Marta Wayt, DO, FACP PAGE 2 PHYSICIAN SPOTLIGHT PRSRT STD U.S. POSTAGE PAID FRANKLIN, TN PERMIT NO.357 PRINTED ON RECYCLED PAPER December 2014 >> $5 ON ROUNDS ONLINE: EASTTN MEDICAL NEWS.COM Enjoying East Tennessee Tennessee Theatre Music has always been part of the atmosphere in our household, and I especially love Christmas music. Whether it was a classic Firestone - Your Favorite Christmas Music album featuring a beautiful, brightly colored bow, which I remember anticipating listening to each year as a child, hymns played on the piano, or holiday classics from my favorite artists, carols ﬁlled our home ... 5 HEALTHCARE LEADER: Dr. Ken Olive As Executive Associate Dean for Academic and Faculty Affairs at East Tennessee State University’s Quillen College of Medicine, Dr. Ken Olive bears a privilege and a huge responsibility: “We’re training the future generations of physicians,” he said frankly. ... 6 BY CINDY SANDERS On average, it takes 12 years and more than $500 million … sometimes signiﬁcantly more … to move a new drug from bench to bedside in the United States. But what happens when there is an ur- gent or emergent need for new drugs, vaccines and biologics to be developed in the wake of a public health crisis? The recent attention on Ebola brought with it an increased interest in the approval process of the U.S. Food and Drug Administration. The FDA is tasked with ﬁnding the criti- cal balance between urgent public need and overall safety and efﬁcacy of drugs being distributed … even in a limited, experimental manner. Under Normal Circumstances Of the 5,000-10,000 compounds entering the research and de- velopment pipeline at any given time, only about 250 make it to the pre-clinical phase of testing. From there, only about ﬁve will make it to clinical trials in humans with only one drug ultimately receiving FDA approval. Generally, developers should expect to spend three- six years in the discovery and pre-clinical phase of the pro- cess. If enough supportive data results from conduct- ing research and animal model studies, then a company approaches the FDA to ask for con- sideration of clinical trials. Only about one of every 1,000 compounds being tested will prove promising enough for a company to ﬁle an Investigational New Drug (IND) application. Approval of the IND by the FDA and an Insti- tutional Review Board leads to another six-seven years being invested in phased human trials. If, after running that gauntlet, the product has the evidence to back its efﬁcacy and safety, a New Drug Application (NDA) is ﬁled for FDA review. From there, drug (CONTINUED ON PAGE 8) FOCUS TOPICS POST ACUTE CARE AUDITS/COMPLIANCE Urgent & Emergent Getting new treatments through the FDA pipeline BY CINDY SANDERS After the sticker shock that accompanied last year’s tax code regulations, many will be happy that 2014 is going out on a quieter note. However, there are still some changes and lingering questions about a number of extenders that could adversely impact your bottom line on both a personal and professional basis. Tony Jones, CPA, a tax services manager for HORNE LLP, said many high-earning individuals are still adjusting to the major changes in 2013 that included higher rates on net investment income and the additional Medicare tax. “’13 was also the year that personal exemptions and line item deductions phased out for high income taxpayers,” he added of the resurfacing of tax rules for individuals with an adjusted gross income over $250,000 and married couples with AGI over $300,000. “In Tennessee, the sales tax deduction is pretty im- portant to us, and that has not been extended … yet,” he said in early November, adding the extender could be approved before the end of the year. “It’s also important to Florida and any state that doesn’t have a state income tax,” he continued. In addition to the sales tax deduction, Jones said ac- countants had their collective eyes on a number of other extenders included in separate U.S. Senate and House bills. The general consensus was that no decision on the fate of these Tax Time: Getting Your Financial House in Order (CONTINUED ON PAGE 8) Tony Jones To promote your business or practice in this high proﬁle spot, contact Cindy DeVane at Tri Cities Medical News [email protected] • 423.426.1142
Marta Wayt, DO, FACP
PRINTED ON RECYCLED PAPER
December 2014 >> $5
Enjoying East TennesseeTennessee Theatre Music has always been part of the atmosphere in our household, and I especially love Christmas music. Whether it was a classic Firestone - Your Favorite Christmas Music album featuring a beautiful, brightly colored bow, which I remember anticipating listening to each year as a child, hymns played on the piano, or holiday classics from my favorite artists, carols fi lled our home ... 5
HEALTHCARE LEADER: Dr. Ken OliveAs Executive Associate Dean for Academic and Faculty Affairs at East Tennessee State University’s Quillen College of Medicine, Dr. Ken Olive bears a privilege and a huge responsibility: “We’re training the future generations of physicians,” he said frankly. ... 6
By cINDy SANDERS
On average, it takes 12 years and more than $500 million … sometimes signifi cantly more … to move a new drug from bench to bedside in the United States. But what happens when there is an ur-gent or emergent need for new drugs, vaccines and biologics to be developed in the wake of a public health crisis?
The recent attention on Ebola brought with it an increased interest in the approval process of the U.S. Food and Drug Administration. The FDA is tasked with fi nding the criti-cal balance between urgent public need and overall safety and effi cacy of drugs being distributed … even in a limited, experimental manner.
Under Normal Circumstances Of the 5,000-10,000 compounds entering the research and de-
velopment pipeline at any given time, only about 250 make it to the pre-clinical phase of testing. From there, only about fi ve will make it
to clinical trials in humans with only one drug ultimately receiving FDA approval.
Generally, developers should expect to spend three-six years in the discovery and pre-clinical phase of the pro-cess. If enough supportive data results from conduct-
ing research and animal model studies, then a company
approaches the FDA to ask for con-sideration of clinical trials. Only about
one of every 1,000 compounds being tested will prove promising enough for a
company to fi le an Investigational New Drug (IND) application.
Approval of the IND by the FDA and an Insti-tutional Review Board leads to another six-seven years
being invested in phased human trials. If, after running that gauntlet, the product has the evidence to back its effi cacy and safety, a New Drug Application (NDA) is fi led for FDA review. From there, drug
(CONTINUED ON PAGE 8)
FOCUS TOPICS POST ACUTE CARE AUDITS/COMPLIANCE
Urgent & EmergentGetting new treatments through the FDA pipeline
By cINDy SANDERS
After the sticker shock that accompanied last year’s tax code regulations, many will be happy that 2014 is going out on a quieter note. However, there are still some changes and lingering questions about a number of extenders that could adversely impact your bottom line on both a personal and professional basis.
Tony Jones, CPA, a tax services manager for HORNE LLP, said many high-earning individuals are still adjusting to the major changes in 2013 that included higher rates on net investment income and the additional Medicare tax. “’13 was also the year that personal exemptions and line item deductions phased out for high income taxpayers,” he added of the resurfacing of
tax rules for individuals with an adjusted gross income over $250,000 and married couples with AGI over $300,000.
“In Tennessee, the sales tax deduction is pretty im-portant to us, and that has not been extended … yet,” he said in early November, adding the extender could be approved before the end of the year. “It’s also important to Florida and any state that doesn’t have a state income tax,” he continued.
In addition to the sales tax deduction, Jones said ac-countants had their collective eyes on a number of other extenders included in separate U.S. Senate and House
bills. The general consensus was that no decision on the fate of these
Tax Time: Getting Your Financial House in Order
(CONTINUED ON PAGE 8)
To promote your business or practice in this high profi le spot, contact Cindy DeVane at Tri Cities Medical News
2 > DECEMBER 2014 e a s t t n m e d i c a l n e w s . c o m
By BRIDGET GARLAND
If blindly looking over Dr. Marta Wayt’s curriculum vitae, one might guess it belonged to someone much older. As a 2012 honoree of the The Business Journal’s 40 under Forty, however, Wayt’s accom-plishments are simply a product of industri-ous youth.
Wayt grew up in West Virginia, and throughout school, enjoyed the sciences in high school. Although she initially thought she wanted to be a veterinarian, Wayt said she felt a calling to go into medicine and specifically liked the philosophy and care model she had seen at a visit to the West Virginia School of Osteopathic Medicine.
After completing her undergraduate degree at Bridgewater College in West Virginia, Wayt was accepted at the West Virginia School of Osteopathic Medicine, but wasn’t certain at first what direction she wanted to take.
