PRINTED ON RECYCLED PAPER April 2016 >> $5 FOCUS TOPICS BEHAVIORAL HEALTH & ADDICTION • SENIOR LIVING ONLINE: NASHVILLE MEDICAL NEWS.COM Leadership Health Care Completes Annual Delegation to D.C. BY KATIE SCHLACTER In the midst of a contentious presiden- tial primary season, a delegation of more than 100 Nashville emerging healthcare leaders visited our nation’s capital to get an inside look at the state of healthcare policy. On March 14 and 15, the Nashville Health Care Council’s Leadership Health Care (LHC) initiative made its 14 th annual trip to Washington, D.C., to hear from top officials about the latest healthcare developments “inside the Beltway” and around the country that will impact Nashville’s $73 billion healthcare industry. (CONTINUED ON PAGE 10) William Kurtz, MD PAGE 2 PHYSICIAN SPOTLIGHT (CONTINUED ON PAGE 6) Residency to Retirement: A Physician’s Guide to Financial Health Financial Experts Offer Step-by-Step Advice for Today’s Providers BY MELANIE KILGORE-HILL Pro athletes aside, some of the biggest paychecks in America belong to physicians. According to the U.S. Department of Labor, primary care physicians earn approximately $240,000 annually, with specialists clearing more than $400,000. While the promise of six figures has spurred on many a struggling med student, learning to manage those numbers is critical to a provider’s long-term financial success. Student Debt First – the ugly. Physicians often enter the workforce with student loan debts in excess of $200,000. Marry another physician, and chances are you’re paying a half million dollars to Sallie Mae. Matthew Harrison, vice president of medical private banking at First Tennessee Bank, said school loan terms are typically 20 to 30 years with monthly payments similar to that of a house mortgage. Follow us on @NashMedNews for updates and breaking news PRST STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.318 2016 LHC Delegates PHOTO: KEITH MELLNICK Fifty Years of Addressing Addiction Cumberland Heights Celebrates Half-Century Mark A little more than five decades ago, Nashville businessman Robert Crichton, Sr. brought up the idea of starting a nonprofit alcoholism treatment center in Nashville to his friend and personal physician Thomas F. Frist, Sr., MD ... 3 Prescription for Disaster? The Rise of Opioid Addiction in Tennessee & the U.S. It’s a fine line to walk … managing patients’ physical pain without exposing them to the pain of addiction ... 5 VUMC Leading National Precision Medicine Study Vanderbilt University Medical Center has been selected to lead the first-of-its-kind study, expected to change the future of precision medicine ... 9 ON ROUNDS
Transcript
PRINTED ON RECYCLED PAPER
April 2016 >> $5
FOCUS TOPICS BEHAVIORAL HEALTH & ADDICTION • SENIOR LIVING
ONLINE:NASHVILLEMEDICALNEWS.COM
Leadership Health Care Completes Annual Delegation to D.C.
By KATIE SCHLACTER
In the midst of a contentious presiden-tial primary season, a delegation of more than 100 Nashville emerging healthcare leaders visited our nation’s capital to get an inside look at the state of healthcare policy.
On March 14 and 15, the Nashville Health Care Council’s Leadership Health Care (LHC) initiative made its 14th annual trip to Washington, D.C., to hear from top officials about the latest healthcare developments “inside the Beltway” and around the country that will impact Nashville’s $73 billion healthcare industry.
(CONTINUED ON PAGE 10)
William Kurtz, MD
PAGE 2
PHYSICIAN SPOTLIGHT
(CONTINUED ON PAGE 6)
Residency to Retirement: A Physician’s Guide to Financial Health Financial Experts Offer Step-by-Step Advice for Today’s Providers
By MELANIE KILGORE-HILL
Pro athletes aside, some of the biggest paychecks in America belong to physicians. According to the U.S. Department of Labor, primary care physicians earn approximately $240,000 annually, with specialists clearing more than $400,000. While the promise of six fi gures has spurred on many a struggling med student, learning to manage those numbers is critical to a provider’s long-term fi nancial success.
Student DebtFirst – the ugly. Physicians often enter the workforce with student loan debts in
excess of $200,000. Marry another physician, and chances are you’re paying a half million dollars to Sallie Mae.
Matthew Harrison, vice president of medical private banking at First Tennessee Bank, said school loan terms are typically 20 to 30 years with monthly payments similar to that of a house mortgage.
Follow us on
@NashMedNews for updates and breaking news
PRST STDU.S. POSTAGE
PAIDFRANKLIN, TN
PERMIT NO.318
2016 LHC DelegatesPHOTO: KEITH MELLNICK
Fifty Years of Addressing AddictionCumberland Heights Celebrates Half-Century MarkA little more than fi ve decades ago, Nashville businessman Robert Crichton, Sr. brought up the idea of starting a nonprofi t alcoholism treatment center in Nashville to his friend and personal physician Thomas F. Frist, Sr., MD ... 3
Prescription for Disaster?The Rise of Opioid Addiction in Tennessee & the U.S.It’s a fi ne line to walk … managing patients’ physical pain without exposing them to the pain of addiction ... 5
VUMC Leading National Precision Medicine StudyVanderbilt University Medical Center has been selected to lead the fi rst-of-its-kind study, expected to change the future of precision medicine ... 9
ON ROUNDS
2 > APRIL 2016 n a s h v i l l e m e d i c a l n e w s . c o m
By MELANIE KILGORE-HILL
For some physicians, the path to a medical specialty is disjointed. That wasn’t the case for Saint Thomas orthopaedist William Kurtz, MD.
At 16, the young Texan was invited to work alongside an orthopaedic surgeon in his hometown of Houston, shadowing the family friend during countless joint replacement procedures. “I knew then I wanted to do that with my life,” said the Nashville surgeon.
With one goal in mind, Kurtz pur-sued his bachelor’s degree in mechanical engineering from Rice University, know-ing the training would prove beneficial in an orthopaedic residency. He graduated medical school from The University of Texas Southwestern Medical School at Dallas with Alpha Omega Alpha honors distinction.
In 2000 Kurtz made the move to Nashville where he completed a residency in orthopaedic surgery at Vanderbilt Uni-versity Medical Center, followed by a sub-specialty fellowship in adult reconstructive joint surgery at New England Baptist Hos-pital in Boston. Now a Tennessee Ortho-
paedic Alliance surgeon, Kurtz serves on the medical staff at Saint Thomas Mid-town Hospital, Saint Thomas West Hos-pital and Centennial Medical Center.
Today, Kurtz’s primary expertise is in the field of joint replacement and revision surgery for the hip, knee, and shoulder, and he performs more than 400 joint re-placement procedures each year. He said orthopaedics has come a long way in a relatively short time.
Customization is a Game Changer
“The greatest advance in orthopae-dics is how healthcare can now be per-sonalized,” Kurtz said. “When I replace a knee, I put in a personalized implant, which has been made specifically for that one patient.”
Kurtz utilizes 3D scanning technology to provide patients with customized knee replacements from ConforMIS, where the surgeon serves on the surgical advisory board. Unlike “off the shelf” counterparts, ConforMIS’s femoral and tibial implants are individually sized and shaped to fit to each patient’s unique anatomy. Five to six weeks later, Kurtz receives an exact rep-lica of the patient’s original knee, which he says means better outcomes and less down time for the patient.
A Perfect FitUtilizing his mechanical engineer-
ing training, Kurtz partnered with Con-forMIS in 2011 to help develop the next generation of joint replacement. Now an influential part of the ConforMIS design team, Kurtz is widely recognized as an early adaptor and leading expert in the
field of customized implants. “We’ve taken charge in terms of
doing research on implants and working on the ins and outs of developing the sec-ond generation of implants,” Kurtz said. “The product design element of figuring out what works well and what doesn’t has given me a more detailed understanding of replacement nuances.”
Ever on the lookout for new ideas, Kurtz works continually in cadaver labs and experiments with new systems on the market to determine the best features to incorporate. He continues to develop technology privately, as well, and has filed more than 13 patents to date. “It’s been a passion of mine to improve care by im-proving tools and implants,” Kurtz said. “It truly is a dream job.”
Saint Thomas Joint Replacement Institute
In August 2015, Kurtz and the STHS ortho team celebrated the grand opening of the Saint Thomas Joint Replacement Institute at Saint Thomas Midtown Hos-pital – a 94,000 square foot renovation with a $25 million price tag.
