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Healthcare Briefs

STATE

Bayou Health Kicks Off

In December Louisiana Department of Health and Hospitals Secretary Bruce D. Greenstein was joined in Mandeville by health care advocates and providers, Health Plan representatives, and Medicaid and LaCHIP recipients to kick off the first day of BAYOU HEALTH enrollment for Northshore and New Orleans Area residents. The four-parish New Orleans and five-parish Northshore areas known as Geographic Service Area A goes live on Feb. 1.

Earlier in the month, DHH announced that all five Health Plans contracted to manage care under the BAYOU HEALTH program had passed their operational and systems readiness review, and each has been certified as having an adequate provider network in the first region of the state to roll out BAYOU HEALTH. The reviews examined each Plan’s ability to handle everything from case management and claims payments, where applicable, to member grievances and fraud prevention.

In addition, the Centers for Medicare and Medicaid Services (CMS) has given the green light to the state’s program. Traditionally, the federal government handles, on average, about two-thirds the cost of Medicaid, while the state picks up the rest. Any changes to the delivery system must be submitted as an amendment to the State Plan that outlines how it operates Medicaid.

To learn more about BAYOU HEALTH and see a Health Plan comparison chart, visit www.bayouhealth.com.

PAR: Increased Oversight for CCNs Needed

In December, the Public Affairs Research Council of Louisiana (PAR) released a report examining the state’s new healthcare privatization initiative. The report, “Checkup on Bayou Health Reform: What Louisiana Needs to Know About Medicaid Managed Care Privatization,” calls for increased legislative oversight of the program and recommends increased public education and discussion about the state’s Coordinated Care Network (CCN) approach.

“The key public policy issue at this juncture is the need for effective oversight, accountability, and program authority, especially given the public dollars involved and the impact on citizens,” states the report, noting the administration’s decision to resist a strong legislative oversight function and to proceed with statewide implementation without the benefit of a pilot program. PAR notes that after 30 years of Medicaid managed care and despite repeated studies, there is no consensus on whether it saves money or improves quality. “The uncertainty surrounding managed care in general and CCNs in particular should alert the state to the need for strong oversight of every phase of the program.”

You can read the full report at http://www.la-par.org/Publications/PDF/PAR_Health careReport.pdf.

LA Providers Committed to EHRs

At the ONC Annual Meeting in Washington, D.C., the Office of the National Coordinator for Health Information Technology (ONC) announced that the network of 62 Health IT Regional Extension Centers (RECs) achieved one of its first major milestones – gaining commitments from more than 100,000 primary care providers (PCPs) to adopt electronic health records in a meaningful way. As part of the network of RECs, the Louisiana Health Information Technology (LHIT) Resource Center has enrolled 1,072 primary care providers in Louisiana to date. Representing roughly one-third of all PCPs in the U.S., these 100,000+providers are building the foundation of a fully-electronic health care system. The LHIT Resource Center, administered by the Louisiana Health Care Quality Forum, provides technical assistance, guidance, and information to support and accelerate health care providers’ efforts to adopt and meaningfully use EHRs in our state.

For more information about the LHIT Resource Center services and the Quality Forum, please visit www.lhcqf.org.

Children’s Hospital Earns CARF Accreditation

Children’s Hospital in New Orleans announced that the Commission on Accreditation of Rehabilitation Facilities (CARF) has granted a three-year accreditation to the hospital’s Rehabilitation Program. CARF officially recognizes health and human service providers as having met standards for quality of service. The accreditation process applies sets of standards to service areas and business practices during an on-site survey. Rehabilitation programs earning CARF accreditation are recognized for their ongoing innovation and continued conformance to the standards of performance.

HHS Expands Senior Medicare Patrol Funding

The U.S. Department of Health and Human Services (HHS) recently awarded $9 million from the Centers for Medicare & Medicaid Services (CMS) to help Senior Medicare Patrol (SMP) programs across the nation continue their work fighting Medicare fraud. The Louisiana SMP, operated by eQHealth Solutions, was awarded $350,000 to strengthen the effort in Louisiana.

The 2011 grants will provide additional funds for SMPs to increase awareness among Medicare beneficiaries about how to prevent, detect, and report health care fraud. Julie Mickles Agan, Louisiana SMP Manager for eQHealth Solutions, said her volunteers have already referred 81 cases to the CMS and the Office of the Inspector General for the Department of Health and Human Services. For more information about fighting Medicare fraud in Louisiana, go to www.stop medicarefraudla.org.

