Louisiana Medical News January/February 2014

By TeD GriGGS

For years, Louisiana has kept accurate records of the numbers of regis-tered and practical nurses the state licenses, but no tool existed to analyze that data by each of the state’s eight workforce regions.

Until now. The Louisiana Cen-

ter for Nursing (LCN), a division of the Louisiana State Board of Nursing (LSBN), has developed a multi-regional, statewide nursing workforce fore-casting model. The LCN describes the model as one of the coun-try’s most comprehensive tools for forecasting supply and demand within the nursing workforce.

“There are regional differences between the supply and de-mand for healthcare. We believe that our forecasting model will

help regional strategic planning, in addition to statewide strategic plan-ning,” said Cynthia Bi-enemy, PhD, director of the LCN.

T w e n t y - s e v e n separate models, which include eight regional models and a statewide model for each level of nursing, were built. LCN worked closely with Barbara Morvant, executive director of LSBN, and Lynn An-sardi, executive director of the Louisiana State Board of Practical Nurse

Examiners to provide data needed for the forecasting model on RNs, APRNs, and LPNs licensed in Louisiana.

The models can forecast the supply and demand for RNs, APRNs and LPNs. The model recognizes that population, tech-

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Forecasting Model Helps Address Nursing Shortage

Dr. Jeffrey WilliamsHolistic healer

Although Dr. Jeffrey S. Williams is a brand new practicing surgeon, his resume already reads like a novella. The young plastic and reconstructive surgeon has three fellowships under his belt, traveled the world for medical missions and trained as an osteopath ... page 3

M&A Trends in the Reform EraA look back at 2013 … Look ahead in the new year

The Affordable Care Act, coupled with new models of reimbursement, has undoubtedly impacted the way the healthcare industry conducts business today and strategically plans for the future. For some industry sectors within healthcare services, a ‘strength in numbers’ mentality has caused a marked uptick in mergers and acquisitions in comparison to a few years ago. ... page 6

Physician Spotlight

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LHA Goals Include Better Quality, Financial Stability, Transparency

By TeD GriGGS

In 2014, the Louisiana Hospital Association will focus on many of the issues that it and its members have emphasized in the last few years, said Paul A. Salles, the group’s new president and chief executive offi cer.

Drumming up voter support for the hospital stabilization initiative, Salles said passing the constitutional protection is “an extremely high priority” for the LHA and its members.

Quality initiatives included in the Centers for Medicare and Medicaid’s Hospital Engagement Network.

2 • JANUARY/FEBRUARY 2014 Louisiana Medical News

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

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

Louisiana Medical News JANUARY/FEBRUARY 2014 • 3

By liSa HaNCHey

Although Dr. Jeffrey S. Williams is a brand new practicing surgeon, his re-sume already reads like a novella. The young plastic and reconstructive surgeon has three fellowships under his belt, trav-eled the world for medical missions and trained as an osteopath. In his personal life, he is an amateur children’s music composer.

Choosing osteopathy as a profes-sion, Williams followed in the footsteps of his great-grandfather and uncle, who were DOs specializing in family practice. “I’m a third-generation osteopath,” he said proudly. Reared in rural Comanche, Texas, Williams grew up hearing stories from his family patriarch about his prac-tice. “Back then, they basically didn’t have any surgery-type specialties,” Williams re-called. “So, my grandfather did surgeries – appendectomies, that sort of thing. But he would tell stories, and I listened to tape recordings of those when I was growing up.”

In college, Williams started doing medical mission work. So far, he has been on several mission trips throughout the world, including Honduras, Guatemala, Belize and India. After the 2010 earth-quake, he traveled to Haiti to treat disaster victims.

All three generations of the Williams DOs trained at the Kansas City Univer-sity of Medicine & Bioscience – College of Osteopathic Medicine. “It’s essentially a difference in philosophy,” he said. “The holistic approach that osteopaths usually ascribe to is the fact that we believe that the body wants to heal itself and we, as practitioners, have to facilitate that pro-cess. The allopathic approach is not so holistic in its teaching.”

After obtaining his DO, the young-est Williams served as a rotating intern at the former New York United Hospital in Port Chester, N.Y., followed by an intern-ship at St. Johns Episcopal Hospital in Far Rockaway, N.Y. Afterward, he served as a general surgery resident at Henry Ford Macomb Hospital in Warren, Mich.

Originally drawn to traumatic sur-gery, Williams changed his mind during one of his medical mission trips when he assisted a plastic surgeon from Penn-sylvania on a cleft lip and palate repair. Williams then nabbed three plastic sur-gery fellowships – fi rst in plastic and re-constructive surgery at Botsford General and Henry Ford Hospital in Farmington, Mich., and also in craniofacial and pedi-atric plastic surgery at the Craniofacial Foundation of Utah in Salt Lake Surgery, followed by a hand and microsurgery fellowship at Kleinert-Kutz Institute of Hand & Microsurgery in Louisville, Ky.

During his medical training, Wil-liams volunteered on a search and rescue

team in Salt Lake City and as a fi tness coach for the Air Force Special Forces Pararescuemen (the PJs) in Louisville, which he continues to do today. An avid outdoorsman, he enjoys snow skiing, mountain biking and running. “Even though I am a lean fi tness enthusiast now, I once was a very overweight teen-ager and young adult,” he explained. “I have had to work hard just like anyone else to stay fi t. Because of my weight early in life, I can sympathize with people who struggle with weight. That is one of the

reasons I volunteered as a fi tness coach during my medical training to help nu-merous strangers achieve their goals. I still travel back and forth to Kentucky from time to time to help them with their training for medical-type issues.”

After completing his studies, Wil-liams joined Plastic Surgery Associates in Lafayette, La. in August. He performs nu-merous procedures including microscopic repairs of the hand, pediatric cranial vault remodeling and aesthetic surgery of the body. “I did multiple fellowships, so I have

a lot of tools in my bag,” he explained.

How did this multi-faceted fellow who trained across the country end up in Cajun Country? “My wife, Doe, is originally from New Iberia, and her family now lives in Shonga-loo, La.,” he revealed. “My family is still in Texas, so they are a short drive away. So, it worked out very

well, and this is just a fantastic practice to join.”

Williams’ pastime as a kids’ music composer melds perfectly with his spouse’s occupation as a children’s novelist and illustrator. Her latest book, The Holy Booger, is geared towards eight to ten-year-olds. “I write original music that my wife is determined to record,” he said. “Considering how reserved I am in public, it always surprises my wife’s friends when she tells them about the songs that I create for our family.”

The young couple is obviously drawn to kids – they have a one year old son, Loch, and another due near press time. “We are looking forward to building a nice little family,” he said.

