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FOCUS TOPICS PEDIATRICS HEALTH EXCHANGES ORTHO/SPORTS MEDICINE

Specialists Travel to See Patients at Remote Clinics for Arkansas Children’s HospitalExpansion of Arkansas Children’s Hospital designed to serve the entire state

(CONTINUED ON PAGE 6)

Doubling Autism Rates in Arkansas Demanding More Attention and Resources Early screening followed by treatment can makes huge difference in outcomes

Autism spectrum disorder rates in Arkansas soared from one in 145 eight year olds in 2002 to one in 65 eight year olds in 2010, reaching an all-time high ... 4

Capitalizing on the ICD-10 Conversion DelayPractice management consultant provides tips for easier transition Healthcare providers collectively exhaled when the Centers for Medicare and Medicaid Services (CMS) announced the adoption of ICD-10 would be delayed ... 7

BY BECKY GILLETTE Anyone who has done a long car trip with an infant can understand how much

it means to parents like Morgan and Preston Despain of Jonesboro that now instead of traveling to Little Rock to take their 13 month old daughter, Annelise, to a special-ist, instead the doctor comes to them in Jonesboro.

“It is a lot easier driving 15 minutes as opposed to six hours,” said Morgan Despain. “She is so young that it is hard spending a whole day traveling. We don’t have to travel six hours so she can see her urologist. The convenience is the number one reason it is so helpful. We are able to get quality healthcare from the Arkansas Children’s Hospital (ACH) right here at home.”

Despain is a school teacher, and being able to have her daughter’s appoint-ments in Jonesboro means she can take off work a half day—or sometimes even less—rather than a whole day.

(CONTINUED ON PAGE 6)

Catholic Health Initiatives Purchase of QualChoice Expected to Provide More Marketplace CompetitionNew ownership of QualChoice could create more jobs

Cedric Pratt, DO

PAGE 3

PHYSICIAN SPOTLIGHT

New ownership of QualChoice could create more jobsNew ownership of QualChoice could create more jobs

Cardiologist Brian Eble, MD, talks to a patient at the Arkansas Children’s Hospital\University of Arkansas for Medical Sciences Centers for Children in Lowell.

BY BECKY GILLETTE

Like in most states, the health insurance marketplace in Arkansas is dominated by one large company. Blue Cross &

Blue Shield of Arkansas has about a 75 percent market share in the state. Groups like the Center for American Progress (CAP)

contend that insurance market domination leads to fewer choices.More than half of the health insurance market is controlled by two carriers in at

least 39 states, said Ben Furnas and Rebecca Buckwalter-Poza, authors of a CAP study Healthcare

To promote your business or practice in this high profi le spot, contact Pamela Harris at Arkansas Medical News.

pharris@medicalnewsinc.com • 5012479189

2 > JULY/AUGUST 2014 a r k a n s a s m e d i c a l n e w s . c o m

Advanced Neurosurgical

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3336 N. Futrall Dr. | Fayetteville, AR 72703 | 479.463.3000 | wregional.com

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BY BECKY GILLETTE

It would be easy for Floyd M. John-son of Searcy to dread his visits to Ced-ric Pratt, DO, at the Magie-Mabrey Eye Clinic, PA.

“When you have a needle stuck in your eye, you wouldn’t think it would be very pleasant,” said Johnson. “But I look forward to seeing Dr. Pratt every month. He is just very professional. We have devel-oped a great relationship. When you find a doctor who will hug you when you see each other, that says a lot about him. He is very warm and welcoming, and his staff is the same way. They reflect his attitude.”

Johnson also deeply appreciates the help with his central vein occlusion that can cause blurry vision. Pratt diagnosed the condition and has been treating it for two years. Johnson is very pleased with the results.

Pratt is board certified in ophthal-mology, and specializes in the medical and surgical treatment of the retina and vitreous. He completed his vitreoretinal surgery subspecialty training at The Ohio State University in 2012 before moving to Little Rock with his family to start practic-ing with Magie-Mabrey Eye Clinic, PA, one of the largest eye clinics in the state with nine ophthalmologists practicing in Little Rock, Conway, Fort Smith and other smaller towns in central Arkansas.

Pratt did his undergraduate work at Abeliene Christian University in Texas where he had the opportunity to go on a medical mission trip to a very impover-ished area of Guatemala. That stoked his interest in practicing medicine.

“I originally wanted to do cardiology because I was fascinated by the heart,” Pratt said. “But when I saw my first cata-ract surgery, I was just amazed. Within 15 to 20 minutes, you could make someone go from non-seeing to seeing. How can I learn more about that? As a profession, it fit my

personality. I love interacting with patients, and it is surgical so I get to use my hands. I feel fortunate I get to use both of those skills. I feel privileged, honestly. People trust me a lot. I take that very seriously.”

He decided to become a retina spe-cialist because the challenges are different than with general ophthalmology, and the potential benefits are tremendous.

“You are sometimes the last hope when people have vision problems,” Pratt said. “You get to see people at their worst, when they are very frightened about los-ing their eyesight, and then at their best after they are healed. When you are able to help them get better, there is a lot of gratitude there. It is very nice.”

The two most common things seen in his practice are diabetes and macular degeneration. In his less than 55-year-old patients, he sees more diabetes than any-thing else. It is a major medical problem increasing in frequency. At the age of 65 and above, macular degeneration be-comes a bigger issue.

“We have newer treatments for mac-ular degeneration to improve vision, and sometimes extend vision,” Pratt said. “A lot of people with a condition that would have blinded them ten years ago are re-taining a lot of sight.”

Retinal detachment is another eye problem he treats. Pratt said usually re-ferral doctors recognize the problem and

refer patients to a specialist for urgent treatment that has the potential for sav-ing vision.

“But, unfortunately, there is no per-fect cure,” Pratt said. “Some people don’t get perfect vision back. But, for the most part, people are pretty happy.”

The type of healthcare available in the U.S. is far above what can be found in many other countries in the world. Pratt’s parents are from Sierra Leone, a very impoverished country in Africa. There is not a retina expert in the entire coun-try. In the future, Pratt, who was born in Washington D.C., would like to do mis-sion trips, possibly one back to the home-land of his parents. But that is on the back burner for now after the birth of Pratt and his wife Adama’s third child, Ian, about a year ago. They have two other children, Christian, 8, and Kaden, 4.

Pratt loves outdoor recreation, par-ticularly biking along the Arkansas River and fishing on lakes. The leisure time ac-tivity he is most passionate about is bas-ketball.

“I really like basketball,” Pratt said. “I probably play too much basketball for my own good. I tore my Achilles tendon playing basketball in the first six months in practice, and had to have surgery. The doctor became the patient very quickly. I learned a lesson from that. Now I give way to the young bucks when they are charg-ing to the goal.”

Pratt earned a Doctor of Osteopathic Medicine at University of North Texas Health Science Center in Fort Worth, Texas. After medical school he did a one-year internship at SUMMA Health in Akron, Ohio. He then completed his residency and fellowship training in Oph-thalmology at The Ohio State University Havener Eye Center. During his training, Pratt was elected chief resident. He also participated in several research projects involving anti-VEGF agents.

