Louisiana Medical News June 2013

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SOU TH LOU ISIANA ED ITION

On Rounds Physician Spotlight

Health eVillages Program Connects Rural Providers

By TED GRIGGS

Dr. Robby LeBlanc Robby LeBlanc was born to run. His knack for distance racing earned the Baton Rouge native a track scholarship to LSU, where he strode alongside athletes from Kenya, Morocco, Jamaica, Germany and South Africa ... page 3

What do Kenya, Uganda, China, and Haiti have in common with St. Mary Parish?

Among other things, major healthcare issues, a lack of economic resources and the connectivity necessary to access medical information needed to provide up-to-date treatments to patients. All of those places also have a partnership with Physicians Interactive, a medical resource app firm that uses Health eVillages, a program of Physicians Interactive and the Robert F. Kennedy Center for Justice & Human Rights, to provide mobile medical devices loaded with healthcare information customized for each location.

The program started with Teche Action Board Inc.’s main clinic in Franklin. The clinic got 10 iPod Touches loaded with the latest, specialized medical content.

Once that pilot is complete, the program can be expanded to all 10 of Teche’s clinics in St. Mary, St. (CONTINUED ON PAGE 11)

Louisiana Firm Courts Concierge Physicians A Sense of Independence

By TED GRIGGS

A few years ago, Dr. R. Michael Murray, an internal medicine practitioner in Birmingham, Ala., was about ready to throw in the towel.

He had a successful practice, with a patient count somewhere between 4,000 and 5,000 people. But he was worn down from seeing 20 to 30 patients a day and putting in 12-hour days, five days a week. Sunday evenings found him still tired and dreading the beginning of the week.

“In my mid- to late 50s, I just started hitting a wall,” Murray said. “I loved what I did, but I just couldn’t keep up the pace.”

The strain took a toll on Murray. His wife said he looked like he was dying. Some of his patients grew alarmed at his appearance.

Murray began casting about for an alternative way to practice. He looked at concierge medi-

Nearing retirement in an era when 70 is the new 50, it can be difficult to picture a time when you won’t be able to hop in your car to run errands, swing a club or a racquet, attend an exercise class, or enjoy an evening out with good friends ... page 8 Dr. R. Michael Murray

(CONTINUED ON PAGE 4)

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ent

Physician Spotlight

Dr. Robby LeBlanc Runnin’ down a dream

By LISA HANCHEy

Robby LeBlanc was born to run.

His knack for distance racing earned the Baton Rouge native a track scholarship to LSU, where he strode alongside athletes from Kenya, Morocco, Jamaica, Germany and South Africa. During his tenure on the team, he traveled around the world to compete in 5k, 10k and cross country races. In his first year, he made the U.S. track team and competed in the World Junior Cross Country Championships in Turin, Italy. Along the route, frenzied fans crowded up six-deep to cheer on his teammates. “It’s such a big deal over there,” he observed. “Here, it’s like an afterthought, not even really considered a sport, but more or less like a hobby.”

However, for the Junior Pan American Games in Cuba, the welcome was not quite so warm. “When we got down there, they put us in kind of almost like a greenhouse at the airport,” he recalled. “They had guards walking around with machine guns. All of the other teams were going right through, but they sat the U.S. team there for about three hours and made us sweat it out.”

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Still, the experience proved positive.

“The main square in Havana looked a whole lot like New Orleans because of the Spanish architecture,” LeBlanc described.

“We had fun whenever we went on those trips. We met a lot of good people.”

LeBlanc’s interest in sports led his career choice as an orthopaedic surgeon. “I had some injuries in high school where I had to see the orthopaedic surgeon,” he recounted. “I enjoyed that interaction.”

His mother, a labor and delivery nurse, also influenced his decision to join the medical profession. After graduating from LSU, LeBlanc went to medical school at LSU in New Orleans. While there, he did rotations with third-year resident Dr. Matthew Williams, an aspiring

hand surgeon who later became LeBlanc’s medical partner. “Matt said that he was considering being a ‘hand weenie,’” he recalled. “I kind of looked into it a little bit at that time. That’s probably the first time I really even thought about it.”

Next, LeBlanc traveled to Little Rock, Ark. for his general orthopaedic surgery training at UAMS. At Arkansas, he was mentored by Dr. Randy Bindra, whose stellar teaching spurred LeBlanc to pursue a specialty in hand surgery. He completed his hand surgery fellowship at the Indiana Hand Center in Indianapolis.

Following his training, LeBlanc decided to return to his home state. In 2010, he joined a multi-subspecialty practice,

Louisiana Orthopaedic Specialists, in Lafayette. “I love Lafayette,” he said. “It’s a phenomenal town. People think it’s a small town, but it’s a big medical community.”

In July 2012, the physician group moved into a brand new, state-of-the-art location at 108 Rue Louis XIV. As one of the only hand specialists in the Acadiana area, LeBlanc sees patients for a variety of conditions, including hand, wrist and elbow arthritis, sports and traumatic injuries of the upper extremity, finger and hand amputations, tendon and ligament problems, nerve compression disorders such as carpal tunnel and cubital tunnel syndromes, vascular surgery and peripheral nerve repair and reconstruction. “I do a lot on the orthopaedic side, like the bones, tendons and the muscles, and also on the plastic and vascular surgery side,” he said. “There’s a lot of depth in hand surgery. I’m very, very fortunate that I really, genuinely love what I do. I love coming to work every day. ” In his personal life, he enjoys spending time with his wife of 11 years, Krista, and their two small children – Mason, age 4, and Caroline, 20 months. He squeezes in five to seven miles of running at a time whenever he can. Occasionally, he pushes his kids in their stroller while trekking along. “I get a good workout, pushing that little stroller five or six miles,” he said.

LeBlanc also tries to fit in 5k races, such as the Crescent City Classic. One year, he was even mentioned in Runner’s World magazine for leading the pacesetting Kenyan runners for a couple of miles. “Running is my addiction,” he said. “Mentally, I just go a little bonkers if I don’t do something athletic.”

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JUNE 2013 • 3

Lending Voice and Vehicle

AARP and RWJF collaborating with select states on national nurse education redesign program

By LYNNE JETER

Twenty states, including five in Medical News markets, are working on a dynamic nurse initiative redesigning nurse education to bolster the advancement of nurses.

The AARP and Robert Wood Johnson Foundation (RWJF), developers of the national program, Future of Nursing:Campaign for Action (Campaign), is working with Florida, Louisiana, Mississippi, Missouri, and Tennessee to implement the Institute of Medicine’s (IOM) evidence-based recommendations on the next chapter of nursing. (The IOM defines “evidence-based practice” as a combination of best research evidence, best clinical experience, and consistency with patient values.) Other states involved in the initiative are Colorado, Connecticut, Georgia, Iowa, Idaho, Kansas, Maryland, Michigan, Nebraska, New Jersey, Pennsylvania, Rhode Island, Utah, Wisconsin and Wyoming. The RWJF committed $3 million to help the states prepare the nursing profession to address the nation’s most pressing healthcare challenges.

The Future of Nursing State Implementation Program will boost efforts already underway across the nation and the District of Columbia. The Campaign, the foundation explained, provides a voice and a vehicle for nurses at all levels to lead system change by collaborating with business, consumer, and other health professional organizations.

“This program is designed to spur progress by supporting action coalitions, most of which are led by volunteers, that are doing promising work to implement the IOM recommendations,” said Susan B. Hassmiller, PhD, RN, RWJF senior adviser for nursing and director of the Campaign. “The foundation is committed to providing states with the support they need to build a more highly

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4 • JUNE 2013

educated, diverse nursing workforce that will improve health outcomes for patients, families and communities.”

The initiative provided two-year grants of up to $150,000 to state-based action coalitions that have made substantial progress toward implementing the IOM recommendations. The grants call for states to match funds.

This pressing issue was addressed at the American Hospital Association’s annual meeting April 28-May 1 in Washington, DC, which focused advocacy efforts on transforming the healthcare delivery system, maintaining essential resources, and reducing the regulatory burden.

The U.S. Department of Labor has identified nursing as the fastest-growing occupation through 2012. More than 1 million new and replacement nurses will be needed to fill the nation’s healthcare needs.

