The 21st Century Cures Act is a landmark bipartisan healthcare innovation law that went into effect on April 5, 2021. Cures includes provisions to promote health information interoperability and prohibit information blocking by “Actors,” which include health information networks, HIEs, health information technology developers of certified health IT, and health care providers.
After a painful odyssey of more than 20 months, the one thing all Americans can agree on is that the CORONAVIRUS-19 pandemic has disrupted every facet of life. Everything from the global supply chain to the educational system have been forced to adapt.
For years, medical professionals have discussed the need to transform the healthcare system, while also keeping it available to all people. There are many different ways of doing this including government programs, fee-for-service, Medicare programs, waivers, etc.
For many physicians, the practice retirement plan can result in providing one of their most significant assets to be used after retirement. These plans are called qualified retirement plans because they fall under requirements of IRS Internal Revenue Code and are eligible to receive certain tax benefits, unlike non-qualified plans. These plans are governed by the Employee Retirement Income Security Act (ERISA).
In my June blog, we looked at what is occurring rate-wise in the Medical Professional Liability market in the United States overall, none of it positive. In this article I want to focus on factors that are just as important as price and which almost always affect premium. (In the third and last installment of this blog I will look more closely at rates in our region, and specifically in Alabama, for both physicians and hospitals).
Why do physicians leave their employment with a practice group?
There’s no single reason for such a separation. A physician's leaving might be planned well in advance, or might be an unplanned, precipitous event.
[This is the first of a three-part series. By the end of the series, I hope to have covered national, regional, local, and personal realities of the medical malpractice market so that the reader (especially physicians, practice administrators, office managers, and hospital executives) has a sense of the current disturbing developments they may be experiencing.]
Mogul, mogul, mogul, drop off. It didn’t take long for the widowmaker, a black diamond trail on Snowshoe Mountain, to send me to the emergency room of Pocahontas Memorial Hospital. Snowshoe Mountain in West Virginia has some of the best snow east of the Mississippi and as a first-time
The physician owners of Alabama Allergy & Asthma Center and Clinical Research Center of Alabama have partnered with an investment group and have received an infusion of growth capital leading to the creation of AllerVie Health, a national network of board-certified allergists and immunologists. Alabama Allergy & Asthma Center locations will be rebranding to AllerVie Health this fall. At present, Clinical Research Center of Alabama will not be rebranding and will retain its name as an affiliate of AllerVie Health.
When the Birmingham Medical News asked me to write a blog, they told me I could write about anything. Anything? Anything.
As we all know, 2020 was a difficult year in the healthcare due to the COVID pandemic. Now, with a large number of people vaccinated, there is hope that things will stabilize.
In the past year, most physicians have been so busy with all the complications and changes in approach to care that resulted from the pandemic that they haven’t had time to examine aspects of their practice that aren’t part of the daily work. If you haven’t performed a recent review of the potential threats to your practices’ financial health, I recommend doing that, starting with your commercial insurance plan.
Partnering with an experienced agent who specializes in the healthcare arena can provide you with multiple carrier options to compare while helping you negotiate more favorable terms than some companies will offer to clients who work directly with the carrier only. Let’s take a look at a few of the items my team is focused on for our healthcare clients and the emerging threats that are continuing to impact more medical businesses.
It has been a difficult 2020 with the ongoing presence of COVID 19 exhausting frontline healthcare entities and stalling the outpatient services. The pandemic has been a devastating historical event, but it has brought sweeping changes for 2021.
State Health Officer is a difficult role to fill, especially this year. While partisanship and conspiracies continue to divide us, it is the job of the State Health Officer to make decisions for the good of all people throughout Alabama. This is exactly what Dr. Scott Harris has done for Alabamians during (and before) the COVID-19 pandemic.
Everyone should have a developed, thoughtful, and unique financial plan. However, newly practicing physicians face more unique financial challenges than most recent graduates due to many having considerable accumulation of student loan debt. Once physicians begin earning income, there are pressures to play catch-up with peers who have had longer to establish their careers and savings accounts.
The U.S. Department of Health and Human Services (HHS) has announced $20 billion in new funding for providers related to the coronavirus pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments are eligible to apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Previously ineligible providers, such as those who began practicing in 2020 will also be allowed to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.