Innovation in OrthopaedicsWilliam Kurtz, MD, Redefining the Future of Customized Joint Replacements
PhysicianSpotlight
Since its 1971 founding in Murfreesboro, NHC has grown to provide a
spectrum of health care services throughout Middle Tennessee and the U.S.
Today, in our centers and our patients’ homes, we are providing a high level of
quality and loving care to all our families. Visit NHCcare.com to explore our full
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For information about services in your area simply call 1-888-INFO-NHC.
Family issues hit close to home. Thankfully, NHC is never far away.
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n a s h v i l l e m e d i c a l n e w s . c o m APRIL 2016 > 3
Healthcare coding changes do not follow conventional wisdom. Fortunately, we do.That’s just the way we do business.
jacksonthornton.com/healthcare 615.869.2050
By CINDy SANDERS
A little more than five de-cades ago, Nashville business-man Robert Crichton, Sr. brought up the idea of starting a nonprofit alcoholism treatment center in Nashville to his friend and personal physician Thomas F. Frist, Sr., MD.
Crichton had recently re-turned from the well-respected Hazelden Treatment Center … forced to travel many miles from home to address his dependency on alcohol because there weren’t many other options in an era where addiction was seen as a moral fail-ing rather than a disease.
While Frist thought it was a good idea, he was in the midst of getting Park View Hospital off the ground. The story goes that Frist wasn’t sure he’d have the time or energy that would be required to start such an important venture from the ground up. However, the physician’s wife, Dorothy, thought differently.
“By morning, Mrs. Frist had con-vinced him to do it,” Jay Crosson, CEO of Cumberland Heights, said with a chuckle. For Crosson, that decision to move for-ward with what would become Cumber-land Heights turned out to be monumental from both a personal and pro-fessional standpoint.
Purchasing a farm on River Road in the western part of Davidson County, Cumberland Heights opened its doors in the summer of 1966 to offer treatment using the principles of the 12 steps with a focus on mind, body and spirit. “Origi-nally, we only took alcoholic men,” noted Crosson. “We still use the farmhouse today for programs, but obviously the campus is much bigger now.”
Over the years, the scope of treatment has also widened to include drug abuse. Crosson said opiate addiction, including heroin, accounts for about 40 percent of treatment, with alcoholism being another 35-40 percent. The balance is made up of those with polysubstance abuse where a mix-ture of substances comes into play including alcohol, opiates, marijuana and meth.
Today the main campus encompasses 177 acres on the banks of the Cumberland River and is licensed for 137 beds for detox and residential stays for adult males, adult females, and adolescent males. In the be-ginning, Crosson said everyone stayed for 21-day or 28-day programs. Now, there are a variety of options to meet people at their point of need, including two residen-tial emersion programs where individuals can stay 30-120 days.
Crosson said an important part of the program is recognizing the destruc-tive nature addiction has on relationships. “Cumberland Heights had one of the first family programs in the nation,” he said. “We not only treat the patient, but we treat the family because addiction is a family disease.”
Typically, families will come in for a mini-camp in the third or fourth week to learn about the disease of addiction and available resources. Toward the end of the program, patients and families interact and work to repair fractured relationships.
In addition to inpatient program-ming, Cumberland Heights will soon have
10 outpatient locations spanning a good portion of Tennessee from Chattanooga to Jackson. The ninth program opened in Crossville on March 7.
“We’re getting ready to open our tenth intensive outpatient program on Music Row,” Crosson said, adding the program should begin accepting patients in the late spring or early summer. “We wanted something in the center of town that could address working people down-town.”
Not only is the Music Row location ideal geographically, but Crosson said it also dovetails nicely with their work within the music community with both famous and not-so-famous artists, producers, songwriters and musicians. The treatment center’s commitment to the music industry was evident earlier this year as MusiCares and Cumberland Heights joined forces in Los Angeles to host a panel discussion for
the industry during the week lead-ing up to the GRAMMY Awards.
“Musicians have special oc-cupational challenges,” Crosson said of the temptations available on the road or in late-night studio sessions.
“One of the things a lot of people don’t know about are the celebrities who come through Cumberland Heights – and that’s
the way it should be,” he said of the im-portance of protecting privacy and of treating everyone in the program in the same manner without regard to fame.
He added the program for musi-cians is largely the same as for individuals from other occupations. However, a day of training is made available for the mu-sician’s work family including managers, publicists and others to help colleagues better understand the obstacles to sobriety and ways to promote a healthful lifestyle. Cumberland Heights also has a music room to allow artists and others to work creatively while in treatment.
“And there are meetings on Tuesday afternoons where recovering musicians and writers come out and talk to those in active treatment. These people have walked that walk,” he said.
Crosson is equally excited about the
Fifty Years of Addressing AddictionCumberland Heights Celebrates Half-Century Mark
Celebrating 50 Years of SobrietyThere are a number of events planned to celebrate Cumberland Heights’ 50th
Anniversary throughout 2016. In addition to the festivities, the treatment center has produced an anniversary booklet, commemorative coin modeled after the sober coins that are a fixture of recovery, and expanded their “Recover Life” communications campaign to raise awareness and honor the success of many who continue to triumph over their addiction each day.
April 6: Women’s luncheon with guest speaker Liz Murray, best-selling author of “Breaking Night.”
May: Opening of the Music Row Intensive Outpa-tient Center
Sept. 17: Alumni and staff picnic with entertainer Paul Williams as guest speaker.
Oct. 5: John Hiatt & Friends fundraising concert at the Ryman.
Fall: “Shelter at the Pond” commemorative ceremony as the original pond is restored and restocked with fish.
December: Endowment Society reception.
For more information on these events, please go online to cumberlandheights.org.
Jay Crosson
(CONTINUED ON PAGE 10)
4 > APRIL 2016 n a s h v i l l e m e d i c a l n e w s . c o m
Using Data to Deliver Care, Decode Complex Treatment OptionsNew Platform Looks to Improve Outcomes, Decrease Costs
By CINDy SANDERS
There are few areas of medicine as complex and compelling as delving into the intricacies of the human mind. The very uniqueness that creates individuality means there are rarely ‘one-size-fits-all’ solutions to multifaceted physical and behavioral health issues.
However, the team behind a newly launched national company believes they have crafted a way to inform clinical de-cisions and improve outcomes on a highly individualized basis while simultaneously lowering costs. Faros Healthcare, LLC – a spinout of Centerstone Research Insti-tute and Indiana University Research & Technology Corporation (IURTC) – has developed a clinical tool that combines ad-vanced predictive analytics with a patent-pending artificial intelligence (AI) platform.
The need for more sophisticated means to effectively treat the whole per-son has become increasingly evident as the industry moves toward value-based healthcare. “Behavioral health, in gen-eral, is really exploding,” noted Tom Doub, PhD, CEO of Centerstone Research Institute, one of the nation’s largest not-for-profit providers of community-based be-havioral health and ad-diction services. “The rest of healthcare is beginning to realize, based
on data and their own practice experience, that behavioral health is a very important part of achieving good health outcomes.”
When depression or other behavioral health conditions are layered on top of chronic diseases such as diabetes or heart disease, Doub continued, the cost to care for that patient is two to three times higher than if the patient was dealing solely with the physical condition. And studies over the last two decades have consistently shown an increased prevalence of depressive dis-orders or other psychiatric conditions in the presence of chronic illness.
“I think all of healthcare is really con-verging on not separating the body and the mind, and that goes along with the sci-ence,” Doub said of the rise in integrated care.
Jim Stefansic, PhD, a biomedical engi-neer who serves as presi-dent of Faros, said finding the optimal route to treat complex physical and be-havioral issues is part of the company’s core mis-sion. Casey Bennett, PhD, the company’s co-founder and chief scientific officer, invented the analytics tool while working with Doub at Centerstsone Research Institute as a data architect and research fellow during graduate school at Indiana University’s School of Informatics and Computer Science.
“We wanted to see if we could essen-
Dr. Tom Doub
Dr. Jim Stefansic
Neighborhood Health Receives Substance Abuse Services Grant
The Department of Health and Human Services recently awarded grant funding totaling $881,931 to three Tennessee health clinics. In Middle Tennes-see, Neighborhood Health’s grant was for $231,931 and will assist in expanding its program of screening patients for substance use disorders and providing intervention, counseling and referral.
