Mississippi Medical News May 2015

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PHYSICIAN SPOTLIGHT PAGE 2

Phillip Ley, MD

ON ROUNDS

Population Health Advances Physicians are buzzing about the new healthcare paradigm America’s independent physicians met mid-March in San Antonio, Texas, for the 20th annual national meeting of TIPAAA – The IPA Association of America, the largest trade association serving independent and integrated physicians in the United States ... 3

Digital Health Flourishes in Mississippi Planned Jackson technology center includes new home for one of UMMC’s fastest-growing services

By JULIE PARKER

Almost daily, Kristi Henderson, DNP, fields calls from business folks interested in leasing space in the new 16,000-square-foot facility being built to house one of the University of Mississippi Medical Center’s (UMMC) fastest-growing services: digital health.

“With our advanced telehealth program, technology vendors from all over the world want to work with us to better refine their

products,” said Henderson, chief telehealth and innovation officer at UMMC, and director of the UMMC Center for Telehealth. “In turn, we get to help craft better solutions for Mississippians. It’s a win-win for everybody.”

The Venyu Technology Park, slated to open July 1, 2016, at the site of the former McRae’s department store in the historic Fondren neighborhood of Jackson, will house the UMMC Center for (CONTINUED ON PAGE 8)

The New Key Payer: Patients Themselves Mastering Population Health Thomas Jefferson University offers nation’s first MS-PopH program The hottest new advanced degree in healthcare, beyond medical school, focuses on a game changer for the nation’s healthcare delivery system: population health ... 4

ONLINE: MISSISSIPPI MEDICAL NEWS.COM

With higher deductibles, practices must shift their collection focus “Historically, patients have gone to the physician, given the receptionist at the physician’s office insurIn order to survive in the current healthcare enance information, paid a co-pay and walked out the vironment, physician offices need to focus more than door,” he said. “Sometime later, the patient would reever on collecting payment from their patients. ceive a statement with the balance to be paid. Things That’s the advice of Harold Ingram, president are changing now.” and CEO of Jackson-based PerforMax Medical ManThat’s because many patients are faced with agement. After more than 25 years of providing adhigher deductibles than ever. Both current employee visory and billing services for medical offices, Ingram health plans and “Exchange” products offered under Harold Ingram notes that the days of medical offices relying almost the Affordable Care Act often carry deductibles of solely on insurance companies and government payers are over.

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PhysicianSpotlight

Phillip Ley, MD

By LUCY SCHULTZE

For most Mississippi cancer patients, traveling to take part in clinical trials at MD Anderson Cancer Center in Houston or Memorial Sloan Kettering Cancer Center in New York is far beyond what’s financially possible.

But regional partnerships can bring similar opportunities closer to home, said surgical oncologist Phillip Ley, MD, of St. Dominic’s Women’s Health and Healing Center in Jackson.

“We can benefit from expertise we don’t have locally, while contributing patient volume to clinical trials,” Ley said. “We may not have the volume and resources to build an NCI-designated cancer center in Mississippi in the current healthcare and political environment. But if we can collaborate with centers that are established, we can offer those opportunities to a lot of patients who wouldn’t otherwise be able to participate in clinical trials.”

It’s a vision for growing such connections that Ley is pursuing at St. Dominic’s since joining the hospital staff a year ago.

Ley has been performing surgery in the Jackson area since 1996 as part of a private group, based primarily at Baptist Medical Center. Joining St. Dominic’s offered a chance to narrow his focus in oncology while pursuing his vision for the cancer program’s growth. High on his list is providing genetic counseling for highrisk patients as well as growing the understanding of genetics and genomics within the medical community.

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“There’s a real crying need for that type of knowledge among physicians these days,” Ley said. “It’s not just oncology; genomics is exploding into every field.”

In addition to predicting the onset of hereditary diseases, genetic science is being used to tailor pharmaceuticals to an individual patient’s genetic makeup and metabolic rate.

“Our ability to predict responses through genomic profiling of patients even goes as far as the primary-care clinic,” he said. “But our ability to perform these

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tests is outstripping our knowledge of how to interpret the results.”

The field has long been an area of interest for Ley, who worked toward a PhD in genetics at MD Anderson before shifting to focus solely on his surgical practice.

Raised in a small town southwest of Houston, Ley was attracted to medicine through his family’s relationship with a local hometown doctor whose office was housed in the back of the drugstore Ley’s family owned.

Ley completed pharmacy school at the University of Texas in Austin before enrolling at Baylor College of Medicine. He completed his residency in general surgery at Scott & White Clinic in Temple, Texas, then went on to complete a fellowship through the University of Texas at MD Anderson.

Ley was drawn to oncology during his residency, for the variety it offered in performing surgical procedures in different parts of the body. His training years during the early 1990s offered plenty of opportunity to find the right fit in a specialty area.

“I was fortunate to do my residency when we were starting to do laparoscopy but still had the benefit of learning through open surgery,” he said. “It was also before all of the work-hour restrictions for residents. If you were motivated, you could do a lot, and the residents had a lot of autonomy. It was kind of the golden era for training.”

Ley has since honed his specialty to focus primarily on surgery for cancers of the breast. He estimates those procedures

– removing about 315 new breast cancers each year – account for three-fourths of his practice. The remaining time he devotes to surgery for melanoma and sarcoma, with a smaller focus on cancers of the gastrointestinal tract and endocrine surgery.

For the latter area, Ley is working to bring on a younger partner who can expand the practice to cover more complex GI surgeries with minimally invasive techniques and robotics.

“We are moving forward on many fronts,” Ley said. “Developing programs for genetic counseling, for follow-ups of high-risk cancer patients and survivors – all of these efforts are very important.”

