By Dr. Ileana Leyva

In an era of precision oncology, we closely track biomarkers, imaging findings and treatment response. Yet one of the strongest predictors of how a patient is truly doing often receives less attention: functional status.

When patients experience progressive fatigue, need more assistance with daily activities or spend more time in bed, clinicians and families may normalize these changes as expected consequences of cancer or treatment.

Yet progressive functional decline is frequently the clearest indication that an illness trajectory is changing. It is often a signal that warrants a broader conversation about prognosis, goals of care and whether the current treatment plan still aligns with what matters most to the patient.

As physicians, we routinely rely on objective measures to assess disease progression. While scans tell us how a tumor is behaving, functional status tells us how the patient is living. Both are essential to understanding prognosis and making care decisions that align with patient goals.

Looking Beyond the Disease

In oncology, performance status is already an established part of clinical decision-making. Measures like the Eastern Cooperative Oncology Group (ECOG) Performance Status help determine whether patients are likely to benefit from additional systemic therapy.

Too often, declining performance status triggers a discussion about whether another treatment is feasible. It should also prompt a conversation about whether another treatment is meaningful — whether the patient’s care plan continues to reflect their priorities.

Consider the patient whose cancer has progressed despite multiple lines of therapy. Hospitalizations become more frequent. Symptoms become harder to control. Walking across the room requires assistance. Meals become smaller. Recovery after each admission takes longer than the last.

Each of these changes represents more than a decline in function. Together, they paint a picture of an illness that is advancing.

When Functional Decline Changes the Clinical Equation

Functional decline should prompt clinicians to reevaluate assumptions. The clinical question is no longer only whether treatment can continue, but whether continued treatment remains consistent with the patient’s goals, priorities and likely outcomes.

Questions worth asking include:

  • Has the patient’s overall condition changed more than the scan suggests?
  • Are repeated hospitalizations helping the patient achieve their goals?
  • What does the patient hope to accomplish in the weeks and months ahead?
  • Would I be surprised if this patient died within the next year?

These conversations are often easier before a crisis develops. When patients still have the ability to participate fully in decisions, they can better express what matters most to them and understand the options available.

A Shift in Focus

One reason these conversations are delayed is the persistent misconception that hospice represents a last resort. In reality, hospice is a care model designed to support patients whose priorities have evolved as their illness progresses.

A hospice plan of care should incorporate the wishes and values of the patient and optimize the patient’s symptom management to allow for the best possible quality of life and function for as long as possible. Hospice is focused on maximizing comfort and preserving dignity, allowing patients to spend their remaining time in the place of their choice.

For patients with advanced cancer, hospice provides expert pain and symptom management while supporting emotional, psychosocial and spiritual needs. It also helps families navigate an increasingly complex stage of illness.

When referrals occur earlier, patients have more time to benefit from these services rather than receiving them only in the final days of life.

Recognizing functional decline allows us to make that transition thoughtfully instead of reactively.

Seeing the Whole Patient

Cancer care has never been solely about treating disease. First and foremost, we are caring for the person living with it.

By paying closer attention to functional status, we gain valuable insight into prognosis while creating opportunities for more meaningful conversations.

Modern cancer care offers more treatment options than ever before. Yet the measure of excellent care is not how long we continue treatment; it is how well we recognize when a patient’s needs and priorities have changed.

Functional decline is often the signal. The challenge for clinicians is deciding whether we are prepared to act on what it is telling us.

Learn more about how hospice supports patients with advanced cancer and refer patients to VITAS by calling (800) 938-7827 or visiting VITAS.com/Refer, available anytime 24/7/365. Download the VITAS mobile app for seamless, one-touch referrals by patient facesheet.

 Dr. Ileana Leyva is the regional medical director for VITAS® Healthcare in South Florida. Learn more about end-of-life care at VITAS.com.



By Lawrence Ward, MD, MPH, MACP

Every conversation about the future of health care eventually revolves around one key question: Will patients have timely access to the outstanding medical care that they need, want and deserve?

At Holy Cross Medical Group, we think about that question every day. We have the privilege of building on a remarkable 71-year legacy of serving South Florida and as part of Trinity Health, a national organization of 92 hospitals. We are proud to be the region’s only Catholic, not-for-profit health system. Our mission calls us not only to provide outstanding clinical care, but to care for every patient with compassion, dignity and respect, particularly those who are most vulnerable.

