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That’s the view of the eight-member panel of industry and medical experts who were invitef by the South Florida Business Journal to share theird views of whatthe $787 billion federa stimulus package means to the health care sector. What emergefd was a broad discussion of how stimulu legislation is just one piece of changw needed in an industry that has run financiallyg amok due to an overreliance on shortfalls in information technologyt and patients whoare undereducated. The Congressional Budgett Office has projected that total nationao spending on health care could hit 48 percent of gross domesti c product by 2050 ifleft unchecked.
To solve this problekm will takemore money, in the short term. The Obam a administration’s $59 billion for health care stimulus spending includes $19 billion for electronif health care records. Starting in doctors who can show meaningful use of electronic medica l records will getincentives – and those who don’t will get declininfg Medicare payments. But, the old-fashioned generap practitioner may also have abig role. Lindwa Quick, president of the , said healtu care reform legislation that coincides with the stimulusz calls for individuals to have a home locatiob or a primarycare provider.
She said that allows for “as community location close to home and getting more done in a actually high clinicaltechnology That, in turn, will also translatew into a less costly the panelists said. Rachel Sapoznik, CEO of , said: “Thew reason I believe in the last 25 years of seeingh health care costs rise dramatically is we have movedf away from the primary care physician knowing the patient to specialists.” Patients go from specialistg to specialist to get each ailment treated, but an overview of their conditiomn and family history is George Foyo, executive VP and chieg administrative officer at , said: “Piggybackinyg on primary care is absolutely right.
All these specialtieds are adding thousands and thousandsof dollars.” One problem is that specialistsx tend to overdo tests because they are so worriefd about legal liability issues, he said. Dr. Tony a family practitioner and president of the Broward CountyMedicapl Association, said reimbursement issues for tests done in his officer also frustrate him. A hospital might get $2,000 for a test from but he can onlyget $200. “I don’t think it’ s anything that’s going to work unless we use some common he said.
Foyo said primargy care physicians historically put an emphasisd on healthprevention efforts, but the lack of it these days is contributinh to an epidemic of diabetes and heartr issues. Baptist Health, which is well known for hospitalsw in Kendalland Homestead, is pushinv forward with outpatient centers – and even venturingb into Broward County. One reason is emergencyt roomsare full, and providing care thers is more costly than at an outpatienf center. “Rather than have patients cometo us, the hospitalx are going out to them,” Foyo said.
Florida’sx 51 nonprofit community health centers aregettinhg $28 million in competitive grants unde r the stimulus legislation, which will also keep patientss out of expensive hospital settings for treatment. Housed Speaker Nancy Pelosi highlighted that durinbg an April visit to a community healt center in Hollywood that willget $1.5 milliojn to open a satellite health center in West Park. One of the advantagex for these types of centers is that they are fundeds with the assumption that their doors will be open to all who which is important because of the number of uninsured South includingundocumented foreigners, Quicki said. Dr.
Welby, meet Bill Gates Mark Sterling, administrativee partner at the law firm ofin Miami, said electronic medicalo records (EMR) fall under the category of “shovel-ready” projects in the world of stimuluw – meaning the technologu exists and can be adopted rapidlyh to put money in the economy. Not everyon e is totally gung-ho on payinbg $50,000 to install an EMR system. Prieto said: “I’rd rather have my old nurse that knew her rather than what hercomputer said.
” He’ws 61 and realizes he would need an EMR system by 2014, “bug I might retire by then,” he Family practitioners have been a dwindling breed in the era of Prieto said he saw one groulp shrink from having 20 to just “The bad news is doctorsa don’t want to go into primary he said. And medical students don’t see it as lucrativew as other areas. Foyo said he hopea ’s new college of medicine will focusx more on primarycare specialists.
But, even soon-to-retird doctors like Prieto might want to put an EMR systen in place because it will increase the valude oftheir practice, said Pete Martinez, chief technology and innovationes officer for the Wellington-based , whicgh provides an EMR system called PWeR. The short-term strategyg will be to put moneyin doctors’ pockets to invesgt in EMR systems, but qualityg of care is the long-term payoff, said Andrew Carricarte, presidengt of in Miami, which also offerss an EMR system.
Disease management shouldc be a major since many doctors still use a manua process to track diabetes and other Michael Kesti, CEO of , a Palmetto Bay healty care management and marketing company, said: “The savings could be tremendous if it’s implementee correctly, if we look at reducing errors and savinvg lives.” There’s a tricklre down to businesses, as If health care costs are that should push down insurance premiums and leave more moneyu in the hands of the employerxs who pay them. “Now, they got that savings, so now they can stimulatse growth and the entire Kesti said. Quantum and IOS are experiencing rapid Carricarte said.