DHH Forecasts Medicaid Deficit

The Louisiana Department of Health and Hospitals’ first forecast for Medicaid spending for SFY 2011-12 projected a $126.7 million state funding deficit, the entirety of which will be addressed through a series of funding adjustments, management tools, and initiatives to slow the growth of certain programs. The plan does not include provider rate cuts or reductions in existing services. The funding shortfall represents about 5 percent of state funding in the Medicaid program. To address the deficit, Medicaid is implementing several measures:
• Recoup money from CommunityCare 2.0 providers who failed to make a good faith effort to attain national certification after receiving payment for doing so
• Implement strategies to manage prior authorizations in the Mental Health Rehab program as the Louisiana Behavioral Health Partnership is phased in
• Employ means of financing adjustments related to expenditures of the Deficit Reduction Act and ARRA-related expenses
• Use funds associated with the LSU DSH audit rule as authorized by the Legislature
• Use federal match from cost reports as certified match.
Additionally, the Department will work with recipients, stakeholders, advocates and providers to identify an additional $3.4 million (about 2.6 percent of the total deficit) of savings in the Waiver programs.

Ochsner CEO Named To HealthLeaders 20 List

Dr. Patrick J. Quinlan, CEO of Ochsner Health System, has been named one of 20 leaders identified by HealthLeaders Magazine as playing a crucial role in making the healthcare industry better. The magazine annually selects 20 individuals across the country as its “HealthLeaders 20.”

Quinlan’s profile highlights Ochsner’s Change the Kids, Change the Future™ program which is an integrated approach in area schools that encompasses education and lifestyle changes for students, staff, and families to improve the health of the next generation. The program focuses on nutrition, exercise, and healthy eating habits, all of which set the stage for children’s ongoing behavior.

Welch is New North Oaks VP/Clinical Services

Shelly Welch has joined North Oaks Health System as Vice President of Clinical Services and Director of Nursing for North Oaks Medical Center in Hammond. With more than 10 years of executive and administrative nursing leadership experience, Welch comes to North Oaks from CHRISTUS St. Patrick Hospital in Lake Charles, where she served as assistant administrator and, most recently, chief nursing officer.

Welch has earned Nursing Executive Advanced-Board Certification and is a member of the American Organization of Nurse Executives. She earned a master’s degree in business administration with a health care management emphasis from Regis University in Denver, Colo. and obtained a bachelor’s degree in nursing from McNeese State University in Lake Charles.

LHCQF Calls For Subject Matter Experts

Since 2007, the Louisiana Health Care Quality Forum has drawn its strength from hundreds of volunteer stakeholders – providers, payers, purchasers, and consumers. As a result of this collaboration, the organization has emerged as the neutral convener, bringing people and organizations together for the shared purpose of improving individual health and the overall health of Louisiana’s residents.

As the Quality Forum continues to mature, they are looking for individuals who would like to share their expertise to help the forum advance innovative and progressive health care initiatives in Louisiana. If you are interested, please visit the Quality Forum website and click the Subject Matter Experts button on the right side of the homepage. It will bring you to a sign-up page with a short form to complete and submit regarding your areas of interest.

If you need more information, please contact Linda Morgan, Marketing and Communications Director, at This e-mail address is being protected from spambots. You need JavaScript enabled to view it. .

LA FQHCs Receive Funding

Under the Affordable Care Act, 500 community health centers in 44 states across the country will receive approximately $42 million over three years to improve the coordination and quality of care they deliver to people with Medicare and other patients. Under this Advanced Primary Care Practice demonstration Medicare will pay community health centers based on the quality of care they deliver. Five centers in Louisiana, located in Abbeville, Clinton, Greenville, Shreveport, and Sicily Island, will be participating. This improved payment system will reward clinics for such things as helping patients manage chronic conditions like diabetes or high blood pressure. In addition, health centers will use this funding to expand their hours, make same day appointments and accommodate patients with urgent care needs.

More information on the Advanced Primary Care Practice demonstration project, can be found at http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated- care-models/fqhc/.

New Leaf Psychiatry & Counseling Center Opens in Livingston

The New Leaf Psychiatry & Counseling Center at North Oaks-Livingston Parish Medical Complex opened to patient care in December. The center, located at 17199 Spring Ranch Road in Livingston at I-12 Exit 19, is staffed by Psychiatrist Michelle Barnum, MD, who is certified by the American Board of Psychiatry and Neurology and has more than 20 years of practice experience.

A second location of New Leaf Psychiatry & Counseling Center is expected to open in Hammond in early 2012 in the North Oaks Clinic Building on the North Oaks Medical Center campus.

