Category Archives: News

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Eat a Cupcake, Raise Money for Cancer Research

Indulge your sweet tooth December 3rd through the 9th at more than 25 Birmingham-area restaurants, bakeries, cafes, and catering companies, and your purchase will support the latest in cancer research at the UAB Comprehensive Cancer Center.

Area eateries will be selling specially-designed sweets all week with 100 percent of the proceeds going to the UAB Comprehensive Cancer Center.

View the full list here»

Sweet on a Cure was developed by the Young Supporters Board of the UAB Comprehensive Cancer Center to help fund research at UAB. Funds raised by Sweet on a Cure 2012 will specifically be used to support the work of promising young cancer investigators.

Learn more by visiting sweetonacure.org »

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Medicare, Health Care Reform and Rehabilitation Services

No matter where you stand politically, health care reform is here and will remain in some form or fashion.

Any health care professional who has treated Medicare and Medicaid patients for the past decade knows reimbursement rates have steadily declined, while regulations for operations have increased. This means providers receive less money but spend more time and resources on meeting regulations and handling paperwork. This is nothing new, but it is something Medicare patients were only recently made aware of.

As children of aging parents, health care providers for Medicare recipients or Medicare recipients ourselves, we need to know what is happening with Medicare today. As of September 1, every Medicare recipient in the United States who has claimed $1,700 of rehabilitation services should have received a letter from the Centers for Medicare & Medicaid Services (CMS) informing them of a $1,880 Medicare cap for these services. The letter states that if they go over this cap, they will be financially responsible for the cost of these services beyond the cap. Most individuals will assume this regulation is part of the current health care reform or is the result of a change, but it is nothing new. Most Medicare recipients just did not know this existed. The end result is that many patients will self-discharge and discontinue services out of concern over the cost. They will do this without taking into account the impact this will have on their long-term outcomes following surgery, stroke, etc.

So where is this coming from? Most Medicare recipients do not realize the program has been functioning under a Medicare therapy cap since 1997. As part of the Balanced Budget Act, rehabilitation services were placed under a $1,740 cap for therapy services. This meant a Medicare recipient could receive only $1,740 of combined physical therapy and speech therapy services and $1,740 of occupational therapy services before having to cover additional charges.

So, if a Medicare recipient has a stroke, he or she gets the following covered: 10 to 15 sessions of speech and physical therapy and 10 to 15 sessions of occupational therapy. If the stroke is severe, this level of service is not even close to what is needed to restore that individual to independent living and a satisfactory quality of life. As a result, in 2006, as part of the Deficit Reduction Act, CMS was allowed to put in place an exceptions process allowing those in need of more “medically necessary” treatment to apply for exceptions to the cap. Today, rehabilitation providers still function under that same cap, which has been increased to $1,880.

Under the previous legislation, only outpatient providers were held to this cap, and hospitals were exempt. However, as of October 1, this cap applies to hospital-based centers as well, and it will be retroactive to January 1, 2012. Therefore, anyone using these services in a hospital will now experience the same Medicare cap restrictions as those using outpatient centers. Because hospital services are reimbursed at higher rates than non-hospital-based services, patients in those settings will only receive eight to 10 covered treatments, versus more in a traditional outpatient setting. Early estimates are that this could impact 30% to 40% of patients treated in hospital-based rehabilitation centers.

What does that mean for your patients? For those patients who receive services in non-hospital-based outpatient centers, nothing changes. These centers have operated for the past 10 years using these guidelines. The only difference is that patients are now aware of it. For those in hospital-based outpatient centers, this will be a huge shift for managing these services. Most providers know about the exemptions process and how to access it if it is in the best interest of the patient. As a physician, your support is critical to ensuring the patient gets the care you prescribe, and ensuring your signature on the plan of care is crucial. For more information about this topic, visit www.apta.org.

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Jeremiah’s Hope Academy and Jefferson County WIA Team Up for Youth

The Jefferson County Workforce Investment Act Youth program has selected St. Vincent’s Health System’s Jeremiah’s Hope Academy (JHA) as one of a select few groups to partner with to assist youth in achieving their education and employment goals.

“Being a part of Jeremiah’s Hope Academy helped encourage me to want more and do more for my life,” explained Gabrielle Scott, a July graduate of the training program affiliated with St. Vincent’s Health System. Gabby, as she is known by family and friends, entered JHA with the support of the Jefferson County Workforce Investment Act (WIA) Youth Program. She is now a Certified Sterile Processing Technician and employed full time.

