March 2014 - IPA of Nassau/Suffolk Countries

IPA of Nassau/Suffolk Counties welcomes our new members:
Pamela Basuk, MD
Dermatology
Bay Shore
Barry Solomon, MD
Dermatology
Dermatique
Smithtown
Stephen Warman, MD
Otolaryngology
ENT Associates of NY
Levittown
Joshua Rosenthal, MD
Otolaryngology
Innovative Otolarnygology, P.C.
Huntington
Noah Zinkin, MD
Otolaryngology
Innovative Otolarnygology, P.C.
Huntington
Abram Mozes, MD
Cardiology
Island Cardiovascular Assoc.
Smithtown
William Spencer, MD
Otolaryngology
L.I. Otolaryngology & Pediatric Airway
Huntington
James Higgins, DO
Family Medicine
Long Island Advanced Healthcare
East Islip
Khalid Noori, MD
Family Medicine
Long Island Comprehensive Care
Deer Park
Salvatore Giantinoto, DO
Family Medicine
Long Island Family Medical
West Islip
Paul Bermanski, MD
Gastroenterology
North Country Medical Associates
Huntington
Richard Fried, MD
Gastroenterology
North Country Medical Associates
Huntington
David Purow, MD
Gastroenterology
North Country Medical Associates
Huntington
Jagpreet Dhillon, MD
Internal Medicine
North Country Primary Medical Care
Miller Place
John Muratori, MD
Family Medicine
Ocean Family Medicine
Bayshore
Peter Klein, MD
Dermatology
Port Jefferson Dermatology
Port Jefferson Station
Adam Korzenko, MD
Dermatology
Port Jefferson Dermatology
Port Jefferson Station
David Silverstein, MD
Dermatology
Port Jefferson Dermatology
Port Jefferson Station
Sherman Chan, MD
Urology
Progressive Urology
Manhasset
Dimitri Kessaris, MD
Urology
Progressive Urology
Manhasset
Michael Ohebshalom, MD
Urology
Progressive Urology
Manhasset
John Gil, MD
Family Medicine
Rocky Point Medical Care
Rocky Point
Dinesh Sethi, MD
Internal Medicine
Smithtown Medicine & Geriatrics
Nesconset
Marc Lewandoski, DO
Internal Medicine
South Shore Medical Care
Deer Park
Balveen Singh, MD
Cardiology
The Huntington Heart Center
Huntington
Daria Blyskal, MD
Family Medicine
East Islip
Michael Ladinsky, DO
Family Medicine
East Islip
Lawrence Northorn, DO
Family Medicine
East Islip
IPA Board of Director Members
John L. Franco, MD
President & Medical Director
Mohammed Azaz, MD
Family Practice
Edward Lipinsky, MD
Otolaryngology
Robert Lazar, MD
Gastroenterology
Steven Parry, MD
Family Practice
John Muratori, MD
Family Practice
Richard Schoor, MD
Urology
Michael Shanik, MD
Endocrinology
IPA Executive Administration
Michael A. Guarino
Executive Director
John L. Franco, MD
President/Medical Director
Francis DiMotta
Chief Operations Officer
JoAnn Marino
Marketing Director
Quality Care Committee Members
John L. Franco, MD
President & Medical Director
Mohammed Azaz, MD
Family Practice
Michael Shanik, MD
Endocrinology
Anthony Spadaro, MD
Pulmonology
Spring 2014
President’s Message...
Are we on the menu yet? The last time I checked, there were
no entrees labels “pan seared physician” or desserts labeled
“physician foster.” However, the pressure is building and the
providers are being led to slaughter.
The uncertainty in the healthcare market has reached an all
time high. Providers must weather the storm that is covering the entire horizon.
We must take control of our destiny and prevent changes to our healthcare system
that will put patient and provider at risk.
Payment reform ICD-10, Population Health Management, HIPPA, SGR, Obamacare
and the exchanges are all fueling the uncertainty.
The IPA will continue its efforts to secure clinical/
financial integration and value contracts. We will remain
the force to keep physicians thriving, independent and
off the menu in this marketplace.
John L. Franco, MD
IPA Accomplishments
During this period of healthcare uncertainty, the leadership of IPA has
been hard at work and making great strides in keeping the IPA relevant
in the Long Island Healthcare Community.