“When I was looking to specialize, I thought about Family Medicine, but de-cided my heart was for the elderly,” she reflected. “I liked difficult disease states so Internal Medicine was a very good fit for me. So I choose Pittsburgh to do my train-ing, and had a great experience.”
Soon after finishing her residency at Mercy Hospital of Pittsburgh, Wayt headed south to escape the Pennsylvania weather and ended up in the Tri Cities, where she found cheaper malpractice rates, the beauty of the mountains, and a much nicer climate.
It was while establishing her practice in the Tri Cities that Wayt discovered her affinity for caring for nursing home pa-tients. “While I did some clinicals in nurs-ing homes as a medical student, I didn’t have the opportunity in my residency. But I had an attending once who said I really should try and see if it [working in a nursing home] fits because there aren’t a lot a doc-tors who do nursing home care...and nurs-ing homes need good docs,” she recalled. “I kept that in the back of my mind, and when I came down here and was trying to build a practice, I thought it would be a nice way to have a few patients and get out in the community a little more. The
more patients I had in the nursing home, the more I liked being there and caring for them. In many ways, it fit the whole spec-trum of care for me.
“I have my practice and then I practice at the hospital, and then I either transition them back into their home or into a nursing home setting. It’s a nice continuum of care, and I can be there for them through all the steps along the way,” Wayt explained.
Although she initially started her nursing home practice at another facility, Wayt found her way to Wellmont Health System’s Wexford House, a skilled nursing facility located in Kingsport, Tenn., where she now serves as medical director.
“We have a lot of exciting develop-ments at Wexford, including a telemedicine program, which makes specialty care much more convenient for the patient; they don’t have to be transported to another facility for consultation. Transportation can be a discomfort and an anxiety,” she shared. “We have started a CHF program, and we are in the midst of starting a COPD pro-gram. And a third program we are going to try to take off the ground is a wound care clinic. We have also begun some internal quality metrics for disease management, looking at outcomes of diabetics in the nursing home, and trying to look at long-term difficult disease states, such as conges-
tive heart failure and COPD, making sure we reduce readmissions by taking better care of them.”
Wexford House also boasts a venti-lator unit, which Wayt explained is very much needed in the area. “There is only one other [ventilator unit] in the Kingsport area, so we have recently expanded our capacity. It’s difficult for people with lung disease to find a place to stay after leaving the hospital until they are stable enough to breathe on their own.”
In addition to Wexford House and her Internal Medicine practice with Wellmont Medical Associates (WMA), Wayt serves as WMA’s Regional Medical Director for the Kingsport region, encompassing Johnson City, Gray, Church Hill, Rogersville, and Kingsport.
“There are several practices within that region that fall under my purview, so I work with my regional director administra-tive counterpart to make sure those prac-tices are running smoothly and the doctors are getting their needs met, whatever they may be, whether it’s how functional their space is, or even if they have enough staff,” she explained. “I also like to communicate news from higher level administration, so we try to meet face-to-face with the docs and let them know we are supporting them.”
Wayt meets on a regular basis with WMA administration to discuss the status of each of the practices in her region and where the group as a whole is going. “Well-mont Medical Associates is a multispecialty group that needs to stay connected and support each other,” she said. “We have doctors at every level of administration so that we have that input.”
Considering WMA’s recent accom-plishments, their strategy appears to be working. “In the almost three years I’ve been with the group, we’ve put into place a dyad model of leadership, with the doc-tors flanking an administrative counterpart; we’ve developed a Patient Centered Medi-cal Home and a hospitalist program; we’ve increased our physician employment by 50 to 60 percent; and we recently received the prestigious Acclaim Award from the Amer-ican Medical Group Association, recogniz-
ing premier, functional medical groups.”If her plate didn’t seem full enough,
Wayt also serves on the WMA Board of Directors and as Chairman of the Internal Medicine Department at Holston Valley Medical Center. And perhaps what she is most excited about is the time she spends seeing patients at the Providence Medical Clinic, a free clinic set up through First Baptist Church in Kingsport and sup-ported through several churches and do-nors in the area.
Patients receive free medical care if they meet certain financial criteria. “It’s just a part-time clinic, but we provide a very good service, so I get excited when more doctors or services step up to the plate and say they can help,” she enthused. “I stay busy, but I enjoy it very much.” Personally, Wayt has several commitments locally. Both her mother and grandmother moved to the Tri Cities, so she enjoys spending time with them, although Wayt said her mother stays busier here than she ever has been, being involved in the community, in-cluding volunteering at Wayt’s free clinic.
Wayt is married, and her husband Tom is a sergeant with the Kingsport Police Department, working as a crime analyst. “We met in Pittsburgh when he worked in the emergency room where I was doing my residency,” she recalled. “Although he’s working on his MBA right now, we enjoy traveling, camping, fishing, hiking, bicy-cling, pretty much anything outdoors.”
Although Wayt could easily take credit for all of her accomplishments, she hum-bly concedes: “I have to give credit to the Lord’s influence in my life and his direc-tion, especially professionally; it has been remarkably providential. I prayerfully con-sider everything that I do.
“Also, I would not have had so many opportunities had it not been for Well-mont. Since joining Wellmont, doors have opened up, and I feel like they really value females in higher levels of position. To me, that has made a big difference,” she con-tinued. “I could be anywhere and be busy, I know that, but I feel like I’ve been recog-nized more and had a lot more opportuni-ties and career advancements since being with Wellmont.”
Marta J. Wayt, DO, FACP
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By MIchELLE hENRy
When my husband began the process of choosing our health insurance plan, I gave only one directive: “Make sure my doctors are on there.” As a cancer survi-vor, the link to my doctors is particularly strong – I believe their care is part of the reason I’m still here. Even when cancer is not part of the equation, most people feel the same kind of connection to their physi-cians. The doctor-patient relationship is an important one.
An article on the subject (by Drs. Susan Dorr Goold and Mack Lipkin, Jr. that appeared in the Journal of General Inter-nal Medicine) describes it well when it says “the doctor–patient relationship is remark-able for its centrality during life-altering and meaningful times in persons’ lives, times of birth, death, severe illness, and healing.”
It is impossible to put a price tag on a solid patient-physician relationship built on trust. But when it comes to choosing a health insurance plan, far too many people may be forced to do just that. If a physician isn’t on an affordable plan or one offered by an employer, the only option is to find another physician.
The recent announcement by Sum-mit Medical Group that in 2015 it will
participate in BlueCross BlueShield of Tennessee’s Network S means fewer East Tennessee residents will have to make that difficult decision. Summit estimates its in-clusion in Network S increases its ability to provide in-network primary care services to a total of more than 109,000 lives.
“This is significant for us given we have not been a part of this network for the past 12 years,” Summit Chief Executive Officer Tim Young said. “We’re pleased to reach a contractual agreement for 2015 and know that this arrangement will be beneficial for our custom-ers who will now have additional access to Sum-mit providers through BlueCross.”
Young noted changes in the health-care marketplace made being part of Net-work S more attractive to Summit.
Summit also participates in BlueCross BlueShield’s Blue Network PSM (Network P). BlueCross BlueShield offers two distinct Blue networks, each with its own group of doctors, hospitals, and other healthcare providers. Network P, a more expensive plan, includes access to the widest selec-tion of doctors and hospitals. Network S, which is more affordable, includes access
to a narrower selection of doctors and hos-pitals. With its lower premium, Network S is more affordable for employers and more accessible to the average person.
BlueCross BlueShield and Summit Medical invested months of discussion re-garding Summit’s participation in Network S, and both parties agree the arrangement is good for all concerned, especially con-sumers.
“We are happy to announce this agreement,” BlueCross BlueShield CEO Bill Gracey said. “Summit Medical Group has a strong history in East Tennessee and serves a large percentage of our customer base, which will now have even more qual-ity and cost-effective providers they can ac-cess across the region.”
“The consumer is the ultimate win-ner,” Young said. “They will benefit from a higher quality of care at a lower cost.”
Summit has earned national recogni-tion for its level of care. The National Com-mittee for Quality Assurance (NCQA), a private, 501(c)(3) nonprofit organization dedicated to improving health care qual-ity, has ranked Summit in the top 10 in the country for all three categories of NCQA recognition: Patient Centered Medical Home, Diabetes Recognition Program and Heart/Stroke Recognition Program.