Physician Spotlight

Dr. Jeffrey WilliamsHolistic healer


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By Karl G. SieG, MD, MrO, FaPa

Most physicians try their best to provide quality care for their patients and do not anticipate being the subject of a medical malpractice lawsuit. However, legal complaints are a reality with which doc-tors have to contend. Once the patient be-comes plaintiff and their attorney proceeds with formal allegations of negligence, the parties to the lawsuit then go about collect-ing as much pertinent information as pos-sible well before trial occurs. This discovery phase of litigation includes carrying out legal procedures like interrogatories which are written questions to the other party in the suit that must be answered under oath. Re-quests for documents are also made as well as the taking of oral depositions. A deposition is another discovery procedure by which a wit-ness’s testimony is taken under oath prior to trial. A stenographer or court reporter tran-scribes all of the questions and answers creat-ing a resultant manuscript. It is the defendant physician’s deposition which is of chief im-portance. During the deposition, opposing counsel typically has an expansive agenda with the goal to obtain as much information as possible. Another objective that they have in mind is to “lock-down” testimony so that what was said at deposition can be used for impeachment in the event there is inconsis-

tent testimony at trial. The deposition experience is indeed

stressful as a physician suddenly finds their integrity and actions called into question. Nevertheless, the defendant needs to be well prepared. Remember that the strengths and weaknesses of the witness are being as-sessed so the impression being made could potentially influence the case in a way which would aid the defense. Preparation begins with a review of the entire database so that there is a clear recollection of the case. A pre-deposition conference with the defense attorney is also obligatory and should in-clude clarification of any potentially confus-ing matters. Do not attempt to conceal any information, even that which you perceive to be unfavorable from your defense team. Honesty and candidness are thus a neces-sity. The physician’s CV should also be checked for any discrepancies, and counsel should be alerted to any web sites or online profiles that are relevant. It is advisable to conduct a mock deposition to further in-crease the witness’s preparedness. Despite any practice demands, the physician should plan ahead and accordingly allow sufficient time scheduling for the deposition. It is also important to be clear about the deposition’s location and do not allow it to occur at the defendant’s office. Following these sugges-tions will reinforce confidence during the deposition which will in turn be reflected in the final written transcript.

Once the deposition begins, remember that a sworn witness is required to tell the truth. Opposing counsel will ask questions in an attempt to foster answers which might reveal new facts or open up problematic areas. The physician should make every ef-fort to keep their answers clear and concise. Listen carefully and pause before answering to allow time so that each question asked re-ceives prudent consideration. It is helpful to remember that the written transcript itself does not reflect the length of time it takes to answer a question. Exceptions to being brief may occur when an explanation is necessary as well as when defense counsel provides specific instruction. A particularly decep-tive scheme to watch out for is a pattern of questioning by opposing counsel intended to prompt only “yes” answers making it hard to say “no” in response to a subsequent ambiguous question. The witness may ask for clarification of confusing or convoluted questions, but should never speculate, guess,

or make inaccurate/unfounded statements. If the question is ultimately not understood, it should not be answered with the response simply being “I don’t know.” Alternatively, an answer may be qualified by saying “ap-proximately” or “to the best of my mem-ory.” Definitely avoid the use of adjectives

and superlatives such as “always” or “never” as these qualifiers can be

later used to distort testimony. If questions are asked about a particular document, ask to see that document and take time to review it to make sure

that it has not been quoted out of context or mischaracterized. Any

pertinent concerns should be noted by the witness on the record. There are circum-stances where both attorneys may wish to have a discussion “off the record.” For the witness however, remember that nothing said is ever “off the record.”

Many attorneys reserve especially im-portant questions for later on into the depo-sition hoping that the defendant will be less guarded, so it is important to be well rested and ask for breaks when needed. Compo-sure and concentration must be maintained while resisting the urge to become overly emotional and hostile as there is vulnerabil-ity to behave in ways which could negatively affect the outcome of the case. Opposing counsel will test the defendant and hope for mistakes which are recorded in the tran-script. Alternatively, they may wait and later on prompt for such behavior at trial. If a mistake is made, simply state for the record that you were in error and correct your statement. There are times where the physician is approached in a congenial man-ner as a tactic to attempt to gain additional information. And if the attorney becomes silent after an answer, the witness should resist the compulsion to continue talking. Never volunteer extra information, agree to supply any additional documents or provide other evidence. Some physicians going into a deposition believe that if they are allowed to explain their case, opposing counsel will dismiss the complaint which is in fact un-likely to occur. If the deposition is to be vid-eotaped, realize that the recording will likely be played for the jury. It would therefore be important to dress appropriately, look di-rectly at the camera, speak clearly and avoid long pauses in this circumstance.

Fortunately, initiating a medical mal-practice lawsuit and winning it are entirely different matters for the plaintiff. Only about 7 percent of medical malpractice law-suits ultimately go to trial, and most of these, about 80 percent, result in a verdict for the defense. By being educated and thoroughly prepared, the defendant physician will not only be better able to cope with completing their deposition, but they will also enhance their likelihood of a favorable judgment.

Coping with Medical Malpractice Depositions

Karl G. Sieg, MD, MRO, FAPA is Medical Director of La Amistad Behavioral Health Services located in the Orlando metropolitan area. Dr. Sieg has also served as a litigation consultant and expert witness in civil matters including medical malpractice and personal injury cases over the past twenty years.

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By lyNNe JeTer

Since Congress passed the Affordable Care Act (ACA) in 2010, doctors have been bailing out of practices posthaste. Exasperated by surging expenses, shrink-ing reimbursements and costly-to-cover government mandates, frustrated physi-cians are citing healthcare reform-related spending as a major reason for selling practices as the rollout progresses.

According to a study by Jackson Healthcare, the nation’s third largest healthcare staffing agency, 12 percent of physicians who sold their practices be-fore sweeping federal legislation became law made the change because they didn’t have appropriate resources to comply with the law and maintain a reasonable ROI. Within the last three years, the rate of phy-sicians selling their practices for the same reason – especially now with dwindling ways to stay fiscally healthy – jumped to 30 percent.

“Of those now considering selling their practices, 36 percent cite the com-plexity of the healthcare reform law as a reason; and 24 percent say they don’t have the resources necessary to comply with the law,” according to Jackson Healthcare’s report. “The burdens also appear to be taking physicians away from their fami-lies. They want better work-life balance, with less time working and more time in their private lives. Forty-three percent feel employment, rather than ownership, will give them that balance.”

Even though no statistical differential denotes the type of physicians who want to remain in private practice versus those ac-tively marketing their practice, nearly half actively seeking to sell are internal medi-cine subspecialists (23 percent), primary care physicians (14 percent) and surgeons (12 percent). Of those internal medicine subspecialists, 23 percent are otolaryn-gologists, 17 percent are urologists, and 13 percent are cardiologists.

Reimbursement cuts (79 percent) and the cost of maintaining a practice (64 percent) were the most commonly cited reasons among internal medicine subspe-cialists who want to sell; 57 percent also pointed to the complexities of healthcare reform as a reason for selling, cited the report.

Three of four surgeons marketing their practices said reimbursement cuts and healthcare law complexities were contributing factors in the decision to sell.

Not surprisingly, hospitals and health systems are acquiring most physician practices (52 percent). Interestingly, solo practitioners accounted for 19 percent of physician practice buys, while physician-owned groups made 18 percent of group acquisitions. Ten percent of doctors who

sold their practices listed their buyer as “other.”

Even though physicians are leaving the ownership aspect of private practice, most aren’t departing the practice of med-icine. Only 9 percent sold their practices because they wanted to retire; 6 percent sold because they wanted to leave the practice of medicine.

