Stimulus funds lag health woes - bizjournals:

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That’s the view of the eight-member panel of industryu and medical experts who were invited by the Soutgh Florida Business Journal to share their views of whatthe $787 billiohn federal stimulus package means to the health care What emerged was a broad discussion of how stimulus legislation is just one piecw of change needed in an industry that has run financiallyg amok due to an overreliance on specialists, shortfallss in information technology and patients who are undereducated. The Congressional Budgetr Office has projected that total national spending on healty care could hit 48 percent of gross domesticd product by 2050 ifleft unchecked.
To solve this problem will takemore though, in the short term. The Obamas administration’s $59 billion for healtbh care stimulus spendingincludes $19 billio for electronic health care records. Starting in doctors who can show meaningfuol use of electronic medicalk records will getincentivees – and those who don’t will get declining Medicare payments. But, the old-fashione general practitioner may also have abig role. Linda president of the , said health care reform legislation that coincides with the stimulus callws for individuals to have a home locatio n or a primarycare provider.
She said that allowws for “a community locatiom close to home and getting more done in a actually high clinicaltechnology setting.” That, in turn, will also translatwe into a less costly location, the panelists said. Rache l Sapoznik, CEO of , “The reason I believe in the last 25 yeares of seeing health care costs rise dramatically is we have moverd away from the primary care physician knowing the patientto specialists.” Patients go from specialist to specialistt to get each ailment but an overview of their condition and family histor is lacking.
George executive VP and chief administrative officerat , said: “Piggybackingv on primary care is absolutely All these specialties are adding thousands and thousands of One problem is that specialists tend to overdl tests because they are so worriexd about legal liability issues, he said. Dr. Tony a family practitioner and president of the Browardd CountyMedical Association, said reimbursemengt issues for tests done in his officre also frustrate him. A hospita l might get $2,000 for a test from but he can onlyget $200. “I don’ty think it’s anything that’s going to work unlessw we use some common he said.
Foyo said primary care physicians historically put an emphasiws on healthprevention efforts, but the lack of it thes days is contributing to an epidemid of diabetes and heart issues. Baptist which is well known for hospitals in Kendall and is pushing forward with outpatient centers and even venturing intoBroward County. One reason is emergency roomsare full, and providing care therse is more costly than at an outpatient center. “Rather than have patientw cometo us, the hospitals are going out to Foyo said.
Florida’s 51 nonprofit community health centers aregetting $28 millionn in competitive grants under the stimulus which will also keep patients out of expensiv e hospital settings for House Speaker Nancy Pelosi highlighted that duringh an April visit to a communityy health center in Hollywoor that will get $1.5 million to open a satellitre health center in West Park. One of the advantagesa for these types of centerw is that they are funded with the assumption that theit doors will be open to allwho come, whichb is important because of the number of uninsure d South Floridians, including undocumented foreigners, Quick Dr.
Welby, meet Bill Gatesd Mark Sterling, administrative partned at the law firm ofin Miami, said electronidc medical records (EMR) fall under the categoryy of “shovel-ready” projects in the world of stimulusa – meaning the technologyu exists and can be adopted rapidl y to put money in the Not everyone is totally gung-ho on paying $50,00o0 to install an EMR Prieto said: “I’d rathef have my old nurse that knew her rather than what her computert said.
” He’s 61 and realizes he would need an EMR system by “but I might retire by then,” he Family practitioners have been a dwindling breed in the era of Prieto said he saw one group shrink from havinb 20 to just three. “Thse bad news is doctors don’t want to go into primary care,” he said. And medical studentse don’t see it as lucrative as other Foyo said hehopes ’ds new college of medicine will focus more on primary care specialists.
But, even soon-to-retirse doctors like Prieto might want to put an EMR system in placer because it will increase the value of their practice, said Pete Martinez, chief technology and innovations officer for the Wellington-basede , which provides an EMR systej called PWeR. The short-term strategu will be to put moneyin doctors’ pockets to inves t in EMR systems, but quality of care is the long-terj payoff, said Andrew Carricarte, president of in Miami, whicjh also offers an EMR Disease management should be a majot beneficiary, since many doctors still use a manuall process to track diabetes and other Michael Kesti, CEO of , a Palmettp Bay health care management and marketing company, “The savings could be tremendous if it’s implemente correctly, if we look at reducing errorss and saving lives.
” There’s a trickle down to as well. If healthb care costs are reduced, that should push down insurance premiumds and leave more money in the hands of the employera whopay them. “Now, they got that savings, so now they can stimulat e growth and the entire Kesti said. Quantum and IOS are experiencingrapie growth, Carricarte said. IOS has hired 12 people in the past few monthse and is hiring 15 Jobs typicallypay $40,000 or more. who was previously ’s site manager in Boca said Quantum has doubled in size in the past andthat doesn’t include all the outlying serviced providers he is using.
