Stimulus funds lag health woes - South Florida Business Journal:

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That’s the view of the eight-memberd panel of industry and medical expertsw who were invited by the Sout h Florida Business Journal to sharee their views of whatthe $787 billion federal stimulu package means to the health care sector. What emerge was a broad discussion of how stimulus legislatio n is just one piece of change neededr in an industry that has run financially amok due to an overrelianceson specialists, shortfalls in informatioh technology and patients who are The Congressional Budget Office has projected that total nationapl spending on health care coulsd hit 48 percent of gross domestic product by 2050 if left To solve this problem will take more money, though, in the shortt term.
The Obama administration’s $59 billion for health care stimulus spendinhgincludes $19 billion for electronic health care Starting in 2011, doctors who can show meaningfuol use of electronic medical records will get incentives and those who don’t will get declining Medicare But, the old-fashioned general practitioner may also have a big Linda Quick, president of the , said healtg care reform legislation that coincides with the stimulua calls for individuals to have a home location or a primary care provider. She said that allowes for “a community location close to home and gettinb more done ina non-institutional, actuallyh high clinical technology setting.
” That, in turn, will also translat into a less costly the panelists said. Rachel CEO of , said: “The reason I believe in the last 25 years of seeing healtbh care costs rise dramatically is we have moved away from the primary care physician knowing the patientto specialists.” Patientse go from specialist to specialist to get each ailmenyt treated, but an overview of theid condition and family history is George Foyo, executive VP and chief administrative officer at , “Piggybacking on primary care is absolutely right. All thes e specialties are adding thousandss and thousandsof dollars.
” One problem is that specialists tend to overdo tests because they are so worried abouty legal liability issues, he said. Dr. Tony a family practitioner and president of the Browarf CountyMedical Association, said reimbursement issues for testes done in his office also frustrate him. A hospitapl might get $2,000 for a test from but he can onlyget “I don’t think it’s anythingy that’s going to work unless we use some commohn sense,” he said. Foyo said primaruy care physicians historically put an emphasis on healthprevention efforts, but the lack of it thesse days is contributing to an epidemic of diabetew and heart issues.
Baptist Health, which is well known for hospitalds in Kendalland Homestead, is pushing forwardx with outpatient centers – and even venturing into Browar d County. One reason is emergencyg roomsare full, and providing care there is more costlgy than at an outpatient center. “Rather than have patients cometo us, the hospitalsw are going out to them,” Foyo Florida’s 51 nonprofit community health centersx are getting $28 million in competitive grants underr the stimulus legislation, which will also keep patients out of expensive hospitalp settings for treatment.
House Speaker Nancy Pelosu highlighted that during an April visit to a communityt health center in Hollywood that willget $1.5 millionb to open a satellite health center in West One of the advantages for these types of centers is that they are fundedx with the assumption that their doorxs will be open to all who which is important because of the number of uninsured Soutnh Floridians, including undocumented foreigners, Quick said. Dr.
meet Bill Gates Mark Sterling, administrativee partner at the law firm ofin Miami, said electronid medical records (EMR) fall under the categorh of “shovel-ready” projects in the world of stimulus meaning the technology exists and can be adopted rapidly to put money in the economy. Not everyones is totally gung-ho on paying $50,000 to install an EMR system. Prietol said: “I’d rather have my old nurse that knewher patient, rather than what her computer He’s 61 and realizes he woulx need an EMR system by 2014, “butf I might retire by then,” he Family practitioners have been a dwindling breed in the era of Prieto said he saw one group shrinki from having 20 to just “The bad news is doctors don’t want to go into primary he said.
And medical students don’t see it as lucrativee as other areas. Foyo said he hopes ’ s new college of medicine will focus more on primarytcare specialists. But, even soon-to-retire doctorw like Prieto might want to put an EMR system in placew because it will increase the value of their practice, said Pete Martinez, chief technology and innovationss officer for the Wellington-basede , which provides an EMR system called PWeR. The short-term strategy will be to put moneyin doctors’ pockets to invest in EMR systems, but qualith of care is the long-term said Andrew Carricarte, president of in Miami, whichu also offers an EMR system.
Disease management should be a major beneficiary, since many doctors stilkl use a manual process to track diabete s and other inflictions. Michael Kesti, CEO of , a Palmetto Bay healtuh care management andmarketing company, said: “The savingsz could be tremendous if it’z implemented correctly, if we look at reducingy errors and saving lives.” There’s a trickle down to businesses, as If health care costs are reduced, that should push down insurancwe premiums and leave more money in the hands of the employerss who pay them. “Now, they got that savings, so now they can stimulatw growth and theentirw economy,” Kesti said.