“Physicians in private practice still outnumber those employed, but this could be shifting as less than half of the respondents with an ownership stake say they plan to remain in private practice,” according to the report.

The last cycle of hospitals snapping up private practices occurred in the 1990s, when hospitals saw the acquisitions as a way of gaining access to more patients. As a result, physicians got sweet deals. But in this buying cycle, the deals aren’t as finan-cially rewarding. Yet the circumstances provide a way for private practice doctors to step out of time-consuming administra-tive roles while also appreciating a steady income and sometimes improved hours as employees. A post-sale downside that im-pacts physicians to widely varying degrees: adjusting to the loss of autonomy.

Simply put, the private practice model has become very expensive to op-erate, John Dubis, CEO of St. Elizabeth Healthcare in Cincinnati, Ohio, explained to CNN Money.

“That’s why it’s diminishing,” he said, noting that most of the 300 physi-cians employed by the hospital’s specialty physicians group were plucked from pri-vate practices.

In December 2012, Montana-based St. Vincent Healthcare acquired Fron-tier Cancer Center, established in 1982. The close-knit group of five oncologists had struggled financially pre-healthcare reform, taking a significant hit in 2003, when Medicare changed the way it reim-bursed doctors for chemotherapy drugs. Despite taking significant pay cuts, the group closed one of its four locations in 2008. With the dark cloud of bankruptcy looming, the group was happy to find a buyer.

“We have a joke,” said Patrick Cobb, MD, an oncologist in the Frontier group told CNN Money, “that there are two kinds of private practices left in America: those that sold to hospitals and those that are about to be sold.”

In a companion survey released by Jackson & Coker, a subsidiary of Jackson Healthcare, a majority of doctors want to see ACA defunded or repealed. A scant 6 percent said it should remain unchanged.

“The more physicians learn about ACA, the more they dislike it and want to start over,” said Richard L. Jackson, chair-man and CEO of Jackson Healthcare.

Physicians Selling PracticesTrend watch: who’s making the move now and why



MERGERS & ACQUISITIONS

By CiNDy SaNDerS

The Affordable Care Act, coupled with new models of reimbursement, has undoubtedly impacted the way the health-care industry conducts business today and strategically plans for the future. For some industry sectors within healthcare services, a ‘strength in numbers’ mentality has caused a marked uptick in mergers and ac-quisitions in comparison to a few years ago. For others, the strategy has been to take more of a ‘wait and see approach’ while trying to figure out just how the new rules will impact their specific markets.

Frank Morgan, who serves as man-aging director for Healthcare Services and Equity Research with RBC Capital Mar-kets, recently shared his thoughts with Medical News on the level of ac-tivity in 2013 and his ex-pectations for the coming year. With more than two decades experience in equity research and investment banking, Morgan primarily focuses his research on facility-based healthcare services including hospitals, skilled nursing and assisted living facilities, long-term acute care (LTAC), be-havioral health services and rehabilitation. Morgan, who has been recognized for his expertise within the health services indus-try by multiple national publications and industry rankings, is a popular speaker and participant in financial panels.

Overall, Morgan said there was a gen-eral uptick in activity in 2013 compared to 2012. That was particularly true within the hospital sector. “’13 … if not a record year … was a very good year for M&A activity,”

he noted. “You really saw it on the not-for-profit side,” he added.

There are several reasons for the ‘super-sizing’ of hospital systems starting with implementation of ACA but exacerbated by other market forces in-cluding an increase in physicians seeking an employment model, implementation of EHR and changing pay-ment methodologies.

“The overarching uncertainty about how the world is going to play out over the next four or five years has led to the leveraging of strengths,” said Mor-gan. He added the leaders of individual hospitals or small systems are faced with deciding to weather the changes on their own or join forces to be part of a bigger group that has the infrastructure in place to manage and deal with the new healthcare delivery landscape.

From mergers to acquisitions to strate-gic joint ventures, there was a lot of move-ment on the not-for-profit side, which makes up about 80 percent of hospitals in America. Dallas-based Baylor Health Care System and Temple, Texas-based Scott & White Healthcare completed their merger in late September to create the largest not-for-profit health system in Texas. Earlier in the year, Michigan-based Trinity Health merged with Pennsylvania-based Catholic East in one of the largest nonprofit mergers of 2013.

And some interesting partnerships occurred between not-for-profit hospi-

tals and systems

and pub-licly traded

operators. Life-Point Hospitals and Duke continued to

acquire hospitals for their joint ven-ture. One of the largest mergers occurred between a nonprofit hos-pital system and a major insurer

when the Penn-sylvania Insurance

Department approved the affiliation between Highmark (a BlueCross BlueShield subsidiary) and West Penn Allegheny Health System, both based in Pittsburgh. After closing that deal in April, Highmark went on to add two more Pennsylvania-based hospi-tal systems to its integrated delivery sys-tem, Allegheny Health Network.

While a lot happened on the non-profit side, Morgan noted there were also major acquisitions within the publicly traded hospital space. “On the for-profit side, there were two notable deals com-pleted or announced in 2013 — Tenet Healthcare & Vanguard Health Systems and Community Health Systems & Health Management Associates.”

In the first deal, Nashville-based Van-guard was the target of Dallas-based Tenet. The latter completed its acquisition of Van-guard at the beginning of October in a deal valued at approximately $4.3 billion ($1.8 billion purchase price plus assumption of $2.5 billion of Vanguard debt).

The second deal, Morgan said, was an-nounced last year and is anticipated to close in the first quarter of 2014. In this case, Franklin, Tenn.-based Community Health Systems seeks to acquire HMA, which is headquartered in Naples, Fla. Just before Thanksgiving, CHS and HMA announced the companies’ proposed merger had been declared effective by the Securities and Ex-change Commission (SEC), clearing the way for a vote by HMA stockholders for or against adoption of the merger agreement. With a purchase price close to $4 billion plus assumption of debt, the overall value of the merger is anticipated to be in excess of $7.5 billion, making it the largest deal since the HCA buyout in 2006. Once the merger is executed, CHS will own and/or operate 206 facilities with more than 30,000 licensed beds.

“From and M&A perspective, I would expect to see a continued robust level of activity,” Morgan said of 2014. However, given the limited number of publicly traded companies and the amount of activity that has already occurred in that space, he said he expects much of the future activity to be in the not-for-profit world.

Behavioral health had a “decent” 2013, Morgan said. Franklin, Tenn.-based Acadia Healthcare enjoyed another healthy year of growth. The company began the year by completing previously announced deals acquiring Behavioral Centers of America and AmiCare Behavioral Centers and then proceeded to acquire additional individual facilities in Georgia, Tennes-see, Florida, and Puerto Rico during the remainder of the year. Morgan said he ex-pected the company to continue to grow in 2014.

A behavioral health “marriage” an-nounced in late 2013 is expected to come to fruition in 2014. In November, the lead-ership of Centerstone, which has a major presence in Tennessee and Indiana, and the H Group, with facilities in Illinois and Kentucky, announced their intent to af-filiate. Although the H Group will operate under the Centerstone flag, David Guth, CEO of Centerstone of America, said the affiliation had no money or assets chang-ing hands and was instead a joint effort to “create a stronger and more effective be-havioral health service organization.” Ear-lier in November, Hazelden and the Betty Ford Foundation also announced a mega-merger in the addiction space.

