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Premier Pulse News for Premier Health Physicians VOLUME 7 | ISSUE 5 | JULY 2020

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Premier Pulse News for Premier Health Physicians VOLUME 7 | ISSUE 5 | JULY 2020 Premier Pulse News for Premier Health Physicians VOLUME 7 | ISSUE 5 | JULY 2020 Future of Health Care in the Era of COVID-19 By Matthew S. Reeves, DO, MBA, chief of integrated care, Premier Health Acknowledging that vast swaths of providers and patients have shortage of severe magnitude, and we are nowhere near engaged in new means of providing health telehealth is a woefully underutilized tool in being out of the thick care that I think they’ll appreciate and want our toolbox. of COVID-19, there to continue. Until this change was forced With great disruption comes the opportunity are some lessons upon them, patients and providers could not for great innovation and leadership. This learned and trends fully understand or accept that change. will be a lesson learned from numerous developing. For example, telehealth, especially in the perspectives – telehealth being just one Over the long-term, outpatient setting, is changed forever. illustration. When we look back on this lower hospital admissions will be the new Patients will demand this ease of access. time, it will be identified as the tipping norm. Hospitals will move toward becoming Providers are going to feel a relief from point transforming our “sick-care” system centers of excellence and/or large intensive running the rat race to keep up by unloading to a “well-care” system. Out of necessity, care units caring for a smaller volume of some of the care to these more efficient new business models will develop that have higher acuity patients. models. Granted, limitations and possible greater vertical integration and collaboration As with any stress/crisis, the best and the abuse of telehealth is a reality. Patients across systems. Value creates volume. Those worst of us show up. With health care, may not accept or understand that not who get value right will see the volume. all moments of clinical value can occur we’ve realized tight capacity margins and The best of us is yet to come. unpreparedness on a national level. remotely based on their desire for ease of access. Hopefully doctors will not acquiesce As always, I’m interested in your viewpoint. Furthermore, the pandemic has forced the to inappropriate telehealth demands and Feel free to reach out to me at global health care system to embrace ways desires from their patients. What is for [email protected] or of doing business that we’ve sluggishly certain though is that we have a provider (812) 361-6876. tried to implement for some time. Now, PremierHealth.com SERVICE LINE UPDATE: ONCOLOGY Redefining Cancer Care By Mikki Clancy, service line vice president, oncology Premier Health Cancer Services is Officials with Premier Health cancer services also are pleased undergoing some exciting changes this to unveil our new marketing plan. This plan started with a very year. Under the leadership of Charles successful set of Cancer Survivor Day activities, including a well- Bane, MD; James Ouellette, DO, FACS; attended virtual event featuring the talents of Mark Marinella, and Ryan Steinmetz, MD, the Oncology MD, Beth Delaney, and Christine Broomhall; the Tree of Life Institute has redefined its vision for the mural of survivor photographs; and our survivor’s billboard future of cancer care in our region. The prominently displayed across our service area. vision of one cohesive program with The implementation of the cancer navigator program has a consistent experience for patients, families, and referring elevated the ease of traversing the scheduling, complexity, physicians is driving a reenergized approach to refining and treatment plan, and journey of dealing with a cancer diagnosis. building our oncology services. Our navigators’ kind, compassionate, and supportive nature Our affiliation with MD Anderson Cancer Network® has assists the patient and family during this scary journey. Nurse verified the outstanding quality provided by our care facilities navigators are available to assist with ANY new diagnosis of as well as the MD Anderson certified physicians and their cancer to ensure a cohesive patient experience. Please consider practices. We have been able to leverage this relationship by an oncology nurse navigator consult for inpatient or outpatient bringing additional programs to our cancer services that will patients via EPIC or the navigator referral form for non-EPIC be implemented over the next few months. Our MD Anderson users. affiliations provide patients access to local physicians certified Over the past several weeks we have been working on additional by one of the leading cancer centers in the nation, while programmatic additions, technology investments, and service receiving care close to home. Utilizing MD Anderson to verify changes for Premier Health cancer services. If you have our quality services provides patients with the ease of mind suggestions for improvement or new ideas, please reach out to and confidence because our local certified physicians have