Birmingham Medical News December 2023

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Shelby Baptist Medical Center Adds New Technologies By ansley FranCO

Shelby Baptist Medical Center has recently acquired several new pieces of medical technology that will improve patient care.

The upgrade began at the end of September, when the hospital installed a new Siemens 256 Slice CT Scanner. “It’s the latest and greatest and a very quick-speed CT scanner,” Diane Baribeau, director of imaging services at Shelby, said. “We also got the cardiac package on the machine which allows us to do a lot of pre-testing on patients’ hearts. We can actually see the entire heart on the scan now, which we weren’t able to do with other scanners.”

The device is capable of capturing three-dimensional images of the entire heart in only two heartbeats, which means that more cardiac patients, including people with a fast heart rate who were pre(CONTINUED ON PAGE 3)

The Philips Azurion at Shelby Baptist.

Promising New Testing and Treatment Options for Alzheimer’s By marTi WeBB slay

The summer of 2023 brought some important improvements in diagnostic screening and treatment options for Alzheimer’s disease. David S. Geldmacher MD, Director of the Division of Memory Disorders and Behavioral Neurology at UAB, called the developments a revolution.

“A blood-based biomarker screening test that came out this summer is a

game changer,” Geldmacher said. “Since Alzheimer’s was identified in 1906, the definitive diagnosis has eluded us. Only in the last several years have PET scans been able to demonstrate the presence of the amyloid plaque in the brain. And even that is not enough to tell us that Alzheimer’s disease is definitely the cause of memory loss because many of us will accumulate some plaque over the course of our lifetime and that, by itself, may not be particularly toxic. Now the blood-based

biomarkers allow us to identify the presence of the abnormal Alzheimer protein (amyloid beta) and also identify evidence it is causing damage to the brain.”

PET scans and spinal fluid biomarkers can support an Alzheimer’s diagnosis, but they are difficult to access. “There are only a few PET scanners in the state, and not many physicians want to do spinal taps,” Geldmacher said. The blood-based biomarker screen, which is commercially David S. Geldmacher MD

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Promising New Testing and Treatment Options for Alzheimer’s continued from page 1 Significant Developments in Diagnosing and Treating Alzheimer’s FDA grants “Full Approval” to Leqembi® CMS confirms “Coverage with Evidencea Development” (CED) for anti-amyloid antibodies JULY 17, 2023 JAMA publishes successful Phase III trial of donanemab

available and can be drawn at local lab facilities, can indicate the probability of whether PET scan, which is a more definitive test, will identify Alzheimer’s changes in the brain.

“Now physicians have the opportunity to really understand the biological relationship between blood biomarkers and the likelihood that Alzheimer’s is causing memory symptoms,” he said. “For patients, this means that if you forgot your car keys or misplaced your glasses, and the biomarker screen is negative, then Alzheimer’s disease is almost certainly not the cause of your symptoms. And that’s good news to have.”

While the screening test has proven to be effective, it is not yet covered by most insurance, including Medicare.

“The downside is the clinical utility and cost effectiveness has not yet been demonstrated to Medicare to their satisfaction,” Geldmacher said. “So for now, Medicare and other insurers don’t pay for this testing. It is out of pocket, and the cost ranges from hundreds of dollars up to several thousand. Many people find

CMS announces plan to remove CED requirement for Amyloid PET Also proposes lifting “once in a lifetime” limit for amyloid PET AUGUST 7, 2023 Publication of the clinical value of Precivity blood based biomarker testing for Alzheimer’s disease (Date of acceptance at the journal: July 9, 2023)

it critically important to know whether or not they have Alzheimer’s changes in their brain so they are willing to make that investment.”

New medications are the second aspect of the Alzheimer’s summer 2023 revolution. In July, the FDA granted full approval to Leqembi®, and Medicare extended coverage for the drug. Also in July, JAMA published a successful Phase III trial of donanemab.