Alabama’s hospitals are grateful to Governor Kay Ivey and State Health officer Scott Harris, MD for their leadership today in announcing a statewide mask order. We appreciate our state’s leaders for highlighting the importance of the mask ordinance in reducing the spread of COVID-19.
Eric Wallace, M.D., the medical director of UAB eMedicine, and Curt Carver Jr., Ph.D., vice president for Information Technology, both at the University of Alabama at Birmingham, were appointed by Governor Kay Ivey to serve on the Broadband Working Group to provide input and guidance on how to allocate funding from the federal Coronavirus Aid, Relief and Economic Security Act.
As the Baby Boomers retire and Millennials join the workforce, managers find themselves with a new challenge in engaging the staff. The baby boomers did not mind following strict rules, nor did they require a daily pat on the back. However, most employees need more than just a task list. They want to feel valued, informed and engaged. Physician leaders and administrators can engage the staff more effectively if they are modeling a positive culture based on a mission statement, values and communicating goals.
Never before in history have we been so limited in our ability to be freely active, to compete, or simply to spectate the sports we love. The devastating effects of Covid-19 are at the front of our collective consciousness, and we have nothing to distract us. Though fall football may be a fan favorite, spring, it can be argued, is one of the best stretches in sports with March Madness, The Masters, Major League Baseball’s opening day, and the ramp up to NBA and NHL playoffs. While we struggle with the frustration as fans without a team to watch or games to attend, my greater sympathies reside with all of the senior athletes, both college and high school, whose final steps on the field, court, green, or rink were never realized.
This is not business as usual, and it is a great time of uncertainty. We are faced with one of the greatest challenges of our lifetime and your services are more critical than ever.
We are in the midst of a historic and unprecedented event. The COVID-19 pandemic of 2020 will be one for the history books. How will history judge our response to this crisis? Certainly we as a nation and as a health system were unprepared for a pandemic of this magnitude. It has exposed the flaws and weaknesses in our health system and pointed out the real need for expanded primary care in our country.
Unfortunately, significant events like the COVID-19 pandemic typically lead to a rise in phishing attacks that leverage the ongoing situation to fool people into providing confidential information or downloading malicious software. Now is a good time to remember a few key characteristics of phishing attacks to help prevent being a victim of a phishing attack.
Valentine’s Day was last month, and as usual, stores were filled with candy hearts while customers snapped up flowers and greeting cards. With Valentine’s Day now in the rear view mirror, while thinking about the holiday, I realized that we tend to overlook the opportunities we have every day to genuinely impact someone else. I found myself wondering how I could turn the seasonal attempts to show someone appreciation into a day-to-day routine. If I carried this mentality with me throughout the year, what downstream effects would follow? How would this impact not only my personal life, but my career and the culture of my organization?
With more healthcare organizations moving to VoIP (Voice-over-Internet Protocol) for their phone and communication needs, it’s important to understand the technology and how to make it work for your business needs. So let’s start with the basics.
Are you struggling to keep your employees engaged? Are you aware of the factors that impact engagement in the workplace? Often, we assume that if employees like their jobs, they will be fully engaged at work, but in reality, healthy workplace engagement extends beyond job satisfaction. Engaged employees not only enjoy their jobs, but are also motivated to work toward a common goal aligned with their company’s vision. It’s a big-picture formula that involves both the organization and management.
According to the Medical Group Management Association (MGMA), the fourth most challenging issue in practice management is collecting from self-pay and high deductible patients. With patient payments representing a growing portion of practice revenue, re-engineering how patient collections are approached is crucial to practice success.
Real estate is the second highest expense behind payroll for most healthcare practices. The benefits of capitalizing during lease negotiations can include a healthy raise through increased profitability, reduced debt, a nicer office and more. On the contrary, if negotiations are not handled properly, the results can be decreased profitability, resulting in the need to produce tens to hundreds of thousands of additional dollars just to pay the same bills that should have cost less.
Just as it’s common for our families to have “Dr. Mom,” it’s also common for one spouse to serve as the family’s Chief Financial Officer (CFO). The family CFO takes the lead in paying bills, making investment decisions, selecting insurance policies and employee benefits, etc. This division of labor is common because one spouse may have more interest in financial matters, and the set-up works fine - as long as both spouses are physically and mentally healthy.