Louisiana Citizens Challenged to Combat Obesity

Health care leaders from across the state gathered recently at the Pennington Biomedical Research Center to announce new health outcomes goals, steps being taken to address obesity in Louisiana, and to issue a challenge to the people of Louisiana to eat healthier and exercise more.

The announcement was made in conjunction with a release of the Pennington Biomedical Research Center’s annual report, “Louisiana’s Report Card on Physical Activity and Health for Children and Youth.” Instead of releasing a letter grade, this year’s report takes a new approach by establishing baseline data for each of the key 19 obesity indicators that Pennington tracks and then setting specific statewide targets for improvement in each indicator by 2020.

The data and targets in the 2011 “Louisiana’s Report Card on Physical Activity and Health for Children and Youth” are specific to the population of children and youth in Louisiana and take a more aggressive approach than the national objectives. The report calls for a 20 percent improvement in physical traits such as obesity and physical fitness, and a 40 percent improvement in modifiable behaviors such as physical activity and nutrition by 2020.

For a copy of the Report Card summary and the full research report, go to www.pbrc.edu or www.louisianareportcard.org.

Randazzo Joins North Oaks Health System

Tracy Randazzo has joined North Oaks Health System as Vice President of Business Development. She will lead the development, implementation, and management of all strategies to meet the communities’ health care needs, communication plans to key audiences, and customer support strategies.

With more than 30 years of health care experience, Randazzo comes to North Oaks from Thomson Reuters, where she served as a consulting manager with the health care division’s Strategy and Change consulting practice. Prior to her association with Thomson Reuters, she served as Director of Health Care Quality for the Texas Hospital Association, and also has held positions in the insurance and managed care industries.

Access to Oral Health Care Increased for At-Risk Kids

Effective Dec. 1st, the Louisiana Medicaid Program began reimbursing physicians for applying fluoride varnish twice each year to the teeth of Medicaid recipients between 6 months and 5 years of age. Previously, Medicaid only covered this service when performed by a dental provider. The aim is to apply the fluoride earlier in a child’s life rather than wait until the first time he/she visits a dentist.

With the implementation of the updated fluoridation varnish policy, physicians, nurse practitioners, physician assistants, registered nurses, and licensed practical nurses will now be reimbursed for applying fluoride varnish.

LHCQF Selects Arcadia Solutions for Quality Project

The Louisiana Health Care Quality Forum has selected Arcadia Solutions, a leader in data-driven health IT services, to provide the organization with health care quality improvement support. The Forum will work with Arcadia to identify and define a statewide Quality Improvement and Quality Measurement methodology to accelerate implementation of these initiatives. This methodology will also integrate the accomplishments of the Forum’s health IT initiatives: the Louisiana Health Information Technology Resource Center (regional extension center) and LaHIE (health information exchange). In addition, Arcadia will define the health IT tools necessary to improve the quality of health care safety and value to the state’s residents.

Children’s Hospital Receives Funding for Innovative Research

The Research Institute for Children at Children’s Hospital has received funding through Grand Challenges Explorations, an initiative created by the Bill & Melinda Gates Foundation that enables researchers worldwide to test unorthodox ideas that address persistent health and development challenges. Principal Investigator Professor Seth Pincus, MD will pursue an innovative global health research project, titled Depletion of CD45RO+ Cells to Eliminate the Latent Reservoir of HIV.

Dr. Pincus proposes to eradicate HIV from patients by using antibodies to eliminate the memory lymphocytes that harbor the reservoir of latent HIV, which is resistant to anti- retroviral therapy. The approach will be tested in a macaque model of latent HIV infection.

LSMS/LSU Study Details Lack of EMR Adoption

Despite potential incentives and penalties as dictated by the American Recovery and Reinvestment Act, or ARRA, which are dependent on a physician’s willingness to use Electronic Medical Record (EMR) technology, the medical community is still hesitant to adopt EMRs, according to a newly published study by Drs. Andrew Schwarz, PhD, and Colleen Schwarz, PhD. Both are professors at Louisiana State University’s E. J. Ourso College of Business and the Center for Computation and Technology. The report, a joint study between the Louisiana State Medical Society and LSU, is titled “Findings on the Non-Adoption of EMR Technology Among Physicians in Louisiana.”

“In our review of the current discourse over EMR, we saw an alarming trend – an attempt to blame the doctors. In our research, we call this ‘pro-innovation bias’ – blaming the individual not adopting the technology instead of taking a critical view of the technology itself,” said Andrew Schwarz. “We wanted to uncover what was really going on with EMR from the perspective of the doctor, with our approach being physician-centric. In the case of the medical community, we have a marketplace where the consumers of the EMR technology (i.e. the physicians) have little to no control over their pricing structure and are being forced to adopt a technology from vendors operating in a free market.”

