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A publication for and about health-care providers in CNY

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APRIL 2015

NEWS

EDITOR-IN-CHIEFAdam Rombel

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ASSOCIATE EDITORMaria J. Carbonaro

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STAFF WRITERSEric Reinhardt

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Norman [email protected]

CREATIVE DIRECTORErin Zehr

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RESEARCH DIRECTORNicole Collins

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Health-Care BRIEFSSYRACUSE — ACR

Health has elected Dr. Cynthia Morrow and attorney Shannon O’Connor to its board of directors.

Morrow, M.D., MPH, is professor of practice in public administration and international affairs at the Maxwell School of Syracuse University. She holds a joint appointment as assistant pro-fessor in the Department of Public Health at Upstate Medical University. Morrow previously served as the commissioner of health for Onondaga County.

O’Connor is an assistant corporate counsel in the City of Syracuse Law Department. Prior

to her law career, she worked with HIV positive and at-risk individuals in Buffalo and the District of Columbia.

ACR Health says it is a nonprofit, community-based organization pro-viding a range of support services to individuals with

chronic diseases, including HIV/AIDS, diabetes, heart disease, obesity, asthma, substance-use disorders, and serious mental illnesses.

Founded in 1983, the organization pro-vides services in nine Central New York coun-ties: Cayuga, Onondaga, Oswego, Jefferson, St. Lawrence, Lewis, Herkimer, Oneida, and Madison.

Morrow, O’Connor elected to ACR Health board

MVP Health Care lost $12.4 million in 2014, which it said was a “nine percent im-provement over 2013.”

The Schenectady–based health insurer announced its 2014 financials in a news re-lease issued April 1.

MVP generated $2.9 billion in revenue last year, up nearly 18 percent from $2.5 billion in 2013. MVP’s membership remained “strong” with “sig-nificant” increases in several program areas, the release stated.

MVP’s fiscal performance in 2014 “significantly exceeded” its earlier projections due, in part, to “greater savings” as part of the integration of Hudson Health Plan opera-tions, the health insurer said.

MVP acquired Hudson, a Tarrytown, New York–based Medicaid managed-care orga-nization, in August 2013.

“MVP ended the year in a

very strong position, grow-ing membership, reducing expenses and investing in a multi-year transformation of our business to better serve our members,” Christopher Del Vecchio, execu-tive vice presi-dent of strategy and innovation at MVP Health Care, said in the release.

MVP also listed what it considered as “achievements” in 2014.

The health insurer said it garnered the “largest” share of the health-care exchange market in upstate New York.

MVP also provides services to more than 6,000 member groups, trusts, and associa-tions and grew that portion of its membership about 12 percent in 2014.

Membership in its Medicaid

managed-care programs also grew about 20 percent last year, the health insurer added.

MVP Health Care is the sixth-largest health insurer

in Central New York, ranked by number of members, ac-cording to the 2015 Book of Lists. The health insurer has more than 62,000 members in Central New York. MVP employs 36 people in the region.

MVP employs 1,500 people statewide and has 700,000 total members, according to updated figures provided by a spokeswoman on April 3.

MVP Health Care posts $12.4 million loss in 2014

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Master of Science in Nursing Education

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CAREER SNAPSHOT:Physical Therapists

Physical Therapists by CNY County NumberBroome 170Cayuga 52Chemung 73Chenango 26Cortland 36Herkimer 46Jefferson 79Lewis 20Madison 62Oneida 239Onondaga 583Oswego 89Seneca 20St. Lawrence 96Tioga 53Tompkins 104CNY TOTAL 1,748NYS Total 17,288

Source: NYSED.gov, as of Jan. 1, 2015

$38.31Hourly mean wage for physical therapists in New York

36%Projected percent change in employment for physi-cal therapists (PTs) in the U.S. from 2012 to 2022

$80,610Annual mean wage for PTs in New York

$51,910Annual mean wage for PT assistants in New YorkSources: BLS and NYS Department of Labor

http://www.sunypoly.edu/graduate

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BY ERIC [email protected]

DeWITT — Four lawyers in the health-care group of Hancock Estabrook, LLP dis-cussed legal issues of tele-health and telemedicine during the Syracuse law firm’s 2015 Health Law Symposium held March 5 at the DoubleTree by Hilton Hotel in DeWitt, near Carrier Circle.

The panel discussion covered topics that included reimburse-ment, licensure, medical-staff credentialing, liability, and se-curity issues.

The attorneys participating included Mary Miner, Meghan Gaffey, Catherine Diviney, and Laurel Baum.

Reimbursement“We have some similarities

and some inconsistencies” on definitions of telehealth in terms of reimbursement, depending on if you speak to general prac-titioners or to Medicare repre-sentatives, Miner said to open her remarks.

For reimbursement, Medicare defines telehealth as a “condition of payment,” meaning telehealth must use an interactive audio and video-telecommunications system that permits real-time commu-nication between the provider and the patient.

“Interestingly, CMS (Centers for Medicare & Medicaid Services) also has a definition of telemedicine under Medicaid, which is the same as this first

definition … but they call it telemedicine,” said Miner.

New York has legislation pending, she added, but cur-rently has a separate definition for telehealth, which includes telemedicine, store and for-ward technologies (such as the use of digital images and telera-diology services), and remote patient monitoring.

“The main limitation to re-imbursement for Medicare has been that they only reimburse for services that are provided to patients in a rural area,” she noted.

But that doesn’t mean that Medicare doesn’t reimburse for other services provided through communication tech-

Hancock Estabrook attorneys discuss telemedicine issues at symposium

Hancock Estabrook attorneys (from left to right) Laurel Baum, Catherine Diviney, Meghan Gaffey, and Mary Miner discuss legal issues of telehealth and telemedicine during the law firm’s 2015 Health Law Symposium held March 5 at the DoubleTree by Hilton Hotel in DeWitt.

See sYmposIum, page 20 4

KeY FactS6Topics

covered:Reimbursement,

licensure, medical-staff credentialing, liability, and

security issues

6Panel

Attorneys:Mary Miner,

Meghan gaffey, catherine Diviney,

and Laurel Baum

The main limitation to reimbursement for Medicare has been that they only reimburse for services that are provided to patients in a rural area.


Poll: Consumers interested in video consultations with doctorsBY NICOLE [email protected]

A recent poll conducted by Harris Poll on behalf of American Well, a telehealth

company, found that 64 percent of consumers would be willing to have a remote video consultation with a doctor.

The most common reason was convenience. Saving time and money, avoiding germs at hospi-tals and clinics, and the comfort of being able to stay at home when

not feeling at their best were other common motives to opt for a video consultation.

Here are some other results re-garding consumer telehealth prefer-ences from the online survey of more than 2,000 adults:

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30 percentThe share of parents who would prefer a video visit with a doctor in the middle of the night

70 percentWould rather have a video consultation to obtain a prescription

6 out of 10Want to refill a prescription via video

63 percentBelieve high-definition video would provide the best remote diagnosis, compared to tele-phone and email

11 percentThe share of 18 to 31-year olds who would switch doctors to get video access

$49 versus $750Cost of a telehealth visit compared to an emergency room visit

http://www.bryantstratton.edu


BY NormaN [email protected]

UTICA — The staffing and recruiting business, a $400 billion industry, is thriv-ing from increased placements and reve-nue, according to a survey from Bullhorn, an online recruiting-software firm.

Fortus Healthcare Resources, head-quartered in Utica, leads this industry trend with a 32 percent, annual-compound-ed growth rate that has put it on the Inc.–5000 list for the past three years. (The 2014 Inc. listing is based on the per-centage of revenue growth when compar-ing 2010 to 2013.) Michael Maurizio, the president, CEO, and founder of Fortus, says the company is poised to double sales in the next few years.

