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May 2014

 

A Word from the President


Welcome to the May issue of NAMSS Gateway, your go-to resource for the latest news from across the industry. Of course, this newsletter is also your go-to source for NAMSS news—and with that in mind, I’d like to take some time this month to remind you all that the Regional Education Summit is just a few short weeks away. If you’re preparing to sit for the CPCS or CPMSM exam, this is a wonderful opportunity to study in connect with others and study in a group setting. While taking the in-person course doesn’t guarantee success on the exam, it’s an engaging and interactive way to determine where you personally need further study. Of course, even if you’re not sitting for an exam, the Regional Education Summit has something to offer: Credentialing 101, a two-day program that introduces attendees to credentialing and gives examples of how and when to apply accreditation standards. If you haven’t already, I hope you’ll consider registering now to join us for one of these valuable courses.

Thank you to all of you for reading this newsletter each month. Read on for the hottest news in the industry!

John Pastrano, BBA, CPCS, CPMSM
NAMSS President
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Headlines


News From NAMSS
NAMSS Regional Education Summit – Three Weeks Away
Apply Today for the NAMSS Board of Directors
NAMSS Scholarship Applications Now Open
Save Now on a Discounted Webinar!

Industry News
"Does Physician Employment Lead to Higher Costs of Care?"
"Hospitals Go Clean, Post Doc Reviews"
"American College of Hyperbaric Medicine Releases Criteria for Physician Credentialing"
"Munster Cardiologist Accused of Implanting Unnecessary Devices"
"CMS Medicare Regulation Reforms: 5 Changes to Note"
"Hospitals Improve Safety Scores, but Many Lag: Leapfrog"
"Despite Sluggish Hospital Hiring, Health Care Reports Job Growth"
"Physician Must Pay Hospital's $730,000 Legal Bill"
"Report: Hospital M&A Deal Volume Dropped in 2013"
"Is Bigger Better? Idaho Hospital Battle A Microcosm of Debate Over Industry Consolidation"


News From NAMSS


NAMSS Regional Education Summit – Three Weeks Away

June 6-7, 2014
JW Marriott Indianapolis
Indianapolis, Indiana


There's only three weeks left until the NAMSS Regional Education Summit! Register now to join us June 6-7, at the JW Marriott in Indianapolis, Indiana.

The NAMSS Regional Education Summit features three high-quality NAMSS educational workshops:
Visit NAMSS online for more details and to register today. And don't forget to book your hotel online or call (317) 860-5800. NAMSS has secured a discount room rate of $169 per night plus taxes and fees for those attending the Regional Education Summit.

We'll see you in Indy!
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Apply Today for the NAMSS Board of Directors

The Call for Board Applications and Nominations is now open. Apply online today to volunteer for one of four open positions on the NAMSS Board of Directors. Open positions include three (3) Directors at Large and one (1) Secretary-Treasurer. All positions officially begin January 1, 2015. For a complete list of open volunteer position descriptions and eligibility requirements, visit the NAMSS website.

For eligibility or application questions, contact info@namss.org.
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NAMSS Scholarship Applications Now Open

NAMSS offers numerous scholarships to MSPs at all stages of their career. Apply or nominate a deserving colleague by June 16th, 2014!

NEW THIS YEAR: Introducing the Aspire Higher Carol Cairns Scholarship Award
This new NAMSS scholarship, funded by The Greely Company, honors Carol Cairns, CPMSM, CPCS, a woman who personifies the ideals of integrity, leadership and knowledge that the profession represents. The award is to recognize medical service professionals’ dedication to higher aspirations and to the achievement of excellence consistent with the standards espoused by NAMSS and its Education Committee. A $2,500 scholarship will be awarded annually, with the inaugural recipient to be announced in September 2014.

Visit NAMSS online to view a full list of available scholarship opportunities and to access the appropriate scholarship application. Questions? Call NAMSS at 202-367-1196 or send an email to info@namss.org.

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Save Now on a Discounted Webinar!

