, May/Jun, Jul/Aug, Sept/Oct, Nov/Dec. We will consider for publication articles relating to medical science, photos, book reviews, memorials, medical/legal articles, and practice management.
•
•
Vision for the Bulletin:
Appeal to the family of medicine in Escambia and Santa Rosa County and to the world beyond. A powerful instrument to attract and induct members to organized medicine.
Mission:
The mission of the Escambia County Medical Society is to promote the art and science of medicine in order to improve the health of our community. | Tradition – Honoring the history of medical care in Escambia and Santa Rosa counties. | Service – Serving the needs of our community through the service of our members in the practice of medicine. | Leadership – Meeting the challenges of the future and safeguarding our community’s health through organized collaboration on the local, state, and national level.
Announcements 2015 Calendar of Events Monday, April 13, 2015 | Pensacola Wahoos Game Doctors Day Celebration Sponsors: Beck Properties, Edward Jones, & Mag Mutual Insurance, Physicians Indemnity, Underwood Anderson Insurance, Inc. Wednesday, May 6, 2015 | Hilton Garden Inn Airport Boulevard Mini Health Vendor Fair & physician speed networking Vendors: BBVA Compass Bank, Catalyst CRE, Dyken Wealth Strategies, Edward Jones, Safe Harbor Tax Advisory, Underwood Anderson & Associates, Inc., Saltmarsh Cleveland & Gund, Panhandle Medical Services, Physicians Indemnity, Plateful of Yum Tuesday, August 11, 2015 | New World Landing Young Physicians Section Meeting | Speaker: Patricia Clark 1 AMA PRA Category 1 Credit™ Social Sponsor: Edward Jones & FD Insurance Sunday, September 27, 2015 | Hemingway’s Bimini Beach Bar Women in Medicine Brunch Sponsors: Danna Gracey Insurance, Edward Jones, Fisher Brown Insurance, Safe Harbor Tax Advisory, Physicians Indemnity, Plateful of Yum October 20, 2015 | Pensacola Little Theater General Membership Meeting | Kevin Pho, M.D. 1 AMA PRA Category 1 Credit™ Social Sponsors: Dyken Wealth Strategies, Edward Jones Dinner Sponsor: Regions Bank November 14, 2015 | Hilton Garden Inn on Airport Blvd. General Membership Meeting | FALL CME Conference Sponsors: Catalyst CRE, Edward Jones, Mag Mutual Insurance, Physicians Indemnity, Safe Harbor Tax Advisory, LLC.
Ad placement Contact Erica Huffman at 478-0706 x2 Ad rates 1/2 page: $350 · 1/4 page: $200 · 1/8 page: $150
View and opinions expressed in the Bulletin are those of the authors and are not necessarily those of the board of directors, staff or advertisers. The editorial staff reserves the right to edit or reject any submission.
(L-R) Christopher Burton, M.D. (ECMS President); Hillary Hultstrand, M.D. (ECMS VP); Doug Broxson (District 3 Republican); Clay Ingram (District 1 Republican); Ellen W. McKnight, M.D. (ECMS Secretary/Treasurer); Brian Kirby, M.D. (ECMS President-Elect). ECMS Executive Committee joins local district representatives for a photo after the ECMS Legislative Round Table on January 27th.
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
3 | ECMS
Membership New Members
Reinstated Members
Frederic Jackson, D.O. Retired Hospice Physician
Pamela Grier-Hall, M.D. Harry Latourette, M.D. Rex Northup, M.D.
