PBCMS 2018 Q2 Final

OnCall

QUARTER 2, 2018

THE OFFICIAL PUBLICATION OF THE PALM BEACH COUNTY MEDICAL SOCIETY

Why We Need Care Coordinators

PBCMS Services Annual Report

Page 8

Page 13

Population Health Shaping the Future Page 11

D

New Program Connects People and Resources

id you know that the Palm Beach County Medical Society (PBCMS) has professionally trained Care Coordinators dedicated to assist the community with PBCMS member physician referrals and community resources?

What is My Health Access?

There is more to well-being than access to health care. Navigating aspects of care such as affordable medication, healthful food, transportation, supportive services in the home, adequate and affordable housing, employment assistance, and caregiver support all impact health outcomes. Addressing social aspects of care is critical to meaningful care planning.

Our Care Coordinators will connect you to community supports available. For additional information, call 561-433-3940.

Palm Beach County Medical Society Care Coordinators Deanna Lessard (standing) and Karen Harwood are professionally trained and certified to connect Palm Beach County residents with programs to improve health care outcomes. Contact them at 561-433-3940.

President’s Report

Brandon Luskin, MD

President Palm Beach County Medical Society

S

We Connect to Make A Difference

o many of us take for granted our access to some type of health care. If we have insurance, we can usually locate services. There are, however, a growing number of people in our county who fall through the cracks. More and more I hear of people who lost insurance, or who are overwhelmed by the task of figuring out what is available for them given their special circumstances. The new “My Health Access” program at the Palm Beach County Medical Society is here to connect all the parties and help them establish insurance programs or benefits options that will enable them to get the care they need. Aside from having tremendous community benefit, our My Health Access program also helps to keep people from using emergency rooms for basic care, or for treatment for advanced problems that might have been managed more effectively at the onset. For more information, see page 2.

Care Coordination is the Future

At the next level, our Care Coordination Program is training local health care workers to qualify for certification. Quality health care has become more and more labor dependent, and Care Coordinators can make a big difference in the management of disease classes such as diabetes and hypertension, significantly improving outcomes and managing health-care costs. These two programs that connect people illustrate the commitment that our Palm Beach County Medical Society has made to improve health care as a whole in our county. For more information, see page 22. These vital programs demonstrate how our society is working to improve the playing field for our physician membership.

The Challenges We Face

Health care will change more rapidly over the next five to 10 years than during the previous 20 years. We are facing the challenges of a Medicare program that has been legislated to evolve into a new and different value-based system. More and more Americans will be hitting Medicare age with less savings

than ever before, so we can predict that enrollment in Medicare Advantage (HMO) type plans will significantly increase. In addition, our non-Medicare patients who have been facing ever-increasing deductibles for their care, also will eventually opt for savings by choosing HMO products for their family coverage. This will allow insurance companies to gain greater control of our health care system as more and more people give up choice. Our circumstances will be further complicated or compounded by an increasing aggregation of health care systems and institutionalization of medicine around us.

Whether we seek to remain independent of these corporate entities, or are employed by them, they will have a profound effect on the medical playing field for all of us.

We have faced so many threats in the past that have never materialized, leading so many of us to be incredulous at this time. The SGR of Medicare that threatened to cut our fees by 20 percent never happened. But the current health care system is not solvent over time, and real changes are on the horizon.

Lets Work Together and Be Heard

There are only so many ways for physicians to connect and organize to keep Medicine a significant component of health care. I do not expect government and industry to easily yield to the concerns of physicians. It is now more than ever of critical importance that physicians embrace change in the united fronts of the Palm Beach County Medical Society, the Florida Medical Association, and the American Medical Association, as well as our specialty societies. The powers that seek to minimize our input are relying on our remaining fragmented, as these changes are inflicted upon us. Physician burnout and apathy are further working against us. Please be heard. Please connect and continue to support our actions on behalf of physicians, to keep medicine a prime component of the evolving health care through your continued memberships in our PBCMS, the FMA, and the AMA. Nobody else is going to help us!

OnCall • Q2 2018

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Contents

BOARD OF DIRECTORS Brandon Luskin, MD

Robert Tome

Marc Hirsh, MD

Roger Duncan

Larry Bush, MD

Shawn Baca, MD

Stephen Babic, MD Andrew Berkman, MD Berna Buyukozturk, Medical Student Dawn Davanzo, MD Kleper de Almeida, MD Michael Dennis, MD James Goldenberg, MD Henry Haire, MD James Heron, MD Hitesh Kapupara, MD

Milad Khoury, MD Krishna Kishor, MD Ekaterina Kostioukhina, MD Claudia Mason, MD Stefan Pasternack, MD Leslie Perla, MD Alan Pillersdorf, MD Ronald Zelnick, MD Jack Zeltzer, MD

President

President-Elect

First Vice President

MD, Secretary MD, Treasurer

Past President

BOARD OF TRUSTEES Jose Arrascue, MD Stephen Babic, MD Shawn Baca, MD Larry Bush, MD

James Goldenberg, MD Maureen Whelihan, MD Marc Hirsh, MD Ronald Zelnick, MD Brandon Luskin, MD Jack Zeltzer, MD Alan Pillersdorf, MD

BOARD OF DIRECTORS Michael Dennis, MD Don Chester President

Treasurer

Ivy Faske, MD

Matt Gracey

Vice President

Jean Acevedo William Adkins, MD Elaine Alvarez Jose F. Arrascue, MD Brenda Atkins Steven Borzak, MD Tish Carlo Ljubica “Jibby” Ciric Patti Corbett