The organization will also use this grant to support medication-assisted treatment (MAT) for opioid use disorder. The program will include assessment, therapy, education, peer support, and care coordination. Four staff members will be added to provide the additional services, and patient enrollment is expected to begin in August.
“Tennessee is in the top 12 states in the country for pre-scribing opioid pain relievers, and unfortunately, ranks 11th highest in the rate of drug-related deaths,” said Mary Bufwack, PhD, CEO of Neighborhood Health. “The number of opioid overdoses continues to increase – 129 in Nashville/Davidson County in 2014 alone. We anticipate screening more than 3,500 individuals in the first year of this program and treating at least 60 in the medication-assisted treatment program.”
In total, $94 million in Affordable Care Act funding was distributed to 271 health centers in 45 states, the District of Columbia, and Puerto Rico to improve and expand substance abuse services, with a special focus on the treatment of opioid disorders in underserved populations. It is estimated the number of un-intentional overdose deaths from prescription pain medications has nearly qua-drupled from 1999 to 2013, and deaths related to heroin increased 39 percent between 2012 and 2013.
Mary Bufwack
tially develop a smart algorithm,” Doub said. “It’s not just one decision you have to make in healthcare, it’s many decisions; and the better you make those series of decisions, the better the outcome for pa-tients.”
With data and demographics from more than 6,700 Centerstone patients with a clinical diagnosis of major clinical depres-sion, of which between 65-70 percent also had a chronic physical co-morbid condi-tion, Bennett and IU Assistant Professor Kris Hauser showed the efficacy of apply-ing the augmented intelligence platform. Using 500 randomly selected patients for simulations, the team was able to utilize AI to improve outcomes by nearly 40 percent compared to baseline while simultaneously lowering the cost of care by about 50 per-cent. The results were published in Artificial Intelligence in Medicine in January 2013,
Stefansic explained Faros AI & Ana-lytics Platform, which is co-owned by Cen-terstone and IURTC, personalizes the approach to care through the use of ma-chine learning. Not only does the software make recommendations on the optimal course of treatment for complex conditions through data analytics from an initial set of parameters and markers, but it has the ability to learn over time and suggest ad-justments to the protocol based on patient outcomes or changes in parameters while also calculating treatment costs.
The cloud-based platform can update in real time to provide point-of-care noti-fications to providers, who can then fac-tor the new cost and outcomes data into the decision-making process to determine whether or not a treatment plan should be modified. Stefansic stressed it was equally critical that providers both feel confident in the results and be able to access the infor-mation as part of their natural workflow.
“Moving both sides of the costs-of-care value equation is essential in transforming
our healthcare system, and we’re incredibly excited to bring this power to providers,” Stefansic said of the platform that integrates with existing EHR and population health software.
“What’s great about our technology,” he continued, “is it’s perfectly suited to treat complex health conditions, and behavioral health fits right in that wheelhouse.” He added the technology is not limited to those with a behavioral health diagnoses but also could be deployed for patients with any num-ber of variables and co-morbid conditions that might complicate a treatment plan.
Stefansic noted there are ‘big tent’ considerations when treating for a set of conditions. However, he continued, when you drill down into the patient population under that big tent, there are many vari-ables. For example, he said, a 65-year-old, widowed diabetic who lives alone in the country probably faces different challenges … and potentially different outcomes … than a 45-year-old diabetic mother of two in the inner city.
Doub likened the additional layer of machine learning on top of the predictive analytics component to the refinements over time in way-finding technology. “It’s like Waze vs. MapQuest,” he explained. “A decade ago, MapQuest told us the straight-est route between two points, but it didn’t allow for variables like road closures or a traffic accident.” Similarly, he continued, both of the women in Stefansic’s example were trying to arrive at the same destina-tion of optimal health, but their journeys would likely look different so the most ef-fective approach to treating them might also vary.
Stefansic added, “We trust the cli-nician knows how to get from point A to point B, but sometimes you still use your GPS because you don’t know what the conditions will be like. We just want to give them more tools.”
Patient Engagement Tablets Used in TriStar Skyline ERTriStar Skyline Medical Center is using technology to engage with patients
during a visit to the emergency room. Patients and their visitors can now use a dedicated tablet for information, to provide real-time feedback or entertain-ment.
“Our new tablets allow patients to use a familiar technology to con-nect with our staff and relevant health information and resources while they are receiving care,” said Heather Stafford, director of emer-gency and cardiovascular services at TriStar Skyline.
The patient will have the capa-bility to: provide real time feedback and reviews of their ER visit, receive information to make a physician appointment, read health content specific to their condition, access MyHealthOne patient portal, sign up for health insur-ance on the spot, and stay entertained by playing games.
n a s h v i l l e m e d i c a l n e w s . c o m APRIL 2016 > 5
By CINDy SANDERS
It’s a fine line to walk … managing patients’ physical pain without exposing them to the pain of addiction. Making the balancing act even more difficult is the in-ability to tell which patients will use medi-cations only as directed and which ones will escalate, sometimes very quickly, to drug abuse.
The face of drug addiction in Ten-nessee and across the country has rapidly changed with images of the strung out, disheveled junkie being replaced by pic-tures of the quintessential soccer mom, established corporate executive or bright young college student.
Recent assessments by the U.S. Drug Enforcement Agency and others have found drug overdose deaths, driven largely by overdose from prescription opioids and heroin, have surpassed motor vehicle acci-dents and firearms as the leading cause of injury death in America. The report found 46,471 people died of drug overdoses in 2013 compared to 35,369 killed in car ac-cidents and 33,636 killed by firearms.
The Federal ResponseIn February, the U.S. Food & Drug
Administration called for a sweeping re-view of agency opioid policies in the face of a national epidemic. FDA Commis-sioner Robert Califf, MD, MACC, said the agency would take a number of steps to reassess its approach to opioid medica-tions including convening an expert advi-sory committee before approving any new drug application that does not have abuse-deterrent properties. Additionally, he said the agency would improve access to nalox-one and support better pain management options, including alternative treatments. In March, Califf announced the FDA would require new overdose warnings for all immediate-release opioids.
On March 15, the Centers for Dis-ease Control and Prevention released new guidelines for prescribing opioids for chronic pain for patients 18 and older in the primary care setting. The guideline recommendations are specific to chronic pain outside of active cancer treatment, palliative and end-of-life care. In making the recommendations, the CDC noted healthcare providers wrote 259 million prescriptions for opioids in 2012, which is enough for every American adult to have a bottle of pain medication.
“More than 40 Americans die each day from prescription opioid overdoses; we must act now,” said CDC Direc-tor Tom Frieden, MD, MPH. “Overprescrib-ing opioids — largely for chronic pain — is a key driver of America’s drug-overdose epidemic,” he continued, adding the guidelines will help phy-sicians and patients make informed decisions about treatment.
In a teleconference announcing the guidelines, Frieden said the risks of using opioids far outweighs the benefits for most patients and noted safer alterna-tives exist.
The 12 recommendations focused on three areas of consideration: deter-mining when to initiate or continue opi-oid treatment; selecting, dosing, duration and discontinuation of a treatment plan; and assessing the risk and addressing the harms of opioid use.
Key points include recognizing non-pharmacologic therapy and non-opioid therapy as preferred for chronic pain, establishing treatment goals with patients including realistic goals for pain and func-tion, considering how opioid therapy will be discontinued if benefits do not outweigh risk, and engaging in ongoing discussions about the known risks and realistic ben-efits of opioid therapy.
When starting opioid therapy, the recommendations call for prescribing at the lowest effective dosage, avoiding in-creasing dosage to ≥ 90 MME/day or carefully justifying that decision, prescrib-ing for three days or less for acute pain and rarely more than seven days, evaluat-ing benefits vs. harms within one to four weeks of starting opioids or escalating dosage, and continuing to evaluate every three months or more frequently.
To assess risk, the CDC calls for cli-nicians to review the patient’s history of controlled substance prescriptions and to check state databases before and during opioid therapy, to use urine drug testing before staring opioid therapy and consider using urine drug testing at least annually, to avoid prescribing pain medication and benzodiazepines concurrently whenever possible, and to offer or arrange for evi-dence-based treatment for patients with opioid use disorder.
Go online to NashvilleMedicalNews.com for links to the FDA announcement, CDC guideline recommendations, and CDC prescribing checklist.
