Louisiana Medical News January February 2015

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Louisiana Hospitals Push to Enroll Uninsured

Dr. Jason CormierNeed for speed

Dr. Jason Cormier likes to go fast. Whenever he gets the chance, he races his Formula 1 go-kart, reaching speeds of up to 155 miles per hour ... page 3

Willis-Knighton’s Radiation Therapy Proton Unit Opens in ShreveportThe compact ProteusONE™ is the fi rst of its kind in the world.

Proteus was the ancient god who could change shape to fi t his circumstances, which is what the new compact proton radiation therapy machine, the ProteusONE (IBA-Belgium) does. It targets a specifi c tumor size and shape very precisely, sparing the patient’s healthy tissues and thus minimizes side effects, as it treats localized cancers ... page 5

Physician Spotlight

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By CINdy SANdERS, ELISABETH BELMONT & JOEL HAMME

Already one of the most highly regulated industries in America, 2015 looks to be another active year across healthcare’s legal landscape. Two past presidents of the American Health Lawyers Association, Elisabeth Belmont and Joel Hamme, took time to share insights and predictions for the coming year.

Subsidies in the Health Insurance ExchangesUnder the Affordable Care Act, individuals with incomes between 100

and 400 percent of the federal poverty level are eligible to receive federal tax credit subsidies for purchasing health insurance on the exchanges. Hamme noted that in King v. Burwell, the Fourth Circuit court ruled the IRS acted law-fully in interpreting such subsidies were permissible not only for state exchanges but also

Hot Button Legal Issues to Watch in 2015


By TEd GRIGGS

Louisiana hospitals are quietly leading the movement to help their patients get cover-age through the Affordable Care Act, with a number of facilities offering advice from navigators and health insurance agents.

Baton Rouge General Medical Cen-ter began by offering the free service once a week, in the front lobby of its Mid City campus. But during the fi rst week of January, the system made help available from 9 a.m. to 9 p.m. at both campuses. Emergency department patients can get enrollment assistance from 9 a.m. to 1 a.m. Patients can get help fi guring out their coverage options, eligibility and the level of fi nancial assistance available.

Access to healthcare coverage is important for patients to take care of themselves and their families, according to Mark Slyter, president and chief executive offi cer of Baton Rouge General. Helping people get covered is just one of the ways the General meets the community’s needs.

Paul Salles, president and chief executive offi cer of the Louisiana Hospital Association, said he’s

not sure how many of the state’s hospitals are bringing in navigators.

“I’ve heard folks tell me that they are facilitating sign ups. It’s not uncommon for them,” Salles said. “A lot of hospitals have traditionally had Medicaid eligibil-ity units in their facility. It’s something that a lot of hospitals have taken an ac-tive role in, helping people get eligible for Medicaid or whatever healthcare

coverage might be out there.”The navigators are specifi c to the Af-

fordable Care Act. Bringing them in, giving people someone to talk to, is a “patient and

community good deed,” Salles said.Getting patients health coverage also benefi ts hos-

pitals. That increased coverage was a major reason the American

Hospital Association, among others, supported the Affordable Care Act, also known as “Obamacare.” The hospital industry accepted

2 • JANUARY/FEBRUARY 2015 Louisiana Medical News

Since we’re singularly focused on medical malpractice protection, your mind is free to go other places. LAMMICO is not just insurance. We’re a network of insurance and legal professionals experienced in medical liability claims. A network that closes approximately 90 percent of all cases without indemnity payment. A network with a 95 percent policyholder retention rate. LAMMICO’s a partner – so that when you insure with us, you’re free to do your job better. And that’s a very peaceful place to be.

Free your mind to think aboutsomething other than med-mal.

Louisiana Medical News JANUARY/FEBRUARY 2015 • 3

By LISA HANCHEy

Dr. Jason Corm-ier likes to go fast. Whenever he gets the chance, he races his Formula 1 go-kart, reaching speeds of up to 155 miles per hour. At the time of the interview, he had just fi nished a gruel-ing race at the NOLA Motorsports Park, home of the largest karting track in the US. “I’m still a little sore,” he revealed.

Good thing he’s an elite athlete. Born and raised in Lafay-ette, La., Cormier was a star basketball player at St. Thomas More High School. He received a schol-arship to LSU, play-ing under renowned coach Dale Brown. After a semi-pro stint in Madrid for the Hornets’ satellite team, Cormier decided to complete his educa-tion. “Playing basketball, I wanted to play in the NBA,” he revealed. “So, after that, it became a dream – it happened, for a little while. I didn’t really see much of a future there, so I returned to academics.”

At the urging of his mother, Corm-ier pursued science and went to medi-cal school. “I was always pretty good in science, and my mother was a biology teacher, so that’s the basis of where my science background comes from,” he ex-plained. He received his medical degree from LSU in New Orleans, where he be-came eligible for the Alpha Omega Alpha Medical Honor Society. While in the Cres-cent City, he served on the LSU School of

Medicine Dean’s Selection Committee, was the med school’s representative to the Louisiana Board of Supervisors, and donated his time monthly to the Student Run Homeless Clinic.

Originally, Cormier wanted to be-come a thoracic surgeon. But, he changed his mind at the urging of his mentors, Dr. Sam McClugage and Dr. David Kline. “Those conversations steered me towards neurosurgery,” he admitted. “Neurosur-gery became something that I identifi ed

with well.”Following his intern-

ship in general surgery and neurosurgery at Duke University Medical Center in Durham, NC, Cormier completed his training at the University of Alabama in Birmingham. He re-ceived the Resident Lead-ership Award from the Division of Neurological Surgery at the University of Alabama. In 2005, he served on the Council of State Neurological Society as a representative of Ala-bama to the American As-sociation of Neurological Surgeons.

In 2010, Cormier re-turned to Lafayette, where he partnered with Dr. Alan Appley at Acadiana Neuro-surgery. “We immediately hit it off,” he said. “Things were put in place that made Lafayette the ideal starting place for my career.”

Currently, Cormier is a Physician Owner at Lafayette Surgical Specialty Hospital, and also practices at Our Lady of Lourdes Regional Medical Center, Re-gional Medical Center of Acadiana and Lafayette General Medical Center. He performs minimally invasive and open spine surgery as well as open and endo-scopic brain surgery. “About 60 percent of what I do is spine, 35 percent is intracra-nial, such as aneurysms, tumors, vascular malformations, and the remainder is pe-

ripheral nerve,” he explained. “It’s a nice spread.”

He particularly enjoys performing cutting-edge techniques, including NICO Brain Path and spinal cord reversal. “We do Brain Path to take blood clots out of the brain through very small craniotomies,” he explained. “There are only 32 sites in the country which have that technology, and Lourdes and Lafayette General are the only two active places now in Louisi-ana. It’s really changed the landscaping of hemorrhagic strokes.”

At interview time, Cormier had just completed a successful spinal cord rota-tion. “There are less than 30 cases in the literature ever written about worldwide,” he reported. “It’s dicey, to say the least, but it’s a very good procedure that works.”

On his off-time, Cormier satisfi es his need for speed. “I am a huge Formula One fan,” he said. “I’ve always loved speed. And so, it made sense that I would get involved in some form of racing.”

For the past two years, Cormier has raced his four go-karts. His prized pos-session is a fi nalist from last year’s world championship held at NOLA Motors-ports. “It’s moderately dangerous, but we push the limits in a lot of things that we do,” he explained. “So, it’s right along the lines of what I do in my profession.”

Besides racing, Cormier is a collector of art and antiques, including a 17th-cen-tury Buddha head and several 16th-cen-tury paintings. The eclectic doc is also a connoisseur of fi ne wine and champagne.

As for the future, Cormier’s dream is to drive a Formula 1 car – once. “I plan to do that, hopefully, in the next two years,” he said.

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Dr. Jason CormierNeed for speed

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for federally run exchanges and those that are a federal-state partnership. However, the Supreme Court has agreed to review this decision.

Hamme explained, “Of the 50 states and the District of Columbia, only 17 have state established exchanges; 7 have partnership exchanges and the remain-ing 27 are federally operated. Thus, if the Supreme Court were to overturn the Fourth Circuit’s decision, individuals in two-thirds of the 51 jurisdictions would be ineligible for subsidies for purchasing health insurance on the exchanges.” He added that while there was some debate as to how detrimental such a decision would prove to be to the ACA, certainly it would be a major setback. “The King case essentially represents the last major legal hurdle for the ACA. If the subsidies challenge fails, ACA opponents will be relegated to trying to repeal or signifi-cantly modify the ACA by legislative and executive branch actions.”

Medicaid Eligibility ExpansionSince the Supreme Court ruling that

mandatory Medicaid expansion wasn’t permissible, 29 states voluntarily have au-thorized Medicaid eligibility expansion or obtained federal approval of an alternate expansion plan to take advantage of gen-erous federal financial support tied to the program. However, Hamme pointed out, the 2014 election results impacting gov-ernorships and state legislatures seem to have strengthened the numbers of those opposing such expansion in several states that were still weighing the options. “In at least one state, it is conceivable that Medicaid eligibility expansion will be re-scinded after having been implemented,” he said.

Hamme continued, “For 2015, the key Medicaid eligibility expansion devel-opment will be whether the slow erosion of state opposition to expansion continues as states decide that they do not want to forego the financial advantages of expan-sion or whether this erosion is abated by

those fiercely opposed to the ACA.” He added it will be interesting to see how flexible the federal government might be with respect to work and work search re-quirements and beneficiary cost-sharing obligations for states that are seeking waivers for alternate expansion models.