Cedric Pratt, DO Retina expert wins over patients with expert care and warm, welcoming manner

PhysicianSpotlight

4 > JULY/AUGUST 2014 a r k a n s a s m e d i c a l n e w s . c o m

BY BECKY GILLETTE

Autism spectrum disorder rates in Ar-kansas soared from one in 145 eight year olds in 2002 to one in 65 eight year olds in 2010, reaching an all-time high. As sober-ing as those statistics are, the bright spot is that the studies done that indicate autism is more common than in the past have also drawn attention to the problem. That has led to greater resources being allocated to provide early treatment of autism that can make profound differences in the future abilities of autistic children.

“The biggest benefi t of this data is it has been provided to leaders in the com-munity and the state who have been able to have a major positive impact on legisla-tion that enhances the availability of ser-vices for families dealing with autism,” said Arkansas Autism and De-velopmental Disabilities Monitoring (AR ADDM) Program Research Pro-gram Manager Allison Hudson, who works in the University of Arkan-sas for Medical Sciences (UAMS) Section of De-velopmental Pediatrics.There is still a lot of re-search being done to fi nd out why autism rates are going up. Hudson said the best answer they have right now for the increase is better identifi cation, including better identifying children with autism in all racial groups. Right now minority groups tend to have lower rates of autism, but that may be because it hasn’t been detected as often in those groups.

“Once we identify children in all racial groups, it might be interesting to see if the prevalence equalizes across racial groups,”

Hudson said. “There are four times as many males as females with autism. There may be something genetic to that. Another thing we are noticing with increases is there has been a switch across the past ten years. Before, we were identifying more chil-dren with intellectual disabilities. Now we are identifying more children with above normal intelligence. Being able to identify children with high intelligence speaks to the improvement in detecting autism.”

Another factor that is being consid-ered possible, but not proven, is advanced maternal age of child-bearing, said Eldon G. Schulz, MD, a develop-mental-behavioral pedia-trician at UAMS who is a professor in the College of Medicine and the College of Public Health.

Schulz and Hudson have been traveling the state to raise awareness of autism which is critical to children receiving the services they need. Infants need to be screened for autism at 18 months, and between 24 and 36 months.

“If the doctor suspects autism, the child needs to be referred to early interven-tion as early as possible to give a child as much opportunity to be treated and hope-fully remediated,” Schulz said. “Treatment can make a huge difference in their lives. We don’t have really great statistics yet, be-cause there is such a wide variety in the se-verity of autism. But we know with proper intervention, including speech, occupation and behavioral therapy, a majority of these kids can enter kindergarten with minimal to no additional services needed. Most can go on to lead a normal life.”

Schulz said the care for treating autism

is very intensive, and needs to be given by every caregiver who comes into contact with the child. That includes parents, grandparents, other relatives, babysitters and therapists.

The prognosis diminishes with more comorbidities. For example, if a child has autism with an intellectual disability, the prognosis is not nearly as optimistic. Other comorbidities that get in the way include severe language impairment, hearing or vi-sion impairments, anxieties and Attention Defi cit Hyperactivity Disorder (ADHD).

“Those can all complicate the diag-nosis and the outcome,” Schulz said. “It makes treatment more challenging.”

Children from low-income families can receive government assistance for therapy, which is very expensive. Behavior therapy alone costs about $50,000 for three years.

Two years ago the Arkansas Legisla-ture passed a bill mandating that insurance companies provide services to children with autism.

“That has helped greatly with access to services,” Schulz said.

AR ADDM Co-Investigator and Cli-nician Reviewer Maya Lopez, MD, said she understands how chilling this diagnosis can be for parents.

“It is a disheartening or sometimes scary diag-nosis,” Lopez said. “But defi nitely we have people with autism who go to college, hold degrees, have jobs, and have their own families. Autism is not a diagnosis that limits a child’s ability to learn and progress. The diagnosis is used to determine how to help them in areas where

they can benefi t from assistance.”Lopez said more in known about au-

tism than in 2002, but it isn’t clear why there has been such a large increase in au-tism.

“Some believe these types of kids got a different diagnosis before such as ADHD, intellectual disability, or severe anxiety,” Lopez said. “But better detection of autism is not an answer satisfactory to everybody for why rates of autism have increased tre-mendously. There is a sense that genetics is part of it. The other part is some type of environmental infl uence on development. There is a group of people here in Arkansas and in other agriculture states who want to know if it is exposure to agricultural chemi-cals. Many people are interested in learn-ing if exposure to neurotoxins is part of the problem.”

Lopez said her best advice to health-care practitioners is do not delay when autism is suspected. They often hear from families that their doctor didn’t want to do anything until hearing back from the au-tism team at UAMS.

“Sometimes that really breaks our heart when a parent says that,” Lopez said. “The important thing is to start working with the child immediately rather than waiting to get the full diagnosis. We don’t have a blood test or x-ray to diag-nose for autism. It takes a whole day for us to evaluate the child. We become a bottleneck for these children. We want to do a quality job, but we know there are kids out there waiting for services. Speech therapy can be started even before diagno-sis. One of the best tools is the early onset of therapy.”

Lopez said the most well recognized therapies include development, physical, development, speech language and occupa-tional therapies. Applied behavioral analy-sis can also be helpful, but is more diffi cult to access in the state. Behavior analysts pro-vide it and there are a limited number of those professionals in the state.

The state government has supported a program known as the Arkansas Autism Partnership Waiver. Children eligible for Medicaid get additional therapy on top of traditional therapy from the early interven-tion program.

“This allows specialists to go into the home and teach the family things to do to help the child,” Lopez said. “This results in 30 to 40 hours per week of therapy in addi-tion to what the child gets in school. Based on the evidence, this is the most effective way to help young children with autism. We encourage parents to apply. It will be to the child’s benefi t.”

Allison Hudson

Doubling Autism Rates in Arkansas Demanding More Attention and Resources Early screening followed by treatment can makes huge difference in outcomes

Dr. Eldon G. Schulz

Dr. Maya Lopez

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I n 2010, Carroll Martindale should have been waiting for a tee time at his favorite golf course. Instead, he was waiting for I time at his favorite golf course. Instead, he was waiting for I something entirely more important: a new liver.

After being diagnosed with liver cancer, Carroll was told he was a candidate for a transplant. While waiting for a donor, he underwent life-prolonging chemotherapy and radiation treatment at the UAMS Winthrop P. Rockefeller Cancer Institute, Arkansas’ official cancer research and treatment facility.

Three years later, the call came and Carroll returned to UAMS for a successful liver transplant.

Today, he is healthy, back on the course and thankful that the best things in life are worth waiting for.

Success.

Visit cancer.uams.eduor call: 501-526-2272

After beating liver cancer, UAMS has Carroll Martindale back in the swing of things.

6 > JULY/AUGUST 2014 a r k a n s a s m e d i c a l n e w s . c o m

“They are very fl exible about often scheduling toward the end of the day,” Despain said. “This is above and beyond what you would expect from a doctor. It is letting us know my daughter is not just a number, but a patient they care about. They are doing what is best for us, not what is best for them.”

In addition to Jonesboro, specialists at the ACH are traveling to see patients at a remote clinic in Lowell, located in North-west Arkansas.

The ACH/UAMS Centers for Chil-dren bring pediatric subspecialty healthcare closer to families across the state for clinic visits and follow-up medical care. There are 21 subspecialty clinics in the Centers for Children located in Lowell and Jonesboro.

“This system of care is a working collaborative between the University of Arkansas for Medical Sciences (UAMS) Department of Pediatrics and ACH,” said ACH Communications Director Dan Mc-Fadden, APR. “We’re bringing the talent and experience of the ACH and UAMS teams to the Northwest and Northeast cor-ners of the state so our patients and families can receive expert care right at home.”