“Current demand for quality nurses far outstrips the supply,” said Sheila Kelly, PhD, project director of the Mississippi Barriers to Nursing Education Survey. “Increased future needs will only exacerbate the crisis. In 2002, the Health Resources and Services Administration estimated that over 30 states were experiencing nursing shortages, and the shortfall would grow to over 44 states by the year 2020.”

The Center to Champion Nursing

Louisiana Firm Courts Concierge Physicians, continued from page 1 cine but wanted something a little different from the management models he’d seen.

Eventually, he came up with a blended practice mode. He limited his practice to 400-plus patients. He added a nutritionist, who also acts as a wellness coach, to his practice. His patients stopped asking him if he was ill.

About the same time, Denham Springs businessman Richard Doughty, a friend of Murray’s and co-founder and co-owner of a $40 million healthcare management firm, began talking to Murray about his business model. Doughty took the practice, benchmarked it, and in 2012 launched Cypress Management Group. Doughty is the company’s chief executive officer, and Murray is Cypress’s medical director.

Doughty said Cypress offers doctors two key differences compared to other concierge management groups: a lower-cost fee structure and a practice model tailored to the needs of the physician and his patients.

Typically, the management firms get one-third of the membership fees patients

pay to be part of a concierge practice, Doughty said. Most concierge management contracts are for five years, and the fee structure is in place for the life of the contract.

But most of the hardest work is done over the first 18 months of moving the practice to the concierge model, Doughty said.

“After that, if the concierge company has done a good job, to maintain that ongoing presence and practice there won’t be nearly as much heavy lifting over the course of that contract,” Doughty said.

Cypress’s fees decrease each year, in proportion to the amount of effort and energy required to maintain the practice, Doughty said.

“The difference for physicians, generally, will be several hundred thousand dollars over a five-year contract,” Doughty said.

Doughty co-founded and co-owned Champion Management LLC, which owned and operated outpatient imaging

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in America (CCNA), an AARP initiative, AARP Foundation, and RWJF serve as the national program office for the Future of Nursing State Implementation Program.

“This new program will help action coalitions get the strategic and technical support required to advance their goals,” said Susan Reinhard, PhD, RN, senior vice president of the AARP Public Policy Institute and CCNA chief strategist. The nonprofit, nonpartisan national organization with more than 37 million members is one of the nation’s most powerful lobbying groups. “Our hope is that states will get the boost they need to be effective in achieving the triple aim of addressing cost, quality and access.”

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centers in the Southeast through joint ventures with more than 150 physicians.

Those partnerships, Doughty said, gave him a clear understanding of the challenges, and the financial realities, that physicians face.

“That’s why our fee structure is different,” Doughty said.

Doughty said Cypress also offers physicians a choice when it comes to practice models.

If the physician wants a straight concierge practice, Cypress can arrange that. If the doctor wants to maintain his or her current patient population, Cypress can arrange a blended model. The physician sees only the patients that opt to join the concierge practice and oversees the mid-levels, the nurse practitioners or physician’s assistants, who manage the non-concierge patients. That way the patients remain in the practice. Cypress can also set up a block-time model so that the physician dedicates a certain portion of the day to concierge patients and the rest of the time to traditional patients.

Doughty said Cypress will work with six practices this year, but he expects growth will accelerate next year.

He doesn’t want the company to grow too fast too soon, he said. But Cypress has already begun scheduling clients for 2014.

Doughty said he doesn’t think concierge medicine is worsening the shortage of primary care physicians.

The current healthcare delivery system is broken, with physicians rewarded for quantity not quality, Doughty said. The continued cuts in reimbursements for physician services are putting more and more pressure on doctors to see more patients or to offset the cuts with ancillary services.

The increase in regulations and compliance issues, the additional time and resources required to deal with insurance issues, billing and collections are pushing many physicians to sell their practices or retire, Doughty said. Physicians don’t have the desire or the ability to see more patients next year than they did this year.

Concierge medicine keeps doctors in practice for years beyond what they might have otherwise, Doughty said.

LegaL Notice

Medical Providers who provided services to workers’ compensation patients may be affected by a class action lawsuit.

Louisiana Medical Providers have sued a number of defendants claiming that appropriate notice was not provided before Preferred Provider Organization (“PPO”) discounts were applied to the bills of Louisiana medical providers submitted under the Louisiana workers’ compensation law. Some of the defendants have settled, but the case continues against Med-Comp USA, Inc., Homeland Insurance Company of New York and Executive Risk Specialty Insurance Company (“Defendants”).

The 27th Judicial District Court of Louisiana, St. Landry Parish, decided that this should be a class action on behalf of a “Class,” or group of people or entities, that could include you. This notice summarizes your rights and options. More information is in a detailed notice available by going to the website below or calling the toll-free number. You must decide whether to stay in the Class and be bound by whatever results, or ask to be excluded and keep rights to sue the Defendants.

There is no money available now and no guarantee that there will be.

Are

you Affected?

Who

represents the clAss?

The Court appointed Thomas A. Filo and Michael K. Cox of Cox, Cox, Filo, Camel & Wilson, LLC of Lake Charles, Louisiana; Stephen B. Murray, Arthur M. Murray, Stephen B. Murray, Jr. and Nicole Ieyoub-Murray of The Murray Law Firm of New Orleans, Louisiana; John S. Bradford and William B. Monk of Stockwell, Sievert, Viccellio, Clements & Shaddock, L.L.P. of Lake Charles, Louisiana, and Patrick C. Morrow and James P. Ryan of Morrow, Morrow, Ryan & Bassett of Opelousas, Louisiana, to represent you as “Class Counsel.” You don’t have to pay Class Counsel, or anyone else, to participate. Instead, if they get money or benefits for the Class, they will ask the Court for attorneys’ fees and costs, which will be deducted from any money obtained, or paid separately by the Defendants. One Class member has been appointed by the Court as the Class Representative.

WhAt

Are your options?

You have a choice of whether to stay in the Class or not, and you must decide this now. To stay in the Class, you do not have to do anything. If money or benefits are obtained, you will be notified. You will be legally bound by all orders and judgments of the Court, and you will not be able to sue, or continue to sue, the Defendants—as part of any other lawsuit—about the legal claims in this case. You have the option of hiring your own lawyer to appear in Court for you.

Generally, the Class includes: all Louisiana medical providers, institutions, and facilities that have provided services to workers’ compensation patients under the Louisiana Workers’ Compensation Act, and whose bills have been discounted, adjusted, paid on a reduced basis, or otherwise paid at less than the Louisiana workers’ compensation fee schedule amount between January If you exclude yourself, you cannot get any money or 1, 2001 and December 31, 2006 according to a PPO agreement, by or through either Med-Comp USA, Inc., benefits from this lawsuit if any are awarded, but you will keep any rights to sue the Defendants for the same or CorVel Corporation. claims and will not be bound by any Court orders or judgments in this case. If you exclude yourself, certain WhAt is this cAse About? legal time limits will apply to the filing of individual This lawsuit claims that the Defendants violated claims. To ask to be excluded, send a letter to the address provisions of Louisiana state law when PPO discounts below, postmarked by July 1, 2013, that says you want were taken in connection with workers’ compensation to be excluded from Williams v. SIF Consultants of medical bills without sufficient prior notice to the Louisiana, Inc. Include your name, address, telephone healthcare providers of a PPO discount as required number, and signature. by the Louisiana PPO Act (see La. R.S. 40:2201 et seq., available at www.Med-CompUSAClass.com). hoW cAn i get more informAtion?

Plaintiffs are asking for money to be paid to the Class Go to www.Med-CompUSAClass.com, call tollin the form of damages as set forth in the Louisiana PPO Act. The lawyers for the Class will have to prove free (877) 846-6340 or write to Med-Comp USA Class Counsel at 723 Broad St., Lake Charles, LA 70601. their claims in Court.

www.Med-CompUSAClass.com • 1-877-846-6340 Louisiana Medical News

JUNE 2013 • 5

Reflux KO

Torax Medical rolls out LINX procedure for GERD patients to select specialists

By LyNNE JETER

A few dozen approved surgeons specializing in gastroenterology procedures across the nation are offering a revolutionary solution for patients with gastroesophageal reflux disease (GERD) that’s so new, many primary care physicians and some specialists aren’t aware of it as an option.