Secretary

Bobbi Horwich Mollie Shulan, MD Andrew Larson, MD Kelly Skidmore Gary Lesser Patricia Thomas Roshan Massoumi Maureen Whelihan, MD Stuart Miro, MD Paul Wieseneck Alan B. Pillersdorf, MD Jack Zeltzer, MD Nancy Proffitt Tenna Wiles, CEO Greg Quattlebaum Brent M. Schillinger, MD

PBCMS STAFF DIRECTORY Tenna Wiles CEO

Mindi Tingler Operations Director

Deanna Lessard

Jim Sugarman

Resource Development

Lauren Stoops

Project Access Director

Karen Harwood

Member Services & Physician Wellness Director

Care Coordination Services Director

Katherine Zuber

Public Health & Disaster Services Director

Membership Development & Events Director

John James

Subscriptions to OnCall are available for an annual rate of $50. For more information contact PBCMS at (561) 433-3940. The opinions expressed in OnCall are those of the individual authors and do not necessarily reflect official policies of Palm Beach County Medical Society or its committees. OnCall is owned and published four (4) times per year by Palm Beach County Medical Society, Inc., 3540 Forest Hill Blvd., #101, West Palm Beach, FL 33406. (561) 433-3940. ©Copyright 2018 Palm Beach County Medical Society, Inc. OnCall Magazine is designed by MillerDesignPros, email us at m.miller@millerdesignpros.com or visit us on the web at www.millerdesignpros.com

D E PA R T M E N TS

Page 6

3 President's Report 6 Med Memo 7 Welcome New Members FE AT U R E S

2 My Health Access 8 Why We Need Care Coordinators 11 Population Health Palm Beach County Medical Society Services Annual Report

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Annual Heroes 18 15th in Medicine Awards Training 22 CHW Program

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OnCall • Q2 2018

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Med Memo

Reception Recognizes 1919 & 2020 Society Members

Mark Your Calendar June 1, 2018

Docs Got Talent Dinner and Show

December 1, 2018

Starfish & Snowflake Gala

Atlantis Country Club, Atlantis Kravis Center Cohen Pavilion August 3-5, 2018

February 2019

Loews Sapphire Falls Resort at Universal Orlando

Venue TBA

FMA Annual Meeting Future of Medicine

PBCMS President Brandon Luskin, MD, and PBCMS Services President Michael Dennis, MD at the reception.

Special thanks to Dr. and Mrs. Michael Dennis for hosting the 1919 & 2020 Societies March 15. Recognition awards were presented to physicians and community partners who have made an annual financial commitment of $2,000 to Palm Beach County Medical Society Services. Contributions provide support for Project Access, Care Coordination Services, Physician Wellness, Disaster Services and other public health initiatives. Dr. Dennis announced the goal of welcoming 50 new 2020 Society members in 2018. For information and benefits of the 1919 and 2020 Society, call 561-433-3940.

2018 Doctor’s Day Celebration PBCMS Services Dinner Features Nick Duran, Esq.

(L to r) Nick Duran, Esq., CEO Tenna Wiles and Dr. Michael Dennis.

(L to r) Brandon Luskin, MD with wife Julie and son Ryan; Brent M. Shillinger, MD and his wife Penny; and Roger Duncan, MD with his family.

PBCMS hosted the Annual Doctors Day Family Celebration on March 24 at the South Florida Science Museum and Aquarium. More than 100 physicians and their families enjoyed an “out of this world” astronaut exhibit, face painting, raffles, balloon art, beautiful sea creatures, scavenger hunt, dinner and desserts. Doctors Day was celebrated nationwide on Monday, March 30.

Dr. Bush Addresses Retired Physicians Group PBCMS hosted a luncheon for the Retired Physicians on April 13 at Cafe Sapori.

Larry Bush, MD (l) presented "Anthrax in the Mail: How It All Unfolded So Who Did This?"

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Q2 2018 • OnCall

Join MEDPAC Today!

MEDPAC is the bipartisan political action committee of the Palm Beach County Medical Society. Its goal is to support and elect pro-medicine candidates at the state and local level. Every year, there are critical legislative votes made in Tallahassee that have a major impact on the practice of medicine.

MEDPAC has proven to be a valuable asset in educating legislators about the concerns of medicine. For more information, go to www.pbcms.org or call 561-433-3940.

The Annual Services Dinner was held on April 26 at Paradiso. Nick Duran, Esq. was the featured speaker and Cynthia Clayton, MD was honored with the PBCMS Services Lifetime Achievement Award and Jibby Ciric, PsyD was named the PBCMS Services Member of the Year.

Women Physicians Connect at Painting Party

PBCMS, Danna-Gracey and SunTrust Medical Specialty Group hosted on March 1 a Women Physician Painting Party at Danna-Gracey in Delray Beach.

Reception Honors Heroes in Medicine

Project Access Meets With Senator Rader

The Heroes in Medicine VIP Reception was attended by more than 100 guests at Equus Country Club in Boynton Beach on April 5. Special thanks to Martha Rodriquez, MD (far left) for hosting the event and to Optimum RTS and FPL for sponsorship.

The Physician Wellness Program

The Physician Wellness Program (PWP) creates a safe harbor for physicians to obtain care, avoid burnout, achieve work-life balance and an improved quality of life. Burnout manifests itself with disengagement, depression, substance abuse, early retirement and even suicide. PWP, which has been funded by the charitable support of those who support and believe in our mission, offers PBCMS members six complimentary, confidential counseling sessions during a calendar year. PWP psychologists and licensed mental health counselors have a great deal of experience in counseling physicians, and they have been thoroughly vetted by PBCMS physicians. The 24/7 support line is 1-800-530-9757.

