Top Docs Radio

Azalea Health This week we started our twice-monthly series with Tanya Mack, CEO of Women’s Telehealth.  Her first guest was CEO and Co-founder of Azalea Health, Baha Zeidan.  Azalea Health is an EMR company that launched in 2008 in Valdosta, GA.  Since then the company has enjoyed steady growth and has been recognized as one […]

Baha Zeidan

Azalea Health

This week we started our twice-monthly series with Tanya Mack, CEO of Women’s Telehealth.  Her first guest was CEO and Co-founder of Azalea Health, Baha Zeidan.  Azalea Health is an EMR company that launched in 2008 in Valdosta, GA.  Since then the company has enjoyed steady growth and has been recognized as one of Inc. 500 Nation’s fastest growing private companies, Georgia Top 40 Innovator, and 2014 Emerging Company of the Year Phoenix Award Winner.

Healthcare IT is at the forefront of revolutionizing trends that will change the way healthcare is delivered and patients’ health and wellness outcomes. Healthcare providers and patients who are resistant to technology may be left behind. Today- EMR’s, patient portals, mobile health apps and wearables, cloud computing, and interoperability are not fringe applications but active advances that allow the patients to become more a part of the healthcare team.

Technology makes that possible. Currently, the global EMR market is $11 Billion and the US remains dominant in EMR adoption. As we move to electronic medical records, EMR’s hold a lifetime of health data and can be used to predict our individual health future through modeling.

Today’s guest, Baha Zeidan, CEO of Azalea Health will be discussing his company’s

EMR and Practice management platform and how it is evolving to incorporate these new technology advances.

Special Guests:

Baha Zeidan, CEO of Azalea Health           

Tanya Mack, President, Women’s Telehealth        

 

Value-based Payments Kimberly J. Rask, M.D., PhD is the chief data officer at Alliant Health Solutions, which is a nonprofit companythat supports quality improvement in public sector health care programs under Medicare, Medicaid and End-Stage Renal Disease (ESRD) Networks across the Southeastern U.S. Dr. Rask is a primary care physician andhealth economist. She also holds […]

Dr. Kimberly Rask

Value-based Payments

Kimberly J. Rask, M.D., PhD is the chief data officer at Alliant Health Solutions, which is a nonprofit companythat supports quality improvement in public sector health care programs under Medicare, Medicaid and End-Stage Renal Disease (ESRD) Networks across the Southeastern U.S. Dr. Rask is a primary care physician andhealth economist.

She also holds joint appointments in health policy and management and medicine at EmoryUniversity. Dr. Rask has published book chapters and peer-reviewed articles on primary care practice, quality improvement, and outcomes measurement.  With more than 20 years of experience in quality research and practice, she also serves on national expert panels on value-based purchasing programs and quality measurement.

The Value-based Payment Modifier (VM) is a relatively new pay-for- performance program that is being used by CMS to pay physicians in part based on how their quality and cost compare to other physicians. It is similar to other pay-for- performance initiatives for hospitals, nursing homes, and home health agencies – and it is part of a larger effort by public and private payers to control health care costs.

Although the VM started as part of the Affordable Care Act (ACA), more recent federal legislation has expanded its reach.  Medicare uses the VM program to adjust physician pay based on quality and cost measures, which vary by specialty. The reimbursement rates for 2016 are based on 2014 Physician Quality Reporting System (PQRS) data.

There are more than 250 quality metrics. Eligible providers are required to select a number of metrics –typically nine – to report. Failure to report PQRS measures can result in a penalty that is applied to all Medicare payments for the entire year. The program is revenue-neutral, so physicians who score well receive higher payments while physicians who have relatively lower scores receive lower payments.

In 2016, only medical groups with 10 or more eligible professionals will be subject to the program. In 2016, all eligible groups could receive a bonus – but only groups with 100 or more eligible professionals face a penalty in 2016. By 2017, the program is scheduled to apply to all Medicare physicians.  Of the nearly 14,000 physician groups that will subject to the VM program in 2016, less than one percent – only 128 groups that include about 4,300 physicians – will receive Medicare bonuses of either 16 or 32 percent; the higher increase will go to the practices with the most high-risk patients.

Meanwhile, more than 5,400 groups that include more than 130,000 physicians will see a two percent pay cut for failing to submit their data. And nearly 60 groups that include more than 10,000 physicians will see a pay cut of one percent or two percent because their quality measures were too low.  Under the MACRA legislation that passed in 2015 that permanently replaced the Medicare sustainable growth rate (SGR) formula, the VM will become one component of a new consolidated performance score.  There will be two payment options for physicians.

Physicians who participate in Alternative Payment Models (e.g., some types of ACOs) will be eligible for an automatic five percent incentive payment every year. Physicians who are not participating in an APM will receive incentives or be subjected to penalties of up to nine percent based on how they perform relative to other physicians on PQRS measures, their use of EHR, quality improvement efforts, and the cost of care for their patients. Since this “new” payment program is similar to the existing VM program, preparing physician practices for success with today’s VM will position practices for success in the future.

Adopting Innovation I sat down with Judy Mod and Trent McEwan of RevenueSphere.  We are in the midst of a significant business transformation – as organizations are redefining their own path to adoption – from recognition of pain through problem resolution. What’s broken? The fundamental shift in the way buyers are now adopting technology is […]

Judy Mod

Adopting Innovation

I sat down with Judy Mod and Trent McEwan of RevenueSphere.  We are in the midst of a significant business transformation – as organizations are redefining their own path to adoption – from recognition of pain through problem resolution. What’s broken?

