Health & Hospitals

NEWS - Health & Hospitals

Health-care reform dominates the national news and the conversation at the local office water cooler, serving as a controversial battleground between Democrats and Republicans.

However, health industry reform is an issue that transcends partisan politics and could have a significant impact on Savannah’s economy. An estimated 18 percent of Georgia residents are currently uninsured, according to the U.S. Census Bureau, a figure that is significantly higher than the national average. Locally, many workers struggle to make ends meet as the cost of care rises, while others face losing insurance as businesses scramble to cover employees.

The question of whether health care is a right or a privilege forms the crux of the debate, with reformers arguing that all Americans are entitled to quality health care and opponents maintaining that it’s not the government’s role to fund an expensive and potentially ineffective national health-care system.

“It’s a tough issue, no matter how you look at it,” said Mills Fleming, a health-care attorney at HunterMaclean in Savannah. “There’s no easy solution.”

According to the Center for Financing, Access and Cost Trends, health insurance premiums for Peach State residents have risen 88 percent since 2000. Through health insurance reform, the Obama administration estimates that as many as 1.5 million middle-class Georgia residents would be eligible for premium credits to ease the burden of these high costs. Plus, health-care reform would offer medical coverage for the uninsured, allowing Georgia’s 147 hospitals and more than 23,000 physicians to better care for their patients.

The Obama administration has emphasized its commitment to working with Congress to pass comprehensive health reform in order to control rising health-care costs, guarantee choice of doctors and assure high-quality, affordable health care for all Americans.  Comprehensive health reform, if successful, would strive to reduce long-term growth of health-care costs for businesses and government, protect families from bankruptcy or debt because of health-care costs, guarantee choice of doctors and health plans and ensure affordable, quality health coverage for all Americans.

“From a policy standpoint, it’s a wonderful idea,” said Fleming. “But in its implementation it will fail because the costs will be absolutely astronomical. This would be the biggest federally funded program ever, costing more than $1 trillion.

If Congress passes a bill for health-care reform, the impact on Savannah’s medical community and the local economy could be significant. A national health-care program could benefit Savannah’s hospitals, like Memorial Health, since they could receive additional reimbursement for indigent care. At the same time, hospitals have fixed expenses, from personnel to medical supplies, that cannot be significantly reduced without compromising the quality of patient care.

“If things continue the way they are, hospitals will continue to struggle with basic operational costs,” said Fleming. “What it takes to save a life, from the order entry clerk to the doctors who treat you when you have a gunshot wound, comes with a significant price tag attached.”

In addition to hospitals, Savannah’s small-business owners could benefit from health-care reform. With tax credits and a health insurance exchange where they can shop for health plans, insurance coverage would become more affordable for small companies across the region.

Dr. Todd Williamson, president of the Medical Association of Georgia, believes that giving patients the right to enter into private contractual agreements with their physicians is the single most important step that lawmakers can take to reform the country’s health-care system.

“We must transform the health insurance model into one that’s owned and controlled by patients,” he said. “Most Americans receive their health-care coverage through a third party, which means their health-care decisions are influenced by their employer or the government. People should be able to purchase the health insurance product that best fits their individual needs.”

However, Georgia’s First City faces a unique set of challenges when it comes to health care. “Savannah’s population is very eclectic in terms of its social makeup,” said Fleming. “We have a high degree of poverty and uninsured people – higher than the national average.”

As a result, a one-size, federally mandated health-care program may not be effective in the Coastal Empire. “What works in Cleveland, Ohio, may not work here in Savannah,” he said. “Whatever comes out of Washington will affect everyone equally, even though every hospital and every doctor isn’t facing the exact same challenges when it comes to health care.”

Whether or not health-care reform measures pass Congress this year, quality medical care remains a key way for Savannah to compete economically. “You have to have outstanding health care to attract businesses and jobs,” said Fleming. “No one is going to move here if we don’t have good hospitals and doctors.”

NEWS - Health & Hospitals

Past efforts to overhaul the nation's health care system had different proponents, different opponents and different plans that were under consideration. But they have two things in common: They all ended in failure, and in every case, opponents used fear as a key weapon in their arsenal.