These new drugs are important because while the older drugs out there can make brain cells work better, they don’t alter the cells’ survival. This new medicine reduces the rates of brain cell death, so they slow the progression whereas the old drugs simply delay the progression. Lecanemab (Leqembi) slows the clinical progression of the disease by 25 to 35 percent.

This can add years of independence for someone whose symptoms are mild.

“The challenge will be to distinguish whether the disease progression is just delayed or actually slowed down, because that can’t be demonstrated by memory tests in the office,” Geldmacher said.

FUNCTION

JULY 6, 2023

Differences in Alzheimer’s disease progression based on treatment types. Symptomatic treatments change the timing of decline. Disease modifying treatments alter the rate of decline.

TIME

“The magnitude of effect for the two medicines is pretty similar for the first year. At some point, probably at six, 12 or 18 months, we’ll redo the PET scan. If the amyloid is gone from the brain, then we’ll know the drug has done its job and we’ll stop using it.

“The trial of donanemab provides hope that the drug can, in fact, be discontinued at some point. At six months of treatment, a third of the people had their amyloid gone. At 18 months of treatment, more than 80 percent had their amyloid gone. So now clinicians thinking that we probably don’t need to give most patients more than 18 months of treatment. Or we can check, and if the amyloid is gone, we’ll stop the drug.

Data from two different medications on the rate of re-accumulation of amyloid after stopping the drugs suggests that the amyloid will still be below the threshold of treatment for five to eight years after stopping the medicine.”

Cost will be one of the big questions for the new medicines. While one of the old medicines, Aricept, costs about

$100 per month, Leqembi costs over $2000 per month. In addition, it must be administered by infusion every two weeks. “This fall, Leqembi announced preliminary results for a subcutaneous injection, so they are continuing to develop simpler means to administer it,” Geldmacher said. “We don’t yet know if it would be home administration, like with insulin for diabetes patients.”

Although many questions still remain about the cost effectiveness of both the screening test and new medications, as well as the convenience of administering the new drugs, it is clear that these new developments will provide many answers in the treatment of Alzheimer’s disease.

“Even if this is not something we are using 20 years from now, it’s something that will inform what we should be working on,” Geldmacher said. “In the end, we are trying to get the right drug to the right people at the right time. And for the moment, that involves some up-front costs, but we expect to save a lot of back end costs for people too.”

Shelby Baptist Medical Center Adds New Technologies, continued from page 1 viously unable to receive a beta blocker to slow it down, can now undergo a CT scan. This will increase the cardiac patient population at Shelby. Likewise, because the new CT Scanner is much faster than the older machine at Shelby, the imaging department is able to do more procedures.

The hospital also added a Philips Azurion system to the Cath Lab. The Philips Azurion is an image-guided therapy system that allows cardiology teams to perform a range of procedures from routine to more challenging cardiac interventions. The system has a 12-inch flat detector that provides highresolution imaging over a large field of view, which allows clinicians to visualize

the aortic valve and a significant portion of the aortic arch or the entire coronary tree in a single view.

The Azurion has lower radiation exposure and incorporates StentBoost technology which results in better image quality. “When we’re looking at the monitor, the images are huge,” said Crystal Holtzapfel, the cath lab manager for non-invasive and invasive cardiology. “This makes it so much easier to see what we’re working on. Also, we can now perform CT scans on the neck and head arteries while in the room, which is pretty cool. We’ve never had that before.”

Another addition to the Shelby Baptist Medical Center is the Mako robotic

surgery system. “The Mako is designed to help the surgeon do a more precise replacement of the knee joint and the hip joint,” said Paula Pool, director of surgical services.

Before hip or knee surgery, the patients undergo a CAT scan. The imaging from the scan is then integrated into the Mako robotic arm, allowing the surgeon to control the robot to make clear cuts in the bone where the arthritis is present.

“It makes a very precise cut for the implant to fit beautifully down into the section where they’re designed to be placed. So there’s very little margin for error like making the cuts too big or too hard, the left or the right,” Pool said. “If the patient were to move or slide any on

during the procedure, the robot knows exactly where the implant is supposed to go based on those images. This system is particularly beneficial for our hospital given our high volume of knee and hip replacements. Medical professionals using the robot underwent additional training to understand the information within the Mako and how to align that with the patient’s anatomy. To be able to offer this state of the art of equipment is going to be invaluable to our patients.”

