Feature Profiles

Physician Spotlight: Dr. Keith W. Hagan
It's easy for Dr. Keith W. Hagan to recall a turning point in his life; a childhood event changed the direction of his life. At age 11, he had polio, a dreaded disease that could leave its victims crippled for life. It was a real threat to children before the Salk vaccine came along. "It changed my life and my career path," he said. "I was thrown into the medical system and watched how those people worked and cared for me."

 Nashville Archives

Advanced Imaging Braces for Reimbursement Hit
Meicare's proposed fee schedule, revealed in August, isn't a document necessarily welcomed by providers of advanced imaging services. What's more, private payers are starting to follow suit. From Medicare's perspective, nuclear scanning and nuclear imaging will soon fall under the sometimes problematic self-referral Stark rules. "That means that a lot of people over the last year have had to revise or even dissolve joint ventures if they were providing nuclear services," said Sara S. Lankford, CPA, and partner with Nashville-based Carter Lankford CPAs.

Teaming Up Against Type 2 Diabetes
Hillary Clinton once famously said, "It takes a village." In Tennessee, however, Gov. Phil Bredesen knows that sometimes what you really need is a team. Concerned about the state's consistently poor showing on national health rankings — many of which have direct ties to lifestyle choices — Bredesen recently announced several new initiatives to turn the tide on type 2 diabetes and get the state moving.

BCBST Expands Electronic Enrollment Program
BlueCross BlueShield of Tennessee (BCBST) has announced enhancements to the Caremark® Rx, Inc. iScribe® electronic prescribing program. The goal is to enroll 250 new BCBS network physicians who write more than 1,000 prescriptions per year. Since the iScribe program first offered the free software to physicians in 2004, 60 Tennessee physicians have come on board and are prescribing meds with handheld devices.

Vandy Receives Funds For Preemie Research
The BlueCross BlueShield of Tennessee Health Foundation has donated a four-year, $2.48 million grant to Vanderbilt for research on how to prevent premature births. The Tennessee Department of Health reports the death rate for premature babies was 44.7 per 1,000, compared to 3.0 per 1,000 for normal gestation babies, in 2004.

Vanderbilt ICU Staff Addresses HAI
Every year more than two million nosocomial, or hospital acquired infections (HAI) are reported in America's hospitals. A nosocomial infection is an infection acquired in a hospital or healthcare facility by a patient who was admitted for a reason other than that infection. The Centers for Disease Control and Prevention (CDC) estimate nosocomial infections create $4.5 billion in excess costs per year and account for nearly 90,000 deaths.

Sixth Trade Mission Connects Nashville with Austria and Poland
For the sixth time, a delegation of leaders in Nashville's dynamic healthcare industry crossed the Atlantic to shake hands and share ideas with their international counterparts. This mission, Sept. 11-15, was to Austria and Poland.

Price Transparency Movement Gains Ground With Executive Order
The Bush administration believes there's something extremely important that's missing in the U.S. healthcare system: A detailed bill. Too often, says President George W. Bush, consumers have no idea what healthcare services cost, and therefore can do little or nothing to take a hand in reining in steadily rising costs.

Managing Partners
More than just a healthcare buzzword, disease management is thought by many to be a significant part of the solution to the nation's overburdened health system. Intuitively, it makes sense. Spend a relatively small amount of money on the front end to manage chronic conditions so that patients avoid complications and hospitalizations that are much more costly on the back end. Elevate prevention to a reimbursable endeavor and avoid some diseases altogether.

Belmont and Vanderbilt Invest in Nursing
An emerging nursing shortage has been projected not only in the United States but also globally. Three things are happening simultaneously that must be addressed in order to avert an impending public health crisis. Those problems affecting the shortage of nurses in this country are an increased demand for registered nurses, a decreased supply of registered nurses and unfavorable working conditions.

Elliott Data Systems Leads Market in FLO® Cart Deployment
Nashville General Hospital nurses were wowed when they began using the medical facility's new portable workstations to capture point-of-care (POC) documentation. "Our staff loves them," said Lora Harnack, MSN, RN, Director of Clinical Informatics for Nashville General, about the workstations on wheels affectionately referred to as WOWs.

