+($/7+&$5(-2851$/ NOVEMBER / DECEMBER 2014 I HEALTHCAREJOURNALLR.COM I $8 of Little Rock Reducing Readmissions SlowING THE REVolVING Door One on One Mark White, CEO Arkansas Blue Cross and Blue Shield Checking in on PAs Buying Time Learning How to SHARE SCAN TO SUBSCRIBE rnals ou J ealthcare H S U D PAI E G TA S O P S U D T S RT S R P Smart, in-depth, award-winning healthcare reporting +/5 November/December 2014 CHIEF EDITOR SMITH W. HARTLEy [email protected] MANAGING EDITOR KAREN TAtum [email protected] EDITOR/WRITER PHILIP GATTO [email protected] CONTRIBUTORS A. D. LIVELY JOHN MITCHELL CORRESPONDENTS RHONDA FINNIE, DNP, APRN, AGACNP-BC, RNFA RAY HANLEY NATHANIEL SMITH, MD, MPH JOSEPH W. THOMPSON, MD, MPH ART DIRECTOR Liz Smith [email protected] SPONSORSHIP DIRECTOR DIANNE HARTLEy [email protected] PHOTOGRAPHER ZoIE CLIFT 2014 Healthcare Journal of Little Rock Advisory Board SARA B. BRADLEY, CPA Vice President- Finance Mercy Health System-Hot Springs SCOTT DAVIS, MD, FACC Interventional Cardiologist Arkansas Cardiology RAY HANLEY President, Chief Executive Officer Arkansas Foundation for Medical Care LYNDA M. JOHNSON Partner Friday, Eldredge & Clark, LLP M. COREY LITTLE Chief Executive Officer Arkansas Mutual Each issue of HENRI ROCA, MD Healthcare Journal of Chief, Integrative Medicine, Central Arkansas Veterans Healthcare System Little Rock provides important articles, Assistant Professor, University of Arkansas Medical School features, and information for health- HAYDEN W. SHURGAR Attorney care professionals. Also included are a Wright, Lindsey & Jennings LLP “One on One” with the Chief Editor, ROXANE A. TOWNSEND, MD Vice Chancellor of Clinical Programs and CEO, University Medical Center Local Correspondents, Hospital University of Arkansas for Medical Sciences Rounds, Healthcare Briefs, and more. MICHELE R. WRIGHT, PhD Pathology Partners, LLC HealthcareJournalLR.com Copyright© 2014 Healthcare Journal of Little Rock The information contained within has been obtained by Healthcare Journal of Your source for local news, Little Rock from sources believed to be reliable. However, because of the possibility of human or mechanical error, Healthcare Journal of Little Rock does information and analysis not guarantee the accuracy or completeness of any information and is not responsible for any errors or omissions or for the results obtained from use of such information. The editor reserves the right to censor, revise, edit, reject or cancel any materials not meeting the standards of Healthcare Journal of Little Rock. 4 NOV / DEC 2014 I HEALTHCARE JOURNAL OF LITTLE ROCK More than 10,000 copies of HJLR are mailed directly to +/5 Central Arkansas November/December 2014 healthcare Our Mission Healthcare Journal of Little leaders. 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Email us at editor@Healthcare healthcarejournallr.com JournalLR.com Advertising and Editorial Offices Call 855.302.7500 6 NOV / DEC 2014 I HEALTHCARE JOURNAL OF LITTLE ROCK November / December 2014 I Vol. 2, No. 1 PAge 12 PAge 18 PAge 24 ON THE COVER reducing readmissions Revolving door has financial repercussions +/5 PAge 28 PAge 34 Features 18 Buying Time A quarter-century of Departments innovation in the battle against Myeloma Editor’s Desk ...........................10 Healthcare Briefs ...................41 24 PAs in Arkansas Hospital Rounds ....................57 An update from ARAPA Advertiser Index ....................66 28 Why SHARE Matters Correspondents Health information exchange in Arkansas Director’s Desk .......................48 Policy .........................................50 34 One on One with Quality .......................................52 Mark White Nursing .....................................54 President and CEO, Arkansas BCBS EDITOR’S DESK “We spend our time searching for security and hate it when we get it.” — JOHN STEINBECK, AMERICA AND AMERICANS Every so often we experience a defining moment in life. The recent appearance of the Ebola virus within the United States has created a heightened awareness of our approach towards public health and our resolve towards protecting the health of healthcare workers. The CDC and its director, Thomas Frieden, MD, have been starkly criticized for the agency’s apathetic response