The Problem in TennesseeIn February, the Tennessee Depart-
ment of Mental Health & Substance Abuse Services (TDMHSAS) reported the state has seen a steady decline in pre-scription opioid drugs seizures according to data from the Tennessee Bureau of In-vestigation.
In 2012, there were 6,988 opioid sei-zures compared to 4,696 in 2014. The drop coincides with the launch of Ten-nessee’s Prescription for Success initiative. However, the law of unintended conse-quences might be in play as the state is seeing an increased appetite for heroin and painkiller replacement medication buprenorphine, which is now widely pre-scribed to ease opioid withdrawal symp-toms and cravings.
“It’s troubling to see these ‘so called’ painkiller replacement therapies dis-pensed by unlicensed clinics getting pa-
tients hooked and dependent on another drug, just as they were to prescription pain pills,” said TDMHSAS Commis-sioner Douglas Varney. “Our statewide, multi-agency Prescription for Success strategy did an excellent job of reducing demand for prescription pain opioid medications, but once again I’m very concerned about what’s emerging in our state.”
There were 82 heroin seizures by the TBI in 2009, rising to 341 in 2014. Similarly, the 437 buprenorphine seizures in 2009 had increased to 1,085 by 2014. While approximately half of Tennessee counties had buprenorphine seizures in 2011-2012, that number rose to nearly 70 percent of counties in 2014-15.
“There were very few heroin seizures by law enforcement in 2011 and 2012,” said Varney. “By 2015, seizures were oc-curring routinely in Tennessee’s larger cit-ies and surrounding counties.”
While the numbers of opioid seizures were down, information released late last year from TDMHSAS showed prescrip-tion pain medicine remained the reigning ‘drug of choice’ across most age groups and illustrates the gap between seizures
of illegally held opioids and the potential abuse of legally held prescribed drugs.
Reviewing two decades of state-funded substance abuse treatment ad-mission data (1992-2012), the research highlighted a trend of prescription drug use across multiple age groups. “Prescrip-tion drug use increased among all the age groups we looked at and jumped signifi-cantly among those in their 20s and 30s,” said Varney.
Based on the data, 59 percent of those aged 21-24 listed prescription drugs as their primary substance of abuse, and 49 percent of those aged 30-34 said the same. While alcohol remains the substance of primary abuse among those 50-54, the number citing prescription drug abuse was also on the rise.
“It’s very clear the addiction to prescription drugs continues to ravage Tennesseans of all ages with the great-est impact occurring among our young people in communities across the state,” said Varney. “We will continue to focus on strategies to reduce the supply and easy availability of prescription pain medicines, in cooperation with law enforcement and other Tennessee agencies. Additionally, we will ensure all Tennesseans have the opportunity to seek treatment and recov-ery for their addictions.”
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Prescription for Disaster?The Rise of Opioid Addiction in Tennessee & the U.S.
Dr. Tom Frieden
Douglas Varney
6 > APRIL 2016 n a s h v i l l e m e d i c a l n e w s . c o m
Fortunate ly , loan forgiveness grants are sometimes of fered through employment at specific research institutions.
“Depending on the specialty, physicians can train as long as 15 years,” said Harrison. “And they’re watching friends that may have started at similar salaries get into the workplace and work their way up, funding 401ks and starting families and their lives much earlier than they are.”
The Protection PhaseThe early years during residency and
those immediately fol-lowing are considered the ‘Protection Phase’ said TMA Medical Bank-ing Division Head and INSBANK First Vice President Blake Wilson. He and Daniel Burke, president of Burke Fi-nancial Group, LLC, collaborated to create a schedule of financial priorities for providers at various life stages. They said the Protection Phase typically includes 27- to 33-year-olds with high debt and low income.
“It’s important to remember that this
time in their life isn’t about paying off loans or accumulating wealth, (but) rather mak-ing sure they’re maintaining an adequate emergency fund/cash reserve and locking in appropriate insurance coverage at a young age, especially if a spouse or children are depending on them,” Burke said.
While saving during residency is un-likely, residents should avoid accumulating additional debt by living on less. Establish-ing a budget and not over committing to high rent, mortgages and car payments also will build good habits. For residen-cies less than five years, Wilson and Burke urge physicians to consider renting over buying, which might not be beneficial in the residency tax bracket. Take advantage of any employer retirement matches, and consider a Roth IRA for excess savings while you in a lower tax bracket.
The Role of Financial AdvisorsAs residencies end, physicians are
often married with families, living pay-check to paycheck and sometimes on credit to make ends meet. Along comes that first job, six figures, and a lifestyle that no longer includes Ramen noodles and PBJs.
Harrison said the absolute first step physicians must make is to acquire a banker and financial advisor accustomed to working with providers. “A common misconception is, ‘I don’t have enough money yet to start financial planning,’” Harrison said. “They don’t really think those first years affect the planning pro-cess much, but any time you invest system-atically for retirement you’ll end up with a larger amount by starting sooner than later.” While there’s no magic number for retirement savings, Harrison said retirees usually maintain a consistent lifestyle liv-ing on 60-70 percent of their salaries.
Harrison said he’s seeing an industry shift toward paying off student loans in those first years post-residency and delay-ing big, pricey purchases. “This age group coming up now has lived through the re-cession, and they saw parents with stable incomes lose jobs or have to downsize,” Harrison said. “They’ve seen friends go to school and train for a position and come out with a master’s degree and not find a job. There’s a responsibility that comes with a good income, and the mindset of physicians today has changed from years ago.”
That often means before the nice house, car, or much needed vacation, phy-sicians are reviewing risk management and life insurance policies. Since a provider’s greatest ability is working with his hands, a good disability policy also is a must.
Mortgage Loan Programs for Doctors
For many new physicians, buying
a home quickly follows suit. For some, particularly in markets where rents are astronomically high, that might mean purchasing during residency. For others, the first big job could require relocating a family to a new city. Throw in the desire to live in a safe neighborhood close to a downtown medical center, and housing costs can be staggering. Many banks today offer special finance options – including zero percent down - available only to physicians.
“Clients are relieved to learn they can move into a new chapter of their lives in purchasing a home and not have to wait for 20 percent down,” said Stephanie Arcelay, mortgage loan officer and doctor loan specialist at SunTrust Mortgage. Their physician mortgage benefit is among the oldest of its kind in the nation, offering loans with zero percent down during internship, residency and fellowship to down payments of 5 or 10 percent post-training.
In 2015 Arcelay closed loans for more than 150 area MDs, DOs, DDS and DMDs. “They often expect to pay a higher rate because there’s no private mortgage insurance, and they want to know what the catch is,” Arcelay said. “It’s an amazing product, but there’s no catch.” SunTrust’s Doctor Loan Program includes 15 and 30 year fixed loans, as well as adjustable rate mortgages (ARMs), most popular among residents temporar-ily moving to a new city like Nashville.
“The Nashville market is very ag-gressive right now and consistently among the top rated areas to live,” Arcelay said. “You’ll have to pay to live somewhere; and right now with rates where they are, it’s cheaper to buy than rent, especially in popular areas.”
The Accumulation PhaseBurke and Wilson define the ages
from 35 to 55 as the ‘Accumulation Phase,’ when the shift moves from finan-cial survival to accumulation. They en-courage docs to develop a student loan repayment strategy and begin maxing out their qualified retirement plan for imme-diate tax deduction.
“This time period is when financial planning takes on an important role in de-fining a projected retirement age so they know how to accomplish their long-term goals and under what timeframe,” Burke said. “If you are a practice owner, invest in your practice. Consider utilizing debt to add staff, locations, equipment and real estate in addition to a working capital line of credit for temporary cash flow needs. With each and all of these investment de-cisions, try to survey each opportunity’s return on investment.”
Wilson cautions providers to not take on more debt than what allows them to comfortably sleep at night and to carefully choose a banking partner that provides ac-cessibility and understands their business.
“If you are a practice or other busi-ness and real estate investor, be sure to make proper transition plans,” Wilson warned. Life insurance-funded buy/sell agreements should be considered, and you should have regular evaluations to assess agreements every one to three years.
“If you have developed financial and investment skills, or if your entrepreneur-ial spirit is not quenched by being a W2 physician, consider diversified investments in businesses and real estate,” Wilson sug-gested. “Have skin in the game, be active, and stress-test for margin for potential economic recessions.” He added, “Invest-ments in medical businesses and real es-tate may be of particular opportunity and expertise.”
