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FOCUS TOPICS OPHTHALMOLOGY • OBESITY

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PHYSICIAN SPOTLIGHT PAGE 3

Mark Bateman, MD ON ROUNDS

We wish all our readers a Happy New Year and look forward to serving you with the latest news in a year that almost certainly will bring many more changes to our healthcare system.

New Studies, Certifications, Partnerships…

A Year of Uncertainty … and Opportunity By CINDy SANDERS

Last month, PwC Health Research Institute released its annual report highlighting the forces anticipated to have the greatest impact on healthcare in the coming year. “Top Health Industry Issues of 2017” outlined 10 areas ranging from healthcare plans under a new administration and the move to ramp up value-based payments … to public health concerns over infectious disease and a public outcry for more transparency in drug pricing. “The report enumerates 10 items, but I think there are some themes,” said Nick Walker, a partner with PwC’s Health Industry Practice. “The fate of the Affordable Care Act dominates the day, and uncertainty is the theme of the day.” He added, “Until the fate of the ACA comes into focus, there is a sense of unrest.” However, Walker continued, “The driving force in healthcare hasn’t re-

Catch up on West TN healthcare news and events by reading the items in Grand Rounds.

ally changed, and that’s the move towards value.” Moving to a value-based system is a bipartisan priority … although the path to get there could look very different once Presidentelect Donald Trump takes office. Walker noted that as a candidate, Trump’s healthcare policy raised more questions than answers with a lack of specificity. Since the election, Trump has moderated his stance, moving from ‘repeal’ to ‘repeal and replace’ to ‘repeal, replace a lot, but keep some.’ Walker noted, “I think the new administration is beginning to understand how disruptive a full repeal of the ACA might be.” He pointed out to simply repeal the law would mean 20 million Americans would lose insurance coverage … and the health systems that serve them would lose reimbursement. “You would see massive uncompensated care in the system, and that’s a big problem. Frankly, it’s almost impossible to do a full repeal,” Walker said. “Also,” he continued, “the Trump Administration

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Examine the briefs on pages 6 & 7. (If you have news to share in future issues, please send it to pamela@memphis medicalnews.com)

Retirement for Rudd

Carl Rudd retires from the Jackson Clinic after 40 years By SUZANNE BOyD

One might say Carl Rudd has eased himself into retirement from The Jackson Clinic, PA. After 40 years as the chief executive officer, Rudd started transitioning into retirement five years ago. When Rudd left the office at the end of December, he

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(CONTINUED ON PAGE 4)

hoped no one would notice his absence because of a seamless transition. Rudd’s roots run deep in the heart of Texas. He began his college education at Lubbock Christian College, finishing his accounting degree at the University of Texas in Austin in 1971. He passed the Certified Public Accoun(CONTINUED ON PAGE 4)

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PhysicianSpotlight

An Enlightened Perspective Bateman brings his experience as a patient to his practice By SUZANNE BOYD

Ophthalmology is something Mark Bateman, MD, is very familiar with on both sides of the ophthalmoscope. As a child dealing with an unusual eye infection, Bateman spent his fair share of time at the eye doctor’s office. When it came time to choose his medical specialty, he clearly knew what his choice would be. Medicine was not a new idea for Bateman since the Lexington, Tennessee native was born into a family of healthcare providers. His father was a dentist, his mother a nurse and his two older brothers both chose to pursue a profession in the medical field. Throughout his college career, which he started at Jackson State and finished at Murray State in Kentucky, Bateman was on a pre-med track. In medical school at East Tennessee State University, he found he consistently gravitated toward eye care. “While I considered doing something in primary care by my third year, I knew ophthalmology was what I wanted to do,” said Bateman. “Since I was on a navy scholarship, all my post graduate training was in the navy. My internship was completed at the Naval Hospital in San Diego, then I spent my operational tour as a flight surgeon for three years. I did my residency at the National Naval Medical Center in Bethesda, Maryland. To complete my obligation to the Navy, I was a staff ophthalmologist in Jacksonville, Florida for two years before joining the Eye Clinic in Jackson in 1994.” Bateman was very familiar with the Eye Clinic and its staff because it was where he had been a patient as a child. “Dr. House and Dr. Price were my doctors growing up,” said Bateman. “Someone had told Dr. House I was an ophthalmologist and he called me as I was getting out of the service to see if I would be interested in joining the clinic.” Just as Bateman felt the call to ophthalmology, as well as to come back home to West Tennessee, it was not long before he felt the call to return to the navy as a reservist. “I always wanted to be in the military as both my parents had been. When I first got out, I had a feeling I wanted to go back in as a reservist,” he said. “While most of what I did as a reserv-