Maurizio is basing his projections on a business plan he began implementing in

November 2013. The first step was to rebrand the firm, which had been known by its two operating corporations: The Fortus Group, Inc., a C-Corp. for the direct-placement business, was set up in 1993 to handle staffing for dialysis units; the second corporation, Fortus Group Travel, Inc., an S-corp. for the travel busi-ness, was created in 2006 to place travel-ing nurses and patient-care technicians. Fortus Healthcare Resources is a d/b/a.

“We recognized the importance of di-versifying the business and expanded our business model to become a full-service consultant,” says Maurizio. “The new brand — Fortus Healthcare Resources — is an integral part of our growth strat-egy.”

The second step was to hire a company CFO to help guide the growth. “I hired Dave (David L.) Keenan,” notes Maurizio,

“a certified public accountant, whose pre-vious experience included working at PriceWaterhouseCoopers for eight years as a tax manager and most recently more than a dozen years at Oneida Ltd. as the vice president of treasury and tax. He also has experience in the mergers and acquisitions area, which we are looking at to supplement our organic growth. Dave has already pointed out a number of opportunities to increase our growth and profitability.”

Keenan is certainly bullish on the di-rection of the company he joined at the end of October 2014. “The direct-place-ment business continues to be strong and consistent,” affirms the new CFO. “But Fortus has seen explosive growth in the travel business, which has grown from $2 million to $6 million just in the last few years. Further growth in both divisions has come from the new initiatives in di-versifying our reach to clinicians in other areas of the hospital outside of dialysis. While the potential for organic growth is our primary focus, if the right opportu-nity appeared, we are open to acquiring a health-care-staffing company. To me, however, our most immediate path is to increase revenue and profitability within our defined organic-growth initiatives.”

The third step was to add the required space to accommodate the projected growth. “In September 2014, we moved our office from the old Harza Building in downtown to our new building on the south side of Utica at 2717 Genesee St. We replaced 5,000 square feet with 8,000 square feet and organized each of the operating corporations on its own floor. This not only gives us room to add staff, but also makes for a smoother opera-tion flow.” Maurizio owns the new office building through a real-estate company he calls Performance Plus, LLC. Oneida County real-property records indicate that the building and land was sold for $475,000 on July 17, 2014. The structure was built in 1980.

DiversificationFortus has come a long way since its

early days of only placing dialysis profes-sionals. “We really are diversified now,” Maurizio stresses. “In addition to dialy-sis health-care professionals, we provide health-care organizations with RNs and LPNs, social workers, dieticians, surgeons, in-service and educational clinicians, ex-ecutive-level management, bio-med tech-

Michael Maurizio, the president, CEO, and founder of Fortus, says the company is poised to double sales in the next few years.

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Health-care placement firm poised for more growth

BY JOURNAL [email protected]

UTICA — The Mohawk Valley Health System (MVHS) will use $300 million from the newly approved state budget as it explores the possibility of a new hospital.

The new hospital would replace the inpatient care currently provided at the St. Luke’s campus of Faxton St. Luke’s Healthcare (FSLH) and at St. Elizabeth Medical Center (SEMC).

MVHS announced the approved fund-ing in a news release issued April 1.

MVHS is an affiliation of Faxton St. Luke’s Healthcare and St. Elizabeth Medical Center, both of Utica. The two organizations teamed up in March 2014.

Gov. Andrew Cuomo had proposed

$300 million to help “create an integrated health-care delivery system in Oneida County,” MVHS said in the news release.

The proposal was part of a $700 million recommendation to support upstate New York hospitals.

“This is an incredible opportunity for our community and we are extreme-ly grateful to the governor and our legislators,” Scott Perra, president and CEO of the Mohawk Valley Health System, said in the news release. “Last fall we began exploring the concept of a new, free-standing hospital. To be able to move forward with this concept changes healthcare in our community and enhances

what we are able to do for the region.”MVHS estimates a new hospital would

cost between $460 million and $500 mil-lion. The state-approved $300 million “helps to lay the foundation for funding,” the organization added.

MVHS would also need additional fi-nancial support from federal and state governments, lending institutions, and philanthropic support from the commu-nity, according to the news release.

MVHS estimates the project will take four to six years to complete with a “num-ber of steps” that need to happen even before the first shovels are in the ground.

“One of the most frequently asked questions is ‘where would we build a new hospital?’ and we don’t know yet,” said Perra. “We are working with Steve DiMeo

and Mohawk Valley EDGE to look for po-tential sites in our area”

The MVHS board of directors will make the final de-termination for the site, according to the news release.

MVHS needs to develop a plan for the hospital, structure, location, services, and staffing in the next 12 to 18 months. n

APRIL 2015 I HEALTHCARE PROVIDER 7

Dr. Sheryl Movsas

PHYSIATRY

A few months ago, this pain su� ererwas climbing the walls

in an entirely di� erent way.

When you can’t do the things you love, it can drive you up a wall. Physical medicine and rehabilitation specialist Dr. Sheryl Movsas is an expert in the diagnosis, treatment and prevention of conditions of the muscles, bones and nerves. Dr. Movsas cares for adults who su� er from a variety of pain and mobility restrictions – from sports and work-related injuries, to stroke, Parkinson’s, multiple sclerosis, cancer, and many more. She uses a range of non-surgical treatment methods including performing injections, prescribing pain medication and orthotic devices, and ordering physical, occupational, or speech therapy. Through early diagnosis, she can help prevent further injury, and maximize function and independence.

For a video and more about Dr. Movsas, visit CPHospital.org or call (315) 714-3350.

State budget includes $300 million for new Mohawk Valley hospital

http://www.CPHospital.org


HEALTH CARECEO TALK Kimberly Boynton,

CEO of Crouse Hospital (right), Quynn Costello, registered nurse (left), and Dr. Michael Jorolemon (back) stand in a treatment room in-side Crouse’s emer-gency department.

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BY ERIC [email protected]

SYRACUSE — Crouse Hospital has plans to renovate and expand its emergency room (ER) in a $35 million project that’s currently in the design phase.

The project will include relocating its PromptCare urgent-care service from its current location across Irving Avenue to the space that the existing emergency department currently occupies.

Crouse has already started the plan-ning and design process for the project to expand the ER, which will increase in size from 8,000 to 16,000 square feet.

The number of ambulance bays will increase from three to five in the project.

The hospital will locate the new ER di-rectly above the Witting Surgical Center in adjacent space that has already been constructed for this purpose.

Some phases of the new emergency room will open in 2017, says Kimberly Boynton, CEO of Crouse Hospital.

“The final phase will open in 2018,” she adds.

Boynton spoke with HealthCare Provider on April 9.

Crouse views the ER as the “front door” to the hospital.

“Our admissions come through the emergency room and hundreds of patients everyday are entering, ei-ther through the emergency room or PromptCare, which is directly across

[Irving Avenue],” she says.PromptCare will eventually close, says

Boynton. The 32 employees will continue their work in the expanded emergency room when the project is complete.

The project’s first phase will involve the build-out of the new space, then the renovations will target the existing ER to handle the patients that had visited PromptCare.

PromptCare treats medical emergen-cies at a “lower level” than the ones requiring treatment in the emergency room, says Boynton.

As the design phase continues, Crouse employees, nurses, physicians, technical staff, patient advisers, and the emer-gency-medical services community are providing input.

“It’s a long pro-cess, but it’s so im-portant when you’re embarking upon a project of $35 million that you get it right,” she adds.

The design work on the project start-ed in 2014, although Crouse has been thinking about this project for several years, says Boynton.

Louis Porcaro of Walpole, Mass.–based LPS Design Associates, Inc. is doing the design work on the project.

Crouse will begin the bid process for a contractor once it completes the de-sign phase.

Crouse on Dec. 18 announced that the Central New York regional economic-development council awarded it $2 million for the project.

Besides the $2 million REDC grant, Crouse hopes to secure additional grant funding to help pay for the $35 million initiative. The Crouse Health Foundation will also conduct a capital campaign,

which has yet to begin. The hospital will also use “operational

dollars,” says Boynton. “The money that the hospital generates

through net income is the money that we put back into the facility for construc-tion projects … equipment, [information-technology] systems … that’s what the bottom line is used for,” she says.