Yesterday, I received a text from my eye doctor informing me that I have not scheduled my yearly exam and need to make an appointment. The notification was an electronic version of the Annual Patient Postcard reminders. But unlike the old postcards, the text included links to automatically call the office or direct me to visit self-scheduling. Booking that appointment has been on my to-do list for weeks, but I seem to only remember to do it after the office has closed. Yet, with one click and about two minutes of my time, the mission was accomplished. That’s when it dawned on me – healthcare is going “Amazon.”
As financial advisors, we help our clients to consider and plan not only for their own goals, but also for some of life’s serious “what ifs.” What if you want to retire early? What if you want to buy a vacation home? What if your child is planning to attend graduate school? What if you need long-term care? What if you are raising a young family and you get cancer?
Sound processes are essential to the success of any business. This is even more important in healthcare, where the ever-changing environment makes process improvement vital in order for a practice to prosper.
Trying to comply with HIPAA can be a challenge for healthcare providers, especially when there is so much confusion about specific aspects of the rules. Policyholders contact SVMIC almost every day for assistance with HIPAA-related issues. In fielding those calls and emails, we have identified some commonalities.
As our society transitioned to mobile phones, a frequently overheard question and related advertising theme was “Can you hear me now?”
Check-ups, tests, and results. Doctors provide, measure, and deliver data to patients every day, often with profound implications. Financial advisors, at least the diligent ones, offer the same to their clients. Much of our data focuses on helping people have confidence that they can do what they want to do and not run out of money at the same time. Approaches and technical tools may vary, often with significant differences in degrees of sophistication. It has been common practice for advisors to use these tools to help project a portfolio’s ability to provide income for retirement. Rates of return are calculated, spending requirements input, withdrawal rates assumed, and end-of-life portfolio values projected.
We have heard a lot from the media on active shooter events throughout the U.S., but how many of these include healthcare facilities? The Homeland Security and the FBI define “active shooter” as “an event where one or more persons actively engage in killing or attempting to kill people in a populated area.” Statistics show active shooter incidents involving healthcare facilities are less common than other events, but they can occur, so planning may save lives.
Like customers in most other industries, patients are turning to the internet to learn about physicians before seeking treatment. The following tips will help your practice manage your physician’s online identity in order to maximize the benefit and reduce the risks associated with online information.
In 2016 Forrester Research analysts focused their attention on emerging social phenomenon in consumer behavior. They identified several key social trends that are impacting our industry’s ability to adapt to changing policy, market trends and patient needs. One trend they observed was the rapid adoption of new solutions and the abandonment of solutions that didn’t immediately provide value. This trend was seen across all industries.
During my 30 years in healthcare consulting, I have seen several reform initiatives come and go.
In many cases, the initiatives have enhanced the ability of consumers to access insurance coverage and ultimately healthcare. In 1993, President Clinton proposed legislation that led to growth in Health Maintenance Organizations (HMOs) and also the HIPAA privacy standards which are still in place today. In the 2000s, President George Bush proposed changes to the Medicare program that led to the implementation of Medicare Part D coverage.
A 2016 report from the Centers for Disease Control and Prevention (CDC) found that 20 percent of Medicare participants 65 or older don’t take their blood pressure medicine as directed.1 Additionally, 20-30 percent of prescriptions for chronic health conditions are never filled and roughly 50 percent are not taken as recommended.1
It’s been more than twenty years since the 1997 revisions to Evaluation and Management guidelines, which focus mainly on physical examination. The 2019 proposed changes provide practitioners a choice in the basis of documenting E/M visits; alleviate the burdens, and focus attention on alternatives that better reflect the current practice of medicine. The implementation of electronic medical records has allowed providers to document more information, yet repetitive templates, cloning, and other workflows have pushed the envelope on compliance in documenting the traditional elements of the visit.
Many Alabama providers participated in the Quality Payment Program in 2017, under MIPS (Merit Based Incentive Program). A handful participated in a MIPS APM (Alternative Payment Model), which is a baby step towards alternative payments, but still left the participants free from downside risks. As we pass the half-way point for the 2018 performance period, exploring risk bearing programs is on the rise.