Shelby Baptist plans to continue improving the facility’s capabilities. In the first quarter of 2024, the medical center will begin the replacement of the second cath lab.

Birmingham Medical News

DECEMBER 2023 • 3

It’s Never too Late for Tax Planning By gerarD J. KassOuF, CPa/PFs CFP©

As the end of 2023 approaches, avoid the April tax surprise by reviewing your income, deductions and credits for the current tax year, and begin to plan for 2024.

Proper planning for taxes requires a careful review of your individual tax situation. No two taxpayers can plan to the same ending result unless they have the exact same fact pattern. So let’s review some general planning points with the caveat that you should review your personal situation to determine the plan best suited to your income and deductions for 2023 and beyond.

Planning must take anticipated future tax changes into consideration. This includes expiring tax provisions, many of which are expected to expire on December 31, 2025. President Biden pledged to extend the tax cuts for taxpayers earning less than $400,000. However, no pledge is made for people making more than $400,000. With 2024 being an election year, tax law changes will become clearer after the November 2024 elections.

Back to 2023, and tax planning. Let’s begin with income. Depending on your tax bracket, defer income, if possible, to

reduce your taxes. If you are fortunate enough to be expecting a bonus, you may be able to arrange with your employer to defer the bonus (and your tax liability for it) until 2024.

Look at your earned income and investment income. However, if you anticipate income levels at or above the 37 percent maximum tax individual tax bracket, consider advancing income into 2024 and 2025 to take advantage of expected lower rates in future years. Income includes wages, Roth conversions, or taxable investment income and capital gain income, among others.

Then consider the timing of deductions, such as charitable contributions, interest or medical expenses to either pay in the current year to reduce 2023 tax or to the next year if that is more appropriate.

Remember that bunching deductions in one year and taking a Standard Deduction in the alternative year can provide a better multi-year tax result.

Consider gifts of appreciated stock, which generate a tax deduction at the full fair market value of the investment without having to pay capital gains tax on the appreciation of the investment.

Make maximum use of retirement plan benefits. Consider fully deferring or contributing to any 401k, 403b, IRA or SEP IRA accounts available to you. Every dollar you defer or contribute will reduce your taxable income. If you have self-employment income in addition to your W-2 income, open your own account to contribute. If your income level permits, contribute to an IRA in addition to your 401k.

Review your interest income on investment earnings. Determine if your taxable interest is appropriate, or if a tax-free investment such as a municipal bond or mutual fund will generate more after-tax income.

Review your investment gains and losses. Tax loss harvesting is a strategy to sell investments at a loss to offset capital

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gain income. Not only can you eliminate the gains on sales of investments and capital gain distributions from mutual funds, but you can also offset up to $3,000 of ordinary income and carry forward remaining losses to future years.

If you are a partner or an S corporation shareholder, take steps to increase your basis in the partnership or S corporation to make possible a loss deduction.

For example, if a shareholder wants to claim an S corporation loss on your own return, but the loss exceeds the basis for your S corporation stock and debt, you can still claim the loss in full by lending the S corporation more money or by making a capital contribution by the end of the S corporation’s tax year (in the case of a calendar year corporation, by Dec. 31, 2023).

Use your credit card to prepay expenses. For example, charitable contributions and medical expenses are deductible when charged to an individual’s credit card account rather than when the credit card company is paid. If eligible, put new business equipment in service before year-end to deduct the cost of the equipment in 2023.

Increase your withholding before year-end to eliminate or reduce an estimated tax penalty. If you expect to owe state and local income taxes when you file your return next year, ask your employer to increase withholding of state and local taxes (or pay estimated tax payments of state and local taxes) before year-end to pull the deduction of those taxes into 2023. Consider utilizing the benefits of the Alabama Accountability Act in the payment of your Alabama State income tax.