Over the course of his career in Mississippi, Ley has introduced a number of surgical oncology techniques to the state, including intra-operative lymphatic mapping and sentinel node biopsy for melanoma and breast cancer patients.

In the late 1990s, Ley contributed patients to the University of Louisville Breast Sentinel Lymph Node (SLN) Registry, which demonstrated that SLN biopsy could be performed safely and effectively.

He was co-author for eight peer-reviewed articles from that study.

Ley introduced neoadjuvant chemotherapy to facilitate breast preservation in breast cancer patients and popularized the use of neoadjuvant chemoradiation in rectal cancer patients to facilitate sphincter preservation and avoid permanent colostomies. He was also among early advocates for cryoablation and radiofrequency ablation of hepatic tumors, and for oncoplastic breast surgery to improve cosmetic outcomes.

“There have been a lot of advances we’ve helped promote – I think to the betterment of cancer patients in Mississippi,” he said. “It’s been a lot of fun, and I’m looking forward to taking the next steps toward building a cancer program with collaborative partners.”

Ley is a fellow of the American College of Surgeons and the Society of Surgical Oncology, and is a member of the American Society of Clinical Oncology, the American Society of Breast Surgeons, the American Society of Breast Disease, the Mississippi State Medical Association and the American Association of Physicians and Surgeons.

He is an advisor to the Mississippi affiliate of the American Cancer Society.

He has supported the Mississippi Witness Project and speaks regularly to cancer support groups and healthcare forums around the state.

Outside of work, Ley is engaged in family life and also enjoys traveling, gardening and target shooting.

He is married to former WJTV news anchor Linda Allen and has three grown daughters.

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Population Health Advances

Physicians are buzzing about the new healthcare paradigm

By JULIE PARKER

America’s independent physicians met mid-March in San Antonio, Texas, for the 20th annual national meeting of TIPAAA – The IPA Association of America, the largest trade association serving independent and integrated physicians in the United States.

The focal point: population health, a relatively new front burner issue unfamiliar to many practitioners. Congress included the model as a component of mandates in the Patient Protection and Affordable Care Act (ACA) (See box).

“We covered a lot of ground at our annual meeting to educate independent physicians about population health,” said Al Holloway, founder and president of TIPAAA. “Once we fully understand what it is, then we’ll find tools, products and services that can assist independent physicians in their daily practice.”

One question that repeatedly popped up: What’s the difference between population health and public health?

“Some view population health as a more modern version of public health, which itself – improving the health of the public – may be a goal, a measurement system, and a conceptual framework that undergirds a profession and a scientific

field,” wrote Michael A. Stoto, PhD, in “Population Health in the Affordable Care Act Era,” published by Academy Health (Feb. 21, 2013).

“Population health differs from public health, at least perceptually, in at least two respects,” Stoto explained. “First, it’s less directly tied to governmental health departments. Second, it explicitly includes the healthcare delivery system, which is sometimes seen as separate from or even in opposition to governmental public health.”

David B. Nash, MD, MBA, founding dean of the Thomas Jefferson University School of Population Health, pointed out that population health “builds on public health foundations.”

Among the building blocks, according to Nash: Connecting preven- David Nash tion, wellness and behavioral health science with healthcare delivery, quality and safety, disease prevention/management and economic issues of value and risk – all in the service of a specific population. Examples: a city, provider’s practice, employee group, hospital’s primary service area or pre-school

children.

Identifying socioeconomic and cultural factors that determine the health of populations, and developing policies that address the impact of these determinants.

Applying epidemiology and biostatistics in new ways to model disease states, map their incidence and predict their impact.

Using data analysis to design social and community interventions and new models of healthcare delivery that emphasize care coordination and ease of accessibility.

“When applied to healthcare delivery, population health differs from conventional healthcare by emphasizing value rather than volume of services rendered,” said Nash.

How will population health affect physicians?

Monumentally, said Kathy Jordan, president of Jordan Search Consultants.

“The primary care practice of the future will look much different than it does today,” she said. “Instead of one-on-one encounters between the patient and their provider, the patient interaction process will include phone visits, email consultations, group visits, education programs and encounters with a variety of care team members. Out-of-office contact will

become the new norm as patient health improves. Additionally, primary care physicians of the future must exhibit leadership and interpersonal skills, as well as a passion for top-tier service delivery. How well they manage the team will directly translate to how well the health of their patient population is being managed, which will directly impact future compensation models.”

Important financially: To be eligible for incentivized government funding, organizations must prove their commitment to, and implementation of, population health, said Jordan.

“They’ll be required to improve the patient care experience, the overall health of populations, and lower per capita costs of case,” she said. “As a more comprehensively integrated system focused on population health begins to dominate, the healthcare industry, healthcare experience and provider recruitment initiatives must also evolve.”

Enter population health management.

Regina Levison, vice president of client development for Jordan Search Consultants, said that “while population health is defined as the health outcomes of a group of individuals comprising a spe(CONTINUED ON PAGE 9)

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Mastering Population Health Thomas Jefferson University offers nation’s first MS-PopH program

By JULIE PARKER

The hottest new advanced degree in healthcare, beyond medical school, focuses on a game changer for the nation’s healthcare delivery system: population health.

Thomas Jefferson University (TJU), home of the nation’s only School of Population Health, received approval March 5 to become the only institution of higher learning in the United States to offer a new graduatelevel degree program: Master of Science in Population Health (MS-PopH). The program is accepting applications for this fall.

“Population health is catching fire.

It’s a raging inferno at the moment,” said David B. Nash, MD, MBA, founding dean of the Jefferson School of Population Health and the Dr. Raymond C. and Doris N. Grandon professor of health policy at Thomas Jefferson University.