Dr. Mark Bateman stands with some of the pieces of furniture he has made. ist was ophthalmology, some was more primary care such as routine physicals. By the time I retired, I was a Captain in the Medical Corp.” Besides his experience as a patient, Bateman was attracted to ophthalmology because it was a specialty that allowed

him to concentrate on a small, albeit complicated area. “Knowing a lot about a small area rather than a little about a lot of things is more in keeping with my personality,” he said “Having had a recurrent eye infection at different times of my life, as well as cataract surgery in one eye

allows me to empathize more with my patients. I can share my story with patients and they appreciate that I can relate to what they are going through.” After more than 20 years in practice at the clinic, Bateman says he has seen more changes in the management of a medical practice than in the management of disease and treatment of eye disorders. “The way we interact with patients is no different but the diagnostic equipment, array of drops, and treatment protocols have improved overall care. Cataract surgery, for instance, has evolved from what I learned in residency,” he said. “Probably the hardest change to accept, other than EHR, is the fact that all the partners that were here when I started have retired and I’m now the senior partner...means I’m getting old.” Away from the office, Bateman is a craftsman of sorts. “I have always enjoyed working with wood and it is a good way for me to unwind. At one time, my wife Jennifer and I were into antiques and did a lot of furniture refinishing. That led me to wanting to make furniture and so I took some classes on it in East Tennessee,” said Bateman. “I have made cabinets, furniture, Windsor chairs, farm tables, bowls, vases, etc. Mostly I make it for family but I have put a few pieces in my daughter’s store.”

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A Year of Uncertainty … and Opportunity, continued from page 1 thinks there are some attractive parts of the law.” Walker said Trump has notably supported guaranteed issue so that those with pre-existing conditions could still have access to coverage and keeping adult children on a parent’s policy until the age of 26. “There’s a recognition that some parts of the program are Nick Walker useful.” While providers, health systems, and industry suppliers wait for direction on how to proceed, Walker said there are measures that could … and should … be undertaken including scenario planning, investing in education and advocacy, and rethinking historic M&A agreements to create new collaborative arrangements.

Walker said a question that should

be on the mind of every innovator is: “When the dust settles, what’s going to be up for grabs and how can I take a shot at it?” Nationally, he noted, several big payers pulled out of exchanges. “That left 1.6 million folks, which translates into $8 billion in premiums, up for grabs,” he said. Walker was quick to add there was a reason those large insurers opted out of specific markets, but he said it still leaves an opportunity to look at technology, collaborations, and other innovations to transform that void into a value proposition. As America enters this new era in healthcare reform, Walker said, “Those who will do best are organizations that have demonstrated the ability to adapt … organizations that have demonstrated the ability to innovate … and organizations that know how to build for value.” For additional insights and information, go online to pwc.com, click on industries and then select health industries.