Organizations earning the NCQA seal
first must pass a rigorous, comprehensive review and annually report on their perfor-mance. For consumers and employers, the seal is a reliable indicator that an organi-zation is well-managed and delivers high quality care and service.
“Choosing the right physician and health care provider can be one of the most important choices a person makes,” said Dr. C. Edward McBride, Summit’s vice president of clinical services. “NCQA recognition programs provide patients with the data they need to make informed decisions.”
Summit Medical Group was formed in 1995 by 37 Knoxville physicians. Today, it is one of the largest primary care based organizations in East Tennessee with 215 physicians and more than 100 advanced practitioners providing care at 53 practice locations in 12 East Tennessee counties. Summit also consists of four diagnostic centers, seven physical therapy centers, three express clinics, corporate wellness program, cen-tral laboratory and sleep services center. Summit provides healthcare services to a total of 308,000 patients, averaging 81,000 encounters each month.
Summit Medical Group to Participate in Blue Network S
Tim YoungDr. C. Edward
4 > DECEMBER 2014 e a s t t n m e d i c a l n e w s . c o m
Profit and Loss: The Top Ten Things Providers Need to Know Part VIII: Medicare Overpayment Appeals—Hurry Up and Wait
BY ERIN B. WILLIAMS AND DIANA L. GUSTIN, LONDON AMBURN, P.C.
This article is the final installment in a series which explores the top ten health law issues and their potential financial consequences on a provider’s practice.
A letter from the Centers for Medicare and Medicare Services (CMS) arrives at your doorstep demanding refund within 30 days of an extrapolated overpayment in the amount of $1 million. Interest will begin accruing monthly on the $1 million overpayment unless payment in full is received within 30 days of the date of the demand letter. Recovery through recoupment may begin if payment is not received or other steps taken. If you act quickly, you may be able to stop Medicare from recouping the extrapolated overpayment for almost six months.
How can I stop Medicare from recouping?
The Medicare Modernization
Act, Section 935, contains statutory protection for your cash flow if you file appeals early. A provider can stop Medicare from recouping an overpayment if a Request for Redetermination, the first level of appeal, is received within 30 days of the date of the CMS demand letter. Providers should be aware that the 30 days begins to run from the date on the letter, not the date the provider receives it.
The Redetermination Decision is made by the Medicare contractor who processed the original claim. If the provider receives an unfavorable or partially unfavorable Redetermination Decision, the provider may also receive a revised demand letter with the interest added for a new overpayment amount. Recoupment of the revised overpayment will begin unless a Request for Reconsideration, the second level appeal, is filed within 60 days of the date of the revised demand letter (calculated from the date of the
demand letter and not the date the provider receives the letter) or within 60 days of the Redetermination Decision. The Request for Reconsideration is filed with the Medicare Qualified Independent Contractor (QIC). To avoid collection, providers should file the Request for Reconsideration within 60 days of the Redetermination Decision since the Carrier may not always send a revised overpayment demand letter.
Although recoupment is delayed during the first two levels of appeal, interest will continue to accrue each month. Providers may decide to make financial arrangements to pay the overpayment to avoid accrual of interest during the pendency of the appeals process.- The federal regulations allow 120 days for filing the Request for Redetermination and 180 days to file a Request for Reconsideration. Early filing for the first two levels of appeal will prevent recoupment and preserve the provider’s cash flow for a few months.
What happens after the first two levels of appeals?
After the provider receives the Reconsideration Decision, any outstanding balance many be recovered by CMS through administration offset (recoupment of the overpayment from accounts receivable). The provider may decide to continue with the appeals process by filing a Request for Administrative Law Judge Hearing within 60 days of the Reconsideration Decision. According to statistics reported by the Office of Inspector General for the Department of Health and Human Services, approximately 56% of claims are fully reversed at the ALJ level in favor of the appellant and 6% are partially reversed.1
Unfortunately, providers cannot stop the collection process (recoupment) after the first two levels of appeal. Filing a Request for Administrative Law Judge Hearing does not preclude Medicare from recouping the remaining overpayment (and accrued interest).
What happens at the ALJ level of appeal?
Federal Regulations require an ALJ decision to be rendered within 90 days from the date that a Request for ALJ Hearing is received.2 However, CMS announced earlier this year that there was a severe backlog of Medicare appeals at the ALJ level, resulting
in an average wait time of 407 days. The Office for Medicare Hearings and Appeals (OMHA) has seen a 225% increase in appeals from 2007 to 2013, and CMS has suspended assignment of most new requests for ALJ hearings for at least two years. During this wait time, interest will accrue and Medicare will continue to recoup extrapolated and actual overpayments identified in the audit.
If the extended wait time for an ALJ hearing will cause a financial hardship, providers may request an extended repayment plan from CMS or may request escalation to the Medicare Appeals Counsel (the fourth level of appeal), if certain criteria is met.
The backlog of Medicare appeals has been the subject of recent congressional hearings, and the Center for Medicare Advocacy filed a class action lawsuit to compel the Secretary of the Department of Health and Human Services to meet statutory deadlines for review Medicare claim denials, specifically the 90 day deadline for ALJ Determinations.3
So, what should you do?Providers should quickly move
through the first two levels of appeals to prevent withholding. This will protect cash flow, and allow providers time to consider the options and make any necessary financial arrangements for repayment of the debt if the claims are not reversed at the first or second level of appeal. The OMHA recently solicited suggestions from stakeholders for addressing the substantial growth in the number of requests for ALJ hearings being filed. The key to success is often the ALJ Hearing. The delay providers are currently experiencing must be resolved by Medicare, or if necessary, by Order of the Court if litigation is needed to keep your business alive and well.
Notes1OIG (HHS), Improvements Are Needed at the Administrative Law Judge Level of Medicare Appeals, OEI-02-10-00340 (Nov. 2012).2See 42 USC § 1395ff(d)(1)(A) and 42 CFR § 405.1016(a)3See Lessler et al. v. Burwell, 3:14-cv-01230, filed 8/26/14 (Dist. of Conn.).
Attorneys Erin B. Williams and Diana L. Gustin focus their practice on healthcare compliance and regulatory matters. For more information on any health law or compliance matters, you may contact Ms. Williams or Ms. Gustin at (865) 637-0203 or visit www.londonamburn.com. Disclaimer: The information contained herein is strictly informational; it is not to be construed as legal advice.Where advanced cytogenetic technology meets old-fashioned service
Genetics Associates Inc. is CAP accredited, CLIA and State of Tennessee Licensed.
Our professional staff includes fi ve American Board of Medical Genetics (ABMG) certifi ed directors.
e a s t t n m e d i c a l n e w s . c o m DECEMBER 2014 > 5
Leigh Anne W. Hoover is a native of South Carolina and a graduate of Clemson University. She has worked for over 25 years in the media with published articles encompassing personality and home profiles, arts and entertainment reviews, medical topics, and weekend escape pieces. Hoover currently serves as immediate president of the Literacy Council of Kingsport. Contact her at [email protected].
By LEIGh ANNE W. hOOVER
Music has always been part of the atmosphere in our household, and I es-pecially love Christmas music. Whether it was a classic Firestone - Your Favor-ite Christmas Music album featuring a beautiful, brightly colored bow, which I remember anticipating listening to each year as a child, hymns played on the piano, or holiday classics from my favorite artists, carols filled our home.
Our adult children tease that I would listen to Christmas music anytime of the year. For this reason, Christmas CDs, yes, I still play them, begin rotating early and are often left in the sound system well into the New Year.
As a December baby, my birthday usually includes a Christmas musical out-ing, and this has been a shared tradition since I was a little girl. In fact, our daugh-ter remembers many of our own special mother-daughter “dates” being to holiday arts activities.
During December, our region has nu-merous opportunities to enjoy the sounds of the season with your family. Many are coming to the Tennessee Theatre in Knoxville, including Jim Brickman’s “On a Winter’s Night,” the Knoxville Jazz Or-chestra, the classic musical movie “White Christmas,” with preceding entertainment from The Mighty Wurlitzer Organ, Joy— An Irish Christmas, the Nutcracker ballet, and even a performance from Mannheim Steamroller Christmas by Chip Davis.
Known as Knoxville’s “Grand Enter-tainment Palace,” the Tennessee Theatre is also the State Theatre of Tennessee, which was designated by the state legisla-ture in 1999. Since its doors first opened in 1928, the historic venue has welcomed countless visitors and entertainment icons.