After a slow start, Morgan noted home health saw some movement by late 2013. “In home healthcare, we did see a little bit of pick up at the end of the year,” he said, noting Louisville, Ky.-based Almost Family acquired Nashville-based SunCrest Healthcare in December. Going forward, Morgan said, “2014 could potentially be a year where you see more consolidation in the home health space.”

M&A Trends in the Reform EraA look back at 2013 … Look ahead in the new year

Frank Morgan


The heart surgeons and cardiologists at The Regional Medical Center of Acadiana’s new Heart Institute are operating with the latest life-saving, valve replacement technology in their hands. We are the first and only facility in Acadiana and third in Louisiana chosen by Edwards Lifesciences as a transcatheter aortic valve replacement (TAVR) hospital.

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nological advances in healthcare, regula-tory changes which affect healthcare and other market forces will vary unpredict-ably in the next seven years.

The model allows users to run simu-lations and examine trends, Bienemy said. For example, if Louisi-ana were experiencing a decline in graduates in nursing programs, the LCN can see how many graduates would be needed in future classes to meet the upcoming demand.

That kind of data analysis is a powerful policy tool, she said. The model can help the nursing indus-try, legislators, and healthcare delivery systems with planning for, recruiting and education efforts.

In the past, Louisiana has experi-enced some signifi cant shortages of RNs, and those shortages had a signifi cant im-pact on healthcare and healthcare deliv-ery.

Even now, statewide Louisiana has a shortage of every type of nurse, Bienemy said. But the LCN model shows the short-fall of nurses isn’t evenly spread, and there are some areas where there may even be a surplus of nurses.

The largest metro regions, Baton Rouge and New Orleans, need more RNs. But in the Alexandria area, there appears to be somewhat of an RN surplus

and at the same time, a shortage of ad-vanced practice registered nurses.

For example, policymakers might use this information to encourage the Alexan-dria region to provide opportunities for RNs to further their education and be-come APRNs, fi lling that shortage.

The LCN worked with the consul-tants that developed the Northeast Ohio Nursing Initiative Forecasting Model. The Ohio model was used as a template for Louisiana’s model, which took around eight months to develop.

The LCN was formed in 2008 by a Senate resolution and funded by the Loui-siana State Board of Nursing and Louisi-ana Health Works Commission.

The LCN and the Board of Nursing felt it was important to develop a state forecasting model in order to better pre-pare for nursing education and supply. Bienemy, who came aboard in late 2009, said she attended a conference where the Northeast Ohio group presented its model. The Ohio model could forecast the need for 17 regions within the state.

But Louisiana had an advantage be-cause it collects nurse licensing data each year. That information includes the area the nurses work and other demographic information, such as age.

In addition to pulling together state-level data, the LCN model incorporates patient utilization data for specifi c settings – hospital inpatient care, emergency de-partments, ambulatory care, home health

and long-term care facilities, Bienemy said. The ability to forecast the supply and demand for RNs, APRNs and LPNs for those specifi c settings provides the state with the ability to more effi ciently tailor recommendations, education initiatives and policies to help fi ll those needs.

“We think we have something that’s pretty unique for our state,” Bienemy said.

Nursing workforce shortages and surpluses tend to be specifi c to particular areas. National data, even when used at the state level, may not be adequate to document the supply and demand for nurses at the regional or county level.

Lisa Anderson, vice president, Cen-ter for Health Affairs/Northeast Ohio Nursing Initiative, said as far she knows, Louisiana is the only state in the country whose forecasting model is sophisticated enough to encompass both state and re-gional data.

The model is functional through 2020 and can be updated annually with new li-censure data and other relevant data as needed.

Forecasting Model Helps Address Shortage, continued from page 1

Cynthia Bienemy

The forecasting model technical report and summary report can be found at the following link http://lcn.lsbn.state.la.us/NursingWorkforce.aspx

Other sectors, said Morgan, were con-siderably quieter in 2013. Senior housing saw some limited activity, as did dialysis. Morgan said the latter was already pretty consolidated with the two big players being DaVita and Fresenius. “Between the two, they already control about 55 percent of the domestic market,” he pointed out.

It was also a fairly quite year for labs, hospice, skilled nursing and LTACs as these sectors restructure and re-evaluate expecta-tions under ACA and the impact of post-acute bundled payments. In the lab space, Morgan noted, “They’re not redeploying capital for growth right now. They’re try-ing to pacify stockholders by buying back shares and paying dividends because of the weaker organic growth because of pricing and volume pressures.”

In general, Morgan concluded, there was good news in the equity markets for a number of healthcare sectors in 2013. “The S&P was up almost 30 percent … health-care services was up over 37 percent,” he noted. For some, the gains were even greater. Morgan said behavioral healthcare was up over 100 percent and hospitals up over 44 percent.

Looking ahead, he said, “I still think you can have really attractive returns for 2014 given valuations are still reasonable and the growth opportunities presented by the Affordable Care Act, but I think you need to pick your subsectors carefully.”

M&A Trends.continued from page 6


By lyNNe JeTer

An experienced practice management consultant best described the looming ICD-10 conversion “as though 19 percent of the GDP will be required to start speak-ing French to each other … and if gram-mar, pronunciation and punctuation aren’t perfect, no money will move.”

The “frighteningly large change” coming Oct. 1 has caught many physician practices off guard, said Jennifer O’Brien, MSOD, a practice management consul-tant with KarenZupko & Associates Inc. “We’re fi nding that some practices have done absolutely nothing to prepare.”

According to the latest Workgroup for Electronic Data Interchange (WEDI) ICD-10 readiness survey results, representing a mix of practices and hospitals, “it’s clear the industry continues to make slow prog-ress, but not the amount of progress that’s needed for a smooth transition.”

Only one in three practices were con-version-ready, with the remainder citing signifi cant obstacles to progress: competing priorities and other regulatory mandates. “All industry segments,” the report con-cludes, “haven’t gained suffi cient ground to remove concern over meeting the Oct. 1 compliance deadline.”

“Apparently, there’s still a lot of hope on the part of providers that it’ll be post-poned again,” said O’Brien. (The ICD-10 conversion was originally slated for Oct. 1, 2013. In 2012, an extension was an-nounced.) “Because of the healthcare.gov debacle, people are thinking that CMS will postpone it again. The experts are saying another postponement is highly unlikely.”

Noting that “denial is only going to make it more painful,” O’Brien recom-mended eight steps for every physician provider to take in early 2014.

Physician providers in a practice that allows them to control their own salary or draw should reduce that amount by 25 per-cent now. “Don’t pay out the rest,” she said. “You’ll likely need it to pay yourself during the fourth quarter (Q4).” By planning for little to no Q4 revenue while also reducing the draw in the fi rst three quarters of 2014, “you can pay yourself in Q4.” O’Brien ex-plained: “Because the entire industry will make a change of such magnitude on the fi rst day of Q4, the revenue cycle is going to be disrupted. Either the practice is going to make mistakes coding, payors are going to have diffi culty processing the claims, or both. For practices that don’t adequately prepare, Q4 could be bone dry.” By com-parison, Canadian physicians reported a productivity reduction of up to 50 percent during their conversion.

