SEPTEMBER JULY 2015 2012 Visit us now online at www.NJPhysician.org
Special Feature: Sovereign Health Cancer Care Horizon Announces ‘Innovative Partnership with Major Health Care Players Report Shows Heights Today’s Health Care Costs Can Reach New Medical Billing Code System’s Deadline Arrives
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DOV GORSHEIN, MD
ALAN SHAIMAN, MD
GOPAL DESAI, MD
NADRA MOULAYES, DO
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Breast Surgeon
OUR TOP DOCTORS CLOSE TO HOME... STEPHAN DORKHOM, DO
STEVE ELIAS, MD, FACS
HOMAM BADRI, DPM
RICHARD MAGGIO, MD, FACS
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Medical Oncologist
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A fully integrated multi-specialty community healthcare system providing clinical excellence and convenient care to
NORTH JERSEY & NEW YORK RESIDENTS Built from the ground up right here in the Garden State, Sovereign Health System has called New Jersey home for more than 20 years. After two decades of steady growth, Sovereign Health System continues to expand its physician ranks, cutting-edge services, and conveniently located facilities to better serve the people of New Jersey and New York. Sovereign knows it’s important to have that one-on-one connection with your nurse and doctor. That’s why at Sovereign you are treated like family -- and why our latest patient-satisfaction rating is 95%. Sovereign provides you with multi-specialty care, ongoing support, and comprehensive services in one fully integrated community healthcare system. In short, we offer peace of mind . . . close to home.
Bayonne
Hawthorne
Ridgewood
Carlstadt
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Staten Island
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Wayne
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Woodcliff Lake
Englewood
Oradell
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Paramus
Fair Lawn Glen Rock
Hackensack Jersey City
New Brunswick– Saint Peter’s University Hospital
Carlstadt
Oradell
Englewood Cliffs
Ridgewood
Paterson
Fair Lawn Freehold* Jersey City Fair Lawn
Wayne– St. Joseph’s Cancer Center
Glen Rock
Hewitt
Mahwah
SJCH Pediatric (Fair Lawn) Wayne
University Center for Ambulatory Surgery (Somerset)
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Special Feature
Sovereign Health Cancer Care
CONTENTS
4
8
Horizon Announces ‘Innovative’ Partnership with Major Health Care Players
9
Eight Other Hospital Systems Involved With Horizon’s New Alliance
10
N.J. Hospitals Excluded From Horizon’s Proposal Worry About Their Future
14
Vitale Has Some Concerns About Alliance, Anticipates a Hearing
14
Report Shows Heights Today’s Health Care Costs Can Reach
15
New Medical Billing Code System’s Deadline Arrives
16
N.J. Health Care Coalition Releases Report Backing Out-Of-Network Bill
16
Barnabas Health Medical Group Expands Through New Affiliation
17
ACA Has Reduced the Number of Uninsured New Jersayans
18
AtlantiCare to Merge with PA-Based Geisinger Health System
19
Prime Finalizes Takeover of Saint Clare’s Health System
20
New President Schwimmer Describes Next Steps for Health Care Qualitiy Institute
20
Westminster-Based AxisPoint Health Appoints CEO, formerly of DermOne September 2015
3
Special Feature
Sovereign Health
Cancer Care Bringing Cutting Edge, Compassionate Cancer Care Closer to Home By Iris Goldberg When CEO and Chairman of Sovereign Health System, John H. Hajjar, MD, FACS, MBA set upon his mission to create a physician-owned and led healthcare system with community-based centers of excellence to deliver highquality, cost-effective care, cancer patients were certainly high on his list of priorities. Within his urology practice, Dr. Hajjar saw many with prostate, bladder, kidney or testicular malignancies that were in need of comprehensive care from a cancer specialist. Often, this required New Jersey patients to travel to academic medical centers far from home, sometimes in different states such as New York or Pennsylvania. In fact, today, many patients with all types of cancer who reside in New Jersey continue to seek cancer treatment elsewhere. With four cancer care centers of excellence located in Hackensack, Jersey City, Wayne and most recently, in New Brunswick, Sovereign Health is providing patients the highest level of cancer treatment within their own communities. Utilizing state-of-the-art technology and recruiting impressively trained oncology experts who have published extensively in leading peer reviewed journals, Sovereign can offer cancer patients top tier care and treatment. The newest member of Sovereign Health’s oncology team is Stephan J. Dorkhom, DO, who treats cancer patients at the $14 million, 32,000 square foot facility just opened on campus at St. Joseph’s Wayne Hospital. The brand new St. Joseph’s Cancer Center will operate in partnership with Sovereign Health to bring comprehensive, advanced cancer treatment to residents of Wayne and surrounding counties and communities. “From the time I was eight years old when my paternal grandmother, whom I loved very, very much, died from metastatic pancreatic cancer, I have wanted to become an oncologist, find a cure for cancer and save other kids from the traumatic experience I suffered as a young child,” Dr. Dorkhom candidly shares. While his early dream of a cancer cure remains elusive, Dr. Dorkhom has remained true to his original goal, receiving his training at some of the most prestigious institutions in
4 New Jersey Physician
Stephan J. Dorkhom, DO
the country in order to develop the expertise to provide positive outcomes for cancer patients. Graduating from Colgate University with honors in molecular biology, Dr. Dorkhom was invited to work at the National Institute of Health (NIH), where he was involved in innovative research to isolate a new cancer gene, with the findings published in the medical literature. Postponing medical school for a year, Dr. Dorkhom seized an opportunity to work in the pharmaceutical field, translating his academic experience into the development of new cancer-fighting drugs. Although this was extremely gratifying, he elected to move on with his medical training and has achieved board-certification in Internal Medicine as well as Hematology/Oncology.
To view “Prostate Cancer: Importance of Getting Screened” click here
During his residency training at Columbia University College of Physicians and Surgeons, Dr. Dorkham was House Staff at Memorial Sloan Kettering where he worked with some of the leading cancer specialists worldwide and authored a paper on hepatocellular carcinoma. Then he pursued fellowship training in Hematology/Oncology at the renowned MD Anderson Cancer Center in Houston. While there he was first author on a book chapter on “Advances in the Treatment of Chronic Myelogenous Leukemia.” (CML) Dr. Dorkhom has also had first author presentations at both the American Society of Hematology (ASH) and the American Society of Oncology (ASCO). Dr. Dorkhom’s publications and presentations are available online.