“When the FDA approved the LINX Reflux Reflux Management System, and the New England Journal of Medicine recently discussed the efficacy of the system, word began getting out,” said Sam Pace, MD, a board-certified gastroenterologist with Digestive Health Specialists in Tupelo, Miss., director of the Heartburn Center of North Mississippi, and a LINX-approved surgeon.

Torax Medical Dr. Sam Pace opted to launch the procedure nationwide at approved centers, usually one or two per state. Torax Medical develops and markets products designed to

LINX closed

restore human sphincter function via its technology platform, Magnetic Sphincter Augmentation (MSA), which uses attraction forces to augment weak or defective sphincter muscles to treat GERD that often irritates the esophagus, causes heartburn and other symptoms. Left untreated, reflux could lead to serious complications, such as esophagitis, stricture, Barrett’s esophagus and esophageal cancer.

“I applaud the medical company for not doing a wholesale release,” said Pace.

“Instead, the company is releasing it to centers that do a lot of reflux work so the proper evaluation can be done.”

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Swallowing

The LINX System’s new device is a quarter-sized flexible band of magnets encased in tiny titanium beads. The magnetic attraction between the beads helps keep a weak esophageal sphincter closed to prevent reflux. Implanted around a weak sphincter just above the stomach, the minimally invasive procedure typically takes less than an hour to complete.

“The force of swallowing breaks the magnetic bond to allow food and liquid to pass through, and then the magnetic attraction closes the lower esophageal sphincter back to form a barrier,” said David Gilliland, MD, FACS, a surgeon with Surgery Associates PA, in Tupelo, also an LINX-approved surgeon.

Until now, physicians had only two options for treating reflux: medication or a surgical Dr. David procedure called laparoGilliland scopic Nissen fundoplication, widely used since the early 1990s. In this procedure, the top part of the fundus is wrapped around the lower esophagus to improve the reflux barrier. Even though Nissen fundoplication may be effective, it has several drawbacks.

“After a patient has fundoplication, he can no longer belch or vomit,” said Gilliliand. “Some patients report gas bloating because of this.”

Three years after sphincter augmentation with the LINX System, the majority of treated patients were able to substantially reduce or resolve their reflux symptoms, while also eliminating their use of reflux-

related medications, according to the New England Journal of Medicine summary.

In 100 percent of patients, severe regurgitation was eliminated, and nearly all patients (93 percent) reported a significant decrease in the need for medication. Ninety-four percent reported satisfaction with their overall condition after having the LINX System procedure, compared to 13 percent before treatment while taking medication.

“For years, surgery for reflux patients would best be described as a static deal, where you sew everything down,” said Pace. “The LINX procedure is dynamic because opening and closing simulates the normal sphincter, except you’re keeping it closed so you don’t have reflux. Now we have a choice for patients that we can tailor-make the surgical approach to this problem.”

Like Nissen fundoplication, the procedure is done laparoscopically through five small punctures in the abdomen.

“Once we’re in the OR, we can decide which procedure the patient is better suited for, depending on anatomy,” Gilliland said. For example, the LINX procedure cannot be done if the patient has a hiatal hernia larger than three centimeters.

Another benefit is a quicker return to solid food.

“We try to get LINX patients to eat regular food right away to train the device,” Gilliland said. “With the Nissen procedure, they’re on a prescribed diet for at least two weeks.”

Because the procedure is new, insurance coverage varies by provider and is usually approved on a case-by-case basis.

Torax/LINX Implanting and Referral Center in Louisiana Surgical Specialists of Louisiana 7015 Highway 190 East Service Road, Suite 200 Covington, LA, 70433 Jimmy Redmann, MD, FACS

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The Trust Factor

Nashville firm reveals results of 7th annual payor survey; trust represents greater factor than rates

By LyNNE JETER

NASHVILLE – In the wake of national health reform, the trust factor between hospitals and health insurance companies is perilously low.

That’s the consensus of 373 hospital and health system administrators responsible for negotiating contracts with major health plans in the seventh annual National Payor Study. Conducted by Nashville-based ReviveHealth, the 2013 survey paints an interesting picture of administrators’ opinions about various private payor trends, including rates, payment of claims, denials and other actions.

“The trust factor is huge when it comes to hospitals and health plans being able to play nice in the new world order of risk— sharing and improved health outcomes,” said ReviveHealth CEO Brandon Edwards.

For the second conBrandon secutive year, hospital Edwards and health system leaders who negotiate managed care contracts with national health insurance companies pointed to WellPoint/Anthem as the nation’s worst plan, with only a 16 percent

favorability rating. WellPoint manages health plans in 14 states, including Anthem Blue Cross in California.

“Even though WellPoint now has a CEO with a strong provider background, he’s got to turn around an aircraft carrier, and that takes time,” said Edwards, noting that business practices and corporate behavior have contributed to the company’s poor reputation. “Their major imperative has to be improving their reputation and rebuilding trust with providers.”

For the third consecutive year, UnitedHealthcare exacerbates its perennial poor showing, ranked worst in all areas of contract negotiations except payment plans. The payor held firm as the health plan with the most consistently poor reputation among hospitals – and the slowest to pay.

“Honesty and candor represent United’s biggest challenges,” noted Edwards.

“Hospitals year in and year out cite UnitedHealthcare’s low rates, slow payments, bureaucracy, and honesty as reasons for their poor rankings.”

Aetna was given high marks for the best rates, followed closely by Cigna.

“Honesty and easy business dealings seem to matter more than rates,” said Edwards. “Otherwise, Aetna would be the best rated plan in every category.”

This year, independent Blue Cross and Blue Shield (BCBS) plans and Cigna tied for the top favorability spot, with 49 percent. Last year, Cigna held the spot alone. In this year’s survey, Aetna’s approval rating was 46 percent, followed

by Coventry and UnitedHealthcare at 30 percent each, and Humana at 25 percent.

Despite having the lowest rates for three consecutive years, BCBS plans earned top ranking for best overall business practices.

“Independent BCBS plans, however, ranked well ahead of Cigna (30 percent compared to 19 percent) in terms of overall best to deal with, despite having the lowest ranking in payment rates to hospitals,” said Edwards. “For several years in a row, the survey revealed a complete lack of correlation between payment rates from any payor, and a hospital’s perception of that payor.”

The survey, conducted in partnership with Catalyst Healthcare Research (CHR) and The Godbey Group, is the only one of its kind in the United States to target hospital leaders who negotiate managed care contracts with national health insurance companies. Respondents included CEOs, CFOs, and managed care/payor relations executives who negotiate on behalf of about one-third of the nation’s hospitals.

“The goal of the study is to provide a national perspective of hospital leaders’ opinions of large health plans,” said Edwards, who initiated the survey after noticing a void in payor ratings. “Even though health plans rate hospitals and their physicians routinely, no one was rating the health plans.”

On an optimistic note, nearly half of all participants believe their negotiated rates will improve this year.

Providers have varying strategies for success, with wellness programs a top priority for their employees, and clinical integration a second focal point.

“Hospitals are taking the lead on wellness and population health programs with their own employees,” said Edwards.

“Now they need to take that experience and go out to local employers with solutions to keep those employees healthy and costs down.”

Nearly 40 percent of respondents reported their hospital had been in at least one public contract dispute in the past five years that resulted in non-participation.

Also, the gap between rates for the largest payor and rates for the second and third largest payors have widened considerably.

“This ‘payor cost shift’ drives up profitability for the biggest plans at the ex(CONTINUED ON PAGE 12)

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JUNE 2013 • 7

RETIREMENT PLANNING

A Sense of Independence

By CINDY SANDERS

Nearing retirement in an era when 70 is the new 50, it can be difficult to picture a time when you won’t be able to hop in your car to run errands, swing a club or a racquet, attend an exercise class, or enjoy an evening out with good friends. Perhaps in the recesses of your mind the possibility exists that you might need a little assistance at some point in the very distant future … but that time is certainly not now.

