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Watch for the Signs: Screen All Patients for Suicidal Thoughts Print E-mail
Written by The Doctors Company   
Thursday, 08 December 2016 00:00

The suicide of a patient is a tragedy for any physician.

Patients with suicidal thoughts or ideation appear occasionally in physician encounters. The Joint Commission recently noted that the rate of suicide is increasing, and suicide is now the 10th leading cause of death in the United States.1 Most people who commit suicide received healthcare services in the year prior to death, usually for reasons other than mental health issues or suicidal thoughts. It's a strong reminder that any patient-no matter what issue is being treated and in any setting-could be at risk for suicide.

The patient's well-being should be the primary concern, but physicians also must consider the potential legal liability that can come from failing to adequately screen patients for suicide risk and taking the proper steps when needed. The remorse a physician may face over missing signs can be compounded by legal action claiming the physician is accountable for the patient's demise. A consistent and formal screening process, plus a response plan, will protect both the patient and the physician.

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Whistleblowers in Health Care- What's a Company To Do? Print E-mail
Written by Anne Novick Branan   
Thursday, 24 November 2016 00:00

Joe, the Practice Manager at a local medical group, cringed as he spied Susan, one of the nurses at the practice, marching toward him with an anxious, yet determined, look on her face. About two months ago, Susan confided in Joe that she heard that certain physicians in the medical group were accepting expensive sports event tickets from diagnostic centers to which the physicians frequently referred patients.

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Last Updated on Friday, 25 November 2016 17:44
Facing Addiction in America Print E-mail
Written by FHInews   
Monday, 21 November 2016 18:31

U.S. Surgeon General Vivek Murthy, MD, MBA released a landmark report on the country's addiction crisis on 11/17/16 entitled The Surgeon General's Report on Alcohol, Drugs, and Health.

According to the author:

Substance use disorders represent one of the most pressing public health crises of our time...Fifty years ago, the landmark Surgeon General's report on the dangers of smoking began a half century of work to end the tobacco epidemic and saved millions of lives. With The Surgeon General's Report on Alcohol, Drugs, and Health, I am issuing a new call to action to end the public health crisis of addiction.

Read more in the current issue of Week in Review>>

Last Updated on Monday, 12 December 2016 14:59
Their brains had the telltale signs of Alzheimer's. So why did they still have nimble minds? Print E-mail
Written by Sharon Begley | STAT   
Tuesday, 15 November 2016 19:06

The defective proteins that are widely thought to kill brain neurons and cause, or at least indicate, Alzheimer's disease do not always have that calamitous result, scientists reported on Monday, raising more doubts about conventional approaches to diagnosing and finding treatments for Alzheimer's.
The researchers analyzed the brains of eight people who died in their 90s and who had excellent recall until then. Three of the eight brains had the defining amyloid plaques and tau tangles of Alzheimer's, yet somehow were "immune to [their] effects," said neurologist Changiz Geula, of Northwestern University Feinberg School of Medicine, who led the study and presented the results at the annual meeting of the Society for Neuroscience in San Diego. "What's significant about these findings is that they show there can be high densities of plaques and tangles in the brains of some elderly individuals who are cognitively normal or even superior."

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Bending the Curve: Boynton Beach based Accountable Care Options Looks to the Future Print E-mail
Written by Jeffrey Herschler   
Tuesday, 08 November 2016 00:00

With 40 member medical practices and slightly more than 12,000 patient lives under management, Boynton Beach based Accountable Care Options ( isn’t the largest Accountable Care Organization (ACO) in Florida, nor does it strive to be. “Certainly that’s one strategy,” concedes Richard Lucibella, MHS, MBA, Director and CEO of the four year old company. “You could try to get real big, real fast with a goal of achieving economies of scale. For us though, it just made sense to grow steadily with quality-focused, like-minded physician partners.”

This strategy appears to be paying off. Three contract years are in the books (2012/2013, 2014 and 2015) and all have resulted in shared savings. “Our PCPs split $7 million in shared savings with the network last year and we are on track for continued success this year,” states Mr. Lucibella. Talk about the Triple Aim among healthcare professionals and you will often be greeted with a cynical look of resignation or perhaps outright derision. Not so with Mr. Lucibella who enthusiastically states that “The Triple Aim is not a pie in the sky goal. We are expanding the definition of medicine to what it should be.” A graduate of University of Pennsylvania’s Wharton School, Mr. Lucibella began his career with the Health Care Financing Administration (Medicare) and was directly involved in the original Medicare HMO risk projects. He has been active in South Florida Medicare risk programs since the mid 1980’s.

As to the future, Mr. Lucibella is quite blunt. “We are aggressively taking on risk. Payer’s don’t want it and most practitioners can’t bear it. But we know how to manage it and profit from it,” he states. Although many primary care doctors fear the good old days are over, the shift to value based care will be a boon to primary care practitioners, according to Mr. Lucibella. “This is revenge of the PCP,” he asserts. Taking additional risk allows Accountable Care Options a SNF waiver, a tele-health waiver and potentially a post acute care waiver. These concessions create resources that can be devoted to expanding chronic care management programs that end up reducing cost in the long run. “If it serves the Triple Aim, the government is going to OK it. This is the smartest CMS we’ve had in thirty years,” states Mr. Lucibella.

Mr. Lucibella is particularly excited about their newly developed ‘Chronic Care Management Program on Steroids’ that targets the 5% of their patient population at highest risk. The full arsenal of resources, including physicians, NPs/PAs, nurses, MAs, behavioral health professionals, pharmacists (through a partnership with Nova Southeastern University), paramedics, palliative care professionals and (soon) nutritionists, is deployed. 

With skepticism rampant in today’s health industry I had to ask Mr. Lucibella if he really believed we could bend the cost curve. “Absolutely,” was his immediate reply. “We are also going to bend the quality curve.”

EDITOR’S NOTE: We first interviewed Mr. Lucibella in  2014. You can read that article HERE>>

Last Updated on Wednesday, 09 November 2016 11:14
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