Before joining Sovereign, Dr. Dorkhom spent some time in Lubbock, Texas where he treated patients with all tumor subtypes in oncology and both benign and malignant hematology. While there he attained somewhat of a celebrity status, appearing in a number of television segments. (See links at right.) Now that Dr. Dorkhom has joined the Sovereign Health Cancer Care team, he is determined to further the core values established by Dr. Hajjar as these are definitely aligned with his own beliefs. “One of the things we are focused on here is striving to deliver compassionate care,” Dr. Dorkhom emphasizes. “We treat the whole patient – mind, body and spirit. Our goal here is to focus on the patient, spend a lot of time answering questions thoroughly and trying to give our patients hope,” he adds. In terms of working in a community-based cancer center, Dr. Dorkhom could not be more delighted. “Cancer patients don’t want to travel. They’re sick and not feeling well so they want to get top of the line care close to home,” he shares. So what I am able to do is bring the training I received at the two best cancer centers in the country right here to the patients who live in this and surrounding communities,” Dr. Dorkhom proudly states.
To view Dr. Dorkhom’s segment on testicular cancer click here
Going forward, Sovereign Health plans to fill its newest cancer center with more oncologists like Dr. Dorkhom and his colleagues in Wayne, who are expertly trained and extremely motivated to provide compassionate care at the highest level to cancer patients within the community. With Sovereign Health’s cancer facilities throughout the state, New Jersey’s cancer prognosis is an optimistic one. September 2015
5
If you are a physician and are interested in joining the Sovereign Health Medical Group, please contact : Paul Angresano, VP, New Business Development at 201-855-8376 / pangresano@sovms.com
Sovereign Health
Sovereign Health
SurgiCare
Development & management company for ambulatory surgery centers (ASC). Same-day procedures performed in a convenient, caring setting. SURGEM, LLC., has new facilities in select markets in New Jersey, New York and Florida with additional facilities coming soon. Our 13 centers are conveniently located, staffed with highy skilled, caring physicians and nurses, equipped with the latest technology, and designed to provide an optional patient experience in a spotless facility and comfortable setting. We treat you the way we would want ourselves or our family members to be treated, and that approach is reflected in everything we do - and in our consistently high patient-satisfaction ratings. Carlstadt 630 Broad St 201-355-1700
Mahwah 400 Franklin Turnpike 201-766-1550
Englewood Cliffs 630 East Palisade Ave 201-503-1522
Oradell 555 Kinderkamack Rd 201-265-8173
Fair Lawn 15-01 Broadway 201-703-8487
Ridgewood 1124 East Ridgewood Ave 201-493-2310
Freehold* 901 West Main St., Suite 302 732-303-1616
SJCH Pediatric (Fair Lawn) 14-01 Broadway 201-791-0100 Wayne 246 Hamburg Turnpike 973-790-0954
Jersey City 631 Grand St 201-830-2280
University Center for Ambulatory Surgery (Somerset) 2 Worlds Fair Dr 732-748-1117 Manhattan, NY** 800 2nd Ave (7th Floor) 212-419-1016
Cancer Care The Physicians of Sovereign Health Cancer Care are fellowship trained to treat malignancies of any site
Sovereign Health Cancer Care offers our patients state-of-the-art technology in a compassionate outpatient setting. With VMAT IRMT and cone beam IGRT, radiotherapy is delivered precisely and safely every day. Our oncology experts have published extensively in the nations’ leading peer reviewed journals and have vast experience treating cancers of all sites, including prostate, breast, lung, brain and cancers of the gastrointestinal and gynecologic systems. Hackensack 20 Woodridge Ave 201-880-7580
New Brunswick - Saint Peter’s 215 Easton Ave 732-745-8590
Jersey City 631 Grand St 201-942-3999
Wayne - Saint Joseph’s 234 Hamburg Turnpike 973-310-0300
Boca Raton, FL 1905 Clint Moore Rd 561-544-5501
Sovereign Health Medical Group
*Located in CentraState Medical Center **Administrative services agreement
Sovereign Health Medical Group was created by physicians with the needs of patients and other physicians foremost in mind
Sovereign Health Urgent Care
Get immediate medical care at Sovereign Health Urgent Care When an injury or illness occurs and you are in need of medical attention on an immediate basis, visiting an urgent care clinic is a smart move. Your time is important, and we are dedicated to seeing you as quickly as possible. Our priority is providing excellent patient care in an efficient manner. Fair Lawn 15-01 Broadway 201-794-3600
6 New Jersey Physician
Glen Rock 85 Harristown Rd 201-479-5450
Hewitt 1900 Union Valley Rd 973-728-5930
•
Breast Surgery
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Orthopedic Surgery
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Cardiology
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Pathology
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Colon-Rectal Surgery
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Podiatry
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Gastroenterology
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Urgent Care Facilities
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Ears, Nose & Throat (ENT)
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Urogynecology
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Emergency Medicine
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Urology
•
General Surgery
•
Radiation Oncology
•
Hematology & Oncology
•
Vein & Vascular Care
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Internal Medicine
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Other Specialties
•
Neurology
Breast Cancer
Awareness Walk OCTOBER 4 new date
OCTOBER 11 on the St. Joseph’s Wayne Hospital Campus *
Proceeds to benefit Breast Cancer Awareness, Educational Scholarships and Prevention *Original October 4 event postponed to October 11 due to inclement weather
University Imaging 246 Hamburg Turnpike, Wayne, NJ on the campus of St. Joseph’s Hospital Featuring a new expanded Walking Route Check in begins at 8:00 a.m. – Step-off at 9:30 a.m. Includes: Breakfast and Give-a-ways
YOU’RE NOT FACING CANCER ALONE...