Preservation/Distribution PhaseFrom age 60 up, providers are in
the ‘Preservation/Distribution Phase.’ Kids are out of the house, their debt load is lower or nonexistent, and investments have grown substantially.
“Providers in this phase should begin heavily weighing their appropriate risk tolerance to ensure they properly mitigate against an economic downturn that could ravage their investment balance and re-tirement income,” Burke said. While es-tate planning should be done as early as the accumulation phase, it often gets de-layed until the preservation/distribution phase. “Their focus often shifts from ‘How much can I accumulate?’ to ‘What kind of legacy will I leave, and will I outlive my savings in retirement?’”
Residency to Retirement: A Physician’s Guide, continued from page 1
The project features eight dedicated operating rooms that are larger and more appropriate for advanced total joint re-placement procedures. The facility also includes dedicated pre-op and recovery units, as well as in-patient nursing units. More than 1,000 shoulder, hip and knee replacements have been performed at STJRI since its opening.
“The Center has been phenomenal,” Kurtz said. “We focus on one topic over and over again, and there’s tremendous value in that.”
A single focus means improved ef-ficiency and the ability to keep clinical staff on the same page. Kurtz said taking
a product line and setting it apart also im-proves quality of care and patient experi-ences.
“Everyone has a goal of getting pa-tients taken care of in the best way possi-ble,” he said. “It’s really improved patient experiences and streamlined the process. The personnel and staff are a lot of fun as well, and do a great job.”
Kurtz and his wife Emily, a Vander-bilt cardiologist, have three children. He also serves on the board of Nashville’s Faith Family Medical Center, which pro-vides care to the underserved in Middle Tennessee.
Innovation in Orthopaedics, continued from page 2
Blake Wilson
Daniel Burke
Matthew Harrison
Stephanie Arcelay
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n a s h v i l l e m e d i c a l n e w s . c o m APRIL 2016 > 7
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HealthcareEnterprise
By CINDy SANDERS
For the nation’s larg-est provider of senior liv-ing services, the equation for success really comes down to the power of one – one individual making a real difference in the life of a senior.
In the case of Brent-wood-based Brookdale Senior Living, that ‘power of one’ is multi-plied across 82,000 asso-ciates in more than 1,100 communities in 47 states. “They are the 82,000 folks forging relation-ships with our residents. They’re the ones who make the magic,” said Brookdale Senior Living CEO Andy Smith.
With the capacity to care for approxi-mately 108,000 seniors and their family members, the company’s mission is to treat each one of those individuals with compas-sion and respect and to view each day as an opportunity to “deeply connect with peo-
ple in a profound and personal way.” It’s those connections that have been captured in a national advertising campaign, which launched last year.
“When we think about our brand, it’s a manifestation of our mission,” Smith said of the campaign. “The brand is an expres-sion of who we are. It’s an expression of the
essence of Brookdale and what we do … and it’s always about our people.”
He added the ‘stars’ of the televi-sion commercials who share touching and sometimes humor-ous interactions with residents are all real Brookdale associates with real stories about real people. “There are no scripts, just their expression of how important their residents are to them, and that’s told in their own words,” said Smith.
“Our goal isn’t to be the biggest, it’s to be the best,” he continued.
Of course, size also helps. “We’re the only participant in the senior living industry who participates in each vertical in the con-tinuum of care at scale across the country,” Smith pointed out.
Brookdale’s service levels run the
gamut from independent living and as-sisted living to memory care and skilled nursing. “Unique to the industry, we have a seamlessly coordinated ancillary services platform built into the company,” Smith said, adding those services include outpa-tient therapy, home health and a growing hospice care business.
In addition to being able to meet vary-ing levels of care, Smith said Brookdale also offers services to meet varying socioeco-nomic levels. While there are many high-end communities, Smith said there are also many that are targeted to those in the middle, which is a space for which he be-lieves demand will grow in the future.
“Demographic tail-winds are behind us,” Smith pointed out. “The country is aging, the numbers of seniors are growing, and the number of caregivers is going down.”
He continued, “I think there is a lon-ger term opportunity for Brookdale and a challenge for the country. We have to fig-ure out how to care for folks.”
Bringing New Life to Senior LivingBrookdale Keeps the Focus on Individuals & Innovation
(CONTINUED ON PAGE 9)
Andy Smith
8 > APRIL 2016 n a s h v i l l e m e d i c a l n e w s . c o m
By CINDy SANDERS
National Healthcare Corporation (NHC) is near-ing completion of its new-est assisted living and skilled nursing center in Middle Tennessee. The Bellevue fa-cility is anticipated to open this spring, according to Gerald Coggin, senior vice president of Corporate Rela-tions for the publicly traded long-term care giant, which is headquartered in Murfrees-boro.
The new center, called NHC Place at the Trace, represents a $38 million investment by NHC that is ex-pected to create more than 200 jobs. True to its name, the 135,000-square-foot facility is located at the foot of the Natchez Trace Parkway at the intersection of Highway 100 and Pasquo (Sneed) Road. Construction is expected to be complete at the end of this month with the center officially accepting assisted living residents later in May.
NHC Place at the Trace includes 170 beds, 90 of which are rehabilitation and continuing care beds, with the remaining
80 designated for assisted living. Of the as-sisted living beds, 20 will be for memory care patients, which Coggin said reflects the growing need in the community for residential services that focus on patients with memory issues.
In making the announcement about this newest NHC facility, Coggin pointed to the continuing growth of the southwest area of Davidson County and the expand-ing need for quality senior care services.
“This area of the county has been re-flective of Nashville’s overall growth,” he
stated. “With that growth comes the need for broader healthcare services for our se-nior population, including rehabilitation services and assisted living. We designed NHC Place at the Trace to provide those services and to do so with the high level of quality care and innovative services for which NHC is well known.”
Assisted living resi-dents have six basic floor
plans with variations available on many of them. Quarters feature one bedroom and one bedroom with a study options, full baths and most include kitchenettes for simple meal prep. Residents and those un-dergoing rehab also have ac-cess to restaurant-type service in a large dining area with meal options available to ac-commodate special dietary needs.
Following national trends, the facility also features ameni-ties and activities requested by seniors. A theater, garden
area, Wi-Fi throughout, and multiple gath-ering places, which includes cocktail and hors d’oeuvres socials, are all available. The facility also employs an activities di-rector for onsite group functions and has a van available to allow residents to take advantage of area attractions and amenities such as the nearby Chaffin’s Barn Dinner Theatre, Cheekwood, and soon-to-be-open One Bellevue Place.
Additionally, the new center features a number of distinctive design elements to enhance the level of care and the experi-ence of patients and visitors, including:
• Shorter hallways to provide closer proximity to patients for NHC partners (the name given NHC staff) and more com-fortable space for the patients;
• Special carpets and furnishings in the memory care space that provide a sooth-ing environment and help patients with dementia recognize space and distance;
• A more home-like design with higher ceilings, upgraded carpeting and more dec-orative touches;
• A large and centrally located gym for both rehabilitation care and residential use; and
• A centralized, professional kitchen to serve the entire facility to ensure con-sistency and quality of food service to all residents and guests.
Coggin said these design elements are critical parts to a center’s success. In addi-tion, NHC Place at the Trace incorporates a variable refrigerant flow mechanical sys-tem to enhance air quality while reducing energy consumption. Coggin said extensive meetings and planning between the facil-ity designer Johnson + Bailey Architects and NHC’s varied healthcare departments helped shape the project and led to the incorporation of key design elements that improve comfort, quality and satisfaction. American Constructors is the contractor for the project.
In addition to the new Bellevue facil-ity, NHC operates nine affiliated centers in the greater Nashville area. The company opened NHC Place, Sumner, in Gallatin last year. A new center, in partnership with Maury Regional Medical Center, is slated to open this fall in nearby Columbia. NHC is also expanding several centers in South Carolina.
By MELANIE KILGORE-HILL
“Just Say No.” For children of the 80s, the U.S. war
on drugs was a vigilant one with warn-ings about illegal substances echoing from classrooms, televisions, and dinner tables. Today the tables have turned, and many of those children are now caregivers to el-derly parents and grandparents. Swamped by a barrage of orange pill bottles and little knowledge of their intended use, these drugs might be legal but are potentially no less le-thal if used improperly.