Nash, a board-certified internist, be-

came involved in promoting quality improvement and lobbying for healthcare policy change in the 1980s. He joined the university in 1990 as a faculty member; the former university president asked him to build the School of Population Health for the campus, which opened in 2008 as the first U.S. academic institution focused on population health. Already, 25 students have completed the graduate certificate

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online program, which takes 12 to 20 months to complete. Its focus: to help current and emerging healthcare leaders understand the new population health paradigm. More than 100 students have completed the onsite Population Health Academy, a 40hour continuing education program, providing an overview of basic concepts in population health.

“Healthcare inside a medical facility is only 15 percent of the story; 85 percent of healthcare happens outside the hospital,” noted Nash. “We have to reach outside the four walls of our hospitals to coordinate with community pharmacies, nursing homes, extended care facilities and the like, and link all of these care providers – from the hospital’s board of trustees to the folks delivering home infusion medication. It’s a big operational challenge. We’re going to have to become a well-oiled, organized, value-generating team.”

Kathy Jordan, president of Jordan Search Consultants, said the new degree program is well-timed.

“The healthcare landscape is shifting more dramatically right now than it has since its inception,” she said. “As an increasing number of healthcare organizations move to models of accountable care, the overall healthcare experience will transform. With an emphasis on proactive preventative care, evidence-based protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen. In some cases, this may require new types of training.”

The comprehensive MS-PopH online graduate degree program will help students develop competencies in five key public health areas – behavioral and social sciences, biostatistics, environmental health sciences, epidemiology and health policy. Students will also develop proficiency in the application of population health skills and principles, culminating in a Capstone project applying theory and lesson in real-world situations.

Already in place at Thomas Jefferson University: a doctoral degree program – PhD in Population Health Sciences –that started four years ago and has 14 students.

The first two graduates will receive their degrees this month.

The doctoral degree is studied onsite, with the goal of preparing leaders with global vision to analyze the determinants of health. Doctoral candidates specialize in one of four areas: health policy, healthcare quality and safety, applied health economics/outcomes research and behavioral/health sciences.

“The PhD in Population Health Sciences isn’t intended for those new to the discipline,” noted Nash. “Preference is given to applicants who’ve completed a master’s degree or master’s level coursework in appropriate fields of study, such as public health, social work, health policy and behavioral sciences.”

The addition of the MS-PopH program came soon after Stephen K. Klasko, MD, MBA, relocated from the University of South Florida (USF) Morsani College of Medicine and USF Health, where his transformative ideas took the Tampa medical school to Dr. Stephen unprecedented heights.

Klasko Klasko is in his first year as president of Thomas Jefferson University and president/CEO of the Thomas Jefferson University Hospital System, now the largest healthcare system in Philadelphia, Pa., the nation’s sixth largest city.

“We’re moving healthcare from a Blockbuster mentality to a Netflix mentality,” said Klasko, pointing out the university began offering population health “before anybody put population health in the same sentence.”

“At Thomas Jefferson University, we created a whole new mission and vision, where health is all we do,” he explained.

“Our vision is to reimagine healthcare education discovery to create unparalleled value. Jobs will be needed in healthcare in 10 years that aren’t even yet imagined, and a good many will be in population health.”

Nash, who also serves as a government and private-sector consultant, chairs the Technical Advisory Group of the Pennsylvania Health Care Cost Containment Council and is a board member of various healthcare organizations, including Humana.

“The great thing about Dr. Nash’s school, it’s not a Johnny-come-lately. He’s devoted his life to population health,” said Klasko. “In most universities, population health is part of another school and lacks the panache … that puts us at the forefront.”

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For additional information on the Jefferson School of Population Health degrees – program content, admissions requirements, deadlines, and tuition and fees – visit http://www.jefferson.edu/university/population-health/degreesprograms/population-health/about.html.

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Help Wanted: Population Health Physician Leaders Filling positions may be a tall order; job-getters will enjoy top-of-license roles

By JULIE PARKER

Finding presentable candidates for population health physician leaders is a tall order, especially since many doctors remain unfamiliar with the new paradigm in post-healthcare reform.

Personnel represents one of three key ingredients to implementing population health management. It’s the glue to connecting data and the changing nature of the overall healthcare experience. The hard shift in practice management has healthcare organizations scrambling to secure top-notch population health physician leaders, a move that keeps physician recruiters like those at Jordan Search Consultants quite busy.

“Our clients know the organizations able to most effectively aggregate and distribute data—to collaborators, team members, and even patients themselves—will succeed,” said Kathy Jordan, president of Jordan Search Consultants.

“Healthcare systems are now implementing robust software systems and population health management programs that help automate data integration, analysis, reporting, and communications so that

real-time evaluations—and adjustments in patient care plans—can be made instantaneously. Having the right IT systems – and IT personnel – in place is critical to advance clinical outcomes, improve care, and lower costs. Organizations with the ability to master data control and predictive analytics to generate decision-driving insights will succeed in population health management.”

Unfortunately, the shortage of primary care physicians (PCPs) – the leaders of population health management – continues to escalate. As population health management becomes the dominant healthcare model, the demand for their roles will be unprecedented.

“As physicians continue to leave the private practice model in favor of employed physician models, cultural fit within an organization will become a key recruitment parameter,” said Regina Levison, vice president of client development for Jordan Search Consultants. “In addition, PCPs will be recruited based on their ability to build consensus, manage teams, and lead a diverse care team to better patient health. Organizations must understand what physicians are looking for clinically,

financially, and administratively to ensure a fit with the organization. Physicians who embrace the care team model, understand how to utilize advanced practice providers, and enjoy leadership opportunities will be in high demand. In addition, recruits must understand new incentive and reimbursement structures. Physicians will be rewarded for meeting care management needs of patients; reimbursement will be tied to quality as opposed to quantity.”

Characteristics of a potential population health physician leader, according to Jordan Search Consultants, include: • A minimum of five to 10 years of practice experience.