Step up the level of your participation in a business activity to meet the material participation standard needed to avoid the passive loss rules. Also, consider disposing of a passive activity to free up suspended losses.

In addition to income tax planning, remember that Gift and Estate Planning should be reviewed too. While the 2023 exemption amount is $12.92 Million, it is scheduled to be significantly reduced in 2025. Annual gifts tax exclusion amounts are $17,000 ($34,000 for couples) in 2023 and increasing to $18,000 ($36,000 for couples) in 2024. Consider utilizing these benefits for outright gifts, gifts to trusts, custodial accounts or 529 college savings accounts.

While the information provided is not all-inclusive and each taxpayer situation is different, it is meant to be a reminder of the importance of planning ahead. You have a few weeks left in 2023 to review your options. Use the remainder of the year wisely, and start early for 2024.

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Birmingham Medical News

DECEMBER 2023 • 5

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By Kelli C. Fleming, Esq.

On October 30, 2023, the Department of Health and Human Services (“HHS”) released a proposed rule establishing penalties for healthcare providers who violate the information blocking rules implemented under the 21st Century Cures Act. Currently, there are no penalties against healthcare providers for violating the information blocking rules.

As a refresher, the information blocking rules are separate and apart from the HIPAA Privacy and Security Rules, which do have established penalties for violations by healthcare providers. The information blocking rules prohibit a healthcare provider, among other “actors” as defined in the rules, from taking any action that is likely to interfere with the access, exchange, or use of electronic health information contained in a designated record set (“EHI”), unless the action is required by law or an applicable legal exception is met.

The eight exceptions to the information blocking rules are complex and each one contains a number of factors that must be met in order to qualify for the exception. To avoid any potential penalties, any provider utilizing an exception should document the use of the exception and how the exception was satisfied.

The information blocking rules apply to any request for EHI from any requestor, not just a request to access information from patients. Further, compliance with HIPAA does not necessarily equate to compliance with the information blocking rules. In other words, a provider can be in compliance with the HIPAA requirements, but be found to be in violation of the information blocking rules. In addition, the information blocking rules can be violated even if there is no harm as a result of the actor’s actions.

Previously, the Office of Inspector General (“OIG”) published a final rule establishing civil money penalties for violations of the information blocking rules by health IT developers, entities offering certified health IT, health information exchanges, and health information networks. However, the OIG final rule did not contain any penalties against healthcare providers for violating the information blocking rules.

The latest information blocking pro-

Kelli Fleming

posed rule aims to implement penalties for healthcare providers who violate the information blocking rules by allowing the OIG to refer such providers to CMS for payment disincentives. The method of payment disincentive depends on the type of provider involved. For eligible hospitals and critical access hospitals, the disincentives include not being able to be deemed a meaningful EHR user in the applicable EHR reporting period. For eligible individual providers, the disincentives include not being able to be deemed a meaningful user of certified EHR technology in a performance period and therefore receiving a zero score in the Promoting Interoperability performance category of MIPS. For accountable care organizations and their participants, the disincentives include not being able to participate as an ACO for at least a year.

“HHS is committed to developing and implementing policies that discourage information blocking to help people and the health providers they allow to have access to their electronic health information,” said HHS Secretary Xavier Becerra. “We are confident the disincentives included in the proposed rule, if finalized, will further increase the appropriate sharing of electronic health information and establish a framework for potential additional disincentives in the future.”

The proposed rule regarding the information blocking disincentives for healthcare providers is currently published in the Federal Register and available for public comment. Written or electronic comments must be received on or before January 2, 2024. Healthcare providers are encouraged to submit comments regarding the appropriateness of the proposed disincentives.

Kelli Fleming is a Partner at Burr & Forman LLP practicing exclusively in the firm’s Health Care Practice Group. Kelli may be reached at (205) 458-5429 or kfleming@burr.com.