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Industry News


Does Physician Employment Lead to Higher Costs of Care?
Becker's Hospital Review (05/08/14) Dunn, Lindsey

Physician employment by health systems has been steadily increasing in the past five years. Initially, it was primary care providers, then cardiologists, who migrated to hospitals as shelter from stiff reimbursement cuts. Others specialists, both surgical and medical, soon followed. Somewhere between 25 percent and 33 percent of physicians are presently employed by hospitals, various studies show. For hospitals, such employment provides a variety of benefits ranging from higher market share to better care coordination to physician involvement in developing care pathways. However, a new study in the latest issue of Health Affairs warns that physician employment leads to higher costs. "Long-standing payment systems are slow to change, and thus, we're left with different payment structures for different sites of care," the article's author writes. "The good news is this is probably a short-term problem, part of the inevitable growing pains that result when an industry goes through transformational change."
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Hospitals Go Clean, Post Doc Reviews
Healthcare IT News (04/29/14) McCann, Erin

The five-hospital Piedmont Healthcare system in Atlanta is one of a growing number of hospital systems to start posting uncensored reviews of their physicians online. Matt Gove, chief marketing officer, said the goal of the new program is to increase transparency and empower patients to make more informed decisions about their health. The reviews are collected by Press Ganey, an independent patient research company, and posted even if they are negative. More than 210 physicians already have ratings listed on Piedmont's website, and Gove said the hospital's other doctors will be added once they each accumulate more than 30 reviews. A recent Journal of the American Medical Association study found that 59 percent of adults consider physician ratings "somewhat" or "very important" in choosing a doctor.
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American College of Hyperbaric Medicine Releases Criteria for Physician Credentialing
PR.com (04/24/14)

The American College of Hyperbaric Medicine (ACHM) last month released recommended guidelines for physician credentialing in hyperbaric medicine. The document, which was drafted by a coalition of opinion leaders in the field of hyperbaric medicine, covers recommended minimal physician credentialing requirements in hyperbaric medicine for both hospital outpatient departments and non-affiliated centers. According to ACHM President Dr. Jeffrey Niezgoda, the rise in specialized wound and hyperbaric centers nationwide has resulted in a growing need for physicians to oversee Hyperbaric Oxygen Therapy. Until now, though, there have been no published national standards or recommendations for credentialing physicians in this important area. Dr. Thomas Serena, vice president of the ACHM, remarks, "We believe this document represents the consensus opinion of recognized leaders in the field of hyperbaric medicine in the U.S."
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Munster Cardiologist Accused of Implanting Unnecessary Devices
NWITimes.com (05/07/14) Renderman, Vanessa

Munster, Ind., cardiologist Dr. Arvind Gandhi is being sued by a couple of former patients, who claim he performed unnecessary surgeries using improper devices and was not qualified to do the work. Both civil lawsuits allege medical negligence, negligent credentialing, and breach of contract and name Gandhi, Cardiology Associates of Northwest Indiana, and Community Hospital as defendants. According to Community Hospital officials, the allegations have no merit. Community Hospital marketing director Marie Forszt wrote in an e-mail: "There was no basis for any of the allegations made against Community Hospital in 2008. Following an extensive investigation, the Department of Justice and the Federal Court dismissed all claims against the hospital in 2012."
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CMS Medicare Regulation Reforms: 5 Changes to Note
Becker's Hospital Review (05/08/14) Adamopoulos, Helen

The Centers for Medicare and Medicaid Services (CMS) has issued a final rule that reforms Medicare regulations deemed unnecessary, obsolete, or excessively burdensome for hospitals and other healthcare providers. These reforms enable multiple separately certified hospitals within a hospital system to share a unified and integrated medical staff. Under the final rule, hospital governing boards are also no longer required to include a member of the medical staff. Instead, they are now required to periodically consult with the person responsible for the organization and conduct of the medical staff. Also under the rule, physicians will no longer be held to a prescriptive schedule for being onsite' registered dieticians and qualified nutritionists will be permitted to order patient diets directly; and, finally, trained nuclear medicine technicians in hospitals can prepare radiopharmaceuticals for nuclear medicine without a supervising physician or pharmacist constantly being present.
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Hospitals Improve Safety Scores, but Many Lag: Leapfrog
Modern Healthcare (04/29/14) Johnson, Steven Ross