In phase one of the study, the researchers conducted 15 face-to-face interviews with physicians across the state who had not adopted an EMR. They also interviewed four other physicians who were either users of EMR or experts on the matter. From those interviews, they came up with 31 factors that were cited as reasons for the non-adoption of EMR technology. Those led to phase two of the study, which was the development and distribution of a web-based survey that went to members of the Louisiana State Medical Society. The 594 physicians who completed the survey were practicing physicians, retired physicians, and medical students/residents from across the state and represented a variety of specialties. Respondents were almost split evenly, with 50.4 percent being adopters and 49.6 percent being nonadopters. Non-adopters of EMR technology had six over-arching concerns with EMRs:
• Negative views of EMR technology
• A lack of impact on their performance as a physician
• Negative views of the EMR marketplace
• Initial and long-term implementation concerns, i.e., cost and re-training
• Institutional distrust, including distrust of the federal and state government and insurance companies
• security and legal concerns.

“There is no demonstrable link between EMR deployments, meaningful use, and quality of care outcomes,” concluded Shwarz. “Rather than taking our time and setting a national strategy, stimulus money and incentive pressure is being put on physicians to adopt questionable technology that is not proven to result in the outcomes that we hope to achieve.”

To view the entire report, visit www.lsms.org/EMRstudy.

Ochsner Among Top Organ Transplant Centers

HealthGrades, a national independent ratings organization, has recognized Ochsner Clinic Foundation’s liver transplant program as among the best in the nation. Of the 111 hospitals performing liver transplant procedures, Ochsner is one of only seven hospitals nationwide to receive the Liver Transplant Excellence Award, and the only hospital in Louisiana to receive this distinction for 2012. Across the four transplant areas included in the HealthGrades assessment (heart, liver, kidney, and lung) Ochsner is one of only 20 hospitals nationwide to receive a 2012 HealthGrades Transplant Excellence Award.

LOCAL

Ochsner Opens New Central Clinic

In November Ochsner celebrated the opening of the $2.2 million Ochsner Health Center – Central at 11424 Sullivan Road.

The expanded clinic, which is located in Central Park Professional Plaza, features:
• 7,500 square feet
• 12 exam rooms
• Laboratory services
• Imaging services including x-ray

With this expansion, Ochsner will now provide more specialty services and pediatric care in addition to adult primary care. The following Ochsner physicians will be available at Ochsner Health Center – Central: Keith Holmes, MD (Internal Medicine); Kenneth Gaddis, MD (Neurology); Lei Gao, MD (Cardiology); Gregory Gaspard, MD (Gastroenterology); Lois Gesn, MD (Pediatrics); Alicia Kober, MD (Pediatrics); and Salvador Velazquez, MD (Cardiology).

BCBSLA Joins Hero Health Hire

Blue Cross and Blue Shield of Louisiana has joined Hero Health Hire, a coalition of companies and other entities in the healthcare industry that are united with the goal of employing disabled veterans. Launched in Washington, D.C., Hero Health Hire includes companies, associations, and hospitals from across the spectrum of healthcare that collectively employ thousands of people. Each has committed to working to help veterans find and retain jobs in healthcare.

The healthcare industry – including insurers, health plans, pharmaceutical companies, device manufacturers, and hospital networks – is considered the fastest-growing industry in our economy, requiring talented individuals to help meet multi-generational healthcare needs. The industry is also uniquely positioned to understand and support the needs of the nation’s wounded warriors. Hero Health Hire unites the healthcare industry with government agencies and the military to understand and eliminate the barriers to employment facing wounded warriors, as well as developing ways to support them in their transition.

For more information about the initiative, including resources for disabled veterans and information on joining the Hero Health Hire program, visit www.HeroHealthHire.com.

Newhauser to Head MBP-LSU Partnership

Kenneth R. Hogstrom, PhD, longtime leader of the medical physics partnership between LSU and Mary Bird Perkins Cancer Center, recently retired after playing a pivotal role in its development and expansion. Wayne Newhauser, PhD, one of the world’s leading medical physics scholars in proton therapy physics, has been appointed as Hogstrom’s successor.