IOS has hired 12 peopl e in the past few months and is hiringb15 more. Jobs typically pay $40,000 or more. Martinez, who was previouslh ’s site manager in Boca Raton, said Quantum has doubles in size in the past andthat doesn’t include all the outlying service providers he is using. Widely publicizexd reports that Britney Farrah Fawcettand “octomom” Nadyaq Suleman’s records were viewed by unauthorized medicalp workers are raising concerns about just how well medical records are protected. Proposed rules in the stimulus legislatio n would require notification to patients whos e medical recordswere exposed.
If 10 or more patientzs can’t be notified, the provider must notifuy the news media or put it on the home page of theitrWeb sites. Sapoznik said patients already worry that employers will see informationhon Web-based systems. “Employees are very concerned about putting their information eventhough it’s private information and the employerf has no access to it,” she “From the insurance perspective, they feel their systems are controllerd and protected for the employees.
” Older patientsw are often stressed about going onlines to even look for a doctor, Sapoznik However, the hospital association’s Quick said there are examples of systemsa working well. A local federatiom of community health centers can know abouft a patient visiting two different centers and what was done in and Humana have links ontheifr systems, but there’s no universalp access across a broader spectrum. Quick said the goal for healtn care should be the type of portability foune withATM cards.
She said if she can go to a foreign country and use herATM card, then why shouldn’tt she have access to prescription information and her latestt MRI in case she fallxs and bumps her head? Foyo said: “Ultimately, we have to creats a system that will allow the patien t to have all that information availabl at a moment’s Sapoznik said personal responsibility as a consumerf needs to be part of the equation: “Shouldd I have three MRIs in a year Should I have a CAT scan, MRI and bloodd tests?” She said consumers also need to gather informationm on whether they are choosing the righty hospital and doctor, and understanfd their capabilities and the outcomes.
Foyo said consumerzs need to understand the costes when they go toa hospital, “just like when you shop for a car, you can get a differengt price for every model in the world.” Consumers will be able to choose because 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 currenrt system to one where a mechanidc is paid to work on a car on anunlimitefd basis, rather than being encouragedc to do preventive maintenance.
In response to continuefd privacy and security concerns about the widespread adoptioj ofEMR systems, Martinez said it’as a misnomer that paper systems or PCs are more Somebody might walk up to a papet system and pull a file, or a thiegf might steal a PC and get a wealth of patienty information, he said. Martinez and Carricartde argue that data is safer storefdon well-protected computer cloud networks. Among the factors are data physicallyimpregnable bunker-like data warehouses and firewall-encryptefd systems. Martinez said health care stands out as a laggard inadoptingt technology.
“Ninety percent of the transaction in this business are paper and fax in the21st century,” he said. the fundamental transformation of this industrty is based onelectronicx interchange.” Florida’s patchwork state budget drew concerns from panelistw about what will happen when stimulus moneyt runs out. In one the Legislature took $800 million in stimulue funds for Medicaid, and then moved $800 million of state money to other partws of thebudget – a “shelol game” in the eyes of stater Sen. Nan Rich. Foyo said the tobaccoo tax willadd $2.5 but the system already has a shortfall. “Therre is a cliff at the end of threew years andwhat happens?
All of this [stimulue money] goes away,” he said. Quick said every extrw 1 percent of unemploymentmeans 100,000 people becom e eligible for Medicaid when their incomes fall low While federal funds used to be 50 percenyt of Medicaid, now it’s up to 56 percent. But, just to fund the now-lowefr 44 percent share, the state needs to increase taxeson cigarettes. The federal money comes with strings tomaintainj eligibility, Quick said. “That’s a good thint because, every time we run shortr on Medicaid money, we start throwing people off the Kestisaid there’s whispering in the hallsd of Tallahassee about what will happen in thre years.
“What I think we can all expecgt is additional taxes to supportr theMedicaid program,” he said. Hogan Hartson’s Sterling wasn’t so “If the economy has improve d inthat time, we will have less pressure on the he said. “If reform efforts are actually implemented in that time and are actually successful during thattime – we may see that clif f put [further] out, or it’s not as an abrupt of a THE DETAILS: Many of the panelistz say their companies are hiring. Baptist Health South Floridaa is looking for as many as 100registeredc nurses, as well as advanced nurse practitioners and licensed clinica l professionals.
Applicants need a year of acutde care hospital experience and aFloridwa license. It has 43 openingsz for professional/clinical positions, most requirintg a state license. Career opportunities also exist inthe respiratory, rehabilitation, accounting, information technology and risk managemenyt areas. Sapoznik Insurance is hiring three to four licensee insurance agents with experiencw in group orindividual life, disability and other ancillary products. It is also lookint for a group insurance quoting specialisrt andaccount administrators.
IOS Health Systems has been on a hiring which is expected to continue throughout the It expects to add sixsales positions, four softwared implementers and four software developers. Most jobs require technical, projecy management and customerservice skills, but training in healthb care and health information technology is
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