Here is what we’ve been up to:
✚ successful recruitment to our current level of over 350
✚ numerous discussions with key healthcare leaders
✚ the second year financial partnership with Blue Cross Blue Shield
✚ including recruitment efforts of South Shore doctors
✚ numerous discussions with other health insurance companies
✚ initiated and developed an enhanced patient care program
in the BC/BS network
Robert Ruggiero, MD
Family Medicine
East Islip
Jay Stambler, MD
Internal Medicine
East Islip
of Nassau/Suffolk Counties
✚ multiple reviews of IPA physicians’ data regarding network
adherence and corrections to same
of Nassau/Suffolk Counties
761 Middle Country Road, Selden, New York 11784
P: 631-698-1900 • F: 631-698-2100
E: [email protected]
✚ a quality care committee
✚ direct visit contact with selected IPA physicians offices to
implement population health management tools
Reflections of 2013
As we reflect back on the 2013, the two prominent guest speakers at our IPA members
meetings last year were Michael Dowling of the North Shore – LIJ Health System and
Dr. Alan Guerci of the Catholic Health System. We can proudly say that we are at the
table trying to lead the healthcare change with both these health systems.
Michael Dowling, President of NS-LIJ addressed our members at the June meeting
and gave us a taste of how NS-LIJ was positioning themselves in the marketplace
and was eager to work with our IPA. Mr. Dowling, the leader of a $5 Billion Dollar,
non-profit healthcare system spent over two hours discussing the benefits of a
collaborative partnership with the IPA and concluded that a strategic alliance will have
a significant impact on its member physicians by establishing a standardized quality
of care, more clout with insurance companies, and a guaranteed outcome through
a “population risk value” payment model, all while maintaining the independence of
member physicians. Mr. Dowling announced that NS-LIJ was becoming an insurance
company, providing insurance products and services to the communities in their
service area. Mr. Dowling explained that this will allow physicians to regain control
of medicine from traditional insurance providers and provide improved health care
outcomes to patients.
Dr. Alan Guerci, President and CEO of the $1 Billion Dollar Catholic Health System
addressed our members at the November meeting and stated that in today’s
challenging healthcare climate, he was in favor of a PHO model and its effectiveness,
and does not believe that hospitals should be responsible for managing physician
practices. He went on to say that CHS did not want to employ more doctors. Dr.
Guerci was eager to have IPA members join their PHO and emphasized the many
benefits of partnering, which included access to IT expertise to help physicians
manage their practices, physician partnerships with equity positions, and enhanced
fee schedules. His background as a practicing physician has made him keenly aware
of the increasingly burdensome demands on providers and stated that “Unless we
treat the doctors’ right, they will all leave the PHO.” Dr. Guerci took questions from
our members and looked forward to aligning with the IPA.
Medical Update...
IPA to roll out Primary Care “Incentive” program
Today’s health care system is highly fragmented, is based on episodic intervention,
and shows inconsistent adherence to evidence-based guidelines. The Enhanced
Personal Health Care Program aims to change that by empowering Primary
Care Physicians (PCP’s) to engage in those comprehensive primary care
functions that move us toward a coordinated, evidence-based care model and
have the greatest impact on achieving the triple aim of improved quality, patient
experience, and affordability.
The doctor-patient relationship is the most important in health care. Every
patient should have a relationship with a primary care physician who knows and
understands their individual health care needs, can provide comprehensive
“whole patient” health care services, and will serve as their champion, helping
them navigate the complex health care system to ensure they get the care they
need when and where they need it. This is the key to improving quality and
outcomes and, subsequently, lowering costs.
The Enhanced Personal Health Care Program is
based on a simple principle – that primary care
physicians and their practice team, provided with
the right tools, information, and resources, are best
equipped to optimize the health of their patients
and improve the affordability of health care. In the
coming year, the IPA will be rolling out this program
to all our Primary Care members.
S2309-2013 - NY Senate Open Legislation - Allows certified nurse practitioners
to practice without collaboration of a licensed physician - New York State Senate
SUMMARY: NYS Bill S2309
Nurse Practitioners are essential in addressing the health care needs of New
York State Residents. With the influx of healthcare consumers because of the
Affordable Care Act and the current health care provider shortages, it is important
for policy makers to consider removing barriers to patient’s access to care by
Nurse Practitioners. Removing obstacles to Nurse Practitioner practice will ensure
the availability of sustainable and affordable care for all New Yorkers. Nurse
Practitioners understand the current focus on efficient chronic illness management
and navigating patient transitions through care.