Secure a substantial Line of Credit (LOC) with a bank to cover payroll and op-erating expenses in Q4. “Like an insurance policy,” she pointed out, “a LOC must be secured before needed.”

Scale back in 2014. “This isn’t the year for capital expenditures, other purchasing and hiring that’s not absolutely neces-

sary,” she said, noting the strategy applies to personal expenditures also. “2014 isn’t the year for physicians to build that dream vacation home.”

Because of increased expenses and de-creased productivity, let employees know now that year-end bonuses are highly un-likely. “It’ll be a belt tightening year,” she said.

Order ICD-10-CM books, software or apps. “Physician practices don’t need ICD-10-PCS, just ICD-10-CM,” she said, noting that CPT will continue to be used to report procedures and services for phy-sicians; ICD-10-PCS is the book hospitals use to report services and procedures. (See “Quick Defi nitions.”)

Depending on the practice, run a frequency report of the top 25 to 75 most commonly used ICD-9 codes with nomen-clature. “For specialty and subspecialty practices, the most common 25 diagnosis codes should be suffi cient, but for internal medicine, emergency medicine, and other practices with a broader scope, there will likely be more than 25,” cautioned O’Brien. “Once you have the list of your most com-monly used ICD-9-CM codes, use your new

ICD-10-CM books to crosswalk them to correct, complete ICD-10-CM codes. Don’t leave this up to the offi ce staff. Do it on your own or with your staff. The process of con-verting your most commonly used diagno-ses to ICD-10-CM will likely demonstrate a need for you to change your documentation of diagnoses and may show a one-to-many crosswalk. That is, what used to be covered with one code will now require additional information to select the correct code from a list of many.”

Don’t plan on leaving the conversion

up to internal billing staff or an external billing service. “When asked, ‘What are you doing to prepare for ICD-10-CM?’ we’ve had physicians and managers re-spond, ‘Our billing service is going to take care of that.’ Guaranteed disaster! ICD-10-CM requires signifi cant, documented input and details from the clinician for accurate, complete codes. There’s no bill-ing service or even computer program that can crosswalk ICD-9-CM codes to ICD-10-CM codes without additional details and input from the clinician.”

Research available ICD-10-CM training. “Many national specialty societ-ies, hospitals and practice management software companies and other organiza-tions are offering ICD-10-CM training for physicians and their staff,” said O’Brien. “If your practice is large enough, it may be cost effective to hire the ICD-10-CM trainer to come to you and your staff. Plan to spend the next several months learning the ICD-10-CM coding system and chang-ing your documentation. Don’t think you can cram for this by going to one or two seminars in the summer. This is like board examinations; only in this case, if you don’t study, prepare and perfect well in advance, the failure could mean fi nancial ruin.”

Preparing for ICD-10 ConversionPractice management consultant shares 8 steps for physicians to take now

Quick Defi nitions

ICD-10-CM: The clinical modifi cation of the World Health Organization’s ICD-10, which consists of a diagnostics classifi cation system. In the United States, ICD-10-CM includes the level of detail needed for morbidity classifi cation and diagnostics specifi city and provides code titles and language that complement accepted clinical practice. The system consists of more than 68,000 diagnosis codes.

ICD-10-PCS: Developed to capture procedure codes, this procedure coding system of 87,000 procedure codes is much more detailed and specifi c than the short volume of procedure codes included in ICD-9-CM.

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The Medicaid program, which has undergone signifi cant reforms beginning with the establishment of Bayou Health in 2012.

Salles has been with LHA for more than 10 years. For the last fi ve, he has served a dual role with the association, as execu-tive vice president of the association and CEO of the Metropolitan Hospi-tal Council of New Or-leans.

Salles said he is very familiar with the issues af-fecting members.

One of the most important involves a November election, when Louisiana vot-ers will decide whether to pass a consti-tutional amendment that provides more fi nancial stability for hospitals, nursing homes, intermediate care facilities and pharmacists. The amendment will allow hospitals to use money from their own operating budgets to draw down federal funds, providing enhanced Medicaid funding for the facilities.

Providers would be protected from cuts by language requiring a super-major-ity vote by the Legislature to cut the base rate.

Hospitals and their supporters say the amendment would help protect health-care for everyone and reduce the pressure to pass along costs to people with insur-ance and their employers. Opponents say protecting healthcare leaves the state with only one area to cut when budget prob-lems arise: higher education.

Salles said the LHA and its members will be extremely active and highly visible in working to raise support for the issue.

Meanwhile, the LHA will continue to emphasize the Hospital Engagement Net-work’s quality-improvement areas. Those include implementing best-care practices to reduce the frequency of adverse drug events; catheter-associated urinary tract infections; central line-associated blood stream infections; injuries from falls and immobility; obstetrical adverse events; pres-sure ulcers; surgical site infections; venous thromboembolism; ventilator-associated pneumonia; and preventable readmissions.

The association is working directly with members and other organizations to make quality improvement a real focus going forward, Salles said.

The quality improvement work is part of a national initiative and began a few years ago, Salles said. Although the LHA and its members have made con-siderable progress in a number of areas, the results haven’t gained much attention outside the industry.

But this year, the LHA wants to start showing people the strides the industry is making on those fronts, Salles said.

Another area the LHA plans to em-phasize in 2014 is the state’s Medicaid program.

Providers have been working with the state Department of Health and Hospitals on a number of Medicaid-related issues and will continue to do so, Salles said. The LHA and its members want to continue to work on some of the administrative issues involved with respect to the new insur-ance companies that operate in the Bayou Health plan.

The Jindal administration pushed to privatize care for two-thirds of the state’s Medicaid population in 2012. Under the program, the private insurers contract with physicians, hospitals and other providers. But the administration and the insurers had been reluctant to share the results of the program. After vetoing transparency and reporting legislation in 2012, Jindal signed a similar bill in 2013. The new law requires the DHH to submit an annual report that provides details on Bayou Health’s mem-bers, eligibility and claims.

Salles said the association will also continue to support transparency in the Medicaid managed care program.

The LHA hopes the new reporting requirement will help answer a number of questions about the program, including:

Have there been any improvements in care as a result of the private fi rms’ oversight?

Are there things that should be changed or looked at or tried differently?

What’s the evaluation of the pro-gram?

Five private insurers manage the care for around 900,000 Medicaid members in Louisiana. An independent review of the program found that the companies complied with state and federal require-ments almost all of the time; the compli-ance scores ranged from 96 percent to 99 percent.

On the national front, Salles said it’s still unclear how the Affordable Care Act will affect everyone going forward.

“There are a lot of different compo-nents of all of this that I don’t think any of us fully understand,” Salles said.

Providers favor health insurance cov-erage, but there are issues with the policies offered through the federal marketplace, he said. One of the things that has been a real issue for providers is the very high out-of-pocket costs associated with some of the health plans.