So Jonathan Oberlander, a political scientist at the University of North Carolina at Chapel Hill, says he's not at all surprised to see recent claims — all thoroughly debunked — that suggest, for example, that bills under consideration would encourage senior citizens to commit suicide when they become ill or infirm.

To read the rest of the story, click here.

 

NEWS - Health & Hospitals

One of the unique services at St. Joseph’s/Candler’s new outpatient therapy clinic in Garden City that opened this month is the region’s only specialized testing facility to help Savannah employers ensure new employees can do the physical work that their job demands. It’s an enhanced approach to hiring to help companies improve their efficiency in the hiring process.
Called the “Physical Capacity Profile,” no other system collects the amount of physical data for pre-employment/post-offer testing as fast, according to Heidi Prado, clinical coordinator.  The profile can determine pre-existing injuries of office workers to ensure they are capable of work in factories that requires lifting heavy loads all day.  The hospital group plans to market the service to businesses throughout Savannah and the surrounding communities.
“This is a proven system that is based on years of testing.  When we medically document that a new employee has the strength to perform the requirements of their new job, the opportunity for injury is substantially reduced,” according to Prado. 
The test collects 28 different measurements utilizing both isometric and dynamic lifting. The PCP system provides a comprehensive three-page report to the employer that clearly displays whether the employee has the physical capability to perform the job for which they were hired, baseline strength and motion abilities, and pre-existing conditions.
St. Joseph’s/Candler’s Physical Therapy department also provides standard occupational medicine services and worker’s compensation coverage for local employers.
The Occupational Performance Corporation manufactures the Physical Capacity Profile testing system; its studies show a 30 percent decrease in worker compensation injury rates when the system is used.
Savannah employers are faced with increased workers compensation premiums and lowering their injury rates will help them control their costs.  St. Joseph’s/Candler personnel will utilize this new service for newly hired employees as a way to protect them from injury.
The testing is fully compliant with EEOC (Equal Employment Opportunity Commission), ADA (Americans with Disabilities Act), and HIPAA (Health Insurance Portability and Accountability Act).
Prado, along with other members of the St. Joseph’s therapy staff, will administer the 30 minute computerized test. 
“Through this comprehensive testing, we can protect new employees by confirming they have the strength to do their job,” Prado said.  “Protecting employees is a major reason we expanded our therapy services, but it should help businesses as well.” 
St. Joseph’s/Candler Physical Therapy will also be able to use the computerized tests to perform return-to-work evaluations and Functional Capacity Evaluations on employees who do suffer an injury.
To learn more about this new service, Prado can be reached at (912) 964-0007 or by e-mail at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

