mississippi medical news march 2015

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Providing Relief for OAB and FI SufferersOxford physician leads region in InterStim procedures; the ‘go-to’ guy for urologists

OXFORD—When InterStim® therapy was FDA-approved in March 2011 for treating patients with fecal incontinence (FI) – 14 years after the federal agency approved it for use on overactive bladders (OAB) – only a scant number of specialty-trained urologists around the country began offering the innovative sacral neuromodulation therapy for bladder and bowel control ... 4

What’s Happening to our Safety Net?Changes, challenges of free clinics and covering the uninsured post-ACA

America’s free and charity clinics are undergoing a transformation, and not necessarily in a good way ... 7

March 2015 >> $5

PROUDLY SERVING THE MAGNOLIA STATE

William Waller III, MD

PAGE 3

PHYSICIAN SPOTLIGHT

ONLINE:MISSISSIPPIMEDICALNEWS.COMNEWS.COM

Baptist Health Systems Opens New Hospital in CarthageCritical access facility also consolidates rural clinics

MHA Pursues Provider-Sponsored Health Plan for MedicaidNonprofi t would compete against existing MCOs

By LUCy SCHULTZE

If the Mississippi Hospital Association has its way, the state’s medical community may soon be taking the fi rst steps toward a new healthcare model — one designed, ironically, to keep more people out of hospitals.

A vision for applying modern monitoring technology and research-based treatment methods to help keep people healthy is behind the MHA’s Mississippi Provider-Sponsored Medicaid Health Plan Playbook.

The Mississippi Legislature is considering in the current session several pieces of legislation that would open the door for the Playbook’s proposal. It aims to establish a nonprofi t, provider-sponsored health plan (PSHP) that would function as an insurance company and compete with existing managed-care organizations (MCOs).

As the Playbook has taken shape over the past few months,

MHA President/CEO Tim Moore has had his hands full simply in communicating with state leadership and as well as providers statewide across the healthcare continuum. As the 2015 ses-sion got underway in January, he was feeling good about how the concept was being received.

“I think it’s a little different from what ev-erybody was anticipating,” Moore said. “We’re talking about moving toward innovation, using technology and building a new business model. This is not just a social program. We’re going to take those tax dollars and do something different with them. That’s what’s got everybody so ex-cited.”

Claude Brunson, MD, president of the Mis-sissippi State Medical Association, said that while

the concept is still in its infancy, it appears to address many of the concerns physicians have had with existing for-profi t MCOs that

(CONTINUED ON PAGE 6)

By LUCy SCHULTZE

A new replacement hospital in a small community 30 miles east of Canton aims to maximize limited medical resources for the benefi t of the rural population.

Jackson-based Baptist Health Systems (BHS) opened its new 25-bed hospital in Carthage in December 2014. The 54,690-square-foot facility serves as a Critical Access Hospital for the Leake County area.

“The entire community has been very supportive,” said Daryl Weaver, CEO of Baptist Medical Center-Leake. “The opening of this hospital is a monumental occasion. Since the last hospital was


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By LUCy SCHULTZE

When William Waller III, MD, chose to enter medical school, it was a clear di-version from the path that had earned his family a place in Mississippi history.

The grandson of former Gov. Bill Waller and the son of longtime Missis-sippi Supreme Court Chief Justice Hon. William L. “Bill” Waller Jr., he neverthe-less had the support of his family in going his own way.

“People often assume that there might have been some kind of pressure from my family to enter the legal profession, but it was quite the opposite,” said Waller, a Hattiesburg dermatologist.

“They were very encouraging when I showed interest and aptitude toward science and medicine,” he said. “They thought medicine was a very noble pro-fession, so there was never any pressure to follow in my father’s or grandfather’s footsteps.”

In practice since 2011, Waller is a member of Hattiesburg Clinic’s Derma-tology-South group. His practice includes both cosmetic and medical dermatology.

“I really wanted to have a compre-hensive practice in which I managed ev-erything skin-related,” he said. “You find some dermatologists who do only medi-cal or cosmetic dermatology, but I really enjoy the diversity of doing a little bit of everything. It’s also very convenient to be able to offer our patients a one-stop shop.”