Crouse will use a bond offering to bor-row about $20 million for the project, says Boynton.

Constructed in 1972, Crouse’s original ER has had “minor” updates over the years. The hospital last updated the facili-ty in 2008, but it is “outdated, undersized,” and “inefficiently configured” given the hospital’s “rising” patient volumes, ac-

cording to the hospital’s news release announcing the REDC grant award.

Crouse’s patient count has increased 39 percent over the last seven years.

Crouse’s total emergency-services vol-ume is the “highest” in the city, with more than 72,000 ER and PromptCare-patient visits in 2013, the hospital said. n

Crouse Hospital’s Boynton discusses plans to expand, renovate ER

eric reinhardt/business journal news network

The space adjacent to the existing emergency room at Crouse Hospital, which will become part of the hospital’s expanded emergency facility.

“It’s a long process, but it’s so impor-tant when you’re embarking upon a project of $35 mil-lion that you get it right,” Boynton says

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SOS shows backbone in transforming its operation

BY norman [email protected]

DeWITT — Syracuse Orthopedic Specialists, PC (SOS), headquartered in Widewaters Park in DeWitt, is a growing 30-doctor group that currently has of-fices in Auburn, Baldwinsville, Camillus, Cicero, Clay, DeWitt, Fayetteville, Liverpool, North Syracuse, and Onondaga Hill.

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Dr. John Fatti, the president of Syracuse Orthopedic Specialists (SOS), relaxes briefly in the Widewaters Park office before seeing patients. SOS is a 30-doctor group employing 620 people in 18 locations in Central New York. In 2014, it saw more than 60,000 patients.


The health-care provider’s recently ex-panded footprint comes on top of explosive growth in the past few years with the ad-dition of two SOS-Plus locations for after-hours care (DeWitt in September 2011 and Onondaga Hill in August 2013), and the ac-quisition of seven physical-therapy centers.

SOS is responding to a few emerging trends in health care.

“There are several things driving our need to grow,” says Dr. John Francis Fatti, president of SOS. “In order to meet the de-mands of our community, we are developing contractual relationships with our payers: the government, private insurance compa-nies, employers [who pay for worker’s com-pensation], coaches and trainers in sports medicine, and the hospitals. Second, to re-cruit a staff of well-trained physicians, SOS needs to offer a variety of sub-specialties, and ancillary services to create efficiencies. Third, the demand for the latest technology is a huge capital burden which can best be supported through economies of scale. And fourth, all payers are ratcheting down their reimbursements to provid-ers. To maintain our revenue, we need to become more effi-cient and care for more patients. It’s also clear to me that reim-bursements are finally moving to a bundled, capitation model, so SOS will need to be involved in the entire episode of the care continuum.”

The initial business plan origi-nated in 1999, when three local orthopedic groups — University Orthopedics & Sports Medicine, P.C., CNY Orthopedics, and Onondaga Hill Orthopedics (a d/b/a owned by eight doctors) — began talks to merge the entities. The merger re-sulted in the founding of SOS in 1999.

“Today, SOS offers comprehensive medical care for musculoskeletal disorders, which includes not just bones but also muscles, ligaments, and tendons,” Fatti em-phasizes. “Our practice offers an extensive list of sub-specialties including foot and ankle, hand and wrist, sports medicine, joint-replacement, and spine. The only sub-specialty not included is pediatric orthope-dics.”

Fatti continues, “Our extension into physical therapy (PT) is a natural fit that dovetails with our strategic plan. Last year (June 16, 2014), we closed on five local cen-ters of Fitness Forum plus Salt City Physical Therapy and Orthopedic Rehabilitation Services [PT, PC].”

SOS did not disclose the financial terms of the deals, but indicated that Jim Smith, the president of Fitness Forum, signed a 5-year contract to help SOS expand. “The

decision to expand into PT was not a finan-cial decision, but rather allows us to offer enhanced, therapeutic services for our pa-tients,” states Fatti. “It also positions us for the ‘bundling’ of reimbursements.”

Size and scopeWhat started out as a concept 18 years

ago is now a major business spread over 18 locations. In 2014, the practice saw more than 60,000 patients. The enterprise occu-pies 135,000 square feet, of which SOS owns approximately 54,000; the rest is leased.

SOS employs 620 people, which includes temps and per-diems (81 are in the phys-ical-therapy division). SOS has grown its employee count 56 percent in just the past five years. Of the group’s 30 doctors, 25 are shareholders in the corporation. HealthCare Provider estimates SOS’s annual revenue at $75 million.

SOS also offers management services to

other health-care practices, such as the New York Spine & Wellness Center (NYS&WC) with locations in the Syracuse area and a presence in the Greater Buffalo region. NYS&WC specializes in the area of acute and chronic pain with special emphasis on spinal disorders.

Along with Dr. Fatti as the president, Michael Humphrey serves as the CEO of SOS, and Dr. Brett Greenky is a cor-porate vice president. Five other doctors in the group join these three to act as the executive committee. The members serve 3-year terms. To help support its rapid growth, SOS has turned to area professional firms: M&T Bank is its primary lender; The Bonadio Group handles the accounting; Wood & Smith, P.C. is the company’s legal firm; and Harbridge Consulting Group pro-vides retirement-planning consulting.

“The need to grow rapidly by attracting new patients is supported by our market-ing program,” Fatti says. “I like to think that SOS is everywhere. We spend 1 per-

cent of our annual budget on community events and promotion, everything from a weekly employee newsletter to sponsor-ing area events. (Some of the community organizations sponsored by SOS are On Point for College, the Syracuse Chiefs, the YMCA of Greater Syracuse, the First Tee of Syracuse, and the Jim and Juli Boeheim Foundation.)”

SOS is gradually increasing its public profile. “I don’t think the public under-stands yet how diverse the organization is and how many services we offer. But word is getting out, and we’re receiving great feedback,” says Fatti. “For example, our two SOS-Plus, orthopedic, immediate-care loca-tions, which are open from 5 p.m. until 8:30 p.m. on weekdays and 10 a.m. to 2 p.m. on weekends, are a big hit with the public, who appreciate both the convenient hours and locations. We have a quality product, and we need to promote it.”

ChallengesThe path to growth is not

without competitors and dif-ficulties in recruiting. “SOS is now one of two major ortho-pedic groups in the region,” notes Fatti. “The Upstate Bone & Joint Center [located on Fly Road in DeWitt] has 21 doctors on staff and also offers comprehensive ortho-pedic care. Like SOS, Bone & Joint promotes one-stop shop-ping, offering consultations, evaluations, and treatment for a full spectrum of ortho-pedic conditions. What’s un-usual is our friendly rivalry. I’m personal friends with the

president, Stephen A. Albanese [M.D.], which makes for a unique relationship. For example, we both share in support-ing Syracuse University athletics, and in June, our two organizations will begin of-fering joint services at Community Hospital (now renamed Upstate University Hospital Community Campus). That makes us both competitors and friends.”

Finding doctors is another challenge. “Recruiting is also a concern as SOS ac-celerates its growth,” Fatti continues. “We have an aging practice and need to attract young doctors to ensure not just our conti-nuity but also our growth. Frankly, it’s hard to attract talented physicians to Syracuse. I teach at Upstate University Hospital, so I know that 90 percent of the residents and fellows have a sub-specialty in orthopedics, thus requiring us to offer a broad range of sub-specialties within the practice. Also, the doctors aren’t interested in employment

The need to grow rapidly by attracting new patients is supported

by our marketing program,” Fatti says. “I like to think that SOS is

everywhere. We spend 1 percent of our annual budget on community events and promotion, everything

from a weekly employee newsletter to sponsoring area events.

See SOS, page 22 4


Loretto expects new PACE CNY facility in DeWitt to open in June BY ERIC [email protected]

DeWITT — Loretto plans to move PACE CNY’s Catherine McAuliffe Center to a new facility at 115 Creek Circle, across from the East Syracuse Fire Station No. 2, in June.