De-prescribing PPIs and Other Medications That Need A Plan

By Laura Freeman

In most Birmingham Medical News articles, you’ll see expert quotes, along with peer reviewed data. This is a different kind of article—first, because expert information on how to help patients come off hard-to-discontinue medications is in short supply. Second, this is an opportunity to take readers inside a process we hope they never have to experience—withdrawal from long-term use of a proton pump inhibitor (PPI) where, due to communication and automation glitches, the patient had to cope with the strong acid rebound while struggling to come off the medication alone.

That patient was me. I’m writing to share what I believe is a need for better established best practice guidelines in helping people withdraw from difficultto-stop medications, including PPIs, antidepressants, psychiatric drugs, pain medications and others.

Beyond almost dying from double pulmonary embolisms, the last six weeks has been the most painful and agonizing of my life, and it’s far from over. It started two days after my six-month checkup, when someone called from my doctor’s

office to tell me to stop the PPI I’d been taking for years because my kidney labs had changed. She seemed confused when I asked if there was time for me to gradually reduce the dose and she repeated that the doctor said to stop it and come in for new labs in a month. That sounded like cold turkey, and I suspected that was going to hurt. I asked her to check and see if the doctor could call in a prescription to help with the acid rebound, and to let me know.

The next day I stocked up on bland food and skipped the first dose of the PPI I had been on since coming off every arthritis NSAID ever withdrawn from the market. The burning started the end of the second day. I popped antacids. The next day the pain turned to sharp agony, and I began throwing up acid. In a couple of more days I was dehydrated, weak, and unable to keep food down I tried sending a message to my doctor through their new text app. I asked him to call and noted that if he needed to bill it as a televisit that would be fine.

A few days later, the app sent back an automated reply saying they didn’t do televisits. It gave the number to call to schedule an appointment, but I was too sick to make it to the office.

Sudden withdrawal from PPI can result in intense stomach pain.

I didn’t know my doctor had called in a prescription of famotidine earlier.

When my pharmacy sent an automated message, I thought it was referring to a refill I had just picked up. This acid blocker would probably have made a difference.

By the time my doctor and I connected, I was in the hospital with double pulmonary embolisms. None of the tests found any reason for them. The hospitalist noted them as provoked, since I had been unable to move much in the past few days.

During the labs, they also found that I had primary hyperparathyroidism. This was why I had been feeling so bad for so long, and they can fix it. I’ll have surgery after I come off the blood thinners.

The irony is that the hyperparathyroidism probably explains why my kid-

ney labs were off. I might not have had to come off the PPI after all. Would I go back on it? No way. It works very well, but I would never risk having to go through withdrawal again.

Observations To Share With Health Care Providers • Unassisted withdrawal from long-term use of PPIs can be much more painful than most people think. Take your best guess and triple it—and add a lot more time. The medications were originally approved only for short term use, but it’s common to see patients who have been taking them for 10 or 20 years.

Acid pumps that have been turned off seem to come back with a vengeance.

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DECEMBER 2023 • 7

Trends in Private Equity Investments in Physician Practices

By James F. Henry

Private equity (PE) investments in physician practices have surged in recent years, reshaping the landscape of healthcare delivery. This trend has been fueled by various factors, including evolving healthcare policies, changes in reimbursement models, and the desire for operational efficiency. Let’s explore the dynamics and implications of this development.

The Rise of Private Equity in Healthcare Physician practices are increasingly becoming attractive targets for private equity firms seeking investment opportunities. The healthcare sector’s complexity and the challenges faced by independent practices in managing administrative burdens, technology adoption, and regulatory compliance have made them prime candidates for external investment.

Key Factors Driving Investments One significant driver behind PE interest in physician practices is the potential for consolidation. Acquiring multiple practices can facilitate value-based care

and population health management.

Moreover, technological advancements play a pivotal role. Private equity investments often include upgrading infrastructure, implementing or improving electronic health records systems, and adopting innovative tools for telemedicine, data analytics, and patient engagement. These technological integrations aim to enhance patient care, improve operational efficiency, and drive improved financial performance.