ACA Going ForwardAs Hamme pointed out, the ACA has

already generated several legal decisions and navigated a number of political and operational obstacles in its relatively short life. However, a number of hurdles … in-cluding the decision on exchange subsi-dies and the law’s unpopularity among large swaths of the public … remain.

“During 2015, interested observers should look to various barometers to as-sess whether the ACA is working … and equally important … whether it is gain-ing the public acceptance needed to as-sure its political survival,” Hamme said. He added some of those measures would

include the administration of the ex-changes, whether offerings to consumers were deemed acceptable in terms of plan choices and affordability, a continued decline in the number of uninsured, and whether or not the ACA could continue to withstand legal and political assaults.

“Like 2013 and 2014, the coming year will witness numerous developments that will lead either to the ACA’s long-term viability or its premature demise,” Hamme concluded.

Fraud and AbuseOn Oct. 31, 2014, the U.S. Depart-

ment of Health and Human Services Of-fice of Inspector General (OIG) released the FY-2015 Work Plan. Always eagerly anticipated, the document gives insight into the OIG’s planned reviews and ac-tivities with respect to HHS programs and operations. Belmont noted, “In the intro-duction to the Work Plan, OIG stated that, in the coming year, the agency plans to continue to focus on issues such as emerging payment, eligibility, manage-ment, IT security vulnerabilities, care quality and access in Medicare and Med-icaid, public health and human services programs, and appropriateness of Medi-care and Medicaid payments.”

Belmont highlighted a few areas of interest for this year:

Hospitals: With 22 substantive areas under review, the OIG is deeply engaged with hospital reviews both on the billing and payment side, and quality of care is-sues, which are a particular priority for current Department of Justice (DOJ) and OIG enforcement efforts. OIG continues to scrutinize CMS contractors’ imple-mentation of outlier reconciliation (of which the OIG has been critical for many years) and remains intensely interested in inpatient versus outpatient payments, the “two midnight” rule for inpatient admis-sions, and cardiac catheterizations.

Hospice: Hospice billings for general inpatient care, a focus of relators and the DOJ, is under close review by the OIG.

Freestanding Clinic Providers: OIG con-tinues to examine certain payment sys-tems such as provider-based services and freestanding clinic payments, with an eye toward reducing disparity of payments based on site of service.

Laboratories: OIG added a review of independent clinical laboratory billing requirements, without further specifying the billing requirements at issue. This may coincide with increased local cover-age determinations by contactors, OIG enforcement against clinical laboratories under its Civil Monetary Penalties Law authority, and OIG’s general heightened scrutiny of technical billing and payment compliance by clinical laboratories, espe-cially specialty laboratories.

Accountable Care Organizations: OIG intends to conduct a risk assessment of CMS’ administration of the Pioneer ACO Model.

Medicaid Managed Care: OIG added a review of state collection of rebates for drugs dispensed to Medicaid managed care enrollees.

Medicare Part D: This is an area where there will be continuing scrutiny of the quality of Part D data submitted to CMS. The OIG also plans to follow up on the steps CMS has taken to improve its over-sight of Part D sponsors’ Pharmacy and Therapeutics Committee conflict-of-in-terest procedure in the wake of the OIG’s critical 2013 report.

Health Information & Technology

“Data now is recognized as one of a healthcare organization’s most valu-able assets, especially as a result of the transition to a more analytically driven industry,” Belmont said. “Given the in-creasing importance of data to a health-care organization, it is advisable for the organization to implement appropriate data governance best practices.”

With the accumulation of data also comes an obligation to make sure pro-tected health information (PHI) stays protected. “In 2015, healthcare privacy and security compliance will continue to expand with respect to the scope, number of enforcement bodies and increased en-forcement activity, and overlapping sets of requirements,” Belmont said. “In ad-dition to the requirements of the HIPAA Privacy and Security Rules, healthcare providers also will need to navigate re-quirements promulgated by the Federal Trade Commission, Centers for Medi-care and Medicaid Services, Office of the National Coordinator, and state at-torney generals. Additionally,” she con-tinued, “increasing exposure for privacy and security breaches may occur as the result of state common or statutory law, despite there being no private right of action with regard to HIPAA violations. As a consequence, healthcare organiza-tions and practitioners need to manage the complex daily operational processes required to maintain appropriate privacy and security of protected health informa-tion and devote necessary resources to ensure regulatory compliance.”

Hot Button Legal Issues to Watch in 2015, continued from page 1

About the ExpertsElisabeth Belmont, Esq. serves as corporate counsel for MaineHealth, ranked among the nation’s top 100 integrated healthcare delivery networks. She is a member of the Board on Health Care Services for the Institute of Medicine and its Committee on Diagnostic Error in Health Care. Belmont is also a member of the National Quality Forum’s Health IT Patient Safety Measures Standing Committee. In addition to serving as a past president of the American Health Lawyers Association, she is also the former chair of

the organization’s HIT Practice Group and the current chair of the Inhouse Counsel Program. In 2007, Modern Healthcare named her to their list of “Top 25 Most Powerful Women in Healthcare.”

Joel Hamme, Esq. is a principal with Powers, Pyles, Sutter & Verville in Washington, D.C. He joined the firm in 1998 and focuses his practice on long term care, Medicare and Medicaid reimbursement issues, provider licensure and certification matters, and litigation in his areas of expertise. He is a member of the District of Columbia and Pennsylvania bars, as well as the bars of the Supreme Court of the United States and numerous federal appeals courts. A past president of AHLA, Hamme is a frequent speaker and lecturer on healthcare issues and has authored

numerous articles and book chapters relating to healthcare law.


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By BARBARA MCCONNELL

Proteus was the ancient god who could change shape to fit his circum-stances, which is what the new compact proton radiation therapy machine, the ProteusONE (IBA-Belgium) does. It tar-gets a specific tumor size and shape very precisely, sparing the patient’s healthy tis-sues and thus minimizes side effects, as it treats localized cancers.

“This is very new and we are the first to have it world-wide,” said Dr. Lane Rosen, radiation oncolo-gist and director of the radiation oncology de-partment at the Willis-Knighton Cancer Center in Shreveport. “This is intensity modulated proton therapy (IMPT) with image guidance and pencil beam spot scan-ning that uses super strength magnets to deposit a more narrow beam of protons into a tumor, resulting in an extremely conformal dose of radiation without the surrounding healthy tissue being dosed.

“We see this as a game-changer in the future of cancer care,” said Rosen.

Over the last 100 years, radiation therapy has evolved to where CT scans image guide the beam, and 3-D conformal therapy and intensity-modulated radia-tion therapy (IMRT) calculate and help lower the dose to surrounding healthy structures.

Rosen continued, “All over the world, 3-D conformal and IMRT are the stan-dard of care in radiation, and they are ex-cellent... So, you may be able to adjust the strength of the beam from different angles and modulate its intensity, but there is still radiation dose going somewhere.” And that’s both in front of and behind the tumor.

A quick chemistry review: x-ray photon radiation is derived from the negatively-charged electrons that circle the nucleus of the atom, whereas proton particles are positively-charged and are within the nucleus of the atom, and along with neutrons are extremely heavy, 2000 times heavier than an electron.

“And that is where proton radiation therapy gets interesting, because it does not have exit dose. The proton is acceler-ated in a cyclotron (at 2/3 the speed of light) and thrown out very fast and is so heavy it pushes tissue out of the way, so it doesn’t do much (though some) damage in front of the tumor; and then eventually it stops-that energy has to go somewhere-and it explodes on the tumor. Now the proton is annihilated; it’s gone, so there is no dose out the back.”

The slowing and explosion of the pro-ton dose on the tumor is called the Bragg

peak.Rosen added that no longer are mul-

tiple beams needed; one proton beam will do because the dose does not have to go anywhere. Higher doses of proton radia-tion can be given because of its unique physical properties, and because you can ‘steer’ a proton because of its positive charge, it is more accurate and precise in localizing the tumor.

Tumors that are close to important body structures such as the brain, spinal cord, optic nerve, heart, bladder and rec-tum, can be more safely treated because of this increased accuracy.

Proton IndicationsProton therapy is for localized tumors

that have not spread, can be used in con-junction with other cancer therapies and is more easily tolerated than other forms of radiation, usually with the same number of treatments.

Historically, proton therapy is widely used in pediatric malignancies, prostate, some lung, brain, orbital and spinal tu-mors.

Since their opening, W-K Proton Center is treating prostate, brain, head and neck, spine, GYN and rectal tumors, and wants to expand into other body loca-tions.

According to Rosen and Greg Son-nenfeld, director of the W-K Cancer Cen-ter, though children are not being treated there now with proton therapy, they are in talks with St. Jude Children’s Research Hospital in Memphis to treat their pa-tients in the future.

The FacilityThe Willis-Knighton Proton Center

began conceptually seven years ago, and construction began in 2012 as a separate building at the back of the W-K Cancer Center. The first patient was treated in September 2014.

Compared to other full-size pro-ton facilities such as at Harvard or MD Anderson in Houston, this is considered ‘compact.’ It took much less money to build, $40 million as opposed to several hundred million, has a much smaller foot-print of 55,000 square feet, and the gan-try that swings into place to position the proton beam in treatment is smaller than existing systems, though it’s still 1.5 stories tall and weighs 90 tons!

Moving this equipment from Bel-gium was a gargantuan task. The cyclo-tron alone weighs 220 tons and had to be transported in halves by ship and giant flatbed trailers.

The treatment area consists of 3 rooms in a row: 2 double-height rooms for the cyclotron and the gantry, and a familiar-looking patient treatment room, with adjacent protected areas for the tech-

nicians and medical physicists.Through the Philips Ambient Expe-

rience, on a wall-mounted touchpad pa-tients customize the music, lighting and images that will help them relax during their sessions.