tant exam and took a job as the try and very forward thinking business office manager for a which meant the environment physician group in Austin. was right. Jackson was ready to “In 1973, I met some people grow and boom which made from The Jackson Clinic while recruiting physicians easier beattending a user meeting for the cause you could show them this computer system our clinic in was an unusual community. If Austin used. The Jackson Clinic a doctor wanted to practice used the same system. It just so specialized medicine in a small happened their business office community in the South it was manager, Elton Winslow, was here or Tupelo, Mississippi, retiring,” said Rudd. “My menwhich gave us an opportunity tor in Austin, George Lehigh, to get established.” actually encouraged The JackFor the first 50 years of son Clinic to hire me as assistant its existence, the clinic was administrator. A year later, I the largest multi-specialty left to be the administrator for a clinic in the state with offices medical group in Memphis, who all over West Tennessee. Due just happened to be Elvis’s docto changes in managed care, tors.” the clinic has focused more on Throughout his time in its presence in Jackson. “The Memphis, Rudd remained growth in Jackson has been somewhat of a consultant for continuous since many of our The Jackson Clinic. “As my patients come here to work suggestions were implemented and shop as well as for their they eventually asked me to healthcare needs. Roughly come back,” said Rudd. “I liked 65 percent of our patients Jackson and the group so it was today live outside of MadiCarl Rudd, on right, enjoys the West Tennessee Healthcare Gala with his successor, a fairly easy decision. Initially, son County,” said Rudd. “To Mark Allen. I was the assistant administrahave the high quality specialtor but in 1976, less than a year ized care we offer, you have to after I returned, I was named administrahave three to four physicians in the same five superior doctors, trained at some of tor at the age of 26. Although I was young, specialty. To keep that many busy, you the best schools in the country, including I was prepared better than my years and have to concentrate them in one area so John Hopkins, Duke and Vanderbilt, did intellect because of the education I had rethey can practice and maintain quality of when they opened the clinic in 1950,” said ceived at the University of Texas. It was a life.” Rudd. “We had to convert from being just phenomenal experience that really taught Over his 40+ years, Rudd has seen a doctor’s office, to being a major delivme how to think.” lots of changes in healthcare. “In the ‘70’s erer of healthcare in the region. Because In 1976, the clinic had 25 doctors people came to you when they were sick we knew our doctors were first rate and and Rudd was challenged with making and you treated them. That is not the the community was supportive, we could the organization a medical center. “We healthcare delivery system of today,” he achieve our goal of delivering the highest really wanted to make it on the caliber of said. “Today, it is identifying and treatlevel of care to our patients.” major healthcare institutions across the ing them before the disease process causes Rudd attributes part of the success of country just in a smaller community. I them to be acutely ill. From electronic achieving this goal to the city of Jackson. had always found the idea of having that medical records to managed care coordi“In the 1970’s, Jackson was probably the level of quality medicine in a rural setnators, there are so many things to help most dynamic community in the state,” he ting to be interesting. It was really what keep a patient from getting ill. Patients said. “It was aggressively recruiting indus-

can now get many diagnostic tests done here without long stays, which is a huge service to patients not only in Madison County but in the 20 surrounding counties we serve.” One thing that has not changed over the years is Rudd’s faith. “Christianity has always been a huge part of what I do and who I am. I purposely chose to be in the Bible Belt because I wanted to be in an environment that being a Christian would be normal and I wanted my sons to experience that as well,” he said. “Being able to demonstrate Christian characteristics in a medical environment is something I am very proud of. When you recognize the fact that you are impacting 125,000 different people’s lives, 700 of which are employees and their families, for the good, is very satisfying.” Rudd says that while he has worked hard on working himself out of his job, he will miss the daily conversations as well as the problem-solving aspects. “My mother once asked me what I do and I told her I take a problem no one knows what to do with and figure out a way to solve it. I have sort of gotten addicted to that part of things,” he said. “I have great confidence in Mark Allen who will be leading this organization into the next chapter. The transition has been going on for so long and in such small steps there will be no abrupt radical changes for anyone, including me. I think a good leader’s job is to prepare the organization to function just as well without them as with them. And after 40 years, I think I have done that.” Retirement for Rudd will be an easy problem to solve because he plans to spend time with his wife of 48 years as well as with his 94-year old mother, four sons and eight grandchildren. Travel is also in the equation for the Elder at Skyline Church of Christ and will include mission trips to Africa.

Scenario Planning

Walker stressed the importance of scenario planning, particularly in uncertain times. Health systems, he noted, par-

ticularly need to think about what might happen, how that could impact business, and what the response should be. What if 20 million lose coverage? What if they don’t, but premiums are higher? What does that do to your system and how does it impact non-urgent procedures? Walker said thinking through various scenarios and possible reactions helps providers remain nimble in the face of uncertainty. “You feel comfortable with health systems who say they don’t know what will happen, but they know how they might pivot depending on how things play out,” Walker noted.