There is both time and money saved on the patient’s end, said Stephen Canon, MD, a professor of pediatrics at UAMS and ACH urologist who fl ies to Lowell and drives to Jonesboro to see patients at the Centers for Children clinics.

“Some families have the time and money to drive to Little Rock,” Canon

said. “Other families who have a hard time making ends meet may not be able to come to Little Rock, even though I know we can care for them better than an adult urolo-gist.”

Besides being able to provide specialty care that some children wouldn’t receive otherwise, the remote clinics show a dedi-cation to customer service that families re-ally appreciate.

“Whenever you fl y or drive to go see patients even once or twice or month, they are very fl attered you have gone to that much trouble to see them,” Canon said. “There is some sacrifi ce. We have to reduce the number of patients we might see in a given day. Patients might not show up for appointments. But it is defi nitely worth it.”

Mark Winslow, vice president of am-bulatory services at ACH, said for a child who lives in a small town, sometimes com-ing to Little Rock – the big city – can be a scary deal. The remote clinics allow them to be treated closer to home, and be back with their families the same day, or even back at school.

The services provided are specialty care. But ACH identifi ed a lack of enough primary care providers in Northwest Ar-kansas, so it worked with Medicaid to add some pediatricians to that area of the state.

“What was happening is we would have kids referred here for specialty care, and they wouldn’t have a primary care pro-vider,” Winslow said. “It was a big prob-lem.”

ACH charters an eight- to nine-seat airplane twice a week to fl y doctors, nurses, audiologists or other medical personnel that are needed for the day up to Lowell.

“We fl y people representing in the neighborhood of 20 services up there,” Winslow said. “The plane is full twice a week and we are really looking at having to recruit more live-in specialists in North-west Arkansas in the years to come. We have two pediatric neurologists in Lowell, and are in the process of trying to recruit a pediatric cardiologist.”

The staff from ACH in Little Rock drives once a week to the clinic in Jones-boro, where they have a full-time pediatric neurologist. Specialists who drive up in-clude those in neurosurgery, genetics, in-fectious diseases and cardiology. There are plans to add gastrointestinal in the coming months.

Winslow said the patient’s needs must not be too advanced in nature because the clinics don’t have MRI or some of the other advanced pieces of equipment available at ACH in Little Rock. But most children can be seen.

“The parents absolutely love it,” Win-

slow said. “Gas prices are really high so a trip from Northwest or Northeast Arkansas to Little Rock is very expensive. Chronic illnesses can be followed up in the commu-nity, which prevents them from having to come down here. The communities of both Northwest Arkansas and Northeast Arkan-sas have embraced us warmly for coming up there. We have had multiple different business people come and ask how they can help us be successful.”

Winslow said it never ceases to amaze him how many people have connections to ACH; they have had a close relative or friend’s child who has been treated at ACH.

“The key is that we are doing a bet-ter job treating the kids by ACH being the children’s hospital not just for Little Rock, but the entire state,” Winslow said. “North-east Arkansas is a highly competitive area for us and Northwest Arkansas has so many kids up there in need of care. If we hadn’t expanded up there, somebody else would have. The other piece we are really trying to get up on the ground up there is more telemedicine for both facilities.”

Specialists Travel to See Patients at Remote Clinics, continued from page 1

For more information visit:Jonesboro: www.centersforchildren.org/Locations/Jonesboro.aspx

Lowell: www.centersforchildren.org

Competition. “This concentration limits employers’

and families’ health insurance options, as well as the care they receive,” the authors said.

The purchase earlier this year of one of the smaller health insurance compa-nies in the state, QualChoice, by Catholic Health Initiatives (CHI), is considered a positive step in providing more balance in the insurance marketplace.

“We hope this will create more car-rier competition in the state,” said David Wroten, executive vice president of the Arkansas Medical Association.

State Insurance Commissioner Jay Bradford said the purchase of QualCho-ice by a non-profi t with more than $8 billion in surplus creates the abil-ity to grow QualChoice.

“CHI has bought a very fi ne small company and, with their capacity, they can grow that com-pany,” Bradford said. “It is good news for consum-ers in Arkansas and probably for multiple states. They have expanded in Arkansas right now, but plan to go into other ven-ues. As an insurance commission, what we want is for our consumers to have a choice. CHI has already decided to go into all regions of Arkansas. Before, Qual-Choice wasn’t able to do that. That gives us another choice in all counties in the

state. I’m very excited about it.”More competition makes for a better

price for consumers, Bradford said. “All companies will be fi ling for their

rates,” he said. “The fact that QualChoice is going to be expanding in the State of Arkansas may encourage other companies to know they have to be competitive to at-tract their consumers. Everyone will have to sharpen their pencils, hopefully.”

In addition to being positive for con-sumers, Bradford said that the purchase and expansion of QualChoice could also be a benefi t for the healthcare community.

“If there are more payers out there, it certainly should be welcomed by hospitals and other providers,” Bradford said.

This new ownership creates signifi -cant opportunities for QualChoice and is also very good for Arkansas, said Qual-Choice President and Chief Executive Mike Stock.

“Through QualChoice, CHI expects to improve and expand access to afford-able healthcare coverage, offering benefi ts and comprehensive care to more individu-als in the markets we serve,” Stock said. “CHI will be in a better position to extend healthcare services to individuals who now have no insurance, making care more af-fordable and accessible, especially to those who are less fortunate.”

Juan Serrano, CHI’s senior vice presi-dent, payer strategy and operations, said their expectation is that through Qual-Choice, CHI expects to provide more

competition in the marketplace. “CHI regards Arkansas as an excel-

lent place to invest in our health insurance operating capabilities and support our organization’s health-plan business devel-opment,” Serrano said. “QualChoice is a key component of our future in this area, and Little Rock will be a transaction cen-ter for national operations. That means we expect more opportunities – and more job growth – in Little Rock and Arkansas.”

Some benefi ts of the increased com-petition were seen with the state’s private option Medicaid expansion. QualChoice provided some catastrophic plans and high value network options that were more af-fordable than the competition. QualCho-ice sold plans to 1,220 of the people who signed up for the private option Medicaid expansion. The private option Medicaid expansion allows people with incomes that are below 138 percent of the poverty level to enroll in government subsidized plans offered by private insurance companies.

There were issues prior to the acqui-sition whether providing healthcare plans that include coverage for contraception and abortions might be at odds with the Catholic Church’s position on birth con-trol.

Arkansas Catholic, the offi cial news-paper of the Diocese of Little Rock, re-ported that Bishop Anthony Taylor had reservations about the deal. Taylor said he was not convinced that CHI’s acquisition of QualChoice would pose no moral or

ethical confl icts with Catholic principals.The U.S. Conference of Bishops’ Eth-

ical and Religious Directives for Catholic Healthcare Services prohibits the use of contraceptives and related reproductive services.

Access to contraception is a require-ment of the Affordable Care Act.

“We don’t anticipate any changes to our benefi t policies and procedures,” Stock said. “QualChoice has always com-plied with applicable state and federal reg-ulations requiring specifi c levels of benefi ts and that will not change. CHI’s mission is to create and nurture healthier communi-ties.”

Stock said that to the extent man-dated benefi ts confl ict with the Catholic Ethical and Religious Directives, Qual-Choice will institute appropriate admin-istrative practices consistent with the way other Catholic organizations have oper-ated health plans and continue to do so within the Catholic moral tradition.