Why Proton Therapy in Shreveport?

The radiation oncology department at Willis-Knighton has a strong history of many early successes. They were one of the first in the United States to do 3-D conformal therapy, one of the first 15 locations to do IMRT and in 2002 they were fourth in the world performing to-motherapy.

Their medical physics residency pro-gram is the largest in the country. Willis-Knighton is joined by the University of Mississippi, Mary Bird Perkins Cancer Center in Baton Rouge and Oncologics, Lafayette.

Is Proton Therapy Effective?Since the first proton facility opened

at Loma Linda UMC in California in 1990, thousands have been treated at now

15 locations in the United States, and sev-eral proton centers are doing some form of IMPT, with new centers being planned, developed or in construction.

A November 2013 study by Drs. Mendenhall, et al, at the University of Florida Proton Therapy Institute, Jack-sonville, using proton therapy for prostate cancer treatment:

for low and intermediate risk patients, the five year biochemical and clinical free-dom from disease progression rate was 99 percent. For high-risk patients, it was 76 percent.

Patients also reported a lower inci-dence of bladder and bowel toxicity.

Cost of Radiation Therapy vs. Proton

Though costs of individual treatments run higher than IMRT, many insurances will cover the treatment, though there seems to be shifting back and forth on how much and which carriers will or will not cover.

Sonnenfeld pointed out that in an August 2014 study published in Oncology

Willis-Knighton’s Radiation Therapy Proton Unit Opens in ShreveportThe compact ProteusONE™ is the first of its kind in the world.


Dr. Lane Rosen


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By: ALEC ALExANdER

For the first time since its enactment as part of the Affordable Care Act (ACA) in 2010, a federal court in a whistleblower action will consider a provision requiring providers to return overpayments within sixty days of when they are “identified.” The upcoming decision by the United States District Court for the Southern District of New York in U.S. ex rel. Kane v. HealthFirst Inc. et al will likely be just the first of many decisions on the subject. Providers and government regulators are poised for what could prove a lengthy dispute at both the trial and appellate lev-els around the ACA’s 60 day rule and its interplay with overpayments in the False Claims Act (FCA) context.

In Kane, the government argues that the defendant providers “identified” overpayments when a whistleblower gave them a report listing claims affected by a software glitch in the company’s system, specifically a bill coding error. The report identified hundreds of affected claims. According to the government, rather than acting promptly to return the identified funds, the defendant fired the whistle-blower and then took more than two years to fully reimburse the Medicaid program.

The provider argues that the whistle-blower’s report, which listed some nine hundred claims totaling over a million dol-lars, was merely a compilation of the uni-verse of claims that may have been wrongly submitted to and paid by Medicaid. Fur-ther analysis was required at that point in order to confirm that the items were in fact overpayments. Further, defendants note that approximately half of the claims initially identified by the whistleblower turned out to have never been submitted or paid. Until all necessary analysis was accomplished, the affected claims had not been “identified.”

In addition to addressing the novel 60 day issue, this case also serves as a clear re-minder that the intersection of the ACA’s 60 day rule and the False Claims Act is a problematic and potentially dangerous area for all providers. In addition to creat-ing the 60 day rule, the ACA also makes the retention of an identified overpayment an “obligation” under the FCA. As such, overpayments are subject to the FCA’s treble (triple) damages provision, as well as to its onerous penalties which range from a minimum of $5,500 up to $11,000 per claim, and can also subject affected pro-viders to possible exclusion from participa-tion in federal programs.

The Kane defendants have moved to dismiss the government’s case because the claims at issue had been identified by them only as “potentially” affected by the bill coding error. There was no initial indication that those claims had actually been billed to or paid by the government. They assert that mere notice of potential overpayment does not give rise to an es-tablished duty to act until 60 days after the overpayment is “identified” which they argue does not occur until the health care provider has actual knowledge of the overpayment.

The government counters that the FCA’s long-standing reverse false claims provision, which prohibits a provider from keeping a known overpayment, and the ACA’s relatively new 60 day rule, are distinct requirements both of which apply to the provider’s conduct in the case. The government clearly thinks that the af-fected claims were sufficiently “identified” at the time of the whistleblower’s initial report. But whether they were “identi-fied” or merely “potential” for purposes of the 60 day rule is not dispositive from the government’s perspective. Rather, the defendant’s alleged failure to act in a diligent manner once the “potential” overpayments were known alone consti-tutes “reckless disregard” and/or “delib-erate ignorance” of the duty to return the overpayments and is therefore actionable under the FCA.

In this regard, the government’s brief argues “while {the 60 day ACA provi-sion} provided a bright line for health care providers for when overpayments must be returned and when FCA liability could be triggered, the ACA did not purport to nar-

row the reverse false claims provision of the FCA, which has wide application to all types of overpayments . . . not simply Medicare and Medicaid funds “knowingly” retained. . . . The Court need not find a violation of the [ACA’s 60 day provision] to find a violation of the reverse false claims provision of the FCA. Separately, the ACA also captures the provider’s conduct. . . . The [FCA’s reverse claims provision] and the ACA’s [60 day] report-and-return re-quirement are not coextensive.”

While not directly at issue in this case, providers should be aware that HHS’s Centers for Medicare and Medicaid Ser-vices (CMS) recently finalized regulations addressing the meaning of “identify” for purposes of returning overpayments in the Medicare managed care arena. Those regulations require recipients of federal funds to act with “reasonable diligence” and state that an entity has “identified” an overpayment when it “has determined, or should have determined through the ex-ercise of reasonable diligence that it has received an overpayment.”

The defendants moved to dismiss the government’s suit on September 22, 2014. The government’s opposition brief was filed on November 10, 2014. The Court has not yet set a hearing or decision date in the matter.

Alec Alexander is a Partner in the Health Care Practice Group of Breazeale, Sachse & Wilson (BSW). Prior to joining BSW, Alec served from 2010 until 2014 as Chief Compliance Officer for CHRISTUS Health Louisiana. From 2002-2010 he served as an Assistant United States Attorney in the Western District of Louisiana focusing on health care fraud enforcement. He was responsible for the investigation, litigation and disposition of all False Claims Act and whistleblower matters in the Western District and led other False Claims Act prosecutions with national scope.

Court to Address Meaning of “Identified” Overpayments under ACA’s 60-day Rule

Willis-Knighton’s Radiation Therapy Proton Unit, continued from page 5

Payers Magazine, MD Anderson Center Center analyzed the total cost of head and neck care between IMRT and IMPT and found proton therapy more cost effective, as well as easier on the patient.

With protons, the tongue and other critical structures of the mouth were avoided, thus less pain, no loss of saliva-tion, weight maintenance, no feeding tube placement and time-consuming re-plan-ning and re-scanning.

Rosen concluded, “Proton therapy

has always been the next logical step after IMRT and IGRT therapy, but has been prohibited in the past by cost, space and over the last 40 years, limitations in the technology itself. But that has all changed.”

Willis-Knighton Cancer Center is on the campus of and part of the Willis-Knigh-ton Health System in Shreveport, Louisi-ana, a nonprofit community healthcare organization since 1924, with a variety of specialized medical institutes and centers.

Further ReadingFive-Year Outcomes from 3 Prospective Trials of Image-Guided Proton Therapy for Prostate Cancerwww.redjournal.org/article/S0360-3016(13)03310-5/fulltext

Oncology Payersissuu.com/magazineproduction/docs/oncology_payers_issue_1_0814_ezine


By TEd GRIGGS

A new triple-degree program created by LSU’s Biological and Agricultural En-gineering Department and the Health Sciences Center – New Orleans will cre-ate research opportunities, and applica-tions for that research, that might not otherwise exist.

The “Fast Path” program slices one to three years from the 12 to 13 years it would normally take a student to com-plete an undergraduate biomedical en-gineering degree, medical school and a PhD.

“What this program also does is it strengthens both programs, the medical school programs and the engineering school’s programs,” said Dr. Jo-seph Moerschbaecher, LSU Health New Or-leans vice chancellor for academic affairs. “It brings our research in-terests together … with specialized engineers and specialized biomedical researchers collaborating on certain research projects that neither one could do alone.”

The program allows students to go from one program at the bachelor’s level all the way to an MD and PhD in a seam-less manner, he said.

The prospects for translational re-search in orthopedics and prosthetics, through advances in electronics, micro-engineering, nano devices, and micro motors are tremendous, Moerschbaecher said. Students and researchers will be able to take advantage of the biomedical re-search opportunities at the new VA Hos-pital in New Orleans, which is scheduled to open in the next year or so.

However, in order to take advantage of those opportunities, students must first qualify for Fast Path. The requirements include a score 30 or higher on the ACT and “significant” Advanced Placement credits in math, English and some arts, humanities, and social sciences.

Only 10 students will be admitted each year. And Moerschbaecher thinks finding students to fill even that limited number of spots will be difficult.

“I think it would have to be a spe-cial student that’s going to want to do this, OK?” Moerschbaecher said. “And it’s a student that’s probably really going to want to focus on a career in academic medicine as opposed to private practice.”

Fast Path students will have to really be into engineering, and they will have to be passionate about taking their medical training and translating it using their en-gineering degrees, he said.

The LSU College of Engineering ex-pects the degree program will also serve as a platform for developing a Biomedi-cal Engineering Research Institute. Since Hurricane Katrina in New Orleans has

seen a flood of young entrepreneurs and the development of a biomedical dis-trict. Graduates of Fast Path would have a number of career options: academia, research in an institution outside or con-nected to academia, or meeting residency requirements to practice medicine

The as-yet-to-be created institute would focus on translational research, the bench-to-bedside or bedside-to-practice

applications that benefit patients and the com-munity.