A native of Jackson, Waller was at-tracted to medicine as early as high school, when an anatomy and physiology class taught by a nurse helped inspire his ambi-tions.

“She was able to really infuse a lot of real-world stories into the book informa-

tion that we were learning,” he said. “It helped me see how much you could help people through medicine, whereas in a lot of other areas of study, you don’t have that real-world connection.”

Waller went on to attend the Uni-versity of Mississippi School of Medicine, followed by an internship in internal med-icine at St. Mary’s Medical Center in San Francisco, Calif. He completed a fellow-ship in clinical research in dermatology and a residency in dermatology at Tulane University in New Orleans, La. At Tu-lane, his work earned the Peterkin Award for the most outstanding original research in dermatology.

Waller was attracted to dermatology for its blend of medical and surgical as-pects, as well as for the opportunity to see patients from all age groups.

“I see patients from a couple of days

old to late in life,” he said. “I like being able to see a little bit of everything and being able to do procedures as well as pre-scription treatment and management.”

The visual aspect of the field was also a plus, Waller said.

“We don’t have to rely on x-rays or a lot of tests to make a diagnosis,” he said. “We can just look at something and know what it is. That kind of quick diagnostic ability is very gratifying for me, and for patients, too.”

When he completed his training, Waller was keen to stay close to New Or-leans and the relationships he’d built dur-ing his time there. He also preferred to join an existing organization rather than trying to launch his own practice from scratch.

Hattiesburg Clinic provided the per-fect opportunity. At Dermatology-South, Waller practices alongside Elizabeth Francis Rose, MD, who joined the prac-tice when it recently moved from its initial office to a bigger, new space at Thompson Park in south Hattiesburg.

“Although Mississippi is underserved with dermatologists, Hattiesburg has actu-ally become quite well-supplied with seven dermatologists and two mid-level practi-tioners,” Waller said. “Most patients here don’t have to wait longer than a week to get an appointment.”

The outlook for patient wait times is also improving statewide, Waller said, since the University of Mississippi Medi-cal Center established the Department of Dermatology in July 2013.

“In recent years, we have been able to attract a good many new dermatologists to the state, and most of them have set up practices in Jackson,” he said. “While that’s been a really positive development for dermatology in Mississippi, getting

an appointment is still fairly tight in most areas.”

To help accommodate patients, Waller provides a late day once a month when he sees patients until 6:30 p.m.

“The young dermatologists who are coming out of training are sensitive to peo-ple having to wait for appointments,” he said. “A lot of my younger colleagues are doing things like offering late and weekend hours to help accommodate the need.”

In his practice, Waller provides surgi-cal dermatology procedures such as skin cancer incisions and cyst removal, as well as medically treating conditions like psoria-sis and eczema. His cosmetic procedures include Botox and fillers, as well as laser procedures and chemical peels. He has also introduced tumescent liposuction for the removal of both deep and superficial excess layers of fat utilizing only local anesthesia.

While his career may have diverged from that which earned his father and grandfather their influential state offices, Waller is not without his own political leanings. He is active with state and na-tional medical societies, serving on the Council on Legislation for the Mississippi State Medical Association and as a rep-resentative to the American Medical As-sociation from the American Society of Dermatologic Surgery.

Waller is a diplomate of the American Board of Dermatology and a fellow of the American Academy of Dermatology. He continues to serve as a clinical assistant professor for the Tulane University School of Medicine in New Orleans, where he staffs a charity clinic every other month.

Outside of work, Waller is an avid traveler and enjoys staying active. He has recently developed a strong interest in cy-cling.

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Soon after Community Health Systems (CHS) announced that a half dozen of its hospitals in the Jackson/Vicksburg region had formed as a single regional healthcare system, Merit Health, news broke that Central Mississippi Medical Center, the largest of the six hospitals, had undergone an executive shakeup and was under federal investigation for alleged “patient dumping.” Next month, Mississippi Medical News will speak with CHS about changes – and charges – concerning the new pact.


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OXFORD—When InterStim® therapy was FDA-approved in March 2011 for treating patients with fecal in-continence (FI) – 14 years after the federal agency approved it for use on overactive bladders (OAB) – only a scant number of specialty-trained urologists around the country began offering the innovative sacral neuromodulation therapy for blad-der and bowel control.