Moving/Relocated
Karen Silverman, D.O. Family Medicine Sacred Heart Medical Group at Tiger Point 1399 Country Club Road Gulf Breeze, FL 32563 P: (850) 416-7734 www.sacred-heart.org Jennifer Payne, M.D. OB/GYN West Florida Medical Group 8333 North Davis Highway 2nd Floor Pensacola, FL 32514 P: (850) 969-2038 Fax (850) 969-2037 Erica Whittingham, M.D. Pediatrics Florida State University COM Hospitalist 5153 North 9th Ave Pensacola, FL 32504 (P) 850-416-7713 Fax: 850-416-7677
Dr. Megumi Maguchi’s has now opened Advanced Geriatrics & Primary Care, LLC, which is located at 9013 University Parkway, Ste. G, Pensacola, FL 32514 Tel: 850-912-8020 F: 850-912-8150 Dr. Rachel Brown has now opened Emerald Shores Rheumatology, which is located at 7552 Navarre Parkway, Ste. 54, Navarre, FL 32566. Tel: 850-684-3445 F: 850- 684-3446 Dr. Victor Hulstrand has changed practices. He is now at Woodlands Medical Specialist on 4724 North Davis Highway, Pensacola, FL 32503. Telephone: (850) 696-4000 Dr. Ken Garrett and Dr. Jeff Buchlater have moved. The Gulf Coast Pain Institute is now at 4901 Marketplace Road Pensacola, FL 32504
Never Forgotten Tyler Vance Lockland, Jr. (1922-2015) passed away on February 17, 2015. Dr. Lockland was a member of Escambia County Medical Society from 1957-1991 and became a life member in 1992. In 1970, Dr. Lockland served as the President of EMCS.
Don’t forget to reserve your tickets for the 2015 ECMS Doctors Day Celebration. Space is limited. Also at Doctors Day you can pick up your copy of the 2015 ECMS Directory!
ECMS | 4
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
E.C.M.S. in the News The state of Florida is facing a serious doctor shortage and the shortage is only expected to worsen in the coming years. There are several things influencing the doctor shortage in our State. In Florida, there seems to be adequate medical school slots but it is residency training programs that are deficient. Therefore, physicians who would have otherwise stayed in our state to finish their training and ultimately practice here are forced to find residency training spots in others states and they do not always return. The areas of the state with the highest population have the greatest numbers of physicians and these areas do not experience the shortages as dramatically as areas that are not as populated. Specialists are in very short supply all over the state but in the more rural areas of the state, patients are often forced to travel long distances for care. I believe another reason for the shortage is that Doctors are fed up with the unending demands of insurance companies, Medicare, and Medicaid. There are continual legal and privacy concerns that hang over every medical decision made by doctors. The drudgery of ineffectual electronic health record has physicians throwing their hands up in disgust. As a result, many doctors are retiring early. Some are setting up concierge practices which limit the number of patients that they see in a year. These factors also contribute to the state-wide shortage of physicians. WEAR Ch3 news contacted the ECMS to interview a physician regarding the physician shortage. I was initially reluctant as I did not view myself as an expert on this topic. I relied heavily on Erica Huffman who came to my office one hour before, with a fact sheet in hand with all the pertinent information. Also, we had a 20 minute conference call with a liaison at the FMA who re-iterated the talking points. It is very important for doctors to make themselves available to the community to answer questions about the changing landscape in medicine. If an opportunity presents itself to advocate for patients, take it, you will get the support you need through the Escambia County Medical Society. Ellen W. McKnight, M.D. ECMS Secretary/Treasurer
Michael Coyle, D.O. Board-Certified Female Pelvic Medicine and Reconstructive Surgeon
EXPERIENCED. HELPING PATIENTS WITH COMPLEX OB/GYN ISSUES. For the past 14 years, Michael Coyle, D.O., has worked diligently to stay at the forefront of advances in women’s health. As the first board-certified female pelvic medicine and reconstructive surgeon in the Southeast U.S., Dr. Coyle is here to help your patients. He specializes in pelvic reconstructive surgery, the treatment of urinary and fecal incontinence, minimally invasive and roboticassisted surgery, and natural bio-identical hormone replacement therapy.
For a patient referral, call 850-983-3528.
Dr. McKnight interviewed by Amber Southard, Channel 3 news ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
6072 Doctor’s Park • Milton, FL 5 | ECMS
MEMBER OF THE MEDICAL STAFF AT SANTA ROSA MEDICAL CENTER.