“I think that will be an ongoing issue that we’ll have to fi gure out how to deal with,” Salles said.

LHA Goals Include Better Quality, Financial Stability, Transparency,continued from page 1

Paul A. Salles

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By lyNNe JeTer

The new obesity guidelines – updated for the first time in 15 years – are geared to primary care providers (PCPs) and offer an algorithm for managing obesity.

The protocol for the management of overweight and obese adults is among four updated guidelines commissioned by the National Heart Lung and Blood Institute, and developed by the American Heart Association and the American College of Cardiology to identify at-risk patients and prescribe appropriate interventions. The timing coincides with the American Medical Association’s recent classification of obesity as a “disease.”

To guide weight management deci-sion-making, an algorithm focuses on the identification of patients with excess body weight and those at risk for obesity-related health problems.

Most information is straightforward: Patients with a BMI of 30 or higher

are considered obese and need treatment. Patients with a BMI 25 to 30 are con-

sidered overweight and should be treated if they have additional risk factors, such as an elevated waist circumference of 35 inches or more for women, or 40 inches or more for men.

However, even though research soundly shows the higher the BMI, the greater the risk for cardiovascular disease, diabetes, and cancer, the question about the use of BMI as a screening tool has drawn debate.

Healthcare providers agree that every 5 to 10 percent of total body weight lost is a milestone that reaps health benefits. But with so many diet programs available – the guideline committee reviewed 17 dif-ferent plans and concurred that as long as there’s a negative energy flow, and the intake of calories is reduced daily to 1,000 or less, it should work – determining the right one, and the amount of weight that’s safe to lose over the course of weeks and months, has also been the center of con-troversy.

The diet, guidelines say, should be a component of a comprehensive lifestyle intervention including physical activity and behavioral changes, delivered by a trained counselor. The guidelines suggest that patients meet with the interventionist 14 times in the first 6-month period.

Donna Ryan, MD, co-chair of the guideline committee and a professor emeritus at Pennington Biomedical Re-search Center in Louisiana, admitted the current approach is for PCPs to simply tell patients to lose weight but “they don’t

really engage in helping patients achieve weight loss, either through referral or pro-viding counseling or prescribing. They’ve been reluctant … but that’s changing.”

What’s not addressed: the reason why some patients make adjustments to lead a healthier lifestyle, but still cannot success-fully reach a more optimal weight for their body frame.

“It’s not as simple as telling a patient, ‘you need to lose weight,’” said Gus Vick-ery, MD, a North Carolina family medi-cine physician. “Sometimes, it takes some investigating to determine the source. It might be thyroid issues, or a combination of medical problems. Unfortunately, we (PCPs) stay so busy … it’s helpful when patients come prepared. It’s OK for a pa-tient to say, ‘I can’t lose weight and I don’t know why. It doesn’t always seem to be a matter of willpower.’”

After Vickery talked to a colleague about the colleague’s doctor-supervised weight loss clinic focusing on a well-rounded, low-calorie, low-carbohydrate food plan, he ditched his own in-house program and began referring patients there. One couple, patients of Vickery, lost a combined 140 pounds in less than a year. Other patients returned to Vick-ery tens of pounds thinner – and much healthier.

“My colleague,” said Vickery, “does the heavy lifting; I monitor the results.”

The impetus for the proactive move-ment of PCPs may be practice for the fu-ture, when they may be accountable for patients who haven’t made sincere efforts to lose weight to get healthier. Patients could eventually be penalized by insur-ers for not taking documented action to achieve a healthier weight.

“I could see (insurers) really increas-ing people’s premiums if they don’t follow certain preventive mea-sures in the future,” said urologist Stan Sujka, MD, a partner of Or-lando Urology Associ-ates in Central Florida. “Unfortunately, we’re becoming a society of regulations. A lot of peo-ple don’t seem to want take personal responsibility for their well-being.”

Recently, to set an example for pa-tients and to improve his health, Sujka dropped 36 pounds in nine months with the assistance of a diet app on his smart phone, a practice he encourages patients to follow as a first course of action for los-ing excess weight.

Obesity: The New Chronic Disease?Updated guidelines encourage PCPs to focus on obesity

Dr. Stan Sujka



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The Offi ce of the State Register pub-lished the following Emergency Rules in the December 20, 2013 issue of the Loui-siana Register:

• Department of Health and Hospi-

tals – Nursing Facilities Cost Reports and Specialized Care Reimbursement, effec-tive January 1, 2014

• Department of Health and Hospi-tals – Behavioral Health Services State-wide Management Organization LaCHIP Affordable Plan Benefi ts Administration, effective December 30, 2013

• Department of Health and Hos-pitals – Behavioral Health Services Phy-sician Reimbursement Methodology, effective December 31, 2013

• Department of Health and Hospi-tals – Behavioral Health Services – Sup-plemental Payments, effective January 18, 2014

• Department of Health and Hospitals – Coordinated Care Network – LaCHIP Affordable Plan Benefi ts Administration, effective December 30, 2013

• Department of Health and Hospitals – Coordinated Care Network – Physician Services Reimbursement Methodology, effective December 30, 2013

• Department of Health and Hos-pitals – Home and Community-Based Services Waivers Residential Options Waiver, effective January 14, 2014

• Department of Health and Hos-pitals – Outpatient Hospital Services Non-Rural, Non-State Public Hospitals Supplemental Payments, effective Janu-ary 19, 2014

• Department of Health and Hospi-tals – Pharmacy Benefi ts Management Program Medication Administration In-fl uenza Vaccinations, effective December 25, 2013

• Department of Health and Hospi-tals – Pregnant Women Extended Services Substance Abuse Screening and Interven-tion Services, effective January 18, 2014

• Department of Health and Hos-pitals – Professional Services Program Fluoride Varnish Applications, effec-tive January 15, 2014

• Department of Health and Hospi-tals – Rural Health Clinics Fluoride Var-nish Applications, effective January 15, 2014

• Department of Health and Hospi-tals – State Children’s Health Insurance Program LaCHIP Affordable Plan Ben-efi ts Administration, effective December 30, 2013

New Emergency Rules Published by State Registrar

Legislative Affairs content is provided by Checkmate Strategies, publisher of Health

Care Information Services. All content © Checkmate Strategies and Louisiana

Medical News, LLC. For more information, readers may contact Cindy Bishop at

225.923.1599 or P.O. Box 80053, BR, LA 70598, or send email to destiny362@aol.

com. Our website is www.checkmate-strategies.com

Legislative AffairsBY CINDY BISHOP

To view these Emergency Rules go to

http://www.doa.louisiana.gov/osr/emr/emr.htm


In the News

“Your smart phone can serve as your personal coach to shed those unwanted pounds,” he said. “It’s easy, free, and stud-ies show it works.”

The two most popular free apps are “Lose It” and “My Fitness Pal,” which al-lows patients to meet pre-set calorie and exercise goals.

Sujka’s partner, Albert Ong, MD, gave him a kickstart on the new lifestyle modifi cation by downloading the “Lose It” app on Sujka’s smart phone and pro-gramming it to lose one pound per week. Sujka is now very close to his college weight goal of 200 pounds.