QualChoice does not cover elective abortions. Therapeutic termination of pregnancy is covered, with preauthoriza-tion, only when determined to be medi-cally necessary, such as when the mother’s life is endangered by continuation of the pregnancy.

CHI owns 89 hospitals in 18 states, including St. Vincent Health System in Arkansas. The non-profi t has assets of $19.3 billion.

Catholic Health Initiatives Purchase of QualChoice, continued from page 1

Jay Bradford

a r k a n s a s m e d i c a l n e w s . c o m JULY/AUGUST 2014 > 7

THE STRENGTH TO HEAL and get back to what I love about family medicine.

Do you remember why you became a family physician? When you practice in the Army or Army Reserve, you can focus on caring for our Soldiers and their Families. You’ll practice in an environment without concerns about your patients’ ability to pay or overhead expenses. Moreover, you’ll see your efforts making a difference.

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BY LYNNE JETER

Healthcare providers collectively ex-haled when the Centers for Medicare and Medicaid Services (CMS) announced the adoption of ICD-10 would be delayed a year, after Congress adopted the Protect-ing Access to Medicare Act of 2014. The new compliance date of Oct. 1, 2015, will require HIPAA-covered entities to con-tinue using ICD-9-CM.

A bonus: With the extra preparation time, payors should be in a better posi-tion to make more timely payments in the fourth quarter of 2015 (Q415).

“Thanks to the delay, providers will have fewer sleepless nights. That said, practices need to stay the course,” said Jennifer O’Brien, MSOD, a practice management consultant with KarenZupko & As-sociates Inc. “Most were way behind; now they’re on schedule.”

O’Brien shared some thoughts on why this delay changes the code set transition very little:

Full implementation and ICD-10 readiness is a 12-24 month process for a practice. For example, practices that scheduled training, software upgrades, or process changes in 2014, do not change those plans. Proceed with your implemen-tation timeline as planned.

One of the Best Practices is to be ICD-10 coding and documenting 25-50 percent of your cases by the end of the fi rst quarter of 2014. If you’ve achieved that goal, continue on your timeline. If you haven’t yet achieved it, continue with your implementation timeline and plan.

If you have only just or not yet started on your ICD-10 implementation, proceed with an aggressive timeline and training plans because the full implementation and readiness takes 12-24 months.

There seems to be a misunderstand-ing among doctors and staff that ICD-10 training is like attending a review course, like they would do just before sitting for board recertifi cation. It isn’t! This isn’t a

test in which you must simply retain the information just to get through or to get started. It’s a whole new system; it’s a new way of doing things that you’ll implement upon learning, and not forget.

The recent MGMA survey results have the gross majority of practices be-hind in implementation and readiness. All a delay does is put more practices on schedule. It doesn’t provide a reason to slow down or change those plans.

The only possible change you should consider making to your implementation plan and timeline is to tighten up your entire revenue cycle, from appointment scheduling (accurate patient demographic and insurance information) to charge cap-ture, time-of-service collections, claims submission, appeals, and to patient ac-count collections.

Don’t slow down; just breathe deeply for a little while. Some practices are mak-

ing the mistake of delaying everything by one full year. At the beginning of 2014, practices were behind because there was simply too much to do. If they delay ev-erything by a full year, at the beginning of 2015, they’ll be behind by their own fault.

Hopefully, the delay will give the pay-ers no excuse to delay payments upon the ICD-10 change in the fourth quarter of 2015. This will make a smoother transi-tion for everyone.

Capitalizing on the ICD-10 Conversion DelayPractice management consultant provides tips for easier transition

Jennifer O’Brien

Access two free Medscape Education modules that provide guidance to small practices making the transition to ICD-10: ICD-10: A Roadmap for Small Clinical Practices  and ICD-10: Small Practice Guide to a Smooth Transition. Continuing medical education (CME) and continuing education (CE) credits are available to physicians and nurses who complete the learning modules.

SOURCE: CMS.

8 > JULY/AUGUST 2014 a r k a n s a s m e d i c a l n e w s . c o m

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FAYETTEVILLE--Mike Dunkel, 47, a lineman from Ozark, is back climbing electrical power poles and distance running after a successful Autologous Chondrocyte Implantation (ACI) pro-cedure performed by or-thopedic surgeons Chris Arnold, MD and Terry Sites, MD, at Physicians’ Specialty Hospital.

“Without this proce-dure, I was pretty much done as a runner,” said Dunkel, who had the sur-gery 18 months ago. “It would have been pretty hard climbing poles, as well. I was just so thank-ful that Dr. Arnold could do the procedure.”

Dunkel had torn his meniscus doing the long jump in high school, an injury that was aggra-vated later in life by the sport he is pas-sionate about, running. That meniscal tear left his articular cartilage exposed and

subjected it to continual wear, resulting in bone on bone contact in the exposed area.

Arnold was the fi rst in the state to perform the procedure and is fourth in the country in the number of ACI surgeries.

“Dr. Terry Sites and I formed the Cartilage Restoration Center about three years ago to help provide younger people who have lost all or part of their cartilage a better option than knee replacement,” Ar-nold said. “We have had excellent results re-implanting a patient’s cartilage cells. What we basically do is two separate sur-geries. We scope the knee fi rst, take a few cartilage cells, and send them to a center in

Boston where they multiply those cells. We put about 48 million of the patient’s own cartilage cells back into the area of the knee that has lost the cartilage. It works. You are using the patient’s cells – the patient’s own DNA – and it has good results. It may pre-vent them from ever having to have a knee replacement.”

Arnold said the majority of this pro-cedure is done through the arthroscope. However, a small incision is made to intro-duce the cartilage into the knee joint. “The autologous cells have been tested to ensure that they are free of any transmittable dis-ease,” Arnold said. “Unlike cadaver trans-plants this does not require that patients be on medications to prevent tissue rejection. You are essentially giving the patient back their own cartilage.”

Arnold has done about 100 of the pro-cedures in the past 3 1/2 years. Patients who meet the right criteria have seen ex-cellent outcomes.

“It has been very rewarding, because instead of replacing a knee in someone who is 30, 40 or 50, repairing their car-tilage with their own cells allows them to avoid a knee replacement at that early of an age,” Arnold said. “It is a little more expensive than knee replacement. The higher cost isn’t for the surgeon, but for getting the cells multiplied. If you do a knee replacement on people in their 30s, they will need knee replacement several times in their life. While the initial cost of a cartilage transplant is more, the long term cost can be much lower.”

Sites said ACI is a biological solution to a previously unsolvable problem.

“Patients ages 15-55 now have the opportunity to restore the damaged sur-face of their knees instead of simply treat-ing their symptoms or replacing the knee joint, which is not biological,” Sites said. “Unlike joint replacement surgery, which has permanent physical limitations, ACI has the potential to return patients to their activities unrestricted.”

After the surgery, it was about four months before Dunkel could go back to work, and during that interim he was ag-gressive with his physical therapy, swim-ming 50 minutes a day and doing other exercises. Dunkel started running again Jan. 1, and ran a half marathon in March.

“I’m back climbing poles, and doing pretty much everything I was doing be-fore,” Dunkel said. “I’m not quite as fast running as before. It takes a while for the muscles to develop. Actually, eventually I should be better because I don’t have that old damage there now.”

Dunkel credits the procedure with sav-ing his career, as well as his favorite hobby.