Dr. Steve Nelson, dean of LSU Health New Orleans’ School of Medicine said in addi-tion to advancing health-care for patients, the program will also create

jobs for Louisiana.Moerschbaecher said typically the

research developed at a university is pat-ented and usually – say 75 percent of the time – those discoveries are spun out as licenses to existing companies or to start-ups.

Technology offers lots of promise for newly established businesses, he said. The

LSU Engineering, Med School Fast Track BS/MD/PhD Program


Dr. Joseph Moerschbaecher

Dr. Steve Nelson


By JULIE PARKER

Five years ago, the 400-bed Boca Raton Regional Hospital in Florida faced a crush of Medicare audits and penalties. The 47-year-old, not-for-profit hospital made a significant change resulting in a complete turnaround by employing an en-tity with which many healthcare providers remain unfamiliar: the health information handler (HIH).

“According to hospital officials there, the previous process had been cumber-some, and meant print-ing, sorting, packaging and mailing documents to Medicare to sup-port claims and to ad-judicate their bills,” said Lindy Benton, CEO of Norcross, Ga.-based Medical Electronic At-t a c h m e n t / N a t i o n a l Electronic Attachment (MEA/NEA), a certified HIH that has electronically deliv-ered and tracked patient medical records for healthcare providers nationwide via CONNECT, an open source health in-formation exchange software that serves as the National Health Information Net-work’s (NwHIN) transmission mode for esMD (electronic submission of medical documentation). “Since one patient re-cord can fill a box or more, hospitals are left paying for all materials, labor and shipping involved … enormous financial considerations for every organization.”

Because the Boca Raton hospital is now able to submit documents electroni-cally via an HIH, the Medicare audit process has dramatically improved and denials related to untimely submission of records have disappeared entirely, Benton noted.

Benton explains: “For example, Medicare allows 45 days from the date of request for hospitals to respond, but Medi-care still sends documentation requests by paper. Typically, by the time the request arrives at the proper hospital department, more than 10 days has elapsed. Manag-ing the entire process requires a very strict time requirement and hospitals often fail to return records to Medicare on time, which blocks hospitals from making ap-peals. By automating the process and se-curely depositing electronic attachments to Medicare’s official information portal, Boca Raton Regional Hospital has pre-vented the loss of at least $350,000.”

What exactly is a health information handler?

The Centers for Medicare & Medic-aid Services (CMS), which manages the HIH program, defines an HIH as “any organization that handles health informa-tion on behalf of a provider.” HIHs are often referenced as claim clearinghouses,

release of information vendors, and health information exchanges (HIEs), and most also provide esMD gateway services.

“esMD is still a work in progress, an ongoing experiment, spearheaded by CMS to support electronic exchange of information between health systems and Medicare audit contractors,” explained Benton. “Prior to esMD, providers had just two ways in which to respond to docu-mentation requests from Medicare review audit contractors – mail or fax. esMD fixed that problem.”

The esMD gateway isn’t set up like a typical website, Benton pointed out.

“Not everyone wanting to submit information via the gateway can simply jump on, upload files and press the ‘send’ button,” she noted. “To interact with CMS through esMD, organizations need access to the portal. The gateways are costly to develop and maintain so hospitals and providers turn to HIHs to facilitate the exchange process. HIHs build and service an esMD gateway for multiple provider participants and submit electronic docu-mentation on a provider’s behalf. As more providers use HIHs to simplify their audit processes, electronic health information exchange also will increase in usability.”

Slated improvements are poised to further streamline this process. The HIH program has been effective for more than three years – phase 1 went into effect on Sept. 15, 2011 – and phase 2 will allow providers the ability to receive electronic documentation requests when their claims are selected for review … when CMS launches it.

“From a business and enterprise per-spective, the move by CMS to launch the program has meant the growth of a number of HIH firms like ours that offer a variety of services and skill sets,” said Ben-ton. “In addition to providing exchange capabilities, some allow for capture of information, scanning, storage and trans-mission in a secure manner. The HIHs also track data sent, and acknowledge and verify that it’s been received by auditors through the gateway … are considered business associates of the organizations they serve, and are required by CMS to follow HIPAA rules.”

Challenges remain, emphasized Ben-ton.

“There are hurdles to widespread implementation as hospitals resist using the solutions because they’re over-whelmed with current technology,” she said. “They’re already so invested in other projects that many are unable to see the benefits of bringing on additional solutions and being able to exchange information with CMS. A prevailing thought is that those managing hospital IT departments simply are overwhelmed and growing ever

Benefitting from ‘Health Information Handlers’

Lindy Benton

January– Public Health/Infectious Disease– Health Law

February– Cardiology– Mergers & Acquisitions

March– Oncology– Healthcare Marketing April – Behavioral Health & Addiction– ICD-10/Practice Management

May – Women’s Health– Health Information Technology

June – Men’s Health– Patient Care Models

July – Personalized Medicine– Medical Schools/CME

August – Ortho/Sports Medicine– Compliance Mandates

September– Pediatrics– Reimbursement

October – Neurology– Health Education

November– Environmental Health/Medicine– Audits/Compliance

December– Pharmaceuticals– Financial/Tax Planning

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Baton Rouge, New Orleans, and Houma/Thibodaux Scott Cavitt • [email protected] • (337) 255-4600

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2015 Editorial Calendar



By CINdy SANdERS

Perhaps it should come as no surprise that there is a major divide between what Americans should do and what is currently being done when it comes adopting healthy cardiovascular lifestyle habits.

Based on data from the Framingham Heart Study – the landmark research proj-ect founded in 1948 by the National Heart, Lung, and Blood Institute – a recent multi-institutional study found few in the United States hit the mark … or even come close … in terms of scoring well on the American Heart Association Cardiovascular Health score (CVH score).

“Ideal Cardiovascular Health: Asso-ciations with Biomarkers and Subclinical Disease and Impact on Incidence of Cardiovascular Dis-ease in the Framingham Offspring Study,” which initially published online in Circulation late last fall, investigated the correla-tion between the seven lifestyle factors used to calculate the CVH score and cardiovascular disease (CVD)

incidence. Multiple past epidemiological studies have shown the correlation between the risk factors and cardiovascular events.

The seven factors used collectively to calculate the CVH score are: 1) non-smok-ing status, 2) body mass index, 3) physical activity, 4) diet, and a favorable profile of 5) serum cholesterol, 6) blood pressure, and 7) blood glucose.

“The better your score, the lower your cardiovascular risk as evidenced by less subclinical atherosclerosis and a lower risk of future cardiovascular events,” noted Thomas J. Wang, MD, director of the Division of Cardiovascular Medicine and physician-in-chief for the Vanderbilt Heart and Vascular Institute in Nashville and a co-author of the study.

“We know a lot of the health practices that are associated with better cardiovascu-lar outcomes, but there seems to be a dis-connect,” added the professor of Medicine at Vanderbilt University Medical Center.

Of the main findings, Wang contin-ued, “The number of individuals who had ideal cardiovascular health scores was low meaning the number of individuals who adhered to five or more of these healthy lifestyle practices was low.”

In fact, he added, only 1 percent of the Framingham participants included in the data (mean age 58 years; 55 percent women, no overt signs of CVD) had opti-mal marks for all seven. “Fortunately, hav-ing zero healthy lifestyle practices was also uncommon at about 1 percent of people. Most people did at least one thing associ-ated with good cardiovascular health,” Wang said.

However, more than 8 percent did fail to meet the ideal CVH score for at least six of the seven lifestyle factors. “The vast majority of people were at four and below … 18 percent fell between five and seven,” he continued of scoring well on the seven benchmarks.

“The fact that such a small number of people actually meet all of the cardiovas-cular health criteria highlights that there is still a big gap with current lifestyle prac-tices,” he stated.

The group studied originated with the Framingham Offspring cohort par-ticipants attending the sixth examination cycle (1995-1998) when a routine assess-ment of subclinical disease was performed along with assays of multiple biomarkers. From the original group of 3,532 potential

participants, more than 850 were excluded for a variety of reasons ranging from preva-lent CVD to unavailable concentrations of biomarkers. While Wang said none of the final sample of 2,680 participants had overt heart disease at the beginning of the study, during the 15 years the cohort was followed after the baseline examination, a significant number of them developed cardiovascular events. He noted those who developed a CVD event tended to have lower CVH scores at baseline.

“I think people feel as if we’re making a lot of progress with cardiovascular dis-ease, which is true … but it’s still the num-ber one cause of death in America,” Wang stressed.

“Physicians could probably do a better job of encouraging their patients to adhere to these healthy practices and give them strategies for adherence, and patients need to do a better job of adhering to them. I think, as with all things in medicine, it is a joint effort,” Wang said.

While the study findings might seem intuitive to some extent, Wang pointed out, “It is important to continually remind physicians about the fundamental impor-

Affairs of the HeartAmericans & Cardiovascular Health

Dr. Thomas J. Wang


CARDIOLOGY


Affairs of the Heart, continued from page 9

AHA Releases Updated Worldwide, U.S. Heart & Stroke Statistics

Last December, the American Heart Association/American Stroke Association released updated heart and stroke statistics in the United States … and, for the first time in the 50 years such information has been provided, added a global perspective with health data compiled from nearly 200 countries.

Key findings from “Heart Disease and Stroke Statistics 2015 Update” include:Heart disease remains the No. 1 global cause of death with 17.3 million

deaths annually. The annual death toll is expected to rise to more than 23.6 million by 2030, according to the report.