Medical/Legal TELEMEDICINE IMPROVES ACCESS TO CARE BUT CREATES LIABILITY RISKS by Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Telemedicine involves the delivery of healthcare—such as remote monitoring or real-time interactions with providers—to patients in remote locations and to underserved patient populations through audio-visual, online, and wireless applications. This leads to improved access to medical care and consultation, more efficient treatment plan implementation, cost savings for patients, and increased patient satisfaction. The use of telemedicine is growing, and the Centers for Medicare and Medicaid Services recently announced that in the 2015 physician fee schedule, Medicare payments to telehealth originating sites will increase by 0.8 percent.1 However, numerous federal and state statutes have created significant liability risks for medical practitioners who engage in any form of telemedicine. The Health Insurance Portability and Accountability Act (HIPAA) established national standards for the use and disclosure of personal health information (PHI) and the prevention of healthcare fraud and abuse. The Office of Civil Rights (OCR) is authorized to conduct investigations and impose monetary sanctions for HIPAA violations. In addition, the Health Information Technology for Economic and Clinical Health (HITECH) Act implemented governmentmandated requirements for breach notification, authorized random audits by the OCR, substantially enhanced penalties for statutory violations, and specified that all transmissions of PHI must be “secure” (encrypted). In the first year of enforcement, the OCR reported the recovery of more than $7 billion in penalties and fines. With the advent of electronic health records (EHRs), the transmission of PHI between patients and providers, providers and payers, and among providers has significantly increased. Practices that engage in any form of electronic data transfers, including telemedicine, must strictly comply with the various statutory requirements of HIPAA and HITECH or risk an OCR investigation and potential fines. Historically, physicians and other healthcare professionals have been licensed exclusively by state boards of practice. Physicians who engage in telemedicine across state lines, therefore, face serious considerations. The scope of practice is generally determined by the location of the patient. Laws governing the practice of medicine vary significantly among the states. Providing care, including the prescription of medication and other controlled substances, to a patient located in a different jurisdiction requires the practitioner to satisfy the licensing requirements of the state in which the patient is located. Without proper licensure, adverse consequences might include criminal prosecution for the unlicensed practice of medicine or disciplinary action by a medical board. A physician who provides medical care across state lines through any form of telemedicine may also be subject to a potential malpractice suit in the event a claim is filed in the jurisdiction where the patient resides, rather than in the jurisdiction where the provider maintains his or her offices. The standard of care will be determined by experts familiar with the community practices in the jurisdiction where the patient is located. Physicians should also be aware that their professional liability policy may not cover a claim that is filed outside a specific territory or jurisdiction. To reduce these liability risks and enhance patient safety: • Comply with HIPAA, HITECH, and state-specific laws when transmitting all PHI. • Ask your system vendor to provide training to you and your staff on how to protect and secure your data. • Ensure robust and reliable high-speed broadband connectivity to support clinical functions. • Check practice requirements and legal limitations in states where you anticipate providing care to patients. Understand reimbursement practices for telemedicine services. • Use telemedicine carefully—and understand any limitations on the reliability and accuracy of the information. • Communicate directly with your professional liability insurer to make certain that your policy extends coverage to all jurisdictions where you provide services. ECMS | 6
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Medical/Legal Reference 1. Wicklund E. CMS boosts telehealth in 2015 physician pay schedule. mHealthNews. http://www.mhealthnews. com/news/cms-boosts-telehealth-2015-physician-pay-schedule. Accessed November 25, 2014. Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors.com/ patientsafety. Richard Cahill, JD, is vice president and associate general counsel at The Doctors Company. He received his Juris Doctorate from Notre Dame Law School and his undergraduate degree (summa cum laude) from UCLA. Mr. Cahill has specialized in healthcare litigation for more than 25 years, including defense of hospital and physician professional liability claims, and he lectures frequently around the country on healthcare topics. Article Description: Telemedicine Improves Access to Care But Creates Liability Risks Telemedicine can improve access to medical care and consultation in rural areas and increase patient satisfaction, but federal and state statutes have created significant liability risks. This article gives patient safety tips for medical practitioners who engage in any form of telemedicine. Tweet: #Telemedicine: Improved access to care doesn’t come w/o liability risks. Protect your patients: http://ow.ly/FCCx9 @doctorscompany