“Only a few doctors in the state do the procedure, so I was blessed to have Dr. Arnold as my doctor,” Dunkel said. “I remember the fi rst time I had my knee scoped, another surgeon said it was one of the worst he had seen. The cartilage was gone. It was rubbing bone on bone. I had quite a bit of pain with it. It was swollen a lot, too.”

A torn meniscus is the most common knee injury requiring surgery in North America, and often results in the type of damage that led to Dunkel undergoing the ACI procedure. While often the meniscus tears result from sports or workplace inju-ries, they can also occur with activities of daily living without any specifi c trauma.

“Once a meniscus is torn, the body’s natural response is to develop pain, as well as swelling,” said Sites. “Patients often complain that the knee may ‘lock’, give way, or go out. Once a meniscus is torn, it loses its normal cushioning affect. This causes the body’s weight to distrib-ute unevenly. As a result of this uneven stress over time, the articular cartilage can wear down which can lead to degenera-tive arthritis. At the Cartilage Restoration Center, we do everything possible to re-pair or even replace torn or worn down cartilage.”

In the past, many knee injury repairs would result in a large incision. Sites said this subsequently changed to performing most cartilage repairs and replacements through the arthroscope.

The Cartilage Restoration Center is the fi rst of its kind in the state of Arkansas, and one of only a few designated cartilage restoration centers in the U.S. They pro-vide a full range of treatment options for knee. The majority of these procedures are performed arthroscopically in an out-patient setting while others occasionally require an overnight stay.

Autologous Chondrocyte Implantation Allows Patient’s Own Cells to Repair Damaged KneesCartilage restoration center leads the state and is fourth in the country in procedure

Dr. Chris Arnold

Dr. Terry Sites

BEFORE AFTER

For more information visit:www.aoshogdocs.com/cartilage-restoration-center-info

or www.pshfay.com

a r k a n s a s m e d i c a l n e w s . c o m JULY/AUGUST 2014 > 9

SVMIC Declares $7.5 M Dividend

BRENTWOOD, TN – State Volun-teer Mutual Insurance Company’s Board of Directors has declared a dividend of $7.5 million to be returned to all policy-holders renewing in the twelve-month period following May 15, 2014.

This is the seventh consecutive year SVMIC has declared dividends for its physician policyholders. Policyholders will receive the dividend in the form of a credit on the renewal premium. Addi-tionally, rates will remain unchanged for 2014.

Since SVMIC’s inception, a total of $335.5 million has been returned to phy-sician policyholders.

A.M. Best Awards LAMMICO an “A” Rating

After 20 consecutive years of main-taining an “Excellent” rating, A.M. Best upgraded LAMMICO’s financial strength rating to A from A- and issuer credit rat-ings to “a” from “a-”.

The world’s oldest and most au-thoritative source of insurer financial performance assigns the “A” rating to companies that have, in Best’s opinion, an excellent ability to meet their ongo-ing insurance obligations. According to Best, “The ratings are reflective of the group’s strong capitalization driven by its conservative loss reserving philosophy, consistently favorable operating perfor-mance, high policyholder retention, and leadership position in providing medical professional liability insurance coverage to physicians and surgeons, other health care practitioners and health care facili-ties in the state of Louisiana.” The up-graded rating underscores LAMMICO’s continued improvement in the financial strength and overall growth of the com-pany.

LAMMICO received its first A- (Ex-cellent) rating from Best in 1994, based on the company’s financial results in 1993. At that time, it was a remarkable achievement for an insurance carrier to receive such a high grade on its very first rating. Last year (2013), Best revised LAMMICO’s rating outlook to positive from stable while affirming the compa-ny’s financial strength rating of A- “Excel-lent.” The revision of the rating outlook was a necessary first step in order for LAMMICO to receive an upgraded rat-ing from Best.

MedEvolve EHR Software is Certified for Meaningful Use Stage 2

MedEvolve, a provider of practice management software, electronic health records (EHR), and physician revenue cycle management services, today an-nounced that its EHR solution, MedE-volve EHR 6.0, has been tested and was certified for Meaningful Use Stage 2 on

April 13, 2014 by Drummond Group’s Electronic Health Records Office of the National Coordinator Authorized Cer-tification Body (ONC-ACB) program. MedEvolve EHR 6.0 met the require-ments for ONC’s Complete EHR 2014 criteria which were adopted by the Sec-retary of the US Department of Health and Human Services. MedEvolve’s EHR 6.0 supports both Meaningful Use Stage 1 and Stage 2 measures, and is certified for use by eligible providers to qualify for

EHR incentives.Drummond Group’s ONC-ACB cer-

tification program certifies that EHRs meet the meaningful use criteria for ei-ther eligible provider or hospital tech-nology. In turn, healthcare providers us-ing the EHR systems of certified vendors are qualified to receive federal stimulus monies upon demonstrating meaning-ful use of the technology – a key com-ponent of the federal government’s push to improve clinical care delivery through

the adoption and effective use of EHRs by U.S. healthcare providers.

This Complete EHR is 2014 Edition compliant and has been certified by an ONC-ACB in accordance with the ap-plicable certification criteria adopted by the Secretary of the U.S. Department of Health and Human Services. This certi-fication does not represent an endorse-ment by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments.

GrandRounds

10 > JULY/AUGUST 2014 a r k a n s a s m e d i c a l n e w s . c o m

NARMC Welcomes Dr. Adam McCall

North Arkansas Regional Medi-cal Center is pleased to announce that Adam McCall, M.D. has joined the active medical staff.

Dr. McCall graduated from Conway High School in 2002. He attended the University of Central Ar-kansas where he received a Bachelor of Science (Biology) degree in 2006. He furthered his education at the University of Arkan-sas For Medical Sciences in Little Rock, where he received his Doctor of Medi-cine degree in 2010.

In March of this year he completed his Residency at UAMS-Area Health Edu-cation Center in Fayetteville, AR. Dr. Mc-Call’s professional recognitions include Student Leader on the UAMS Christian Medical and Dental Association. He has participated in Medical Mission Trips to the Dominican Republic, India, and South America. Dr. McCall is Board Cer-tified by the American Board of Family Practice.

Dr. McCall has joined the NARMC Family Medicine Clinic in Harrison.

Chasse Conque Appointed Senior Director of Development for UAMS Medical Center

Chasse Conque has been appoint-ed senior director of development for the University of Arkansas for Medical Sciences (UAMS) Medical Center.

Conque joined UAMS in February 2011 as the director of development for the Col-lege of Medicine. In 2012 he was part of the College of Medicine’s best fund-raising year in six years helping raise more than $6 million. He has worked closely with the college’s Board of Visi-tors as well as UAMS physicians and re-searchers to help raise funds in all areas – clinical, research and education.

Working under Renie Rule, the UAMS College of Medicine’s executive director of development, Chasse has been a key figure in the college’s devel-opment efforts which have raised $15 million over the last three years, accord-ing to Lance Burchett, UAMS vice chan-cellor for institutional advancement.

He is replacing Sue Williamson, who is retiring after a 30-year career at UAMS.

Prior to coming to UAMS, Conque spent five years at the University of Ar-kansas at Little Rock (UALR) where he was the director of development for athletics. While there he started Spec-tacUALR, the largest ongoing fundrais-ing event for the university. Conque was named to the “Arkansas Business 20 in

their 20’s” list in 2011.He earned his bachelor’s degree at

the University of Central Arkansas and a Master of Business Administration from UALR.