• Board certification.

• A good understanding of the way Electronic Medical Records (EMRs) work.

• A plan to help move the population health management team to the next level.

• Mentoring ability.

• Advanced education.

“We’ve changed how we evaluate physician candidates and physician leaders so we can provide a better slate of can-

didates to our clients,” said Jordan. “We want to assess their ability to embrace population health, their understanding of population health, and their attitude and ability to treat patients under a population health model. We have to dig more deeply. The physician leader of the population health management team will be working at the highest end of their license.

We evaluate their ability to give direction and make assignments to the team and to educate their colleagues. They’ll need to assess where the team is strong, and where it needs additional education, training and support. It’ll be dictated not only by geography, but also by the socioeconomic element of the population being served.”

Clients are thrilled, said Jordan, when the consulting firm finds a candidate who already knows the EMR system they’ve implemented.

“That’s one less bridge to cross,” she said.

One of the most pleasant surprises Jordan Search Consultants’ recruiters have discovered in physician leader candidate pools is the growing number of physician candidates who have, or are (CONTINUED ON PAGE 8)

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*ANDERSON - 2PG SPREAD - 4-15 MS MED NEWS _Layout 1 4/8/15 1:29 PM Page 1

Anderson First in State to Offer TomoTherapy for Cancer Patients

Meridian cancer center takes lead in next-level radiation treatment

TomoTherapy uses a linear accelerator merged onto a comDoctors at Anderson Regional Cancer Center in Meridian, MS, are now treating cancer patients with the most advanced radi- puted tomography (CT) based framework, which allows radiation ation system available, rivaling systems used at some of the largest to be delivered in a helical fashion from 360 degrees. Treatments cancer treatment centers in the world. Anderson’s new can be continuously delivered to the tumor from every angle. More TomoTherapy System® is beam directions also proAnderson Regional Cancer Center team members with the new TomoTherapy system. vides assurance that the one of only 13 TomoTherdose will be confined to apy systems in the nation, the tumor, reducing the and the only one in the state risk of short- and longof Mississippi.

The term side effects.

TomoTherapy System delivAnderson added, ers treatments with in“The TomoTherapy Syscreased speed and precision tem can efficiently treat while reducing radiation exlarge tumors, or multiple posure to surrounding tumors in different areas of healthy tissue. the body in the same treat“At Anderson Rement session. The system gional Cancer Center, we also enables patients with take pride in offering the most advanced cancer treatment options available,” said Dr. R. recurring tumors to receive additional radiation that would not Scott Anderson, Radiation Oncologist. “The TomoTherapy System’s have been performed with traditional radiation systems.” unique design and capabilities give our team the ability to target The TomoTherapy System excels at treating cancers that are tumors in ways never before thought possible and deliver aggres- historically difficult to treat such as head and neck, esophageal and sive, extremely accurate and highly individualized treatment for lung. TomoTherapy can increase the chances of controlling a solitary each patient. We’re excited to offer this leading-edge technology to pulmonary nodule from 45 percent with surgical resection to 70 our patients as part of our continued commitment to high quality percent using this technology. In some cases, lung cancer patients patient care.” will receive only one week of TomoTherapy treatments as compared to seven weeks with traditional radiation therapy systems.

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R. Scott Anderson, MD, FACR, reviews results of the new TomoTherapy system.

“TomoTherapy has amazing promise for gynecologic and prostate cancers as well, and we are working with one of the most advanced planning systems in the world to help add those treatments to this program,” Anderson said.

TomoTherapy radiation sessions are non-invasive and typically pain free. The TomoTherapy System is clinically proven to be effective and improve patients’ quality of life.

Anderson Regional Cancer Center has been providing cancer care for residents of East Mississippi and West Alabama since 2000. The center is fully accredited by the College of Surgeons Committee on Cancer, providing Radiation Oncology, Medical Oncology, Chemotherapy, Nutritional Counseling, Social Services/Patient Navigation and a Tumor Registry. The physicians of Meridian Oncology Associates, Dr. John Clay, Dr. John Halbrook, Dr. Dwight Keady, Dr. John Voss, and Dr. Matthew Cassell, are an integral part of the cancer program at Anderson.

As the most comprehensive health system in East Mississippi and West Alabama, Anderson is the established leader in offering premier medical services. Anderson’s healthcare professionals are committed to the continued mission of providing a heritage of healing and improving life for the people they serve.

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Targeting T rgeting Cancer with Ta Unmatched Accuracy

Introducing a radiation therapy py system py y th he patient. that revolves aroundd the With integrated daily CT imaging and a 360º delivery pattern, the TomoTherapy® Treatment System customizes delivery based on patient anatomy, allowing treatment to zero in on cancer like never before. Anderson Regional Cancer Center is now treating patients with the most advanced radiation system available.

Regional Cancer Center Meridian, Mississippi www.andersonregional.org MAY 2015

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Help, continued from page 5

Digital Health Flourishes in Mississippi, continued from page 1

pursuing, advanced business degrees, such as an MBA, perhaps with a concentration in healthcare management, MHA (masters of healthcare administration), MPH (masters of public health), MHI (masters of healthcare informatics), MMM (masters of medical management), or MS-PopH (masters of population health).

“The MMM is a relatively new degree,” Jordan said, adding the MS-PopH degree program is a brand new offering at Thomas Jefferson University, the nation’s only school to offer that particular advanced degree. “They’re educating themselves to lead the charge.”

On the flip side, PCPs who otherwise might be excellent candidates for those positions simply lack time to pursue higher education.

“The rank-and-file practicing physician in a community doesn’t need a degree in population health to see his patients,” said Al Holloway, founder and president of TIPAAA (The Independent Physicians Association of America). “No, that doesn’t make sense. Having an understanding of population health will impact his practice, but he doesn’t need a degree in it.”