providing
educational loans for studies in
medicine, nursing, medical technology and the ministry. For more information, visit
www.fellowsfund.org
MS1461 Fellows Med Soc. 2015.indd 1 1/9/15 10:50 AM ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
7 | ECMS
Medical/Legal DIAGNOSTIC ERROR IDENTIFIED AS THE MOST COMMON ALLEGATION IN MALPRACTICE LAWSUITS by David B. Troxel, MD, Medical Director, The Doctors Company
Problems related to diagnostic error are the most common allegation in medical malpractice claims, according to industry sources such as the PIAA’s Data Sharing Project. The Doctors Company reviewed 7,438 claims closed from 2007–2013. The claims involved 10 medical specialties: pediatrics, emergency medicine, internal medicine, family medicine, hospital medicine, cardiology, general surgery, gynecology, orthopedics, and obstetrics. Twenty-five percent of these claims (1,877 claims) were diagnosis-related. The analysis then focused on the variance between these medical specialties in the incidence of alleged diagnosis-related error and the specific diagnoses involved. Overall, 34 percent of nonsurgical specialty claims were diagnosis-related (the number one allegation in these claims). For surgical specialties, 14 percent were diagnosis-related (the third most common allegation in these claims). The top five diagnoses for each medical specialty’s diagnosis-related claims involve commonly encountered conditions with differential diagnoses that are well-known to most physicians. For example, in family medicine, which had the largest number of diagnosis-related claims of all 10 specialties (417 claims, or 37 percent of all claims), the top five diagnoses involved lung cancer (4.3 percent), acute MI (4.3 percent), breast cancer (4.1 percent), colorectal cancer (3.6 percent), and prostate cancer (3.4 percent). By comparison, in emergency medicine, with 242 diagnosis-related claims, or 58 percent of all claims, the top five diagnoses involved fractures (13.4 percent), acute CVA (13.4 percent), acute MI (5.4 percent), meningitis (4.5 percent), and appendicitis/spinal epidural abscess (each 2.5 percent). In orthopedics, which had 215 diagnosis-related claims, or 13 percent of total claims, the top five diagnoses were post-op infection (11.2 percent), bone and soft tissue cancer (5.6 percent), compartment syndrome (4.2 percent), fracture malunion (3.3 percent), and pulmonary embolism (2.3 percent). Furthermore, 52 percent of the top diagnoses are found repeatedly in different specialties; e.g., acute MI appears in emergency medicine, internal medicine, family medicine, hospital medicine, and cardiology. This suggests that knowledge deficiency is not the primary cause of diagnostic error and that other factors play an important role. The following are some of the factors that can lead to diagnostic errors. Physicians should keep these factors in mind when making a diagnosis to reduce risks and enhance patient safety: • First-impression or intuition-based diagnoses. • Narrowly focused diagnoses influenced by a known chronic illness. • Failure to create a differential diagnosis. • Impaired synthesis of diagnostic data from various sources, such as medical history, physical examination, diagnostic tests, or consultations. • Failure to order appropriate diagnostic tests. • Context errors. • Failure to follow diagnostic protocols. • System-related errors, such as poor communication or electronic health record design flaws. • Human-factor errors, such as impaired judgment, fatigue, or distractions. In an effort to better understand the causes of diagnosis-related error, the Institute of Medicine has appointed a Committee on Diagnostic Error in Health Care. The committee will examine a range of topics, such as the epidemiology of diagnostic error, the burden of harm and economic costs associated with diagnostic error, and current efforts to address the problem. The committee will propose solutions that may include definitions and ECMS | 8
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
Medical/Legal boundaries, educational approaches, behavioral/cognitive processes and cultural change, and health information technology. To achieve the desired goals, the committee will devise conclusions and recommendations that will propose action items for key stakeholders. Contributed by The Doctors Company. For more patient safety articles and practice tips, visit www.thedoctors. com/patientsafety. David B. Troxel, MD, is secretary of the Board of Governors and medical director of The Doctors Company. Dr. Troxel is clinical professor emeritus, School of Public Health at the University of California at Berkeley. He is past president of the American Board of Pathology and the California Society of Pathologists. He serves as chairman of The Doctors Company Foundation and as a member of the Patient Safety and Technology Committees at The Doctors Company. Article Description: Diagnostic Error Identified as the Most Common Allegation in Malpractice Lawsuits Problems related to diagnostic error are the most common allegation in medical malpractice claims. This article summarizes a review of 1,877 specialty-specific, diagnosis-related claims that closed from 2007–2013 and outlines some of the factors that can lead to diagnostic errors. Tweet: Diagnosis-related errors are most common #medmal allegation. Learn what leads to these claims: http://ow.ly/ EGdR0 @doctorscompany