“Since losing weight, a lot of my pa-tients have asked, ‘how did you do it?’ After explaining to them about using their (smart) phones to lose weight, many of them have come back to the offi ce and told me their doctors for years have been telling them to lose weight but have never told them how,” explained Sujka. “They’ve told me they’ve found the app simple and effective. As a result, I wrote up the prin-ciple of using your smart phone to lose weight. A lot of patients appear more ex-cited about losing weight than the effects of Viagra or Cialis!”

Overall, the guidelines don’t focus on specifi c obesity medications. Only orlistat (Alli or Xenical) was available during the committee review process. Since then, the FDA has approved new diet drugs – lor-caserin (Belviq) and phentermine/topira-mate (Qnexa) – that are recommended for use as “an intensifi cation approach.”

Bariatric surgery for weight loss was the fi fth and fi nal recommendation “when other interventions fail.”

Obesity, continued from page 11

Blue Cross and Blue Shield of Louisiana Promotes Carmouche to Executive Vice President

BATON ROUGE- Blue Cross and Blue Shield of Louisiana has promoted Dr. David Carmouche to the position of executive vice president of external operations and chief medical offi cer. Carmouche previously was senior vice president and chief medical offi cer for the state’s oldest and largest health in-surer.

Mike Reitz, Blue Cross president and CEO, said that in his new position Carmouche will play a larger role in coordinating and executing corporate strategy.

In addition to heading up Blue Cross’ Clinical Solutions division, Car-mouche now will lead and have the sup-port of the Network Administration and Sales and Marketing divisions. He will continue leading the company’s medi-cal staff in its efforts to promote health and wellness, implement population health strategies to more effectively manage chronic diseases, promote clin-ical quality and assist in the transforma-tion of the healthcare delivery system and its payment structure.

Carmouche joined Blue Cross in September 2012 as senior vice presi-dent and chief medical offi cer after spending 15 years in internal medicine practice at the Baton Rouge Clinic. He brought with him both interest and experience in preventing and manag-ing chronic illnesses, improving quality and transforming healthcare delivery. In his fi rst year at Blue Cross, he began communicating actively on Twitter (@DrCarmouche) and launched a LinkedIn group called the Louisiana Quality Care Network, where healthcare profession-als share information and best practices.

CareChex® Names Ochsner #1 In Baton Rouge, Top 10 Percent In Nation For Hospital and Surgical Care

NEW ORLEANS – CareChex®, a division of COMPARION, has named Ochsner Medical Center – Baton Rouge number one in Baton Rouge for medical excellence in 11 specialties, including Overall Hospital Care, Overall Surgical Care, Cardiac Care, Orthopedic Care and Gastrointestinal Care. Addition-ally, Ochsner was named number one in Louisiana for Major Cardiac Surgery and Coronary Bypass Surgery as well as in the top ten percent in the nation for Overall Hospital Care, Overall Surgical Care and Neurological Care.

The Overall Hospital Care and Overall Surgical Care categories com-prise ratings of all[1] inpatient medi-cal conditions and surgical procedures treated and performed by full-service hospitals, such as cancer care, cardiac surgery and spinal surgery.

Utilizing extensive clinical data from the Hospital Quality Alliance and the Centers for Medicare & Medicaid Ser-vices, CareChex® provides a compre-hensive evaluation of all components of medical quality including:

• Process of care - measures spe-cifi c processes that should be followed during heart attack and heart failure, pneumonia, outpatient procedures, sur-gical care and preventive care, among others.

• Outcomes of care – measures mortality and complication rates, in-patient quality indicators and patient safety indicators

• Patient satisfaction – measures overall hospital ratings, doctor and nurse communication, hospital environ-ment, and staff responsiveness, among others.

CareChex® provides these fi ndings to consumers, providers and purchas-ers of U.S. medical care, including many Fortune 500 companies.

Medical Detox Program Reopens at University Hospital & Clinics

LAFAYETTE- University Hospital & Clinics (UHC) has re-established its Medical Detoxifi cation Program, which

is now open and seeing patients. The former medical detoxifi cation unit, which operated under the name of First Step, has been closed since February 2012, when State of Louisiana budget reductions forced its closure.

This makes UHC Lafayette’s only hospital-run inpatient medical detox facility.

The voluntary inpatient program will provide 24-hour medically super-vised evaluation and treatment to eligible patients 18 years or older. The mission of the program is to provide the “fi rst step” in a patient’s rehabilitation process by providing a safe, therapeutic detoxifi cation experience, while mini-mizing the painful effects of withdrawal. This will allow the patient to complete the remaining steps of their recovery and rehabilitation in a more compre-hensive program at another facility.

Compass Health will manage the 12-bed medical detox program for UHC by providing trained detox nursing and counseling staff members and super-visors. UHC, in cooperation with LSU Health System, will provide physician services. The hospital will provide the support of a pharmacy, diagnostic and testing services, and dietary and envi-ronmental services.

Lafayette General Health now has the ability to transfer patients willing to receive needed medical detox services from any of its affi liated emergency de-partments to the inpatient program at UHC.

In order to be admitted into the program, a patient must meet certain criteria, the most important of which is a primary diagnosis of Substance Depen-dence and/or Substance Withdrawal. They must also voluntarily agree to par-ticipate in the treatment program.

LHA Promotes Prados To Executive Vice President and COO

BATON ROUGE- Sean Prados, FACHE, has been promoted to Execu-tive Vice President and Chief Operating Offi cer of the Louisiana Hospital Association.

Prados will be re-sponsible for overseeing the government relations and strategic healthcare policy development activities of the As-sociation including management of the LHA’s member constituency groups and other member engagement activities in addition to his current responsibilities.

Prados joined the LHA in February 1999 and was promoted to Executive Vice President in 2008. Before joining the LHA, he spent several years as an independent lobbyist where he devel-oped expertise in healthcare, managed care, workers’ compensation, transpor-tation and agriculture. He also served in the U.S. Marine Corps.

Prados received a Bachelor of Arts in Government from Nicholls State University and a Master of Public Ad-ministration with a concentration in healthcare administration from Louisi-ana State University. He is also a Fellow in the American College of Healthcare Executives.

Regional Extension Center Assistance Available For Medicaid Specialists In Louisiana

BATON ROUGE – The Louisiana Health Information Technology (LHIT) Resource Center, the state’s regional extension center (REC) is now provid-ing outreach, technical and support ser-vices to help Medicaid specialists meet Meaningful Use (MU) objectives.

The Medicaid Specialists Program is the result of funding received from the Louisiana Department of Health and Hospitals (DHH) Medicaid Offi ce through the Centers for Medicaid and Medicaid Services (CMS). It is focused on assisting providers who were previ-ously ineligible for support from RECs for MU initiatives offered by the Offi ce of the National Coordinator for Health Information Technology (ONC).

Specialists are eligible for this pro-gram if they meet specifi c criteria in-cluding the 30 percent patient thresh-old established by CMS. They must demonstrate each year that at least 30 percent of their patient volume is attrib-uted to Medicaid during a selected 90-day reporting period.