Connecting with Insurers in Real Time
Ask physicians in an independent practice to identify their biggest frustrations, and they will inevitably include "insurance compliance and paperwork" on the list. Checking patient eligibility, submitting clean claims and then waiting for payment all take valuable time and cost big dollars.

Documentation Leads to Practice Differentiation
There are only four ways to grow a business, and the same ways apply to healthcare practices: (1) Increase the number of customers/patients you have; (2) Increase the number of times they do business with you; (3) Increase the value of service you provide each visit; and (4) Improve the systems you use to provide products and services (patient care).

Is Your Practice Ready for End-of-the-Year Accounting?
They're as certain as death — taxes. And Merwin Ullestad, a tax member at Kraft CPAs in Nashville, said now's the time for that end-of-the-year push to ensure physician practices will be ready to file. "One of the most important things probably right now is for the businesses to get a handle on where they think they're going to be year-end.

Attacking Bad Debt
To help alleviate bad debt problems, Nashville-based Affiliated Creditors, Inc. (ACI), a 20-year-old collection firm specializing in healthcare for the last quarter-century, has incorporated a collections program into its practice that has won accolades from healthcare providers. "By focusing on the revenue cycle, we've developed a closed loop system for facilities to implement in their business office processes," explained Chad Williams, ACI vice president of sales and marketing.

Integrated Wealth Management
Healthcare professionals establish, review and adapt business plans for their practices on a regular basis. Following a business plan helps meet client needs and enhance market share. The plan sets out your chosen market, how best to attract that market, and establishes sales and earnings projections. Good practice management procedures are essential to running an efficient, profitable firm.
by Bob Bolen

Using VistA to Improve Hospital and Practice Management
While you may have heard of the Veterans Health Information Systems and Technology Architecture (VistA), what you may not know is that enterprising companies are taking the highly successful clinical information technology system and adapting it for use by their healthcare clients. Offering cost-savings and efficiencies, use of the VistA model outside government in both hospitals and physician practices might even be a significant step toward uniform electronic health records, experts say.

Do You Know the Changes to Medicare's Inpatient Final Rules?
Medicare's wage index rate, used to adjust hospital inpatient and outpatient payments based on geographic location, was slightly delayed this year, not published until mid-October. The reason why is something hospitals need to pay particular attention to, according to Roger Greenup, a certified public accountant and shareholder with HORNE LLP in Nashville.

Take Your Hospital for a Profitable Drive
Imagine running a business and, at the click of a mouse, easy-to-understand charts and graphs pop on your screen to illustrate in surprising detail just how your individual venture compares financially with its peers on a state level. The Tennessee Hospital Association, in conjunction with Nashville-based entities LBMC eHealth Solutions and eTransX, gave that power this year to 28 small and rural Tennessee hospitals.

New Twists on Established Drugs
Both rosiglitazone (Avandia®) and metformin (Glucophage®, Fortamet® and others) already have an established market share for managing Type 2 diabetes. However, recent clinical trials provide evidence that the two may actually help prevent the disease in high-risk populations.

Tennis Therapy Provides Opportunities for Social Growth
When 19-year-old Lauren Best first came in 2004 to Love Tennis, a nonprofit, therapeutic recreational program for special needs individuals, she couldn't rotate her hips, swing and step simultaneously or make solid eye contact. She also had poor motor planning, hand-eye coordination and social interaction skills. Within a year she was competing in the Tennessee Special Olympics Summer Games thanks to her improved physical and cognitive abilities on the court and group settings. This year, Lauren won a gold medal at the 2006 state Special Olympics in tennis skills.

Care and Cure
One of only 16 facilities in the nation recognized by the National Institutes of Health as a Diabetes Center of Excellence, the Vanderbilt Eskind Diabetes Clinic runs the full gamut of services ranging from research, prevention, and education to disease management and treatment of comorbid conditions.

ADA Calls on Congress for Increased Access, Funding
The prevalence of diabetes in America is well documented, and the incidence rate of the disease is growing on an almost daily basis. Type 2 diabetes, which is typically triggered by poor lifestyle choices, has become a focus of many state and local programs aimed at keeping children and adults active and eating healthy so that they might avoid the disease and its serious co-morbid complications.