NEWS - Health & Hospitals

TBR Staff

St. Joseph’s/Candler, Savannah’s third-largest employer with over 3,800 employees, contractors and volunteers, is the first business to implement a single-stream recycling program as part of the City of Savannah’s new recycling efforts.
The hospital recognizes the importance of recycling and thinks other companies should too, according to SJ/C President and CEO Paul P. Hinchey.
The Savannah single-stream recycling program began in January with the collection of residential recyclables, and has performed beyond expectations, according to City Manager Michael Brown, and the Ccity is ready to expand to provide the service to the business community.
Single-stream recycling eliminates putting various recycled materials in different bins, such as newspapers, aluminum cans, plastic and magazines. All accepted recyclable products can go into one container, cutting costs of the bins and labor to handle all of the containers. And, it increases participation, statistics have shown.
Hinchey, Mayor Otis Johnson and Brown are holding a press conference today, Monday, April 6, at Candler Hospital to call attention to the hospital system’s decision and to further explain the single-stream recycling option for the business community.
“We had been studying recycling on our own for some time,” explained Scott Larson, public relations manager for St. Joseph’s/Candler, “and were looking at a total cost of $200,000 a year for employees, contractors and equipment if the city had not put in a recycling program.”
That study was headed up by Kevin J. Myers, hired as St. Joseph’s/Candler’s director of environmental services back in 2003, who had previously run a multi-stream recycling program at the University of Pennsylvania’s hospital. “It was extremely expensive,” he said. “The is a great program that Savannah has put in. We are looking at cost avoidance of as much as $240,000 a year,” he added.
St. Joseph/Candler has also agreed to end its contract with a private vendor for removal of regular solid waste and accept the city’s bid of $143,000 versus the hospitals’ current bid by a private vendor of $153,000 this year.
Savannah workers will take over the solid waste removal as of May, according to Myers.
The hospitals’ medical waste is handled by other vendors and is not part of regular solid waste or recycling programs.
“Our medical waste goes out through a vendor and is transported off our site and moved to a facility that either sterilizes it or incinerates it. For example, pathological waste has to be incinerated, by law,” explained Myers.
The city has provided the single-stream bin at no cost to the two hospitals, which arrived last week. “We have already begun,” said Myers. There is still labor cost for the hospital to handle the single-stream bins, but “we have probably eliminated three-fourths of our costs by this program.”
Previously, the two hospitals were only recycling cardboard, though responsible disposal of computers and light bulb programs were also in place. But now, all aluminum, office paper, newspapers, magazines and plastic (except #6 plastic, Styrofoam) will be recycled. The city does not allow hand towels to be recycled from businesses, either, according to Myers.
“This is a great program in that its single streamed. It makes it a lot easier. Other methods are very labor intensive,” he said.
“We are looking at rolling this out across the entire St. Joseph’s/Candler system,” Myers said, looking at expanding in stages to push it out throughout the entire system. “We have already approached our medical group managers and our property management groups,” he added.
“Our goal is to keep our landfills free of any unnecessary items, any non-biodegradable items, Myers concluded.
All three of the city’s hospitals, including Memorial Health, are within the city limits.
The Chatham County Commissioners voted in March to hold up on implementing recycling in the balance of unincorporated Chatham County, due to projected costs and concerns about the county budget.

NEWS - Health & Hospitals

SBJ Staff

Editor’s Note: The Savannah Business Journal has worked for more than six weeks on this story, interviewing over 10 people involved in the important issue of physician’s reimbursement.