Chairman: David Rasa, MD,R.Ph Co-Chairs: Lynn Heydt and Donna Cochrane
WE’LL BE WITH YOU
EVERY STEP OF THE WAY
Walker $10 per person
(includes tee shirt) Suggested donation
Corporate / Team Sponsor $100
At Sovereign Health Cancer Care, our culture is built around one word – empathy. We understand and share the feelings, anxieties and emotions of our patients as our own family. When it comes to breast cancer, Sovereign Health Cancer Care is dedicated to providing you with the best and most compassionate care from our staff and physicians. Our state-of-the-art technology and cutting-edge treatments are designed to diagnose and treat cancer as early as possible. Our convenient locations mean you don’t have to travel far to receive the care you deserve. Simply put, Sovereign Health Cancer Care is devoted to you and your well-being, and to providing you with excellent care, close to home.
(includes signage at event) Team members strive for a minimum of $25 in sponsorship donations. Upon receiving your registration a team kit will be sent to you.
Health Partner $300
(includes sign recognition and listing on websites)
Step out, call
973.956.3304 or visit
www.bit.ly/stjosephscancerwalk2015 Health Partners Sponsored by the Sisters of Charity of Saint Elizabeth
Please join the Sovereign family in supporting those with breast cancer on October 11, 2015 at the Breast Cancer Awareness Walk at St. Joseph’s. >>
FELLOWSHIP TRAINED PHYSICIANS DEDICATED TO YOUR CARE
NADRA MOULAYES, DO Breast Surgeon
DOV GORSHEIN, MD Radiation Oncologist
STEPHAN DORKHOM, DO Medical Oncologist
Sovereign Health Cancer Care - St. Joseph’s Cancer Center 234 Hamburg Turnpike, 973-310-0300
www.sovereignhealthsystem.com SOVEREIGN MEDICAL SERVICES, INC.: 85 HARRISTOWN RD, GLEN ROCK NJ, 07452 | 201-834-1100
Health Insurance
Horizon announces ‘innovative’ partnership with major health care players By Anjalee Khemlani
Rewarding doctors for sending patients home faster and healthier is not a part of the traditional health care system, but a new alliance in the state — featuring many of the biggest names in the industry — hopes to change that. Horizon Blue Cross Blue Shield of New Jersey announced Thursday a new program geared toward decreasing out-of-pocket costs for its members, and holding health care providers accountable for quality care. The state’s largest insurance provider says it is partnering with six of the biggest New Jersey health care systems and the largest medical group to create the OMNIA Health Alliance, which will promote value-based service, an increasingly popular trend nationwide. The company is calling the program a first-of-its-kind, “extremely innovative collaboration,” one that will financially benefit both policyholders and employers. Horizon officials said it is too early put a dollar figure on any potential savings on premiums, but said they will be “substantial” when the plan rolls out in October. However, someone familiar with the details of the plan, who was not authorized to speak on the potential savings, said the partners had access to the following data from 2014. In that year, the person said, Horizon BCBSNJ members treated at a patient-centered practice, as compared with traditional practices, experienced better quality care measures, including a: • 6 percent higher rate in improved diabetes control; • 7 percent higher rate in cholesterol management for diabetic patients; • 8 percent higher rate in colorectal cancer screenings; and a • 3 percent higher rate in breast cancer screenings. Additionally, the person said, Horizon BCBSNJ members treated at a patient-centered practice, as compared with traditional practices, experienced lower costs, including an: • 8 percent lower rate in hospital admissions; • 5 percent lower rate in emergency room visits; and a • 9 percent lower total cost of care. This plan, Horizon officials said, includes national, mid-level, labor, small and individual markets, as well as being on the national health care exchange, but does not include Medicare or Medicaid. Horizon CEO Robert Marino added that the overall effect of this new plan would be “lower premiums, lower cost sharing and value created through wellness and better population management.” Here’s how it will work: Expanding on Horizon’s patient-centered medical home program, this partnership incentivizes health providers to send patients home, rather than adding services piecemeal during a visit. The idea is not new, as a national trend of transparency in health care has been developing similar solutions in the past few years, but it is the biggest push ever seen in New Jersey. Here’s how Horizon Blue Cross Blue Shield feels the OMNIA Health Alliance will impact various groups: Health care providers: bigger pay for improved quality of care, reduced costs of duplicate or excess services Businesses: lower premiums on policies for their employees Policyholders: lower out-of-pocket costs Horizon: shift in health care financing, lower cost of health care Joel Cantor, director of the Center for State Health Policy, said the program could be a game-changer. “This is a very bold shift for them and is something that could be influential in shaping the New Jersey health care delivery system,” he said. The new OMNIA Health Alliance includes Atlantic Health System, Barnabas Health, Hackensack University Health Network, Hunterdon Healthcare, Inspira Health Network, Robert Wood Johnson Health System and Summit Medical Group.
8 New Jersey Physician
The size of these groups assure the program will have impact. Last year, these organizations combined to serve a total of 4.8 million patients. In addition to the OMNIA partners, eight hospital systems, or a total of 12 hospitals, will be a part of Horizon’s Tier 1 plan: Cape Regional Medical Center, Cooper University Health System, Englewood Hospital, Meridian Health, Shore Medical Canter, St. Joseph’s and Princeton HealthCare System. Horizon, meanwhile, has 3.8 million covered lives, by far the largest number in the state. Because of this, partnering made sense, Hackensack University Medical Center Chief Financial Officer Robert Glenning said. Rather than waiting for legislative action, Glenning said, “We saw this as a concrete action we could take with a large health plan in-state to really look to move to better patient experience, reducing per capita cost of health care.” A joint governing body will be created with senior-level members of each partner, as well as Horizon, in order to ensure accountability, as well as allow refinement as needed. In addition, a third-party system will be used to collect patient responses, which will help in determining the success and quality of care. But with the shift comes a large risk for both Horizon and the health care systems, Cantor said. It could be a major success or fail miserably. “In the longer run, Horizon is making a bet that health systems will learn how to do this well, but not well enough to not need Horizon anymore,” Cantor said. Many industry leaders feel some dramatic change needs to take place. The current system of health care, they say, rewards providers financially for added fees, and there is no benefit to ensuring a patient gets well quickly. Because of that, they say the current system of piecemeal fees is not sustainable, and changes have to be made to a value-based system in order to curb rising health care costs for all involved parties. This partnership, however, only benefits Horizon members, leaving other insurance networks out of the loop. David Knowlton, president of the NJ Health Care Quality Institute, said that could be an issue. “The other shoe is yet to drop,” he said. “This is going to be fascinating to watch because of the implications. “They are so big that they can drive people in given markets out of business.”