The 38,000-square-foot building sits on a 10-acre property that will include parking for 30 shuttle buses and 130 cars.

The center’s move also means the health-care services it provides are also moving.

PACE CNY has operated in a 15,000-square-foot space on the first floor of Loretto’s main campus — on Brighton Avenue in Syracuse — since 2000. It has outgrown the space and needs to expand.

“We felt … really the only way we could continue to serve people and expand in our community is to build a new center,” says Penny Abulencia, senior vice president and director of PACE CNY at Loretto.

The Brighton Ave. space has been “cramped” for the last three to four years, she adds. The organization decided to pur-sue the new center in 2010.

Abulencia and Kimberly Townsend, president and CEO of Loretto; Ellen O’Connor, CFO of Loretto; and Ruth Kirk, pro-gram director at PACE CNY, spoke with HealthCare Providerin early March.

Health-care servicesLoretto submitted an application for a “limited” certifi-

From L to R: Kimberly Townsend, CEO of Loretto; Penny Abulencia, senior vice president and director of PACE CNY at Loretto; Ruth Kirk, program director at PACE CNY; and Ellen O’Connor, CFO of Loretto, discussed the upcoming move of the PACE CNY program to its new facility at 115 Creek Circle in DeWitt, across from the East Syracuse Fire Station No. 2.

ERIC REINHARDT/BUSINESS JOURNAL NEWS NETWORK

APRIL 2015 I HEALTHCARE PROVIDER 13

cate of need (CON) for the McAuliffe Center’s diagnos-tic and treatment center, says Abulencia.

Its diagnostic and treatment center provides primary care, along with dental, podiatry, and vision care, she adds.

“Our dental department [also] serves Medicaid [pa-tients, including] children [and] adults, not related to PACE … that’s going to be in that building,” says Abulencia.

The New York State Department of Health ap-proved Loretto’s application for the limited CON in spring 2014, says O’Connor.

That application wasn’t for the entire new McAuliffe center, but for the “smaller portion” of that cen-ter because it’s New York state regulated, she notes.

Loretto had to re-quest permission to move the diagnostic and treatment center, says Abulencia.

Loretto provides care for the PACE CNY program through the diag-nostic and treatment center (the PACE CNY clinic) and the licensed agency for home care.

Physicians and nurse prac-titioners provide the PACE CNY program’s primary med-ical care, says Abulencia.

“We really coordinate that specialty care, providing it when it’s needed but many times, we can manage it in the center and that’s what we do,” she adds.

Coordination of care some-times involves managing a patient’s medication, says O’Connor.

“….to hear the numbers of medication that any one person is on at any time is mind boggling … through the PACE program, they can man-age those medications and,

many times, reduce [them],” the Loretto CFO adds.

PACE CNY works at “maxi-mizing people’s opportunity to age well in their own homes,” says Abulencia.

Loretto has the oldest-age PACE program in the country, she contends.

“They are staying with us five years because we are im-proving the quality of their life and their health,” Abulencia contends.

Diverting people from skilled nursing facilities and keeping them in their homes with services is “re-

ally a huge push” on the part of the both the federal and state govern-ments, according to Townsend,

“PACE was probably one of the pioneer pro-grams that the federal govern-ment and the state government brought together to try to do that. It’s still a model. It’s the model of the future,” says Townsend.

New facilityConstr uction

on the new facility in DeWitt started in June 2014 and

should finish in April, says Kirk.When asked about the

new center’s amenities, Kirk explained that the new cen-ter will include smaller activ-ity rooms for arts and crafts; larger rooms for lunch and gatherings; heated flooring in the bathing area; and a larger salon area.

“[PACE enrollees] are [also] going to have an out-side patio area that they’ll be able to enjoy,” says Kirk.

Once PACE CNY moves to the DeWitt location, Loretto will consider several possibili-ties for the available 15,000-square-foot space, including expanding its rehabilitation

services, says Townsend, the Loretto CEO.

It’ll be part of Loretto’s strategic plan covering the years 2015 through 2018 as the organization reviews its entire campus “as a whole,” Townsend adds.

The current program at Loretto serves about 270 peo-ple, while the new building can accommodate and serve about 400 residents, Abulencia says.

About 80 employees will

move to the new McAuliffe Center in DeWitt.

PACE CNY is a nonprofit corporation that Loretto owns and sponsors, according to its website. The organization, a community-based, managed-care program, describes itself as an “alternative to nursing care that allows the frail el-derly to continue to live in the community.” The acronym PACE is short for a program of all-inclusive care for the elderly. n

BY COMPARISON

38,000:Square feet of the

new facility

15,000:Square feet of

PACE CNY’s old facility

The exterior of the new facility for the PACE CNY program located at 115 Creek Circle in DeWitt, across from the East Syracuse Fire Station No. 2.

ERIC REINHARDT/BUSINESS JOURNAL NEWS NETWORK

http://www.healthwearrental.com


“One of the best aspects of health care reform is it starts to emphasize prevention.”

— Anne Wojcicki

M y recent column described the monumental Medicaid Man- aged Care Reform Initiative

(MMCRI) being implemented by New York state as rapidly as possible. The

reform initiative is being implemented under the umbrella of the Delivery System Reform Incentive Program (DSRIP) with the formation, implementa t ion , and operation of 25 Performing Provider Systems (PPS) throughout the state.

Acronyms, ac-ronyms — when it comes to health care, their use is without limits.

The Central New York Care Collaborative (CNYCC) is the state-au-thorized PPS for six counties in Central New York. Cayuga, Oneida, Cortland, Onondaga, Madison, and Oswego coun-ties represent the primary counties form-ing the PPS Region Provider Network. CNYCC health-care providers accounted for less than $1 billion of Medicaid spend-ing in 2013, which represents less than 2 percent of total New York annual Medicaid spending ($55 billion). As one might ex-pect, the vast majority of state Medicaid spending occurs in the greater New York City metro area, where there are 15 sepa-rate PPS regional entities.

The focus of this column is on stra-tegic positioning for community-based health care and human-service providers in the CNYCC region. Each of the 25 Performing Provider Systems is led by hospital systems. In the case of CNYCC, sponsors include Auburn Community, Faxton St. Luke’s, St. Joseph’s, and Upstate University hospitals.

The hospitals in the CNYCC region are supported by more than 100 health-care and community-based providers who have committed to be a part of the CNYCC Network that will provide cost-effective, coordinated managed care to Medicaid-eligible individuals in the region (https://cnycares.org).

Each PPS was required to submit proj-ect implementation plans to the New York State Department of Health by April 1, 2015. These implementation plans relate directly to the 11 DSRIP reform projects selected by CNYCC, following a compre-hensive needs assessment. The CNYCC projects are extensive and affect virtually every one of the more than 100 Medicaid service providers in the region. The proj-ects selected by CNYCC requiring an implementation plan are as follows:

a) Create integrated delivery systems that are focused on evidence-based medi-cine/population health management

b) Emergency-department care triage for at-risk populations

c) Implementing the INTERACT proj-ect (inpatient transfer-avoidance program for SNF)

d) Hospital home-care collaboration solutions

e) Integration and co-location of pri-mary-care services and behavioral health services

f) Institute for Healthcare Improvement — implementation of its “Conversation Ready Model” for palliative-care options

g) Strengthen mental health and sub-stance-abuse infrastructure across sys-tems

If the initiatives above sound like monu-mental efforts at moving mountains, they are. Others may say, “I thought we were doing an effective job in each of these areas already.” Those individuals would be dead wrong. The current Medicaid service delivery system is fragmented as evidenced by the more than 100 providers in the six-county region.

So, from a strategic-positioning per-spective, what should a community-based Medicaid service provider do in response to the MMCRI and PPS structure?

The answer to this strategic question is both complicated and complex. This is particularly true since community-based service providers are purported to be an integral component to the primary objectives of MMCRI. Those objectives are a 25 percent reduction in avoidable Medicaid emergency-room visits, hospital admissions, and readmissions within 30 days of discharge, over a five-year DSRIP timeframe.

