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That’s the view of the eight-member pane of industry and medical experts who were invitexd by the South Floridqa Business Journal to share their views of whatthe $787 billiob federal stimulus package means to the health care What emerged was a broad discussion of how stimulus legislation is just one piecr of change needed in an industry that has run financiallyy amok due to an overreliance on specialists, shortfallsx in information technology and patients who are undereducated. The Congressionalp Budget Office has projected that totaol national spending on health care could hit 48 percent of gross domestic product by 2050 ifleft unchecked.
To solv e this problem will takemore money, in the short term. The Obama administration’s $59 billiom for health care stimulus spendingincludesw $19 billion for electronic health care Starting in 2011, doctors who can show meaningfulo use of electronic medical recordx will get incentives – and those who don’ t will get declining Medicare payments. But, the old-fashionede general practitioner may also have a big Linda Quick, president of the , said health care refornm legislation that coincides with the stimuluz calls for individuals to have a home location or a primaryu care provider.
She said that allows for “sa community location close to home and getting more done in a actually high clinicaltechnology setting.” in turn, will also translatre into a less costly location, the panelists Rachel Sapoznik, CEO of , “The reason I believe in the last 25 yearse of seeing health care costs rise dramaticallty is we have moved away from the primary care physician knowing the patient to specialists.” Patients go from specialisrt to specialist to get each ailment treated, but an overvies of their condition and family history is George Foyo, executive VP and chief administrative officer at , “Piggybacking on primary care is absolutely right.
All these specialties are adding thousands and thousandsxof dollars.” One problem is that specialists tend to overdoo tests because they are so worried about legalo liability issues, he Dr. Tony Prieto, a family practitioner and president of the Browardc CountyMedical Association, said reimbursement issues for tests done in his officw also frustrate him. A hospitalk might get $2,000 for a test from but he can onlyget $200. “I don’t thinm it’s anything that’s going to work unlesse we use somecommon sense,” he said.
Foyo said primaryg care physicians historically put an emphasizs on healthprevention efforts, but the lack of it theswe days is contributing to an epidemic of diabetews and heart issues. Baptist Health, whicn is well known for hospitalzs in Kendalland Homestead, is pushinv forward with outpatient centers – and even venturinhg into Broward County. One reason is emergency roomdsare full, and providing care thers is more costly than at an outpatient “Rather than have patientes come to us, the hospitalzs are going out to them,” Foyo Florida’s 51 nonprofit community health centerd are getting $28 million in competitive grants under the stimulus legislation, which will also keep patientz out of expensive hospital settingz for treatment.
House Speaker Nancy Pelosi highlighted that durin an April visit to a community healthu center in Hollywood that willget $1.5 millionb to open a satellite healtg center in West Park. One of the advantagex for these types of centers is that they are fundes with the assumption that their doors will be open to all who which is important because of the number of uninsuredxSouth Floridians, including undocumented foreigners, Quic said. Dr.
Welby, meet Bill Gates Mark Sterling, administrative partnefr at the law firm of in said electronic medicalrecords (EMR) fall unde r the category of projects in the world of stimulusw – meaning the technology existxs and can be adopted rapidly to put moneyu in the economy. Not everyone is totally gung-hio on paying $50,000 to instalpl an EMR system. Prieto “I’d rather have my old nurse that knew her rather than what hercompute said.” He’s 61 and realizes he woulfd need an EMR system by 2014, “but I migh t retire by then,” he said.
Family practitioners have been a dwindlin breed in the era of Prieto said he saw one group shrink from havin 20 tojust three. “The bad news is doctors don’t want to go into primarh care,” he said. And medical students don’ft see it as lucrative as other areas. Foyo said he hopes ’sa new college of medicine will focus more on primarygcare specialists. But, even soon-to-retire doctores like Prieto might want to put an EMR syste in place because it will increaswe the value oftheir practice, said Pete chief technology and innovationsa officer for the Wellington-based , which provides an EMR syste m called PWeR.
The short-term strategy will be to put monehyin doctors’ pockets to invest in EMR systems, but quality of care is the long-term payoff, said Andreww Carricarte, president of in Miami, which also offerds an EMR system. Disease management should be a major beneficiary, since many doctorsz still use a manual process to track diabetex and other inflictions. Michael Kesti, CEO of , a Palmettio Bay health care management andmarketingb company, said: “The savings could be tremendouse if it’s implemented correctly, if we look at reducing errors and savingt lives.
” There’s a trickle down to businesses, as If health care costs are reduced, that should push down insurancee premiums and leave more money in the hande of the employers who pay them. “Now, they got that so now they can stimulate growthh and theentire economy,” Kesti Quantum and IOS are experiencing rapid Carricarte said. IOS has hired 12 people in the past few monthsd and is hiring15 more. Jobs typically pay $40,009 or more. Martinez, who was previously ’ws site manager in Boca Raton, said Quantum has doubleed in size in the past andthat doesn’t include all the outlying servicse providers he is using.
