South Florida Hospital News
Tuesday October 15, 2019
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July 2019 - Volume 16 - Issue 1

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It’s been said the only constant is change, but when it comes to telehealth, change has been taking steroids. Enabled by a healthcare industry looking to better serve patients, protect its bottom line, and desired by an increasingly technology-addicted customer base, delivering clinical services without an in-person visit has gone from barely on the radar to potentially revolutionizing the delivery of care within a generation.

Insurance underwriters use simple loss ratios (losses and expenses divided by premiums) as one of the tools with which to gauge a company's suitability for coverage. High loss ratios, in which the losses approach, equal, or exceed the premium, are not good. One factor that has a large effect on loss ratios are “shock loss” claims, catastrophic losses so large that they have a material effect on the underwriting results of an entire insurance company.

On June 2, the application period opened for Quantum Foundation’s Quantum in the Community (QIC) program, which provides grant money to help grassroots charities in Palm Beach County meet the basic needs of the county’s most vulnerable residents. Now in its ninth year, the program is celebrating its success by increasing the pool of available funds to $1 million, with selected nonprofits receiving up to $25,000 each.

From a financial and revenue perspective, there are several competing factors that go into running a successful non-profit health care system while also meeting the growing and varied needs of patients. With a budget of $1.2 billion, Broward Health is one of the largest public health care systems in the nation and, as with any organization of this size, we face a myriad of challenges.

This month we are celebrating our 15th business anniversary. What started out in a tiny home office is now a well-respected and credible publication still being produced in a tiny home office. (What can I say, Carol abhors change! But I really think I deserve a new chair.) In our first issue of South Florida Hospital News — July 2004 —we promised to provide positive information about the individuals and organizations which make our industry second to none in the nation and still growing.

Patient Navigator for Palm Beach County HealthCare District Michaëlle Schütt-Ainé is among more than 100 people who have completed Care Coordination Training through the Palm Beach County Medical Society (PBCMS). She is a Certified Community Health Worker (CCHW), an emerging occupation in the health care industry and one of the state’s top six evolving health care occupations, according to a recent report prepared by the Florida Center for Nursing.

If you pay close attention, you’ll see examples daily. Examples where an hourly employee (not a manager, not an executive) has a service recovery that saves the day. Recently, I was up north attending a decent sized dinner party at a local restaurant. By decent size, I mean 12 people. 

When opportunity knocks in the healthcare realm, you have to be ready. And one of the best ways to be prepared is to establish connections in the industry who already know your skills and work ethic. According to Madison Workman, COO of Coral Gables Hospital, being part of an educational and networking organization such as the South Florida Healthcare Executive Forum (SFHEF), can open doors to advancement that prospective healthcare professionals may not have even realized existed.

During a recent Town Hall meeting of the Dade County Medical Association (DCMA), physician frustration with continued reimbursement challenges from insurance carriers boiled over into a lively and highly productive conversation. The focus on the discussions related to the Medicaid Managed Care Program and the Enhanced Payment Program which when fully implemented will guarantee Medicare level reimbursement for all in-network physicians providing services to pediatric Medicaid Beneficiaries. 

The healthcare industry has reached a digital precipice where ignoring such forces is no longer an option—especially in the middle market, where entities face unique challenges compared to their larger counterparts, including growing competition from all sides. According to BDO’s inaugural Middle Market Digital Transformation Survey, compared to their counterparts in financial services

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