Still, in your most prudent moments, you know the big house and big yard are really too big now that the children are grown and gone. And you hate the thought of your spouse or the kids hurriedly having to make critical decisions should something happen to you.

Still, you just aren’t ready to give up your self-sufficiency. And why should you when a solution exists that allows you to keep your independence while having a contingency plan in place?

Sagewood in Phoenix

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Sagewood in Phoenix

Life Care Services has been developing and managing senior living communities for more than four decades. As the nation’s leading manager of full-service senior living communities, the company For a growing number of senior adults, owns or operates more than 80 comcontinuing care retirement communities munities in 28 states and the District (CCRCs) provide the best answer – supportHeritage in Brentwood of Columbia and serves nearly 30,000 ing active, independent lifestyles while offering residents. increasing levels of care when required. That Erik Gjullin, vice president/director of plained that residents arrive while indepencontinuum allows residents to age in place. marketing & sales for Life Care Services, exdent with the knowledge that assisted living, Headquartered in Des Moines, Iowa, skilled nursing and memory care facilities are available onsite. Key draws for living in CCRCs are the socialization aspect and knowing that once you are in, you have a home for life. Yet, Gjullin said, the focus of their communities is on maintaining wellness and independence.

“The driver for our prospects, who are looking for solutions to senior housing, is to live somewhere where it’s easy to participate in a lifestyle that enhances health,” he said.

Gjullin explained Life Care Services takes a ‘whole person’ approach to wellness. “Our HealthyLife™ Services program is really the overall health and wellness program that we practice in all our com- Erik Gjullin munities. It’s not just fitness,” he continued, “It’s nutrition. It’s socialization. It’s education.

It’s ongoing lifestyle that really creates the wellness for the whole person.”

While a number of programs and services are consistent across Life Care Services developments, the communities are far from ‘cookie cutter.’ Gjullin said, “The Providing assistance with the identification, treatment, unique part of it is people live in different and monitoring of physicians who suffer from a physical or geographic regions for a reason. They like mental condition, in order to promote patient safety and the lifestyle. They like the architecture. So if you go into our community in Phoenix, to ensure the continued availability of skilled physicians Ariz., it looks like it belongs in Phoenix. It’s got local architecture, spaces and cuisine.

It’s got the flavor of the southwest.”

Residents enjoy a range of living options from apartment-style residences to garden villas to detached cottages. Manicured lawns, gardening plots, walking

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and biking trails, guest accommodations, a clubhouse with restaurant-style menus, day spa, putting green, cocktail lounge, fitness center, library, convenience store, weekly cleaning service, 24-hour security and more are part of the well-appointed surroundings.

Luxury, of course, does come with a price. Gjullin said residents pay a one-time entrance fee and ongoing monthly fee, both of which vary depending on the size of the residence selected.

The monthly fee, he continued, “covers everything you could possibly think about that you would be paying if you were living in your own residence.”

At death or upon moving, there are two return-of-capital plans that give back either 80 percent or 90 percent of the entrance fee to the resident or the estate. If residents needs to move to a higher level of care … either temporarily or permanently … they are guaranteed a bed, and the monthly fee remains the same as in the independent living phase.

“As you move through the continuum of services, your monthly fee does not increase,” Gjullin said of a unique aspect of Life Care Services. In comparison to a skilled nursing facility where a room could cost $300-$400 a day, those who transition within the CCRC continue to pay their monthly fee … for a couple in an apartment-style residence that typically runs under $200 a day and under $100 a day for an individual in a one-bedroom apartment. “If you wanted to preserve your assets, what other program would you select?” he questioned.

Again, Gjullin stressed, the goal is to keep seniors spiritually, physically, mentally and emotionally healthy for as long as possible to enjoy the array of options that come with this type of community. On any given day, seniors can be found attending a yoga class, planning community outings, choosing from chef-inspired cuisine, working out in the fitness center, sipping cocktails with friends or enjoying a relaxing manicure.

“Our philosophy is choice, flexibility, and control,” Gjullin said. “That’s what we offer people who live here. That’s what seniors want. They didn’t get to the point where they could afford to live in a community like this and not have that as a basic philosophy.”

Legislative Affairs

Halfway Through the Session: How’s the Legislature Doing?

At this writing, state lawmakers are at the halfway mark of the 2013 Regular Session of the Louisiana Legislature. The legislature must adjourn sine die no later than 6 p.m. on Thursday June 6, 2013.

Cindy There has been a plethora of healthcare related measures contemplated this session. Lawmakers considered scope of practice issues related to optometrists, ophthalmologists, nurse practitioners and physical therapists. The Medicaid expansion measures have been vetted in both the House and the Senate. The hospital association has been successful in their promotion of the hospital stabilization bill and the companion constitutional amendment. There has been no lack of healthcare related measures this session. Additionally, watching the budget process this session has been interesting. How the $500 million budget deficit will be addressed remains to be seen, but there has been no lack of plans floated, from increasing the tax on tobacco products to eliminating tax credits, and exemptions to assessing fees on programs such as Early Steps.

The following legislative instru-

Bishop tions.

ments have made their way through the entire legislative process as of May 9, 2013.

To view any of these measures, go to www.legis.la.gov

ment for Fiscal Year 2013-2014

SCR 15, Claitor Expresses the sense of the Louisiana Legislature on the need for colorectal cancer screening examina-

HB 10, Pearson Adds certain hallucinogenic substances to the list of Schedule I controlled dangerous substances

SR 18, Broome Designates April 15, 2013, as Earl K. Long Medical Center Day. SR 28, Murray Requires submission for approval by the Senate Committee on Finance of any cooperative endeavor arrangements between the LSU Board of Supervisors and a private entity involving the change in management of a public hospital.

SR 51, Mills Designates April 25, 2013, as “School-Based Health Center Awareness Day” Below is a list of measures that are still active: HB 1, Fannin Provides for the ordinary operating expenses of state govern-

HB 6, Schroder Provides that the crime of carrying a firearm or dangerous weapon on school property shall not apply to off-duty law enforcement officers

HB 15, Mack Adds certain compounds to the Schedule I classification of controlled dangerous substances HB 21, Burns, H Provides with respect to reporting of mental health information regarding the purchase of firearms HB 35, Barrow Provides for retirement eligibility of employees of state hospitals under certain conditions HB 79, Hensgens Provides relative to school crisis management and response plans HB 82, Hill Limits the sale and purchase of products containing dextromethorphan

HB 89, Hoffmann Provides relative to the use of seclusion and physical restraint to address the behavior of certain students HB 95, Dixon Provides relative to eligibility criteria for admission or readmission to a public school and prohibits the denial of admission or readmission based on certain student characteristics HB 103, Badon Provides relative to criminal penalties for possession of marijuana or synthetic cannabinoids and the applicability of the Habitual Offender Law relative to possession of marijuana or synthetic cannabinoid offenses HB 110, Norton Requires that La. Medicaid eligibility standards conform to those established by the Affordable Care Act HB 111, Hoffmann Prohibits outdoor smoking within 25 feet of certain exterior locations of state buildings HB 120, Pugh Authorizes the La. State Board of Nursing and the La. State Board of Practical Nurse Examiners to accept certain accreditations for nurses

HB 121, Montoucet Provides with respect to the membership of the Workers’ Compensation Advisory Council HB 150, Greene Requires recognition of assignment of health insurance benefits to health care providers HB 153, Foil Expands the income tax check off applicable to prostate cancer to include all types of cancer = HB 155, Cox Provides relative to school safety, security, and crisis HB 156, Schexnayder Provides relative to boards and commissions HB 160, Reynolds Delays implementation of certain teacher evaluation program requirements and requires legislative approval of the value-added teacher assessment model prior to implementation of the requirements HB 173, Hazel Amends Louisiana’s safe haven law to provide that a child 12 months old or younger may be relinquished to a designated emergency care facility HB 212, Brossett Provides relative to the creation of a statewide mapping

and planning system for certain schools HB 214, Jefferson Provides relative to parental involvement in public schools HB 216, Shadoin Provides relative to the ability of the Patient’s Compensation Fund Oversight Board to invest certain funds HB 221, Connick Authorizes certain dual employment and dual office holding for physicians HB 226, Richard Creates the crime of prohibited sexual contact between a psychotherapist and a client or patient HB 228, Fannin Provides relative to balance billing by and reimbursement of no contracted facility-based physicians for covered health care services rendered in an innetwork health care facility HB 230, Pope Provides relative to the definition of “eligible student” for participation in the Student Scholarships for Educational Excellence (voucher) Program HB 233, Smith Provides that eligibility standards for the La. Medicaid pro(CONTINUED ON PAGE 10)