I find it intriguing that physicians are one of the only professionals who pledge an oath before practicing their craft. Other notable “oath” moments in our country focus mainly on Nationalism and Service (Military, Law Enforcement, Public Servants and Naturalization among others). How different might some professionals behave, if included in their daily duties, was the acknowledgement that they are working under an assumed set of values and principles that help guide their tasks? For CERTIFIED FINANCIAL PLANNER™ professionals this exists, not in an oath form however; but within principles expressing ethical and professional ideals.
Fraud. It’s an ugly thing and it’s everywhere, the medical industry is no exception. When most people think about fraud, they think about white collar criminals stealing millions of dollars from big name companies, or the “dark web” where most of our social security numbers and credit card numbers are floating around just waiting for a buyer. The truth is most businesses will experience some type of fraud during their operation. It is so important for owners and business managers to be constantly vigilant to protect their practices.
I recently visited a specialty practice at a major health system. As I approached the registration desk a posted sign directed me to a standing kiosk to sign in. The family member I accompanied to the visit was unable to stand at the kiosk, so I provided the needed information and signed her in. Although it was a quick and seamless process, I was concerned because if I needed assistance, there were no employees to ask. Many practices have implemented kiosk sign-ins and have someone to assist a patient with the process if needed. Practice administrators have made the decision to implement kiosk to assure verification of the current insurance policy and prompt the patient to pay any out of pocket expense before they see the doctor. Many of the kiosk solutions allow a pre-registration via email to allow the patient to populate data and upload information from their own device at their convenience. Benefits of Kiosk Sign-ins include: reduction in the staffing at the front desk, decrease in patient wait time, and most impressively is the increase of time of service collections.
As today’s healthcare drive pushes practices even further down the path of pay for performance versus the older models of pay for volume, administrators and executives throughout healthcare are researching and implementing ideas to provide an overall better experience for patients.
According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.
In 2012, I read this article that made me question much of what I thought I knew about my profession of serving clients as a guide for their financial decisions. The designation following my name for which I had worked so hard at obtaining? Good, but not enough. The incredible technology –from complex financial forecasting to automated investment management? Lacking.
2018 marks 23 years since Children’s of Alabama entered the primary care market, expanding our footprint and brand awareness outside of our main campus on Birmingham’s Southside and strengthening our relationship with doctors who care for kids.
The new tax reform law — commonly referred to as the "Tax Cuts and Jobs Act" (TCJA) — is the most significant tax legislation in decades. Although the law was passed only a few weeks ago, the impact on the economy and business outlook cannot be overlooked as the stock market rally continues and both individuals and businesses appear the most optimistic in quite some time.
Birmingham, AL – Behavioral Health Systems, Inc. (BHS), a Birmingham-based corporation administering national behavioral health programs since 1989, will be hosting a national economic and legislative forum on Wednesday, April 18, 2018 at The Club in Birmingham, from 8:00 am to 5:00 pm.
In the past few years, when we discussed patient satisfaction it pertained only to patient surveys and results. Some managers believe surveys are utilized by specialties, such as, plastic surgery who primarily practice on a cash basis. Consumerism is here to stay! Cost and quality will create a level playing field in healthcare. When working with a practice, I love to sit in the waiting room to see operations from the patient’s point of view. I also search the specialty online to review the competition and the effectiveness of the practice’s website; I may also see online reviews.
Between phone calls with clients on another day in the financial trenches at Raymond James & Associates, I brainstormed for a good topic to pontificate upon to the readers of this fine publication, and I hope you’ll agree I found it.
Over the last year or so, cryptocurrencies and blockchain technology have grabbed the attention of global markets and its participants.
When Michele Kong was a little girl growing up in Malaysia, she knew the world was filled with both wonder and danger. She surprised herself and her family when she managed to kill a not-so-small python that slithered into their home. She laughs now remembering the incident, but she said someone had to do it to protect her family, and she had the shovel.
As we finalize 2017 participation in the Merit Based Incentive Program, most of us focused on improved performance in quality since the category carried the highest weight of 60%. Those who had previous success in Meaningful Use found the Advancing Care category easy to address. The Practice Improvement category is new and somewhat vague, but many practices were already performing tasks that qualified as an improvement activity. It is important to document the approach to improvement and track success because this category is subject to audit in the future.