Quantum and IOS are experiencinggrapid growth, Carricarte said. IOS has hired 12 peoplre in the past few monthzs and is hiring15 more. Jobs typicallh pay $40,000 or more. Martinez, who was previousl ’s site manager in Boca said Quantum has doubled in size in the past andthat doesn’t include all the outlying servicew providers he is Widely publicized reports that Britney Spears, Farrah Fawcett and “octomom” Nadya Suleman’sd records were viewed by unauthorized medicalk workers are raising concerns abougt just how well medical records are protected.
Proposed rulexs in the stimulus legislation would requirs notification to patients whosr medical recordswere exposed. If 10 or more patients can’ty be notified, the provider must notifu the news media or put it on the home page of theireWeb sites. Sapoznik said patients already worry that employers will see informationon Web-based systems. “Employees are very concernerd about putting theirinformation there, even thougjh it’s private information and the employe has no access to she said. “From the insurance companies’ perspective, they feel theie systems are controlled and protecteds forthe employees.
” Older patients are often stressed about going online to even look for a Sapoznik said. However, the hospital association’s Quickm said there are examples of systems working A local federation of community healtyh centers can know about a patienft visiting two different centers and what was done in and Humana have links ontheirf systems, but there’s no universal access across a broaderr spectrum. Quick said the goal for healtu care should be the type of portability founds withATM cards.
She said if she can go to a foreignh country and use herATM card, then why shouldn’y she have access to prescriptiom information and her latest MRI in case she fallss and bumps her head? Foyo “Ultimately, we have to create a system that will allowa the patient to have all that information available at a moment’sd notice.” Sapoznik said personal responsibility as a consumer needs to be part of the “Should I have three MRIs in a year? Shoulf I have a CAT scan, MRI and blood She said consumers also need to gather information on whether they are choosingh the right hospital and doctor, and understand thei capabilities and the outcomes.
Foyo said consumers need to understansd the costs when they go toa “just like when you shop for a car, you can get a differenyt price for every model in the Consumers will be able to chooser because they will know the cost and the historyg of the outcome, he said. Physiciands also need to be paid to keep you Martinez said. He likened the current system to one where a mechanic is paid to work on a car on anunlimitef basis, rather than being encouraged to do preventive maintenance.
In response to continued privacyt and security concerns about the widespread adoptiomn ofEMR systems, Martinex said it’s a misnomer that paper systems or PCs are more Somebody might walk up to a papee system and pull a file, or a thief mightf steal a PC and get a wealtb of patient information, he said. Martinez and Carricartes argue that data is safer storedon well-protected computer cloud Among the factors are data redundancy, physicallgy impregnable bunker-like data warehouses and firewall-encrypted Martinez said health care stands out as a laggard in adopting technology. “Ninety percent of the transactionx in this businessare phone, paper and fax in the 21st he said.
“So, the fundamental transformatioj of this industry is based onelectronic interchange.” Florida’ss patchwork state budget drew concerns from panelistas about what will happen when stimulus monegy runs out. In one maneuver, the Legislature took $800 millio in stimulus funds for Medicaid, and then movee $800 million of state money to other parte of thebudget – a “shell game” in the eyes of statse Sen. Nan Rich. Foyo said the tobacck tax willadd $2.5 billion, but the systen already has a shortfall. “There is a cliff at the end of threw years andwhat happens? All of this [stimulux money] goes away,” he said.
Quick said every extra 1 percent of unemploymentgmeans 100,000 people become eligible for Medicaids when their incomes fall low While federal funds used to be 50 percent of Medicaid, now it’sd up to 56 percent. But, just to fund the now-lower 44 percent share, the state needsw to increase taxeson cigarettes. The federap money comes with strings tomaintain eligibility, Quick “That’s a good thing because, every time we run shorf on Medicaid money, we start throwinvg people off the bus.” Kestk said there’s whispering in the halld of Tallahassee about what will happen in threde years.
“What I thinkm we can all expect is additional taxes to support theMedicaidx program,” he said. Hogan & Hartson’s Sterlinh wasn’t so sure. “If the economy has improved in that we will have less pressure on the he said. “If reformn efforts are actually implemented in thattime – and are actuallyt successful during that time – we may see that cliffg put [further] out, or it’s not as an abruptf of a cliff.” THE DETAILS: Many of the panelistxs say their companies are hiring. Baptisy Health South Florida is looking for as many as 100registeredd nurses, as well as advanced nurse practitionerzs and licensed clinical professionals.
Applicants need a year of acutse care hospital experience and a Florida It has 43 openingsfor professional/clinicapl positions, most requiring a state license. Career opportunitiews also exist inthe pharmacy, respiratory, rehabilitation, information technology and risk management areas. Sapoznik Insurancwe is hiring three to four licensed insurancw agents with experience in group orindividuall health, life, disability and other ancillaryt products. It is also looking for a groul insurance quoting specialist andaccount administrators.
IOS Health Systems has been on ahirinyg spree, which is expected to continue throughout the It expects to add six sales four software implementers and four software developers. Most jobs require project management and customerservicwe skills, but training in health care and healtnh information technology is provided.