James Goldenberg, MD Named 2017 Palatucci Advocate of the Year

PBCMS Services Project Access Director Lauren Stoops (r) met in Tallahassee with Senator Kevin Rader to advocate for FAFCC and Project Access in Tallahassee.

Call for Nominations for Delegates to FMA House of Delegates

Did you know that Palm Beach County Medical Society has one of the largest delegations to the Florida Medical Association and the American Medical Association? Our Society is respected for its strong leadership in representing physicians and addressing policies impacting our patients.

Nominations are now open for physicians to serve as Delegate for the FMA Annual Meeting to be held August 3-5 at the Loews Sapphire Falls Resort at Universal Orlando. This is an excellent opportunity to join with your colleagues in shaping the future of medicine. For additional information contact Amanda Krudis by email amandak@pbcms.org or by phone 561-433-3940, x106.

PBCMS Services Welcomes New Board Members Ms. Bobbi Horwich Mrs. Mas Massoumi Mr. Gary Lesser

Dr. Stuart Miro

Dr. Mollie Shulan

Ms. Patricia Thomas

Ms. Kelly Skidmore

Welcome New PBCMS Members Congratulations to James Goldenberg, MD who was recently selected as the 2017 Palatucci Advocate of the Year by the American Academy of Neurology. Dr. Goldenberg was recognized for his commitment to advocacy and his outstanding accomplishments in creating the South Florida Physician Leadership Academy.

Mirylsa Colon-Martinez, MD - Orthopedic Surgery Brijeshwar Maini, MD - Cardiology Cheryl Moss-Mellman, MD - Internal Medicine Courtney Elizabeth Rowling, MD - Psychiatry - Addiction Medicine Ofer Shustik MD - Family Medicine Residents -FAU-Schmidt College of Medicine Internal Medicine Mishah Azhar, MD Miles Graves, MD Lilibeth Jauregui, MD Anitha Chandran, MD

Joseph Henain, MD

Roberto Lorenzi, MD

Haider Al Taii, MD

OnCall • Q2 2018

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Trends

Judy Dunn, RN

Jose Arrascue, MD

Christopher Irizarry

Robert E. Tome, MD

Care Coordinators

Here’s Why We Need Them in Palm Beach County and Beyond

W

By Leon Fooksman

hen patients seek medical care today, they’ll likely interact with any number of doctors, nurses, medical assistants, or other trained professionals — not to mention insurance and billing offices — across multiple settings.

If health care providers aren’t able to coordinate with each other, the consequences can be harmful to patients, resulting in medication errors, needless or repetitive diagnostic tests, and unnecessary emergency room visits, hospital admissions, and readmissions.

Beyond leading to lower quality-of-care and worse health outcomes, poor coordination also can drive up medical costs through preventable hospitalizations, duplicative tests, and other avoidable spending. Studies estimate inadequate care coordination amounted to up to $45 billion in wasteful spending in 2011 alone.

Care Coordinators in Great Demand

To address this problem, a growing number of medical practices, hospitals, clinics, and other facilities in Palm Beach County and across the nation have created many categories of new care coordinators positions in recent years. Besides helping to trim costs by reducing duplication of services, they serve as liaisons between patients and the health care system, ensuring that patients receive the care they need and that they understand their medical conditions, medications, and other instructions.

Care coordinators are in such demand that Palm Beach County Medical Society (PBCMS) is helping to lead training and certification for care coordinators in the area. Learn how we train care coordinators on page 22.

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Q2 2018 • OnCall

We asked local health care administrators and physicians to discuss the role of care coordinators in their field. Here are their answers.

Christopher Irizarry, vice president and executive director of clinic services at Health Care District of Palm Beach County: “Care coordination is the future of health care and critical to ensuring patients are treated efficiently and effectively. It is critical with the lack of resources, that we begin working on making certain patients are treated appropriately,

“Care coordinators serve as liaisons between patients and the health care system.”

Leon Fooksman, Staff Writer, OnCall

with a minimal level of confusion to avoid waste and medical errors. Is this a good idea, and why? Coordinating patient care ensures patients are not using specialty services that are not necessary, ensures providers are discussing the patient’s care to identify positive outcomes and reduce redundancy, and reduce waste and medication errors.”

Judith Dunn, RN, manager of business services at CareerSource Palm Beach County: “Our first responsibility is to our patients to ensure they receive the best care we can provide. Responsible care coordination can prevent both pre- and re-hospitalization in some cases. Care coordinators assist patients and families with finding medical specialists,

Care Coordination: the Right Care, at the Right Time, in the Right Setting Medical Specialists of the Palm Beaches (MSPB) is the largest multi-specialty group in South Florida. They are constantly searching for innovative solutions to help improve the lives of their 65,000 patients. In some cases, it’s solutions such as care coordination that appear to be simple until one realizes the depth of the positive impact and the myriad of missing links in the health care system. It’s these missing links that care coordination can solve to help provide the right care, at the right time, in the right setting.

Sounds simple? As health care has evolved, there is tremendous pressure on the federal government and health plans to meet the demands of

our aging population and the associated costs. Especially with the elderly population, the most critical times in their care delivery is when there is a transition from one setting (hospital) to another (home) or a change in health status due to an incident. Those transitions can be confusing and very costly. Recognizing the gaps in care can be closed by care coordination is a significant step in the right direction.

With every transition, there is a “hand off” from one provider to another; care coordination closes those gaps. Simply put, care coordination is the glue that has been missing! MSPB is dedicated to further developing this platform in partnership with the PBCMS.

required testing and follow-up with prescribed medical regiments. Sometimes, patients must choose between paying bills, purchasing medication or feeding their families. Care coordination can provide information about programs to assist with services and while alerting the physician about socio-economic issues that could lead to a health crisis and readmission.”