One of the key strategies for commu-nity-based providers to consider has been and continues to be the formation of and membership in one or more Independent

Provider Associations (IPA). 1. Independent Provider Association

(IPA) definedAn individual group of physicians and/

or other health-care providers that are under contract to provide services to members/enrollees of different MCOs, ACOs, and PPSs, as well as other insur-ance plans, incorporating a fixed-fee per enrollee (capitation) or based on a pay-for-performance model (partial capitation), service care-outs, and/or targeted perfor-mance incentives.n For example, the primary focus of

managed-care organizations (MCOs) since the early 1970s has been on reduc-ing the utilization of emergency room and hospital inpatient admissions.n The increased recent emphasis on

reducing hospital re-admissions is an area where community-based providers can have direct and significant influence.n An IPA serves as the fiscal interme-

diary between groups of providers, which are members of the IPA and the MCO.

2. Types of IPAsa. Independentb. Captive — typically owned/controlled

by the MCO or a health systemc. Partnership between MCO and IPA

entitiesDepending upon facts and circumstanc-

es, any one of the three alternatives may be appropriate. Provider control is greatest in the independent model IPA. Depending upon the attitude and relationship be-tween the PPS/MCO and the individual providers, the captive and partnership models may be desirable or, alternately, not feasible.

3. Characteristics of the Independent IPA modeln Formation of the independent IPA is

a grass-roots effort of the providers who are also members of the IPA.n Board representation consists only

of representatives from participating pro-vider members of the IPA. n Decision-making authority rests with

the IPA board that is initially appointed by the IPA provider members.n Can be formed as either taxable or

tax-exempt, depending on membership, structure, and objectives. n Contract negotiations with PPSs/

MCOs are managed directly by the IPA board, its independent legal counsel, and

CNY Strategic Positioning for Community-Based Health Care and Human-Service Providers

GERALD J.ARCHIBALD

NONPROFIT MANAGEMENT

See archibald, page 22 4

W hen Ashley Thayer qualified for the Boston Marathon last May, she was a first-time mara-

thoner. Little did she know that the half-marathon she’d entered on a whim a few months earlier would lead to an obses-

sion. But the obses-sion almost came to a screeching halt when she took a cou-ple of weeks off from training and found

she couldn’t even run a mile without sear-ing pain in her side.

“My primary-care provider told me I had bursitis in my hip,” says Thayer. “And he told me I needed physical ther-apy. I heard about the running screening program at Canton-Potsdam Hospital’s Physical Rehabilitation Program and de-cided to try it,” she says.

As a former varsity athlete in team sports, Thayer had never had a problem like this before. She wasn’t sure what to expect from the Running Screening program.

“I knew I had to get serious if I wanted to be ready for Boston,” says Thayer. “I met with Laurie Matthews, PTA, who performed an analysis of my gait, balance, form, and showed me videos of myself in action,” she says.

According to Matthews, the running screening program is designed for ev-eryone from novice to elite runners who

want to perform at their peak. She’s joined in the program by Tracy French, PT, who also conducts screenings for runners and joggers everywhere from the starting line of a road race to the CPH Physical Rehabilitation Department at 49 Lawrence Ave. in Potsdam.

“The fitness of muscles and joints is just as important as cardiovascular condition-ing for the best results when starting a running program or when athletes want to take their performance up a notch,” said French, who has special training in running analysis.

“Once you have identified the compo-nents of your running style that could be detrimental to your success, you can then focus on modifying your running form to become more efficient, decrease your risk of injury, decrease pain associated with running, and improve your competitive performance,” said French.

Therapy follows the initial screening, if indicated, and is individualized. “Laurie was able to identify a problem in my hip alignment that she corrected by taping my side so my muscles would have to re-learn how to move,” Thayer said. “She even involved my sister so I could get help at home taping up before a run, and she rec-ommended a change in my shoes, too.”

Following this therapy, Thayer says she feels like she’s ready for the arduous training regimen required for Boston. As

a grad student in the Community Health program at SUNY Potsdam — who spends her precious spare time as a personal trainer at the college’s Fitness Center — she’s familiar with a disciplined approach to meeting goals, and knowing when to seek help.

“I love the marathoner spirit,” Thayer says. “It’s like still being on a team, except now you’re competing against your own best performance, with a lot of people sup-porting you. I wouldn’t be running pain- free like I am now if it weren’t for Laurie’s help,” she says. “If you’re thinking about getting into a marathon, or just starting out a running program, the road is long but really rewarding at the end.”

For more information about the running screening program at Canton-Potsdam Hospital, interested athletes of all abilities can call (315) 261-5460. n

Rebecca Faber is a runner, cancer survivor, nursing student, and public relations profes-sional who splits her time between Potsdam and Boston. Contact her at [email protected]


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Benefit PlanConsulting

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Our services include:

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Physical Therapy Gets Marathoner Prepped for Boston

pictured left to right, ashley M. Thayer, mara-thoner, grad student, and personal trainer at SUNY potsdam, works with Ed M. Smith, iii, of Clay, on his cycling form.

reBecca faBer

VIEWPOINT

subm

itted

phot

o

A recently enacted New York state law requires that com-

mercial insurers cover re-imbursement for telehealth

and tele-m e d i c i n e services as they would other wise cover those services for in -person visits. The law seeks to help e l i m i n a t e barriers to

obtaining necessary health care, especially in the state’s rural and underserved com-

munities.Under the new state law,

the terms “telehealth” and “telemedicine” are differenti-ated for reimbursement pur-poses. “Telehealth” generally refers to the technology used to enable the remote clinical services. It is defined as, “de-livering health-care services by means of information and communications technolo-gies.” These technologies, including telephones, remote patient monitoring devices or other electronic means, provide access to health as-sessment, diagnosis, consul-tation, treatment, education, and case management of a patient’s health care remotely.

Telehealth includes non-real time communication of health data. For example, telehealth technology is often used for treatment of chronic condi-tions from a distance, such as cardiac monitoring.

The term “telemedicine” generally refers to the remote delivery of clinical health-care services by means of real time two-way electronic audio-visual communications. Such communications include the application of a secure video conferencing or store and for-ward technology to facilitate the assessment, diagnosis, consultation, treatment, edu-cation, care management, and self-management of a patient’s health care. Thus, telemedi-cine is similar to a typical phy-sician office visit in that the patient and physician interact as if in the same examination room — although they could be hundreds of miles apart. For example, a physician in an office could discuss a patient’s laboratory-test results with the patient, who is in her home,

via videoconference.New York is the 22nd state

to enact a telehealth parity law. Millions of dollars have already been invested in equipment across the state by health-care providers to allow for telehealth services. The new law will ensure that patients who are not able to travel to specialists or who have chronic conditions re-quiring frequent monitoring, to receive reliable remote care that is reimbursable under their health plans. n

Maureen Dunn McGlynn is a partner in the business depart-ment of Mackenzie Hughes LLP, a law firm based in Syracuse. She focuses on health-care law as she advises, counsels, and litigates for hospitals, physicians, physician-practice groups, den-tists, diagnostic and treatment centers, and other health-care providers. This article is drawn from a March 3 post on the Mackenzie Hughes Plain Talk blog. Contact McGlynn at [email protected]


The Business Journal News Network Call (800) 836-3539 today to subscribe

New Law Requires Insurance Coverage for Telehealth and Telemedicine Services

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camden family care

REBECCA FRIEMANN has joined the staff of Camden Family Care. A graduate of Marywood University in Scranton, Pa., she earned her master’s degree in physician-assistant studies. Friemann also re-ceived her bachelor’s degree in Spanish language and pre-physician assistant studies with a minor in nutrition and dietetics at Marywood.

