Austin ER Specialists Strained By Transfers From Other Cities

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1 VOLUME 3 NUMBER 28 PAGE 1 OF 5 September 11, 2006 Published every Monday, Texas Healthflash is copyrighted by HCPro, 100 Hoods Lane, Marblehead, MA 01945, and is transmitted solely to the subscriber. Any unauthorized copying, duplication or transmission is strictly prohibited. Charter subscriptions are $139. For group and bulk subscriptions, call 800/ CUSTOMER SERVICE CENTER Subscribers: if you do not receive your copy of HealthFlash, send a request to: For renewals or other subscription questions, please call: 800/ By fax: 866/ By EDITORIAL SUBMISSIONS To submit an item for consideration, contact Kathryn Mackenzie, Editor. By By fax: 512/ By phone: 512/ ADVERTISING OPPORTUNITIES To advertise in Texas Healthflash, please contact Lisa Dotolo. By By fax: 800/ By phone: 800/ ext TOP STORIES Austin ER Specialists Strained By Transfers From Other Cities Hospital officials say city in danger of oversaturation AUSTIN Transfer patients from cities around Texas are stretching Austin s hospitals and on-call emergency physicians to the limit, say officials at the Seton Family of Hospitals. Christopher Ziebell, chief of emergency medicine at University Medical Center and president of Seton's medical staff, says the number of transfer patients to Seton s hospitals has increased more than 60% in the past year from an average of 33 per month to an average of 53 per month. He says now the hospitals are seeing up to 60 transfer patients each month. We are at a critical point. The risk is that we ll become as saturated as other cities have and lose our on-call coverage. Our specialists are already feeling overburdened, says Ziebell. He says that even larger cities that have their own trauma centers like Dallas, San Antonio, and Houston are sending patients to Austin for emergency care. It seems odd to me that San Antonio, which has three Level 1 trauma centers, is transferring neuro patients to Austin, which has none, says Ziebell. According to Seton's data, the University Medical Center Brackenridge treated 17 neurosurgery patients from Bexar County in fiscal year 2006, even though there are only 15 active neurosurgeons in Austin compared to 28 in San Antonio. No available hospital beds for a particular specialty and/or a lack of available specialists are typically cited when hospitals send patients to Austin, Ziebell says. We have an ICU, and if we have any beds in that ICU, we take patients. Some trauma centers divide their ICU up by specialty and will only take neuro patients if there are neuro beds available. What they don t explain is that they ve made the neuro ICU unnecessarily small as a way to control their exposure, he says. As fewer specialists become willing to be on call for emergencies after «CONTINUED ON PAGE 2» For more information on how Pinnacle can increase your OR efficiency, call: or

2 Medical Staff Leadership Seminars by The Greeley Company Visit or Call 800/ PAGE 2 of 8 IN BRIEF» Michael DeBakey, MD, often referred to as the father of modern cardiovascular surgery, died July 11 of natural causes at the age of 99. In a career that spanned more than 70 years, DeBakey performed more than 60,000 heart surgeries. The famed Houston heart surgeon served as medical adviser to U.S. presidents and foreign heads of state. In April DeBakey was presented with the Congressional Gold Medal by President Bush and members of Congress. DeBakey has been credited with a number of medical firsts and served as chancellor emeritus of Baylor College of Medicine in Houston. He was buried Friday at Arlington National Cemetery.» Linda McClung, senior vice president for marketing, communications, philanthropy, and system services for Dallasbased CHRISTUS Health, has been elected to a three-year term on the Board of Trustees of the U.S. Catholic Health Association. The CHA board, which consists of 25 trustees, provides governance by working with members to set directions that support and strengthen the Catholic health ministry s mission. In her role at CHRISTUS Health, McClung is responsible for identity and brand management, communications and media relations, coordinating the health system s philanthropy efforts, and overseeing the customer research department.» The Texas Health and Human Services Commission has awarded $7.8 million in grants for a new program that will pair nurses with low-income, «CONTINUED ON PAGE 3» TOP STORIES CONTINUED FROM PAGE 1 Trauma cont. hours, especially in the fields of neurosurgery, orthopedics, plastic