Robert Tome, MD, a family medicine doctor in West Palm Beach: “The new paradigm of health care is care coordination, which is going to play a significant role in cost containment of health care dollars. All payers are changing the reimbursement model to pay for performance with value-based payments and gainsharing agreements to deliver high quality-low cost coordinated care. All providers will have to consider quality and cost in their decision-making when referring patients to hospitals, other providers, skilled nursing and rehabilitation facilities and home health agencies.”

Jose Arrascue, MD, a nephrologist in Atlantis: “Health care coordination is an indispensable component of medical care, especially for the management of patients with chronic diseases such as cancer, diabetes, heart, renal and pulmonary.

The health care coordinator, under a physician’s supervision, helps to ensure the patient and the family have a clear understanding of the medical plan, including medications, changes in lifestyle, follow-up visits, etc. There’s ample documentation that this approach leads to the Triple and Quadruple Aim, because it provides better care, better health, and lower cost by decreasing preventable complications, such as costly admissions to the hospital. And it also creates a satisfied physician workforce because physicians feel best when their patients do well. This approach of care will continue to grow because it provides better value to pay for medical care in the future.”

How do we continue expanding care coordination in Palm Beach County?

What’s next? MSPB is committed to expanding their staff’s knowledge of care coordination in order to develop the best platform to serve their patients.

At MSPB, they are always striving to improve the care they provide. They have the trust of the community and consider that to be a great responsibility. Their endeavor to provide the community with peace of mind is a top priority.

And yes, MSPB has a comprehensive approach to preventive health care as well.

Medical Specialists of the Palm Beaches 5700 Lake Worth Road Lake Worth, Florida 33463 561-649-7000 www.mspbhealth.com

Irizarry: “PBCMS has been a crucial partner by educating and coordinating care coordinators throughout the county. This effort raises awareness of the program and the importance of care coordination throughout the community. The Health Care District has benefited from the PBCMS training program. Currently, our care coordinators manage the sickest employees in the system. Patients with multiple core morbidities are identified and assigned a care coordinator who ensures the patient is educated on the illness, medication, and a healthier lifestyle. In addition, patient care is coordinated throughout the continuum of care to ensure efficient and effective care. Using data, we ensure that no patient falls through the cracks, and that patients are afforded an opportunity to receive appropriate care outside of the emergency room.”

Dunn: “Care coordinators are essential in all aspects of health care from birth to senior care. As our aging population in Palm Beach County grows, we must increase the number of care coordinators to meet their needs. CareerSource PBC is helping to build a jobs pipeline with our valued partner PBCMS, which provides the health care training for local talent to obtain certification. CareerSource PBC works with employers to promote care coordination and provide the certified talent with opportunities for increased wages.”

Tome: “The expansion of care coordination in Palm Beach County is an integral part of health care. In addition to the Care Coordination program by PBCMS, nursing and medical assistant programs at our local colleges will include this program in their curriculum. With this knowledge and training, other members of the workforce will be able to help the providers deliver high-quality, low-cost coordinated care to the population of Palm Beach County.”

Leon Fooksman, Staff Writer for OnCall, leon@digitalstoryline.com, Twitter at @ compellingstory

OnCall • Q2 2018 9

The NEW Financial Dialogue

Life Insurance Policy Audit & Review Based on a study by the National Association of Insurance Commissioners, over 60% of people who own life insurance have no idea what they own or how it works. Twenty-nine percent of people also said that they need more insurance but no one has asked them about it.

We all know that life insurance is not easy. It’s hard to know if you have the right kind of insurance. It’s hard to know if you have enough and it’s hard to know if you need any at all.

Today’s life insurance policies are complex financial instruments and should be monitored like any other asset in your portfolio. The insurance companies have made it even harder by confusing us with products like:

Lou J. Fuoco, CPA Managing Partner lfuoco@fuoco.com

• • • • • • •

Term Whole life Universal life Variable universal life Indexed universal life Survivorship Flexible premiums

• • • • •

Renewability Convertibility Investment in stocks and bonds, some not Cash value guarantees Definite and indefinite periods

Why be surprised? A life insurance policy surprise is almost never good. A policy audit & review can tell you if your

policy is in trouble or headed for it, and what corrective action may be possible.

It’s important to understand that life insurance is not a buy-and-hold proposition. Like another asset it must be actively managed. Performing an periodic audit and review of your policies accomplishes that. An audit and review considers factors beyond just the policy statement and includes product suitability, product design, and performance.

The following are some of the areas evaluated:

• Does your policy still meet your financial needs?

• What was the original goal of the policy?

• Is it still valid? If not, what is the new goal?

• Is the original beneficiary designation still appropriate?

• Is the policy ownership structure still appropriate?

• Can you get more coverage for the same premium payment?

• Can you reduce your premium payment for the same amount of coverage?

• Has your health improved, thereby creating the opportunity to reduce premiums?

• Are policy charges competitive?

• Is the insurance provider financially stable?

If you have not done so recently, we strongly recommend that you review your existing life insurance policies. At TFG, we offer a FREE audit and review of your policies.

Contact us at 561-209-1101

Did you know that a policy’s long-term guarantees and projected performance are only as good as the financial strength of the insurer? A permanent life insurance policy is literally intended to be in force for a lifetime: yours. An audit evaluates an insurer’s financial health as determined by various rating agencies and provides a review of the company’s financial strength as compared to statutory requirements and other insurers.

Did you know that approximately 40% of non-guaranteed universal life policies and approximately 35% of variable universal life policies are illustrated to lapse during the insured’s lifetime or within five years of life expectancy? An audit evaluates premature lapses in policies, especially those that were intended to last insured lifetime.