“For the first 50 or so years of its life, [the Tennessee Theatre] was a movie the-atre,” explained Executive Director, Becky Hancock. “Movies were shown every day of the week, except Sunday, with several showings per day, so thousands and thou-sands of people came…every week.”
During that era, there was a house band and an organist. Going to a first run movie or to see a touring show in a movie palace was truly a grand affair. Many re-call memories of their grandparents’ first dates and even proposals, and some of these stories are shared on the Tennessee Theatre’s website.
According to Hancock, the theatre was a first run movie house from 1928 until 1972, but it went through a strug-gling time in the 1960s. When the down-town declined, the theatre was forced into showing second run films.
In 1977, the Tennessee Theatre closed for the first time and would expe-rience several openings and closings until businessman Jim Dick, owner of Dick Broadcasting, purchased the theatre in 1980.
“He [Dick] did that mostly for the
World’s Fair, which happened in 1982, but also because he loved the theatre and wanted to preserve it,” said Hancock. “His com-pany ran it for 15 years from 1980 until 1995.”
Although the City of Knoxville de-clined Dick’s offer to donate the Tennes-see Theatre, this opened the door for the nonprofit 501(c)3 to be formed and re-ceive the donation. A board still governs the theatre today, as the Tennessee His-toric Theatre Foundation, with a goal of preserving and seeing the theatre thrive as a performing arts venue.
From the marquee sign, to the 56-foot tall horizontal “TENNESSEE” sign, the Tennessee Theatre is truly a recogniz-able Knoxville landmark. Known as one of East Tennessee’s most precious build-ings, the theatre was restored to its former grandeur in 2005. Today, the facility is a state-of-the-art performing arts center, where “past opulence and current tech-nology” have been married.
“It was a completely comprehensive
project,” explained Hancock. “It was a one hundred per-cent renovation
and restoration…back to the 1928 feel and
look in terms of original car-pet pattern, all the draperies and curtains and valances were replaced…and all of the paint surfaces were completely re-stored to original colors and brightness.”
To bring the facility up-to-date, the backstage area was demolished and rebuilt offering a much larger, modernized space. However, just walking into the lobby truly brings patrons back to an era of grandeur and great expectation.
“There’s no other building like it in the world,” said Hancock. “Movie palaces were built by the hundreds in the late 20s, but there aren’t that many left today.”
According to Hancock, about 40 touring shows and six Broadway titles are presented at the venue per year. Addition-ally, many scheduled shows are rentals. Each appears to a diverse audience with something for everyone.
December presents an opportunity
for many to enjoy a variety of shows at the Tennessee Theatre, such as Mannheim Steamroller and others, and experience the holiday season in a very special way.
“New generations of people, espe-cially since 2005, are creating those same kinds of memories that their parents and grandparents were able to create in the 30s, 40s, and 50s,” said Hancock. “It’s one of the things we are most proud of is to introduce the theatre and its beauty and memorable moments to new generations of people.”
Hancock enjoys seeing patrons arrive and experience the atmosphere of the Ten-nessee Theatre for the first time. In addi-tion to the grand lobby and staircases, there are five, massive Czechoslovakian crystal chandeliers, valued at $250,000 each, which are breathtaking. With the impres-sive domed ceiling, plaster ornamentation, and burgundy velvet seating, the inside of the auditorium is also awe inspiring.
“They just don’t build them like this anymore,” said Hancock. “The setting does add to the overall experience… Not only are the audience members enjoying themselves, but the musicians and the cast and crew of these touring shows are enjoy-ing themselves as well because it’s such a pretty place.”
For additional information of the Tennessee Theatre and upcoming shows, visit www.tennesseetheatre.com
Now, let’s go enjoy some Christmas music!
Enjoying East TennesseeTennessee Theatre
6 > DECEMBER 2014 e a s t t n m e d i c a l n e w s . c o m
Dr. Ken OliveBy JENNIFER cULP
As Executive Associate Dean for Academic and Faculty Affairs at East Tennessee State University’s Quillen College of Medicine, Dr. Ken Olive bears a privilege and a huge responsibility: “We’re train-ing the future generations of physi-cians,” he said frankly. “We keep in mind that our product is really people who are going to be phy-sicians taking care of patients in the future. That’s a responsibility we take seriously, and try to make sure that every single student who graduates is qualifi ed to have the public trust when they begin their residency and their practices.”
Olive has long been interested in academics and the transfer of knowledge. Entering the medi-cal fi eld seemed like a good way to apply his lifelong interest in science, and he entered college at Duke University intending to pursue that path. During a “temporary diversion” during which he considered becoming a scien-tist, rather than medical practitioner, “I viewed myself as being a college profes-sor,” he explained. He returned to his original interest in medicine, however, feeling “that was where God wanted me to be,” he said.
After graduating from medical school at East Carolina University, which he fi -nanced with a military scholarship, he spent seven years serving in the United States Air Force. While undertaking his internal medicine residency training at an Air Force academic medical center, he re-alized that he greatly enjoyed the teaching environment, and ultimately combined his academic and medical interests by becom-
ing a faculty member in internal medicine at Quillen in 1989.
Now, as Executive Associate Dean, Olive still sees patients at Quillen ETSU Physicians and teaches classes, but his primary responsibility is overseeing the medical student education program—supervising the curriculum; maintaining quality assurance; making sure that the curriculum is integrated appropriately across the four years of schooling; ensuring that Quillen students experience active, patient-centered learning, rather than just sitting in a classroom; and determining the best allocation of resources.
The job is not without challenges. “We’re not the wealthiest state here in Tennessee, so we try to run a really ex-cellent medical program on a relatively lean budget,” he said, noting that the
ever-changing medical landscape requires constant education and ad-aptation. The challenges of the work are outweighed by its compensa-tions, however. “I get to work with a lot of interesting people; we have a really talented group of medical stu-dents here. They come from widely varying backgrounds, and they’re really fascinating people to get to know,” he said, going on to explain that students at Quillen arrive fresh out of college, from teaching careers, as military veterans, pastors, and any number of previous careers, from all different locations and all walks of life. Interacting with students is Olive’s favorite part of his job, and working to help students struggling academically or with personal dif-fi culties can prove challenging, but extremely rewarding.
Olive is a long-time member of the American College of Physicians
(ACP), a national organization of internists and the largest single-specialty physician group in the United States. With a mem-bership numbering 141,000 internists, internal medicine sub specialists, medical students, residents, and fellows, ACP aims “to enhance the quality and effectiveness of healthcare by fostering excellence and professionalism in the practice of medi-cine,” per its mission statement.
Olive, who is board-certifi ed in in-ternal medicine and geriatric medicine, joined the organization early in his career. “I actually became a resident member [of ACP] during my fi rst year of residency and have been a member since…that would have been 1982,” he recalled. He has been a member of the Tennessee Chapter’s Governor’s Council for more than a decade and served as the Governor
of the chapter from 2009-2013. This year, Olive was awarded a Mastership designa-tion in internal medicine by the American College of Physicians.
“It’s an extremely high honor to be se-lected by your peers,” Olive explained, and not something one can really apply for or campaign to earn. Mastership candidates deemed distinguished in the practice of internal medicine are nominated by their peers, and only 40-50 of the individuals nominated are eventually chosen to receive the designation each year. “It’s an incred-ibly big honor,” he said. In April, Olive plans to attend a convocation ceremony in Boston, where he will formally be con-ferred his Master’s hood and certifi cate.
Olive and his wife, Janine, Director of the Human Research Protections Pro-gram at ETSU, are active members of Euclid Avenue Baptist Church in Bristol, Tennessee, and enjoy spending time out-doors. “We’re both avid readers—my wife more so than myself,” he admitted, and Olive also collects coins, a hobby he has maintained since he was 12 years old. Ol-ive’s two grown daughters work as a retail manager in New Orleans and at Bristol Regional Medical Center, and his step-sons work as a university archives librar-ian at the University of Houston and an administrator for a law fi rm in New York, respectively.
After completing his military obliga-tion, when he was searching for a profes-sional home where he could exercise his strengths and interests, “ETSU was the place that proved the best fi t,” Olive re-called. Twenty-fi ve years later, his deter-mination has certainly proved correct, and countless graduates of Quillen College of Medicine have Olive’s efforts to thank for excellent medical education upon entering residency and practice.