The Leapfrog Group has published its latest semi-annual hospital safety score card for the nation's hospitals, showing that nearly a third of hospitals have improved their performance by at least 10 percent since 2012. Leapfrog ranks safety performance using letter grades. In the latest score card, 804 hospitals received an A, 668 earned a B, 878 hospitals were given a C, 150 received a D, and 22 were hit with an F. "The data tells us that more hospitals are working harder to create a safe environment," said Leapfrog CEO Leah Binder. The report also ranks states by percentage of hospitals with A rankings. Maine placed first in the latest report. Critics of the score card say that it is unfairly biased against those hospitals that do not participate in Leapfrog's annual survey.
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Despite Sluggish Hospital Hiring, Health Care Reports Job Growth
Crain's Detroit Business (05/06/14)

Preliminary seasonally adjusted figures from the U.S. Bureau of Labor Statistics show that health care continued to add jobs during March. However, the industry's employment growth occurred largely outside of hospitals, which until recently were a steady source of payroll gains. Health care added approximately 18,700 jobs in March, a 0.1 percent increase to total 14.7 million. For the year ended March 31, health care added 198,200 jobs -- an increase of 1.4 percent. Hospital hiring, meanwhile, was essentially unchanged with 1,700 new jobs in March. This continued a trend of uneven growth and some job losses in recent months. By contrast, ambulatory-care providers added 12,600 jobs last month, up 0.2 percent, for total employment of 6.6 million. Physician office hiring also increased 0.2 percent in March, with 5,600 new jobs.
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Physician Must Pay Hospital's $730,000 Legal Bill
Lexology (04/24/14) Tabler Jr., Norman G.

In late April, the Tenth Circuit socked heart surgeon George Cohlmia with a $733,000 legal bill for his failed challenge of a Tulsa hospital's termination of his practice privileges. One of Cohlmia's patients died during a procedure and another was permanently disfigured. In its review, St. John Medical Center determined that the surgeon had failed to follow proper protocols and suspended his privileges -- an action upheld by a review committee, the medical executive committee, and the St. John board. All three acted in accordance with the Health Care Quality Improvement Act's (HCQIA's) hearing and review provisions. Cohlmia made a federal case of it -- eight of them, actually, against 19 defendants, charging everything from defamation to monopoly to racial discrimination (he had Native American patients). He lost every claim either on motions to dismiss or motions for summary judgment.
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Report: Hospital M&A Deal Volume Dropped in 2013
Becker's Hospital Review (05/08/14) Adamopoulos, Helen

A new report from Irving Levin Associates shows that the hospital sector witnessed a 21.5 percent decrease in merger and acquisition deal volume to 84 acquisitions last year versus 2012. In the U.S. market, though, the number of hospitals and hospital beds involved in such deals topped a five-year high. The increase was driven by a couple of mega-mergers: Community Health Systems and Health Management Associates, then Tenet Healthcare Corp. and Vanguard Health Systems. In a separate report released in April, Irving Levin Associates noted hospital merger and acquisition volume decreased 42.9 percent year-over-year to a dozen deals in the first three months of this year.
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Is Bigger Better? Idaho Hospital Battle A Microcosm of Debate Over Industry Consolidation
Kaiser Health News (04/22/14) Galewitz, Phil

The purchase by Idaho's largest hospital system of the state's biggest physician practice two years ago sparked hope that the merger would revolutionize the quality of care. Instead, it triggered a costly legal battle with state and federal regulators and competing hospital systems. Officials at St. Luke's Health System thought they would be helped by the Obama administration, because the federal health law encourages hospitals to collaborate with physicians to enhance quality and reduce costs. But the Federal Trade Commission (FTC) litigated, claiming St. Luke's purchase of the Saltzer Medical Group was anti-competitive and would lead to higher costs for Idaho patients. Commission officials refute the assumption that there is a broad conflict between the Affordable Care Act and antitrust laws. "The issues are in those small number of cases where collaboration occurs in a way that gives participants excessive marketplace power," said the FTC's Deborah Feinstein.
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