Top 3 Reasons to choose Panhandle Medical Services:
1. Experience 2. Quality 3. Maximized Collections MEDICAL BILLING • CREDENTIALING BOOKKEEPING • AUDITING
YOUR HEALTHCARE REAL ESTATE EXPERTS
We understand the importance of Physician Satisfaction, Patient Experience, and Operating Efficiencies
PRACTICE EVALUATIONS PAYROLL PREPARATION • CONSULTING
Real Estate Strategy Facility Maintenance Construction Management Lease Administration
Property Management
Special Projects
New Developments
Since 1992
For a free billing review contact us at: BRANDON MCFARREN: 850.698.6068 BMcFarren@CatalystCRE.com Visit us at www.CatalystCRE.com ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
4901 Grande Drive • Pensacola, FL 32504 Phone (850) 478-1312 • Info@panhandlemedical.com
www.PanhandleMedical.com 9 | ECMS
Practice Management HOW KEY PERFORMANCE INDICATORS CAN HELP by Dana Peeterse, VP of Operations, Panhandle Medical Services LLC
Ask yourself, “Are my collections being maximized?” Whether you said “yes” or “no”, ask yourself, “How do I know my collections are being maximized?” If you are not incorporating Key Performance Indicators (KPIs) into your practice, you may not know the true answer to either of these questions. Too often we hear that the provider is making enough money to support his needs. But too often the provider is working too hard for the money being collected. What are Key Performance Indicators? KPIs are performance measurements that measure the success of your practice. They will help you determine if you are working too hard or if your staff or billing company are not working hard enough. Days in Accounts Receivable (DAR) – This is one of the most important KPIs to review on a monthly basis. This KPI helps you determine how long it takes on average to collect your charges. We recommend that when you review your total charges and collections at the end of the month, you also make sure that your Days in Accounts Receivable is looked at carefully as well. Typically this KPI is calculated by dividing your current Accounts Receivable by the average charges for the previous three months times 30 days. For example: June charges - $100,000 July charges - $125,000 August charges - $95,000 Ending Accounts Receivable - $110,000 DAR = [110,000/((100,000 + 125,000 + 95,000)/3)] X 30 days = 31 days It is important to note, though, that your payor mix will drive your DAR. A provider with high Medicare and low Auto and Work Comp will have a much lower DAR than a provider with the opposite mix. When determining what a good DAR would be, you need to consider your mix. Some medical societies can also provide you with an average DAR for your specialty. If your DAR exceeds the recommended days, a prompt audit of your billing processes should be performed. Accounts Receivable Distribution (ARD) – This KPI should also be reviewed on a monthly basis. In order to calculate your ARD, you would divide the outstanding balance in each of the 30, 60, 90, 120 days columns of your AR report by the total outstanding accounts receivable. Total 30 Days 60 Days 90 Days 120 Days $110,000 $95,000 $10,000 $2,500 $2,500 100% 86.4% 9% 2.3% 2.3% It is important that you monitor this KPI to make sure that you do not have claims that are not being worked. This KPI can also be affected by your payer mix. Medicare and most commercial payors should pay in 14 to 21 days. Therefore, if you do not have mostly auto or work comp, you should see the highest percentage under 30 days. For instance, a primary care seeing mostly patients with Medicare or commercial plans, should easily have 90 to 95% in the under 30-day column. If your over 90-day column or over 120-day column is higher than the under 30-day column or the under 60-day column, again, you should promptly audit your billing processes. You may find that it is a billing issue, but it could also be a sign of a credentialing or even a payor issue. Average Collection Percentage (ACP) – Understanding this KPI is very important. Most providers will ask their peers about their Average Collection Percentage to benchmark if they are in line with where they should be. But, unless each provider has exactly the same fee schedule, with the exact payor allowables, and the exact payor mix, these two providers are comparing apples to oranges. Although the Average Collection Percentage is more complex than the above calculations, it is not impossible. ECMS ECMS || 10 10
ESCAMBIA ESCAMBIA COUNTY COUNTY MEDICAL MEDICAL SOCIETY SOCIETY IN IN CONJUNCTION CONJUNCTION WITH WITH SANTA SANTA ROSA ROSA COUNTY COUNTY