Stroke, which has fallen to the No. 4 cause of death in the United States, remains the No. 2 cause of death in the world. Although the number of deaths per 100,000 declined worldwide between 1990 and 2010, the number of people having a first or recurrent stroke increased each year, reaching 33 million in 2010.

In the United States, nearly 787,000 people died from heart disease, stroke and other cardiovascular diseases in 2011. Nearly 2,150 Americans die daily from cardiovascular diseases … or one person every 40 seconds … accounting for approximately 1 in every 3 deaths in this country.

Additionally, about 85.6 million Americans are living with some form of cardiovascular disease or the after-effects of stroke.

The AHA estimates direct and indirect costs of CVD and stroke in this country to be more than $320 billion.

Breaking heart disease out separately from stroke in America, heart disease remains the number one killer in the United States with more than 375,000 dying annually … or about one person every 90 seconds.

Nearly half of all African-Americans have some form of cardiovascular disease and more than 39,000 died from heart disease in 2011.

On the plus side, the death rate from heart disease fell about 39 percent between 2001 and 2011. The physical and cost burden, however, remain incredibly high. About 735,000 people in America have heart attacks each year (accounting for approximately 120,000 deaths), and cardiovascular procedures and operations increased around 28 percent between 2000 to 2010.

By CINdy SANdERS

According to recent American Heart Association statistics, there is a great deal of work to do to improve ‘Life’s Simple 7’ … the seven key health factors and behav-iors that increase risk for heart disease and stroke. Below is a sample of key findings from the latest statistical update.

SmokingWorldwide, tobacco smoking and sec-

ondhand smoke was one of the top three leading risk factors for disease and contrib-uted to an estimated 6.2 million deaths in 2010.

Despite improvements in smoking rates and education, 16 percent of stu-dents grades 9-12 report being current smokers. Among adults, 20 percent of men and 16 percent of women are cur-rent smokers.

Physical ActivityAlmost one-third of adults in the

United States, 31 percent, report partici-pating in no leisure time physical activity.

Among students 9-12, only about 27 percent meet the AHA recommendation of 60 minutes of exercise every day.

Healthy DietLess than 1 percent of American

adults meet the AHA’s definition of ‘ideal healthy diet’ and essentially no children met the definition. Increasing whole grains and reducing sodium remain two of the biggest challenges.

Research between 1971 and 2004 showed American women consumed an average of 22 percent more calories and men an average of 10 percent more by the end of that time frame.

Overweight & ObesityMore than 159 million U.S. adults …

69 percent … are overweight or obese.Additionally, nearly one-third of

American children … 32 percent … are overweight or obese with about 24 million

being classified as overweight and 13 mil-lion as clinically obese.

CholesterolAbout 43 percent of Americans have

total cholesterol of 200 mg/dL or higher, and about 13 percent of Americans have total cholesterol over 240 mg/dL.

About 33 percent of Americans have high levels of LDL and around 20 percent have low levels of HDL.

High Blood PressureAbout 80 million U.S. adults, or 33

percent, have high blood pressure. Of those, about 77 percent are using antihy-

pertensive medication(s) but only about 54 percent have their condition controlled.

Hypertension is projected to increase by about 8 percent by 2030.

Rates of high blood pressure in Afri-can-Americans are among the highest of any population in the world. In the United States, 46 percent of African-American women and 45 percent of African-Ameri-can men have high blood pressure.

Blood Sugar/DiabetesAbout 21 million Americans … or

nearly 9 percent of the adult population … have diagnosed diabetes. Another 35 percent of Americans have pre-diabetes.

How We Stack Up on the Seven CVH Score Factors

tance of healthy lifestyle factors in lower-ing the risk of cardiovascular events.” He added, “It also serves as motivation for the scientific community to better understand the biological mechanisms linking lifestyle factors such as diet and exercise to lower cardiovascular risk.”

Wang recognized medical interac-tions occur in very tight timeframes these days, which makes it difficult for providers to cover the full spectrum of useful infor-mation with patients. However, he noted, there are a number of organizations at the

national level – including the American Heart Association and National Heart, Lung, and Blood Institute – that offer excel-lent tools and resources that can be printed or accessed online to help patients better understand the importance of healthy life-style strategies.

“It’s clear that a better lifestyle would not just be associated with better cardio-vascular outcomes but also with less death from cancer and other diseases, as well,” Wang concluded of the critical need to change American habits.

$155 billion worth of cuts to Medicare and other payments over a decade to help the federal government pay for other improve-ments. Those cuts were supposed to be offset in large part by increasing the number of patients with insurance. So far, Obamacare enrollment hasn’t been as robust as originally projected.

For now, it remains unclear how many pa-tients hospitals are helping get advice with enrollment or are actually enrolling. Salles said he has heard anecdotally that signups in some areas have been brisk, and that Louisiana hospitals are better organized this time around.

A year ago, the enrollment efforts were less coordinated, Salles said. Some of the navigator rules weren’t in place until shortly before the open enrollment period began. As a result, people were getting certified as navigators right up until the last minute.

“Now that it’s gone through the first year, it’s a bit more organized,” Salles said.

A year ago, Ochsner Health System was one of the few providers that had navi-gators and agents on-hand to help patients. The system is again offering onsite enroll-ment at all of its hospitals.

Ochsner recognizes the “tremendous value” of the coverage, premium subsidies and benefits available through Healthcare.gov to patients and people without health insurance, said Patti Muller, vice president, Commercial Development.

Ochsner is a Champion for Coverage offering education to the community in all of its hospitals. The health system is also a Certified Application Counselor Organiza-

tion offering on-site enrollment assistance to anyone seeking assistance with applying and enrolling into coverage. In addition to these two Centers for Medicare and Medic-aid Services designations, Ochsner has also partnered with Health Agents for America to offer help through certified health insur-ance agents across the health system.

“Our goal is to convert as many un-insured patients and individuals to become fully insured health insurance card carrying patients and individuals, giving them peace of mind and access to care for themselves and their families,” Muller said.

B. Ronnell Nolan, president and CEO of Health Agents for America, said Loui-siana is the only state where hospitals and insurance agents are coordinating efforts to help people get help with ACA enrollment.

The association hopes to achieve that kind of effort nationwide, Nolan said.

Meanwhile, although the expected ACA coverage increase has yet to emerge, the law does provide hospitals with a major savings avenue. In 2014, then U.S. Health Secretary Kathleen Sebelius gave the OK to charitable foundations, including those of hospitals, to help pay for patient premi-ums through Health Insurance Market-places.

Some hospitals are using their foun-dations to buy coverage for so-called “fre-quent flyers,” patients who repeatedly visit emergency departments each year for chronic conditions. These patients, 1 per-cent of the population, account for roughly 20 percent of all healthcare costs.

Salles said there could be some Louisi-ana hospital foundations making “one-off” enrollment decisions for these patients. But he hasn’t heard of any systematic efforts to enroll high-cost patients.

Paul Salles

Louisiana Hospitals, continued from page 1


Dr. Ann Marie FlanneryPEDIATRIC NEUROSURGEON

Dr. Flannery’s office is located in the Kids Specialty Center

4704 Ambassador Caffery Parkway, Lafayette.For appointments call 337-371-3101

or 1-877-302-2731.Womens-Childrens.com

Ann Marie Flannery, M.D. is board certified in pediatric and adult neurosurgery. She specializes in the diagnosis, management and treatment of children’s surgical and traumatic nervous system conditions, including: traumatic injuries of the brain, spine and nerves; gait abnormalities (spasticity); craniosynostosis (skull abnormalities); excess water on the brain (hydrocephalus); brain and spine tumors; and other surgically-treatable abnormalities of the nervous system.

Dr. Flannery has almost 30 years of experience in the field of neurosurgery, specializing in pediatric and general neurosurgery. Most recently, she has been leading a group of pediatric neurosurgeons in developing evidence-based guidelines for the treatment of common pediatric neurosurgical disorders.

By JULIE SPEEd

Hospitals are investing more in creat-ing outpatient service departments to meet rising patient demand while simultane-ously reducing inpatient surgical procedures and generating new rev-enue streams, said Matt Malone, CPA, a mem-ber of HORNE’s Health Care Valuation specializ-ing in physician contracts.

“The Stark law is implicated in post-acqui-sition employment arrangements because physician compensation is required to be consistent with fair market value (FMV),” said Malone, adding “the federal anti-kick-back statute is implicated because of the referral relationship between the newly-em-ployed physician and the hospital-employer. To mitigate compliance risk and document the determination of FMV physician com-pensation, most hospital internal processes and some third-party independent apprais-ers rely primarily on published survey data to assess the relative value of the physician’s service. Widely available physician com-pensation surveys assist with benchmarking

and evaluating compensation and provide a look at physician compensation and pro-duction in an array of metrics.”

Those surveys aren’t without their weaknesses, Malone said, and simple re-liance on compensation and production survey data to create a FMV compensation model often isn’t enough to derive FMV physician compensation.

An issue with physician compensation data, as reported in some of the market sur-veys, is self-reported information, including some portion of ancillary technical compo-nent profi ts, said Malone.

“Consider for example, a physician group practice that internally distributes profi ts from in-offi ce ancillary services, such as imaging or clinical lab services, versus a hospital-controlled group that retains the billings and profi ts from the same services,” he explained. “In this example, physicians from the group practice would report higher compensation due to the ‘baked in’ ancillary profi t, while physicians employed by the hospital-controlled group would re-port lower compensation.”

However, market surveys simply aver-age responses regardless of clear differences in the practices. Those differences create a challenge for administrators relying on mar-

ket data to determine compensation levels where no ancillary technical component profi ts are present, such as in direct hospital employment of physicians. The market data doesn’t self-adjust for this obvious discrep-ancy, nor does it provide information to help assess TC-free adjusted rates, said Malone.