Eight other hospital systems involved with Horizon’s new alliance By Anjalee Khemlani Eight other hospital systems — representing a total of 12 hospitals, many of which are in South Jersey — will directly benefit from the OMNIA Health Alliance that was announced Thursday, NJBIZ has learned. The alliance is a partnership between Horizon Blue Cross Blue Shield of New Jersey, six major health systems, which include 22 hospitals, and one major physician’s group. The original announcement, however, did not including the additional hospital systems, which will be a part of the Tier 1 plan when it rolls out in October. AtlantiCare (based in Pomona), Cape Regional Medical Center (Cape May), Cooper University Health System (Camden), Englewood Hospital (Englewood), Meridian Health (Wall), Shore Medical Center (Somers Point), St. Joseph’s (Paterson) and Princeton HealthCare System (Plainsboro) will be included in the program, according to someone familiar with the partnership. The OMNIA Alliance includes Atlantic Health System, Barnabas Health, Hackensack University Health Network, Hunterdon Healthcare, Inspira Health Network, Robert Wood Johnson Health System and Summit Medical Group. The alliance partners will be involved in the governing committee tasked with overseeing the new healthcare delivery method and ensuring compliance and quality. Including the eight other partners, six of which are located in South Jersey, will help create a statewide network of hospitals for Horizon members to choose from.
September 2015
9
N.J. hospitals excluded from Horizon’s proposal worry about their future By Susan K. Livio NJ.com Hours after the state's largest insurance company announced Thursday it was forging a partnership with 34 hospitals to "significantly transform how health care is financed and delivered in New Jersey," officials from St. Francis Medical Center in Trenton, a small but renowned community hospital excluded from this new venture, said they were contemplating a grim future. "This would have a significant financial impact, and could affect the future viability of Saint Francis Medical Center," said spokeswoman Kim Barnes. Horizon Blue Cross Blue Shield of New Jersey's plan that will be phased-in beginning in January appeared to create a distinct group of winners and losers in New Jersey's cutthroat health care marketplace, industry insiders and observers said. Consumers accustomed to rising premiums every year would win, Horizon executives said, by seeing their out-of-pocket expenses decline if they agreed to use the 34 "tier one" hospitals and affiliated doctors that have agreed to accept lower reimbursement rates. These 34 hospitals would benefit by seeing greater patient volume. And the 22 hospitals who were accepted into the "OMNIA Alliance" would earn higher reimbursements if they show they are providing quality care by keeping people healthier at a lower cost, Horizon executives said. "Through the OMNIA Health Alliance, we are all making a long-term commitment with a new level of trust, cooperation, and energy that will benefit health care consumers in New Jersey," Horizon Chairman and CEO Robert A. Marino said. The biggest players in the state's hospital landscape are included in the alliance, such as Atlantic Health, with its flagship hospital Morristown Medical Center, Robert Wood Johnson University Health, based in New Brunswick, Barnabas Health, based in Livingston, and Hackensack University Medical Center. Yet many of the remaining 38 hospitals in New Jersey who are left out expressed confusion over why they weren't selected, and concern for their future. Patients would still be allowed to use these "tier two" hospitals, but they would pay more. Marino and other executives who announced the plan said they would share more details about cost in the next month. The 2016 rates listed on the State Health Benefits Program website indicate a big price difference between tier one and two hospitals. State employees would pay no deductible if they used a tier one hospital, but would pay a $1,500 deductible for a tier-two facility. Patients would see they out-of-pocket expenses capped at $2,500 at tier-one facilities compared to $4,500 at tier-two hospitals. Those seeing a primary care doctor or a specialty physician would pay $5 and $15 if they are affiliated with tier-one hospitals, compared to $20 and $30 co-pays for doctors at tier-two facilities, according to the website. Enrollment in the new OMNIA Alliance and tiering plans is optional for state employees when the open-enrollment period begins in October, Horizon spokesman Thomas Rubino said. But state employees in specific HMO plans who decline to choose a plan will be "auto-enrolled into the OMNIA Alliance plan," he said. Sen. Joseph Vitale (D-Middlesex), chairman of the state Senate Health, Human Services and Senior Citizens Committee, said he is concerned about the power Horizon is wielding. He said he would hold a legislative hearing to dissect what the changes will mean for consumers and the stability of the hospital industry. "I don't know if the state's largest insurer gets to decide which hospitals succeed and which ones don't," Vitale said. Vitale said he sees a lot of gaps in hospital coverage. Burlington County has no Omnia or tier-one hospitals. Neither does Trenton. The only Catholic hospital is Saint Joseph's Medical Center in Paterson, and many inner-city, safety net hospitals are conspicuously absent, he said. Vitale said he was particularly concerned about the exclusion of Trinity Health, with St. Francis in Trenton, Our Lady of Lourdes Medical Center in Camden, and Lourdes Medical Center of Burlington County. The Trenton and Camden facilities are renowned for their cardiac care. Horizon has recognized St. Francis' high marks on the Leapfrog Group's patient safety scorecard, said Barnes, Trinity Health's spokeswoman. Trinity asked to join the OMNIA and tier-one group, but was turned down without explanation, she said. "As one of the top hospitals for safety, we're sort of scratching our heads trying to understand what criteria they used," Barnes said. Horizon "engaged in a thoughtful and deliberate selection process in developing the OMNIA Health Alliance," Rubino said, explaining these hospitals "share a vision and commitment to reward high quality health care, the ability to impact the health status of large populations, strong brand reputations among consumers and employers, and the resources and capabilities to use new technology to deliver more effective and efficient health care to our members." Rubino declined to be more specific.