surgery, and ophthalmology, hospitals have to be willing to pay more to keep them on call, Ziebell says. Hospitals in each of these communities need to recognize the responsibility to their citizens. They have to shore up their on-call and beef up their own systems, he says. We pay for our doctors to be on call, and the price is continuing to go up. It s unfortunate, but it s also reality. Ziebell says his hope is that other Texas communities will find a way to care for their trauma patients locally before emergency physicians in Austin decide to stop taking on call patients altogether. Seton is committed to taking care of anybody and everybody who needs care, especially in the 11 counties we serve. We are certainly not trying to push business away, he says. What we are doing is raising a red flag to say if we are treating patients from West and East Texas, we aren t going to be able to meet the needs our communities here. Seton is the largest provider of healthcare services in Central Texas, serving an 11-county population of 1.7 million. The network includes five urban acute-care hospitals, including the only Level II Trauma Center in Central Texas, two rural hospitals, a mental health hospital, three primary care clinics for the uninsured, and a number of well-health clinics. Medical Board Reduces License Processing Time, Clears Backlog Licensing time declines from 100 days to 44 days AUSTIN The Texas Medical Board has reduced the time it takes to process medical license applications by 56 days, clearing the backlog of applications it has been struggling to eliminate for more than a year. Board officials say the addition of six full-time employees appropriated by the Texas Legislature during the last session has allowed them to shave the average time it takes to get a medical license from about 100 days in September to 44 days in June. We have already exceeded the goal established by the Texas Legislature, which is an average of 51 days to issue licenses, says Roberta Kalafut, MD, TMB s board president. The legislature asked us what we needed to get the job done and they gave us what we asked for. It was enough. The licensing backlog began after voters in Texas approved Proposition 12 in 2003, granting the Legislature the authority to cap noneconomic damages in «CONTINUED ON PAGE 3» Learn from industry leaders on how to better position your healthcare organization for financial and operational performance improvement as well as explore top business models that news-making organizations are using to improve profits. Cutting Edge Strategies to Improve Operational & Financial Improvement September 8-9, 2008 Pre-Conference Workshop, Sept 7 View the conference brochure and registration form at: For more information call:

3 PAGE 3 OF 8 Continued IN BRIEFContinued from from page page 2 first-time mothers to improve prenatal care and provide one-on-one child development education and counseling. Nine organizations have been awarded funding for the Texas Nurse-Family Partnership program, which was authorized by SB156 during the last legislative session. They are: Healthy Family Initiatives in Houston, $1,522,800; The Children s Shelter in San Antonio, $875,822; Tarrant County Health Dept., $860,720; Texas Tech University Health Sciences Center School of Nursing, $854,835; Parkland Health and Hospital System in Dallas, $806,284; University Health System in San Antonio, $808,154; YWCA of Metropolitan Dallas, $795,409; Any Baby Can of Austin, $756,725; and City of Port Arthur Health Department, $548,130. The program will begin Sept. 1. Pregnant women are eligible for the program if they meet the requirements for Medicaid services including having a family income at or below 185% of the federal poverty level.» The Centers for Medicare & Medicaid Services says it paid nearly $2 million in bonuses to Texas physicians who took part in Medicare s 2007 Physician Quality Reporting Initiative. Overall, CMS which is still paying out to some states will pay $36 million in bonuses to physicians, physician group practices, and other PQRI eligible professionals across the nation. The average incentive amount for individual physicians is more than $600 and average incentive payment for a physician group practice is more than $4,700, «CONTINUED ON PAGE 4» TOP STORIES CONTINUED FROM PAGE 2 License cont. healthcare liability cases. Physicians and physicians-to-be flocked to the state in numbers never anticipated by even the staunchest supporters of the proposition, and the resulting influx caused a backlog that left some doctors waiting up to eight months