easy Dr. Bane, Dr. Ouellette, or me. access to MD Anderson faculty and best practices. PHYSICIAN PROFILE Collegiate Athlete Returns Home to Practice Sports Medicine Aloiya Earl, MD office. I started shadowing my own sports What is the last book you read? What is your clinical medicine physician when I was 14 and knew Lessons by Gisele Bundchen this was my dream career. I started watching specialty? Primary What is your favorite song in your playlist? care sports medicine YouTube videos of gruesome sports injuries “Tennessee Whiskey” by Chris Stapleton with Premier to desensitize myself when I was a freshman in high school. What is your favorite food? Orthopedics Three-way tie between tacos, pizza, and ice Who are the people who influenced and/or Where did you go to cream school? mentored you? What is your favorite hobby? I went to University of South Carolina for Dr. Luke Ragan – my own sports medicine Volleyball, watersports/lake days, traveling undergrad, University of Toledo for medical physician and subsequent mentor; Dr. Fred school, The Ohio State University for Miser at Ohio State, who showed me the What is your favorite animal, and why? residency, and University of Alabama for compassionate humanity of medicine and Penguins because they lie on their stomach fellowship. the importance of a primary care foundation; to slide across ice and they search for the and Dr. Jimmy Robinson, my fellowship smoothest perfect pebble to give to their What brought you to Premier Health? director at Alabama who I suspect invented love interest I was excited to come back to my home the musculoskeletal system because that’s Where is your favorite vacation spot, and state of Ohio and join a group where I how well he knows and teaches it. could practice 100 percent sports medicine. why? Premier Health has also given me the What is one thing most people don’t know Hawaii! It has vibrant green mountains and opportunity and flexibility to incorporate about you? teal blue water. It feels like a different planet. My childhood (and still) career aspiration nutrition, sports psychology, sports Describe something (a thing, person, place, was (is) to be a Zamboni driver for an ice rink. performance, and exercise prescription into experience, etc.) for which you are especially my practice. Where is your hometown? thankful: My support system Why did you choose medicine as a career? Lambertville, Mich. (near Toledo, Ohio) I grew up as a distance runner and volleyball What, if any, sports team(s) do you cheer for? Pick a side player, but I had several overuse injuries Alabama Crimson Tide, South Carolina throughout high school and into college Gamecocks, Ohio State Buckeyes, Kentucky iPhone or Android which kept me visiting the sports medicine Wildcats iPhone Early bird or night owl Night owl Beach bum or mountain hiker? Beach bum Dress shoes or tennis shoes? Dress shoes Paperback or e-reader? Paperback because I love the smell of book pages Coffee or tea? Coffee Cooking or baking? Baking Sweet or salty? Sweet PHYSICIAN ADVISOR’S CORNER Clinical Documentation Andrew B. Maigur, MD, system director, Premier Physician Advisor Program It’s imperative metrics (abstracted from coded data). Your • It is in the hospital’s best interests. The as physicians to quality measures are publicly available hospital is being judged by certain quality realize that Clinical for review on Medicare’s Physician measures, and rewarded or penalized for, Documentation Compare (https://www.medicare.gov/ in turn. If our hospital looks substandard Integrity is a quality physiciancompare/) and may guide on Hospital Compare (https://www. initiative. Accurate, potential patients’ choice of provider. medicare.gov/hospitalcompare/search. high-quality clinical • It is also important that physicians html?,) patients and payers may avoid documentation understand the process of audits and our services. If our sites of care look bad improves communication, increases denials and the financial impact on the in value-based purchasing, they may lose recognition of comorbid conditions that are hospital. At this time, most physicians money. No margin, no mission. responsive to treatment, validates the care have not felt any repercussions from a Some of you might think, “I don’t care about that was provided, and shows compliance recovery audit contractor (RAC) denial, the hospital’s reimbursement.” I would ask, with quality and safety guidelines. As a but the impact on a hospital is very is it fair that the hospital provides state-of- fellow physician, I am positive that I would tangible. Not surprisingly, the top 10 the-art care for your sick patients and incurs not have to persuade you to want to take RAC-denied diagnoses are often similar soaring costs of care but does not receive the excellent medical care of your patient. to the top 10 queried diagnoses. Hence, appropriate reimbursement? Absolutely not! Here are four reasons why you should be good documentation done concurrently I would ardently encourage you to consider invested in optimal documentation: will only help to improve the outcome CDI and Coding as your allies to facilitate of a RAC audit.
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