Education & Advocacy

“High performance organizations will invest in education and advocacy,” Walker said. This is particularly important in light of a new president with a strong business foundation but little healthcare or policy background. Walker pointed out it isn’t

necessarily intuitive to recognize there is an interplay between guaranteed issue and premiums. Instead, a crash course in healthcare requires the disparate parts of the industry to explain the complex intertwining that causes a ripple effect with each decision. “Sharp organizations are pushing the envelope here,” he said.

Innovative Collaborations

“Historically, you’ve seen mega mergers. I think what you’re going to see in this new economy is more partnership strategies,” Walker said. He added those strategies might be in the form of joint ventures or other collaborations. Already, the industry is seeing more partnerships between for-profit companies and notfor-profit health systems and collaborations based on specialized expertise or geographic reach where partners work together but maintain autonomy.

Opportunity from Adversity

Retirement for Rudd, continued from page 1

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GrandRounds Dr. Ashraf Alqaqa Published in Journal of Clinical & Experimental Cardiology MARTIN - Healthcare providers with patients who suffer from migraines headaches—especially those with aura— would be wise to have a heightened level of awareness of their patients’ cardiovascular disease risk factors. Those are the findings highlighted in a scholarly review authored by Ashraf Alqaqa, MD, a cardiologist with Tennova Specialists – Martin. Dr. Alqaqa is also the chief of cardiovascular services and

director of the chest pain unit at Tennova Healthcare – Volunteer Martin. His conclusions were recently published in the Journal of Clinical & Experimental Ashraf Alqaqa Cardiology. Though the precise connection is not clear, clinical studies indicate an association between migraine headaches and several cardiovascular conditions, including stroke, coronary artery disease, mitral valve prolapse and cardiac arrhythmias according to Alqaqa.

He said that clinical data suggests that brain ischemic changes—possibly caused by insufficient blood flow to the brain— may occur during migraine headaches and have been observed to involve other organs, mainly the heart. Migraine headaches are more intense than a typical tension headache and cause significant pain. They are divided into two categories—migraines with aura and migraines without aura. Aura refers to sensory warning symptoms, which often begin between 10 and 30 minutes before the throbbing headache, such as

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flashes of light or ringing in the ears. Dr. Alqaqa’s review notes that it is uncertain if there is a causal relationship between migraine headaches and certain cardiovascular conditions—meaning one leads to the other—or if the relationship is simply coincidental. Nonetheless, he suggests the link provides clear guidance. Additional studies are needed to fully understand the association between migraine headaches and heart and vascular diseases Alqaqa said.

Dr. David Helm Earns Board Certification JACKSON - Dr. David Helm, a psychiatrist at The Jackson Clinic, is now board certified, American Board of Psychiatry and Neurology. He received his Doctor of Medicine from the University of Louisville School of Medicine, LouisDavid Helm ville, KY. The Jackson Clinic is a multi-specialty group practice of over 130 physicians in 25 specialties and subspecialties.

PUBLISHER Pamela Z. Harris pamela@memphismedicalnews.com EDITOR Pepper Jeter pjeter@southcomm.com SALES 501.247.9189 Pamela Harris CREATIVE DIRECTOR Susan Graham sgraham@nashvillemedicalnews.com GRAPHIC DESIGNERS Susan Graham, Katy Barrett-Alley CONTRIBUTING WRITERS Suzanne Boyd Cindy Sanders All editorial submissions and press releases should be sent to pamela@memphismedicalnews.com Subscription requests can be mailed to the address below or emailed to pamela@memphismedicalnews.com. West TN Medical News is now privately and locally owned by