Even though it’s easy to assume the lion’s share of discovery and testing on the Medtronic device emanated from major metropolitan areas, much of the early work actually took place in the tiny city of Oxford via urologist Doyle “Land” Ren-froe, MD.

Renfroe, founding partner of Oxford Urology Associates, near Baptist Memo-rial Hospital-North Mississippi in Oxford, has quickly become the “go to” doctor for InterStim, a reversible treatment that uses electrical pulses to stimulate sacral nerves just above the tailbone. He has arguably performed more InterStim procedures than any urologist in the South.

Problem Solving“I first began studying severe cases of

overactive bladder in the late 1990s.” said Renfroe, 52, who earned undergradu-ate and medical school degrees from the University of Mississippi, where he also ran track during college. “At that time, very few doctors in the United States were

doing the procedure.”Chuck Secrest, MD, at Mississippi

Urology, introduced Renfroe to InterStim therapy.

Medtronic’s bladder control therapy, delivered by the InterStim® system, has been FDA-approved since 1997 for uri-nary incontinence (UI) and since 1999 for urinary retention and significant symp-toms of urgency-frequency.

Here’s how it works: The sacral nerves – generally S2, S3 and S4 – ac-tivate or inhibit the bladder, sphincter

and pelvic floor muscles that contribute to urinary control. More specifically, S3 influences pelvic floor behavior. Electri-cal stimulation artificially excites nerve pathways that may activate or inhibit muscle action, depending on their normal function. Electrical pulses may stimulate somatic nerve fibers without prompting simultaneous contractions of the bladder. This may decrease the UI symptoms of urgency, frequency, urinary retention and urge incontinence.

Implanting the InterStim neuromod-

ulation system requires outpatient surgery with local and/or sedation anesthesia. The sacral neurostimulator is inserted under the skin via a small incision in the upper buttock. The long-term lead is im-planted under the skin, with one end of the lead connecting to the neurostimula-tor and the other lead end placed in the sacral foramen adjacent to the third sacral nerve (S3). Generated by the neurostimu-lator and delivered by the lead, the elec-trical stimulation modulates nerve activity to improve bladder and bowel function in many patients who were previously, many times, out of treatment options.

Each patient undergoes a test phase prior to final implantation to ensure a pos-itive response prior to implanting the per-manent neurostimulator. This therapy is not an option for patients with a mechani-cal obstruction of the urethra or prostate.

Taking OffSince completing his first InterStim

procedure in 2002, Renfroe has im-planted more InterStim neuromodulation systems than any doctor in the South. A simple screening test to verify candidacy for the therapy has driven patients to Renfroe, whose volume of Medtronic’s bladder control therapy cases continues to increase.

As a result of his success, Renfroe has spoken at the corporate offices of Medtronic in Minneapolis, Minn., dis-cussing the benefits of InterStim and case studies, and to other groups regionally.

“This procedure can absolutely re-store a patient’s quality of life,” Renfroe emphasized. “Patients with overactive bladders and fecal incontinence will fre-quently refuse to leave their homes for fear of not being able to quickly find a bathroom. It can become psychologically debilitating.”

InterStim therapy is a treatment for patients with chronic, debilitating symp-toms of voiding dysfunction who have been unsuccessful finding relief via medi-cation or diet alteration. Because this type of bladder dysfunction can have a crip-pling impact on a patient’s social and per-sonal life, effective therapy provides great potential for life-changing benefits.

“For patients who have reached that point, this can be a life-changer,” Renfroe said, pointing out that success rates for In-terStim therapy top 90 percent.

Other specialists have noticed the im-pressive results.

“Dr. Renfroe knows more about this procedure than just about anybody because he’s done more of them than anybody else in this part of the country,” said urologist Jeffrey G. Clark, MD, of Brookhaven. “Doctors seek advice from other doctors who have done certain pro-cedures. Land is the guy to see about In-terStim; there’s no question about it.”

Providing Relief for OAB and FI SufferersOxford physician leads region in InterStim procedures; the ‘go-to’ guy for urologists

Dr. Land Renfroe has arguably performed more InterStim procedures than any urologist in the southeastern US.