Funding indigent care is a difficult challenge for all of our area’s local hospitals. Both hospitals run or managed by “for-profit” companies such as Memorial University Medical Center, and those with nonprofit status, such as St. Joseph’s/Candler, deal with laws that require hospitals and physicians to provide for the medical needs of patients who arrive at their emergency rooms for care and lack health insurance coverage.
Philip Schaengold, president and CEO of Memorial, estimates that roughly 20 percent of the hospital’s patients are covered only by Medicaid, where reimbursement is relatively low for both the hospital and any physicians involved in a patient’s care. And, another 10 percent of Memorial’s patients are indigent or “self-pay, where the odds of collecting any money for services is a relatively low probably,” he says.
St. Joseph’s/Candler also provides a significant level of indigent or low reimbursement care. But what is not often discussed, is that, not only are the hospitals not being reimbursed. but physicians who provide the care are not reimbursed in some counties in Georgia. Chatham County is one of those counties.
Many of these physicians are private business owners, not employed by the hospitals, who are running private companies with employees, and they have operating expenses and overhead like any other business entity. They have “privileges” at various hospitals, and some even rent space for their practices within the hospitals.
But when they are called to provide care to an indigent patient, whether it’s a head trauma from an accident on the highway or to deliver a baby, the physician is not getting paid. In many cases, the physician’s staff is also involved in the care and follow-up with the patient. The physician is paying his or her employee but not being reimbursed for their payroll or payroll taxes, as well.
“They’re not giving enough” towards paying physicians for providing care to the indigent, in the opinion of Dr. Jules Toraya, president of the Georgia Medical Society (GMS). “They require us to take care of people, but they don’t pay us to do it.”
Of the more than 700 physicians in Chatham County, more than 500 belong to Chatham County’s physician’s association called the Georgia Medical Society, led this year by Toraya, who owns Obstetrics & Gynecology Associates at 5353 Reynolds St., located within Candler Hospital.
GMS is Georgia’s oldest medical society and the oldest continuously functioning medical society in the United States. Despite its name, GMS is not a statewide group; its physician members are local.
In April, the society invited Georgia State Rep. John Lunsford from McDonough down to Savannah to come and speak. His topic was “Transparency in Healthcare, defining Charity, Indigent Care & Community Benefits.” Paul Hinchey, president and CEO of St. Joseph’s/Candler Hospital System, and Charles Neumann, who at the time was the interim president and CEO of Memorial University Medical Center, were both invited but sent a joint letter to Toraya informing him that they declined to attend. He isn’t happy about that decision.
Lunsford presented the GMS members with a number of facts about how hospitals in Georgia are run, about the Georgia Alliance of Community Hospitals to which most nonprofit hospitals in Georgia belong, about the financial condition of the Alliance’s member hospitals and about the amount of money Lunsford alleges that the Alliance spends on lobbying.
Much of the information presented to GMS, however, is grossly inaccurate.
Two particularly inflammatory pieces of information being disseminated by Lunsford stand out. First, he told local physicians that hospitals in Georgia have a $ 5 billion pool of money that they are not spending and that he contends could be used to reimburse physicians for their service to indigent and Medicaid patients.
Not true, according to Monty M. Veazey, president of the Alliance and Hinchey. By state and federal law, hospitals must retain a level of cash and liquidity that is a percentage of the hospital’s borrowings, like any other business with operating and capital equipment loans. It’s strictly business and banking procedures and regulations.
Hinchey walked the SBJ through his hospital systems’ overall financial position, borrowing positions and available cash, The cash the hospital has at the close of its financial periods is in line with what must be maintained, and not spent.
The same is true for Memorial University Medical Center, according to Schaengold.
The second piece of information being disseminated by Lunsford, and by Toraya on behalf of GMS, involves the number of lobbyists hired by the hospitals’ Alliance to represent them at the Georgia State House and in Congress.
Lunsford told the GMA, and Toraya recently wrote in an opinion piece he published in a local newspaper, that the Alliance has 96 lobbyists. “It’s their lobbying club,” he told the SBJ.
In Georgia, as well as at the federal level, all lobbyists must be registered. The Alliance, in fact, has only three non-employee lobbyists registered with the State of Georgia.
Lobbying registration law requires that all individuals who might speak to an elected official on behalf of a group or organization are defined as a “lobbyist.” Therefore, Veazey, as the executive director of the Georgia Alliance of Community Hospitals, also must be registered, as is attorney Julie Ellen Windom, vice president of the Alliance. The same is true for the Alliance’s public relations specialist.