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Managing your healthcare costs during retirement
BY WILLIAM M. MORRIS, CDFA, CERTIFIED DIVORCE FINANCIAL ANALYST, UBS FINANCIAL SERVICES INC.
With healthcare costs skyrocketing, all retirees need to consider how their finances will be affected. In fact, medical care is usually one of the single biggest costs during retirement. So, as we work together to prepare for your retirement, we thought these ideas might provide clarity on this complicated topic.
Time and inflation, plus the effects of aging, will make healthcare a growing part of your budget in later years. In fact, medical inflation is a key factor to consider. Through April 2014 alone, CPI medical care costs rose 2.4%, whereas other CPI categories rose an average of 0.3% (1). According to the Health and Human Services (HHS) services, 70% of Americans need some form of long term care during their lifetimes. The cost of all kinds of long-term care varies depending upon where in the country you live. An assisted living facility, for example, can cost up to $72,000 annually (2). Medicare does not cover long term care services, making them yet another retirement expense to consider.
If you plan to retire before age 65
In the past, employers provided post-retirement health benefits for early retirees beginning at age 55. As the result of escalating healthcare costs, few companies continue to offer this retiree healthcare. Retiring early might have forced you to look for health insurance in the open market. Fortunately, the Affordable Care Act (ACA) has created new options for healthcare for early retirees.
One the most important provisions of the ACA for you as an early retiree is the establishment of state health insurance exchanges. You can no longer be declined coverage for age or a pre-existing condition. These exchanges offer at least two health insurance carriers and varying levels of coverage you can purchase. The exchange operates in the same way a large employer plan does: younger, healthier individuals are included so the cost can stay lower for everyone.
You may also meet the requirements for health insurance
premium subsidies available through the public exchanges. Your eligibility for these subsidies depends on upon MAGI (modified adjusted gross income). In order to qualify, your MAGI cannot be more than 400% above the Federal Poverty Level (FPL). For example, in 2013-2014 a 60-year- old couple with $62,000 MAGI would be able to take advantage of premium subsidies in a public health insurance exchange.
Age 65: Medicare at a glanceBeginning at age 65, Medicare
will continue to be the foundation of your healthcare coverage. As a retiree, while there is no need to enroll in a health insurance exchange. Medicare shouldn’t be your only coverage. Medicare does provide protection against many healthcare services; it does have relatively high deductibles, cost sharing requirements and gaps. Here’s a brief overview:
• Part A covers inpatient hospital stays, and hospice care. It is free to individuals and their spouses who have paid into Medicare for 10 years, or 40
quarters. Part A benefits are subject to a deductible ($1,216 per benefit period in 2014) and coinsurance.
• Part B pays physician visits, outpatient services, preventative services added by the ACA, and home health visits. Premiums vary based on income ranging from $104.90 to $335.70 per month.
• Part C refers to the Medicare Advantage program through which individuals can enroll in a private health plan such as HMOs, PPOs, and fee for service plans and receive all Medicare Parts A and B benefits. It is also possible to include a Part D plan to Medicare Advantage as well for an additional fee. Coverage, premiums and out-of-pocket costs vary because Medicare Advantage is offered by private companies. Beneficiaries purchase Medicare Advantage to assist in covering expenses not generally covered through Parts A and B. It is not a national plan; therefore Medicare Advantage isn’t offered everywhere.
• Part D is a voluntary, subsidized
(CONTINUED ON PAGE 9)
Greg Gilbert Katie Graham Brooke ThurmanStacy SchuettlerAndrew McDonaldJenny Harvey
Meet Some of the Faces Behind Our Healthcare Experience.
Date: The 3rd Thursday of Each Month Time: 11:30 AM – 1:00 PM
Location: Indian Path Medical Center Conference Room, Building 2002,
Second Floor, Kingsport
2ND THURSDAY 3RD THURSDAY
developers will probably wait another six months-two years for the FDA to complete the review process.
Speeding Up the TimelineHowever, noted Jennifer Rodriquez, a
spokesperson for the FDA, “There are sev-eral paths for making drugs and biologics that qualify available as rapidly as possible … such as Fast Track, Priority Review, Ac-celerated Approval and Breakthrough Des-ignation.”
Fast Track is a process to facilitate development and expedite review for drugs to treat serious conditions and fill unmet medical needs, which is defined as providing a therapy where none exists or providing a therapy that could potentially be better than anything currently available.
Priority Review allows for a quicker process and indicates the FDA’s goal is to take action on an application within six months of receiving data.
Accelerated Approval gives the FDA a mechanism to get drugs that fill an unmet condition approved using a surro-gate or an intermediate clinical endpoint
rather than waiting the years it could take to fully show a drug is clinically meaning-ful over the long haul. Such surrogate or intermediate endpoints – ranging from laboratory measures to improved morbid-ity and mortality rates – are reasonably likely to predict the clinical benefit of a drug.
Breakthrough Designation is given to drugs or therapies intended to treat serious conditions that are deemed to offer substantial improvement over other avail-able therapies.
“Under certain circumstances, the FDA can also enable access for individu-als to investigational products through mechanisms outside of a clinical trial, such as through an Emergency Investigational New Drug (EIND) application under the FDA’s Expanded Access program,” Ro-driguez said. “In order for an experimental treatment to be administered in the United States, a request must be submitted to and authorized by the FDA.”
She added the FDA is ready and will-ing to work with companies and investi-gators focused on serious public health
issues, such as caring for Ebola patients in dire need of treatment, “to enable access to an experimental product where appro-priate.”
Rodriguez continued, “Under the FDA’s Emergency Use Authorization (EUA) mechanism, the agency can also enable the use of an unapproved medical product, or the unapproved use of an ap-proved medical product, during emergen-cies when … among other circumstances … there are no adequate, approved and avail-able alternatives.”
She explained the EUA is an important way for the FDA to allow broader access to available products. It was the mechanism put in play this past August that allowed the FDA to authorize use of a diagnostic test developed by the U.S. Department of Defense to detect the Ebola Zaire virus in individuals.
In times of public health crisis or epi-demic, Rodriguez noted, “The FDA’s role during situations like this involves sharing information about medical products in de-velopment, as well as communicating our assessment of product readiness and clarify-
ing regulatory pathways for development.” She added the FDA works with other U.S. government agencies, international part-ners, and medical product sponsors to move products forward in development as quickly as possible without compromising patient safety.
She also noted the FDA plays an impor-tant role in disseminating evidence-based information to the public. “Unfortunately, during outbreak situations, fraudulent products claiming to prevent, treat or cure a disease almost always appear,” she said of those who play on public fears.
While the agency has a number of mechanisms to move the science more rapidly through the pipeline, Rodriguez stressed that doesn’t mean the agency gets away from its primary goal of making sure the American public has access to safe, ef-fective treatment options.
“It’s important to note that every FDA regulatory decision is based on a risk-benefit assessment of scientific data that includes the context of use for the product and the patient population being studied,” she con-cluded.
Urgent & Emergent, continued from page 1
extenders would be made until after the No-vember elections. This year, all 435 seats in the House of Representatives and one-third of the seats in the Senate were in play.
Retirement FundsJones said most physician practices still
operate on a cash basis and are still mak-ing a profit. To avoid higher corporate tax rates, it’s quite common to distribute ‘left-over’ cash to partner physicians in the form of a bonus where it will be taxed at the in-dividual rate.
“There is one deduction they can ac-crue and pay later, and that’s retirement plans,” Jones noted. “You get a deduction for the money that goes into retirement plans. Then you don’t have to pay taxes on
any of that until you do pull it out … and hopefully, by then, you’re in a lower tax bracket.”
For those who wish to take advantage of the tax benefits that come with funding a retirement plan, Jones said there are sev-eral options. The easiest is to put money in a traditional or Roth IRA, but that limits an individual to $5,500 for the year ($6,500 for those aged 50 or older).
“If they want to save more, they need to look at another type of retirement plan where they can put away up to about $55,000 depending on the vehicle,” he said. Jones continued, “It’s too late to put a 401K plan in place for ’14, but if they don’t al-ready have one, they (physician practices) should definitely think about it in 2015.
Section 179 Depreciation“In the past several years, a business
could expense up to $500,000 of new, fixed asset purchases during the year,” Jones said. On top of that, he continued, “They could also expense 50 percent of new equipment purchases … a 50 percent bonus deprecia-tion.”