Challenges and Concerns While private equity investments bring opportunities for growth and operational enhancements, they also raise concerns. Critics worry about the potential impact on the quality of patient care and physician autonomy. The profit-driven nature of private equity ownership, and its associated prioritization of revenue generation and cost reduction efforts, has been criticized as potentially having a negative effect on patient outcomes.

Additionally, the shift from small, independent practices to larger, corporatized entities may alter the doctor-patient relationship. Patients could perceive a decline in personalized care due to standard-

ized processes and a focus on efficiency.

Regulatory scrutiny is another concern. The involvement of private equity in healthcare raises questions about compliance with regulations such as the Anti-Kickback Statute and the Stark Law, which are intended to prevent financial considerations from affecting physicians’ clinical judgment.

Trends Shaping the Future Looking ahead, several trends are poised to influence the trajectory of private equity investments in physician practices: Private equity investors are increasingly targeting specialized practices like dermatology, ophthalmology, and orthopedics due to their potential for higher margins and growth opportunities. Likewise, a continued emphasis on technology integration to enhance patient care, improve operational efficiency, and drive better outcomes will remain a key focus.

And the emphasis on managed care may result in more collaborations between private equity firms, healthcare systems, and insurance companies in order to create comprehensive care networks.

While private equity investors see opportunity in the healthcare field, they will

need to navigate evolving regulatory landscapes and ensure compliance to mitigate risks associated with regulatory changes.

Conclusion Private equity investments in physician practices are transforming the healthcare industry by reshaping care delivery models, enhancing operational efficiency, and driving technological advancements. While these investments offer opportunities for growth and innovation, they also pose challenges related to patient care, regulatory compliance, physician autonomy, and the evolving nature of the doctor-patient relationship.

Moving forward, a delicate balance must be struck between achieving financial success and ensuring patientcentered care. Collaborations between private equity, healthcare providers, and policymakers will play a crucial role in shaping a sustainable future for physician practices within the dynamic landscape of private equity investments.

James F. Henry practices in the Birmingham office of Phelps Dunbar where he specializes in healthcare law.

Podcast Visit www.birminghammedicalnews.com and on the top horizontal bar, click podcast Or go directly with this QR code:

Coming in December: Micah Howard, MD My Anxiety – Mental Hygiene in a Complicated World

8 • DECEMBER 2023

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Birmingham Medical News

DECEMBER 2023 • 9

De-prescribing PPIs and Medications That Need A Plan, continued from page 7 • If you need to tell patients to stop PPIs, please tell them yourself. They are going to need someone who can tell them how to stop. You’re about to ask them to do something very painful and disruptive.

If you have to delegate, you will need someone trained to answer questions, advise patients and coach them through it. Also, if you have patients who need to come off the medication, please allow adequate time for them to gradually taper their dose so the process is less painful.

• Friends don’t let friends take constipation-causing antacids in an attempt to counter the acid surge. It is just too big, multiple tablets aren’t enough, and soon the lower GI problems will rival the upper GI pain.

• Famotidine seemed to help, but I had to work with it to find the best time to take it. An hour before lunch on an empty stomach at least gives me a chance to keep lunch down. Any food eaten later will likely be back in a bout of acid nausea, which makes keeping evening meds down difficult. Sucralfate tablets, which my doctor prescribed before each meal, seem to help make eating less painful.

• Patients may find helpful. What helped most was choosing very bland, soft food with nothing oily on it. Take small bites and chew very well. You are going to want more than you can keep down, especially as you start to get better. Eat

less than you want and you’ll have a better chance of keeping it.

Although there are other methods of withdrawal, including one that allows patients whose condition is less serious to occasionally take a dose or a smaller than current dose of a PPI when needed.

The method that seems to be most successful in withdrawal from long term use is a gradual step down in dosage over a period of several weeks

Sources For Current Recommendations Deprescribing.org is a Canadianfunded research-based website offering peer consensus recommendations for algorithms to assist in deciding when to discontinue a medication and in choosing the plan most suited to helping patients in different scenarios withdraw from medications that are difficult to stop. Videos outlining recommendations for several drugs are available on YouTube. earch Deprescribing.org and name of drug.