The need for these type of leaders is unprecedented, said Jordan.

“As the demand increases, and we continue to have a very limited supply of physician professionals for these leadership positions, automatically the compensation goes up,” she said. “That’s something I hope potential candidates will strongly consider.”

Telehealth and serve as a focal point of the Mississippi Healthcare Corridor, a master plan lauded by state leaders and lawmakers.

“Mississippi is a national leader in telehealth,” said Gov. Phil Bryant, a staunch supporter of technology advancement. “We’re not only growing the medical corridor in the Jackson metro area, we’re ensuring we have the infrastructure in place to develop new healthcare solutions that can improve the lives of Mississippians.”

Even though most of the new technology center’s structures already exist, the building to house the UMMC Center for Telehealth is being specifically designed to meet the state’s growing demand for digital health services. The center functions as a virtual clinic, including direct medical diagnostics and treatment from physicians, specialists, and nurses, and medication dispensation.

Already, demand for digital health services is rapidly increasing. In 2012, the UMMC Center for Telehealth had 95 contracted sites via partnerships with clinics, hospitals, physicians and specialists across the state. Since then, the number has climbed to 166 access points for telehealth visits. More than 30 specialties are represented.

“Right now, we have about 8,000 consultations per month, and that’s a conservative estimate,” said Henderson, noting that ICU patients and patients in their homes aren’t included in that number.

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“If I counted individual visits, it would clearly be different than the number of unique individuals, since we often engage with patients on a daily or weekly basis.

By the time the center opens, we anticipate the number of consultations will have doubled.”

The greatest demand for digital health services has come from hospitals and physician practices needing assistance help monitoring patients with chronic conditions in their homes, in between doctor visits, a service Henderson said “will be one of the larger arms of our practice.”

The new home of the UMMC Center for Telehealth will include a telehealth operations center, telehealth technology operations center, and a remote patient monitoring center.

“The new space for UMMC’s Center for Telehealth demonstrates our commitment to a healthier Mississippi,” said Henderson.

A national leader

Mississippi has become a national face for digital health advancement, garnering federal funding for advancements in remote patient monitoring. The sparsely populated state of nearly 3 million was one of only seven nationwide to receive an “A” rating from the American Telemedicine Association last year for telemedicine policy and regulations.

Last March, UMMC received a U.S. Department of Agriculture grant to place equipment and provide services to sites in 10 counties – nine Appalachian and one in the Delta. Also last year: Bryant rolled out a pilot partnership between the state, North Sunflower Medical Center, and corporate sponsors to assist diabetes patients in the Delta through telemedicine, arming 200 patients with special Internet tablets for medical services. Additionally, UMMC and Mississippi Children’s Home Services, aided by a state-federal grant, unveiled a first-of-its-kind partnership to improve children’s mental health services, with a hefty telemedicine component.

Earlier this year, the South Central Telehealth Resource Center covering Arkansas, Mississippi and Tennessee, based at the University of Arkansas Medical Sciences (UAMS) Center for Distance Health, held its third annual South Central Telehealth Forum at the Hilton Jackson Hotel in downtown Jackson. It

UMMC’s initial foray into digital health took place in 2003 with the telemergency pilot program that created a statewide network with hospitals and clinics to provide access to various specialties, including cardiology, psychiatry and radiology. Since then, the center has helped nearly a half million Mississippians via telehealth.

marked the tri-state resource center’s first meeting in Mississippi. The March 2 conference focused on sustainability, clinical programs, program development and technical understanding of digital health.

“We’re a leader largely because of the telemedicine legislative reimbursement package that lawmakers passed early on,” Henderson shared with participants.

For example, Florida leaders are lobbying this year for passage of a comprehensive telemedicine bill, but even the Florida Medical Association (FMA) isn’t pushing for telehealth consultations being reimbursed at the same rate as in-clinic visits. That’ll come after comprehensive legislation without a financial component is passed. Mississippi lawmakers approved the vital financial reimbursement component in 2012.

An entrepreneurial link

Also part of the new UMMC Center for Teleheath: an Innovation Living Lab to serve as an incubator for healthcare technology innovation and solutions.

Tony Jeff, CEO of Innovate Mississippi, formerly known as Mississippi Technology Alliance, said several factors converge to make sense for Mississippi to lead the nation’s telehealth movement.

“We’re a very rural state, obviously, and it’s very difficult to deliver healthcare across very rural environments,” he said.

“Better Internet connections are essential, and we’re fortunate to be the recipients of C Spire’s fiber optic home initiative.

With Mississippians connected, we can do amazing things concerning telehealth issues. Just one example: very detailed scans. Another: Mississippi is an emerging leader in the space of physical, occupational and speech therapy.”

Last spring, Innovate Mississippi held a healthcare-focused startup event that generated much concept-to-marketplace interest from investors. In 2014, 15 percent of startups that came through the Innovate Mississippi Entrepreneurial Development had some medical or healthcare component, Jeff said.

“This year, we’re on track to see that ratio rise to 20 or 25 percent,” he said.

“The really interesting space is going to be the capitalist side of telehealth, as business models emerge that provide physicians with a faster way to see patients, but coding and reimbursement doesn’t keep pace.

The end results will be amazing and more efficient, but it’ll be a bit of a mess in the meantime.”

Reduced hospital readmissions and subsequent lower per patient costs among other savings will more than offset the funds spent on the UMMC Center for Telehealth.