Practice Management To determine your Average Collection Percentage, you would need to calculate your average collection percentage by payor then weight it based on your specific payor mix. The following would be an example of calculating your ACP: Allowable % Payor Average Payor of Charge Mix Collection % Medicare 60% 50% 30% Florida Blue 70% 35% 24.5% Commercials 65% 10% 6.5% Auto & Work Comp 70% 5% 3.5% Average Collection Percentage 64.5% This KPI will help indicate when you have an overall problem with your collections. It should remain steady from month to month, but if there is a drastic change in your Average Collection Percentage, it would need to be reviewed immediately. A large shift in your payor mix would certainly cause your ACP to change from a steady percentage. Monthly Collection Goal (MCG) – This KPI should be reviewed on a daily basis. MEDICAL NUTRITION THERAPY At the beginning of each month, you Nutrition Counseling For should set your Monthly Collection Goal Weight Management by multiplying the average charges over Eating Disorders Diabetes the last three months by your Average Heart Disease Collection Percentage from above. P……… PPR Renal Disease & more NUTRITION PRIVATE PRACTICE MCG = [(100,000 + 125,000 + Also Offering 95,000)/3] X 64.5% = $68,800 Once you have determined your Corporate Wellness Consulting Clinical Nutrition Consulting monthly goal, it can be monitored daily to Cooking Classes determine if the collections will fall short for the month or meet the goal. If there 4300 Bayou Blvd Suite 37 is any indication that the goal is going to Pensacola FL, 32503 fall short, it is important to determine the (863) 236-9390 www.platefulofyum.com reason. Dietitian/Owner: Titi Ayanwola MPH, RD, LD We understand that as a provider, your most important goal is to provide the best possible services to your patients. However, utilizing the above Key Performance Indicators will help you maximize your collections and allow you to work smarter not harder.
ESCAMBIA ESCAMBIA COUNTY COUNTY MEDICAL MEDICAL SOCIETY SOCIETY IN IN CONJUNCTION CONJUNCTION WITH WITH SANTA SANTA ROSA ROSA COUNTY COUNTY
11 11 || ECMS ECMS
cont. from page 1
a good habit to get into if we want to connect with our patients and make them feel heard. Patients aren’t the only ones who get frustrated with physicians’ lack of communication. Dealing with office staff is also a challenge in many practices. There are times when it is difficult to get everyone on the same page, or when staff don’t seem to get the big picture. Often this boils down to a communication problem. We as physicians are so busy during the day that we don’t always communicate clearly what we need or expect from our staff. There have been times when I have expected the staff to know what they should do and then do it without stopping to make sure we are clear about what I want them to do. It is important to take time on a regular basis to talk with staff and make sure they understand the vision and goals that you have for the office. When they understand what is expected and how it will help the office run more efficiently or help your patients, they are more likely to buy in to what you want from them. But as important as it is for us to communicate with our staff, it is just as essential that we allow them to communicate back to us. They are on the front line of patient interaction and may see or hear things that we don’t. We have to create an environment where our staff feels comfortable to approach us with problems, questions or suggestions. They should feel as though they are part of the team. I have seen too many offices with high staff turnover because they are not treated well. They were afraid to speak up and certainly wouldn’t question the way things were done. However, we can’t get the best
ECMS | 12
out of others if they are working in an environment of fear. We should create an environment of collaboration and open communication. Part of that communication includes listening. If we are open to the suggestions of our staff, we maybe able to improve patient interaction, copay collection, workflow efficiency, or lower office supply and equipment costs. They also may be more willing to let you know about a mistake that could have had serious consequences - like prescribing a medication to a patient that has an allergy to another medication in that class. I was always glad when my staff caught these things and brought them to my attention because it helped to improve the patient’s experience and our bottom line. We would not have benefited from our staff’s input if we hadn’t maintained open communication and made them feel a shared responsibility for running the office well and providing a great experience for the patients. This space isn’t big enough to go into all the specific ways we can improve communication within our practices. But as I told our physician colleague from Nigeria who asked me how to improve healthcare leadership in his country, we can go a long way if we start developing better communication skills. If this is an area you would like to learn more about, don’t hesitate to reach out to me. I want to help our physicians be the best healthcare leaders they can be for their practice and their patients.