The academic medical physics program is an applied physics program within the LSU College of Science. The partnership leverages Mary Bird Perkins’ clinical team and facilities, treatment planning and dosimetry laboratories, and commitment to patients as well as LSU’s expertise in imaging and medical physics within LSU’s Department of Physics and Astronomy. This combination of resources improves patient care, provides a rich arena for medical research, and provides much needed manpower in this highly-specialized field for Louisiana and the nation.

A board certified and licensed medical physicist, Newhauser earned degrees in nuclear engineering and medical physics from the University of Wisconsin. He worked at the German National Standards Laboratory (PTB), the Harvard Medical School and Massachusetts General Hospital, and The University of Texas MD Anderson Cancer Center at Houston. Dr. Newhauser has published more than 80 peer-reviewed journal articles, leads federal research grants, and mentors students and post-doctoral fellows. He also serves in leadership roles of the American Association of Physicists in Medicine and the American Nuclear Society.

OLOL College/BRCC Work on Transitions

Our Lady of the Lake College has entered into a formal articulation agreement with Baton Rouge Community College (BRCC) to allow graduates of BRCC who have received an Associate of Science in Nursing (ASN) to enroll seamlessly into the Bachelor of Science in Nursing (BSN) program at OLOL College.

Trends in healthcare show that medical facilities are increasingly interested in hiring RNs who hold a Bachelor of Science in Nursing. According to a 2008 Robert Wood Johnson Foundation/Institute of Medicine report “nurses should achieve higher levels of education and training to respond to increasing demands…patient needs have become more complicated, and nurses need to attain requisite competencies to deliver high-quality care.”

Peak Into Dutchtown

Peak Performance Physical Therapy recently completed construction and opened its newest Ascension Parish location just off Hwy 73, next door to Dutchtown High School. The brand new building houses a large area for physical therapy, a special clinic for hand injury rehabilitation, and a 25,000 gallon Swim-Ex rehab pool for aquatic therapy. Peak Performance also has clinic locations in Baton Rouge, Denham Springs, Brusly, and Prairieville.

BCBSLA Launches New Health Plan

In the face of rising healthcare costs and increasing chronic illness statewide, HMO Louisiana, Inc., a subsidiary of Blue Cross and Blue Shield of Louisiana, has launched a new model of care in the Baton Rouge market. According to BCBSLA, the product is the first of its kind in Baton Rouge and is available to small businesses and individuals as of Jan 1, 2012.

The product, called Community Blue, offers comprehensive, coordinated, patient-centered care for people in the Baton Rouge market, including East Baton Rouge, West Baton Rouge, and Ascension parishes. Members have a select network of doctors and providers from within the Blue Cross network to choose from, and in exchange pay lower premiums.

The core of this product is a patient- centered medical home model. Each patient is connected with a primary care physician who leads a team with shared medical service duties, providing for the patient’s healthcare needs and working with other medical providers when more support is needed.

SBR Clinic Gains Medical Home Recognition

The National Committee for Quality Assurance (NCQA) has announced that the Earl K. Long Medical Center (EKLMC) South Baton Rouge Clinic at the Leo S. Butler Community Center has received Level 2 recognition from the Physician Practice Connections-Patient Centered Medical Home (PPC-PCMH) program for using evidence-based, patient-centered processes that focus on highly coordinated care and long-term patient-physician relationships.

Capital Area Go Red For Women Luncheon Promotes Heart Health

The American Heart Association hosts its annual Go Red for Women Luncheon on February 9 at the Crowne Plaza Baton Rouge beginning at 9:30 a.m. Chairpersons for the event are Vicki Brooks, long-time American Heart Association supporter, and Missy Rockenbaugh of Kean’s Fine Dry Cleaning. Also, this year’s honorary chair is Louisiana First Lady, Supriya Jindal.

The luncheon, emceed by WBRZ-TV’s Sylvia Weatherspoon, is part of the Go Red For Women movement that encourages local women to take charge of their heart health by making it a top priority so they can live stronger, longer lives. Guests can participate in free health screenings by Ochsner Health System, interactive health stations, group photo opportunities, and a silent auction from 9:30 a.m. to 11:30 a.m.

The ticketed heart-healthy luncheon program, beginning at 11:30 a.m., features food prepared using recipes by Holly Clegg. Three local women affected personally by heart disease will share their inspirational story of survival. Closing out the luncheon program is a fashion show featuring clothing from Macy’s. Local heart disease survivors and other prominent Capital Area women will be modeling the clothing.

Tickets for the Capital Area Go Red For Women luncheon are $100 payable in advance. To purchase tickets and for more information, please call 770-612-6180 or visit the local Go Red For Women website www.heart.org/batonrougegored and click on Your Event.