to get licensed. The board says the number of physician license applications increased from from 2,992 in fiscal year 2005 to 4,026 in fiscal year The number was 4,041 in fiscal year The board has received more than 3,000 applications this fiscal year and expects to again exceed 4,000 applications. "We had the same number of licensure analysts in 2007 as we had in 2003, even though the number of applications we received had increased by 57%," says Kalafut TMB also has eliminated the licensing backlog, it says. Thirty-three applications were waiting to be screened last month. As recently as February, there were 507 applications backlogged, taking about 90 days to process. Texas is an attractive place for physicians to practice, as the number of applications we receive demonstrates, Kalafut says. But the sudden jump in the number of applications put a serious strain on a licensing system designed for a far fewer number. That problem has been addressed. AG s Office Sues Nursing School Owners For Operating Illegally Owners charged $10k for training that could never be used RICHARDSON The Texas attorney general s office has sued the operators of a Richardson nursing school that was shut down by state regulators for operating without a license. According to Attorney General Greg Abbott, Esther and Tobechi Oleru operated the Esther Medical Tutorial and Nursing Review Center without the required certificate of approval from the Texas Workforce Commission. They also allegedly conned nursing students into paying up to $10,000 for training that was not approved by the Texas Board of Nursing and would not qualify them to take the Texas nursing licensure examination. When students inquired about mandatory clinical training, the Olerus referred them to a nearby nursing home. However, students who contacted the nursing home were told that it was neither affiliated with Esther Medical, nor scheduling clinical training, Abbott s office says. The TWC issued a cease and desist order against the Olerus in February «CONTINUED ON PAGE 4»

4 Medical Staff Leadership Seminars by The Greeley Company Visit or Call 800/ PAGE 4 OF 8 IN BRIEFContinued from page 3 with the largest payment to a physician group practice totaling more than $205,700. The PQRI is a voluntary program, and physicians can receive bonus payments of 1.5% of their total allowed Medicare charges, subject to a cap, by submitting quality information for services they furnish between July and December More than 109,000 physicians in 50 states participated in 2007» Irving-based USMD Inc. has appointed Karen Fiducia as president of its hospital division. She will oversee the division s operations and financial performance. Prior to joining USMD, Fiducia served as interim CEO at Quorum Health Resources, a company that handles strategic consulting and hospital operational and financial management. She is also a Fellow of the American College of Health Care Executives. USMD is a development and management company of physicianowned healthcare facilities and services.» Health insurance premiums throughout the Southwest, including Texas, are expected to increase 7.3% in 2009, marking the lowest rate increase in the region in four years, according to Hewitt Associates Inc. HMO premiums for the Southwest region increased 13.7% on average last year. Nationwide, HMO rates are expected to increase 11.8% lower than last year's initial rate increases of 13.2%. Hewitt says employers could reduce overall rate increases next year by two or three percentage points through aggressive «CONTINUED ON PAGE 5» TOP STORIES CONTINUED FROM PAGE 3 Lawsuit cont. after receiving complaints from students. Even so, the Esther Center continued to operate and accept new students up until the end of May. Last week s court-ordered injunction prevents Esther Medical from soliciting new students or collecting tuition from existing students. The lawsuit, filed in Dallas County, also seeks fines of up to $20,000 for each day the school was in violation of the state s Deceptive Trade Practices Act and $1,000 for each day it was in violation of the Texas Education Code. Calls to the school were not answered. HHS Chief Receives Criticism Over TIERS Expansion Proposal Legislators say Medicaid recipients would suffer from plan AUSTIN Health and Human Services officials surprised and angered state lawmakers last week by presenting a plan to switch at least 1 million people to a new eligibility system for benefits, including Medicaid, in the next year. Health and Human Services Commission chief Albert Hawkins caught a legislative panel