However, he added, the market gravi-tates toward unadjusted survey numbers, as the hypothetical physician considering employment amongst other available alter-natives, generally wouldn’t be expected to ac-cept employment at adjusted, TC-free rates.

“Prudent practice indicates the use of multiple valuation approaches and methods in determining FMV physician compensa-tion, a practice that’s advantageous when considering the shortcomings pointed out by many thought leaders regarding the use of market data only,” Malone said. “In one such approach, the income approach, the valuator analyzes the historical and ex-pected fi nancial statements. Adjustments to account for non-professional services … an-cillary income now retained by the hospital-employer outside the practice’s operations … are applied to refl ect the true operation of the physician’s practice.”

Adjustments to arrive at the applicable basis of accounting, and also normalizing

adjustments to account for non-recurring or extraordinary items, are also applied to yield net professional economic earnings, which is the income the physician is able to generate from professional services and what’s used as the basis of compensation. A signifi cant by-product in the application of the income approach is in recognizing spe-cifi c economic dynamics present within the practice and local market, including rates paid by payers specifi c to the local practice, said Malone. The application of multiple approaches culminates in the synthesis and reconciliation process, at which point all methods are assessed as more or less reliable based on such factors as reliability of data and pertinence to the subject arrangement.

“A position taken solely in reliance on surveys can be weakened by nature of the data,” he said. “A deeper dive to under-stand the survey data, coupled with the use of other approaches and methods, can help mitigate the risk of miscalculating FMV compensation.”

The income approach in particular adds additional credibility to the analysis when ex-ecuted correctly, said Malone, noting that experienced valuators can play a vital role by assisting hospitals in navigating the complex FMV physician compensation process.

Determining Fair Market Value of Physician Compensation Horne’s Matt Malone discusses ‘the devil in the details’

Matt Malone


By JULIE PARKER

When Beverly Smallwood, PhD, was making the rounds discussing her candidly writ-ten book and video training program, This Wasn’t Sup-posed to Happen to Me: 10 Make or Break Choices When Life Steals Your Dreams and Rocks Your World, based on many adversities she and others had overcome, she admittedly thought most of her woes were behind her.

However, life stopped Smallwood in her tracks on Aug. 25, 2014, a typical Monday packed with clinical client ap-pointments.

“I’d received a call from the jail of a neighboring county, asking if I could come and evaluate an inmate that was causing all kinds of problems by behaviors as ex-treme as smearing feces on the wall,” recalled Smallwood, a psycholo-gist specializing in coun-seling trauma survivors. “As you might imagine, they were quite eager to get him transferred to a hospital for mental treat-ment. I agreed to help.”

Around 5:45 pm, Smallwood was in the midst of the 30-min-ute journey on a state highway, traveling 55 mph in the right lane.

“Suddenly, there was a loud crash, the sound of breaking glass, and chaos as the car was tossed this way and that,” she recalled. “Then the vehicle came to a stop, smoke coming into the car. The airbags

were all deployed, and my seatbelt was

still intact.”S m a l l w o o d ’ s

Nissan Murano was totaled; the Jaws of Life

were needed to pry her from the twisted metal.

Her left hip was broken in two places, along with

other painful injuries that would keep her in the hospi-

tal for fi ve weeks.Smallwood later learned a

woman driver with only minimal liabil-ity insurance had sped across two lanes from the opposite side, never slowed down in the median, and plowed directly into her SUV.

“That was the beginning, but not the end of the ordeal,” recalled Smallwood, who endured surgery and had begun the lengthy rehabilitation process when an-other family tragedy occurred. “Ten days after my accident, the unthinkable and unimaginable happened. My beloved old-est grandchild, Joseph, committed suicide. It was a total shock. Joseph was a wonder-ful Christian boy who’d never given his parents a minute’s trouble.”

In addition to the unspeakable grief of losing her grandson, Smallwood felt the additional pain of being unable to be there to comfort her daughter, Amy, son-in-law and Joseph’s two brothers.

“The shock, grief, and every emotion in the human psyche have been almost unbearable,” she said. “But I knew that I had purpose and that I still had work to

do. So I hung on.” Then, just before Christmas, Small-

wood’s family suffered another devastat-ing loss when news broke that her former brother-in-law had been found dead, ap-parently from foul play. At press time, the case remains under investigation.

“In all of these experiences, I’ve had to be absolutely in submission to and dependence on God and to put the ‘10 Choices’ to work as never before,” said Smallwood. She still uses a walker and a cane to move around, just returned to the driver’s seat in December, remains unable to sit for more than 45 minutes without signifi cant pain, and refuses or minimizes potentially addictive pain medication.

“I’d experienced tragedy and trauma before in my life, and walked through hor-rifi c places with thousands of others in my clinical practice at The Hope Center and in my seminar audiences,” she said. “But these experiences, piled on top of each other, were defi nitely dream-stealers and world-rockers. It hasn’t been easy.”

Smallwood took her own advice and turned her worries over to a higher power.

“So many amazing things have hap-pened that can only be attributed to God’s mercy,” said Smallwood. “I remember being in the hospital after hearing the news about Joseph when the bank called, saying I was in the hole and needed $4,500 that day to cover overhead expenses. I wasn’t in a position to work, obviously, so I told the banker I’d call her back. I put the situation in God’s hands. That afternoon, my assistant pulled a check from the mail for $5,000 from a forensic case that was

considerably past due. The timing! That’s just one example. It’s happened over and over.”

Smallwood’s also learned afresh the power of social media. Her continuous candid and hopeful Facebook updates have received thousands of thumbs up from friends, family, and supporters.

“I’m not sure exactly where all this is taking me, but it’ll continue to center around my life’s mission to help bring out the best in people,” said Smallwood, who acknowledged the physical limitations and rehabilitation process have spurred her to consider work she might not have done otherwise. While she will still do some counseling and coaching of other therapists at The Hope Center, she’s also implementing new ways of helping people. For instance, she’ll soon co-launch an on-line leadership training program, Leading in Good Faith, with fellow leadership ex-pert Barry Banther. Additionally, she and her daughter Amy, Joseph’s mother, will unite as consultants and team developers with Rodan & Fields, an anti-aging skin care program developed by two world-renowned dermatologists.

“Even when you experience losses that rob you of physical abilities or impor-tant relationships, you don’t quit,” Small-wood said. “As long as you’re breathing, you have purpose. Sometimes, it just re-quires a little adjustment to fi gure out how you fulfi ll your purpose in a changed life situation.”

In the last six months, Smallwood has reached a deeper realization that every-thing in life can shift and change in an in-stant, often through no fault of one’s own.

“I can remember lying fl at of my back in that hospital bed, unable to move or get up on my own, and humbly dependent on healthcare workers for the most embar-rassing and intimate of personal care,” she said. “I’ve found that every source of se-curity other than God can be taken away. In my case, I lost my health, my ability to work, my independence, and even the ability to live out the strong value of family support. But I didn’t lose my faith. What you learn in the valley far surpasses what you typically learn on the mountaintop.”

Overcoming an Abundance of AdversityPopular motivational speaker and psychologist lives the meaning of “Physician, Heal Thyself”

Dr. Beverly Smallwood

When Beverly Smallwood, PhD, was making the rounds

and others had overcome, she admittedly thought most of her woes were

and my seatbelt was still intact.”

Nissan Murano was totaled; the Jaws of Life

were needed to pry her from the twisted metal.

Her left hip was broken in two places, along with

other painful injuries that would keep her in the hospi-

tal for fi ve weeks.Smallwood later learned a

Psychologist Beverly Smallwood, PhD, established The Hope Center in 1984 for counseling and evaluation services, and Magnetic Workplaces ™ for corporate leadership and teambuilding programs. A frequent motivational speaker, her audiences are worldwide.

New Orleans BioInnovation Center has a number of startups run by students and/or graduates from both LSU and Tulane University.

Moerschbaecher said the new degree program came together fairly quickly, a year or so after faculty members began to discuss the idea.

“Faculty members can get together and talk and say, ‘It would be neat if we could do this and do that,’” Moersch-baecher said. “But they have to have the support of an administration.”

LSU President King Alexander is very, very supportive of these types of collaborative research and educational activities, Moerschbaecher said. King’s backing and encouragement was criti-cal to rapidly organizing Fast Path and launching it as quickly as it has been.

Moerschbaecher is hoping that the early excitement about the program will

result in long-term accomplishments.“I think 10 years from now we should

have a thriving, active program that’s spun off some signifi cant translational research, that has generated some really important cooperative research with the VA Hospital, that has attracted students that might otherwise leave Louisiana or not even consider Louisiana in terms of their higher education curriculum,” he said. “I’d hope it would be somewhat of a magnet for students, bioengineering fac-ulty, and biomedical research faculty to bring them into New Orleans, into Baton Rouge, to generate signifi cant victories, if you will, in terms of translational re-search.”

The key to maintaining enthusiasm about Fast Path will be making sure that people are kept abreast of how students are doing and how the program has pro-gressed, he said.

LSU Engineering, Med School Fast Track, continued from page 7

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By CINdy SANdERS

After a record-setting year of mergers and acquisitions in the healthcare sector for 2014, a recent survey by U.S. audit, tax and advisory firm KPMG LLP indicates 2015 will offer more of the same.

A number of considerations ranging from cash-rich balance sheets to changing business models driven by the Affordable Care Act to easier access to capital are ex-pected to fuel the continued feeding frenzy for those looking to enlarge their corpo-rate footprint. Conversely, for those facing increasingly tight margins and regulatory oversight, the timing could be right to take the money and run.