10 New Jersey Physician
Assemblyman Reed Gusciora and Assemblywoman Elizabeth Muoio (both D-Mercer) and Trenton Mayor Eric Jackson said they intended to contact Christie administration officials next week to inquire how no Trenton hospital could be included in Horizon's partnership. "Ultimately, the decision to leave our capital city and its residents without a Tier One provider jeopardizes Trenton's access to quality healthcare at more affordable rates," Gusciora and Muoio said in a joint statement. "Horizon's actions threaten to create a gaping void in affordable coverage for those who most need it." Mayor Jackson said on Monday he intended to ask for an "emergency meeting" with officials from the state Department of Banking and Insurance to discuss how Horizon could be allowed to exclude Capital Health Regional Medical Center and St. Francis Medical Center, which serve his city. "I'm really concerned about the impact to those in my city - the women, children and minorities," Jackson said. "I understand the business perspective, but at the root of this, it should be about caring for all people." Jersey City Medical Center, Monmouth Medical Center in Long Branch and Newark Beth Israel — all owned by Barnabas — are included in OMNIA, said Suzanne Ianni, president of the Hospital Alliance of New Jersey, the trade group for safety net hospitals who treat the most low-income and uninsured people. But St Francis' exclusion "is quite concerning for the residents of Trenton, state employees and the hospitals that serve them. Not only is this an access issue for Trenton, it could negatively affect the bottom lines of the hospitals that currently serve that population," Ianni said. Officials from some tier-two hospitals that stood to lose market share and patient volume touted their value but declined to speculate what Horizon's announcement might mean for their bottom line. Saint Peter's University Hospital in New Brunswick was among them. "Saint Peter's is a stand-alone Catholic institution that operates New Jersey's largest neonatal intensive care unit, delivers more babies than anyone else in central New Jersey, is home to the region's first accredited breast center, and operates New Jersey's only hospital to be ranked by The Joint Commission in all five key quality indicators, including heart failure, acute myocardial infarction, surgical care, pneumonia, and childhood asthma," said Philip Hartman, Saint Peter's spokesman. "Thousands of New Jersey's healthcare consumers prefer Saint Peter's as their provider of first choice, believing that bigger isn't always better, and that clinical expertise and personal attention are of prime importance." Some consumer advocates said they could not form an opinion yet until more details were available, but expressed guarded optimism over Horizon's announcement. "At first glance, it could be a positive thing but I will reserve judgment until I can see some of the ramifications," said India R. Hayes Larrier, a health care organizer for Citizen Action New Jersey. "Giving a tiered benefit which allows consumers to be able to judge their own costs, is good. You also have to think about it down the line. They may be paying less, but do they have access to less care or the care (they) need?" The hospitals participating in OMNIA are: •
Chilton Medical Center
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Clara Maass Medical Center
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Community Medical Center, Toms River
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Hackensack UMC Mountainside
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Hackensack University Medical Center
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Hackensack UMC at Pascack Valley
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Hunterdon Medical Center
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Inspira Medical Center Elmer
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Inspira Medical Center Vineland
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Inspira Medical Center Woodbury
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Jersey City Medical Center
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Monmouth Medical Center, Southern Campus
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Monmouth Medical Center
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Morristown Medical Center
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Newark Beth Israel Medical Center
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Newton Medical Center September 2015
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Overlook Medical Center
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Robert Wood Johnson University Hospital Rahway
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Robert Wood Johnson University Hospital Somerset
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Robert Wood Johnson University Hospital New Brunswick
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Robert Wood Johnson University Hospital HamiltonSaint Barnabas Medical Center
Hackettstown Medical Center, which is in the process of being acquired by Atlantic Health, and Meridian Health, the Shore-based hospital system that is merging with Hackensack, will ultimately be folded into the OMNIA group, Horizon officials said. Other hospitals that will not be part of the OMNIA partnership, but will be considered Tier One offering reduced costs are: AtlantiCare; Cape Regional Medical Center, Cooper University Health System; Englewood Hospital; Shore Medical Canter; St. Joseph's Medical Center; and Princeton HealthCare System.
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Vitale has some concerns about alliance, anticipates a hearing By Anjalee Khemlani State Sen. Joe Vitale said he is deeply concerned about some of the details in the OMNIA Health Alliance, the “innovative” program Horizon Blue Cross Blue Shield of New Jersey announced Thursday. The plan will attempt to change the way health care is delivered and administered throughout the state as Horizon and its partners will use a more value-based method to deliver care. Six hospital systems and the state’s largest physician’s group form the alliance and the governing committee. But the alliance goes deeper than those 22 hospitals. Eight other systems also will reap the benefits. The problem, according to Vitale (D-Middlesex), is that these hospitals do not serve much of the state’s poorest areas. “I am concerned about the hospitals who have not been granted that class, that tier, about how this will affect their bottom line,” Vitale said in a phone interview Thursday. Under the plan, members are now incentivized to use the Tier 1 hospitals, leaving state-funded facilities and lower-tier facilities to only service Medicaid and Medicare patients. This is of great concern to Vitale. “There is a lack of inner-city hospitals on the list, and this could have a devastating effect on their viability,” he said. The impact, he said, is not only health related. Vitale feels it could potentially mean a greater burden on taxpayers, which is a bad problem for a state known to have some of the highest health care costs and taxes in the country. And health care costs are a concern here for the state, because it is obligated to support hospitals without preferred plans. The announcement does have both a positive and negative financial impact, Vitale said, but the negative means more state support is going to be needed. Vitale said he would comment no further, but ended by saying he anticipates holding a hearing in the near future.