off guard last week when he said the state intends to shift 953,000 elderly and disabled Medicaid patients into its problem-plagued "integrated eligibility" system by September The panel was formed in response to poor performance by TIERS pilot programs rolled out in 2003 that included wait times for food stamp applications that were three times longer than the federal mandate and high staff turnover. Members at the joint House and Senate committee meeting to discuss the TIERS program expressed shock and dismay that the state had made the decision to expand the system without consulting them. "I'm concerned that the commission is going to take one of the most vulnerable populations, the elderly and disabled, and convert these extremely complicated cases into TIERS so quickly," said Rep. Elliott Naishtat (D-Austin). He added that there could be "dire consequences" for Medicaid recipients. Hawkins maintains that the current mainframe computer used for Texas benefit applications is outdated and expensive. House Human Services Committee Chairman Patrick Rose (D-Dripping Springs) told Hawkins it is "critical" that high standards are established before any expansions of the program. Hawkins agreed to draft a new plan that includes specific criteria that would be met before TIERS is expanded, though he noted the system is being improved and more workers are being hired. Kathryn Mackenzie

5 HIRE POWER: HEALTHFLASH CLASSIFIED ADS WORK! Call: ext 1348 PAGE 5 OF 8 IN BRIEFCONTINUED FROM PAGE 4 negotiations, changes in plan offerings and designs, and an increased focus on employee health and productivity.» Tenet Healthcare Corp. has reached a three-year agreement with Blue Cross and Blue Shield of Florida. Financial terms of the agreement were not disclosed. The new agreement includes all commercial and Medicare products offered by Blue Cross Blue Shield and covers Tenet s 10 acute-care hospitals in Florida. Pinecrest Rehabilitation Hospital, a 90-bed rehabilitation facility in Delray Beach, also is included in the agreement.» The Fort Bend County Commissioners Court approved an agreement with the Texas Medical Center in Houston for a new park-and-ride operation to help employees struggling to pay high gas prices get to work. Fares will vary based on distance and range between $7 to $8 per round trip, averaging about $147 to $168 monthly. The Medical Center says the park-and-ride program could save commuters up to $7,500 a year in gas expenses. Currently, most commuters driving alone from Fort Bend to the Texas Medical Center spend an estimated $ monthly, with an annual cost of nearly $6,000, while those commuting to and from Katy may spend up to $9,000. Park and ride services will begin in August.» Valley Regional Medical Center-Brownsville is "nurse friendly," according to the American Nurses Credentialing Center. The group gave the hospital a "Pathway to Excellence" designation. To receive this designation, the hospital has to meet several criteria, including offering continuing education opportunities; encouraging feedback from nurses on patient care; establishing nursing-leadership organizations in the hospital; and offering competitive pay.» The Commonwealth of Massachusetts' Health Insurance Connector Authority and Irving-based Perot Systems Corp. announced that Perot will provide information technology and business process services to support the state's program to assist low-income Massachusetts residents choose healthcare plans. The program aims to lower health insurance costs and provide benefit coverage options to state residents. The Commonwealth Care program is for residents earning up to 300% of the federal poverty level who are not offered employer-sponsored insurance. There are currently more than 174,000 members. EVENTS August 5-7 Rural Health Trifecta: Collaborating to Make a Difference. Austin. Sponsored by: Texas Rural Health Association. Info: August HFMA Lone Star Chapter Meeting. Dallas. Sponsored by: Healthcare Financial Management Assn. Info: September 7-11 ASHES 23rd Annual Conference. San Antonio. Sponsored by: The American Society for Healthcare Environmental Services of the American Hospital Assn. Info: September Texas MGMA Fall Meeting. Houston. Sponsored by: Texas Medical Group Management Assn. Info: October th Annual ASHHRA Conference and Exposition. Austin. Sponsored by: The American Society for Healthcare Human Resources Admin. Info: October Texas Managed Care Conference & Trade Show. The Woodlands. Sponsored by: TAHP. Info: October th Annual Convention & Trade Show. Austin. Sponsored by: Texas Health Care