the centers at st. camillus

The Centers at St. Camillus has announced that MICHAEL CONNOR will serve the organi-zation as its new rela-tionship development coordinator. He will work to maintain and increase relationships with donors and event underwriters, en-hance relationships with family members of residents and patients, and help publi-cize and promote the needs of the facility throughout the community. Connor was director of public relations for Loretto from 2005 to 2012, and currently enjoys a more than 30-year association with Syracuse Opera— both on stage as a principal artist and administratively, most recently as director of advancement.

crouse hospital

CHERYL ABRAMS has been appointed director of communications and digital media at Crouse Hospital. She has been at Crouse since 2006. Abrams previ-ously was director of public relations at the Syracuse Symphony Orchestra and Everson Museum of Art. A graduate of the Leadership Greater Syracuse pro-gram, Abrams earned her bachelor’s de-gree in English/communications from Le Moyne College and will graduate in May from the Newhouse School at Syracuse University with a master’s degree in com-munications management. Abrams has won a number of local and national writ-ing awards (including one for the Crouse

website) and was recently named to the Editorial Advisory Committee of AHA’s communications arm, the Society for Healthcare Marketing and Development. She also serves as an adjunct faculty member at Newhouse.

faxton st. luke’s healthcare

The Faxton St. Luke’s Healthcare (FSLH) medical staff recently announced its 2015 officers. BRIAN P. BOYLE, M.D., has been named president. He is an anesthesi-ologist with Sunset Anesthesia Associates and a staff anesthesiologist at FSLH since 1990, where he has served as chairman of the Anesthesia Department since 2011. He received his bachelor’s degree from the University of Notre Dame and attend-ed medical school at SUNY Upstate Medical University in Syracuse. WALEED ALBERT, M.D., has been named vice president. He is an infectious disease specialist in private practice. Waleed earned his doctorate in medicine from the Faculty of Medicine of Damascus University in Damascus, Syria. DANIEL C. GOODMAN, M.D., has been named sec-retary/treasurer. He practices at Slocum-Dickson Medical Group in Utica and has served as chair-man of the Department of Medicine at FSLH. Goodman attended medical school at SUNY Downstate Medical Center in Brooklyn and completed an internship and residency at St. Vincent Hospital in Worchester, Mass.

the oaks at menorah park

MARY E. KIMBERLY recently became di-rector of The Oaks at Menorah Park. She will oversee the operations of this 47-apartment independent living fa-cility on the Menorah Park campus. Kimberly succeeds Jan Edwards who re-tired at the end of 2014. Kimberly joined Menorah Park in 2012, and was previ-

ously the director of patient services for Menorah Park Home Care. Before joining the organization, she held positions as a nurse case manager and registered nurse. She received her RN from Crouse Hospital School of Nursing.

rome memorial hospital

SURINDER KHOKHAR, M.D. has joined the staff at Rome Memorial Hospital as a member of its hospitalist team. He spent several years as an instructor at the Government Medical College and Hospital in Chandigarh, India. Khokhar also has years of experience performing cardiol-ogy research, and has had several papers published by various medical journals. A graduate of Silchar Medical College in Silchar, India, Khokhar completed his residency in in-ternal medicine at St. Luke’s Roosevelt Hospital in New York City. He is also certified in HIV/AIDS prevention and control, and recognizing and reporting child abuse maltreatment and neglect.

vna homecare

VNA Homecare has promoted CHERYL MANNA to chief operating officer. Most recently, she served as direc-tor of managed care operations for VNA Homecare Options, LLC, VNA Homecare’s Managed Long Term Care program. Manna joined VNA Homecare in 2013, bringing 26 years of home-health-care experience to the system. She is a graduate of SUNYIT. DEBORAH MACIEWICZ has joined VNA Homecare as senior director of care manage-ment. She is a graduate of the Marcy Psychiatric Hospital School of Nursing and is certified by the Commission for Case Manager Certification. The former director of clinical services for Senior Network Health, one of New York’s first managed long-term-care plans, Maciewicz has more than 30 years com-munity health nursing experience. n

Friemann

HealtH-Care Career

NEWS

ConnorAlbert

Goodman

Kimberly

Khokhar


PHYSICAL-THERAPY PROVIDERSRanked by No. of Licensed PTs

Rank

NameAddressPhone/Website

PTsPTAs

EmployeesCNY

Locations Areas of Specialization Top Local ExecutivesYear

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ABOUT THE LISTInformation was provided by representatives of listed organizations and their websites. Other groups may have been eligible but did not respond to our requests for information. Organizations had to complete the survey by the deadline to be included on the list. While The Business Journal strives to print accurate information, it is not possible to independently verify all data submitted. We reserve the right to edit entries or delete categories for space considerations.

WHAT cOnSTITUTES THE cnY REgIOn?Central New York includes Broome, Cayuga, Chemung, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, Seneca, St. Lawrence, Tioga, and Tompkins counties. nEEd A cOPY Of A LIST?Electronic versions of all our lists, with additional fields of information and survey contacts, are available for purchase at our website, cnybj.com/ListsResearch.aspx WAnT TO BE On THE LIST?If your company would like to be considered for next year’s list, or another list, please email [email protected]

THE LISTResearch by Nicole [email protected] (315) 579-3911Twitter: @cnybjresearch


PHYSICAL-THERAPY PROVIDERSRanked by No. of Licensed PTs

Rank

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16.Sitrin Medical Rehabilitation Center��%25-.7��?.� .@��*;=/8;-�� (��<2=;27�,86

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aBOUT THE liSTInformation was provided by representatives of listed organizations and their websites. Other groups may have been eligible but did not respond to our requests for information. Organizations had to complete the survey by the deadline to be included on the list. While The Business Journal strives to print accurate information, it is not possible to independently verify all data submitted. We reserve the right to edit entries or delete categories for space considerations.

WHaT cOnSTiTUTES THE cnY rEgiOn?Central New York includes Broome, Cayuga, Chemung, Chenango, Cortland, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, Seneca, St. Lawrence, Tioga, and Tompkins counties. nEEd a cOpY Of a liST?Electronic versions of all our lists, with additional fields of information and survey contacts, are available for purchase at our website, cnybj.com/ListsResearch.aspx WanT TO BE On THE liST?If your company would like to be considered for next year’s list, or another list, please email [email protected]

THE LISTResearch by Nicole [email protected] (315) 579-3911Twitter: @cnybjresearch


SYMPOSIUM: For 2015, Medicare has expanded the services for which it will reimburse Continued from page 4

nologies. “They just don’t call it telehealth or

telemedicine,” said Miner.For example, Medicare reimburses

for teleradiology but it’s not telehealth “because the patient isn’t present at that time,” said Miner.

For 2015, Medicare has expanded the services for which it will reimburse under telehealth, which include annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management services, she noted.

Miner also talked about chronic-care management, which doesn’t fall under the telehealth definition because “it’s not necessarily provided by a communication technology in real time.”

She called it an “important develop-ment for Medicare” because these ser-vices, which are provided to beneficiaries with chronic conditions, can involve care management, care planning, communica-tions between providers, and medication management.

“Previously, these services were not reimbursed separately,” she said.

Miner thinks it signals that Medicare is recognizing that it will need to start reim-bursing for the services to “get away from these costly, face-to-face interactions” and to be “more proactive” in treating patients before they have “really significant health problems.”

Physicians could provide the treatment through “other types of communication technologies,” such as phones or secure messaging, she added.

The New York State Legislature in 2014 approved the Telehealth Parity Law, Miner noted.

“What that means is that now com-mercial payers and Medicaid are going to be required to reimburse for certain telehealth services,” said Miner.

But she also noted the state isn’t currently enforcing the law because Gov. Cuomo’s signature on the legisla-tion was contingent on making some changes to the bill that the legislature approved.

The law was scheduled to take effect Jan.1, but payers “weren’t going to have enough time to adjust,” Miner said.

Other issues centered around what the law would require insurers to reimburse; and reimbursing telemedicine when in-surers wouldn’t reimburse for the same services that were provided in a face-to-face visit, she added.

The Senate and Assembly are current-ly considering some chapter amendments

to the legislation, Miner said.