“We are seeing a convergence of fac-tors facing providers, health plans, and drug and device makers that are forcing them to make tough decisions about strategy,” noted Bill Baker, the national partner in charge of transaction services for KPMG’s Healthcare & Life Sciences Practice. He added those hard decisions sometimes include selling their business or practice.

Texas-based Baker, continued, “Tech-nology, regulation, consumerism and push-back from employers and government payers are reshaping all facets of healthcare, forcing companies to review all of their op-tions. The capital markets – low interest rates and strong valuations – are creating favorable conditions for those considering selling or divesting assets.”

The Year That WasThe Associated Press recently reported

2014 was one of the most active years for healthcare M&A activity in the last decade. KPMG noted that through the first three quarters of 2014, deal value across all indus-try sectors reached nearly $1 trillion, return-ing the United States to pre-recession levels.

Irving Levin Associates, a leading healthcare market intelligence firm based in Connecticut, seconded the sentiment with data showing similar transaction increases specific to the healthcare industry. In nine of 13 healthcare industry sectors, there were an increased number of deals for 2014 in comparison to 2013. Through Dec. 19,

2014, Levin’s The Health Care M&A In-formation Source had captured 1,208 deals across healthcare, which was an increase of 17 percent over 2013. Spending also was up significantly for deals in 2014 v. 2013 at $386 billion compared to $163 billion.

Leading the way in transactions was eHealth (up 65 percent in 2014) and bio-technology (up 50 percent). Long-term care, managed care, pharmaceuticals, rehabilita-tion and other services also had double digit increases in deal activity for 2014 over 2013.

Behavioral health and medical devices had more modest gains at 6 percent and 4 percent, respectively. However, transactions are anticipated to be strong in the coming year. Nashville-based Acadia Healthcare led the way in the behavioral health mar-ket with a fourth quarter announcement the company would purchase CRC Health Group out of Cupertino, Calif., which has more than 140 programs treating 44,000 patients daily. The transaction, estimated to be valued at nearly $1.2 billion, is expected to close in the first quarter of 2015.

2015 M&A Outlook SurveyLooking ahead, KPMG, in collabora-

tion with SourceMedia’s Research Practice Group (publisher of Mergers & Acquisi-tions), surveyed 738 M&A professionals in the United States last fall about anticipated activity across a broad spectrum of indus-tries. Survey participants work in senior management at companies advising an array of industries including healthcare, en-ergy, financial services, technology, manu-facturing, and consumer products.

Of those surveyed, a full 82 percent said they were planning at least one acquisition in 2015 and 10 percent said they expected to do 11 or more deals this coming year. Perhaps not surprisingly, deals touching the health-care industry, which is in the midst of trans-formative change, were predicted to lead the way with 84 percent of the experts saying they expected heavy healthcare activity.

Almost half of respondents (47 percent) expect technology companies, including those tied to the healthcare industry, to be the most active individual industry sector for mergers and acquisitions. Coming in second, nearly one-third of the profession-

als anticipate pharmaceuticals and biotech-nology to be the most active M&A sector in 2015. Expiring patents for a number of leading drugs plus the need to hone product portfolios to build ‘franchises in key treat-ment categories’ are two factors behind the anticipated jump in activity for the pharma/biotech industry.

Additionally, 27 percent of the experts think healthcare providers are ripe for con-solidation and cited forces tied to the ACA as being the primary driver of such moves. However, regulatory factors are expected to play an increasingly prominent role in de-cision-making on the front end considering the Federal Trade Commission’s scrutiny of several large deals last year.

Among those being surveyed, some due diligence issues were seen as a bigger factor within the healthcare industry than in other sectors. In addition to how a merger or acquisition might impact the competi-tive landscape, healthcare providers also are perceived as being more concerned about cultural shifts when joining forces. The ex-perts cited the cultural assessment as being a larger factor for healthcare companies in comparison to all industries (32 percent v. 28 percent).

“Mergers and acquisitions are never easy for everyone involved,” Baker pointed out. He added that negotiating a favorable and mutually acceptable transaction is just the first step. “Managing the various stake-holders of ownership, employees, customers and vendors during an integration process can be daunting … and, if not executed properly, can destroy the very benefits the transaction was modeled on generating,” Baker said.

Another due diligence issue expected to factor prominently in healthcare transac-tions is volatility of future revenue streams, which was cited as a key issue among re-spondents for healthcare companies at a rate of 58 percent as opposed to ‘all industries’ at 51 percent. Interestingly, ‘quality of earn-ings,’ while still a key due diligence factor for the healthcare sector, trailed industry aver-ages at 29 percent for healthcare companies compared to an average of 42 percent for all industries.

By JULIE PARKER

ST. LOUIS – When Francine Kaufman, MD, was completing an endo-crinology and metabolism fellowship at the Children’s Hospital of Los Angeles, part of the University of Southern Cali-fornia (USC) School of Medicine, she be-came intrigued with finding a clinically proven way to control blood sugar for six to nine hours for patients who have trouble man-aging blood glucose.

“During my fellow-ship in the late 1970s, I watched my patients with diabetes convert from having a tremendous amount of high glucose all the time to ex-periencing significant hypoglycemia,” said Kaufman, a world-renowned pediatric endocrinologist and former president of the American Diabetes Association. “Back then, we didn’t have evidence that showed how controlling glucose even mattered. It wasn’t scientifically validated until 1993.”

Also in the early 1990s, scientists were beginning to use uncooked cornstarch to treat glycogen storage disease, a very rare ailment in which glucose values cannot be controlled because the liver blocks stored glucose from being released.

“Children with glycogen storage dis-ease are profoundly hypoglycemic all the time,” she said. “We were feeding them grams and grams of cornstarch four to six times a day. So I began thinking there must be some way to use a little bit of very complex starch to be slowly released in combination with protein.”

In the late 1990s, when final evidence validating the importance of controlling glucose was published, Kaufman began experimenting in her own kitchen to come up with a complex carbohydrate formula in food form for diabetes and weight man-agement.

“I thought many of my patients didn’t have adequate meat or dairy pro-tein, so I embraced an alternate form,” said Kaufman, an early advocate of soy protein.

The first food product she developed, adding protein to the sugar-free pudding concept, was something her children jok-ingly called a “vanilla pudding brick.” The key ingredient was uncooked corn starch, a low-glycemic carbohydrate that metabolizes slowly and helps to control blood sugar for longer than anything else on the market.

“The cornstarch made it quite thick,” she said, with a good-natured laugh. “At that point, I wasn’t concerned much about taste. To me, it was just a big sci-ence project. A bonus was that my family learned I could cook, which nobody really believed!”

That “vanilla pudding brick” served as an “a-ha” moment for Kaufman, who

recognized that using a more mature and scientifically validated formula could translate to mass production.

Kaufman received assistance through USC’s commercialization program on securing patents and worked on scien-tifically validating the product. Kaufman also teamed up with a former Eli Lilly as-sociate, who saw the potential for launch-ing the product nationwide, even though

the marketplace was quickly becoming flooded with “nutrition bars.” Together, they established Extend Nutrition and collaborated with food scientists to final-ize the formula, find the correct level of heat to cook the cornstarch, and prepare the products for mass production.

One problem lingered: how to im-prove the taste.

“Stevia was a great idea for us, as well

as adding some vitamins to the gluten-free product,” said Kaufman.

Today, Extend Nutrition features four product categories: bars, crisps, drizzles and shakes. Last November, the company rolled out two new products in tandem with National Diabetes Month: all-natural protein bars- chocolate and caramel, and cookies and cream flavors.

Blood Sugar Control: From Kitchen Experiment to Commercial Success

Dr. Francine Kaufman

Experts Predict Another Year of Robust Healthcare M&A



West Jefferson Chosen by American College of Cardiology for Patient Navigator Program

MARRERO- West Jefferson Medi-cal Center (WJMC) is the only hospital in Louisiana chosen by The American Col-lege of Cardiology (ACC) as part of a pio-neering team approach to keep patients healthy and at home following admission for heart attack or heart failure. The 35 hospitals selected nationwide are the fi rst participants in the ACC Patient Navigator Program, which is the fi rst program of its kind in cardiology and supports national efforts to reduce unnecessary patient re-admissions.

“West Jefferson is very pleased and excited to have been chosen for the ACC Patient Navigator program. Through this partnership, we look forward to enhanc-ing our current processes and forging new ones that will allow us to improve the quality of care we deliver to our patients,” said Monica Bologna, Vice President of Service Line Development at West Jeffer-son Medical Center.

Nearly one in fi ve Medicare patients hospitalized with heart attack and one in four Medicare patients hospitalized with heart failure are readmitted within 30 days of discharge, often for conditions seem-ingly unrelated to their original diagnosis. Readmissions can be related to issues re-lated to stresses of the initial hospitaliza-tion, patient fragility at time of discharge, a lack of understanding of discharge in-structions, and the inability to carry out discharge instructions.

“The Patient Navigator Program is a unique collaboration between the cardio-vascular care team, patients, and families to manage the stress of hospitalization for complex conditions in a way that allows patients to return home, remain healthy, and avoid the need for readmission whenever possible,” said ACC President Patrick T. O’Gara, M.D., FACC. “West Jef-ferson’s program coincides with national

initiatives to reduce readmission rates for patients with cardiovascular conditions. More importantly, it will directly benefi t patients and their families.”