That, however, has changed dramati-cally. “In 2014, that $500,000 limit dropped to $25,000, and that 50 percent bonus de-preciation is not in effect either at this time,” Jones said, adding the bonus depreciation extender could well be reinstated when Congress reconvenes after the elections. “We hope they’ll reinstate it, but we don’t know for sure.”
Jones went on to explain what the limit changes might look like for a physician practice. Using a hypothetical example, he said if a physician had a net income of $450,000 in 2013 and purchased a piece of equipment with a price tag of $400,000, the doctor could effectively drop his or her net income to $50,000. Then, using the bonus depreciation rules, that remaining $50,000 could also be expensed out to pull the tax-able amount down to zero.
“But in 2014, in that same scenario of $450,000 net income, you could only take $25,000 plus regular depreciation off the top,” Jones said, adding the tax burden would be much higher this year. (Note, there are also rules that come into play pertaining to annual dollar thresholds that are not included in this simplified example). If the bonus depreciation extender is ulti-mately put back in play, then the physician could deduct another $200,000 tied to the new equipment purchase plus normal dep-recation and the $25,000 covered under 179 depreciation.
Although, the latter scenario is clearly preferable, Jones pointed out that with or without the bonus depreciation, physicians should expect to pay more in taxes for 2014 than would have occurred under the much more generous 2013 rules. For those who have purchased new equipment this year or are planning to do so by Dec. 31, it will be particularly important to follow any last minute changes to the bonus depreciation extender.
As for the bottom line, Jones noted, “In 2013, there were so many changes. In 2014, there hasn’t been quite as much. It’s pretty much more of the same.”
Jones is based in the Jackson, Tenn. office of HORNE, one of the top 50 ac-counting and business advisory firms in the country with offices in Alabama, Louisiana, Mississippi, Tennessee and Texas.
Tax Time: Getting Your Financial House in Order, continued from page 1
e a s t t n m e d i c a l n e w s . c o m DECEMBER 2014 > 9
The Literary ExaminerBY TERRI SCHLICHENMEYER
On Immunity by Eula Biss; c.2014, Graywolf Press, $24.00 / $27.99; Canada, 207 pages
You’re question-ing the viability of a rite that children have undergone for decades: vaccinate or not?
You’ve read the pros and the cons, and your mind swims. But once you read On Immunity: An Inoculation by Eula Biss, you’ll understand a little more.
While modern medicine is surely that, vaccination has been around for quite awhile: in the mid-1700s, many no-ticed that milkmaids exposed to cowpox were immune to smallpox, and they acted accordingly. Even before that, though, parents in China and India practiced a form of vaccination called variolation. And before that, birth was “the original inoculation.”
As the daughter of a doctor, Eula Biss got the full round of vaccines that most babies of her generation received. She debated, however, about vaccinating her own son from a strain of fl u that was going around when he was an infant, which led to the greater question: which vaccines – if any - are necessary?
The complication, she learned, is that we can’t see vaccine “just in terms of how it affects a single body, but also in terms of how it affects the collective body of… com-munity.” Total world-wide immunization against disease is nearly impossible, but sta-tistics show that if the right percentage of a population is immunized, it can halt an epidemic. The majority effectively protects the minority.
So is it better to receive natural immu-nity from a disease by contracting it?
Not necessarily, says Biss. While it’s true that we wouldn’t be a species with-out viruses (a “surprising amount” of our genomes consist of “debris from ancient viral infections”), allowing your children to catch certain childhood diseases now can be detrimental to them later in their lives.
Hand sanitizers aren’t the answer, either, since they kill “indiscriminately,” promote antibiotic resistance, and leave behind traces of unsavory chemicals. And part of the vaccine-or-not issue is that mis-information can, well, go viral.
And yet, “uncomfortable with both sides” of the argument, and “overwhelmed by information,” Biss went ahead with the schedule of inoculations for her son. “I still believe,” she says, “there are reasons to vaccinate that transcend medicine.”
When you see something these days about vaccinations, it’s easy to conclude that it might fi ercely be for or against. Not so with On Immunity.
With cautious deliberation and care-ful refl ection, author Eula Biss offers read-ers a good balance in this debate, which is
delightfully welcome. As a mother, she’s obviously had to ponder the issue and her conclusions are based in fact and personal anecdote, al-though she also includes the perfect amount of history and literature for entertainment.
I’m not sure this book will change any minds, but it does offer a fair mix to consider if you’re a parent facing the decision.
Being Mortal: Medicine and What Matters in the Endby Atul Gawande; c.2014, Henry Holt; $26.00, 304 pages; c.2014, Doubleday; $32.95 Canada, 304 pages
As with many fi nales, that perfect ending to a perfect meal left you satisfi ed for the rest of the evening. It was, like some conclusions - a little night-cap, a fi nal chapter, a last dance, the lin-gering notes of a favorite song - a thing to savor.
Can the end of life be so sweet? Per-haps. There are steps to make it so, as you’ll see in the new book Being Mortal by Atul Gawande.
For about the last century, the aver-age lifespan for North Americans has been increasing. Modern medicine has taught doctors how to save lives but, until rela-tively recently, it didn’t teach them how to deal with life’s end.
That, says Gawande, is unfortunate. In many cases, doctors feel extremely un-comfortable discussing the end of life with their patients. That often leads to protocol that precludes quality of life when there isn’t much life left to have.
We’ve come to this point, this reluc-tance to face death, because we’re no lon-ger familiar with it. A century ago, people died at home, often after self-treating their ailments. Hospitals were not places to get better, says Gawande; medicine back then usually had little impact on life or death. When penicillin, sulfa, and other drugs be-came available, however, hospitals became places for cure. Nursing homes, he says, were for people who needed additional care before going home.
But medicine isn’t the only thing that’s changed: aging has, too. We live longer, we expect our parts to last longer, and we’re surprised when health fails. But does that make aging a medical problem?
To a geriatrician, it might be – but Gawande says there aren’t enough doctors of geriatrics and, without them, we have a lessened chance to sidestep problems that could diminish the quality of life in later years. He says, in fact, that the elderly don’t dread death, so much as they dread the losses leading up to it: loss of indepen-
dence, of thought, of friends.But long before that happens, Gawa-
nde says, there are conversations that need having; namely, what treatments should, or should not, be done? How far would you want your physician to go?
Let me tell you how much I loved this book: I can usually whip through 300 pages in a night. Being Mortal took me three.
Part of the reason is that author Atul Gawande offers lingering food for thought in practically every paragraph – whether he
writes about the history of aging and dying, one of his patients, or someone in his own family. I just couldn’t stop thinking about the points he made with his anecdotes and with this information, how it could radicalize our lives, and how it fi ts for just about everybody.
We are, after all, not getting any younger.
I think if you’re a caretaker for an elderly relative or if you ever plan on growing old yourself and want to maintain quality of life, this book is an
absolute must-read. For you, Being Mortal is informative to the end.
Terri Schlichenmeyer has been reading since she was 3 years old, and she never goes anywhere without a book. She lives on a hill in Wisconsin with two dogs and 11,000 books.
As with many fi nales,
and with this information, how it could radicalize our lives, and how it fi ts for just about everybody.
an elderly relative or if you ever plan on growing old yourself and want to
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drug benefi t. These plans are offered through private insurers who have been approved by Medicare. Part D is also offered on a sliding scale depending upon income. Each company determines its own premiums and the prescription drugs it covers. Before enrolling in a Part D plan or adding it to other Medicare plans, be sure that the drugs you take are part of the program.
Medigap is a supplement to Medicare A and B and is sold by private insurance companies. It is coverage that can help pay some of the healthcare costs that Parts A and B don’t cover, such as copayments, coinsurance and deductibles. Some Medigap policies also offer coverage for services that original Medicare doesn’t cover, such as medical care when you travel outside of the United States. Unlike Medicare Advantage, Me digap policies don’t include original Medicare cover age—they supplement it. Also, Medigap policies don’t cover Part D, so an additional prescription plan must be purchased to get Part D coverage.
Be sure that you make note of the deadlines for applying for Medicare for the fi rst time, renewing or changing carriers. Missing deadlines can result in penalties that will impact your Medicare going forward.