“This development is a wonderful marriage of high-tech, high-innovation activities that represents the economic future of Mississippi,” said James E. Keeton, MD, UMMC vice chancellor for health affairs and dean of the School of Medicine. “From our new Telehealth Center, we’ll literally be able to bring some form of healthcare services to every Mississippian who has a network connection.” mississippimedicalnews

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The New Key Payer: Patients Themselves, continued from page 1 “These new products offer an average monthly premium of $52 – but the other side of the coin is, while people may have insurance, it only serves them if something catastrophic happens,” he said. “Most of the people who didn’t have insurance before don’t have an extra $5,000 now.”

Adapting to this shift calls for medical offices to rethink both their business practices and the philosophies that drive them, Ingram said.

“The bottom line is that, with more money coming out-of-pocket, the patient has a decision to make as well as the clinic,” he said. “You’ll have patients putting off going to the doctor’s office because of what they have to pay, and you’ll also see patients shopping for providers based on fees.”

According to Ingram, the adjustments physicians’ offices should consider in response to changes in deductibles include: Treating patients as customers Once patients are faced with spending more of their own money at the doctor’s office, they’re more likely to “price shop” and seek out lower cost alternatives for the services they need.

“Unfortunately, many offices, while providing excellent medical care, did not view the patient as a customer,” Ingram

said. “This will need to change.”

The experience of patients as they move from check-in to waiting room to exam room to business desk affects the value they place upon what they’re being asked to pay.

“Medical practices should be sensitive to the patient’s experience while at the office,” Ingram said. “If patients are going to be ‘shopping’ for services, the office needs to find a way to create an experience that is unique to draw patients to the practice.”

In addition to keeping patients coming through the door, practices that can provide a high-value experience for patients may also be able to charge more for their services, he said.

Affirming the value of care Collecting from patients isn’t about greed. It’s about what’s fair.

When physicians and their staff feel uncomfortable about asking patients to provide payment, it may be time for everyone to reaffirm the value of the care they’re providing.

“I recommend a ‘fairness doctrine’ for the office,” Ingram said. “That is: A patient should expect excellent care from the providers, and the providers should expect compensation for the services provided.”

Population Health, continued from page 3 cific demographic population, population health management is a business model centered on the delivery of comprehensive care and management of total risk.”

The foundational Regina shift in the healthcare Levison experience will morph from an industry driven by reactivity to an industry driven by proactive measures, said Levison.

“The goal of population health is to keep a patient population as healthy as possible and minimize the need for costly interventions, procedures, emergency room visits, and hospitalizations,” she said.

Checking up on check-out It may be the last step to a patient’s experience in the office, but their experience at the check-out window cannot be overlooked for medical practices intent on receiving payment.

“Although it may seem insignificant, the way patients are addressed at checkout is very important in the collection process,” Ingram said. “It is easier to collect from a patient when a staff member is face-to-face with him than after he leaves the office.”

Are the staff members in the checkout office comfortable working with patients in a way that is both sensitive to their financial situation and confident of the services’ value?

“One of the problems a lot of clinics have is that they don’t know how to ask for money,” Ingram said. “It’s an ironic thing that I’ve witnessed in medical offices: The person at the checkout identifies more with the patient than the physician. It makes them reluctant to ask patients for money.”

Front-end activity needs attention, too, to make sure that the practice receives all the payment it’s due from the insurance company.

“To do so, the office staff should verify eligibility, identify what the patient’s portion of the visit will be, determine if a prior authorization is needed, and determine if the patient has a Primary Care Provider that is required to refer the patient to the practice,” Ingram said.

As an increasing number of healthcare organizations move to models of accountable care, the overall healthcare experience will be reconstructed, said Jordan.

“Within this transformation, we’ll see an altered patient and physician experience,” she said. “With an emphasis on proactive preventative care, evidencebased protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen.

“Although the results of these initiatives won’t manifest for a decade or more, population health management will almost certainly improve the quality of lives for millions of individuals throughout the country.”

Adding electronic options Clinics that don’t provide a range of convenient ways for patients to pay may be missing out on prompt payments.

In the age of email, statements can be sent electronically to save time and expense. Practice websites can include a patient portal that allows them to pay online with a credit card. Other credit card strategies can be used to keep collections issues at bay.

“Keeping a credit card on file with the authorization to use it could improve collections on balances associated with patient responsibility,” Ingram said. “One clinic, for example, requires patients to give credit card information at the time an appointment is made. If the patient does not cancel an appointment prior to the scheduled time, the patient’s credit card will be charged a no-show fee.”

Offering payment plans for large balances also help with collections.

“Discounts for paying in full may also be considered,” Ingram said. “Flexibility and incentive will certainly help the clinic’s bottom line.”

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The ACA and Population Health The Patient Protection and Affordable Care Act (ACA) addresses population health in four significant ways: •

Provisions to expand insurance coverage target the advancement of population health by improving access to the healthcare delivery system.

•

Other provisions seek to enhance the quality of care delivered.

•

Lesser known provisions aim to improve prevention and health promotion measures within the healthcare delivery system.

•

The final set promotes community- and population-health based activities, including the establishment of the National Prevention, Health Promotion and Public Health Council, which has already produced the mandated National Prevention Strategy and Prevention and Public Health Fund for monetizing Community Transformation Grants.

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HIT: Optimization Through Integration

By CINDY SANDERS

You can love it, hate it, fear it or revere it … but technology has become an integral part of healthcare processes on both a clinical and operational level. Therefore, you might as well learn to optimize it.

That was a key part of the message Chris Miller, principal with Nashvillebased Cumberland Consulting Group, and Deb Dulac, director of PRISM and business systems for the University of Vermont Medical Center, shared with audiences at the recent HIMSS15 Annual Conference & Exhibition. More than 38,000 professionals flocked to Chicago last month to attend the premier health information technology conference, which included more than 300 peer-reviewed education sessions, vendor exhibits touting the latest technology options, updates on government regulations impacting the industry and keynote speakers ranging from Bruce Broussard, president and CEO of Humana, to George W. Bush, 43rd president of the United States of America.