Our New York state legislators are currently making critical decisions on the
future of Nurse Practitioner practice. Proposed bills range from simple removal
of barriers including removal of the written practice agreement by Senator
Montgomery’s Bill S2309 to varying levels of transition to practice. The Assembly
Budget includes language similar to Assembly member Gottfried’s Bill A4846. It
is important that you familiarize yourself with the actual language embedded in
these documents and understand the implications on providing patient care and
professional practice.
For more information, query http://open.nysenate.gov/legislation/bill/S2309-2013
In the News...
In a Health Affairs Blog entitled “Accountable Care Growth in 2014: A Look
Ahead,” David Muhlestein notes that there are now 606 ACOs in all 50 states
covering an estimated 18.2 million lives under commercial and public contracts.
The article examines what factors might affect the growth rate of the ACO
movement in 2014, including the forthcoming
release of first year results for the early
Medicare Shared Savings Plan ACOs,
the impact of political changes on both a
federal and state level and the importance of
consumer preference affecting ACO growth.
“Accountable care represents a paradigm
shift in how health care is delivered,” says
Andrew Croshaw, managing director and partner at Leavitt Partners. “The early
successes or failures of ACOs will directly impact how and where future ACO
growth will occur.”
This forward-looking analysis of the ACO landscape highlights several significant
aspects: • Physician groups continue as the predominant ACO sponsor type although
others are becoming increasing involved.
• Early results will play a significant role in helping non-ACO providers that are
closely watching the movement for both positive results and a model to follow.
• Federal legislation related to a permanent fix of the Medicare SGR and statelevel Medicaid programs could have serve as a catalyst in the proliferation of
ACO-like programs.
If you’re interested in viewing the full post, please visit Health Affairs-Blog Area.
In a Health Affairs Blog entitled “Medicare ACO’s: Mixed Initial Results and
Cautious Optimism,” David Muhlestein notes that active followers of health
policy have eagerly awaited the outcome of the early Medicare Accountable Care
Organizations, which could indicate how the overall accountable care movement
is progressing.
On January 30, the Centers for Medicare and Medicaid
Services released preliminary financial data for the
first two rounds of the Medicare Shared Savings
Program (MSSP) with mixed results. Of the 114 ACOs
in the program, only 54 of the ACOs saved money
and only 29 of those saved enough money to receive
bonus payments. While the 54 ACOs that saved
money accounted for a net savings of $128 million for Medicare, it’s uncertain if
those savings were offset by any losses from the remaining organizations. Overall,
the results were similar to last year’s 2012 Pioneer ACO results.
If you’re interested in viewing the full post, please visit Health Affairs-Blog Area.
Around Our Community...
Michael Guarino sat down with Susan Hughes, Vice President, SCNB, Smithtown
to discuss what’s new in banking services for physicians at SCNB.
MG: Can you tell about if Suffolk County National Bank offers any special services
to physicians?
SH: The answer is emphatically, YES. Of course we offer the full range of deposit,
loan and cash management –including lock box --for physician practices. This
niche is a special focus at SCNB.
This year, we have added something new for physicians, including Independent
Physicians. On the personal banking side, we also believe that professional
achievement has its rewards, and are pleased to offer SCNB’s Preferred Banking
for Accomplished Professionals. The new package is offered to physicians in
medical practices that maintain their primary banking relationship with SCNB.
It includes loan products such as an Executive Line of Credit, flexible terms on
Residential Mortgage Financing, an ATM rebate account (don’t you just hate
those pesky ATM charges?), free checking, a special money market account,
and more. We are very excited about this package, and our ability to extend our
banking relationships to the physicians in the practices we serve. We welcome the
opportunity to demonstrate how the extraordinary service we provide translates to
the consumer side for this professional niche.
For over 120 years, SCNB has served the needs of businesses and consumers
on Long Island with the highest levels of service in the industry. Loans are subject
to credit approval and residential mortgages are subject to credit approval and
appraisal. For more information, please contact Susan Hughes, Vice President
and Branch Manager at 631.979.3400 or at [email protected].
Shortage of Doctors Likely To Worsen
A recent article from the New York Times discussed the looming problem of a
doctor shortage. The Association of American Medical Colleges estimates
that in 2015 the country will have 62,900 fewer doctors than needed, and that
number will more than double by 2025 as the expansion of insurance coverage
and the aging of baby boomers drive up the demand for care. Providers say they
are bracing for the surge of the newly insured into an already strained system.