Louisiana Medical News

JUNE 2013 • 9

Halfway Through the Session, continued from page 9 gram shall conform to those established by the Affordable Care Act and requires reporting of program outcomes

HB 383, Lopinto Provides relative to the lease of a hospital by a Jefferson Parish hospital service district

HB 234, Williams, P. Requires that owner identification information be marked on every removable dental prosthesis fabricated by a dentist or pursuant to a dentist’s order

HB 390, LeBas Clarifies definition relative to colleges of pharmacy

HB 235, Badon Increases the tax on cigarettes and dedicates a portion of the proceeds of the tax HB 241, Wilmot Expands the applicability of the medication attendant provisions to the office of aging and adult services HB 251, Talbot Requires DHH to institute Medicaid cost containment measures to the extent allowed by federal regulations HB 273, Lorusso Provides relative to reports, records, and adjudicatory functions of the La. State Board of Medical Examiners HB 275, Willmott Authorizes podiatrists to obtain patient histories and perform physical examinations under certain conditions

HB 391, LeBas Clarifies powers and duties of the Louisiana Board of Pharmacy relative to nonresident pharmacists HB 392, Bishop, S. Provides relative to credentialing and claims payment functions of managed care organizations participating in the La. Medicaid coordinated care network program HB 393, Anders Provides relative to prescription drug benefits of managed care organizations participating in the La. Medicaid coordinated care network program HB 412, Cox Revises the definition of “school” for the purposes of the Louisiana Smokefree Air Act HB 414, Huval Authorizes agency fees on health and accident insurance policies

HB 281, Simon Creates a single license for behavioral health services providers

HB 417, Ritchie Increases the state tax on certain tobacco products and dedicates the monies

HB 284, Ortego Transfers governance and control of state hospitals from LSU to human services districts and authorities of the state and provides for delivery and financing of health services by such districts and authorities

HB 429, Hollis Provides relative to prohibiting mandatory participation in a health care system

HB 291, Price Changes composition and requirements relative to Advisory Committee on Equal Opportunity HB 294, Ritchie Provides relative to regulation of long-term care insurance policies HB 304, Talbot Increases the state tax levied on cigarettes HB 322, Thierry Requires birthing facilities to perform pulse oximetric screening for certain heart defects on each newborn in the care of those facilities HB 342, Huval Provides relative to balance billing by and reimbursement of noncontracted health care providers of emergency medical services HB 355, LeBas Provides relative to access to state prescription monitoring program information HB 356, LeBas Defines compounded pharmacy-generated product HB 374, Stokes Provides relative to timing of payment of insurance premium taxes to the commissioner of insurance

10 • JUNE 2013

HB 434, Morris, Jay Requires spending due to constitutional or other mandates to be considered in a separate appropriation bill from spending that is not required to be funded if health care or higher education funding is reduced HB 436, Garofalo Provides relative to final passage of the general appropriation bill HB 449, Burrell Provides for a time-limited expansion of Medicaid eligibility standards in La. to conform such standards to those provided in the Affordable Care Act until Dec. 31, 2016 HB 450, Ivey Provides with respect to the medical treatment schedule HB 451, Barrow Requires hospitals to offer pertussis (whooping cough) vaccinations to parents of newborns HB 479, Barras Provides an exception to annual ethics training requirements for certain hospital employees HB 508, Cromer Creates an income and corporation franchise tax credit for manufacturers, producers, and importers of medical devices for amounts paid as federal excise taxes on the sale of medical devices HB 524, Burrell Provides relative to group blanket health and accident insurance

Louisiana Medical News

HB 527, Hoffmann Provides relative to the practice of optometry and the regulation of such profession HB 532, Kleckley Provides for a hospital stabilization formula and assessment and creates the Hospital Stabilization Fund and provides for uses of the fund HB 533, Kleckley Creates the Medical Assistance Trust Fund as a constitutional fund, creates accounts for each provider paying fees into the fund, and provides for uses of the fund HB 537, Jackson, K. Levies an additional tax on cigarettes and other tobacco products and authorizes the dedication of such monies HB 545, Cromer Provides for an alternative long-term care benefit option for Medicaid applicants with life insurance policies who enter into certain viatical settlement contracts HB 549, Leger Establishes the MediFund for statewide advancement of biosciences and medical centers of excellence HB 569, Brown Eliminates restrictions on performance of physical therapy services without a prescription or referral HB 574, Robideaux Increases the state excise tax on certain tobacco products HB 575, Montoucet Provides for the definition of a rural hospital for purposes of the Rural Hospital Preservation Act HB 582, Simon Provides relative to parking spaces for certain disabled persons HB 592, Thibaut Provides for the adequacy, accessibility, and quality of health care services offered by a health insurance issuer in its health benefit plan networks

HB 677, Fannin Makes supplemental appropriations for Fiscal Year 20122013 HB 713, Stokes Increases the state excise tax on certain tobacco products and reduces certain excise tax discounts HCR 4, Norton Directs the secretary of DHH to expand eligibility standards for the La. Medicaid program to conform to those established in the Affordable Care Act HCR 7, Barrow Suspends laws authorizing DHH to implement resource allocation models for Medicaid-covered home- and community-based long-term care services HCR 8, Edwards Amends administrative rules to provide that La. Medicaid eligibility standards conform to those established in the Affordable Care Act HCR 51, Barrow Directs DOA, DHH, and LSU to cease all efforts to privatize state hospitals immediately HCR 53, Cromer Memorializes congress to repeal that portion of the federal health care reform legislation which imposes a health insurance tax HCR 75, Barrow Requires transparency in Medicaid managed care programs operated by DHH HCR 90, Smith Creates a task force to study and evaluate the effectiveness of sexual health education programs used throughout the state and other states HR 47, Hunter Requires submission for approval by the House Committee on Appropriations of any cooperative endeavor agreement between the Louisiana State University Board of Supervisors and a private entity involving the change in management of a public hospital

HB 614, Huval Provides for licensing and regulation of individuals and entities as health insurance navigators for a health benefit exchange

SB 21, Mills Limits liability for a nonprofit corporation entering into a cooperative endeavor agreement with the Department of Health and Hospitals to operate a supports and services center

HB 623, Jackson, K. Increases the state tax on certain tobacco products

SB 26, Peterson Repeals the Louisiana Science Education Act

HB 638, Stokes Provides relative to the Louisiana Health Plan

SB 33, Brown Provides relative to a minority hiring survey by the division of minority affairs in the Department of Insurance

HB 645, Cromer Provides relative to an internal claims and appeals process and external review procedures for health insurance issuers HB 652, Abramson Provides relative to health care financing HB 674, LeBas Provides relative to pharmacygenerated drugs

SB 35, Heitmeier Provides for health action plans by the Department of Health and Hospitals SB 36, Heitmeier Prohibit smoking on the grounds of and inside the facilities or buildings utilized by the institutions managed and supervised by certain postsecondary education management boards

SB 55, Johns Provides for Medicaid transparency

SB 189, Heitmeier Provides relative to the practice of optometry

SB 57, Dorsey-Colomb Creates the Louisiana Sickle Cell Commission

SB 192, Erdey Provides for nurse practitioners and licensure by the Louisiana State Board of Medical Examiners