Did you know that a “guaranteed renewable” policy is very important because without it, reduced health could render you uninsurable?

Did you know that a significant number of policies have the wrong ownership and incorrect beneficiary language causing unintended income tax problems and can have disastrous consequences for the owners and their families?

fuoco.com

M

ore than a quarter century as a faculty member understand this and are actively adapting, innovating and buildat Thomas Jefferson University has afforded me ing population health and value into their systems. a unique opportunity — the chance to be one of One way in which the CMS continues to support the Triple those sitting in the driver’s seat throughout the Aim is through its value-based programs that reward health transformative movement known as population health. care providers with incentive payments for the quality of care I was privileged to lead the development of the Jefferson they deliver; e.g., tying provider payment to evidence and health College of Population Health (JCPH) — the first college of outcomes rather than units of service (pay-for-performance its kind in the U.S. when the doors opened in 2009. Not by models), reimbursing providers for coordination of care in coincidence, the college’s mission is closely aligned with (for- patient-centered medical homes, bundling payments for phymer Centers for Medicare sician and hospital services & Medicaid Administrator) by episode or condition, Dr. Donald Berwick’s visionbasing compensation on ary Triple Aim that laid the accountability for managgroundwork for reforming ing patients across care setthe U.S. health care system. tings via accountable care The Triple Aim calls for the organizations.4

By David B. Nash, MD, MBA simultaneous pursuit of: In March 2016, the U.S. • Improving the health of the population by transforming Department of Health and Human Services (HHS) announced a system organized around sickness to one organized that it had reached its goal of tying 30 percent of Medicare around health. payments to one of these alternative payment models — nearly • Improving the individual experience of care — or a year ahead of schedule. By the end of 2017, the percentage is patient-centeredness — by engaging the population in im- predicted to increase to 50 percent, and there is reason to believe proving their own health. To fully that private payers are moving in the understand an individual’s expe“Population health same direction at a similar pace. rience of care, one must take into At the individual or group physiand value-based cian practice level, the golden key to consideration the broad ranging social determinants of that perpopulation health is a patient registry. care are the son’s health: the environment Clinicians must know which of their and conditions in which the papatients have chronic conditions (e.g., most powerful tient lives, works, and relaxes. diabetes, hypertension, coronary artools we have...”

• Reducing per capita costs by tery disease) because payment for reducing waste — specifically services will increasingly be tied to David B. Nash, MD, MBA clinical waste due to error and the health outcomes of their patients. system failure. Although this may seem counterintuitive, A registry need not be complex or expensive — easy to use the evidence is compelling. High quality actually costs less. tools are available from scores of sources, e.g., Healthy Planet, Phillips Wellcentive. A registry enables clinicians to compare their patient population outcomes with regional and national Overcoming Challenges As a pioneer in an emerging academic field, JCPH faced norms; this, in turn, helps clinicians to identify and close care innumerable challenges that ranged from writing a curriculum gaps in their own practices. from scratch, to grappling with the need to make the program principally online (to meet the needs of working professional Optimistic About the Future students), to identifying administrators and expert faculty for Perhaps the greatest challenge to population health lies in graduate degree programs in Quality and Safety, Health Pol- changing provider attitudes and transforming the traditional icy, Applied Health Economic and Outcomes Research, and culture of medical practice in the U.S. For those who are 35 and Population Health (an amalgam of the other disciplines). In younger, practicing based on evidence rather than personal exaddition to these programs, JCPH now encompasses Jefferson’s perience, continual measurement and evaluation, transparency longstanding graduate program in Public Health and a variety and accountability are already standard operating procedure. of graduate certificate programs.

For those in the 40-60 age range, accepting and integrating these Two integral and closely related national trends will contin- changes will be more difficult. And, for those in the over 60 age ue to shape U.S. health care: 1) the shift toward value-based bracket, the natural resistance to change may be a permanent care and 2) the pursuit of population health. The real news is impediment. Despite being an internist in the oldest bracket, I that, over the 7+ years since its implementation, the ACA has remain very optimistic about the future and am fully committed irreversibly shifted the health care cost structure and brought to the transformation of our health care system. about fundamental changes in care delivery.

The enduring goal of the U.S. health care system is a healthy (References for this article supplied upon request.) population; population health and value-based care are perhaps the most powerful tools we have for achieving that goal. Health David B. Nash, MD, MBA, Dean, Jefferson College of Population Health, care providers, CMS, employers and private payer organizations Philadelphia, Pennsylvania

Population Health Shaping the Future of U.S. Health Care

OnCall • Q2 2018 11

ANNUAL REPORT 2017-2018

Together - Making A Difference in Health Care

Our Impact

Programs

• Expanded Project Access Network and provided $1.3 million in donated care to over 1,000 low-income, uninsured patients • Established the Dental Care Partnership, a collaborative effort to bring critical dental care to an underserved population • Launched the Community Health Worker (CHW Care Coordination) Training Program and graduated 80 students • Implemented Physician Leadership Program for 24 South Florida Physicians • Launched the “My Health Access Program” to help all Palm Beach County residents access health care and services • Convened Opioid Epidemic Task Force and developed a community-wide plan • Partnered with University of Miami Medical School MD/MPH Capstone Program on Adverse Childhood Experiences Project (ACES) • Established Physician Wellness Program

Events Palm Beach County Medical Society Services (PBCMSS) was founded in 2001 by the physician leadership of the Palm Beach County Medical Society to expand the reach of physicians in the community. Today, the organization is led by a qualified board comprised of physicians, health care professionals, and community leaders who take seriously their responsibility to develop innovative and collaborative solutions to priority health issues.