towards its containment policies and its view towards the responsibility of healthcare workers and their compliance with procedures. The CDC has been charged with the responsibility from the federal level to detect and respond to new and emerging health threats. The response is coming. About 10 years ago I worked for Thomas Frieden at New York City’s Department of Health and Mental Hygiene. My general impression was Dr. Frieden was a straight-up guy who takes public health very seriously. During that time, under Frieden’s leadership, New York City instituted smoking bans throughout the City which appeared to many New Yorkers as an overreach of government’s involvement in public health. The smoking ban model was later replicated by many cities and communities. So, my opinion is, change is coming. Public health is usually taken for granted until these types of situations arise. Then, we bring our focus to the public health possibilities which range in reactions from possible concern to outright panic. The mission of public health is to best gauge the truest possibilities and act on that likelihood with reasonableness. We want enough protective measures without overshooting the mark with needless bureaucracy and infringement of freedoms. This is a tough balancing act. Healthcare organizations all across the country are reevaluating their infectious control protocols to account for new and emerging threats such as Ebola. There aren’t many priorities for healthcare organizations more important than protecting the health of healthcare workers. Many healthcare organizations generally have held a “patients first” mantra. Healthcare workers have always functioned with a controlled risk when dealing with patients. This will continue with a heightened awareness towards threats of injury or infection. No place is perfect. But, we all know we can and should do better. The new mantra will be “people first.” There’s never a dull moment in healthcare. New and changing types of injury and illness inspire new and changing treatments and policies. We are getting close to 20% of the GDP dedicated to healthcare. That means much of the population is focused on improving the health of others. It’s not an easy task. And, considering the risks, changes, and complexity of providing healthcare, I hope caregivers who are technically skilled and care for our well-being understand the gratitude we have for the work they do. Smith Hartley Chief Editor [email protected] READMISSIONS For the past two years, hospitals nationwide have adapted to a new Affordable Care Act rule that exacts penalties if a Medicare patient is readmitted within 30 days of discharge. The Medicare Readmission Reduction Act was adopted to take a bite out of the annual $26 billion it costs the government when Medicare patients return to the hospital. e reducing readmissions Revolving door has financial repercussions By John Mitchell READMISSIONS The third year results, which will reduce maximum three percent. In Arkansas, no hospital payments in the newly started fed- hospital was at the three percent maximum, eral fiscal year for all Medicare patients (not but 47 percent * of the state’s hospitals were just for readmitted patients), were recently assessed a penalty, just below the national announced. In total 2,610 hospitals will for- average of 49 percent. feit up to three percent of their Medicare Nationally, the penalties will amount to payments, with 39 hospitals penalized the $428 million in the 2015 fiscal year. This focus on readmissions represents one of the biggest paradigm shifts in recent hospi- tal management memory. “The old mindset was that every patient – even a readmission - was a good patient,” said Doug Weeks, Executive Vice President & Chief Operating Officer at Baptist Health, referring to the financial metrics hospitals must consider to operate. He stressed we need so patients don’t this attitude has changed, unnecessarily return,” with a bit of a “juggling Weeks added. act” to meet admission cri- Week’s assessment is teria that both satisfies length echoed by Dr. Stephen Jencks, of stay protocol and properly pre- one of the first researchers to iden- pares the patient for discharge to avoid read- tify the high rate of readmission in America. ** mission.