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GrandRounds WTH Expands Partnership with MedeAnalytics to Support its Revenue Lifecycle Management Strategy EMERYVILLE CA - West Tennessee Healthcare, a public, not-for-profit healthcare system, announced it has expanded its partnership with MedeAnalytics, a pioneer in healthcare analytics, by adding Patient Access and Denials Management capabilities. Having already experienced success with MedeAnalytics’ ICD-10, Compliance and Revenue Cycle solutions, West Tennessee Healthcare hopes to create process efficiencies, further reduce denials and gain new insights into their entire revenue cycle across the system and its physician group. The new capabilities are being deployed across the organization’s hospitals and physician practices. Jeff Blankenship, CFO of West Tennessee Healthcare said they recognize the need to better position themselves for the future and have thus adopted a financial strategy to include all aspects of the revenue lifecycle – from patient access to mid-cycle to the business office., so they are expanding their partnership with MedeAnalytics to help execute on this strategy. Those results include over 4,000 record reviews, $3.7 million in refunds and $900,000 in appeals over a four-year period. In the midst of a new accounting system conversion, West Tennessee Healthcare recognized that MedeAnalytics could once again deliver value by helping identify revenue and workflow gaps during the transition and help manage processes between new centralized registrations, the denials team and the existing revenue cycle team. Since working with MedeAnalytics, West Tennessee Healthcare has progressively added capabilities for Revenue Cycle, Compliance, Self-Pay, ICD-10 and Revenue Integrity. With the recent addition of patient access and denials management, the health system plans to improve point-of-service cash collections, pre-registration rates and insurance verification, and reduce denials and bad debt across all four of their hospitals and physician group. Taking an enterprise approach to managing the revenue lifecycle enables organizations to see the full picture – from the very first touch point in patient access, to documentation and coding in the mid-cycle, to billing and collections in the business office. .

New Coalition To Support The Alzheimer’s Community JACKSON - A group of concerned West Tennesseans recently joined together to form the Alzheimer’s Community of West Tennessee. Their mission is to educate and support families in local communities dealing with Alzheimer’s disease and other forms of dementia. The group, made up of medical and

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care giving professionals, hopes to build a community environment that is supportive to these individuals and their families. Alzheimer’s disease is now the sixth leading cause of death in our country and it has become the most expensive disease to treat – surpassing both cancer and heart disease according to Regina Smith, Senior Services Manager at West Tennessee Healthcare and founding member of the Alzheimer’s Community. There are over 400,000 caregivers in

Tennessee providing 476 million hours of unpaid care for their loved ones with this disease. We must offer not only the best care available, but also the resources, support, and education they need to survive this journey. The Alzheimer’s Community has planned several events for 2017 including a senior walk/run, a presentation that allows participants to experience dementia, and the seventh annual Alzheimer’s Caregivers Conference featuring Teepa Snow. This event draws

hundreds of caregivers annually to learn more about caring for a loved one suffering from Alzheimer’s or dementia. Funding for the conference and other educational programs, support, and resources are made possible through the Alzheimer’s Fund at the Foundation. For more information on the Alzheimer’s Community of West Tennessee, contact Regina Smith at (731) 541-8757. To make a donation to the Alzheimer’s Fund visit www.wthfoundation.org/give

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WE’VE COMPLETED

100 HEART VALVE REPLACEMENTS WITHOUT O P E N HEA RT S U R G E RY

Jackson Madison County General Hospital began offering TAVR (Trans-Aortic Valve Replacement) three years ago. Our multi-disciplinary surgical team trained to bring this new procedure to West Tennessee and have now completed 100 of these life-saving procedures. TAVR allows people who were previously not considered healthy enough for heart valve replacement to gain a new lease on life.

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Juan F. Rodriguez, M.D. , MPH Electrophysiologist

Dr. Rodriguez joins Dr. Shawn Baldwin at West Tennessee Heart & Vascular Center's Heart Rhythm Clinic. Dr. Rodriguez He recently completed a Clinical Cardiac Electrophysiology Fellowship at Harbor-UCLA Medical Center and Samaritan Hospital in Los Angeles, CA.

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West Tennessee Heart & Vascular Center's Heart Rhythm Clinic is a leader in Cardiac Electrophysiology (EP) – the diagnosis and treatment of abnormal heart rhythms.

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January 2017 WTMN  

West TN Medical News January 2017

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