Stimulus funds lag health woes – bizjournals:

That’s the view of the eight-member panel of industry and medica experts who were invitex by the South Florida Businesa Journal to share their views of whatthe $787 billionh federal stimulus package means to the health care What emerged was a broad discussion of how stimulus legislationm is just one piec e of change needed in an industry that has run financially amok due to an overrelianc e on specialists, shortfalls in information technology and patientx who are undereducated.
The Congressiona l Budget Office has projectef that total national spending on health care could hit 48 percentg of gross domestic product by 2050 if left To solve this problem will takemore though, in the short term. The Obama administration’sd $59 billion for healty care stimulus spendingincludes $19 billion for electronic healtyh care records. Starting in 2011, doctords who can show meaningful use of electronic medicalp records will getincentives – and those who don’ will get declining Medicare But, the old-fashioned general practitioner may also have a big Linda Quick, president of the , said health care reforjm legislation that coincides with the stimulus calls for individualds to have a home location or a primaryg care provider.
She said that allows for “a community location closer to home and getting more done ina non-institutional, actually high clinicap technology setting.” That, in turn, will also translat into a less costly location, the panelists Rachel Sapoznik, CEO of , said: “Thes reason I believe in the last 25 yearas of seeing health care costs rise dramatically is we have mover away from the primary care physician knowinf the patient to specialists.
” Patients go from specialist to specialisg to get each ailment treated, but an overviesw of their condition and family history is George Foyo, executive VP and chief administrative officer at , said: “Piggybacking on primary care is absolutel y right. All these specialties are adding thousandzs and thousandsof dollars.” One problem is that specialists tend to overdol tests because they are so worried about legal liabilit issues, he said. Dr. Tony a family practitioner and president of the Broward Count yMedical Association, said reimbursement issuess for tests done in his office also frustrate him.
A hospitao might get $2,000 for a test from Medicare, but he can only get “I don’t think it’x anything that’s going to work unless we use somecommonn sense,” he said. Foyo said primaruy care physicians historically put an emphasisw on healthprevention efforts, but the lack of it these days is contributintg to an epidemic of diabetes and hearg issues. Baptist Health, which is well knowb for hospitals in Kendall and is pushing forward with outpatientcenters – and even venturintg into Broward County.
One reasojn is emergency roomsare full, and providingf care there is more costly than at an outpatient “Rather than have patients come to us, the hospital are going out to them,” Foyo said. Florida’sw 51 nonprofit community health centers aregetting $28 milliohn in competitive grants under the stimulus which will also keep patients out of expensivre hospital settings for House Speaker Nancy Pelosi highlighteed that during an April visit to a community health center in Hollywood that will get $1.5 million to open a satellitew health center in West Park.
One of the advantagees for these types of centers is that they are funded with the assumptionm that their doors will be open to all who which is important because of the number of uninsureSouth Floridians, including undocumented foreigners, Quicko said. Dr. Welby, meet Bill Gatesz Mark Sterling, administrative partner at the law firm of in said electronic medicalrecords (EMR) fall under the categoryy of “shovel-ready” projects in the world of stimuluws – meaning the technology exists and can be adopted rapidly to put money in the economy. Not everyone is totally gung-hok on paying $50,000 to install an EMR system.
Prieto “I’d rather have my old nurse that knew her rather than what hercomputet said.” He’s 61 and realizes he would need an EMR systemn by 2014, “but I mightf retire by then,” he said. Familyu practitioners have been a dwindling breed in the era of Prieto said he saw one group shrink from havinbg 20 tojust three. “The bad news is doctors don’t want to go into primaryh care,” he said. And medical students don’t see it as lucrativw as other areas. Foyo said he hopes ’a new college of medicine will focus more on primarucare specialists.
But, even soon-to-retirr doctors like Prieto might want to put an EMR systemj in place because it will increase the value oftheirf practice, said Pete Martinez, chief technology and innovations officer for the Wellington-baserd , which provides an EMR system called PWeR. The short-ternm strategy will be to put money in pockets to invest inEMR systems, but quality of care is the long-terk payoff, said Andrew Carricarte, president of in which also offers an EMR Disease management should be a major beneficiary, sincee many doctors still use a manua l process to track diabetes and othet inflictions.
Michael Kesti, CEO of , a Palmetto Bay healtj care management andmarketing said: “The savings could be tremendous if it’s implemente d correctly, if we look at reducintg errors and saving lives.” There’s a trickle down to as well. If health care costs are reduced, that shoule push down insurance premiums and leave more monet in the hands of the employers whopay “Now, they got that savings, so now they can stimulate growthn and the entire economy,” Kesti said. Quantum and IOS are experiencingfrapid growth, Carricarte IOS has hired 12 people in the past few monthxs and is hiring 15 more.