Consider how to pay for long-term care
As noted above, most Americans will eventually need long-term care—ongoing care to help them with the activities of daily living. This may be ongoing care for someone with an injury, chronic illness or disability. A long-term care insurance policy, or a life insurance policy with a long-term care rider, generally pays a daily benefi t for eligible services provided at home, at an adult daycare center, or in as assisted living facility or nursing home. Details of coverage vary widely from plan to plan, but generally the younger you are when you buy the policy, the lower the premiums will be. Whether you purchase long-term care insurance or choose other strategies to pay for long-term care, careful fi nancial planning can help you preserve assets and cope with these challenges.
Disclaimer: This article has been written and provided by UBS Financial Services, Inc. for use by its Financial Advisors. Neither UBS Financial Services, Inc. nor its employees provide tax or legal advice. You should consult with your legal and/or tax advisors when making decisions about retirement plans and retirement plan distributions. The information contained in this article is based on sources believed to be reliable, but its accuracy cannot be guaranteed.
Notes1US Department of Labor, Bureau of Statistics, Consumer Price Index as of 4/14.2Genworth Cost of Care Study 2013.
The Bottom Line, continued from page 7
10 > DECEMBER 2014 e a s t t n m e d i c a l n e w s . c o m
National health care leader joins Mountain States teamPublic health and Medicaid expert to lead innovation and development for system
JOHNSON CITY – Mountain States Health Alliance announced that Anthony (Tony) Keck will serve as the system’s senior vice president and chief development of-ficer. Keck has been serv-ing since 2011 as director of South Carolina’s Depart-ment of Health and Human Services.
Keck brings with him more than 25 years of ex-perience in health care management, consulting, policy leadership and academics, and has served as a health policy advisor for two currently sitting gov-ernors. Prior to his appointment by Gov-ernor Nikki R. Haley of South Carolina, Keck served three years in the administration of Louisiana Governor Bobby Jindal as health and social services policy advisor to the gov-ernor, and as chief of staff and then deputy secretary of the Louisiana Department of Health & Hospitals.
Keck was active in establishing the Louisiana Health Care Quality Forum after Hurricane Katrina, serves on the Board of the National Association of Medicaid Direc-tors, the executive committee of the Na-tional Academy of State Health Policy, and was a member of the National Academy of Sciences Institute of Medicine’s committee on governance and financing of graduate
Wellmont Further Supports Russell County with Donation to Veterans Memorial ParkLEBANON, Va. – Wellmont Health System is helping Russell County salute its veterans with a donation to support a new park the com-
munity has built in their honor.David Brash, Wellmont’s senior vice president of business development and rural strategy, presented a $1,500 check to Lebanon Mayor
Tony Dodi during a brief event Thursday, Nov. 13. The money will be used to help finish remaining components of the Russell County Veterans Memorial Park, which is located in front of the Government Center.
Wellmont has developed a growing partnership with the Leba-non community, recently opening an urgent care facility to comple-ment the sleep center and heart services it already offers. The urgent care and sleep center are operated by Wellmont Medical Associates, and heart services are delivered by the Wellmont CVA Heart Institute.
The Town of Lebanon has built the park in conjunction with American Legion Post 208, which had the vision for the memorial, and Lebanon Veterans of Foreign Wars Post 9864. It features five walls, each of which represents a different branch of the military, and they have been placed in a five-point-star formation. Flags for the Army, Navy, Air Force, Marines and Coast Guard fly by their respec-tive walls.
In the center is an empty chair placed by Rolling Thunder, Ten-nessee Chapter 4, to remember those who have been prisoners of war or are missing in action. Nearby is the refurbished town cannon.
More than 400 veteran memorial plaques have been placed on the walls, but there is still room for others. To be eligible, a person must be a current or honorably discharged member of the Army, Navy, Air Force, Marines, Coast Guard, National Guard or Reserves. Those who were killed in action, died while they were on active duty from other causes, are missing in action or have been a prisoner of war can also have a plaque on one of the walls.
Anyone wishing to add names to the walls can pick up an application at Town Hall or request one be mailed by calling Jackie Hubbard, the town’s financial administrator, at 276-889-7200. The cost for a plaque is $75.
Some elements of the park, which is already open to visitors, remaining to be completed include fencing, landscaping, a waterfall and benches.
The town is still accepting donations. Checks can be made payable to Town of Lebanon, with a notation for the park, and mailed to P.O. Box 309, Lebanon, VA, 24266.
Borja helping patients get best of both worlds through Integrative Medicine Clinic
JOHNSON CITY – When it comes to defining integrative medicine, Dr. Anton Borja likes to describe it as getting the best of both worlds.
“Integrative medicine is a new way of looking at an old form of medicine,” ex-plained Borja, director of the Integrative Medicine Clinic in East Tennessee State University’s Department of Family Medicine. “It is patient centered, focuses on the whole patient and incorporates evidence-based therapies – both old and new.”
Combining eastern medicine like acu-puncture, osteopathic manipulation and other natural remedies with western medi-cine practices more commonly seen in the region, Borja said, allows a physician to bet-ter treat the whole person rather than focus-ing just on a specific ailment.
Borja originally trained in Traditional Chinese medicine and maintained a practice in it for years in California. He later complet-ed his medical degree at A.T Still University, School of Osteopathic Medicine in Arizona, medical training at Lutheran Family Health Center in Brooklyn, N.Y., internship at Columbia University/NY Presbyterian and his family medicine residency at ETSU.
He began an acupuncture clinic at the Family Medicine clinic in Johnson City last year and then stayed at ETSU as a faculty member in an effort to push for further use and avail-ability of integrative medicine at the facility.
“Now, the Integrative Medicine Clinic is thriving. There’s a demand for it. It really is the best way to practice medicine,” Borja said. “I try to incorporate my training in both aspects of medicine to come up with a treatment plan that will most benefit my patient.”
For some patients, the solution might be acupuncture, herbal medications or mindful-ness-based stress reduction such as meditation or Tai Chi. For others, the fix might be a prescription for a pharmaceutical drug. Still others may be treated with a combination of the two forms of medicine.
For more information about the Integrative Medicine Clinic at ETSU Family Medicine Associates, call 423-439-6464. The clinic is located at 917 W. Walnut St. (continued on page 11)
Representatives of Wellmont Health System and the Town of Lebanon gathered for a check presentation at the Russell County Veterans Memorial Park. In the photo are, left to right, Mayor Tony Dodi; Councilman Hassel Kegley; Councilwoman Deanna Jackson; David Brash, Wellmont’s senior vice president of business development and rural strategy; Town Manager Michael Duty; and Vice Mayor J.C. Boyd.
e a s t t n m e d i c a l n e w s . c o m DECEMBER 2014 > 11
GrandRoundsmedical education, which recently released its final report, Graduate Medical Education That Meets the Nation’s Health Needs.
Keck will begin his service with Mountain States in mid-December 2014. He will oversee the system’s efforts to advance population health management in addition to oversee-ing the corporate marketing and communica-tions functions, the activities of the Mountain States Foundation, government programs, strategy, and commercial business services. He and his wife have purchased a home and will reside in Bristol, Tenn.
Three Leaders Who Have Helped Shape Wellmont Honored by THA
KINGSPORT – Three leaders who have played integral roles in Wellmont Health System’s delivery of superior health care with compassion have been honored by the Tennessee Hospital Association.
Dr. George Milum Testerman, a trauma surgeon at Holston Valley Medical Center, was selected as a physi-cian recipient of the Meri-torious Service Award. T. Arthur “Buddy” Scott Jr., a longtime board mem-ber for Holston Valley and Wellmont, earned the same award for board members. And Phyllis Dossett, director of clinical services at Han-cock County Hospital, was chosen to receive the Nurse of Distinction award.
All three were recog-nized Friday, Nov. 7, at the hospital association’s annual meeting in Nashville.
“Dr. Testerman, Mr. Scott and Ms. Dossett have made remarkable contribu-tions to the high quality of care our patients receive and reinforced the strong ties we enjoy with the com-munities we are privileged to serve,” said Bart Hove, Wellmont’s in-terim president and CEO. “We thank them for their tireless efforts and are grateful they have committed so much of their lives to the betterment of our region.”
Hove said Dr. Testerman has per-formed admirably as a key member of the Level I trauma center at Holston Valley since its inception 26 years ago. In addition to delivering lifesaving care, he has gener-ously provided a significant gift to Wellmont Foundation to create the George M. Tester-man, MD, Injury Prevention Fund.