That mission continues to attract physicians who want their careers to have both professional excellence and deeper purpose. Doctors, physicians’ assistants, nurse practitioners, nurses and the full spectrum of health care professionals choose to work at Holy Cross Health because they believe in providing care in the spirit of the Gospel by treating every patient—regardless of faith, income level, race, ethnicity or sexual orientation—in a compassionate, empathetic, comfortable, hopeful and healing environment.

South Florida is an extraordinary place to live, but it is also one of the nation’s most competitive health care markets. While advances in technology, new treatments and innovative models of care continue to transform medicine, none of them replace the importance of having exceptional physicians caring for patients in our community.

Demand for health care continues to rise as our population grows and ages, yet the supply of physicians has not kept pace, and is in fact declining. Every health system is competing to recruit outstanding physicians and advanced practice providers in order to deliver top quality care close to home. Across the country, health systems face growing challenges in recruiting and retaining physicians for a variety of reasons. Today’s physicians are more mobile and less apt to commit to a single job for their entire career, as they often did in the past. This frustrates patients who trusted a specific doctor with their health for years, but must cycle through physicians every time one leaves the practice and/or area.

Recruitment today is also about far more than offering a competitive salary. Many experienced physicians are approaching retirement, while younger physicians increasingly seek to join organizations that support professional growth, teamwork, wellness, a healthy balance between work and family life, and feel connected to a mission that extends beyond medicine itself.

Retention is just as important as recruitment. Patients value continuity and communities are strongest when physicians build long-term relationships with the people they serve. At Holy Cross Health, we prioritize creating a culture where physicians feel respected, listened to, supported and empowered. This ultimately translates into better patient care and healthier communities.

As our community continues to grow, so must the breadth of services we offer. We are continually evaluating opportunities to expand specialty and surgical care, strengthen primary care and develop programs that address the evolving needs of our patients. Whether that means bringing new specialists to our community, enhancing multidisciplinary care or improving access through technology, every decision is guided by one objective: delivering exceptional care where, when and in what manner patients need it.

The future of health care in South Florida depends on organizations that are willing to invest not only in facilities and technology, but in the physicians who dedicate their lives to caring for others. We are optimistic that by remaining committed to our mission, investing in our people and continuing to earn the trust of our community, Holy Cross Health will continue to serve South Florida with excellence for many years to come.

Dr. Lawrence Ward is Chief Medical Officer of Holy Cross Medical Group.



By Agrippina Fadel

Some of the most meaningful lessons in nursing come from the people who teach by example.

Every semester, clinical preceptors across South Florida welcome Florida Atlantic University Christine E. Lynn College of Nursing students into their units, clinics and practices, sharing not only their clinical expertise, but also their compassion and approach to patient care. Through these experiences, students gain confidence, refine their skills, and begin to envision the kind of nurse they hope to become.

“The Christine E. Lynn College of Nursing is deeply grateful for the clinical partnerships that make these experiences possible,” said Dean Cameron G. Duncan, Ph.D., DNP. “Our students learn alongside outstanding nurses and health care professionals in settings ranging from community practices and specialty clinics to leading health systems, including Pediatric Associates, Baptist Health, HCA Healthcare, Palm Beach Health Network and Holy Cross Health. Every preceptor invests in the future of nursing, and every preceptor makes a difference.”

For Bachelor of Science in Nursing (BSN) student Sydney, that difference came in the Intermediate Care Unit at Holy Cross Hospital, where she worked with her preceptor, Jason.

“He made a lasting impact on my clinical experience by fostering a supportive and encouraging learning environment. His patience, professionalism and dedication to teaching helped me become more comfortable and confident in my skills. Jason consistently took the time to explain concepts, involve me in patient care and make me feel valued as a student nurse.”

For fellow BSN student Joie, her clinical rotation in the Surgical Intensive Care Unit at Boca Raton Regional Hospital helped confirm where she wants to build her career.

“Entering a unit with a higher acuity than I’ve ever been previously exposed to, I was nervous about making mistakes, asking stupid questions and not understanding certain disease processes. My preceptor Mike never made me feel unintelligent and was excited to answer all of my questions. He has taught me so much and helped me build the confidence to practice my skills and communicate in interdisciplinary teams. Mike and all of the SICU staff at Boca Regional are team players and have confirmed to me that I have a true passion for the ICU.”

The connection between academic nursing and clinical practice is essential to the success of future nurses, Duncan said.