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cover outpatient Medicaid services under MississippiCAN.

“Only by placing physicians at the center of the decision-making process can we deliver higher-quality care at a lower cost,” Brunson said.

“The program outlined in this Play-book appears dedicated to improving the health and well-being of the Medicaid population. The integrated healthcare delivery system proposed represents the insights of dozens of organizations and healthcare stakeholders in Mississippi — and that is good for Mississippi Medicaid beneficiaries.”

The Playbook fulfills a pledge the MHA gave to the Legislature at the close of the 2014 session, to articulate not just why but how Medicaid could save money while keeping people healthier.

Last spring, the MHA gathered a steering committee of physician and ad-ministrative leadership from across the state to begin developing a new model to present to legislators. To help guide the project, MHA contracted with Evolent Health of Arlington, Va., which brought in additional support from Boston-based Spring Consulting Group. Manatt Health Solutions has been providing additional guidance in legal and regulatory require-ments. Additional work has been done by Horne, WiseCarter and Bradley Arant.

While the consulting groups have worked to find similar solutions in other states, Mississippi is different in that it is

one of a handful of states which has not expanded Medicaid under the Affordable Care Act (ACA). Pushing for expansion is not part of the MHA’s current agenda.

Currently, the Medicaid program provides care for more than 781,000 Mississippians — nearly a quarter of the state’s population.

Under the Playbook’s concept, a new health plan for Medicaid would focus on population health management (PHM), an approach that emphasizes preventa-tive services and helps the beneficiary stay as healthy as possible by engaging early to prevent acute-care episodes and expen-sive interventions like ER visits, hospital-izations, imaging tests and procedures.

In addition to promising cost sav-ings for the state, the proposal reflects the interest Gov. Phil Bryant and other state leaders have in supporting healthcare as an economic driver. According to the Playbook, the Mississippi PSHP would introduce competition among Medicaid MCOs, reinvest money through jobs that stay in-state, and boost workers’ produc-tivity through better health.

For physicians, the Playbook spells out benefits including more empower-ment and autonomy to appropriately care for patients, better access to data and improved financial security and sustain-ability.

The Playbook sketches out a three-year roll-out schedule that would begin with focused pilot programs in 2016 and

expand statewide in the second half of 2017. The plan envisions reaching out to include the inpatient population in the second half of 2018.

The Playbook’s agenda for the cur-rent Legislature includes adding statutory authority for a non-HMO entity such as the Mississippi PSHP to participate in managed care.

“We’re asking to be treated just like the managed care companies,” Moore said. “We will prove to everybody that a provider-sponsored plan can do a better job — both on the payment side and in the treatment of patients.”

Moore said the next steps would in-volve working with physicians to draft the new health plan — as well as continuing to communicate with everyone from hos-pital administrators to pharmaceutical groups to home health providers about how they can adapt to the new model.

“This is a whole different ballgame,” Moore said. “When we talk about sav-ing Medicaid money, we’re talking about cutting revenue to hospitals — and that requires an entirely new thought process within hospitals.

“We’re working on ways that some hospital jobs can be repurposed to focus on prevention, with payment on a per-member-per-month basis. That couldn’t happen within the first year. But, in time, if we can get good enough with the data elements to understand how the popula-tion reacts to treatment and protocols, we

can move to more arrangements like that. “Now you’re really talking about a

changing world.”

MHA Pursues Provider-Sponsored Health Plan for Medicaid, continued from page 1

What is MHA proposing in a Provider-Sponsored Health Plan?

• Nonprofit organization

• Designed, sponsored, governed and operated by the provider

• Patient-centric in nature and employing strategies to engage and activate patients and families in their care

• Emphasizing preventive services to keep patients as healthy as possible, through delivering prompt coordination of care at the right time

• Locally owned and managed within the state

The Mississippi Provider-Sponsored Medicaid Health Plan Playbook is available as a PDF on the MHA website, mhanet.org.


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By JULIE PARKER

America’s free and charity clinics are undergoing a trans-formation, and not necessarily in a good way.