This year, we have strengthened existing programs and expanded our efforts to address Physician Wellness, Care Coordination, the Opioid Epidemic and Adverse Childhood Experiences (ACES). Our commitment to address these issues has been made possible by the partnership and generous support of physicians, health care organizations, foundations, education, government grants, businesses, and donors.

It is an honor to work with our community partners, dedicated volunteers and committed Board of Directors.

Together we are making a difference engaging physicians, enhancing access to care and addressing the health care needs of our community. I invite you to join us.

Michael T.B. Dennis, MD President

• Hosted 11th Annual Future of Medicine Summit & Medical Education Poster Symposium with over 400 attendees • Recognized Palm Beach County Heroes in Medicine at 14th annual luncheon • Held annual Starfish & Snowflake Gala which celebrated organization leaders

Community Support and Recognition

• Over 2,000 participating volunteers • Launched 2020 Donor Society • Welcomed 3 new members to 1919 Society • Recognized 5 Hippocrates Society members • Partnered with University of Miami MD/MPH Capstone Program • Provided internship opportunities for Florida Atlantic University Health Administration students and Florida Atlantic University School of Social Work students • Certified by Nonprofits First • Recognized by American Association of Medical Society Executives with the Profile in Excellence Award

2017-18 Board of Directors

Michael T.B. Dennis, MD President

Ivy Faske, MD Vice President

Don Chester Treasurer

Matt Gracey Secretary

Douglas D. Dedo, MD Immediate Past President

Jean Acevedo

William Adkins, MD Elaine Alvarez Jose F. Arrascue, MD Brenda Atkins Steven Borzak, MD Tish Carlo Ljubica “Jibby” Ciric Patti Corbett Andrew Larson, MD

Heather Miller, Esq. Alan B. Pillersdorf, MD Nancy Proffitt Greg Quattlebaum Brent M. Schillinger, MD Brandyce Stephenson Maureen Whelihan, MD Paul Wieseneck Jack Zeltzer, MD

INNOVATIVE PROGRAMS Making A Difference Physician Wellness Program CHW Care Coordination Training Program CHW Care Coordination Training Program provides community health workers innovative training to enhance skills needed for improved patient experience and participation in care. Participants learn about chronic medical conditions; activities which improve health; cultural competency; patient advocacy skills; and communication strategies such as motivational interviewing. The goal is to improve health outcomes and enhance the patient experience.

Physician Wellness Program The Physician Wellness Program was created to promote physician well-being and create a safe harbor for physicians to receive confidential counseling and support.

Disaster Services: HERC

Healthcare Emergency Response Coalition’s (HERC) mission is to develop and promote the health care emergency preparedness, response and recovery capability in Palm Beach County. HERC has 25 member organizations that include our 15 county hospitals and other emergency organizations to ensure our safety at all times.

This year, HERC and PBCMS partnered to form the PBC Opioid Task Force to address a major public health epidemic.

MRC The Medical Reserve Corps’ (MRC) mission is to improve the health and safety of Palm Beach County residents by organizing and utilizing public health, medical, and other volunteers to respond to natural or man-made disaster events and other local public health needs.

The Future of Medicine

South Florida Excellence in Physician Leadership Institute A two-year pilot project, funded by the Physician’s Foundation for physician leadership, focused on addressing leadership challenges faced in a diverse community. Each class is comprised of selected physicians from Broward, Dade and Palm Beach County

Project Access Project Access is a network of physicians, hospitals and health care providers who donate care to the low income uninsured residents in Palm Beach County. Including coordinating specialty care, hospital care, and ancillary services, Project Access volunteers have provided more than $12 million to over 11,000 individuals in need.

The Future of Medicine Initiative has brought together community leaders to define issues, establish partnerships and implement strategies for change The Future of Medicine Summit, The Summit brings together national and community health care leaders to explore the “hot topic” issues facing health care.

A special focus on medThe New Reality of Healthcare ical education is proOctober 1 2 -13, 2017 vided with the James J. Byrnes, MD, Medical The Future Student and Resident of Medicine Poster Symposium.

Hilton Palm Beach Airport - West Palm Beach For registration or sponsorship opportunities visit www.pbcms.org/events or call 561-433-3940

Making a Difference in Healthcare.

Recognizing Excellence

Volunteers are the heart of our organization with over 2,500 volunteers participating in our programs.

CHW Care Coordination Extraordinary Service Awards • 2017 Outstanding Leadership Award - Dr. Stuart Miro • 2017 Outstanding Community Partner Award - Florida Blue Rachel Ringley

Disaster Services Extraordinary Service Award

• 2017 HERC and MRC Member of the Year - David A. Summers, RN

Project Access Extraordinary Service Awards

• 2017 Hospital Provider - JFK Medical Center • 2017 Ancillary Service Provider - Palm Beach Radiology • 2017 Physician Practice Provider - Arthritis Associates of South Florida - Dr. Mary Pat Clements & Dr. Steven Goodman

2017 PBCMSS Extraordinary Service Award • West Palm Beach VA Medical Center

Hippocrates Society Collaboration and partnership are the core values of the Hippocrates Society.

We are honored to recognize the following hospital medical staffs for their participation in the Hippocrates Society. With their support programs such as the Future of Medicine, Heroes in Medicine, and educational programs.

Heroes in Medicine

Bethesda Health Baptist Health South Florida

For the past 14 years, with the continued support of Rendina Companies the Heroes in Medicine Award luncheon has recognized the outstanding individuals and organizations who have made a significant contribution to healthcare and have demonstrated a commitment to community service.