“Our faculty provide the foundation, and our preceptors help students bring that knowledge to life through real patient care. Together, they prepare graduates who are ready to enter the profession with confidence.”

Interested in becoming a clinical preceptor? Learn more about partnering with the Christine E. Lynn College of Nursing to help educate and inspire the next generation of Nursing Owls at bit.ly/FAUpreceptor

 Clinical preceptors may be eligible for a six-credit tuition waiver after completing 300 hours of service, receive a certificate that may be used toward nurse practitioner recertification, enroll in continuing education certificate courses, connect with Florida Atlantic faculty and explore future adjunct or clinical faculty opportunities, and be recognized through the college’s communications channels.



By Trevor Biglin, Esq.

The healthcare revenue cycle has undergone a remarkable technological transformation over the past decade. What were once primarily billing and claims management systems have evolved into sophisticated, data-driven platforms capable of automating workflows, identifying reimbursement trends, and providing actionable financial insights. As healthcare organizations continue to navigate shrinking reimbursement margins and increasing administrative complexity, revenue cycle software has become an indispensable strategic asset.

Among the most significant trends shaping the industry is the integration of artificial intelligence and machine learning into revenue cycle operations. Modern platforms can now identify claims at high risk for denial before submission, prioritize accounts based on recovery potential, and analyze historical payment patterns to uncover reimbursement opportunities. By automating repetitive administrative tasks, these technologies enable revenue cycle teams to focus their time and expertise on higher-value activities that directly improve financial performance.

Another rapidly growing trend is contract intelligence. Rather than simply processing payments, advanced revenue cycle platforms increasingly compare actual reimbursements against contractual expectations, automatically flagging payment variances and potential underpayments. For healthcare organizations managing numerous payer agreements, this capability provides valuable visibility into reimbursement performance and helps identify trends that may otherwise go unnoticed.

Predictive analytics has also become an increasingly powerful tool for healthcare leaders. Executive dashboards now offer real-time visibility into denial rates, aging accounts receivable, payer-specific performance, and cash flow projections. Instead of reacting to reimbursement issues after they occur, providers can proactively identify emerging risks and allocate resources where they are likely to have the greatest financial impact.

Automation continues to improve patient access and front-end revenue cycle functions as well. Real-time eligibility verification, prior authorization workflows, and electronic claim editing help reduce preventable billing errors while improving operational efficiency. These advancements not only accelerate reimbursement but also enhance the patient experience by reducing administrative delays and unexpected billing issues.

While these technological advancements have transformed revenue cycle management, software alone cannot solve every reimbursement challenge. Many of today’s most significant financial issues extend beyond what automation can address. Complex payer disputes, contract interpretation, out-of-network reimbursement, coordination of benefits issues, and evolving regulatory requirements often require experienced professionals capable of applying strategic, operational, and legal analysis to resolve difficult reimbursement matters.

Technology excels at identifying opportunities, but experienced revenue cycle specialists remain essential for acting on the insights those platforms generate. Likewise, as reimbursement disputes become increasingly complex, many healthcare organizations are finding value in partners who combine advanced technology with deep expertise in managed care contracting, appeals, arbitration, and healthcare law.

Looking ahead, the most successful healthcare organizations will not be those with the most software, but those that effectively integrate intelligent technology with experienced revenue cycle professionals. Revenue cycle software will continue to evolve, providing increasingly sophisticated data and automation. However, maximizing reimbursement will continue to depend upon an organization’s ability to interpret that information, develop effective recovery strategies, and respond to an increasingly complex reimbursement environment.

As healthcare reimbursement continues to evolve, intelligent revenue cycle platforms will undoubtedly remain a critical component of financial success. However, technology is most powerful when paired with the expertise necessary to transform data into meaningful financial results.

Trevor Biglin, Associate, Abril Law, can be reached at tbiglin@abrilaw.com.

 



By Vanessa Orr

As healthcare organizations continue to navigate workforce shortages, regulatory changes, technological innovation and evolving patient needs, the demand for skilled healthcare leaders continues to grow. Hospitals, health systems, physician practices, public health organizations, insurance companies and others are always looking for those who understand what it takes to manage and command these organizations.

Florida Atlantic University’s Master of Health Administration (MHA) programs prepare current and aspiring healthcare professionals to lead organizations, improve patient outcomes, and navigate today’s increasingly complex healthcare environment. These degree programs combine business, leadership, finance, healthcare policy, operations, and quality improvement to prepare graduates for administrative and executive roles. The programs also equip professionals with the skills to improve patient outcomes, enhance organizational performance, and navigate the evolving healthcare landscape.