Providers who satisfy the Medic-aid threshold, who have not received a Year 2 payment from Medicaid, and who are not under another contract for REC direct assistance would qualify for this program, explains Nadine Robin, Health IT Program Manager for the Quality Forum. Specialist physicians, dentists, nurse practitioners and certain physician assistants are among those eligible for participation.

“This program enables health care providers who serve our Medicaid population to receive the assistance of the LHIT Resource Center in meeting Meaningful Use of electronic health re-cords,” Robin says. “DHH-Medicaid has made these funds available to reduce the cost for these providers to utilize our services. We’ve assisted more than 1,700 health care providers across the state and look forward to working with the specialists as they adopt and imple-ment EHRs for their patients.”

For more information about the Medicaid Specialists Program, eligibility guidelines and types of assistance, con-tact Robin at [email protected] or call 225-334-9299.

Sean Prados

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


LaHIE Now Includes More Than 500K Unique Patient Records

BATON ROUGE- The Louisiana Health Information Exchange (LaHIE) now features more than 560,000 unique patient records.

“What this means is, there are now almost 600,000 Louisiana residents with patient records in the health informa-tion exchange. For those patients, it means their physicians have greater, more timely access to their health re-cords,” Munn explains.

To date, 33 hospitals and clinics are live with LaHIE, and 68 are actively onboarding. The exchange has par-ticipation agreements with more than 170 hospitals, providers, clinics, school-based health centers, home health agencies and other health care compa-nies across the state.

Our Lady of the Lake Heart & Vascular Institute Named to Becker’s Top 100

BATON ROUGE – Our Lady of the Lake has been named to the list of “100 Hospitals with Great Heart Programs” by Becker’s Hospital Review.

Our Lady of the Lake Heart & Vas-cular Institute is recognized for offering the only level-three accredited chest pain center in south Louisiana, and hy-brid operating rooms that allow mini-mally invasive and traditional surgical procedures to merge with advanced imaging technology. Our Lady of the Lake, a Blue Cross Blue Shield Blue Distinction Center for cardiac care, was also one of 164 to earn the American College of Cardiology Foundation’s Sil-ver Performance Achievement Award in 2013 for high standards in heart attack care.

New Surgeon Joins Center For Restorative Breast Surgery

NEW ORLEANS– The Center for Restorative Breast Surgery (CRBS) in New Orleans is pleased to announce that Board Certifi ed Plastic and Re-constructive Surgeon Dr. Matthew Whitten Wise has joined the team of Doctors Frank Della-Croce, Scott Sullivan and Christopher Trahan. Dr. Wise graduated with a B.S. in Biology from Duke University in Durham, North Carolina and received his Medical De-gree from University of South Alabama in Mobile. He served both his internship and residency in general surgery at LSU Health Sciences Center, followed by an additional residency in plastic surgery at the Cleveland Clinic in Ohio.

Dr. Wise brings with him vast expe-rience from providing clinical services at a number of hospitals in the New Orleans region since 2005, performing over 2500 advanced microsurgical and other reconstructive and aesthetic pro-cedures. “We are honored to have Dr. Wise join our staff and look forward to sharing his professional, academic and research achievements with our pa-tients,” states Dr. Sullivan, Co-Founder of CRBS. “He is a skilled surgeon with the compassion and gentleness we have always provided to our patients.”

St. Elizabeth Hospital Weight Loss Surgery Center Reaccredited

GONZALES – The Weight Loss Sur-gery Center at St. Elizabeth Hospital has been reaccredited as a Bariatric Surgery Center of Excellence by the American

Society for Metabolic and Bariatric Sur-gery/ Bariatric Surgery Center of Excel-lence (ASMBS BSCOE).

According to David Provost, MD, FASMBS, Chair of the ASMBS Bariat-ric Surgery Review committee, ASMBS BSCOE accreditation acknowledges the commitment of St. Elizabeth’s Weight Loss Surgery Center to quality improvement and patient safety for its bariatric surgery patients.

In his letter to St. Elizabeth Hospi-tal CEO, Robert Burgess, and Medical Director of St. Elizabeth’s Bariatric Sur-gery, Provost said that St. Elizabeth’s center meets the needs of bariatric surgery patients by providing multidis-ciplinary, high-quality, patient-centered care.

Cancer Center Names New Medical Director

BATON ROUGE- Charles G. Wood, MD was recently named medical direc-tor of Mary Bird Perkins Cancer Center. Wood is a member of Southeast Louisiana Radiation On-cology Group (SLROG), a group of radiation oncol-ogists practicing exclu-sively at Mary Bird Perkins Cancer Center locations.

Wood is also a member of both the head and neck and the lung cancer multidisciplinary care teams for Mary Bird Perkins – Our Lady of the Lake Can-cer Center.

A Baton Rouge native and summa cum laude graduate of LSU, Wood received his Medical Doctorate from the Louisiana State University Health Sciences Center School of Medicine in Shreveport, La., where he was class Valedictorian.

Peoples Health Promotes Suzanne Whitaker to Assistant Vice President of Communications

METAIRIE – Peoples Health has announced the promotion of Suzanne Whitaker to assistant vice president of communica-tions.

Prior to joining Peoples Health, Whita-ker served as director of communications at Park Place Entertainment in Gulfport, MS. Her prior experience also includes serving as senior communica-tions specialist at Entergy Corporation, where she created and implemented internal and external communications campaigns, as well as handled crisis communications and media relations, namely during Hurricane Katrina resto-ration efforts.

Whitaker earned a Bachelor of Arts in speech communications from Cali-fornia State University, Northridge and holds an Accreditation in Public Rela-tions certifi cation through the Public Relations Society of America (PRSA).

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In the News

The Perkin Alternative Birthing Center Opens At Ochsner BaptistNEW ORLEANS -- Thanks to a generous donation led by Nicolas Perkin, New

Orleanians now have more options when it comes to birthing choices. The Perkin Alternative Birthing Center (ABC) opened today in the Ochsner Baptist Women’s Pavilion making it the only hospital-based alternative birthing center in the re-gion.

A staff of Certifi ed Nurse Midwives provides mothers with a natural, holistic birth experience in a homelike environment. Midwives offer compre-hensive prenatal care in the Perkin ABC clinic, where they help mothers design individual birthing plans. Personalized birth options include water birth, labor support and alternative birth positions.

The Perkin ABC features two birthing rooms, each set up like home with a com-fortable double bed and a family room and shared kitchen for guests to relax and visit during labor and delivery. Each room in the ABC offers a birthing tub, birth stools and a yoga swing. And, should a mother or baby require additional medical attention, Ochsner’s Level III Regional Neonatal Intensive Care Unit and Labor and Delivery department are just steps away.

Perkin led the effort to establish the ABC in response to the excellent care his wife, Natalie, received from Ochsner physician Dr. Elizabeth Lapeyre.

Dr. Alfred Robichaux, Chairman of Obstetrics and Gynecology, Ochsner Baptist; Michael Hulefeld, Chief Operating Offi cer, Ochsner Health System; Nicolas Perkin and Natalie Perkin.

Dr. Matthew Whitten Wise

Dr. Charles G. Wood

Suzanne Whitaker


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Louisiana Medical News January/February 2014