Report shows heights today’s health care costs can reach By Anjalee Khemlani The high cost of health care, and especially outrageous out-of-network costs in New Jersey, are well known, but a new report highlights some of the fee hikes compared with Medicare. The report from America’s Health Insurance Plans released Friday analyzed out-of-network charges for more than 18 billion private health insurance claims. Some of the findings include: • Patients that underwent low back disc surgery faced potential excess charges averaging more than 2,300 percent of the Medicare fee. • Charges for cervical/thoracic spinal injections averaged more than 2,100 percent of the Medicare fee for the same procedure. • Knee surgeries incurred charges averaging more than 1,600 percent of the Medicare fee. • Some patients seeking ultrasonic guidance for biopsies saw potential excess charges averaging more than 1,200 percent of the Medicare fee. "Improving access to health care requires us to fundamentally address the barriers to affordability, including the excessive prices charged for medical services," AHIP CEO and President Marilyn Tavenner said. "This latest report demonstrates the serious cost pressures facing consumers who want affordable access to care and the added financial burden caused by soaring out-ofnetwork medical bills." Less than a month ago, a report from the NJ for Health Care coalition, in partnership with Consumers Union, detailed the ways in which health care consumers can unknowingly arrange for out-of-network services, only to be blindsided later on by a potentially hefty bill that is not covered by their providers. Both reports provide adequate support for pending legislation, sponsored by Assemblymen Troy Singleton (D-Mount Laurel), Gary Schaer (D-Passaic) and Craig Coughlin (D-Woodbridge) and state Sen. Joseph Vitale (D-Woodbridge), which aims to protect consumers from surprise out-of-network bills and cap out-of-network billing. “It is still on the front burner and we need to keep it there. We want to try and get something done in this term, and not go beyond that,” Coughlin said in an interview with NJBIZ.
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“I realize that this is a zero sum game. If we are saving $92 million, someone is not making $92 million. (Opponents’) concerns are legitimate, and we will try to address them as best as we can. But we have to try and achieve a method of controlling health care costs,” he said. “I’m not in the business of putting hospitals out of business who are providing health care to the people when it’s critical, so we have to balance the equities.” “We have created a bill that is going to be able to get bipartisan support because it protects consumers,” Coughlin said, adding that many of his Republican colleagues have agreed to get on board.
New medical billing code system’s deadline arrives By Anjalee Khemlani October 1 marks the start of a new billing code system in health care nationwide, and ends the race to meet the conversion deadline. The new ICD 10 coding system, which is created by the World Health Organization, has been around since the late 1990s, but only recently has been pushed as part of the billing system in the U.S. The Center for Medicare and Medicaid Services set the Oct. 1 deadline, after multiple delays over the years, and hospitals and physicians have been slowly implementing the new system. CMS said there would be a one-year grace period, allowing health care facilities to be paid despite errors in using the new codes. The changes from the old system include thousands of additional codes — due to the recognition and discovery of new diseases, as well as differentiating between types, such as type 1 and type 2 diabetes. Independent physicians and small groups have been especially hit hard financially by this new system, according to Larry Downs, CEO of the Medical Society of New Jersey. They have lost tens of thousands of dollars in both time spent away from their practices, attending trainings, as well as the cost of upgrading their electronic systems. The Society joined with the N.J. Hospital Association and ensured members had the resources they needed. Specifically, MSNJ worked with financial institutions to extend small lines of credit if need be to help cover the costs incurred by conversion, as well as to be a safety net in the event payment is delayed from some errors in processing by the new system. Though there has been compliance, there have been complaints, Downs said. The ICD system is used for data collection globally, but in the U.S. it is also used for billing, and has therefore created an extra administrative burden.
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N.J. health care coalition releases report backing out-of-network bill By Andrew George A major New Jersey-based health care coalition released a report Wednesday in support of the passage of an out-of-network health care bill, which is currently being considered by the state Legislature. In its report entitled “Surprise Medical Bills: What they are and how to stop them,” the NJ for Health Care coalition, in partnership with Consumers Union, detailed the ways in which health care consumers can unknowingly arrange for out-of-network services, only to be blindsided later on by a potentially hefty bill that is not covered by their providers. “This is a growing problem that continues to expand and affect more and more New Jersey consumers,” said Maura Collinsgru, program director with New Jersey Citizen Action, which is responsible for convening the coalition. “It’s a statewide problem that demands a statewide solution. We need a health care system and solution that is transparent and fair and protects all consumers from these out-of-network surprise bills in the future.” As it has currently been proposed, the legislation sponsored by Assemblymen Troy Singleton (D-Mount Laurel), Gary Schaer (D-Passaic) and Craig Coughlin (D-Woodbridge) and state Sen. Joseph Vitale (D-Woodbridge) would shield consumers from surprise out-of-network bills as well as provide protections when emergency care is received at both in-network and out-ofnetwork hospital facilities. Under the measure, out-of-network providers would bill a patient’s health care provider using a new payment system established by the legislation, which would set a health price index using data from actual paid claims for a given service. With the index serving as a median, the out-of-network provider would be able to bill a patient’s health care provider for 75 percent to 250 percent of the index and a mandatory arbitration process would be used to settle all disputed claims. That arbitration process was the chief concern of many when the bill went before the Senate Commerce Committee in June. Lawmakers are expected to take the issue back up later this fall. “The New Jersey Legislature has the power to stop this unfair practice in its tracks,” said Consumer Union Program Director Chuck Bell. “The bill now advancing in the Legislature would go a long way toward fixing this problem, but not if the special interests have their way. The physician associations and hospital systems who oppose this bill want to protect their right to continue bloated billing practices — even price gouging. These hidden practices are harming consumers. New Jersey needs to adopt protections that do away with surprise medical bills once and for all and reign in the excesses of out-of-network billing in general.” States like Illinois and New York have already passed similar pieces of legislation. “As the report details, this problem is incredibly urgent,” said report contributor and New Jersey Appleseed Public Interest Law Center Director Renee Steinhagen. “Consumers falling victim to this practice are struggling with medical debt and the practice is a major driver of increased health care costs for everyone in our state. We need the state to adopt a comprehensive and strong solution, and without delay.”
Barnabas Health Medical Group expands through new affiliation By Anjalee Khemlani Barnabas Health Medical Group announced a new addition to the group of physicians in its health network today. Whiting Medical Associates LLC is affiliated with Community Medical Center in Toms River, a Barnabas Health facility. WMA began as a two-physician group called Village Medical in 1977 and has since grown to include five doctors, who focus on preventive care and geriatric medicine. The list of services include annual wellness examinations, urgent care visits, ear wax removal, minor surgeries for benign small skin lesions, routine preventive pelvic examinations and PAP smears as well as joint and tendon injections and bracing for minor orthopedic concerns. In-house diagnostic and care services include electrocardiogram and Holter monitor tests, spirometry lung tests, vaccinations for influenza and pneumonia, and diabetes education and counseling, according to a statement from Barnabas. The physicians of Whiting Medical Associates include Elena Buenaviaje, Crisnoel Cervantes, Danna Dela Cruz, Mario Gallardo and Vicente Magsino Jr.