Boca Raton Regional Hospital

2017 Hero of the Year Roger Duncan, MD

JFK Medical Center Jupiter Medical Center Wellington Regional Medical Center

Donors Making A Difference Boca Raton Regional Hospital Foundation

JFK Medical Center

C and A Johnson Foundation

Michael T.B. Dennis, MD

CareerSource Palm Beach County

National Association of County and City Health Officials (NACCHO)

DCA for Health Eugene and Nancy Beard

Physician Foundation Quantum Foundation

Florida Association of Free and Charitable Clinics

Rendina Healthcare Real Estate

Florida Department of Health

The Ernst & Gertrude Ticho Charitable Foundation

Florida Medical Association Health Care District of Palm Beach County Jarden Consumer Solutions Community Fund, Inc.

Trustbridge Health United Way of Palm Beach County Urban Areas Security Initiative (UASI)

1919 Society

The Power of Community For the past 20 years, I have kept the quote by Margaret Meade on my office wall – “Never doubt a small group of thoughtful committed individuals can change the world, it is the only thing that ever has.” It is this belief that guides my work at the Medical Society. I am honored to work with committed physicians and community leaders.

During the past year we have experienced a great deal of turmoil in health care.

While the future is uncertain, there is one thing that is clear — all health care is local.

Yes, the challenge is great, but we have a strong commitment to ensure that we address the health care needs of our community. From navigating and providing care to the uninsured, supporting the educational and wellness needs of our physicians and medical students, coordinating disaster preparedness services, addressing the opioid epidemic and more, Palm Beach County Medical Society Services is proud to be a community partner.

Tenna Wiles

CEO, Palm Beach County Medical Society & Services

Palm Beach County Medical Society physicians have a proud tradition of serving the community. The 1919 Society is a leadership Giving Society which has demonstrated a long term commitment to our community.

Henry Haire, MD James Goldenberg, MD J. John Goodman, MD & Judy Goodman, Esq. Howard Allen Green, MD

Jose F. Arrascue, MD

Alan B. Pillersdorf, MD

Shawn Baca, MD

Brent M. Schillinger, MD

Jeffrey Berman, MD

Ida Sebastian, MD

Larry Bush, MD & Maria Vazquez-Pertejo, MD

William Slomka, MD

Michael T.B. Dennis, MD

Robert Tome, MD Ronald S. Zelnick, MD

Malcolm Dorman, MD

Jack Zeltzer, MD

2020 Society Founded in 2017, donors of annual gifts of $2,000 or more are recognized as members of the 2020 Society.

Members receive personal health coordination, invitations to member only events and free admission to the Future of Medicine Summit.

Founding Members Mr & Mrs Eugene Beard Mrs & Mrs JT Kuhlman Mr & Mrs Jack Luther Mr & Mrs Barry Snyder

For more information, visit www.pbcms.org or call 561-433-3940

INCOME

Financial Statement

EXPENSES

1200000

1,181,757.75 Grants & Contributions

1000000

1000000

800000

800000

600000

600000

400000

400000

200000 0

200000

231,501.36 Fund Related

Total Income

841,183.45 Direct Program Costs

0 $

1,413,259.112

tions 59,026.86 Opera

113,528.69d Fund Relate

Total Expenses

1,013,739.00

$

Palm Beach County Medical Society Services is a 501c3 charitable organization which relies on the generosity of our donors. Please visit us at www.pbcms.org to learn more about our programs. If you would like to learn how you can support our mission, please contact us at pbcms@pbcms.org or call 561-433-3940.

Events

Heroes in Medicine co-chairs Greg Quattlebaum and Jibby Ciric, PsyD welcome the more than 600 guests.

15th Annual Heroes in Medicine Awards

By Susan W. Fell

M

ichael Dennis, MD, the president of the Palm Beach County Medical Society Services, recognized on April 20 the nearly 50 Heroes in Medicine Award Winners at the 15th annual luncheon at the Kravis Center’s Cohen Pavilion. Dr. Dennis reminded the more than 600 attendees that each and every one of these exceptional Heroes has impacted the greater health care community and helped change a small part of the world for the better.

Dr. Galvin Named Hero of the Year

James Galvin, MD, an award-winning Hero in the Health Care Innovation category, was honored as the 2018 Hero of the Year. Dr. Galvin is internationally recognized as an expert on Lewy Body Dementia, Parkinson’s disease and Alzheimer’s disease. In 2015, he came to Florida to spearhead a clinical research infrastructure in Palm Beach County to test innovative therapies, ready them for market, and develop strategies for diagnosis and care to improve the lives of patients and their

18

Q2 2018 • OnCall

families. The founding director of Florida Atlantic University’s Comprehensive Center for Brain Health, Dr. Galvin’s current research focuses on detection of chronic conditions in older adults from diverse cultural, racial and socioeconomic backgrounds and how those conditions affect brain health, increase risk of neurologic disease and decrease quality of life for patients and their families. His vision is to translate that research into programs and practices that

James E. Galvin, MD Hero of the Year reduce health disparities and improve outcomes in people from all backgrounds.

A board-certified neurologist, Dr. Galvin is the developer of the novel Quick Dementia Rating System, which is being used around the world in dementia prevention studies and clinical trials

A board-certified clinical immunologist, internist and allergist, Dr. Stein Mark R. Stein, MD, has discovered and re- Medical Director/ of Allergy solved life-threatening, President Associates of the often very obscure and Palm Beaches, rare complex medical receives the Lifetime conditions in his patients. Achievement Award.

He is recognized internationally for his research especially on gastroesophageal reflux related airway diseases. His work with the American Lung Association and many other community service activities add up to a stellar lifetime of achievement.

The event’s honorary for new medications. Our exceptional Hero of the Year James chairperson, Alan Pillersdorf, MD, and co-chairpersons Greg Galvin, MD, is helping our aging population live longer and Quattlebaum and Jibby Ciric, were joined by Palm Beach County healthier lives.