Assn. Info: Tracie Harrison, MD, assistant professor of nursing at the University of Texas, has received $1.3 million from the National Institutes of Health for a study comparing white and Hispanic women s experience with disabilities. Harrison will compare how 55- to 75-year-old white and Hispanic women developed mobility impairment and how it impacts their lives. Compared to their white counterparts, Hispanics with disabilities report greater levels of functional limitation, difficulty with daily activities and unemployment due to impairments, she says. FREE THREE-WEEK TRIAL! Sign up a colleague for a FREE three-week trial. Just fill out the form to the right and fax this sheet to 800/ November TOTA Mountain Central Conference. Austin. Sponsored by: Texas Occupational Therapy Assn. Info: Get your event listed in HealthFlash! details to: NAME COMPANY ADDRESS CITY, STATE, ZIP PHONE

6 to place a listing, please call 800/ , ext page of 8 f e a t u r e d c a r e e r o p p o r t u n i t i e s Network Management Manager Responsible for the management and/or coordination of all activities that involve the IEHP-Direct IPA related functions. Manage and train the Contract managers, assist in the review of network coverage and ensure adequate network coverage exists at all times. 3 yrs exp. with medical groups and in-depth knowledge of all aspects of managed care operations with extensive HMO operations, contracting, provider relations, project management, and claims processes with emphasis on contract negotiation and analysis. Bachelor s degree required. Care Management Manager, RN Responsible for the development and implementation of case management services, processes, and policies. Working directly with the Plan IPA s/medical groups and hospitals to ensure coordinated, continuous care of Members and serve as a primary Plan liaison. Manage staff assigned to the CM section of the Medical Services Dept. Valid CA RN license and CA driver s license required. Management exp. and 3 yrs of UM or CM in a health care delivery setting and HMO managed care exp. UM Nurse and CM Nurse Responsible for working directly with IEHP Medical Groups, hospitals and internal staff to ensure that member cases requiring medical intervention and/or assistance are triaged appropriately. Three years managed care exp. Medi-Cal exp. preferred. Valid CA RN or LVN license. IEHP offers a competitive salary/ benefits package. INLAND EMPIRE HEALTH PLAN San Bernardino, CA FAX (909) EOE ADMINISTRATIVE DIRECTOR San Francisco Bay Area Redwood, City Sequoia Physicians Network, a newly formed managed care physician entity a service of CHW Medical Foundation, seeks an experienced, dynamic and highly self-motivated individual to build and direct this startup organization, based in Redwood City, CA. Comprised of medical group and independent physicians, the Network is committed to providing high-quality, compassionate, and cost conscious health care services to members enrolled in a wide range of Health Plans. Reporting to the Executive Director of CHW Medical Foundation, the Administrative Director has oversight responsibility for daily operations, marketing, and business development. This senior administrator will work collaboratively with the talented leadership of CHW Medical Foundation, CHW Managed Care, and Sequoia Hospital to meet the health care needs of communities served by the Network, while building strong business relationships with brokers, health plans and employers. Evidencing keen business acumen, the successful candidate will partner with physician leadership, staffing strategic and operating committees and ensuring that immediate and long-term marketing and financial goals are achieved. Managing a small local staff, this administrator will foster an organizational culture that thrives on best business and clinical practices. Requirements: Graduate from an accredited college or university; Masters Degree in Business Administration or Healthcare Administration is preferred. Five years prior management experience with a IPA, Medical Group, HMO or Physician Management Services Organization with significant capitated managed care business. The smart and highly motivated candidate we select will have a track record of succeeding in increasingly more responsible positions while handling a broad range of issues and functions; he/she will possess strong interpersonal skills and the capacity to do what it takes to achieve organizational excellence. For consideration, please apply on-line to requisition #57608 at or submit resume to CHWMF is an equal opportunity employer.