Jobs typically pay $40,000 or Martinez, who was previously ’es site manager in Boca Raton, said Quantum has doubled in size in thepast year, and that doesn’tg include all the outlying service providera he is using. Widely publicized reports thatBritney Spears, Farrah Fawcett and “octomom” Nadya Suleman’s recordw were viewed by unauthorized medicalo workers are raising concerns about just how well medical records are protected. Proposed rules in the stimuluzs legislation would require notification to patientw whose medical recordswere exposed.
If 10 or more patientz can’t be notified, the provider must notify the news mediq or put it on the home page of theidWeb sites. Sapoznik said patient s already worry that employers will see informatiohon Web-based systems. “Employees are very concerned about puttint theirinformation there, even thoughb it’s private information and the employer has no accesws to it,” she “From the insurance companies’ they feel their systems are controlled and protected for the Older patients are often stressed aboutf going online to even look for a Sapoznik said. However, the hospitao association’s Quick said there are examples of systemwsworking well.
A local federation of communityt health centers can know about a patient visiting two different centers and what was donein each. and Humanaz have links on their systems, but there’sx no universal access across a broader spectrum. Quick said the goal for health care should be the type of portability found withATM cards. She said if she can go to a foreig country and use herATM card, then why shouldn’t she have accesss to prescription information and her latest MRI in case she fall and bumps her head? Foyo “Ultimately, we have to create a systenm that will allow the patient to have all that informatiojn available at a moment’a notice.
” Sapoznik said personal responsibility as a consumer neede to be part of the “Should I have three MRIs in a year? Shouldr I have a CAT scan, MRI and bloor tests?” She said consumers also need to gathet information on whether they are choosing the right hospitapl and doctor, and understandr their capabilities and the outcomes. Foyo said consumers need to understanfd the costs when they go toa hospital, “justf like when you shop for a car, you can get a differentf price for every model in the world.” Consumersd will be able to choose because they will know the cost and the historyg of the outcome, he said.
Physiciand also need to be paid to keep you Martinez said. He likened the current systemk to one where a mechanic is paid to work on a car on anunlimitee basis, rather than being encouraged to do preventivse maintenance. In response to continued privacuy and security concerns about the widespread adoptioh ofEMR systems, Martinez said it’s a misnomer that paper systems or PCs are more secure. Somebody might walk up to a paper systejm and pulla file, or a thief migh steal a PC and get a wealtb of patient information, he said. Martinez and Carricarte argue that data is safer storedon well-protectef computer cloud networks.
Among the factors are data physicallyimpregnable bunker-like data warehouses and firewall-encrypteed systems. Martinez said health care stands out as a laggard inadopting technology. “Ninety percent of the transactions in this business are paper and fax in the21st century,” he “So, the fundamental transformation of this industrg is based on electronic interchange.” Florida’sx patchwork state budget drew concerns from panelists abouty what will happen when stimulus money runs out.
In one maneuver, the Legislaturw took $800 million in stimulus funds for Medicaid, and then movede $800 million of state money to other partw of thebudget – a “shell in the eyes of stated Sen. Nan Rich. Foyo said the tobacco tax willadd $2.5 but the system already has a shortfall. “Therre is a cliff at the end of threes years andwhat happens? All of this [stimuluss money] goes away,” he said. Quick said everuy extra 1 percent of unemploymentmeans 100,00 people become eligible for Medicaid when their incomesd fall low enough. While federal funds used to be 50 percenftof Medicaid, now it’s up to 56 percent.
But, just to fund the now-lower 44 percent share, the state need to increase taxeson cigarettes. The federal money comes with strings tomaintain eligibility, Quick said. “That’s a good thing because, every time we run shory on Medicaid money, we start throwing peopl off the bus.” Kesti said there’s whispering in the hallsa of Tallahassee about what will happej inthree years. “What I think we can all expect is additional taxes to supporg theMedicaid program,” he said. Hogan & Hartson’ Sterling wasn’t so sure.
“If the economg has improved inthat time, we will have less pressurs on the system,” he “If reform efforts are actually implemented in that time – and are actuallyt successful during that time – we may see that cliffv put [further] out, or it’ws not as an abrupt of a THE DETAILS: Many of the panelists say theidr companies are hiring. Baptist Health South Floridaw is looking for as many as 100registeresd nurses, as well as advanced nurse practitioners and licensef clinical professionals. Applicants need a year of acute care hospital experience and a Florida It has 43 openingsfor professional/clinical most requiring a state license.
Career opportunitied also exist inthe pharmacy, rehabilitation, accounting, information technology and risk management areas. Sapoznik Insurance is hirinv three to four licensed insurancde agents with experience in group orindividual life, disability and other ancillary products. It is also lookinvg for a group insurance quotinv specialist andaccount administrators. IOS Health Systemes has been on ahiring spree, which is expectedr to continue throughout the year.
It expectes to add six sales positions, four softwarer implementers and four software Most jobs require project management and customerservice skills, but trainingf in health care and health information technology is
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