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Census: ACA has reduced the number of uninsured New Jerseyans By Anjalee Khemlani New U.S. Census data released Wednesday credits the Affordable Care Act for reducing the number of uninsured in New Jersey. The state’s total population is about 8 million, of which 7.63 million had health insurance in 2014, an increase of 234,000 from 2013. The numbers exceed both state and national projections, and has saved the state about half a billion dollars per year due to Medicaid expansion, according to the New Jersey Policy Perspective. Part of this increase is due to increased offerings of health benefits from employers. A 2014 survey by the New Jersey Business Industry Association shows responses from businesses small to large all identify health care costs as a major concern. More than 70 percent of employers said they are unlikely to discontinue coverage, despite rising cost. However, how they deal with the increase varies. Some employers increase cost sharing with employees, while others allow it to eat at their profits.
Mary Beaumont, vice president of NJBIA, said that employers choose to continue coverage in order to remain attractive to current employees and potential new hires. In addition, the state is leading the nation for savings from Medicaid expansion. “New Jersey was rewarded under the ACA for expanding eligibility in NJ Family Care and it has reduced the state’s charity payments to hospitals,” the NJPP said in a statement. But earlier this month, legislators from diverse and populous regions of the state are still worried about the lack of resources to help enroll more members. A letter signed by Congressmen Donald Payne, Jr. (D-10), Bill Pascrell, Jr. (D-09) and Albio Sires (D-08) revealed that the numbers of insured New Jerseyans isn’t all that high. “To date, 41.5 percent (Hudson), 44.2 percent (Passaic) and 47.8 percent (Union) of eligible residents have enrolled in coverage,” they wrote. The Census data shows that only 11 percent of New Jerseyans do not have healthcare coverage, according to the NJPP. “This is welcome news to the many struggling New Jerseyans who have been hit hard by the prolonged downturn in the state’s economy,” said Raymond Castro, NJPP senior policy analyst. “The state has a long way to go to create more jobs and increase wages, but at least major progress is being made to reduce the economic hardship and incredible worry for so many families that results from unpaid medical bills.” Prior to the marketplace, New Jersey saw the number of uninsured slowly climb over the past two decades. September 2015
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AtlantiCare to merge with Pa.-based Geisinger Health System By Beth Fitzgerald
The Atlantic City-based AtlantiCare health system will join Pennsylvania's Geisinger Health System, whose model calls for marrying the financing of care through a health plan with a hospital and doctor network, the two organizations announced Tuesday. The systems signed a letter of intent last November and are now moving forward to a merger that they estimated will take nine to 12 months for state regulatory review. AtlantiCare will continue to use its name, a well-established brand in the southern New Jersey marketplace. Geisinger’s health plan has 467,000 members who receive medical care from a physician-led system with a 1,100-member multispecialty group practice, eight hospital campuses and two research centers. AtlantiCare is an integrated system of health care services that includes the three-location AtlantiCare Regional Medical Center and the AtlantiCare Physician Group. Its 700 physicians deliver health care to southern New Jersey communities at nearly 70 locations. “The main thing to take away from this is we are both looking at the future the same way and recognizing that health care in the United States is changing to the value-based model,” AtlantiCare Chief Executive David P. Tilton said. “We went looking for a partner that saw the world the way we did and had the same point of view and found Geisinger. “They expressed a willingness to help us continue our transformation,” Tilton said. “We’ve done a lot of work already in these value-based models but they will bring their tools, their capabilities, their competencies and intellectual capital to South Jersey to help us transform. It will help AtlantiCare continue to grow and be more innovative.” He said both are nonprofit hospital systems, and the merger will not involve a financial payment to AtlantiCare. Tilton said Geisinger is already licensed as a health insurance company in New Jersey. “That is a key element of their model,” he said. “They are able to drive a lot of innovation in care through having access to premium dollars and providing support to physicians and hospitals to change the way they provide care and the way they serve populations of people.” Tilton said the fact that Geisinger is based in Danville, Pa., will not be an obstacle to working with the AtlantiCare population base. He noted Geisinger has already expanded into Maine and West Virginia. “They have been able to share and transfer what they have learned in Pennsylvania to other locations,” he said. “They have been able to achieve the same kinds of cost, quality and patient experience outcomes in those locations as they have in (Danville) and the surrounding community.” He said AtlantiCare physicians will go to Pennsylvania to study Geisinger’s best practices, and Geisinger will send people to New Jersey. AtlantiCare already has been adopting some of Geisinger’s tools and approaches, he said, “and I see no reason why we can’t accelerate it.” He said AtlantiCare has a lot to offer Geisinger: “We are a nationally recognized organization ourselves for the work we have done and I think there is an opportunity for both of us to benefit from the relationship.” AtlanticCare has spent a half-dozen years preparing to move away from the “fee-for-service (model), where the more you do, the more you get paid,” Tilton said. The organization believes that model is “obsolete and not adding any great value to the consumer any longer.” He said AtlantiCare has been building its primary care network and transforming those practices, adding new IT tools to help physicians manage patient health. But he added that Geisinger has more “practice management tools” that are very advanced. He also said AtlantiCare’s IT system is “pretty good, but I will tell you theirs is more advanced than ours. They’ve been at it a lot longer than we have.” The key now is to accelerate the ongoing transformation of AtlantiCare, Tilton said: “Speed is very important as you transform an organization like ours. It is inevitable that America is moving into these new value-based models and we want to lead that work. We want to reshape health care, particularly in southern New Jersey.” Kevin Brennan, chief financial officer of Geisinger, said the organization has been building an integrated health network with hospitals, physicians and health plans since the 1970s and now has clients all across the country, including New Jersey, as well as Maine, West Virginia and Delaware. “The idea of taking some of our models of care delivery and organizing the financing of care through a health plan is something that we have a lot of experience with.” While AtlantiCare is “doing some of this, they wanted to ramp that up faster and broader.” He said Geisinger believes “the market is ripe for the introduction of successful care redesign on a population-wide basis. We know that the current payment models in the United States is the fee-for-service model is waning and the interest in treating populations smarter is in all of our data resources and all of our evidence-based programs.” He said Geisinger has about $4 billion in annual revenue, while AtlantiCare has about $800 million.