Federal/state differencesMiner went on to outline some differ-

ences between how New York and the federal government are treating telemedi-cine.

The first is a difference in definition, she said.

Telemedicine is defined as the two-way interaction, but the Telehealth Parity Law is going to require commercial insurers to reimburse for these other technologies, including the “store and forward” technol-ogy and then for something called remote patient monitoring.

“It’s sort of similar to what Medicare is doing with the chronic-care management. Remote patient monitoring is going to be services provided to a patient in their home and it’s for patients that have chron-ic-care needs that need frequent monitor-ing or have technology-dependent care, such as a ventilator, continuous oxygen, or something of that nature,” said Miner.

New York also won’t limit the originat-ing site where the patient is located to rural areas, she added.

“So, that’s another important devel-opment that providers will not be lim-ited in that same way that they are under Medicare,” Miner said.

In addition, the way New York is defin-ing qualified providers who can bill for these services, is “at this point, much more expansive than Medicare.”

“It’s going to include social workers, speech pathologists, genetic counselors.”

She noted that part is “subject to change.”

LicensingIn her remarks, Gaffey spoke about pro-

fessional licensing requirements, which “are generally set at the state level.”

The location of the telemedicine pro-vider will determine the state in which the provider will need a license, she said.

“For instance, if you have a patient here in New York … and a doctor who’s actu-ally physically located in Texas providing telemedicine services to the patient, in which state is the care actually being provided?,” Gaffey asked, in illustrating her example.

In 2000, the state’s Office of Professional Medical Conduct indicated that “as far as they’re concerned, the state in which the patient is located and receiving the services is actually the state of care,” said Gaffey.

Providers who wish to provide tele-medicine services to patients in New York

they need a license to perform such a service in New York, she added.

Gaffey also discussed credentialing, not-ing that Medicare, the Joint Commission, and New York … have all [approved] new standards in the last few years that allow providers to rely on the credentialing practices of the telemedicine provider’s location.

“The good news as far as credentialing is that the standards that Medicare and The Joint Commission in New York have passed … are almost identical, so as long as you can make sure you’re following one set of standards, you’re probably fol-lowing them all,” said Gaffey.

The Joint Commission is an Oakbrook Terrace, Illinois–based independent, nonprofit organization that accredits and certifies more than 20,500 health-care organizations nationwide, according to its website.

LiabilityIn addressing the liability issue for tele-

medicine, Diviney said that a successful personal-injury claim involves four ele-ments, including duty, breach, causation, and damages.

“You had a duty, you breached the duty. That caused the injury, and … because of the injury, I had damages,” said Diviney

Diviney then used the remainder of her remarks discussing duty and breach “be-cause the causation and damages … flow from the first two issues,” she added.

SecurityFinally, Baum discussed issues in-

volving privacy and security, noting that telemedicine will often involve communi-cation between a provider and a patient over a Skype transmission.

Skype is a messaging program that requires a web camera and an Internet connection to speak with someone who has the same configurations in a different location.

“Somebody in your organization, and it’s definitely going to involve your se-curity [people], needs to be involved to make sure that you have some risk analy-sis … of the equipment you’re using and your service provider,” said Baum.

She also noted the ongoing debate about whether Skype should be con-sidered a business associate under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which would require an agreement out-lining the Skype-provider relationship as business associates. n


nicians, nephrologists, and administrators. Our specialty areas include nephrology, trav-el positions, ambulatory, and perioperative/surgery. Fortus also offers clinical-practice consulting. With more than 20 years of industry experi-ence, we help our clients pre-vent critical staff gaps, reduce the time-to-hire as well as the cost-to-hire, provide the best clinical talent available, and eliminate staffing hassles. The bottom line is that health-care institutions need to focus on their patients: We help them do that.”

Maurizio’s revenue of $120,000 in year one has blos-somed into a business that generated $2.6 million in rev-enue in 2009, $6.2 million in 2012, and more than $10 mil-lion last year. Fortus head-quarters currently houses a staff of 40, of whom 30 are recruiters. The company em-ploys another 60 nurses and patient-care technicians who are in the field. In addition to the Utica office, Maurizio set up an office in Hof, Germany in 2008 to make permanent placements, primarily in Europe. “We live in a global economy, and we want to take advantage of opportunities outside our borders,” asserts Maurizio, who is the sole stockholder of the enterprise. Keenan notes that the Hof office currently represents ap-proximately 6 percent of the non-travel-related revenues.

Maurizio and his leadership team, which includes Keenan; Jeremy Enck as the vice president of sales, and Kathy Paquette as the director of human resources, are focused on outpatient-based services as the primary growth area. “We see areas like oncol-ogy, emergency medicine, labor and delivery, and burn centers growing in their de-mand for our services. But the number-one growth area for us is ambulatory-surgery

centers. (December 2014 fig-ures from the U.S. Bureau of Labor Statistics indicated that of the 34,000 new jobs created in health care that month, 16,000 were in ambu-latory settings.) “The country has an aging population. Our care-facilities need nurses to fill in as needed. They also need executives. This is a very competitive industry, but what’s really interesting is that most of our competi-tion comes from national and international recruiting com-panies.”

Maurizio muses on how high-tech the business has become. “I started this busi-ness with a rotary telephone and a Rolodex,” he quips. “Today, we supplement the phone with emails and a va-riety of social media, and the Rolodex has been replaced by sophisticated databases that monitor our various expenses for the traveling nurses such as housing, car rentals, and per-diems, while also helping us to offer 24-hour concierge service.” Dan Hartman, the communications executive with the company, adds that Fortus utilizes Facebook, Twitter, and LinkedIn as chan-nels for communicating with their clients, candidates, and media contacts. “I estimate that I spend a couple of hours each day communicating via social media,” he observes. “We use Facebook and Twitter a lot to reach out to our nurses and to candidates, and the recruiters also leverage LinkedIn … Our blog posts are another way to educate our audience about the industry and the company.”

MaurizioMaurizio, 57, is a self-de-

scribed “Southside boy” who attended high school in Utica before matriculating at Paul Smith’s College to major in hos-pitality. In 1984, he went to work as a salesman for Whitehall Laboratories, a Fortune 100

company. The Southside boy was promoted to division manager before he left to join Baxter International, a global, diversified health-care company that developed, manufactured, and marketed products for chronic and acute conditions, such as kidney disease. In 1988, Maurizio went to work for the Boston office of Carter/MacKay, a company formed in 1970 to place sales, sales-management, and marketing personnel plus scientific profes-sionals in the health-care indus-try. Family reasons brought him back to the Mohawk Valley to start his own firm.

“Placement is a tough busi-ness,” declares Maurizio, “because it’s a double sale. First you have to convince doctors, nurses, technicians, and administrators that the companies we represent are the right choice. Then you have to convince your clients that you have the best candi-

dates to fill the open positions. We spent years building our reputation as the number-one nephrology recruiter in the world. Now we are getting traction with health-care pro-fessionals in the ambulatory-surgery specialty. There’s no doubt that we’re on track to see our revenues … [balloon] to the $20 million mark.”

Fortus’s growth has been re-flected historically in the num-bers posted on the Inc. 5000. The company was also recog-nized last year by BizEventz and The Business Journal as one of the “Best Places to Work” in the 16-county Central New York area. Maurizio was hon-ored recently by The Staffing Industry Review magazine, a publication featuring the 100 most influential people in the staffing industry.