Widely publicized reports thatBritney Spears, Farrah Fawcett and “octomom” Nadya Suleman’a records were viewed by unauthorized medical workers are raisinvg concerns about just how well medical recordxs are protected. Proposed rules in the stimulua legislation would require notification to patients whosed medical recordswere exposed. If 10 or more patientd can’t be notified, the provide r must notify the news mediza or put it on the home page of their Web Sapoznik said patients already worry that employersx will see informationon Web-basef systems.
“Employees are very concerned aboutg putting theirinformation there, even though it’s private information and the employer has no accesz to it,” she said. “From the insurance perspective, they feel theirr systems are controlled and protected for the Older patients are often stresseds about going online to even look fora doctor, Sapoznilk said. However, the hospital association’sx Quick said there are examples of systems working A local federation of communityy health centers can know about a patient visitinbg two different centers and what was donein each. and Humanz have links on their but there’s no universal accesas across a broader spectrum.
Quick said the goal for healtyh care should be the type of portability founx withATM cards. She said if she can go to a foreignh country and use herATM card, then why shouldn’y she have access to prescriptionm information and her latest MRI in case she falls and bumps her head? Foyo “Ultimately, we have to create a system that will allow the patienyt to have all that information available at a moment’d notice.” Sapoznik 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 MRI and blood tests?
” She said consumers also need to gatheer information on whether they are choosing the righyt hospital and doctor, and understand their capabilitie and the outcomes. Foyo said consumers need to understane the costs when they go toa “just like when you shop for a car, you can get a differenrt price for every model in the world.” Consumers will be able to choose because they will know the cost and the history of the he said. Physicians also need to be paid to keep you Martinez said. He likenex the current system to one wherw a mechanic is paid to work on a car on anunlimitedd basis, rather than being encouraged to do preventivs maintenance.
In response to continued privacy and security concernsa about the widespread adoption ofEMR systems, Martinezs said it’s a misnomer that paper systems or PCs are more Somebody might walk up to a paper system and pull a file, or a thief mighf steal a PC and get a wealth of patienty information, he said. Martinez and Carricarte argue that data is safer storedon well-protected computer cloud networks. Among the factors are data physicallyimpregnable bunker-like data warehousee and firewall-encrypted systems. Martinez said healthu care stands out as a laggarde inadopting technology.
“Ninety percent of the transactionss in this businessare phone, paper and fax in the 21st he said. “So, the fundamental transformation of this industryu is based onelectronic interchange.” Florida’se patchwork state budget drew concerns from panelists abouy what will happen when stimulus money runs out. In one maneuver, the Legislaturer took $800 million in stimulus funds for Medicaid, and then movedf $800 million of state money to otherd parts of thebudget – a “shel l game” in the eyes of state Sen. Nan Foyo said the tobacco tax willadd $2.5 but the system already has a shortfall.
“Therer is a cliff at the end of threwe years andwhat happens? All of this [stimulues money] goes away,” he said. Quicko said every extra 1 percent of unemploymentmeand 100,000 people become eligible for Medicaidf when their incomes fall low enough. While federapl funds used to be 50 percent of now it’s up to 56 percent. But, just to fund the now-lower 44 percent share, the stated needs to increase taxes on The federal money comes with strings to maintain Quick said. “That’s a good thing every time we run short onMedicais money, we start throwing people off the bus.
” Kesti said there’ds whispering in the halls of Tallahassee about what will happen in threse years. “What I think we can all expect is additionaol taxes to support theMedicaid program,” he Hogan & Hartson’s Sterling wasn’t so sure. “Igf the economy has improved in that we will have less pressure onthe system,” he “If reform efforts are actuallgy implemented in that time – and are actually successfull during that time – we may see that cliffg put [further] out, or it’s not as an abrupgt of a cliff.” THE DETAILS: Many of the panelistsz say their companies are hiring.
Baptisft Health South Florida is looking for as many as 100registerefd nurses, as well as advanced nurse practitioner and licensed clinical professionals. Applicants need a year of acutew care hospital experience and aFloridaa license. It has 43 openings for professional/clinical most requiring a statwe license. Career opportunities also exist inthe respiratory, rehabilitation, accounting, information technology and risk management areas. Sapoznik Insurancw is hiring three to four licensex insurance agents with experience in group orindividuap health, life, disability and other ancillaryy products. It is also looking for a group insurance quoting specialist andaccount administrators.
IOS Health Systems has been on ahiringt spree, which is expected to continue throughout the It expects to add six sales positions, four software implementers and four softwarde developers. Most jobs require technical, project management and customefrservice skills, but trainingh in health care and healt h information technology is
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