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“It is an especially challenging time in health care; however, we stand at the brink of making significant enhancements that will benefit patients for generations to come,” said Dr. Glenn Steele Jr., Geisinger’s chief executive. “Today’s announcement is good news for the people we serve, and we look forward to making a positive difference in southern New Jersey.” In a joint announcement, they said their emphasis is on implementation of evidence-based medicine programs, enhancing capabilities and clinical services, optimizing the use of the electronic health records and clinical informatics, along with implementing population health management and value-based payment models. “Over time, we will improve the patient experience and health status of the community, reduce the total cost of care while improving quality and efficiency, transform care from episodic to value-focused, and provide meaningful coordination across all of health care,” Steele said. Annette Catino, chief executive of the managed health care company QualCare, said it wasn't clear that the merger would benefit New Jersey. She said of Geisinger, "Their model works great where they are in their geography. I'm not sure that it's a model that is easily transferable to this part of New Jersey." Mark Manigan, health care attorney with Brach Eichler said, "The Geisinger/AtlanticCare transaction is interesting because Geisinger has a robust provider sponsored health plan in Pennsylvania, which is the natural extension of the population management and risk bearing business models that many New Jersey health care systems are spending lots of time and resources positioning themselves for. Geisinger is already there."
Prime finalizes takeover of Saint Clare’s Health System Prime Healthcare Services has completed its acquisition of New Jersey's Saint Clare's Health System, the for-profit hospital chain announced Thursday. Prime had announced in August that the transaction had closed July 31, but would not be effective until later in the summer or early fall. Now it is official, the company said Thursday in a news release. The deal includes four medical centers — Saint Clare’s Hospital in Boonton, Saint Clare’s Hospital in Denville, Saint Clare’s Hospital in Dover and Saint Clare’s Health Center at Sussex — as well as other facilities in Morris and Sussex counties. “Prime Healthcare looks forward to expanding its presence in the Garden State and partnering with the Saint Clare’s community of dedicated physicians, nurses and employees,” Dr. Prem Reddy, chairman, CEO and president of Prime, said in a prepared statement. “We are committed to providing the best quality care in each and every community we serve, and the addition of Saint Clare’s to the Prime Healthcare family will allow us to continue that tradition.” Prime, which purchased the hospitals from Catholic Health Initiatives, has pledged to hire substantially all employees in the system; invest $30 million in capital improvements over the next five years; maintain charity care at or above current levels; and follow the Catholic ethical and religious directives for health care services.
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New President Schwimmer describes next steps for Health Care Quality Institute By Anjalee Khemlani Linda Schwimmer has taken the helm of the New Jersey Health Care Quality Institute in Pennington. As the new president of the institute, Schwimmer said she intends to continue the legacy left behind by David Knowlton, and carry out the mission to take on initiatives to further transparency and accountability in the health care industry. “Putting information out there on quality was groundbreaking. Now the entire payment system is moving in that direction,” Schwimmer said in a phone conversation. Some of the challenges facing the institute include lack of data and lack of access to data, a challenge not unique to the state, she said. Her goal is to push for more access to data, similar to what has happened in Minnesota, where the whole state has dashboards on where it is on quality measures and community health measures. Other states also have information publicly available to look at patterns of practice and prices of common surgeries or services — all to help individuals make the choice of which combination of price and quality best suits them. “Once we start sharing data with health care providers and communities and patients, that’s when we really starting having a conversation about what it is we really want, what we are looking for in health care, what is the quality of life, so to speak,” Schwimmer said. Another topic of concern for Schwimmer is where the dollars are going in health care. “It used to be 8 percent went to pharmaceuticals, and that has grown exponentially and is now closer to, though it varies by population, 12 to 15 percent in the commercial market. And newer specialty drugs, like those for hepatitis C or rare diseases, have seen a lot of cost growth and there are a lot of questions. Some drugs are life-saving like hep C, but some are questionable of whether they are any better than lower-cost drugs,” she said. Historically, there are lower rates on generic use, but the same issue is a challenge nationally. All of these concerns and issues can be addressed by driving the conversations for restructuring payment methods, service delivery methods and policies that affect health care, as the institute has been doing. The one program Schwimmer is particularly proud of and hopes to continue growing is the Mayor’s Wellness Campaign. The institute helps towns create health awareness and push for improved wellness by providing information about grants and funding for programs, connecting with local partners and other strategies, and creating a network among the participating mayors. Schwimmer has had experience in the legal system, as a business administrator and working with the government on policies. But she has also seen health care from the lens of a consumer and a mother. “Health care is very personal, and that’s why it gets politicized so quickly. Everyone needs it and everyone uses it. I have experience understanding the process of policies and state budgets and how it all comes to fruition. It can seem illogical but there is always a back story, and that helps me to get it,” Schwimmer said.
Westminster-based AxisPoint Health appoints CEO Ron Geraty to helm former McKesson division, eyes tens of millions in technology investments By Alicia Wallace Westminster-based AxisPoint Health, formed this year when McKesson Corp. sold its health care technology and services unit to investors, appointed Dr. Ron Geraty as chief executive. Geraty's experience in the population health and care management area includes serving as the CEO of Alere, a competitor to McKesson's care management division. During Geraty's tenure, Alere grew from $1.2 million in revenue in 2001 to more than $500 million in 2009. "We hope to make this a high-growth company as well," Geraty said of AxisPoint. AxisPoint, which was sold to private equity firm Comvest Partners and Mosaic Health Solutions for an undisclosed sum, has more than 850 employees nationwide, including about 200 in Westminster. The company's services include workflow software for payer organizations, case management and condition management services to help manage costs between patients and providers, and a nurse advice line. With AxisPoint now a standalone entity and no longer a "rounding error" of a giant health care conglomerate, the firm will have a greater sense of focus, Geraty said. He anticipates tens of millions of dollars will be invested in technology and services.
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