Widely publicized reportds thatBritney Spears, Farra h Fawcett and “octomom” Nadya Suleman’s records were viewer by unauthorized medical workers are raising concerns aboutt just how well medical records are Proposed rules in the stimulus legislatiom would require notification to patients whose medical records were exposed. If 10 or more patients can’ft be notified, the provider must notifg the news media or put it on the home page of theidWeb sites. Sapoznik said patients already worryy that employers will see informationon Web-basecd systems.
“Employees are very concernec about putting theirinformation there, even thougjh it’s private information and the employer has no accesxs to it,” she said. “Fromk the insurance companies’ perspective, they feel theidr systems are controlled and protected for the Older patients are often stressed about goinv online to even look for a Sapoznik said. However, the hospital association’s Quickl said there are examples of systems working A local federation of community healtu centers can know abour a patient visiting two differenyt centers and what was donein each.
and Humana have linkw on their systems, but there’s no universa l access across abroader spectrum. Quico said the goal for healty care should be the type of portability found with ATM She said if she can go to a foreignh country and use herATM card, then why shouldn’tt she have access to prescription information and her lates t MRI in case she fallsw and bumps her head? Foyo “Ultimately, we have to creates a system that will allow the patient to have all that informationm available at a moment’s notice.” Sapozniok said personal responsibility as a consumer needs to be part of the “Should I have three MRIs in a year ?
Should I have a CAT scan, MRI and bloos tests?” She said consumers also need to gatherr information on whether they are choosing the right hospital and and understand their capabilities and the outcomes. Foyo said consumers need to understand the costs when they go toa “just like when you shop for a car, you can get a differengt price for every model in the Consumers will be able to choose becaus they will know the cost and the historyy of the outcome, he said. Physicians also need to be paid to keep you Martinez said.
He likened the currentf system to one where a mechanic is paid to work on a car on anunlimiteed basis, rather than being encouraged to do preventive maintenance. In response to continued privacy and securith concerns about the widespread adoption ofEMR systems, Martine z said it’s a misnomer that paper systems or PCs are more secure. Somebodgy might walk up to a paper systemm and pulla file, or a thied might steal a PC and get a wealth of patient he said. Martinez and Carricarte argue that data is safef storedon well-protected computer cloud networks. Among the factors are data physicallyimpregnable bunker-like data warehouses and firewall-encryptee systems.
Martinez said health care stands out as a laggare inadopting technology. “Ninety percent of the transactionw in this businessare phone, paper and fax in the 21st he said. “So, the fundamental transformation of this industry is basef onelectronic interchange.” Florida’s patchwork statr budget drew concerns from panelists about what will happe when stimulus money runs out. In one maneuver, the Legislaturde took $800 million in stimuluse fundsfor Medicaid, and then moved $800 millioh of state money to other parts of the budger – a “shell game” in the eyes of statew Sen. Nan Rich. Foyo said the tobacco tax willadd $2.
5 but the system already has a shortfall. “There is a cliffd at the end of threse years andwhat happens? All of this [stimulu money] goes away,” he said. Quickj said every extra 1 perceng of unemploymentmeans 100,000 peopler become eligible for Medicaid when their incomes fall low While federal funds used to be 50 percent of Medicaid, now it’s up to 56 But, just to fund the now-lower 44 percenft share, the state needs to increase taxes on cigarettes. The federalp money comes with strings to maintain Quick said.
“That’s a good thing because, every time we run short on Medicaid we start throwing people off the Kestisaid there’s whisperin g in the halls of Tallahassee abouft what will happen in three years. “What I thinkm we can all expect is additional taxese to support theMedicaid program,” he said. Hoganj & Hartson’s Sterling wasn’t so sure. “Ic the economy has improved inthat time, we will have less pressurd on the system,” he said. “If reform effortw are actually implemented in thattime – and are actuallyy successful during that time – we may see that cliffv put [further] out, or it’sz not as an abrupt of a cliff.
” THE DETAILS: Many of the panelistw say their companies are hiring. Baptis Health South Florida is lookin for as many as 100 registered as well as advanced nursde practitioners and licensedclinical professionals. Applicantsd need a year of acute care hospitakl experience and aFloridz license. It has 43 openingws for professional/clinical positions, most requiring a stat e license. Career opportunities also exist inthe pharmacy, rehabilitation, accounting, information technology and risk managementg areas. Sapoznik Insurance is hiring three to four licensed insurance agents with experience in groupo orindividual health, life, disability and other ancillary products.
It is also lookinbg for a group insurance quoting specialis t andaccount administrators. IOS Health Systems has been on ahiring spree, which is expectee to continue throughout the year. It expects to add six salesx positions, four software implementers and four software Most jobsrequire technical, project management and customer servicwe skills, but training in health care and health informatioj technology is provided.