That’s why Home Instead Senior Care is launching a national effort to educate seniors and caregivers on the risk of medi-
cation misuse. Home Instead provides per-sonalized care, support and education to help enhance the lives of aging adults and their families, including Alzheimer’s assis-tance and hospice support.
In a recent survey of seniors, Home Instead found that nearly one-fifth of those taking five or more prescription medications have experienced challenges in managing their medications, including keeping track of which medications they have taken and when. Let’s Talk about RxSM offers families free resources and tips, as well as insight into po-tential medication pitfalls facing seniors.
Challenges for Seniors “We’ve been talking about medica-
tion management for a while now and have been diving in to have those conver-sations with families,” said Maggie Lea, Home Instead franchise owner for Middle and East Ten-nessee. Of seniors sur-veyed, at least 57 percent were taking four or more prescriptions, with one-fourth taking six or more, and 20 percent admitted to experiencing challenges.
“With those numbers, we really needed to look at med safety,” Lea said. Medication challenges extend beyond taking the wrong pill. Factors affecting mismanagement in-clude costs, the ability to open bottles and read instructions, taking meds no longer
needed and simply remembering to take them.
All in the FamilyLea said medication management
should be a family affair. Learn about a se-nior’s medications and provide reminders as needed. A complete medication list should be reviewed often by the family and pro-vider to ensure all drugs are still necessary. Use pill boxes and medication trackers, or look into pharmacies like Simple MedsSM that package medications and vitamins in single-dose packs. Many local pharmacies also are willing to bubble wrap medications together, including over-the-counter drugs and supplements, at no additional cost.
Since some elderly adults refuse to take pills, families can also talk to the pharmacist about putting it in liquid form or the pos-sibility of breaking medication up into food. “You have to be creative with what you do, but don’t get discouraged,” Lea said. “Ask a pharmacist for help and come up with a plan everyone in the household is comfort-able with.”
It’s also important for providers to have ongoing conversations with family mem-bers. “What we see with families is that no one is talking to them,” Lea said “They feel as though they’re on an island and don’t know where to go. Providers need to know how to start those conversations and provide families with resources to help.”
For more information and tips, go to www.LetsTalkAboutRx.com.
NHC Place at the Trace Prepares to OpenNew Bellevue Facility Anticipates May Occupancy
Medication Errors & the ElderlyHome Instead Senior Care Helps Families Avoid Medication Mismanagement
Maggie Lea
This one bedroom with den floor plan from the recently opened NHC Sumner Place in Gallatin will also be offered in Bellevue.
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By MELANIE KILGORE-HILL
Vanderbilt University Medical Cen-ter has been selected to lead the first-of-its-kind study, expected to change the future of precision medicine.
In February, officials with the White House and National Institutes of Health (NIH) announced VUMC would lead the Direct Volunteers Pilot Studies under the first grant to be awarded in the federal Precision Medicine Initiative Cohort Pro-gram. The program’s objective is to build a broad and diverse national research co-hort of 1 million or more U.S. volunteers whose participation will provide the plat-form for expanding approaches to preci-sion medicine to benefit medical science for decades to come.
As part of the Direct Volunteers Pilot Studies, VUMC will create and optimize a prototype informational website that is engaging to a diverse array of potential volunteers and develop an interface for obtaining consent and basic enrollment and health information that is efficient, effective and secure. The initiative is sup-ported by a one-year grant from the PMI Cohort Program.
A National Effort with a Familiar Face
Joshua Denny, MD, MS, was named principal investigator for the unprec-
edented study. An associate professor of Biomedical Informatics and Medicine, he served on the national PMI Working Group of the NIH Advisory Committee to the Director. Denny, who has been a fixture at Vanderbilt since his undergrad years, began his work in genomics in 2007 when the NIH kicked off a program that would become the Elec-tronic Medical Records and Genomics Network (eMERGE).
“I had also been working on Vanderbilt’s biobank to help launch that,” Denny said. “I became very deeply in-volved in the genetics aspect of medicine – how they alter me-tabolism and response.”
He went on to lead the research ware-house side of BioVU, now the largest sin-gle site biobank in the world. Denny then joined an elite group of researchers partner-ing with the NIH and wrote a series of pa-pers for internal consumption outlining key aspects of the precision medicine initiative. The group convened April 2015 and their report was released in September.
In February 2016, the first of many anticipated grants was awarded to Vanderbilt. While VUMC will partner with other sites to collaborate on data collection and promotion, VUMC is the
VUMC Leading National Precision Medicine Study
Dr. Joshua Denny
The company’s size and geographic diversity also provide a front-row seat to witness how seniors interact with the system across the continuum of care and the necessary scale to develop and imple-ment innovations and best practices based on those observations.
“It’s interesting to see how the senior living industry interfaces with the health-care system,” Smith said. “It’s an evolving and maturing relationship.”
He added it’s also a relationship in which Brookdale is playing a growing role. In light of newer payment models that em-phasize keeping patients healthy, hospitals and health systems are paying much more attention to where and how older patients live and what impact that might have on a senior’s overall health.
A few years ago, Brookdale received a coveted CMS Innovation Grant to test the ‘Implementation of Innovations to Reduce Acute Care Transitions’ (INTERACT) program in 75 communities. “We showed demonstrable improvement in hospital re-admission rates and drove them down by 17 percent compared to baseline,” Smith said.
He added the company is actively en-gaged in other innovations around care, as well. “We are spending a lot of time, effort
and energy to really improve the quality of care our residents receive every day.”
Technology is playing an increas-ing role in social, emotional and physical health. Smith said seniors are becoming much more technologically savvy. Brook-dale is currently working on a social media portal geared to seniors that would allow residents to communicate more easily with family and friends. The company is also using a host of technological tools and dif-ferent methodologies in memory care units to stimulate seniors with some degree of memory impairment.
Other innovations are geared toward improving quality of life. “Our culinary team has developed a special set of spices that takes the changing tastes of seniors into account,” Smith said.
Whether it’s major care advancements or seemingly minor acts of thoughtfulness, Smith summed up, “The very essence of Brookdale is our mission, which is to en-rich lives.
Bringing New Life, continued from page 7
Mark Your CalendarApril 16: Installation of Meharry Medical College’s 12th President10 am • The Temple Church, 3810 Kings Lane
James E.K. Hildreth, PhD, MD, who began his tenure as president and CEO of Meharry Medical College on July 1, 2015, will be formally installed as the 12th president of Meharry during an Investiture Ceremony. The renowned HIV/AIDS researcher and Rhodes Scholar received his undergraduate degree from Harvard, his doctorate in immunology from the University of Oxford in England, and his medical degree from Johns Hopkins.
April 23: March for Babies8 am • Nissan Stadium Riverfront
The 2016 March for Babies raises awareness and funds for the March of Dimes mission with a three-mile walk – new this year, ‘Run for Babies’ 5K race. For more information or to register, go to marchforbabies.org/event/nashvilletn.
April 29-May 1: MedTenn 16Embassy Suites Murfreesboro
The Tennessee Medical Association’s annual convention is anticipated to draw 300 physicians, medical practice managers and other healthcare professionals to Murfreesboro for more than 32 hours of CME, installation of new officers, professional networking and the annual policymaking session of the TMA House of Delegates. For more information, go to tnmed.org.
only clinical site for the study and received the single scientific award. Denny hopes the program will become a decades long study, comparing it the famed Framing-ham Heart Study, which began in 1948 with 5,209 adult subjects and is now on its third generation of participants. That on-going study is widely credited for revealing now common understandings about heart disease and heart health.
It Takes a Village … or TwoThe greatest initial challenge will be
enrolling those 1 million volunteers: a feat Denny hopes to achieve in four to five years. “The biggest benefit of participating is con-tributing to science and being able to shape it,” Denny said. “Participants also win from the standpoint of being able to get some of their data back and be a part of communities where you can provide a voice.”
While the program is still in its in-fancy, Denny hopes to soon learn how to research and engage that volume of par-ticipants so they want to stay involved. The next few months will be spent figur-ing out mechanics and building the initial infrastructure. Denny said local providers will play a key role in helping to recruit participants, as well.
“There will come a time when pro-
viders will be more engaged, once we’re really ready to start recruiting,” Denny said. “Anyone in the country can volun-teer, which means providers can share information with their patients. A lot of things come into play.”