When Maurizio says the company is poised to double its revenues, the only ques-tion is: how quickly? n

FORTUS: Maurizio and his team are focused on outpatient-based services as the main growth area Continued from page 6

http://www.staffleasing-peo.com


individuals designated with contract-nego-tiation authority.n Primary advantage for the PPS/

MCO is that through a single signature, a regional network of providers can be PPS/MCO network participants without having individual negotiations with each provider.n Single-signature contract authority

by the IPA Board is powerful from a nego-tiation and leverage perspective.n In order to pass legal requirements

and anti-trust regulations, an IPA cannot be formed for the sole purpose of nego-tiating rates.

n Rather, in addition to rate negotia-tion, the IPA must assume some degree of financial risk and/or targeted perfor-mance-based incentives as a condition of the contract with the PPS/MCO.n In order to effectively function as a

joint network entity of multiple providers, there must be some evidence of “clinical and financial integration” (e.g., electronic medi-cal records, billing systems, clinical proto-cols, etc.) among IPA provider members.n Financial risk, coupled with clinical

and financial integration, represent “safe harbors” that allow regional provider IPA

networks to operate without substantial risk of anti-trust challenges.

Membership in a provider-sponsored IPA is one of many strategic considerations for community-based service providers to evaluate in developing an appropriate strategic position that is responsive to inte-grated and regional reform initiatives. n

Gerald J. Archibald, CPA, is a partner in charge of the management advisory services at The Bonadio Group. Contact him at (585) 381-1000, or via email at [email protected]

unless the group offers ancillary services which allow for participation in and control over the patients’ entire episode of care. I can’t overstate that this is a major attrac-tion, maybe our best recruiting tool. We utilize recruiting agencies to help identify candidates, but the best technique is word of mouth. That’s why our doctors are always talking directly to candidates. In the end, the best success is with prospects who grew up in this area and [who] have family ties.”

While Fatti is optimistic about SOS’s busi-ness plan to be the leading, regional ortho-pedic practice, he has concerns about the direction of health care in America. “This is my 35th year as a physician, during which I have seen a number of changes in the de-livery of health care,” reflects Fatti. “I think the advances in technology are absolutely amazing. Our increasing capacity to image is critical to a proper diagnosis; advances in joint-replacement … [remind me that the bionic man is here]; and physical-therapy techniques have improved manifold. Add to this the latest research to help us under-stand how the body heals. We also have electronic-medical records that allow any provider to have real-time information on a patient’s medical history. That’s a tremen-dous aid to the physician. And we offer multiple locations and extended hours for the convenience of our patients.

“But challenges have also come with the changes in medicine,” Fatti continues. “To begin, doctors seem to have less time to spend with their patients because of declin-ing reimbursements. After all, medicine is not all science and technology; there is no substitute for personally observing the patients and interacting with them. I also think we need more medical candidates in the pipeline. Health care has taken a hit, because we’re not attracting the top numbers to our profession. I see this

from decades of teaching medical students and from declining applications to medical schools. Many of our best and brightest students have abandoned medicine for a better way to make a living. We need to bring those students back into the fold of this noble profession.

“And finally, technology and the reim-bursement system have created the need for a huge support staff,” Fatti adds. “When I started in my first practice, there were five docs and five support staff. Today, SOS has 11.3 support staff for each doctor. Now, some of that is because we have so many locations, but some of it has to do with the overreaching need to obtain authorizations. We have many talented employees who spend much of their time just calling for au-thorizations. We also have more than 10 em-ployees focused on our IT needs and more than 30 X-ray staff members in support of our multiple locations. For those of us who went into medicine to take care of people, it’s becoming much more complicated and less directly rewarding.”

ChangesThe many changes at SOS are designed

to keep the practice ahead of the changes that are reshaping health-care delivery. The creation of multiple locations, the proposed geographic expansion, the inclusion of mul-tiple sub-specialties, the surgery center, and the decision to offer physical therapy are all examples. The most recent example oc-curred on Jan. 1 of this year when SOS was selected to participate in an innovative pro-gram created by the Centers for Medicare & Medicaid Services (CMS). The “Bundled Payments for Care Improvement” (BPCI) initiative is an agreement with CMS to reimburse providers based on financial and performance accountability. BPCI replaces the fee-for-service model in the expectation

that “… bundled payments can align the incentives of all providers — hospitals, post-acute-care facilities, physicians, and other practitioners — allowing them to work closely together across all specialties and settings.” (according to a CMS fact sheet dated 1/30/14.)

SOS is one of only three area providers to join the program. “I think the future of medical reimbursement is the idea of bun-dling,” notes Fatti. “We call it bundling, but it’s really capitation: One payment to cover the entire cost of a patient’s care. Done correctly, this model delivers higher-quality patient care, better care coordination, and even lower costs. For SOS to be the leading practice in our region, this is just one more step to stay ahead of the curve in the ever-changing health-care landscape.”

Fatti, 60, is a Syracuse native. He gradu-ated from Christian Brothers Academy in 1972, received his bachelor’s degree from the University of Notre Dame in 1976, and earned his medical degree in 1980 from the Upstate Medical Center. Fatti completed a general-surgery internship at Hartford Hospital in 1981, his residency in orthope-dic surgery from Upstate in 1985, and his fellowship in hand surgery from the Tufts New England Medical Center in Boston. He joined CNY Orthopedics in 1986 and SOS in 1999. Fatti and his wife, Jacqueline, live in Camillus. The couple has three children, one of whom is a doctor in the SOS practice. When not helping patients, Fatti enjoys golf and fly-fishing.

Humphrey, the SOS CEO, earned a bachelor’s degree in accounting from Utica College. He worked with Ernst & Young as a CPA and then worked in finance at St. Joseph’s Hospital and Crouse Memorial Hospital in Syracuse before joining SOS. Humphrey has been CEO for more than 10 years. n

SOS: The many changes at SOS are designed to keep the practice ahead of the changes that are reshaping the health-care industry Continued from page 11

ARCHIBALD: Membership in a provider-sponsored IPA is a strategic consideration Continued from page 14


PROGRAM AGENDA7:30-8:30 a.m.Registration, Networking & Breakfast Reception

8:30-8:35 a.m. Welcome remarks by Bill Dehmer, Managing Director, Upstate New York/Western New England/Northern Pennsylvania, Chase, & Mark Allen, Executive Director/Division Manager, Upstate NY & Northern Central PA, Chase

8:35-8:40 a.m. Rob Simpson, President of CenterState CEO

8:40-8:55 a.m. Keynote Speaker, Richard Raiford, Managing Director/Head of International Banking, JP Morgan Chase & Co.

8:55-9:05 a.m. Introduction of Moderator

9:05-9:45 a.m. Panel Discussion: Panelists:

JP Morgan Chase & Co.

Banking, JP Morgan Chase & Co.

International Business Alliance

9:45-9:55 a.m. Open Q&A for panelists

9:55-10:00 a.m. Closing Remarks

10:00-10:30 a.m. Optional Networking

Tuesday, June 2, 20157:30-10:00 AM

Genesee Grande Hotel, Syracuse, NY

Doing Global Business in CNY will spotlight the Central New York region as an attractive destination for international businesses and highlight the bene� ts of foreign exchange and

doing business globally. The event includes a keynote speaker, followed by an esteemed panel of business leaders who will emphasize the importance of how we can capitalize on

our opportunities to position Central New York as a leading global city.

Presented By:Proud Media Partner: Produced By:

Tuesday, June 2, 2015Tuesday, June 2, 2015

DOING GLOBAL BUSINESS IN CNY

The Central New York Business Journal269 W. Jefferson St.Syracuse, N.Y. 13202-1230

Presorted StandardU.S. Postage Paid

Syracuse, N.Y.Permit # 568

EXCELLENCE I N H E A LT H C A R E

AWARDS

EXCELLENCEEXCELLENCE

NOMINATE NOW! Deadline: August 24

Event Date: October 22, 2015Time: 5:30 PM - 8:30 PM

Location: The Lodge at Welch Allyn

Presented By

The 4th annual Excellence in Health Care Awards recognizes our region’s top health-care industry leaders, innovators, and companies. This awards-recognition event will honor those individuals and/or organizations that have a signi� cant impact on the quality of health care and services in Central New York. Honorees will be spotlighted in the HealthCare Provider and the Business Journal!

For category descriptions and other event information, visit bizeventz.com or email [email protected]

Presenting Sponsor: Signature Sponsor: Award Sponsor:

Proud Media Partner: Produced By:

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