Partnering with Patients and Physicians
The American Diabetes Association serves as the lead organization for the support of patients and physicians dealing with this pervasive disease through awareness and education campaigns, community outreach, funding for research and legislative advocacy efforts. On a local level, the Middle Tennessee office of the ADA is active on all of these fronts. Director Beth Zeitlin said much of what they do falls into four "buckets."

Save the Dates: 2007 Local ADA Events
May 7, 2007: The ADA Golf Challenge Chaired by Dr. John Anderson and Healthways' Dana Williams, this fun scramble at Hillwood Country Club is well known for the great (and many) prizes.

CLiRpath Offers Weapon Against Unnecessary Amputations
Diabetes is a cruel disease that takes a systemic toll on those who are diagnosed with the chronic illness. One common complication is peripheral arterial disease (PAD), in which plaque blocks arteries in the small vessels of the foot and leg and can ultimately lead to lower limb amputation.

Top 10 Southern Holiday Retreats for Doctors
Traveling during the holidays with family and friends is becoming as much a tradition as fruitcake, eggnog and brightly wrapped gifts. If you're looking for somewhere new to celebrate, consider these prized holiday getaways that cater to physicians and their families.

CMS Proposes Significant Revisions to Ambulatory Surgery Center Payment System
Significant changes are underway with respect to Medicare reimbursement for procedures performed at free-standing outpatient ambulatory surgery centers (ASCs). A proposed new rule released by the Centers for Medicare & Medicaid Services (CMS) on Aug. 8, 2006 significantly modifies both the procedures that may be reimbursed by Medicare at ASCs and the amount of that reimbursement. The proposed rule has not yet been finalized, and it is likely to generate a great deal of public comment in the coming months.
By Philip Berg

Fixing Physician Pay
In 2007, Centers for Medicare and Medicaid Services (CMS) projects it will pay approximately $61.5 billion to 875,000 physicians and other healthcare professionals. The current Medicare law includes a statutory formula that requires CMS to reduce payments to physicians and other professionals by 5.1 percent (the "negative update") for individual procedures in 2007.
By Richard G. Cowart

Karen Denham Joins Odyssey HealthCare
Odyssey HealthCare is pleased to welcome Karen Denham as Community Education Representative for the Jackson office. Ms. Denham brings over 10 years of healthcare marketing experience to our program.

Stonecrest Medical Center Announces The Association Of Juris Shibayama, MD
StoneCrest Medical Center recently announced that Juris Shibayama, MD, an Orthopaedic Spine Surgeon, has joined the medical community of Middle Tennessee.

MedSolutions CEO Honored for Industry Innovation, Entrepreneurship and Managing Rapid Growth
MedSolutions President and CEO Curt Thorne recently received the Promise Award from the Nashville Business Journal to honor one leader out of 100 healthcare executives in Middle Tennessee who has successfully launched or nursed a young enterprise into a vibrant, growing venture.

Vanderbilt University School of Nursing's Ann Minnick Appointed to U.S. Department of Health and Human Services National Advisory Council of Nurse Ed
U.S. Health and Human Services Secretary Michael Levitt has appointed Vanderbilt University School of Nursing's Ann Minnick, PhD, RN, FAAN, to the National Advisory Council on Nurse Education and Practice (NACNEP).

Williamson Medical Center's Diabetes Self-management Program Recertified
Williamson Medical Center's diabetes self-management program has been recertified by the American Diabetes Association.

Beth Berry Named THA Senior Vice President of Government Affairs
Beth Berry has been named senior vice president of government affairs at the Tennessee Hospital Association (THA).

First Colony Healthcare Taps Henry Trost as Project Administrator
First Colony Healthcare, LLC, a full service healthcare real estate and development company, has added fifteen-year-veteran, Henry Trost to its growing team, officials announced today.

Third Annual Neuroscience Symposium Set for Nov. 30
Skyline Medical Center will host the third annual Neuroscience Symposium on Thursday, Nov. 30, from 8 a.m.-4:15 p.m. Designed for health professionals, the comprehensive workshop will provide attendees with 6.75 contact hours.