Vanderbilt researchers involved with the Direct Volunteers Pilot Studies also include Paul Harris, PhD, director of the Office of Research Informatics; Consuelo Wilkins, MD, director of the Meharry-Vanderbilt Alliance; and Sunil Kripalani, MD, director of Vanderbilt’s Effective Health Communication Program.
Bradley Malin, PhD, founder and di-rector of Vanderbilt’s Health Information Privacy Laboratory, will help construct platforms that protect the privacy of co-hort participants. Jill Pulley, MBA, direc-tor of Research Support Services in the Office of Research, will oversee program architecture and organization.
This summer, the NIH will award cooperative agreements for the full imple-mentation phase, including establishment of a Coordinating Center to oversee Di-rect Volunteer recruitment, Healthcare Provider Organizations to enroll more participants, and a Biobank capable of storing and managing blood, urine and saliva samples for analysis.
Brookdale Belle Meade
10 > APRIL 2016 n a s h v i l l e m e d i c a l n e w s . c o m
The delegation featured discussions with members of Congress, administration officials and national thought leaders about key healthcare policy issues, federal healthcare spending priorities and healthcare reform implementation.
On the first day of sessions, Darin Gor-don, director of TennCare, discussed Med-icaid policy issues with Matt Salo, executive director of the National Association of Medicaid Directors, and a panel of health-care technology experts discussed the state of interoperability. During the keynote din-ner hosted by the Nashville Health Care Council, Kristen Soltis Anderson, Republi-can pollster and author of “The Selfie Vote: Where Millennials are Leading America,” gave delegates an expert perspective on the 2016 presidential election.
“The 2016 delegation provided our city’s emerging healthcare leaders with new insight into what’s happening – and what’s next – in healthcare policy,” said Hayley Hovious, Council president. “This year, the upcoming presidential election and its possible implications for national healthcare policy made for an enlighten-ing and impactful experience.”
The annual delegation to Washing-ton is a signature LHC program. This year’s agenda also included:
• U.S. Senator Lamar Alexander (R-TN)
• U.S. Representative Jim Cooper (D-TN)
• U.S. Senator Bob Corker (R-TN)• U.S. Representative John Yarmuth
(D-KY)• Jitin Asnaani, Executive Director,
CommonWell Health Alliance• Jeff Cohen, Executive Vice Presi-
dent, Public Affairs, Federation of Ameri-can Hospitals
• Richard G. Cowart, Esq., Chair, Health Law and Public Policy Depart-ment, Baker Donelson
• Will Howorth, Director of Develop-ment and Special Assets, HCA
• Kerry McDermott, Vice President, Public Policy and Communications, Cen-ter for Medical Interoperability
• Janet Marchibroda, Director of Health Innovation, Bipartisan Policy Cen-ter
• Meena Seshamani, MD, PhD, Di-rector, Office of Health Reform, Depart-ment of Health and Human Services
• Jake Sherman, Congressional Re-porter, Politico
• Kate Spaziani, Vice President, Grants and Federal Relations, New York – Presbyterian Hospital
• Cathy Taylor, DrPH, Dean, Gor-don E. Inman College of Health Sciences and Nursing
• Vindell Washington, MD, Principal
Deputy National Coordinator, Office of the National Coordinator for Health In-formation Technology
Seshamani headlined the delegation’s second day of sessions, updating delegates on the state of implementation for various healthcare reform initiatives.
“The Washington, D.C., delegation always delivers new insights and informa-tion that LHC members can take home and use to enhance their business strate-gies,” said Benson Sloan, LHC chairman and director of Corporate Development for MEDHOST. “This event provides Nashville’s emerging healthcare leaders with speakers and networking opportuni-ties that are unparalleled in quality.”
Participants in this year’s delega-tion represented diverse sectors of Nash-ville’s healthcare industry, including hospital management, health insurance and healthcare IT, as well as professional services such as finance, law, communica-tions and accounting. Delegation scholar-ships were awarded to Adam Harthcock, COO, Utilize Health, and Bryan Harris, chief Fellow, Infectious Diseases, Vander-bilt University Medical Center.
PwC served as presenting sponsor for this year’s LHC Delegation to Washing-ton D.C. Supporting sponsors were BDO USA, Bradley Arant Boult Cummings, Change Healthcare, GE Healthcare and Kraft Healthcare. Lovell Communi-cations served as communications sponsor.
An initiative of the Nashville Health Care Council to nurture the talents of fu-ture leaders, LHC provides members with unique educational programs and network-ing opportunities. With membership of more than 900 up-and-coming healthcare industry leaders from 350 companies, LHC is the foremost organization for emerging industry leaders in the field.
Three Questions for Benson SloanBy CINDy SANDERS
Benson Sloan, board chairman for Leadership Health Care and director of Corporate Development for MEDHOST, shared his thoughts on the 2016 LHC Delegation to D.C., answering three questions from Nashville Medical News.
Was there a specific speaker or panel discussion that particularly stood out to you?
One of the most interesting speakers of the two days in Washington, D.C was the keynote speaker Kristen Soltis Anderson. Kristen’s portrayal of the millennial generation illustrated how we consume information in 140 characters or less, expect near real-time interactions with friends or co-workers, and would rather start a company than have a mortgage. The millennial generation is changing the way political candidates campaign, and soon the way they vote and operate.
What are your key takeaways from this year’s event?The two-day lineup of speakers left the delegation with plenty to consider:• Solving for interoperability and creating a base architecture or platform
for providers to administer care is critical to the evolving practice of value-based care.
• InsureTN will need to seek creative solutions for gaining approval of ex-panding Medicaid.
• It’s clear that bundle payments/alternative payment models will continue to be a fixture of CMS reimbursement. Judging providers on quality and value will reduce costs and improve the health of the patient but aligning incentives between providers, payers and technology vendors will be the accelerant.
What is the value of the annual LHC Delegation to D.C., and do you think it impacts our local healthcare industry?
Leadership Health Care nurtures the talents of up-and-coming executives in healthcare. The LHC Delegation to D.C. gives our members a rare opportunity to interact with members of Congress, top administration officials, and national thought leaders in a small-group setting, while learning about the latest health-care policy developments. The chance for delegates to connect with D.C.-based leaders, as well as fellow delegates, over a two-day period is invaluable.
On the other side of the coin, this trip is also a chance for LHC to showcase Nashville’s dynamic healthcare industry to the D.C. network. Building relation-ships in D.C. and educating policymakers about our perspective in the field high-lights Nashville’s significant, diverse expertise. This is important as Nashville’s healthcare community works to move the industry forward.
Leadership Health Care Completes Annual Delegation, continued from page 1
Delegtates received insight and information from Washington insiders including panelists (L-R): Janet Marchibroda, Director of Health Innovation, Bipartisan Policy Center; Dr. Vindell Washington, Principal Deputy National Coordinator, Office of the National Coordinator for Health Information Technology; Jitin Asnaani, Executive Director, CommonWell Health Alliance; Kerry McDermott, Vice President of Public Policy and Communications, Center for Medical Interoperability
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Music Row center’s proximity to Belmont University and Vanderbilt University. He noted there is a large national movement called the Collegiate Recovery Movement that helps students with addiction issues and supports sober living. “We want to be part of that community, as well,” he stated.
Everyone who participates in any of the programming is encouraged to par-ticipate in aftercare for a year or more, in addition to attending 12-step meetings. “Cumberland Heights is a safe place to come home to,” Crosson said of staying connected after the intensive portion of treatment ends. “It keeps them connected. In addition to that, you are with the same group of people. These people get to know you so if you don’t show up, they’ll call to make sure you are okay.”
Crosson knows from first-hand expe-rience how essential that level of care and accountability is to maintaining sobriety. “I was a patient here at age 26 in 1989,” he explained. After successfully finishing treatment, he became an active member of the alumni association and became an aftercare leader. He joined the staff
in 1993 and was serving as the organiza-tion’s CFO before stepping into the CEO position on an interim basis in 2014 and permanent basis in May 2015.
“Because of my addiction, I needed a new start,” Crosson said. “Cumberland Heights is a place of second chances and new beginnings. That’s true for patients but also many employees.”