“Over the past five years, there has been a huge shift towards technology largely because of the HITECH Act of 2009 and government programs like Meaningful Use that have helped drive the technology in healthcare,” Miller said. Although slower to adopt technology into daily operations – particularly in a clinical setting – than many other industries, healthcare has increasingly been pressed to take an ‘all in’ stance.

Miller noted that over the last few years, technology has fundamentally changed the way providers … both large and small … operate. He added the challenge is balancing the adoption of technology with everything that brings.

“Today anything a healthcare organization wants to change in a business or clinical process requires a change in their technology, and likewise, any change in their technology has an impact on the care they provide or their revenue,” he said. “I think healthcare entities were used to thinking of technology as a separate entity, but now it’s so intertwined,” added the Atlantabased HIT expert.

In their HIMSS presentation, Miller said he and Dulac focused on how to manage and optimize technology now that it has become so pervasive, while at the same time accounting for all the other changes happening in healthcare including a swi-

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tchover to ICD-10, meeting ongoing and new Meaningful Use requirements, actively engaging patients, supporting accountable care models, and the myriad other programs that require attention.

The bottom line is that thinking of each of these mandates or initiatives as individual tasks to conquer leads to madness … or at least extreme frustration. Instead, Miller said the question should be, “How can organizations effectively manage all of those together with a higher degree of efficiency and lower overall cost?”

He continued, “When I think implementation, somewhere between 25-30 percent of the time spent on these changes is spent on testing so if you can group – effectively overlap testing on these programs – you can significantly save time.”

More than just testing, though, Miller said very deliberately grouping initiatives under a single governance project structure helps with a range of other issues from interoperability to simplification for end users. “Being able to group things together almost makes it irrelevant as to what changes were made,” he said of the finished product in the minds of those actually using the technology.

The ‘ripping off the bandage’ approach means one educational update for those end users as opposed to having to create an educational module for each individual initiative. Not only does a rolling schedule of changes often feel more overwhelming, but also the time away from desks learning the new processes would typically be less under a grouping structure than to have 10 separate trainings for 10 separate initiatives.

Miller was quick to admit that creating overarching technology structures could be difficult without staff or contracted expertise, which makes it more problematic for small practices.

“Whether you see it as a good or bad thing, there’s certainly a lot of consolidation in the market. Small private practices are becoming more and more rare,’ he said.

“I think one of the reasons is it’s becoming increasingly difficult for groups like that to manage all these changes.”

Miller added larger practices or health systems enjoy the economies of scale that make it easier to incorporate the rapid number of changes taking place. However, he added that in addition to HIT consultants, software vendors typically also offer at least some assistance in helping clients assimilate new processes into their workflow.

“Managing technology is only getting more complex,” he concluded. “Organizations need to be intentional and strategic in how they do that … whether that’s implementing analytics platforms, system upgrades, system optimization, Meaningful Use programs, or ICD-10. They need to be looking at ways they can consolidate those initiatives to be more effective with their resources and increase the return on their technology investment.”

GrandRounds HBOT at Ocean Springs Hospital

Singing River Health System (SRHS) is pleased to announce that Hyperbaric Oxygen Therapy treatment will now be available at Ocean Springs Hospital Wound Care Center in addition to the comprehensive wound care services currently provided. With a total of seven hyperbaric chambers, Singing River Health System offers one of the largest hyperbaric oxygen treatment facilities on the coast.

Singing River Health System now has a Wound Care Center at both Singing River Hospital and Ocean Springs Hospital locations. The Wound Care Centers offer specialized equipment and highly trained staff for the management of problem wounds. Physicians, nurses, physical therapists and hyperbaric technologists coordinate with primary physicians to provide a comprehensive range of services to meet the total needs of the patient. Various treatment options are available for different types of hard to heal wounds.

Wound treatment can range from doctor prescribed medicated dressings to the latest in high-tech hyperbaric oxygen therapy.

Dr. David L. Spencer Sr., a member of South Mississippi Surgeons and the Singing River Health System Medical Staff, serves as Director of the Wound Care and Hyperbaric Medicine Program at SRHS. Dr. Spencer, Sr. is Board Certified in Hyperbaric Medicine and is a Board Certified General Surgeon with 33 years of experience in General, Vascular, and Thoracic Surgery. He joined South Mississippi Surgeons in 1981 after completion of his general surgery residency. He is a Fellow of the American College of Surgeons.

Memorial Physician Clinics Welcomes Ronald Kellum, MD

Memorial Physician Clinics welcomes Ronald Kellum, MD, in the practice of Family Medicine at Hancock Family Practice, 4433 Leisure Time Drive, Diamondhead.

Dr. Kellum received his medical doctorate at The American University of the Caribbean, located in St. Maarten. He completed his Family Medicine internship at Aultman Hospital in Canton, Ohio and Family Medicine residency at Barberton Citizens Hospital in Barberton, Ohio.

Dr. Kellum is Board Certified in Family Medicine.

Memorial Physician Clinics Welcomes Dr. Roberta Chilimigras

Memorial Physician Clinics welcomes Roberta Chilimigras, MD, in the practice of Family Medicine in Waveland.

Dr. Chilimigras received her medical doctorate from Ohio State University, School of Medicine. She completed her internship at Bronson Methodist Hospital in Kalamazoo, Michigan; and her residency in Physical Medicine and Rehabilitation at Northwestern University, School of Medicine at the Chicago Rehabilitation Institute Chicago, Illinois.

Dr. Chilimigras is Board Certified in Family Medicine.