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
As the nation’s largest physician-owned medical malpractice insurer, with 75,000 members, we constantly monitor emerging trends and quickly respond with innovative solutions. And our long-standing relationships with the state’s leading attorneys and expert witnesses provide unsurpassed protection to our over 15,000 Florida members. When these members face claims, they get unmatched litigation training tailored to Florida’s legal environment, so they enter the courtroom ready to fight—and win. Join your colleagues—become a member of The Doctors Company.
CALL OUR JACKSONVILLE OFFICE AT 800.741.3742 OR VISIT WWW.THEDOCTORS.COM
UNCOMPROMISING
IN FLORIDA, FLORIDA, WE PROTECT OUR MEMBERS WITH THE BEST OF BOTH WORLDS: NATIONAL RESOURCES AND LOCAL CLOUT
PROTECTION ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
13 | ECMS
Isn’t it time you called the med mal and cyber insurance specialists? Julie Danna and Arlene Gardner, your local medical malpractice specialists, have become well known throughout the state as strong advocates for health care providers, as well as creators of society and network insurance purchasing programs. Danna-Gracey is an independent insurance agency with a statewide team of specialists dedicated solely to insurance coverage placement for Florida’s doctors and healthcare providers, including medical malpractice, workers’ compensation, and cyber liability insurance. For a no-obligation assessment of your current coverage, call Julie or Arlene at 850.995.9119.
Delray Beach • Jacksonville • Miami • Orlando • Pensacola julie@dannagracey.com • 850.995.9119 • www.dannagracey.com
Defending southeast physicians for more than 30 years We invest our financial strength in you • The best Florida attorneys
• Doctor2Doctor® peer support
• Florida peer physician claims review
• Consistent dividends*
• Industry leading Patient Safety
• Owners Circle® rewards program
Medical malpractice insurance for Florida physicians To find out more about the products and services MagMutual offers in Florida, contact:
Staige Hoffman MagMutual 813-781-3184
Lesa Kemp
MagMutual 904-813-9284
MagMutual.com
* Dividend payments are declared at the discretion of the MAG Mutual Insurance Company Board of Directors. Since inception, MAG Mutual Insurance Company has distributed more than $136 million in dividends to our policyholders. Insurance products and services are issued and underwritten by MAG Mutual Insurance Company and its affiliates.