SB 67, Peterson Creates the Louisiana Statewide Education Facilities Authority SB 73, White Constitutional amendment to grant the Southeast Baton Rouge community school system in East Baton Rouge Parish the same authority granted parishes relative to MFP funding and raising revenue for schools SB 75, Buffington Provides with respect to monies deposited into the Medicaid Trust Fund for the Elderly SB 76, Buffington Provides for use of monies in the Louisiana Medical Assistance Trust Fund SB 82, Mills Phases in an exemption from local sales tax on certain inhibitors and complex biologics if the Revenue Estimating Conference estimates a certain percentage increase in state general sales tax SB 86, Morrell Provides relative to the Louisiana Mental Health Counselor Licensing Act SB 102, Buffington Provides exemptions from sales and use tax levied for certain VEGF inhibitors and certain complex biologics SB 125, Peterson Provides that eligibility standards for the La. Medicaid program shall conform to those established by the Affordable Care Act and requires reporting of program outcomes SB 126, Smith, G. Provides relative to health insurance rate review and approval SB 134, Morrell Provides for licensure of behavior analysts SB 150, Adley Provides for authorized agents for purposes of criminal history checks on nonlicensed persons and licensed ambulance personnel SB 169, Walsworth Provides an exemption from sales tax on the sale of meals to staff and patients of nursing homes and adult residential care providers SB 180, Erdey Provides relative to the division of insurance fraud in the Department of Insurance SB 185, Murray Provides relative to Medicaid and certain managed health care organizations providing health care services to Medicaid beneficiaries SB 187, Thompson Provides relative to veterinarians and the Prescription Monitoring Program

SB 198, White Consolidates the functions of the Louisiana Emergency Response Network and the Bureau of Emergency Medical Services into the Louisiana Emergency Medical Services and Response Network SB 199, White Creates and provides for the Southeast Baton Rouge Community School Board and school system in East Baton Rouge Parish SB 205, LaFleur Provides for the establishment of foreign language immersion programs in local public school districts SB 206, LaFleur Provides for empowered community schools SB 220, Walsworth Provides for the “Louisiana Has Faith in Families” Act SB 221, Ward Enacts the Louisiana Has Faith in Families Act SB 222, Walsworth Revises licensure procedures for child day care centers and facilities SB 232, Ward Provides for the allocation of monies appropriated from the Tobacco Tax Health Care Fund SB 235, Thompson Provides relative to requirements for certain public-private partnerships SB 246, Nevers Provides for the dedication of revenues realized from the expansion of health insurance coverage pursuant to the Affordable Care Act SCR 25, Gallot Requests the LSU Board of Supervisors and the governor to keep the Huey P. Long Medical Center open and viable.

SCR 41, Broome Requests DHH to examine the benefits of routine nutritional screening and therapeutic nutrition treatment for those who are malnourished or at risk for malnutrition, as well as examine the benefits of such actions as part of the standard for evidenced-based hospital care.

SCR 42, Broome Acknowledges the role of optimal infant nutrition during first year of life and that new mothers require assistance to provide the best nutritional start for their babies and urges DHH to facilitate maternal and infant nutrition awareness and provide access to nutritional programs.

Legislative Affairs content is provided by Checkmate Strategies, publisher of Health Care Information Services. All content © Checkmate Strategies and Louisiana Medical News, LLC. For more information, readers may contact Cindy Bishop at 225.923.1599 or P.O. Box 80053, BR, LA 70598, or send email to destiny362@ aol.com. Our website is www. checkmate-strategies.com

Health eVillages Program, continued from page 1 James, St. John and Terrebonne Parishes.

Teche, a nonprofit, serves close to 18,000 people in those parishes.

Devin Paullin, executive vice president of corporate business development at Physicians Interactive and an Advisory Board member of Health eVillages, said the damage wrought by Hurricane Katrina, the BP well disaster in the Gulf of Mexico, and the general Devin Paullin economic challenges of that region resulted in situations that almost identically mimic the kinds of things seen in Kenya and Uganda.

“To be very specific, one of the key things that we encountered is a challenge to connectivity,” Paullin said. “So they don’t have, let’s say, the best access to wireless Internet or an information infrastructure that’s giving them constant, upto-date information.”

Teche is a non-profit group with limited financial resources. Clinicians there have had to rely on books and sketchy Internet service for medical references and clinical support tools.

Teche’s clinics, practitioners and nurses aren’t necessarily equipped to go out and buy the most up-to-date equipment, Paullin said. The Health eVillages program helps with that.

In a news release, Teche CEO Dr. Gary Wiltz said the new devices and apps will help the clinics’ staffs improve the health and well-being of their patients and the community.

Physicians Interactive hopes that putting the proper clinical decision support resources into healthcare professionals’ hands will transform the way they provide primary and preventive healthcare for those patients.

One major difference between the four parishes and other areas where Health eVillages is involved is the content loaded in the mobile devices, Paullin said.

In Kenya, the health challenges may involve pre-natal and post-natal care. In Southwest Louisiana, the content is more about treating patients exposed to toxic chemicals and the respiratory, dermatologic and other complications that may result.

A recent study of Gulf Coast residents in four states by the Louisiana Environmental Action Network found 87 percent of those surveyed were experiencing medical conditions potentially linked to the oil spill and cleanup effort.

Read Louisiana Medical News Online: LOUISIANA MEDICAL NEWS.COM

Donato Tramuto, chief executive officer and vice chairman of Physicians Interactive, founded the Health eVillages program in 2011.

Each time there was a disaster – Hurricane Katrina, the earthquake in Haiti, the tsunami in Japan and the BP well – Tramuto and Physicians Interactive tried to figure out ways to help, Paullin said.

Usually that mean the company and its employees would make donations or hold fundraisers.

But Tramuto realized that emergency responders and health practitioners always had the same problem: they couldn’t bring a medical library with them in their backpacks, Paullin said. The same held true in Kenya and China; even without a disaster, there were situations in rural areas where practitioners couldn’t access the medical information needed to give patients up-todate treatment.

So Tramuto took Physicians Interactive’s Skyscape product and set up Health eVillages to supply the device and the app to healthcare professionals who didn’t have those sorts of resources. Under the program, Paullin said, Health eVillages comes in and analyzes the situation, trains the practitioners, provides the devices and the content and continued support and training.

Paullin said the program’s initial goals include making sure practitioners have all the materials they need and that the content is useful and being used.

If it’s not being used, Health eVillages goes back to the clinics to find out why and what would be better, he said. In the next few months, the program will also be measuring detailed outcomes that can show improvements in care.

Elsewhere, the program has already made strides in a number of key situations, Paullin said. A nurse in Kenya used a mobile device to review the procedures for how to resuscitate a baby that isn’t breathing when it is born.

It’s a delicate procedure because newborns could easily be injured, he said.

Three hours later, the nurse used that technique to resuscitate a newborn; now both mother and baby are fine.

Paullin said Health eVillages hopes to expand its work to other areas, including additional locations along the Gulf Coast and in Louisiana.

The problem is funding. It costs around $200 to put a device into a physician’s hands, Paullin said. As a non-profit, Health eVillages is always looking for sponsors and partners to help fund additional opportunities, to increase funding for the work that’s already underway or to provide the hardware.

LSMS

Making Louisiana a Better Place to Practice Medicine Since 1878

Hurricane Season is Here, Now What?

by LSMS Executive Vice President Jeff Williams

Educating Patients

While most parts of the country experience the traditional four seasons of winter, spring, summer, fall, Louisiana has a fifth - hurricane season.

It’s equally important that your patients be prepared during hurricane season in the event of an emergency.

Remind them to: LSMS Executive Vice President Jeff Williams

For physicians, now is a critical time to assess how prepared you are for this time of year. In 2009, the Louisiana State Medical Society Educational and Research Foundation (LSMS ERF) compiled a resource titled, Healthcare and Disaster Planning: Understanding the Impact of Disasters on the Medical Community (available at healthcaredisasterplanning.org).

The report documents the major breakdowns and failures of emergency preparedness plans and responses related to healthcare in an effort to educate physicians and the healthcare community on the need to reassess their emergency preparedness plans in light of the lessons Louisiana learned. Without proper planning, the ability of the physician to render appropriate medical care is compromised. To protect their patients and their practices, all physicians should take notice of the lessons detailed in the report.

In this publication, physicians can find information on how a disaster affects healthcare; tools for hazard assessment; how to prepare for a catastrophe; best practice recommendations; and physicians’ perspectives on policy, planning, and moving forward.

This information is presented through empirical literature and, most importantly, through the stories of the medical professionals who were the frontline workers during Hurricanes Katrina and Rita.