Terrebonne General Medical Center and Ochsner Health System Announce Strategic Partnership

HOUMA- Terrebonne General Medi-cal Center (TGMC) and Ochsner Health System (Ochsner) recently announced their intent to expand their current suc-cessful collaborative efforts in managing Leonard J. Chabert Medical Center into a more formal strategic partnership. The partnership will create greater opportu-nity to focus on shared savings and de-crease the overall healthcare cost while maintaining exceptionally high quality care.

This partnership is similar to many other relationships formed across the country, allowing systems to meet the goals and challenges of healthcare re-form while staying independent. The partners, TGMC and Ochsner, will work together to take advantage of joint pur-chasing ability and also develop data and analytics to concentrate on supply chain management and other large organiza-tional expenses to reduce the cost of de-livering care.

In a joint statement, Phyllis Peoples, President and CEO, TGMC and Warner Thomas, President and CEO, Ochsner Health System said:

“This partnership is an example of two leading organizations coming together to build upon our common vi-sion to lead in a time of change. The new business model created by this partner-ship provides strategic benefi ts to both organizations, refl ective of the greater cooperation and coordination needed among health systems as we prepare for the future. This is a natural progression of our existing relationship and together we will build upon our unique strengths and deliver far more to the people of the tri-parish region than we can individually. We look forward to expanding our ability to collaborate.”

TGMC and Ochsner’s partnership will

allow both organizations to maintain cur-rent governance and independence. This relationship will not include a merger or acquisition of organizations. In addition to their unique missions, each organiza-tion will retain their name, assets and em-ployees to allow them to continue serving their patients.

Tulane Consolidates Women’s and Children’s Services in Jefferson Parish

NEW ORLEANS – Tulane Health System has relocated all pediatric ser-vices from Tulane Medical Center to Tu-lane Lakeside Hospital for Women and Children in Metairie. The move brings together all of Tulane’s women’s and chil-dren’s services to one location.

“Our pediatric move marks a new beginning for Tulane Lakeside Hospital for Women and Children,” said Dr. Wil-liam Lunn, CEO of Tulane Health System. He noted that Lakeside has a long and distinguished history of offering excep-tional women’s healthcare services in Jef-ferson Parish. “We are proud to offer a wider breadth of services for children at our convenient location in Metairie; much closer to the homes and schools of many of our patients,” said Lunn.

In addition to offering a full con-tinuum of 24 pediatric specialties, Tulane Lakeside is equipped with:

• 7-bed Pediatric Intensive Care Unit• 26-bed Pediatric Inpatient Unit• 6-bed Specialty Care/Oncology

Unit• 26-bed Neonatal Intensive Care

Unit• Full Service Pediatric Emergency

Room• Full Service Child Life ProgramThe dedicated Pediatric Emergency

Room will be staffed with Board Certifi ed Pediatric ER physicians with ER wait times available at TulaneLakeside.com. The fa-cility has recently added a child-friendly low-dose CT scanner, MRI, pediatric en-doscopy, a pediatric pulmonary lab and neurodiagnostics. Tulane’s pediatric out-patient clinics are also being moved to the Lakeside campus in Metairie.

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Louisiana Medical News is published monthly by Louisiana Medical News, LLC in affi liation with Medical News, Inc. All content ©Louisiana Medical News, LLC and Medical News Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. Medical News will assume no responsibilities for unsolicited materials. All letters sent to Medical News will be considered Medical News property and therefore uncondition-ally assigned to Medical News for publication and copyright purposes. Louisiana Medical News and the Helvetica font logo are registered trademarks of the publisher and may not be used without the prior written consent of the publisher.

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PRINTED ON RECYCLED PAPER

In the News

The bars contain 130-140 calories, 22 carbs, and 10 grams of protein.

“Our new formula is better than any-thing we’ve ever done,” she noted.

As a result of six clinical studies and 17 international patents, Extend Nutrition products have been verifi ed and proven to be effective in helping to control blood sugar and limit hunger. The products are now available through Target, Walgreens, Kroger, Publix, CVS Pharmacy and other national chains. The products are also on-line at online at Amazon.com and directly from www.ExtendBar.com.

Medical and healthcare professionals can contact the company at 1-800-887-2919 or email [email protected] to receive samples.

“We’re always in discovery,” said Kaufman, who’s been very pleased with the results. “A good company never runs on their laurels.”

Blood Sugar Control, continued from page 13

more nonchalant about the idea that tech-nology is going to save them or their em-ployers any more than already has been promised.

“In fact, recent reports have begun to surface claiming that CIOs at struggling health systems have little faith that new technologies, on top of recently imple-mented systems like EHRs, will do much good for them since these other solutions – the EHRs – had such little positive effect on their organizations’ bottom lines. Sim-ply put, they’re sensing a bit of personal doom and growing tired of all the hype. It’s unfortunate.”

Also, for payers, despite the obvious benefi ts of encouraging HIH relationships with physicians, esMD and electronic ex-

change aren’t top priority, considering all the issues being managed, including the current federal insurance overhaul.

“Perhaps time will change this, but for the foreseeable future, esMD isn’t likely to gain the traction it needs to become an industry standard,” observed Benton. “What’s fortunate is that service providers like HIHs are having a positive impact on the healthcare environment and are bring-ing down some pretty mighty horses, while also helping bring about better workfl ows, improved effi ciencies and increased profi t-ability. Despite the lack of awareness sur-rounding these healthcare partners and their impact across the sector, many are still unaware of HIHs’ purpose and the very term by which they’re defi ned.”

Benefi tting, continued from page 8


LHA Welcomes New Staff Members

BATON ROUGE- The Louisiana Hos-pital Association (LHA) recently appoint-ed Scott Cornwell as the Vice President of Healthcare Reimburse-ment and Kathryn Mount, FACHE as a Healthcare Reimbursement Analyst.

Scott previously served as the Director of Reimbursement for Och-sner Healthcare System. He brings over 25 years of experience working in hospital fi nance, including work with HCA, St. Patrick Hospital and Opelousas General Hospital. Scott graduated from McNeese State University with a degree in account-ing.

Kathryn comes to the LHA from Blue Cross and Blue Shield of Louisiana, where she was the Senior Reimbursement Ana-lyst. She also previously worked as a fi -nancial analyst at LSU Health and Wom-an’s Hospital. She received her master’s degree in Health Administration from Tu-lane University and her bachelor’s degree from LSU.

Paul A. Salles, LHA’s CEO welcomed the new associates, saying “We are excit-ed to have Scott and Kathryn at the LHA and look forward to their involvement in helping to serve our members on issues related to healthcare reimbursement.”

LAMMICO Declares 8th Consecutive Dividend

METAIRIE- The LAMMICO Board of Directors has declared another dividend for its policyholders, marking the eighth time since 2008 the company has autho-rized the payment of a dividend to its insureds. The announcement, approved by the Louisiana Department of Insur-ance, affects over 6,500 insureds who will receive a 5% dividend of the LAMMICO premium during the fi rst quarter of 2015.

“We make this most recent dividend with confi dence, while maintaining a sur-plus level that ensures the reliable pay-ment of claims over any cycle,” said LAM-MICO’s President and Chief Executive Offi cer Thomas H. Grimstad, M.D. “We are a fi nancially strong company because of the partnerships we have developed with our insureds for more than 30 years. LAMMICO will keep its focus on our poli-cyholders, by providing innovative prod-ucts, strong defense and advocacy.”

The 5% dividend declared totals ap-proximately $2.6-million. Including this most recent dividend, LAMMICO will have returned a total of $45-million to its policyholders since 2008.

C. Bryan Miller, MD named CMO of SMH Physicians Network

SLIDELL- In an important leadership development, Slidell Memorial Hospital Chief Executive Offi cer Bill Davis recently announced C. Bryan Miller, M.D., has become the Chief Medical Offi cer of the SMH Physi-cians Network. In this role, Dr. Miller becomes the second physician to join the senior management leadership team at SMH, Davis said.

A Family Medicine specialist, Miller has been a member of the SMH Physi-cians Network for four years. In addition to this new position, Miller will continue to see patients in his practice as a member of the SMH Physicians Network.

“Hospitals and physicians are more accountable now for the delivery of high-er quality and more effi cient care deliv-ered at a lower cost. We believe having a physician of Dr. Miller’s experience in primary care join our senior leadership is vital to that end,” Davis said.

Miller will be a liaison between the

network physicians and SMH administra-tion. He will participate in the network’s administration to ensure an effective bal-ance between administrative and clinical processes. He will oversee network peer review and quality assurance panels. He will help develop and implement medical protocols, patient care programs, medical practice policies and procedures. Dr. Miller will also work to identify opportunities and alternatives to improve effectiveness and effi ciency of the network.

Medical News is pleased to provide space for press releases by providers in our Grand Rounds section. Content and accuracy of the releases is the sole responsibility of the issuer.

Scott Cornwell

In the News

Kathryn Mount

Dr. C. Bryan Miller

Let’s face it: Louisiana has some of the highest healthcare costs and worst disease outcomes in the country. But working together, we can change for the better. That’s why Blue Cross and Blue Shield of Louisiana has developed Quality Blue – our series of programs designed to improve the health of our members.

Blue Cross works with doctors, hospitals and clinics in our network to be part of the solution. Doctors can earn recognition and even extra payments for taking steps that help their patients get and stay healthy while keeping costs in line.

And together, we create a healthier, more affordable system for all of us.

For more information about how you can enroll in our Quality Blue programs:

Call 1-800-716-2299 Email [email protected] Visit www.bcbsla.com/QBprograms

01MK5881 10/14

Good Health Has Its Rewards

Blue Cross and Blue Shield of Louisiana is incorporated as Louisiana Health Service & Indemnity Company and is an independent licensee of the Blue Cross and Blue Shield Association.

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