Adding together the staff and the outside, hired lobbyists, the Alliance’s list with the State of Georgia only contains a total of six to seven people in total, depending on the time of year.
By comparison, Georgia Physicians Association, the PAC of the Georgia State Medical Association, has 20 registered lobbyists in Georgia working on behalf of physicians. Putting aside what appears to be disinformation, the issue of whether physicians should be paid for providing indigent care in Chatham County, is an important one for area physicians.
Surprisingly, physicians are not able to take non-reimbursed work as a business loss or a tax deduction, an issue that both Hinchey and Schaengold agree might be a reasonable solution.
“That makes some sense to me. Certainly, many of our physicians are running a business, and you would think that something like that might exist in the tax codes,” Hinchey said in a recent interview.
Some counties in Georgia pay physicians who provide indigent care, particularly in certain specialty care areas such as orthopedics. Veasey, who also sits on the board of his county’s hospital, said that that county pays some of the physicians to provide indigent care, “so that someone will show up.”
As to whether hospitals in Chatham County can afford to pay physicians, Toraya states that GMA disagrees with the definition of “community benefits” that the hospitals define as part of their non-reimbursed costs on their operating statements, balance sheets and required reports.
State laws vary widely as to what is defined as a community benefit that a hospital provides. Toraya and Lunsford explain that some hospitals include bad debt, un-reimbursed cost of Medicare, charity care, cash and in-kind contributions, community health improvement services, health professionals education, medical research, economic development projects and housing programs.
“This is a rip-off of the taxpayer of the state,” believes Toraya, because many hospitals in Georgia receive public funds to operate, such as the Level 1 trauma unit at Memorial. “Defining what is a community benefit needs a standard definition,” he said. “It’s minimal, what they are really spending for community benefits in many instances.”
Veazey says that Toraya is misinformed. “In our county, for example, we provide flu shots for seniors and defibulators for the public schools. Some of these projects are funded by funds raised by our foundations. They are not counted in our hospital’s unreimbursed costs,” he explains.
“What he’s not taking the time to see is that a lot of community benefits are not paid for by bonds that are generated by the hospitals, they are done by privately donated funds to the hospital, funds that are contributed to the hospital foundation, for instance,” Veazey said.
Certainly, the issue of health care for uninsured patients is topical, with the current national discussion in Congress about providing health insurance to a larger percentage of U.S. residents.
According to Toraya, 28 percent of emergency patients in Chatham County are between 18 and 65, too old to be covered by PeachCare for children and too young for Medicare coverage.
But Veazey adds that what Toraya is not acknowledging is that there is another issue, that many physicians will not accept patients who are on Medicaid in those years between 18 and 65, because they “lose money on those patients. They’re not welcome there. And they refer them over to the ER of the local hospital, which compounds the situation in the ER,” he states.
Veazey also states that Toraya does not understand about hospital financial filings. Hospitals do not make financial filings at the county level; only hospital authorities do that. “Every hospital in the state, every year, must file a report with the state, and that is done,” he said.
“It is a legitimate complaint of physicians, when an indigent patient presents themselves,” said Schaengold. “But the problem right off the bat is your definition of an :indigent patient; you have the Medicaid patients. The reimbursement to physicians is very low. It is true that in some locales, the hospitals have had no choice but to pay physicians to care for patients that have presented themselves to the hospitals in order to fulfill their responsibility as a community hospital.”
“My personal opinion is that it’s really unfortunate that we are asking physicians to provide care that our Medicaid and state and federal system should pay sufficiently for. What you’ve got is a broken system which leaves some hospitals with no choice but to pay some physicians to provide, particularly in specialty care areas,” he added.
“In Chatham, we are blessed with having many physicians that have volunteered to provide services to patients that do not have insurance. We have been very fortunate that our physicans care so much for this community that they are willing to take on this burden on our behalf,” he said.
Hinchey agrees, and also points to the long list of community services, programs and clinics that his hospitals and physicians provide to the community.
Schaengold, who was just named Memorial’s CEO as of June 1, added, “I just came back this afternoon from visiting Union Mission, and I was so pleasantly surprised to learn that 35 of our dentists provide free services to people without insurance. And it just shows you that we have people who are not asking to be reimbursed to care for the less fortunate in our community.”