• Stay informed on the event.

• Maintain an updated list of all personal physicians for their family members, including office phone numbers and after-hours or emergency contact numbers.

• Make decisions early about sheltering at home or locating appropriate shelter and medical services for family members who require special healthcare needs.

• Have at least one week’s worth of medicine on hand, especially prescriptions, as needed for each family member.

• Charge cell phones ahead of the event.

• In the event of an evacuation, take important family documents, such as insurance policies, mortgage papers, and physician contact information.

This and much more information is available to the public at lsms.org/emergencypreparedness.

LSMS Pledge to Members The LSMS is committed to providing its member physicians with all of the information they need to succeed and thrive in their profession, and doing so in the face of an emergency or disaster is perhaps the most critical time when our Society can help support our members.

To find out how you can become a member, please visit lsms.org today.

For more information on Health eVillages or to donate, go to www.healthevillages. com or email info@ healthevillages.com

Louisiana Medical News

JUNE 2013 • 11

In the News CIS Welcomes Cardiologist Leon Kraft, MD BATON ROUGE- Dr. Leon Kraft has joined the Cardiovascular Institute of the South (CIS) team of cardiologists at 7941 Picardy Avenue in Baton Rouge.

Dr. Kraft has practiced cardiology for nearly 35 years. He earned his Bachelor of Science in Biology Dr. Leon Kraft from Wesleyan University in Middletown, Connecticut and received his doctorate from Yale University School

of Medicine in New Haven, Connecticut.

Dr. Kraft completed his cardiology fellowship at the University of Alabama at Birmingham and his internal medicine residency at Washington Hospital Center in Washington, D.C. Dr. Kraft is board certified in cardiology and internal medicine. He is a member of the National Medical Association, Louisiana State Medical Society, East Baton Rouge Parish Medical Association, and East Baton Rouge Parish Medical Society.

Dr. Deepak Awasthi Presents at Global Spine Meeting in Hong Kong THIBODAUX– Deepak Awasthi, MD, board-certified neurosurgeon on active staff at Thibodaux Regional Medical Center, recently participated as a presenter at the 3rd Global Spine Congress (GSC) in Hong Dr. Deepak Kong. Dr. Awasthi spoke Awasthi on the latest approaches to minimally invasive spine surgery.

The GSC is an important international event, meeting the specific needs and interests of spine specialists from all continents. More than 900 surgeons and researchers gathered at this year’s event to interact and share ideas regarding current trends in spine surgery and exploring future innovations.

Dr. Awasthi is board certified by the American Board of Neurological Surgeons, and is a fellow of the American College of Surgeons. He specializes in minimally invasive spine surgery, complex spine surgery, and neurotrauma.

UNIQUE

LGMC wins one of four 2013 Innov8 Lafayette Awards

AWESOME

LAFAYETTE- Innov8 Lafayette named LGMC one of its 2013 Innov8 Award winners for opening the first telemedicine clinic in Acadiana. The awards were presented in a ceremony April 22 at the Acadiana Center for the Arts.

The Innov8 Awards, a project of the Greater Lafayette Chamber of Commerce, celebrate innovators in Acadiana by showcasing local technological achievement and entrepreneurship. Lafayette General won the Medical category for its telemedicine clinic opened at Stuller, Inc.’s global headquarters in May 2012.

The Innov8 Award winners are selected by a group of seven local businesspeople in four categories.

The Trust Factor, continued from page 7

I can be anything. Do anything. I know I’m protected by the strength of the cross, the security of the shield. And the power of more top doctors and specialists. I have the card that opens doors in 50 states to compassionate healers and quality care. So I can be AWESOME.

#TOPDOCTORS www.bcbsla.com

The card accepted by more top doctors.

01MK5324 4/13 Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company

12 • JUNE 2013

Louisiana Medical News

pense of the smaller market share plans,” said Edwards. “That’s proven by the fact that more than one-third of hospitals would fail to meet profit margin goals if all private payor rates were the same as their largest payor.”

Contracting priorities for the upcoming year – the top three are the same as 2012 – involve: 1. Increasing rates with the largest payor.

2. Producing better language protection against denials.

3. Increasing rates with the second and third largest payors.

4. Balancing the threat and opportunity of narrow networks within the hospital’s market.

5. Having better contracting language with the largest payor.

6. Procuring better reimbursement for high-cost drugs, implants and other carve-outs.

7. Expediting claims processing and payments.

8. Improving rates for Medicare Advantage plans.

9. Shifting reliance away from the largest payor.

10. Bundling payments for medical home, ACO, or other population health strategies.

SOURCE: ReviveHealth.

In the News

NEW IBERIA — Progressive Acute Care, a Louisiana based healthcare company, officially assumed ownership of Dauterive Hospital in New Iberia making the hospital the newest and fourth member of Progressive’s Louisiana hospital system. Dauterive Hospital now joins several Progressive Acute Care Louisiana facilities which currently serve rural markets across the state including Avoyelles Hospital in Marksville; Oakdale Community Hospital in Oakdale; and Winn Parish Medical Center in Winnfield.

“We welcome the entire healthcare family of Dauterive Hospital to the Progressive Acute Care organization,” comments Dan Rissing, Progressive CEO. “As a Louisiana based company, we share the wonderful and unique Louisiana values and caring spirit that has been so much a part of Dauterive Hospital since its founding in 1920,” he adds.

Progressive announced its intent to purchase Dauterive Hospital March 21st with the acquisition becoming official May 1st. Jerry Fornoff, CEO of Dauterive Hospital commented on plans for the next several months for the hospital. “Together, our physicians, Board of Trustees, hospital department heads, and administration and support staff will work with Progressive leadership to develop a plan for growing services, technology and the physical campus. Our community will see the renewed commitment to our area and to the future of healthcare delivery by Dauterive Hospital as this plan is developed.”

Fornoff also assured the community that the hospital isn’t changing its name, won’t be cutting staff or services and affirmed that the hospital’s physicians will continue to provide a full range of healthcare services. “As the premiere hospital in our community, Dauterive Hospital is poised to build upon its strong foundation of excellence in healthcare service,” Fornoff stated. “Dauterive Hospital has been part of the fabric and history of our community and the surrounding area for more than 90 years. We don’t take the responsibility of caring for the people of this part of Louisiana lightly,” he adds.

LSUHSC Research Discovers New Drug Target For Metastatic Breast Cancer

NEW ORLEANS- Research led by Dr. Suresh Alahari, Professor of Biochemistry and Molecular Biology at LSU Health Sciences Center New Orleans, is the first to report that two specific tumor suppressor genes work in concert to inhibit the growth and spread of breast tumor cells to the lungs. The research is published this week online in the Journal of Biological Chemistry.

Working in a mouse model, the LSUHSC research team studied LKB1, an enzyme that functions as a tumor suppressor in the small intestine, and Nischarin, a novel protein that regulates breast cancer cell migration and movement discovered

by Dr. Alahari in 2000. Thirty percent of lung adenocarcinomas have an LKB1 gene mutation, and high levels of the LKB1 protein in breast cancer cells have been shown to significantly inhibit tumor growth. The LKB1-interacting protein is also structurally similar to Nischarin. The researchers suspected that the two suppressors might relate to each other, and they did in fact discover a functional and biochemical link between them.

The researchers demonstrated that Nischarin and LKB1 regulate breast cancer cell migration, anchorage-independent growth, tumor growth, and metastasis.

They also identified a new pathway by which LKB1 suppresses tumor cell movement.

Metastasis, a complex process involving cell growth, tumor cell migration, and invasion is a leading cause of cancerrelated deaths. Therefore, it is important to identify the molecular targets that can prevent cancer metastasis.

“The molecular mechanisms of tumor suppressor genes are not clearly understood, and each discovery moves us another step closer to a treatment advance or cure,” notes Dr. Alahari. Excluding skin cancer, breast cancer is the most common type of cancer among women in the United States. The American Cancer Society estimates 232,340 new cases of invasive breast cancer among American women this year, and 2,240 among men in the US, with 39,620 deaths in women and 410 deaths in men.