It has now been two years since the implementation of ICD-10, everyone survived! While denials have been minimal, the goal of implementing ICD 10 to acquire more specificity and a complete picture of health has not been fully achieved. Physicians and managers have created a new set of shortcuts to assure payment of claims, relying on paper superbills or inappropriate conversions from ICD 9 to ICD 10.
Albert Einstein once said, “Life is like riding a bicycle. To keep your balance, you must keep moving.” Moving is one thing the City of Opelika is determined to do…even on two wheels.
Most all medical practices are preparing a MACRA project this summer. Our healthcare team has had the opportunity to speak to many physicians and managers regarding preparation for the transition from volume to value based medicine and reimbursement. A large project can be overwhelming for any practice but this is more than a project, it is a culture change!
The city of Marion is an old town rich in Alabama history that pre-dates the Civil War. It’s home to many antebellum homes, Judson College and Marion Military Institute, the nation’s oldest military junior college. Few people may know that a young Coretta Scott, born and raised in Marion, wed her husband, Rev. Dr. Martin Luther King Jr., on the front lawn of her mother’s home just north of Marion in 1953. It’s this small town’s amazing history that called out to Dr. Shane Lee when he was looking to set up a practice.
TUSCUMBIA – When you walk into Dr. Suzanne Blaylock’s office at the Helen Keller Pavilion, there’s a medical journal on her desk, paused and waiting for her to return to continue reading the most recent article. On the wall behind her chair are framed reminders of why she choose anesthesiology as her specialty – awards recognizing her from the Peer Reviewed Professionals, the Consumers’ Research Council of America as one of America’s Top Anesthesiologists, and the Consumers’ Research Council of America’s Top Physicians. Dr. Blaylock always knew she’d have a career in medicine, but what she got was so much more.
The Mobile area has many sites for tourists to visit during a stay. From the Gulf Coast Exploreum Science Center & IMAX Theater, the USS Alabama Battleship, the beautiful flowers of Bellingrath Gardens, dipping your toes in the warm Gulf waters of Dauphin Island, to celebrating Mardi Gras at the Mobile Carnival Museum, there’s one attraction in Mobile that may not immediately catch your attention, but you surely should not miss…the Mobile Medical Museum.
As we approach the beginning of summer, our minds are likely not on summer vacation. The process of assessing our electronic medical record vendor, absorbing the details of MIPS, and making the decisions on how to prepare, is overwhelming for small practices. The transition to value based medicine has been evolving over the last 10 years in stages; adopting electronic health record, Quality Reporting, and Meaningful Use. Many administrators and physicians did not realize the importance of each project; from choosing the right EMR, to implementing it properly, therefore achieving best practice workflows.
MONTGOMERY – Boyde Jerome “Jerry” Harrison, a family practitioner from Haleyville, was formally installed as president of the Medical Association of the State of Alabama during the 2017 Inauguration, Awards Presentation and 50-Year Physician Recognition Dinner on Friday, April 14.
Physicians Giving Back with Lee Irvin, M.D.
You probably don’t know Lee Irvin, M.D., of Mobile, and he’s fine with that. He’s the kind of gentleman you’d love to hang out with and have a drink or dinner with…swap stories with. But it’s easy to see that his medical mission over the last couple of years wears heavy on his heart.
MONTGOMERY – On March 29, officials from the Medical Association of the State of Alabama participated in a proclamation signing ceremony declaring March 30, 2017, the Second Annual Doctors’ Day in Alabama formally recognizing Alabama’s nearly 17,000 licensed physicians serving millions of residents through private practice, in hospitals, in research, and in other health care facilities.
A 34-year-old male presented to a family medicine physician for chronic low back pain. The physician is comfortable prescribing opioids and has many patients on scheduled drugs. The patient has had chronic pain for many years and has undergone multiple treatments including physical therapy, steroid injections and many medications. On presentation, the patient was on Robaxin and oxycodone (four times a day). His past history is positive for hypertension and alcohol abuse, although he stated he hasn’t drank in the past year. He works as a laborer.
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