A major Japanese study of PPI withdrawal options has been completed and is expected to publish shortly. Preliminary expectation is that it will recommend tapered withdrawal reducing dosage over several weeks as more likely to be successful than simply stopping use.

GRAND ROUNDS

Chen Named New Medical Staff President at Children’s Mike Chen, MD, MBA is and UT Health Sciences Cenassuming the role of Presiter in Houston. He trained in dent of the Medical Staff at general surgery at the UniverChildren’s of Alabama. Chen, sity of Florida, and completed who currently serves as fellowships in Transplantation surgeon-in-chief, is also the and Pediatric Surgery before Director of the Division of joining UAB in 2009.

Pediatric Surgery at UAB. As Chen’s clinical interests president, he will represent include all aspects of pediMike Chen, MD the interests of the hospiatric surgery with a particutal’s physicians and medical personnel. lar focus on anorectal malformation, He will also serve as a liaison between Hirschsprung’s disease, bowel managethe medical staff, the hospital executive ment, congenital anomalies, thoracic leadership, and the Board of Trustees. defects, and minimally invasive surgery.

Chen attended the University of Texas

Complete Health Rebrands Norwood Clinics Across Birmingham Norwood Clinic, which joined the Complete Health family of primary care practices in January of this year, has been renamed Complete Health.

Norwood Clinic has been caring for patients in the Birmingham area for nearly 100 years and is one of Alabama's largest privately held, multispecialty practices. Complete Health is one of the Southeast's fastest-growing privately held primary care groups.

Complete Health locations now include the former Norwood clinics in Fultondale, Gardendale, Guin, Grandview, and Brookwood Baptist Medical Center.

Over the past five years, Complete Health has grown by acquisition from

one primary care clinic in Ormond Beach, Florida to now 25 locations across Florida, Alabama, and Virginia. The group has over 140 primary care providers and offers additional on-site services, including imaging, lab, pharmacy, and point-of-care diagnostic testing.

Complete Health specializes in senior care, including programs such as chronic care management, transitional care management, Power Over Diabetes, a patient education and support program, and dedicated Member Support Representatives who provide nonclinical assistance to help support the patient's care plan.

Alabama Infant Mortality Rate Improves

Solutions as unique as your business Health care providers with business interests across the South turn to Phelps for counsel on their legal needs.

Physician groups, health care systems, rural hospitals, dental practices, individual physicians and everything in-between, turn to Phelps for day-to-day-counsel as well as for their most pressing legal issues and business opportunities. It’s more than our casework that sets us apart. It is our energy and passion for solving our clients’ challenges.

George Morris, Partner 2001 Park Place North Birmingham, AL phelps.com

10 • DECEMBER 2023

Birmingham Medical News

The Alabama Department of Public Health announced the 2022 Alabama infant mortality rate was 6.7 deaths per 1,000 live births, a decrease from the 7.6 rate in 2021. Alabama's infant mortality rate, however, remains higher than the provisional U.S. rate which is 5.6. While Alabama’s rate improved, the national rate trended upward for the first time in 20 years.

State Health Officer Dr. Scott Harris said, “I am pleased that the 2022 infant mortality rate has decreased to the lowest rate ever. The enduring disparity between birth outcomes for black and white mothers, however, is disturbing. Despite advances

in healthcare, the black infant mortality rate is consistently twice the rate for white mothers.”

Statistics regarding Alabama births and pregnancies include the following: • There were 58,040 births in Alabama in 2021 and 58,162 in 2022. There were 443 infant deaths in 2021 and 391 in 2022.

• Overall births to teenagers continue to decline.

• The percentage of births with maternal smoking was 4.8 in 2022, a decrease from 6.1 in 2021 and the lowest percentage recorded.