Medical Society Services leaders who introduced honorees in several categories — an impressive presentation accompanied by Nearly 50 Award-Winning Heroes Honored inspirational videos, accolades and triumphal personal stories.

Heroes in Medicine Awards were presented to a wide range For example, one of the beneficiaries of a Project Access program of health care professionals including physicians, medical spe- Giselle Miranda and her son Julian Sierra Miranda, extended a cialists, pharmacists, mental health professionals, hospital CEOs, Giselle Miranda and her son Julian Sierra Miranda, flanked by presenters researchers, medical students, nonprofit organizations and othMaureen Whelihan, MD (l) and Jean Acevedo, Acevedo Consulting Inc. ers who have done extraordinary work.

Honorary Chair of the Heroes in Medicine Alan Pillersdorf, MD recognizes Wade Kuzmick for the generosity of the Rendina Healthcare Real Estate — the Founding Benefactor of Heroes in Medicine.

Gina Melby Receives the Leadership Award

Gina Melby, CEO of JFK Medical Center.

Gina Melby, the CEO of JKF Medical Center, the first female CEO in the Center’s 50-year history, received the Leadership Award for helping shape the health care landscape of the county. She spearheaded JFK’s growth from a community hospital to a major tertiary center and developed two freestanding emergency rooms in Boynton Beach and Palm Beach Gardens as well as the merger of JFK and West Palm heartfelt thank you to the doctors and hospitals who diagnosed, Hospital among a number of treated and performed her life-saving breast cancer surgery. other achievements.

Proceeds from the event benefit Project Access, which provides resources and health care for low income, uninsured resDr. Stein Is Lifetime idents of Palm Beach County as well as other valued programs Achievement of the non-profit PBCMS Services.

Award Winner Heroes in Medicine recognizes the following sponsors: Mark R. Stein, MD, the Founding Benefactor–Rendina Healthcare Real Estate, Grand Medical Director/President of Patron–The Palm Beach Post, and Benefactors–Trustbridge and Allergy Associates of the Palm Acevedo Consulting.

Beaches, received the Lifetime For a complete list of the 2018 Heroes in Medicine award Achievement Award for 2018. winners, go to www.pbcms.org.

OnCall • Q2 2018 19

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“ I think a hero is any person really intent on making this a better place for all people.”

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Congratulations to Dr. Arif Dalvi, neurologist, on being nominated for Palm Beach County Medical Society’s 2018 Heroes in Medicine.

561.882.6214 www.PBNI.com

C

Care Coordinators Are Key to Improved Outcomes

By Karen Harwood

are coordination training provides skills needed to help patients address challenges to care and motivate them to set achievable realistic goals. Medical staff often do not have the training or opportunities to acquire the skills and knowledge needed to carefully and effectively carry out care coordination tasks. Transportation to a medical appointment, affordable medication, healthful food, and rent assistance are all challenges not naturally associated with chronic disease management. However, studies show that health outcomes are closely associated with these factors.

Successful chronic disease management can be achieved by Community Health Workers (CHWs). According to a study, care guides were hired by a primary care clinic, trained for two weeks to address non-clinical aspects of care, and were assigned to help 332 patients and their providers manage their diabetes, hypertension, and congestive heart failure. Patients

showed improvement with cholesterol levels, blood pressure control, tobacco usage, eye examinations and kidney function.

One year later, failure by these patients to meet nationally recommended guidelines was reduced by 28 percent. CHWs served an average of 111 patients at an annual per patient cost of $392. Another study showed pairing Nurse Practitioners and CHWs together “demonstrated $157 reduction in per patient cost for every 1 percent drop in systolic blood pressure and a $190 reduction in cost for every 1 percent drop in diastolic blood pressure.�

Growing Need Addressed

The Palm Beach County Medical Society Services CHW Care Coordination Training Program was developed in response to a growing need for more effective and efficient health care delivery. Trainees learn the scope of services for a care co-

ordinator; key aspects about chronic medical conditions that afflict their patients/clients; lifestyle activities that improve health; knowledge about cultural competency; advocacy skills for community needs and services; communication skills to affirm patients’/clients’ rights; roles and responsibilities as well as communication strategies such as motivational interviewing. Program graduates give the program high marks calling it “essential,” “useful,” and “very instructive.” Many cited the Motivational Interviewing session as the most enlightening aspect and helpful in dealing with patients. Graduates state the quality of interactions with patients has improved, and the frequency of communication with patients has increased.

Participants of the CHW Care Coordination Training receive the full complement of education hours and content areas needed to fulfill the training requirements (30 CEUs) for the Community Health Worker Certification offered through the Florida Certification Board.

The training is held at CareerSource PBC and meets Fridays from 1-4 p.m. The next training session runs from October 5 to December 15, 2018.

Karen Harwood, Care Coordination Services Director, karenh@pbcms.org

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PAID WEST PALM BEACH, FL PERMIT NO.515

3540 Forest Hill Blvd. Suite 101 West Palm Beach, FL 33406 RETURN SERVICE REQUESTED

Docs t n e l a T t o G Palm Beach County Medical Society Services invites you to attend

Friday, June 1, 2018

event This special the w ill showcase Talent Spectacular h of Palm Beac c si ians Co unty ’s Phy an d Dentists

Reception/Art Exhibit 6 p.m.

Dinner & Show 7-9 p.m. $75 per person Atlantis Country Club 190 Atlantis Boulevard, Atlantis, FL

Mistress of Ceremonies Leslie Gray S treeter

Proceeds to benefit the programs of Palm Beach County Medical Society Services

Ticket and Sponsorship Information: www.PBCMS.org or call 561-433-3940