In 1993, Crosson said there were about 100 employees. Today, the nation-ally recognized treatment center employs more than 350. Crosson said he thinks much of the success comes from being ex-pertly focused on their core competency. Equally, though, he credits the “spirit of Cumberland Heights,” which he said is evident the minute you step on campus. That nurturing spirit is something the founders hoped people would find and latch onto when they arrived on the farm at a low point in their lives.
“It’s a place of refuge,” Crosson said. “Nobody gets here at the end of a winning streak.”
But over half a century, thousands have left with the tools to turn the game around.
Fifty Years, continued from page 3
n a s h v i l l e m e d i c a l n e w s . c o m APRIL 2016 > 11
YOUR PRIMARY SOURCE FOR PROFESSIONAL HEALTHCARE NEWS
SOUTHCOMM BUSINESS MEDIA, INC.
Chief Executive Officer Chris Ferrell
Chief Financial Officer Ed Tearman
Chief Operating Officer Blair Johnson
Executive Vice President Mark Bartel
Vice President of Finance Carla Simon
Vice President of Production Operations Curt Pordes
Vice President of Content/Communication Patrick Rains
Controller Todd Patton
Creative Director Heather Pierce
Capella, RegionalCare MergeIn late March, Franklin-based Ca-
pella Healthcare and Brentwood-based RegionalCare Hospi-tal Partners announced the intent to merge into a new company called RCCH Health Partners (RegionalCare Capella Healthcare). The new company will have 18 hospital campuses in 12 states with more than 13,000 employees, 2,000 affiliated physicians, and revenues of $1.7 billion.
RegionalCare Board Chair and CEO Marty Rash will assume the role of executive board chair for the com-bined company and Capella President and CEO Michael Wiechart will lead the new company in the same roles, as well as joining the company board.
Sherry Leaving for WisconsinIt was announced last month Saint
Thomas Health COO Bernie Sherry will lead Ascension Health’s operations in Wisconsin. His new role with Ascen-sion, the parent company of STH, is effective April 4 and includes three health systems that combine to run 27 hospitals and 150 clinics in Wisconsin.
A long-time health leader in Nash-ville, Sherry was president and CEO of the former Baptist Hospital (now Saint Thomas Midtown) before expanding his duties to include administrative leader-ship of Saint Thomas West, as well. Last year, he was promoted to COO of STH.
Bender Joins Mercy as Director of Development
Mercy Community Healthcare re-cently announced the addition of Alli-son Bender as their new director of development. Bender brings an exten-sive background in devel-opment and fundraising to her new role with more than 20 years of event planning, donor develop-ment and grant writing experience.
She served as executive director for The Shalom Foundation since 2008 and prior to that was regional director for the Muscular Dystrophy Association. In her prior roles, Bender impacted thou-sands of individuals with medical and behavioral health needs. A Nashville native, she received her bachelor’s de-gree from the University of Tennessee.
TriStar Skyline Welcomes Neurologist
John Witt, MD, a neurologist and vascular neurologist, has joined the Neuroscience Center at TriStar Skyline Medical Center and has been named medical director of the Comprehensive
Stroke Center. Witt completed his
electromyography fel-lowship at Mayo Clinic in Scottsdale, Ariz. And his neurology residency at Washington Univer-sity/Barnes Hospital in St. Louis. His areas of clinical interest include stroke, multiple sclero-sis, dementia, neurorehabilitation, and electrodiagnostic medicine.
Combs Joins Centerstone Behavioral health provider Center-
stone recently announced the addition of Heather Combs as vice president of Payer Con-tracting and Strategy. In her new role, Combs will be responsible for devel-oping payer strategies, negotiating contracts, developing and manag-ing client relations with the managed care industry, and overseeing emerging healthcare payer organizations.
She has more than 16 years of ex-perience working in the healthcare field in managed care contracting, account management and sales and previously worked with Cigna, MedSolutions, and UnitedHealthcare. Combs is a graduate of the University of Kentucky.
Patterson Named TriStar StoneCrest COO
Sean Patterson assumed the role of chief operating officer for TriStar Stone-Crest Medical Center in March. He joins TriStar StoneCrest from TriStar Skyline Medical Center, where he served as as-sociate chief operating officer for the past two years. During that time, Patterson orchestrated the expansions of the Neuro Intensive Care and Medi-cal/Surgical units, piloted multiple tools to assist with MyRounding Patient Ex-perience software, and managed staff-ing and labor productivity. He began his career with HCA as a manager of performance improvements in 2012 and before that was assistant administrator at St. Mary’s Health System in Evans-ville, Ind. Patterson earned both his un-dergraduate degree and MHA from the University of Kentucky.
TOA Moves to ONEC1TYLast month, Tennessee Orthopae-
dic Alliance opened a new office in Nashville’s ONEC1TY development. The practice’s newest and largest site is located at 8 City Boulevard and replac-es TOA’s 301 21st Ave. N. office.
Featuring new equipment through-out, including advanced imaging tech-nology, TOA ONEC1TY offers physical therapy, hand therapy, MRI, the latest digital X-ray, and features new services including CT and fluoroscopic proce-dures. Additionally, the new location
offers an extended hours walk-in clinic that will provide both adult and pedi-atric patients with acute, but not life threatening, injuries immediate access to orthopaedic care. The walk-in clinic will also treat injured workers and offer drug-screening services to the workers’ compensation community.
Let’s Give Them Something to Talk About!
Awards, Honors, AchievementsThe University of Tennessee Health
Science Center (UTHSC) College of Dentistry Alumni Association recent-ly presented its 2016 Outstanding Alumnus Awards, the association’s highest honor, to Philip Wenk, DDS ’77, presi-dent and CEO of Delta Dental of Tennessee, and to Justin D. Towner III, DDS ’45, a longtime Memphis perio-dontist who helped found the associa-tion.
The Middle Tennessee Chapter of Associated General Contractors (AGC) recently presented Turner Construc-tion’s Nashville office with a Build Tennessee Award for the company’s work on the Saint Thomas Health Joint Replacement Institute. Turner Construction received an AGC Award of Excellence - the highest honor available within the Build Tennessee Awards in the $16-18 million renova-tion category.
The Employer Support of Guard and Reserve (ESGR), an organization within the Department of Defense, has recognized Nurse Manager Kristi Crass, of Saint Thomas Rutherford Hos-pital, for her unwavering support of her service member employees.
The American College of Health-care Executives of Middle Tennessee has announced the 2016 board mem-bers and officers. Bob Fink, FACHE, chief pharmacy executive for Commu-nity Health Systems has been elected president. Charlotte Burns, FACHE, vice president of network affiliates for the TriStar Division of HCA is presi-dent-elect; and Kevin Spiegel, CEO of Erlanger Health System, is the state regent. Andrew McDonald, FACHE, a partner in the Healthcare Consulting division for LBMC is immediate past president.
Nashville-based HCA has been rec-ognized as a 2016 World’s Most Ethical Company® by the Ethisphere Institute, a global leader in defining and advanc-ing the standards of ethical business practices. This is the seventh consecu-tive year HCA has been honored.
The Money Trail
Nashville-based Urgent Team Holdings, which operates more than 20 clinic locations in three states, recently received a big boost from Texas invest-ment firm Crestline to the tune of $35 million in debt and equity funding.
GrandRounds
Marty Rash
Michael Wiechart
Bernie Sherry
Allison Bender
Dr. John Witt
Heather Combs
Sean Patterson
Philip Wenk
Women
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S P O N S O R E D B Y
Sharon Adkins, MSN, RNExecutive DirectorTennessee Nurses Association
Stephanie Bailey, MD, MSDirector of Public Health Initiatives &Dean of the College of Health SciencesTennessee State University
Beth R. ChaseCEOc3/consulting
Kriste GoadChief Marketing Offi cerReviveHealth
Hayley HoviousPresidentNashville Health Care Council
Rita Johnson-MillsPresident & CEOUnitedHealthcare Community Plan of Tennessee
Amy S. LeopardPartner, Co-Chair of Privacy &Information Security TeamBradley Arant Boult Cummings LLP
Nancy SchultzVice PresidentThe North Highland Company
Divya Shroff, MD, FHMChief Medical Offi cerTriStar Centennial Medical Center
Karen SpringerPresident & CEO Saint Thomas HealthSenior Vice PresidentAscension Health/Tennessee Ministry Market Leader
T I C K E T S AVA I L A B L E AT N A S H V I L L E M E D I C A L N E W S . C O M