The LSUHSC team also included Prachi Jain, Somesh Baranwal, Shengli Dong, Amanda Struckhoff, and Rebecca Worthylake from the Departments of Biochemistry and Molecular Biology and Oral Biology.

The research was supported by grants from the National Institutes of Health, the Susan Komen Foundation, and the Louisiana Cancer Research Consortium.

Louisiana Health Cooperative Granted Insurance License

METAIRIE - Louisiana Health Cooperative, Inc., (LAHC) has obtained its license from the Louisiana Department of Insurance to provide health insurance coverage statewide beginning in January 2014 . Based in Louisiana, LAHC was selected by the United States Department of Health and Human Services (HHS) on September 28, 2012 to create and operate a Consumer Oriented and Operated Plan, or “CO-OP” statewide. LAHC is Louisiana’s first non-profit health insurance CO-OP and plans to provide a variety of health insurance options for individuals and employers throughout the state.

“Louisiana Health Cooperative looks forward to providing Louisiana residents with a new choice of affordable insurance benefit options,” said Terry Shilling, LAHC Interim CEO. “We plan to promote community health and well-being by involving the members and providers that we serve in the delivery of high quality, integrated health care services.”

Enrollment in LAHC will begin October 1, 2013.

Enabling authorized providers to electronically share health information through a secure and confidential network.

Benefits include » Better care coordination and patient management » Timely access to patient records » Improved patient safety/reduced medical errors » Enhanced patient/physician communication » Increased security of records » Improved public health reporting » Reduced medical costs » Improved access to information in emergencies and disasters

A Health Care Quality Forum Initiative

Dauterive Hospital Ownership Change Complete

» Streamlined connectivity with eHealth Exchange

More than 130 hospitals, clinics, physician practices and health care companies throughout Louisiana are now participating in LaHIE. For more information or to schedule an on-site demonstration, contact lahie@lhcqf.org or call (225) 334-9299.

In partnership with the Office of the National Coordinator for Health Information Technology (ONC), U.S. Department of Health and Human Services, Grant #90HT0050/01.

lhcqf.org Louisiana Medical News

JUNE 2013 • 13

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In the News Louisiana State Nurses Association Installs New Board of Directors BATON ROUGE- The Louisiana State Nurses Association (LSNA) recently hosted its Annual Nurse Day Event at the Baton Rouge Marriott. With over three hundred and sixty Registered Nurses and nursing students from around the state in attendance, presentations focused on issues impacting nursing patient care at the national and state level.

Program speakers included Jennifer S. Mensik, PhD, RN, NEA-BC, Second Vice President of American Nurses Association (ANA); Dr. Mensik addressed changes taking place at ANA and within the State Nursing Associations to increase the responsiveness of the organizations to nursing issues. Mr. Calder Lynch, Health Policy Advisor for the Louisiana Department of Health and Hospitals, presented an overview on the impact of healthcare changes in Louisiana, and Mr. Randal Johnson, LSNA Lobbyist from Southern Strategy Group gave a 2013 legislative update.

Immediately following the educational offerings and committee updates, Dr. Jacqueline Hill convened the Louisiana State Nurses Association biennial House of Delegates. The House of Delegates represents the voting voice of the nurses holding state membership and is composed of the LSNA Board of Directors and elected delegates from each district.

The Louisiana State Nurses Association is pleased to acknowledge and congratulate the newly installed 2013-2015 Board of Directors: President, Dr. Carol A. Tingle, Baton Rouge District President-Elect, Mrs. Norlyn Hyde, Ruston District Vice-President, Dr. Carllene MacMillan, Lafayette District Secretary, Mr. Gordon Natal, New Orleans District Treasurer, Dr. Debra Shelton, Shreveport District Chair, Clinical Practice Council, Dr. Deborah Garbee, New Orleans District Chair, Leadership and Management Council, Ms. Rose M. Schauhbut, New Orleans District Chair, Bylaws and Resolutions Committee, Ms. Laura Tarcza, New Orleans District Chair, Education Council, Dr. Stephanie Pierce, New Orleans District Chair, Research and Informatics Council, Dr. Ann Carruth, Tangipahoa District Chair, Workplace Advocacy Council, Ms. Frances Finley, Alexandria District All business before the House of Delegates was completed in two sessions, with the final session including the installation of the new LSNA Board of Directors for 2013-2015 and the House of Delegates was then adjourned on April 27, 2013 14 • JUNE 2013

Louisiana Medical News

Peoples Health Appoints Lela Blanco to Regional Director Metairie, La. – Peoples Health has announced the appointment of Lela Blanco to regional director. Blanco ensures coordination of clinical care across the care continuum within her region for members enrolled in health plans from Peoples Health, a MediLela Blanco care Advantage company serving a 23-parish area that includes New Orleans and Baton Rouge. She organizes the administration of health plan benefits and monitors the effective operation of the region under the purview of the Eastbank offices. Blanco is responsible for recruiting and managing regional staff and contributes innovative ideas to improve regional and departmental functions. She communicates with physicians, hospital administrators and other members of the healthcare team to promote plan member satisfaction and high-quality care.

Blanco brings three decades of experience in nursing and healthcare administration to her position. Prior to joining Peoples Health, Blanco served as patient care manager for two intensive care units at Touro Infirmary in New Orleans. During her time in that position, her units increased both productivity and compliance with patient safety and coding guidelines. She also previously served in a variety of staff nursing and supervisory positions at the University of Mississippi Medical Center in Jackson and Memorial Medical Center in New Orleans.

Blanco earned a Bachelor of Science in Nursing from William Carey College in Hattiesburg, Miss. She is a member of the American Association of CriticalCare Nurses.

Peoples Health Appoints Anna LaBauve to Regional Director Metairie, La. – Peoples Health has announced the appointment of Anna LaBauve to regional director for the Southland region. LaBauve ensures coordination of clinical care across the care continuum within her region for members enrolled in Anna LaBauve health plans with Peoples Health, a Medicare Advantage company serving a 23-parish area that includes New Orleans and Baton Rouge. She ensures that health services are appropriately provided in inpatient and outpatient facilities, including contracted and non-contracted providers. LaBauve is responsible for recruiting and managing the Southland region staff and contributes innovative ideas to improve regional and departmental functions.

She communicates with physicians, hospital administrators and other healthcare providers, as well as the Peoples Health regional medical management team, to promote member satisfaction and high-

quality care.

LaBauve brings almost 20 years of nursing management experience to her position. Before joining Peoples Health, she worked as director of nursing for Bayou Home Care, where she managed budgets, supervised staff and ensured compliance. She also has experience as a director of nursing in both the hospice and nursing home environments. As a lifetime resident of Houma, she understands the unique cultural and wellness issues of Peoples Health plan members in the Bayou region.

LaBauve earned an Associate Degree in Nursing from Nicholls State University in Thibodaux. She holds a current Louisiana registered nurse license.

Women’s & Children’s Earns Radiology Accreditation LAFAYETTE – Women’s & Children’s Hospital, a campus of The Regional Medical Center of Acadiana, recently received additional national accreditation for the quality radiology services it offers Acadiana families.

The hospital, 4600 Ambassador Caffery Parkway, volunteered to undergo a rigorous review by the American College of Radiology. ACR awarded the hospital’s efforts with a three-year accreditation for Ultrasound services.

Ultrasound imaging, also known as sonography, uses high-frequency sound waves to produce images of internal body parts to help providers diagnose illness, injury, or other medical problems.

The department also recently received ACR accreditation for Computed Tomography (CT), sometimes called a CAT scan, Positron Emission Tomography (PET scans), Nuclear Medicine and Magnetic Resonance Imaging, or MRI, of the neck, head and spine.

“When patients see the ACR gold seal, they can rest assured that their prescribed imaging test will be done at a facility that has met the highest level of imaging quality and radiation safety,” said Raleigh White, Radiology Department Director for Women’s & Children’s Hospital.

The ACR is a national professional organization serving more than 34,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.

AM Best Revises LAMMICO Outlook Upward METAIRIE-- After 19 consecutive years of maintaining an “Excellent” rating, the world’s oldest and most authoritative source of insurer financial performance has revised LAMMICO’s rating outlook to positive from stable and affirmed the company’s financial strength rating of A- (Excellent).

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