Conque will continue to work with Rule and College of Medicine Dean G. Richard Smith, M.D., as well as UAMS Medical Center CEO Roxane Townsend, M.D, and Brigitte Grant, associate vice chancellor for development, to identify philanthropic opportunities for the med-ical center and College of Medicine.

UAMS, UAF Offering Grants to Spur Telehealth Research, Collaboration

The University of Arkansas for Medi-cal Sciences (UAMS) Translational Re-search Institute and the University of Arkansas, Fayetteville (UAF) are offering pilot grants to study the state’s nationally leading telehealth programs, a relatively new practice that allows doctors to reach patients in distant locations.

The one-year Translational Research Institute Pilot Research Awards will fund as many as four telehealth projects at up to $15,000, with an additional $5,000 available to projects that involve a UAF collaborator.

Telehealth uses two-way interac-tive video and imaging devices to de-liver specialized medical services, from emergency stroke treatment to the care of premature infants. Arkansas ranks sec-ond nationally in telehealth availability, and it has the lowest ratio of rural resi-dents to telehealth sites, according to the National Telehealth Resource Cen-ters Report.

UAMS has more than 40 pioneering clinical telehealth programs that utilize the state’s infrastructure, but many of the programs lack the data needed to promote broader adoption, said Laura James, M.D., director of the UAMS Translational Research Institute.

The institutions’ leaders said the col-laborative funding initiative is designed to foster research between physicians engaged in telehealth programs and re-searchers.

Cynthia L. Sagers, Ph.D., associate vice provost for Research and Economic Development at UAF said they expect to see research that tests the clinical out-comes, cost effectiveness and compara-tive effectiveness of these programs so that they can be more broadly adopted.

Every county in Arkansas has at least one telehealth site and most counties have several. All UAMS Regional Cen-ters, most of the state’s hospitals, Feder-ally Qualified Health Centers, and county health departments are linked through telehealth. Arkansas has 945 telehealth endpoints, 421 anchor health care insti-tutions, and 495 interactive video units.

The UAMS Translational Research Institute’s mission is to help accelerate

research that will improve the health and health care of people in Arkansas and across the country. TRI is one of 62 re-cipients of a National Institutes of Health (NIH) National Center for Advancing Translational Sciences (NCATS) Clinical and Translational Science Award (CTSA).

UAMS Researchers Awarded $4.4 Million Grant for Space Radiation Health Research

A team of University of Arkansas for Medical Sciences (UAMS) research scien-tists recently was awarded a three-year $4.4 million grant by the National Space Biomedical Research Institute (NSBRI) to investigate the degenerative or long-term health effects of space radiation on cardiovascular health, as part of the newly formed Center for Space Radia-tion Research.

Marjan Boerma, Ph.D., associate professor of pharmaceutical sciences in the UAMS College of Pharmacy Divi-sion of Radiation Health, will lead the research team and serve as its principal investigator.

Compared to the general popula-tion, people exposed to radiation in dif-ferent scenarios on Earth have shown higher incidences of cardiovascular dis-eases like hypertension, ischemic heart disease and stroke. The cardiovascular system seems more sensitive to ionizing radiation than previously believed, Boer-ma said. Hence, the researchers will seek to determine if radiation encountered during space travel has similar negative long-term consequences for cardiovas-cular health. They also will look for ways to reduce the health risks from radiation exposure in space.

One of the countermeasures against radiation injury that they’re interested in is tocotrienol, in the vitamin E fam-ily, Boerma said. They will use and test gamma-tocotrienol because it has been shown to be very effective in protecting against radiation injury. Now, since toco-trienols also have several other benefits for heart and blood vessels, they’re go-ing to test to see if it reduces cardiovas-cular effects from space radiation.”

In addition to Boerma, other UAMS scientists and faculty at the center in-clude: Martin Hauer-Jensen, M.D., Ph.D., associate dean for research and direc-tor of the Division of Radiation Health in the UAMS College of Pharmacy; Alan Tackett, Ph.D., professor in the UAMS College of Medicine Department of Bio-chemistry and Molecular Biology; and Igor Koturbash, M.D., Ph.D., assistant professor in the Department of Environ-mental and Occupational Health in the UAMS Fay W. Boozman College of Pub-lic Health. Hauer-Jensen will serve as co-director of the center, while Tackett and Koturbash are co-investigators.

Arkansas Medical News is published bi-monthly by Medical News, Inc., a wholly-owned subsidiary of SouthComm, Inc. ©2014 Medical News Commu-nications.All rights reserved. Reproduction in whole or in part without written permission is prohibited. Medical News will assume no responsibilities for unsolicited materials. All letters sent to Medical News will be considered Medical News property and therefore uncondition-ally assigned to Medical News for publication and copyright purposes.

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SOUTHCOMMChief Executive Officer Chris FerrellChief Financial Officer Patrick Min

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GrandRounds

Dr. Adam McCall

Chase Conque

a r k a n s a s m e d i c a l n e w s . c o m JULY/AUGUST 2014 > 11

Mutual Interests. Mutually Insured.

Who would you trust to be there when you need to defend your professional reputation? Looking at the numbers, there is no comparison. When it comes to your medical professional liability insurance, it pays to do your homework.

Contact Sharon Theriot at sharon.theriot@svmic.com or call 1-800-342-2239.

Follow us on Twitter @SVMIC www.svmic.com

ARKANSAS MUTUAL

Industry Experience 38 years 6 years

Arkansas Experience 25 years 6 years

A.M. Best Rating A (Excellent) Not rated

A.M. Best Rating History A (Excellent) or better for 30 consecutive years

None

Operations Managed 100% in-house with some of the lowest expenses in the country

Managed pursuant to a contractual agreement with an affiliated entity that is partially owned by management of Arkansas Mutual and outside investors

Percentage of premium spent on operating expenses

17% 66%

Surplus as regards policyholders

$496.7M $2.8M

Total dividends returned to Arkansas physicians

$13.5M $0

Dividends returned to Arkansas physicians in the last five years

$8.6M $0

Dividends returned to Arkansas physicians in the last five years as a percentage of premium

9% 0%

This chart contains information extracted from the December 31, 2013 Statutory Annual Statements of each company and from other publicly available sources.

InCharge HEALTHCARE 2013

Y O U R P R I M A R Y S O U R C E F O R P R O F E S S I O N A L H E A L T H C A R E N E W SArkansas

mfs.13incharge.cvr.indd 1

12/6/12 2:39 PM

In Arkansas’s powerful healthcare industry, one constant is change. This is a state where thought leaders are always willing to make strategic moves ... not to keep pace with the latest trends ... but to set them.

SPACE DEADLINE: February 27CREATIVE DEADLINE: March 5

Keeping up with Arkansas’s dynamic

healthcare industry can be challenging, which

is why this annual issue will be a resource

readers turn to again and again. Make sure

your message is seen by advertising in this

important guide that has a 12-month shelf

life. Be sure and include this one-of-a-kind

directory in your 2015 media plan.