ECMS | 14
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
In the Community BAPTIST MEDICAL GROUP NEWS Florida Blue Names Baptist Medical Group Its Clinical Partner at Pensacola Retail Center Florida Blue and Baptist Medical Group announce that Baptist Medical Group will provide clinical operations at the Florida Blue Health Care Services location at the Florida Blue Pensacola Retail Center. Established in 2012, Florida Blue Health Care Services is a first-ofits-kind, full-service primary care facility from Florida Blue. Housed as part of the Pensacola Retail Center, Florida Blue brings affordable insurance coverage and face-to-face service to the market, combined with primary care services available to Blue Cross and Blue Shield members only. The new partnership with Baptist Medical Group allows members to take advantage of an industry leading provider of care in Pensacola, and an organization that share’s Florida Blue’s commitment to high-quality and affordable health care. Baptist Medical Group of Baptist Health Care in Pensacola is a team of more than 200 doctors, physician’s assistants, nurse practitioners, nurses and support staff who provide services for communities in northwest Florida and south Alabama. Florida Blue Health Care Services utilizes an innovative model of delivering primary care services. Its care strategy will help to decrease medical costs and increase quality outcomes by focusing on care coordination, consumer empowerment and lack of redundancy. The goal is to allow Blue Cross and Blue Shield members better access to health care, increase satisfaction with their care and improve their overall health. The primary care services are for Blue Cross and Blue Shield members age 2 and up – any member from anywhere in the country can use the facility. Services provided include: • Primary care services • Annual physicals • Acute sick visits • Chronic condition management
• Care coordination • Flu shots • Adult vaccinations • Health screenings • Lab services • Access to health records online, including a care plan Baptist Medical Group began clinical operations on Feb. 2, 2015. Florida Blue Health Care Services hours are Monday through Friday, 8 a.m. to 5 p.m., and Saturday from 8 a.m. to noon. Lab hours (services provided by Quest Diagnostics) are Monday through Friday, 8 a.m. to 1 p.m., and Saturday from 8 a.m. to noon. Baptist Health Care Receives Nuclear Cardiology Accreditation by IAC Baptist Hospital, Gulf Breeze Hospital and Baptist Medical Park – Nine Mile Cardiovascular Diagnostics are the only facility’s in the area that have been granted a three-year term of accreditation in Nuclear Cardiology by the Intersocietal Accreditation Commission (IAC). Accreditation by the IAC means that Baptist Hospital, Gulf Breeze Hospital and Baptist Medical Park- Nine Mile Cardiovascular Diagnostics have undergone a thorough review of its operational and technical components by a panel of experts. The IAC grants accreditation only to those facilities that are found to provide quality patient care, in compliance with national standards through a comprehensive application process including detailed case study review. IAC accreditation is a “seal of approval” that patients can rely on as an indication that each facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of Nuclear Cardiology.
FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE PENSACOLA CAMPUS | CHANGE HAPPENS The Pensacola Regional Campus has enjoyed a highly dedicated, skilled and stable group of clerkship directors for the past 12 years. The original nine clerkship directors still occupy those positions This summer two of them will be retiring. Please join with me in thanking Drs. Jacobi and Chicola for their 12 years of service to our students. Both of them helped develop our original clerkships and have done a masterful job of implementing the curriculum at our regional campus. Both have a passion for medical education and it shows in their work. We can not thank them enough. They will be missed. Replacing Dr. Jacobi will be Dr. Dennis Mayeaux. Dennis will move from his role as Clerkship Director for Family Medicine into the same role in Geriatrics. Dr. Mayeaux was recently promoted to Clinical Professor in the Department of Family Medicine and Rural Health. He is an exemplary educator and we can look for him to continue the legacy that was created by Dr. Jacobi for this mission-based clerkship. Our new Clerkship Director for Family Medicine is Dr. Hillary Hultstrand. Dr. Hultstrand has been on our clerkship faculty since 2009. She has consistently received accolades from the
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY
students and Dr. Mayeaux during this time. In addition, she has assumed a number of leadership roles with the Escambia County Medical Society. I believe her to be a perfect fit. Our new Clerkship Director in Surgery is Dr. John Tyson. John has been a clinical faculty member since the matriculation of our inaugural class in 2003. He is a recipient of our Outstanding Educator Award and a master teacher and mentor in our community based model of medical education. We are very excited to welcome Drs. Tyson and Hultstrand to the team. With the leadership of all of our clerkship directors and the expertise of you as clinical faculty our program will thrive in the coming years. Paul McLeod, M.D., Senior Associate Dean For Regional Campuses Florida State University College of Medicine Pensacola Regional Campus
15 | ECMS
www.edwardjones.com
Meeting on your schedule, not ours. Face-to-face meetings. One-on-one relationships. How did Edward Jones become one of the biggest financial services companies in the country? By not acting like one. With more than 10,000 offices. Including the office of Rick Lambert, CFP® in Pensacola.
Rick Lambert, CFP® Financial Advisor .
1800 W Garden Street Pensacola, FL 32502 850-429-8403
Member SIPC
MKT-8275-A-AD © 2013 EDWARD JONES. ALL RIGHTS RESERVED.
ECMS | 16
ESCAMBIA COUNTY MEDICAL SOCIETY IN CONJUNCTION WITH SANTA ROSA COUNTY