7 to place a listing, please call 800/ , ext page 7 of 8 e m p l o y m e n t o p p o r t u n i t i e s Monarch HealthCare is a medical group ( IPA ) of over 2500 independent physicians in private practice dedicated to practicing medicine the way it was meant to be. Monarch HealthCare is owned and operated by doctors who believe in working collaboratively with all stakeholders to improve the delivery of healthcare in the communities we serve. We are an industry leader in providing coordinated care! Our commitment to our employees and our employee dedication to our physicians and patients is what differentiates us. CORPORATE CONTROLLER - Monarch HealthCare is currently searching for a detail oriented professional to join us as our new Corporate Controller. Reporting to the Chief Financial Officer, the Controller is directly responsible for the daily management of all accounting and budgeting functions, including: month end closing, planning, analysis, payroll, capitation and treasury processes and ensuring overall conformity with GAAP. Monarch s Controller is also responsible for maintaining the proper internal controls, policies and ensuring procedures are in place to ensure the Company s assets are properly safeguarded. The Controller is also directly responsible for training, mentoring, coaching and, as necessary, building a strong Finance staff. Our ideal candidate for this management role will be a CPA (MBA a plus), with 5 years prior experience in a managed care setting in an equivalent role. Strong MS Office skills along with a clear communication style required. Monarch HealthCare has assembled a competitive compensation package that recognizes the many contributions by our dedicated employees and strives to keep our employees as satisfied, long term business partners! Our competitive salary, robust employee health plans, generous retirement package and work-life balance vacation schedules are the cornerstone of our employee friendly health and welfare plans! To join the best IPA in Orange County, send a current resume to where great careers begin! For more information on this position and all of our available career opportunities, please visit our website at Retained Executive Search FOR SENIOR DIRECTORS Combining 15+ years as a hospital executive and 7 years with national retained search firms, Christine McGuire applies the same senior executive search process for your hard-to-find, extremely important Director-level searches. Visit or call Cedars-Sinai Health System, an integrated healthcare delivery system, has the following opening within its growing medical group division. If you are seeking an exciting career opportunity with a world-class organization, take another look at Cedars-Sinai. PRACTICE ADMINISTRATOR Seeking an individual with extensive healthcare operations experience to direct daily operations of all multi-specialty medical practice locations. The preferred candidate will have more than 5 years of medical office management experience and will enjoy forging strong physician and staff relationships, overseeing staffing functions related to recruitment, orientation, training and general medical office management. BA required, Masters preferred. Send resume to: Human Resources, 200 N. Robertson Blvd., Suite 101, Beverly Hills, CA FAX:(310) E- mail:

8 to place a listing, please call 800/ , ext page 8 of 8 e m p l o y m e n t o p p o r t u n i t i e s Serving the Los Angeles Community for over 150 years. It s a matter of life. PIONEERING VISION, UNWAIVERING MISSION, providing care with gentleness and kindness. Join the St. Vincent family and fulfill your mission. We have the tools, training and support to help you become one of the best in your field. We are currently seeking PHARMACISTS: St. Vincent Medical Center Pharmacy has 32 Pyxis 3000 medication stations and we are adding 4 in surgery, 2 in our Doheny ICU and 2 in our new Acute Rehab unit. Orders are received in all 4 of our satellites plus our MAIN Pharmacy via scanning and we just activated our Pyxis C-II safe. Our transplant program is growing and our new ortho group performs a large # of total hip and knee replacement procedures. We offer competitive rates and an excellent benefit package. For more information about our career opportunities, please apply on-line via our website at: (www.stvincentmedicalcenter.com). For immediate consideration, contact: St. Vincent Medical Center 2131 W. Third Street Los Angeles, CA Fax: M/F/D/V EOE

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