NEWS - Health & Hospitals

Inc. magazine today ranked Spine & Sport of Savannah, Georgia NO. 357 on its 28th annual Inc. 500, an exclusive ranking of the nation’s fastest-growing private companies. The list represents the most comprehensive look at the most important segment of the economy—America’s independent-minded entrepreneurs. Companies such as Microsoft, Zappos, Intuit, GoDaddy, Under Armour, Jamba Juice, American Apparel, Oracle, and hundreds of other powerhouses gained early exposure as members of the Inc. 500. Congrats to the entire team at Savannah’s own Spine & Sport.

NEWS - Health & Hospitals

Savannah’s Hospitals Tap Different Sources

When you or a family member is in need of blood at a local hospital, you expect it to be available. The source of the blood is not top of mind. There seems to be an endless number of blood drives going on every month, located at public buildings, shopping malls, schools and places of business.
But in Chatham County, the region’s three hospitals actually use two very different sources of blood, each competing a bit for donors and sponsoring organizations for mobile collection drives, and each with different distribution methodologies.
Memorial University Medical Center gets its blood from The Blood Alliance, a not-for-profit company, headquartered out of Jacksonville, Fla., with a local office and management team in Savannah. The company is the sole provider of blood and blood products for the hospital Beaufort Memorial in Beaufort county also uses The Blood Alliance.
St. Joseph’s Candler hospital system gets its blood and blood products from the American Red Cross system.
According to John Helgren, media coordinator for The Blood Alliance, the company was asked to come into the Savannah market by Memorial in 2001 to provide the hospital with a “more efficient source of blood for the hospital’s need.” All blood collected in Chatham County by The Blood Alliance stays in the county, and goes to Memorial.
“We are the only community blood bank in the area. The blood we collect stays in Savannah,” he says. And it takes a look of blood to meet the hospital’s needs. “In September, we have 30 mobile drives. We also have two dedicated donor rooms that run daily. On average, we need 1,000 pints of blood a month, and that’s what we’re trying to supply a month ahead at all times,” Helgren said.
The Blood Alliance runs one collection center on Memorial University Medical Center hospital grounds at 4700 Waters Ave., and one at their office at Hodgson Memorial Dr. A number of area companies and groups are major supporters, including The Savannah Waterfront Association which sponsored a mobile unit on River St. near the Waving Girl statue over the Labor Day weekend.
Conversely, blood collected locally by the American Red Cross supports blood needs on a national level, shared across a regional, national and international system. But that also means that St. Joseph’s/Candler can tap into a national system for blood and blood products, which is the norm according to Dean Smith, director of the Blood Services division of the Savannah Chapter of the American Red Cross. Robin Wingate is CEO of the Savannah Chapter.
But Smith’s responsibilities, his blood collection district, runs down the Georgia Coast to St. Augustine and inland to Treutlan County, one of several districts in Georgia.
He’s been in Savannah for seven years, overseeing blood collection and import, and was formerly with a community blood bank.
“A pint of blood you donate to the American Red Cross travels to wherever it is needed,” explains Smith. “Actually, Georgia is an importing region,” he said, and does not collect enough blood for its needs. “We rely on other areas of the country to meet our needs, and import approximately 50,000 units a year into the State.”
“About 5 percent of the eligible population gives blood; in Georgia , however, it’s closer to 3.5 percent,” Smith says.
Why? There are a different factors. “We have a lot of rural areas. Just the sheer distances to get to a collection site are different from other areas of the country,” he said. And there is a large minority population in Georgia. “Minorities, as a rule of thumb, tend to not donate as often. While we have some wonderful minority donors in our area, for the most part, as a rule of thumb, that is true.”
In addition to collecting blood, the Red Cross has a larger mission including disaster relief, Armed Forces support, health and safety education and disaster preparedness training. A recent “Disaster Preparedness Expo was hosted by the Savannah Chapter at the Wal-Mart on Ogeechee Rd. to help area residents prepare for the hurricane season and other disasters. Partner agencies at the event included the Salvation Army, Humane Society, Southside Fire Department, CEMA, Savannah Police and the Port Wentworth Fire Department, all on hand to help folks with their disaster preparations.
The Savannah Red Cross staff distributed close to a thousand packets of disaster preparedness information, according to Tina Hardy, Director of Public Support. "Everyone had a great time and received a lot of good information to help them prepare for disasters,” she said
At the event, the Savannah Red Cross took the opportunity to showcase one of three, fully equipped, shelter trailers purchased through receipt of a Wal-Mart Foundation Grant. "These trailers will be prepositioned in our western most counties which become evacuation routes in the event Florida evacuates" said John Wright, Savannah Emergency Services Director. .
The Red Cross runs a blood collection center at the corner of Abercorn and Tibet Streets, open six days a week. (Mon-Thurs, from 11 a.m to 7 p.m; Friday from 8 a.m. to 3 p.m.; and Sat. from 8 a.m. to 2 p.m.) Upcoming blood drives the first week of September are planned at Southside Baptist Church and at Armstrong Atlantic State University.
If blood has to be purchased by The Blood Alliance, it is not cheap. “It can run $300 a pint and up, but is not dependent on type. The price for blood products varies,” said Helgren. The Blood Alliance can also tap in to a network of other community blood bank companies, such as theirs.
The Blood Alliance’s local manager is Michael Matthews who oversees the two centers in Savannah, along with Brenda Marion and Cindy Monchecourt, Donor Resource Consultants.
And collections have been going well this year, though recently, “…it’s summertime. Summertime is often challenging because schools are out, people are away and so we see fewer donations, but we see more accidents so usage goes up,” explained Helgren. “We’ve seen a need for “O negative,” the universal blood type which can be transfused into a patient with any blood type,” he said. “We contact other community blood banks to see if they can help provide us with blood types that we may be short of.”
Both groups urge businesses, organizations, schools and church groups to host blood drives. And both have mobile units that can come on-site for the event.
“Whether you donate to us or another not for profit center, it’s all going to help people. As long as you’re donating somewhere, that’s the bottom line,” said Smith.