For more information, contact: Pamela Harris, 501.247.9189, pharris@medicalnewsinc.com

nashvillemedicalnews.com

2012 // InCharge Healthcare // NASHVILLE MEDICAL NEWS 5

4 NASHVILLE MEDICAL NEWS // InCharge Healthcare // 2012

InCharge HEALTHCARE

InCharge HEALTHCARE

A

Clint AdamsCFOArdent Health Services

One Burton Hills Blvd., Suite 250

Nashville 37215

615.296.3000

ardenthealth.com

Adams, who joined Ardent in 2003, brings more

than 20 years of accounting and healthcare experi-

ence to the lead financial role for the health services

company. Previously, he was an audit senior man-

ager for Ernst & Young, where he managed large

and medium-sized audit engagements of multiple

SEC healthcare and technology companies. He also

served as controller for PathGroup Inc. and was an

audit manager and staff accountant for Deloitte.

A CPA, Adams is a member of the Healthcare

Financial Management Association.

Robert Adams

Chairman & CEO

National HealthCare Corp.

100 East Vine St.

Murfreesboro 37130

615.890.2020

nhccare.com

Adams has served NHC for 35 years – 18 of them

as senior VP, 10 as COO and five as president and

CEO. He became chairman of the board on Jan.

1, 2009, and has been CEO since Nov. 1, 2004. He

has extensive long-term care experience, including

serving NHC as a healthcare center administrator

and regional VP as the company grew into a 76-

unit chain with almost 10,000 beds in 12 states.

Sharon Adkins, MSN RN

Executive Director

Tennessee Nurses Association

545 Mainstream Drive, Suite 405

Nashville 37228

615.254.0350

tnaonline.org

Prior to assuming leadership for the state’s

professional nursing organization in 2006, Adkins

held various leadership positions at Vanderbilt,

where she maintains an adjunct faculty position at

the Vanderbilt University School of Nursing. She

holds a bachelor’s of science in nursing from the

University of Minnesota, a master’s of science in

nursing administration from VUSN, and is a 1997

graduate of the Parish Nurse Preparation Institute

at the Marquette University College of Nursing.

Clifford Adlerz

President & COO

Symbion Healthcare

40 Burton Hills Blvd., Suite 500

Nashville 37215

615.234.5900

symbion.com

Adlerz has served as president of Symbion since

May 2002 and as COO and a board director since its

inception in 1999. Previously, he was COO of UniPhy,

an operator of multi-specialty clinics, independent

practice associations and related outpatient services.

He also served as division VP of HCA Inc. and

regional VP of HealthTrust, with responsibility for the

operations of 14 hospitals in two states.

Karen AhernSenior VP, National Healthcare Finance

Fifth Third Bank

424 Church St.

Nashville 37219

615.687.3115

53.com

In July 2011, Ahern stepped into the role oversee-

As director of clinical research at Centerstone,

Ayer works with a team of nationally known

researchers managing clinical trials focusing on

schizophrenia, depression, older adult needs,

conduct disorders, homelessness, and nicotine,

alcohol and methamphetamine abuse. He

received a doctorate in behavior analysis at

Western Michigan University and is a member of

the American Psychological Association.

B

Buddy BaconCEOMeridian Surgical Partners

5141 Virginia Way, Suite 420

Brentwood 37027

615.301.8140

meridiansurg.com

From 1996 to 2003, Bacon was CEO and CFO

for Medifax-EDI Inc., a local healthcare informa-

tion technology company that was acquired by

Atlanta-based Crescent Capital for $117 million.

Bacon then teamed up with Surgical Alliance

co-founders Kenny Hancock and Cathy Kowalski

to assemble a team to run Meridian, which now

manages 16 surgery centers in 12 states in

partnership with physicians.

Ben BakerCOOCareHere215 Jamestown Park Drive, Suite 204

Brentwood 37027

615.661.5680

carehere.com

Baker is the former president of Precision Data

Management Systems, which markets information

technology consulting services. He is a certified

master black belt in the Six Sigma quality man-

agement process pioneered by General Electric.

CareHere runs 90 on-site healthcare clinics in 17

states. Its payroll has risen to about 160 people

from 90 a year ago.

Jeff Balser, MD, PhD

Vice Chancellor for

Health Affairs & Dean

Vanderbilt University

School of Medicine

1161 21st Ave. S.

D-3300, MCN, Nashville 37232

615.936.3030

medschool.vanderbilt.edu

A Vanderbilt School of Medicine graduate, Balser

joined his alma mater as an associate dean in

1998 and was named chair of VUMC’s Depart-

ment of Anesthesiology three years later. In 2004,

he became the chief research officer and led the

moved the medical school into the top 10 in NIH

funding. In October 2008, Balser was named

associate vice chancellor for Health Affairs and

became the 11th dean of the School of Medicine

since its founding in 1875. Eight months later, he

took on the top job upon the retirement of Harry

Jacobson, MD, who hand selected Balser as his

successor and worked closely with him for a

smooth transition.

Lee BarfieldMemberBass Berry & Sims

150 Third Ave. S., Suite 2800

Nashville 37201

615.742.6200

bassberry.com

Barfield has practiced law with Bass since 1978

and is a member of the litigation and healthcare

industry practice areas of the firm. He has

ing national healthcare lending after joining Fifth

Third in 2008 as director of healthcare banking.

Previously, the healthcare finance veteran was with

SunTrust Robinson Humphrey and also headed up

healthcare finance at National City. In 1996, Ahern

became the first finance professional elected to

the board of the Nashville Health Care Council.

Dave Alexander, MD

PresidentTennessee Orthopaedic Alliance

301 21st Ave. N.

Nashville 37203

615.329.6600

toa.com

Specializing in sports medicine and hand surgery,

Alexander is president of TOA. The board-certified

orthopaedic surgeon, who holds a certificate

of added qualification in surgery of the hand,

received his medical degree from Vanderbilt,

where he also completed surgical and orthopaedic

residencies. Recently, Alexander was recognized

as one of the nation’s ‘Top Doctors in Orthopaedic

Surgery’ by Castle Connolly Medical, a healthcare

research company. He is he former chairman of the

board for Ortholink Physicians Corporation.

Don Alexander

CEOTennessee Medical Association

2301 21st Ave. S.

Nashville 37212

615.385.2100

tnmed.org

Alexander has been with the Tennessee Medical

Association since joining the organization as a

field agent in 1973. He was named to the top

staff spot in 1995 but announced his intentions

to retire before the end of 2012. The organization

has named Russ Miller as his successor. During his

nearly four decades with the TMA, Alexander has

advocated on behalf of physician members on

a variety of legislative, educational and practice

issues. Prior to joining the staff, he worked briefly

as a consultant for the GA-TN Regional Health

Service in Chattanooga.

Tom Anderson

Co-founder, Vice Chair

Capella Healthcare

501 Corporate Centre Drive, Suite 200

Franklin 37067

615.764.3000

capellahealth.com

Anderson co-founded Capella with Dan Slipkovich

in April 2005. His current focus is on development.

Previously, he was senior VP of acquisitions and

development for Province Healthcare, where he

completed transactions involving 18 hospitals

before Province was sold to LifePoint. He began

his career in 1975 in public service with the Tennes-

see Division of State Audit.

Doug Andrews

Co-founder & President

Lam-Andrews Advertising

1201 Eighth Ave. S.

Nashville 37203

615.297.7717

lam-andrews.com

Andrews, who co-founded this healthcare

communications firm in 1991, is responsible for

business development, operations and strategic

planning. He also serves as the firm’s technology

director, applying a range of online marketing ex-

pertise to help clients maximize brand awareness

and lead generation using web-based tactics.

Hal AndrewsCo-founderMainland Morgan & Co.