The fundamental shift in the way buyers are now adopting technology is increasing the complexity surrounding the decisions being made about what strategic business problems to adopt – what operational approaches to adopt to fix the problem – and ultimately technically what to buy.

Trent McEwan

The rule of thumb is the more complex the organization, the more disruptive your innovation, the more difficult your market development; the bigger drag this adoption problem is likely having on your business growth. The more disruptive the innovation = The more complex the adoption.

One critical effect – 80% of sales today are being lost – not to the competition – but to “non-decision”; RevenueSphere, LLC, the problem we solve is the process of adoption across the entire life cycle (problem, operational, technical, and financial), bridging the widening gap between buyers and sellers.

Special Guests:

Judy Mod, CEO, Chief Adoption Officer, RevenueSphere

 

Trent McEwan, COO/CTO, RevenueSphere

Georgia’s Philadelphia College of Osteopathic Medicine I hosted Dr. Bill Craver to talk about the Georgia campus of Philadelphia College of Osteopathic Medicine.  Dr. Craver is the dean and chief academic officer of the osteopathic medical program at the Georgia Campus of the Philadelphia College of Osteopathic Medicine, which is also known as GA-PCOM, in […]

Dr. Bill Craver

Georgia’s Philadelphia College of Osteopathic Medicine

I hosted Dr. Bill Craver to talk about the Georgia campus of Philadelphia College of Osteopathic Medicine.  Dr. Craver is the dean and chief academic officer of the osteopathic medical program at the Georgia Campus of the Philadelphia College of Osteopathic Medicine, which is also known as GA-PCOM, in Suwanee.

Dr. Craver is a professor of surgery, is board certified by the American Osteopathic Board of Surgery, and is a fellow of the American College of Osteopathic Surgeons. Dr. Craver earned a degree in physical therapy from the University of Delaware. He worked in the areas of physical therapy and sports medicine at the Hershey Medical Center before enrolling at Philadelphia College of Osteopathic Medicine, where he earned a doctor of osteopathic medicine degree with honors.

Dr. Craver completed a residency in general surgery at the Osteopathic Medical Center of Philadelphia. He cared for patients in Jasper, Georgia and Hardinsburg, Kentucky before coming to GA-PCOM.  GA-PCOM is a private, not-for-profit branch of the fully accredited Philadelphia College of Osteopathic Medicine, which has a 117-year tradition of excellence. Located in Suwanee, GA-PCOM was established in 2005.

It offers a Doctor of Osteopathic Medicine degree, a Doctor of Pharmacy degree, a Master of Science degree in Biomedical Sciences, and a Master of Science degree in Physician Assistant Studies.   The campus also includes the Georgia Osteopathic Care Center, which is an osteopathic manipulative medicine clinic that is open to the public by appointment.

What is osteopathic medicine and what does it mean to be a D.O.? Andrew T. Still, M.D., was dissatisfied with the effectiveness of 19th century medicine. He was one of the pioneers of osteopathic medicine – and he was one of the first of his time to study the attributes of good health to better understand disease. Dr. Still’s philosophy is based on the unity of all body parts and views the musculoskeletal system as a key element of health.

Dr. Still introduced the idea of returning the body to health through manipulation based on a thorough understanding of the body’s systems.  Along with M.D.s, today’s D.O.s are licensed to prescribe medication and perform surgery in all 50 states.  Osteopathic physicians practice a “whole person” approach to medicine, treating the entire person rather than just the symptoms.

With a focus on preventive health care, D.O.s help patients develop attitudes and lifestyles that don’t just fight illness but help prevent it as well. D.O.s are trained to be doctors first and specialists second. The majority of D.O.s are family-oriented primary care physicians. Many D.O.s practice in small towns and rural areas,

where they often care for entire families and communities.

Special Guest:

Dr. Bill Craver, Dean and Professor of Surgery, Georgia campus, Philadelphia College of Medicine            

Surviving With Incurable Breast Cancer This week I sat down with breast cancer specialist, Dr. Amelia Zelnak, of Atlanta Cancer Care.  We talked about patients dealing with incurable breast cancer or they have a malignant recurrence.  Pfizer, maker of several medications used to treat various cancers, have launched an initiative, “Breast Cancer: A Story Half […]

Dr. Amelia Zelnak

Surviving With Incurable Breast Cancer

This week I sat down with breast cancer specialist, Dr. Amelia Zelnak, of Atlanta Cancer Care.  We talked about patients dealing with incurable breast cancer or they have a malignant recurrence.  Pfizer, maker of several medications used to treat various cancers, have launched an initiative, “Breast Cancer: A Story Half Told”. 

This effort aims to expand the breast cancer conversation on multiple fronts.  As the website states, “Earlier this year, Pfizer unveiled the results of two complementary studies that uncovered gaps in the breast cancer conversation within society at large and between patients and physicians in the doctor’s office, and along with leaders in the breast cancer community issued a public call-to-action to expand the breast cancer dialogue to include metastatic disease. Breast Cancer: A Story Half Told – Supporting Workplace Conversations aims to identify gaps in the current conversation about breast cancer and the workplace, and encourage healthcare professionals and employers to join together with women with breast cancer to better address their unique workplace needs.”

We talk about this and more.  Check back soon for more info!