UAB Research Awards Breaks Record at $774.5 Million for 2023 UAB has reached another research milestone, having received $774.5 million in research grants and extramural awards for the 12-month period ending September, 2023, an 8.2 percent increase from fiscal year 2022. This milestone marks a $247.5 million increase in funding over the past five years and a 73 percent growth over the past nine years.

UAB ranks among the top five

percent of universities in the United States based on all federal research and development spending in FY 2022. Within the $774.5 million record, $413.7 million came from National Institutes of Health awards, keeping UAB in the top one percent of all NIHfunded institutions. Furthermore, all six of UAB’s health-related schools are in the top 15 public universities in NIH funding in FY 2022.

Congressman Gary Palmer Visits Surgical Institute of Alabama EDITOR & PUBLISHER Steve Spencer

VICE PRESiDENT OF OPERATIONS Jason Irvin

CREATIVE DIRECTOR Katy Barrett-Alley

CONTRIBUTING WRITERS Jane Ehrhardt, Ashley Franco, Laura Freeman, Lynne Jeter, Marti Slay

GRAND ROUNDS Congressman Palmer with Dr. Swaid and the SIA staff.

US Congressman Gary Palmer recently visited Surgical Institute of Alabama (SIA) where he toured the facility and met with Dr. Swaid Swaid and the management team. Swaid and the SIA team talked with Palmer about current Ambulatory Surgical Center (ASC) legislation that SIA supports. They told Palmer about the struggles that all ASCs face, and provided information on the services they provide to their communities.

Brookwood Baptist Utilizing Mako Robotic for Hip and Knee Replacements

Ribbon Cutting for New Brookwood Cath Lab

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In October, Brookwood Baptist Medical Center installed a Mako Robotic Surgery System for hip and knee replacement surgeries, adding to the hospital’s catalog of available roboticassisted procedures. The system is designed to enhance surgical accuracy when removing diseased bone and cartilage from a damaged joint, as well as when guiding the implant into place.

Feedback generated by the Mako system helps the surgeon to stay within clearly defined boundaries so that no healthy bone or tissue is inadvertently removed.

Brookwood CEO, Jeremy Clark, cuts the ribbon.

In November, Brookwood Baptist Medical Center held a ribbon-cutting event to celebrate the opening of the hospital’s brand new Cardiac Catheterization Laboratory. The new cath lab, a 1,700 square-foot, $3.6 million renovation, has been active since mid-October and medical teams have already completed several cases.

Answer the call to practice in rural Alabama

ARMSA Scan to visit Birmingham Medical News Blog

Earn $50,000 a year!

The Alabama Rural Medical Service Award (ARMSA) incentivizes primary care physicians and NPs to practice in rural, medically-underserved areas in Alabama. Eligible PCPs receive $50,000 a year and NPs receive $30,000 a year for up to 3 years as a service loan payable by years of service. PCP and NP must not have practiced in the rural area within 3 years of October 1, 2023.

We’re looking for NPs in family medicine and for physicians in the primary care fields of: ARMSA is administered by the Alabama Office of Primary Care and Rural Health and is supported by the Office for Family Health Education & Research, UAB Marnix E. Heersink School of Medicine

For details visit https://aohw.org/2022-armsa or email ARMSA@uabmc.edu

• family medicine • internal medicine

• general pediatrics • internal medicine/pediatrics

Apply for ARMSA today!

Birmingham Medical News

DECEMBER 2023 • 11

WWW.SIPOASIS.COM/NETWORKOSCOPY | (205) 623-1200

‘Twas the night before Christmas, with hackers arrayed To steal doctors’ data, and then to get paid, Absconding with records and ePHI, Holding them ransom and selling online.

Poor, unwitting patients, they hadn’t a clue ‘Til insurance claims got denied or reviewed.

And then came the audits, the lawyers, the press, Uncomfortable questions, which triggered distress.

Compliance lost out to complacence instead.

They’d all ignored HIPAA. Now the practice was dead.

Don’t be like these doctors.

The hackers are crass.

Just call SIP Oasis and cover your ass.

Ron Shoe

CybertechnoLOLogist

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