3100 West End Ave., 7th Floor

Nashville 37203

615.312.7118

After serving as managing

director with private investment firm The Martin

Companies, Andrews launched Mainland Morgan

& Co., a holding company with interests in health-

care, information technology and real estate, in

2011. Recognized for his entrepreneurial vision,

Andrews provides strategic advisory services

to a variety of companies in the healthcare

technology and services industries. In addition,

he serves on the boards for Care Team Connect,

Shareable Ink, Medify, SurgiChart and Nashville

Capital Network. In 2007, Andrews launched

Data Advantage, which he ultimately sold to

The Martin Companies. He began his career as a

healthcare attorney.

Nancy Anness

VP of Advocacy and Outreach

Saint Thomas Health

102 Woodmont Blvd., Suite 800

Nashville 37205

615.284.7847

sths.com

1n 1991, Anness was recruited by Vanderbilt to

start the Vine Hill Community Clinic. Four years

later, she joined Saint Thomas Health to launch

community clinics to serve the poor. After 13

years as the executive director of the Saint

Thomas Family Health Centers, she moved into

her current position in 2008.

Doug Ardoin, Jr., MD

CMOTriStar Health System

110 Winners Circle, First Floor

Nashville 37203

615.886.4900

tristarhealth.com

Ardoin was named CMO for the TriStar division

in November 2011. He came from New Orleans

where he served in the same capacity for HCA’s

Delta Division. Ardoin is responsible for continual

improvement of clinical and patient safety out-

comes, as well as greater physician engagement

and alignment in the areas of physician leadership

and clinical variation reduction across the divi-

sion. Previously he served as physician-in-chief

of Memorial Hermann Healthcare System and

CEO of Memorial Hermann Northwest Hospital in

Houston. Prior to that, the board-certified family

physician was in private practice.

Mark Awh, MD

Founder & President

Radsource, LLC

8 Cadillac Drive, Suite 200

Brentwood 37027

615.376.7500

radsource.us

An authority on magnetic resonance imaging,

Awh was a founder of Radsource, a joint venture

between United Surgical Partners International

and Imaging Specialists, PLLC, in 2001. Awh

oversees the imaging management company,

which offers services ranging from interpretation

to developing imaging centers. Prior to founding

Radsource, Awh served as director of MRI at Saint

Thomas Hospital and as president of one of the

nation’s largest radiology private practices.

David AyerDirector of Clinical Research

Centerstone Research Institute

44 Vantage Way, Suite 280

Nashville 37228

615.463.6240

centerstoneresearch.org

defended hospitals, doctors and nurses in

medical malpractice cases. He has also counseled

healthcare providers on hospital operational

issues, child abuse reporting, fraud and abuse and

other healthcare regulatory issues.

Shari Barkin, MD

Chief of General Pediatric Division

Monroe Carell Jr. Children’s

Hospital at Vanderbilt

2200 Children’s Way

Nashville 37232

615.936.2425

childrenshospital.vanderbilt.org

Barkin was named to her post in 2006 and also

serves as a pediatrics professor. Her research

focuses on improving and preventing instances

of childhood obesity. She recently received a

Tennessee State Implementation Grant to test

the effect of an obesity intervention program for

Latino families with young children.

David Bartholomew

President & CEO

HCCA International

405 Duke Drive, Suite 210

Franklin 37067

615.255.7187

hccaintl.com

Bartholomew was responsible for growing

Staffmark from a one-office startup in 1991 to one

of the largest staffing companies in America. He

joined HCCA in 2009 and focuses on its domestic

division, including HCCA Anesthesia, a provider of

certified registered nurse anesthesia services for

physician offices, surgical centers and hospitals;

NRS Healthcare, a Middle Tennessee-based

provider of per diem medical staffing; and HCCA

Clinical Research Staffing. He is a past chairman

of the American Staffing Association.

Samuel W. “Bo”

Bartholomew III

CEOPharmMD5200 Maryland Way, Suite 200

Brentwood 37027

615.346.0880

pharmmd.com

Prior to helping launch PharmMD, Bartholomew

served as vice president of business development

for Integration Management Inc. He also served

as managing partner of Integration Ventures

LLC, a joint venture partner of Integration

Management. Earlier, Bartholomew was associate

administrator for Centennial Medical Center in

Nashville and associate administrator at HCA’s

then-new StoneCrest Medical Center. He serves

on multiple boards including the Minnie Pearl

Cancer Foundation and Tennessee Center for

Bioethics and Culture.

Regina Bartlett

CEOHendersonville Medical Center

355 New Shackle Island Road

Hendersonville 37075

615.338.1000

hendersonvillemedicalcenter.com

Prior to joining HMC, which is part of HCA’s

TriStar network, Bartlett served as the chief

nursing officer for South Pittsburg Hospital (now

Grandview Medical Centers), and as several other

leadership positions with Parkridge Medical

Center in Chattanooga, where she started her

career with HCA in 1978.

John BartonExecutive VP –

Specialized Banking Industries

Regions Bank

315 Deaderick St.

Nashville 37201

615.770.4242

regions.com

In December 2011, Barton was named to oversee

specialized industries including healthcare,

which he had led since 2009. Previously, he was

managing director and co-head of the Nashville

healthcare group at SunTrust Robinson Hum-

phrey. He has also held management positions at

CRC Equities and Third National Bank.

Thomas Bartrum

ShareholderBaker Donelson Bearman

Caldwell & Berkowitz

211 Commerce St., Suite 800

Nashville 37201

615.726.5641

bakerdonelson.com

A practicing attorney, Bartrum works in the areas

of healthcare regulatory and transactional law as

well as fraud and abuse allegations. He has de-

voted much of his practice to hospital-physician

joint ventures and other collaborations and writes

extensively on the subject of healthcare law.

Matt BassettSenior Vice President

Revive Public Relations

209 10th Ave. S., Suite 404

Nashville 37203

615.742.7242

revivepr.com

The California healthcare PR firm, listed among

the top 15 such firms in the nation, opened its

second office in March 2011 and tapped Bassett,

along with Kriste Goad, to oversee the new

Nashville location. Bassett has more than 15 years

of public policy experience. Previously, he was

vice president of public policy for dialysis service

provider DaVita. Prior to that, Bassett served as

chief of staff for Kentucky’s Cabinet of Health and

Family Services and senior advisor to Governor

Ernie Fletcher for health and insurance policy.

Dale Batchelor, MD

Executive VP & CMO

Saint Thomas Hospital

4220 Harding Road

Nashville 37205

615.222.2111

stthomas.org

In May 2006, Batchelor was named CMO of Saint

Thomas Hospital. For more than 20 years, he has

served the hospital, its patients and physicians

through roles of chief physician executive, interim

chief operating officer and interim president and

CEO (January 2005-May 2006). Board-certified

and trained at Vanderbilt University Medical Cen-

ter, Batchelor, a member of Saint Thomas medical

staff since 1986, has practiced ophthalmology in

Nashville since 1979.

Bill Bates, MDChairman & Founder

digiChart Inc.

100 Winners Circle, Suite 450

Brentwood 37027

615.777.2727

digichart.com

A clinical professor of obstetrics and gynecology

at Vanderbilt University Medical Center, Bates

launched digiChart, an HIT solutions and services

company in the field of women’s health. Prior to

digiChart, he was a professor of obstetrics and

gynecology and dean of the College of Medicine

WHO’S IN CHARGE?In April of 2015, the premiere issue of Arkansas InCharge Healthcare will answer that important question.

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