This fund was the latest example of Dr. Testerman’s efforts to promote safety in the region. He and the rest of the trauma team were instrumental in securing Sullivan County’s designation as a Safe Commu-nity by the National Safety Council. He also wrote a research paper on red light cameras the Kingsport Police Department used to increase traffic regulation and reduce acci-dent rates. In addition, he has devoted con-siderable attention to safety and accident reduction for all-terrain vehicles.
Hove said Scott has been a key figure in the history of Holston Valley and Well-mont, offering expertise and wisdom at
pivotal moments for the organization. He served on the Holston Valley board for 32 years and was a member of the Wellmont board for 14 years.
He was chairman of the Holston Val-ley board during the planning process of Project Platinum, a $114 million update of Kingsport’s flagship hospital. He was also a board member during other substantial milestones at Holston Valley, including es-tablishment of the Level 1 trauma center and opening the neonatal intensive care unit.
Scott was chairman of the Wellmont board when it began evaluating Wellmont’s strategic options for the future, a process that continues today. He also helped guide the system through major growth and tre-mendous advancements in the broad spec-trum of services it offers. Plus he played a vital role in ensuring many Wellmont initia-tives became a reality through his service as a director and member of the executive committee for Wellmont Foundation.
Hove said Dossett is a proven leader whose breadth of service to Hancock Coun-ty is extraordinary. While her office is in ad-ministration, Dossett is frequently elsewhere at the 10-bed hospital – working in the emergency department, assisting patients’ family members, entering electronic medi-cal records, rounding on patients at home and in the hospital, providing rides to those with transportation issues, greeting visitors and working with nurses.
Dossett has also made a positive differ-ence in the quality of care and quality of life in the community. In 2013, she and Shaun-da Brooks, a registered nurse at Hancock County helped all hospital staff earn their CPR certifications. Dossett is a basic life sup-port instructor and serves on the board of directors for Hancock County EMS, Amedy-sis Home Health Care and the Foster Child Review Board.
Frontier Health CEO to Retire, Board of Directors Announce New CEO
JOHNSO N CITY—Frontier Health’s CEO Charles E. Good announced his plans to retire effective January 2, 2015, after 36 years of service in both se-nior leadership and clinical roles.
Frontier Health’s Board of Directors Chair Gary Mabrey said of Good’s role in developing community mental health services in Northeast Tennessee and Southwest Virgin-ia, “Charlie saw advantages in local mental health and community organizations coop-erating to meet regional needs and was one of the leaders who made sure services continued despite turbulent health care change. We’re glad he’s agreed to stay on as a consultant during this transition.”
The Board of Directors appointed Dr. Teresa Kidd as Frontier Health’s new CEO. She has served as President since August 1 and will assume the additional responsi-bilities of CEO effective January 2.
Dr. Kidd is a licensed psychologist and received her PhD from the University of Ten-nessee, Knoxville in 1980.
Dr. George Milum
Buddy Scott Jr.
Dr. Teresa Kidd
Mountain States’ new leadership team complete for JCMC, Washington County
JOHNSON CITY – Mountain States Health Alliance has its new leadership team in place for Washington County and Johnson City Medical Center, headed by Melody Trimble, who serves as market CEO for all of Mountain States’ Washington County operations.
The leadership team, chosen over the last few months from both within and outside the organization, will oversee Johnson City Medical Center and portions of the operations of Nis-wonger Children’s Hospital, Franklin Woods Community Hospital and Woodridge Hospital, which together make up Mountain States’ largest and busiest market. Johnson City Medical Center is the flagship facility of Mountain States’ 14 hospitals, serving as a regional referral center and offering level 1 trauma services to the health system’s 29-county service area.
The leadership team includes: Tony Benton, chief operating officer; Richard Boone, chief financial officer; Kenny Shafer, associate administrator; Dr. Clay Runnels, chief medical office; Rhonda Mann, chief nursing officer
Trimble, a Fellow of the American College of Hospital Executives (FACHE), worked with Mountain States CEO and President Alan Levine when he was also with HMA. She said she’s found this region to be both beautiful and friendly.
Trimble has joined the Washington County Economic Development Council and said she plans to serve on the Mountain States Foundation Board of Directors and the Hospital Alliance of Tennessee. She and her husband, Mike, have two grown daughters, Mary (and husband Daniel) and Michaela, as well as three beloved grandchildren who live in Knoxville.
Here is more on the rest of the leadership team:Tony Benton, VP and COO – A Mountain States veteran, Benton served as interim CEO
of Washington County operations since former JCMC leader David Nicely left in April for a job with another health care system in Middle Tennessee. Benton has also served as vice president of strategic planning, CEO of Franklin Woods Community Hospital and vice presi-dent of marketing and communications during his 13 years with Mountain States. As Franklin Woods CEO, he helped lead that hospital to national recognition for top performance in clinical outcomes and patient satisfaction.
Richard Boone, VP and CFO, JCMC – Richard spent more than 20 years with HMA in vari-ous roles including group operations finance, overseeing 35 hospitals in 11 states. Although not related to the famous late actor of the same name who starred in many Westerns, Richard has an interest in cattle, as Richard and his wife, Earlene, raise registered Polled Hereford and Black Hereford cattle.
Kenny Shafer, Associate Administrator, Washington County – Shafer also came to Moun-tain States from HMA, where he was assistant administrator at Spring Hill and Brooksville Re-gional hospitals in Florida. He’s a big fan of golf, hiking and being outdoors, and received his bachelor’s degree from Florida Gulf Coast University and his master’s from University of Florida – thus is a Gator fan. He and his wife, Kaitlyn, have a 7-month-old daughter named Blaire.
Dr. Clay Runnels, VP and CMO, Washington County – Runnels most recently served as chief medical officer at Indian Path Medical Center in Kingsport. He has served at Mountain States as an emergency department physician, assistant medical director and medical direc-tor for emergency services, and corporate medical director for emergency services. He has been involved in the co-management of the 12 Mountain States emergency departments, including oversight for more than 125 physicians and mid-level providers. He and his wife Emily have five children, and Runnels enjoys coaching their teams in baseball and soccer whenever he can.
Rhonda Mann, VP and CNO, JCMC – Mann took the chief nursing officer position in July after serving as CNO and assistant administrator at Franklin Woods Community Hospital since its opening in 2011, leading that hospital to national recognition for top performance in clinical outcomes and patient satisfaction. Prior to her role at Franklin Woods, she was the CNO and assistant administrator at Johnson City Specialty and North Side Hospitals. She has held several other key positions with Mountain States since 1995, including ICU charge nurse and house supervisor at JCMC. Mann received her nursing degree from East Tennessee State University, masters of business administration from King College, and completed a fellowship with the Healthcare Advisory Board.
Two more changes involve Woodridge Hospital, the 84-bed inpatient provider of mental health and chemical dependency services for adults, adolescents and children. Lindy White, vice president and CEO at Franklin Woods, will also take on the role of CEO at Woodridge. White recently came to Franklin Woods after nearly 20 years at Smyth County Community Hospital, in Marion, Va.
Additionally, Joshua McFall, chief financial officer at Franklin Woods, will also serve as the CFO at Woodridge Hospital. He has been with Mountain States since 2009. Both White and McFall will join the current Woodridge leadership team anchored by Dru Malcolm, assistant administrator and chief nursing officer.
Left to right: Dr. Clay Runnels, CMO; Rhonda Mann, CNO; Tony Benton, COO; Melody Trimble, CEO; Richard Boone, CFO; and Kenny Shafer, associate administrator.
Independent member of the medical staff
Niswonger Children’s Hospital brings a new specialty to the region. Dr. Valentine T. Nduku
is helping to establish the Tri-Cities’ first pediatric neurosciences program, an important
part of our continuing expansion of specialized services for children. He comes to Johnson
City from Cincinnati Children’s Hospital, recently ranked as the fourth best pediatric
neurosurgery and neurology program in the country.
With the medical direction of Dr. Nduku, Niswonger Children’s Hospital will be able to
provide treatment for a wide range of pediatric neurosurgery needs, including:
• Epilepsy and seizure disorders
• Congenital neurological diseases
• Pediatric head trauma
To learn more about this program, please visit msha.com/pediatricneurosurgery.