According to Sherien Khachiche, admissions coordinator with the College of Business Executive Education team, these courses are geared for two different audiences: those already in healthcare who seek a change from clinical or bedside care into more administrative/ leadership-focused roles, and those transitioning to healthcare who seek a switch from their current career, or who work in a specified department and seek to switch to the healthcare industry. These may include business and data analysts, HR managers, operations coordinators, program/project coordinators and more.

“Pursuing my Executive Master of Health Administration has been one of the most meaningful experiences of my career,” said Engagement Consultant Kadian Goldson, ’25. “It strengthened my leadership skills, expanded my understanding of healthcare systems, and gave me the confidence to take bold steps toward my future.”

FAU’s In-Person Executive MHA is offered in person on the Boca Raton campus every three weeks on Saturdays and Sundays. New cohort classes begin in the fall and spring and the next intake date is Aug. 29. FAU’s Online Executive MHA is offered in a fully remote environment and can be completed anywhere at any time. The next intake begins on Aug. 22 for this program, which is offered in fall, spring and summer.

Enhanced Career Opportunities

Earning an advanced degree while working full time requires commitment, but the long-term career benefits can be significant. The Executive MHA program prepares participants to manage teams, drive organizational change, and make strategic decisions that can help them qualify for supervisory, management, and executive positions.

“Our MHA coursework covers healthcare finance, operations, organizational behavior, law and policy, informatics and quality management, and more, preparing graduates to make informed decisions that improve organizational performance and patient care,” says Khachiche. “Students also learn to analyze healthcare systems, improve organizational performance, and address complex challenges using data and evidence.”

In addition, the programs strengthen knowledge of healthcare policy and regulations to help professionals navigate the evolving healthcare landscape and enhance communication and leadership skills by emphasizing collaboration, negotiation, conflict resolution, and executive communication.

Through the program, participants can also expand their professional networks by connecting with faculty, healthcare executives, alumni and peers. Through internships and Leadership Bootcamp experiences, students collaborate on real-world healthcare challenges while building valuable executive leadership experience.

“The program gives you practical tools and leadership skills you may not find in other programs,” said Supervisor, Medical Support Assistant Dvante Baham, ’26. “Experiences like the Leadership Bootcamp provide access to different healthcare leaders and offer valuable insights from professionals in the field.”

Additional Healthcare Leadership Programs

In addition to the Executive MHA program, FAU offers a number of other options to help professionals move forward in their careers. This includes an MBA in Artificial Intelligence and an MBA in Health Administration, among others.

The MBA in Artificial Intelligence is a new concentration offered in all of FAU’s MBA programs, . It is designed to equip business leaders with the knowledge and skills to thrive in today’s AI-driven world.

“This concentration brings advanced AI concepts into the MBA core, giving individuals the breadth of a management degree and the depth to steward AI initiatives across functions,” said Khachiche, noting that competitive advantage comes from translating emerging technologies into scalable business results. The program is offered both on-site and on-line. Visit https://business.fau.edu/masters-phd/mba-program/executive-mba/concentrations/artificial-intelligence/.

The MBA in Health Administration prepares students to provide leadership, vision, and management for healthcare facilities such as hospitals, physician offices, group medical practices, home health care agencies, outpatient clinics, and nursing care providers. Offered on-campus or online, this degree is designed for professionals seeking to apply business expertise within healthcare organizations.

For healthcare professionals looking to transition skills and better understand the area of reimbursement, medical billing and coding, regulatory and compliance practice, and overall office operations, FAU offers stand-alone certificates in Medical Business Management.

“Any member of the public can complete them and they do not have to be active students,” said Khachiche. “This is especially useful for those looking to open their own practices or seeking to advance within their current roles in these healthcare spaces.”

The certificate program, offered two to three times per year depending on demand, is offered online and on-campus and is available in three modules; Anatomy, Terminology, Billing and Coding; Legal, Regulatory and Compliance Practices and Office Operations.

FAU also offers over 60 professional development programs designed and taught by subject matter experts. These include Lean Six Sigma Green Belt Certification; Fundamentals of Power BI; Introduction to Project Management; Certificate in Artificial Intelligence in Business; Certificate in Medical Business Management; Executive Certificate in Analysis; Leadership Courses for Rising Executives and more.

For more information, visit https://business.fau.edu/masters-phd/mha.