One challenge that often arises for recent high school graduates is the difficulty that young people face in finding purposeful work when they enter the adult work force. While college is not an option for many, everyone deserves the opportunity to find meaningful work in a setting that treats all persons with dignity.

St. Vincent’s Health System’s Jeremiah’s Hope Academy (JHA) is a licensed postsecondary school that provides training in seven entry-level healthcare careers. The education and training meets eligibility requirements for graduates to sit for national certification examinations. JHA has teamed with the Jefferson County WIA Youth program to provide a way for out-of-school youth, ages 18-21, to receive the training they need to become employed in one of the in-demand healthcare jobs in the Greater Birmingham area.

“The Jeremiah’s Hope Academy was truly a blessing from God. It was an awesome journey that was worth completing.  I tell all my friends they need to go to Jeremiah’s Hope!”

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The new president of Princeton Baptist Medical Center introduces herself.

From the C-Suite: Betsy Postlethwait, President, Princeton Baptist Medical Center

Q: What brought you to Princeton Baptist Medical Center?
A: I came to Baptist Health System and Princeton in 2004, shortly after I relocated to Birmingham from Houston, TX. I joined the system at a time of great change in the organization and felt that my skills as a health care executive could contribute to Baptist’s faith-based mission and vision for the future. I was particularly drawn to Princeton as the founding hospital for Baptist Health System, which began in 1922, and its continued commitment to the West End community.

Q: You mention that Princeton began as a faith-based ministry of healing. How has that shaped its culture?
A: I think “culture” is the key word. The cornerstone of who we are is our faith-based mission, which truly pervades everything we do. Princeton has a culture of compassionate care, and we take every opportunity to bring that faith into the healing environment for our patients and their families — and for our staff and physicians as well. Our culture is also one of clinical excellence. Again, it’s that compassionate, faith-based care that drives us to want to provide clinical excellence.

Our culture is very patient-centered. It’s reflected in our Patient Promise and the Baptist Experience. It’s recognized by our staff and demonstrated by their professionalism. We’re very proud of our team members and the professional excellence they display each day.

As we transition from the older, more traditional health care delivery model to a new, patient-centered one, we are seeing improvements in coordination for the patient’s continuum of care from pre-hospital care to post-hospital care. It’s a better way to keep patients healthy. The focus is on wellness, good health and caring for patients in a more holistic way.

Q: As Princeton Baptist Medical Center celebrates its 90th birthday, what excites you about the future? 
A: I believe the future is bright for Princeton. Health care organizations are in a challenging era of health care reform as we try to move from a fee-for-service based environment to an environment of bundled payment and value-based purchasing. The focus is clearly on providing the highest quality care to our patients at a lower cost. Fortunately, Princeton is prepared to do that. We are a very efficient organization, and we will continue to look at ways to build on that efficiency.

This year, we developed our Lean Innovation Council. The goal is for every staff member to look at processes in their department in a different way and identify ways to be more efficient, get rid of waste and provide excellent quality care based on what is valuable to our patients and families.

We’ve worked diligently on our Baptist Experience and our Patient Promise. I’m encouraged because the Princeton staff has really been engaged with that. We get letters from families that are so heartwarming. People truly sense the difference the Baptist Experience offers. “I’m here for you” is not just a phrase that everybody says; it’s something that comes from the heart of our employees. Their compassion and sincerity really speak to our patients and their families — it is speaking heart to heart; it’s genuine; and it’s making a difference. Anyone who comes to our campus can tangibly feel that difference, and that’s very exciting to me.

Q: What are your top three initiatives for the hospital in the coming year?
A: Within the next year, we will move into our newly constructed east expansion, which includes new operating rooms, new gastroenterology suites, new classroom space and a complete renovation of the space being vacated. This $57 million expansion will change the face of our facility and provide exceptional, cleared space to care for our patients. Also, we will complete the rollout of our electronic health record with the Epic system to improve the overall quality and safety of care for our patients. Our third top initiative is to continue our clinical integration journey with our physician-led, physician-driven organization, the Baptist Physician Alliance.

Q: What are your top strategic priorities over the next two to five years?
A: Like all health care providers, we face many strategic imperatives for the next five years as we navigate health care reform. At Princeton, we will be focused on managing our cost of care, improving our clinical outcomes, ensuring the care we provide is coordinated across the health care continuum, and continuing to work with our patients and their families so that they are empowered to take great ownership in their health care.

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