PUBLISHED BY: SouthComm, Inc. ASSOCIATE PUBLISHER Kathy Arich karich@mississippimedicalnews.com Ad Sales: 601.941.3075 ACCOUNT EXECUTIVE Perry Patterson LaCour placour@mississippimedicalnews.com Ad Sales: 601.941.1603 NATIONAL EDITOR Pepper Jeter editor@medicalnewsinc.com LOCAL EDITOR Julie Parker jparker@medicalnewsinc.com CREATIVE DIRECTOR Susan Graham susan@medicalnewsinc.com GRAPHIC DESIGNERS Katy Barrett-Alley, Amy Gomoljak James Osborne, Christie Passarello

CONTRIBUTING WRITERS Cindy Sanders, Lucy Schultze, Julie Parker CIRCULATION subscriptions@southcomm.com —— All editorial submissions and press releases should be emailed to: editor@medicalnewsinc.com —— Subscription requests or address changes should be mailed to: Medical News, Inc. 210 12th Ave S. • Suite 100 Nashville, TN 37203 615.244.7989 • (FAX) 615.244.8578 or e-mailed to: subscriptions@southcomm.com Subscriptions: One year $48 • Two years $78 SOUTHCOMM Chief Executive Officer Paul Bonaiuto President Chris Ferrell Chief Financial Officer Ed Tearman Executive Vice President Of Digital And Support Services Blair Johnson Director Of Financial Planning And Analysis Carla Simon Vice President Of Human Resources Ed Wood Vice President of Content Curt Cordes Vice President Of Production Operations Curt Pordes Group Publisher Eric Norwood Chief Revenue Officer Dave Carter Director Of Digital Sales & Marketing David Walker Controller Todd Patton Creative Director Heather Pierce Mississippi Medical News is published monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm, Inc. ©2015 Medical News Communications.All rights reserved. Reproduction in whole or in part without written permission is prohibited.

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GrandRounds Baptist Health Systems Announces Employee Additions and Certifications

Wendy Polk, APR, has joined Baptist Health Systems in Jackson, Miss. as Director of Corporate Communications. She holds a Bachelor of Science degree from the University of Southern Mississippi and a Master of Science in Communication from Wendy Polk Mississippi College. For almost 25 years, she has worked in the field of communications in the Jackson area. She previously served as the Director of Marketing and Communications for River Oaks Healthcare and as a Strategic PR Manager at GodwinGroup.

Amanda McGruder, MBA, RRT-NPS, has joined Baptist Health Systems in Jackson, Miss. as the Director of Respiratory Care.

She has 18 years of respiratory care experience.

McGruder was previously Amanda McGruder an account executive for Draeger Medical Inc. and had served as a respiratory therapist at Baptist in the past. McGruder holds a Master of Business Administration, Bachelor of Science in Business Administration and a Minor in Health Care Management from Kaplan University. She received her respiratory

therapy degree from Hinds Community College and received certification as a Neonatal Pediatric Specialist.

Baptist Physical Therapist Mary Austin and Baptist Occupational Therapist Lisa Hodges have become Certified Ergonomics Assessment Specialist (CEAS).

This certification proMary Austin vides training in OSHAcompliant ergonomics analysis applicable in industry, healthcare and office workplace. Ergonomics assessments help to identify potential hazards Lisa Hodges that contribute to the development of musculoskeletal disorders.

It provides implementation of cost-effective, high-impact solutions for prevention of workplace injury. As a certified ergonomic assessment specialist, one can be instrumental in delivering practical solutions for risk reduction and increased employee productivity.

Gillean Named to NMMC Rehab Leadership Post

Tobie Gillean, LCSW, CCM, has been named director of North Mississippi Medical Center’s Rehabilitation Institute and Skilled Nursing Facility.

Gillean has been employed by NMMC for 20 years in a variety of roles,

most recently serving as clinical coordinator for the Rehabilitation Institute and Skilled Nursing Facility. In her new position, she will provide operational oversight to clinical and Tobie Gillean support services for both facilities, as well as for North Mississippi Physical Medicine and Rehabilitation.

She earned her bachelor’s degree from Mississippi State University and her master’s degree in social work from the University of Southern Mississippi. She is a licensed clinical social worker and certified case manager.

Gillean is program chair for the local chapter of the National Association of Social Workers and serves on the board for the Mississippi Society for Social Work in Health Care Leadership.

Keel Joins NMMC-West Point as Administrator

North Mississippi Medical CenterWest Point is pleased to announce that Barry L. Keel has accepted the position as the hospital’s administrator.

Keel, an Alabama native, comes to NMMC-West Point from Bay Medical Center – Sacred Heart Health System, a 323-bed hospital in Panama City, Fla., where he served as chief executive officer. He previously worked as the Alabama Market CEO for Health Management Associates with market leadership

responsibility for Riverview Regional Medical Center in Gadsden, Ala., and Stringfellow Memorial Hospital in Anniston, Ala. In addition, he has served as CEO with several Alabama hospitals including Vaughan Regional Medical Center in Selma, Lawrence Medical Center in Moulton, Northwest Medical Center in Winfield; and Andalusia Regional Hospital in Andalusia.

He received his bachelor’s degree in health administration from Auburn University in Auburn, Ala., and a master’s degree in health policy and administration from Mercer University in Atlanta, Ga.

Hattiesburg Clinic Anesthesiology Welcomes Painter

Christopher Painter, DO, recently joined Hattiesburg Clinic Anesthesiology.

Dr. Painter received his medical degree from Lake Erie College of Osteopathic Medicine in Erie, Pa. He served an anesthesiology internship and residency at Milton S.Hershey Medical Center Dr. Christopher Painter in Hershey, Pa. Dr. Painter is board certified by the American Board of Anesthesiology. His professional affiliations include the American Medical Association, American Society of Anesthesiologists and Mississippi State Medical Association.

www.bcbsms.com Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Company is an independent licensee of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.

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