According to a 2014 report by the National Association of Free and Charitable Clinics (NAFCC), patient demand has spiked 40 percent while dona-tions have dropped 20 percent.

“As soon as there was the perception of universal health-care, the likelihood of receiving donations goes down,” Colin McRae, JD, told the Wall Street Journal in December.

For the last two fiscal re-ports ending June 30, Orlando-based Shepherd’s Hope, one of the nation’s most successful free clinic networks, experienced a 22 percent increase in patient volume, seeing 16,973 patients in 2012-13, and nearly 21,000 patients in 2013-14. Based on trends, the free clinic expects patient volume to climb to 24,000 for the 2014-15 fiscal year.

“It’s a concoction of the most toxic kind without the resources to resolve it,” said Marni Stahlman, CEO of Shepherd’s Hope, noting a May 2013 report by the

Congressional Budget Office showed that even though the healthcare law is expected to reduce the number of uninsured by 25 million in 2023, 31 million Americans will remain uninsured. “The role of the free clinic is more critical than ever.”

Medicaid expansion, or the lack of it, lies at the heart of the problem.

In Medical News’ coverage area, Ar-kansas and Kentucky are among 28 states

that have expanded Medicaid. Alabama, Florida, Georgia,

Louisiana, Mississippi, Missouri, North and South Carolina, Ten-nessee, Texas, and Virginia are among 18 states that haven’t ex-panded Medicaid and aren’t likely to, with the exception of Tennes-see, one of four states anticipated to possibly expand in 2016.

David W. Strong, who will leave the University of North Car-olina (UNC) Health Care system next month to take over as CEO of the expansive Orlando Health network in Florida, pointed out an aspect of Medicaid expansion that doesn’t get much press.

“It’s important to note the bulk of every state’s Medicaid program is already funded by the federal government,” said Strong. “All

states are relying on significant federal funds now. Unfortunately, by not expand-ing Medicaid, Florida and North Carolina are among the biggest losers in the coun-try because of the population base. Ulti-mately, we all bear the burden for the lack of expansion because people will continue to seek care in our emergency depart-ments and facilities.”

Much national attention has been

placed on Florida, the nation’s fourth most populated state with 18 million residents and the highest percentage of 65 and older adults. The sunshine state ranks 41st on the list of highest volume of uninsured resi-dents nationwide.

“What you have is a really bad sand-wich. Without resources, insurance, or access to healthcare, many Floridians who’ve been captured in the healthcare coverage (Medicaid) expansion gap find themselves without anything,” said Stahl-man. “There’s also a gap on the high end.”

According to a 2014 Modern Health-care report, the nation’s busiest emergency room is Florida Hospital, with 206,800 visits to emergency departments at Flor-ida Hospitals in Altamonte, Apopka, Celebration Health, East Orlando, and Kissimmee – and Winter Park Memorial Hospital.

Orlando Health’s Orlando Regional Medical Center accounted for the nation’s fifth busiest ER, including emergency de-partments at the Arnold Palmer Hospital for Children, University of Florida (UF) Health Cancer Center, Dr. P. Phillips Hospital, Lucerne Hospital, South Semi-nole Hospital and the Winnie Palmer Hospital for Women & Babies.

What’s Happening to our Safety Net?Changes, challenges of free clinics and covering the uninsured post-ACA

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“Florida is at a particular disadvan-tage because we have one of the highest uninsured rates in the nation, and a com-paratively smaller percentage of residents on employer healthcare plans to absorb the cost,” said Florida Hospital CEO Lars Houmann. “Federal, state and local fund-ing sources cover some but not all costs. And so the burden is passed on to insured patients and their employers in what’s commonly called the cost shift … a hid-den tax applied to premiums, co-pays and deductibles.”

University of Florida economists pre-dict $4.7 billion in Medicaid dollars will be sent to other states in 2016, including nearly $400 million to Ohio, where Re-publican Gov. John Kasich has reduced the state’s budget by $404 million over two years by expanding coverage.

Despite previous opposition to the idea, recently reelected Florida Gov. Rick Scott announced more than two years ago that he supports a legislature-approved, three-year Medicaid expansion. How-ever, Scott, a Republican, hasn’t marked it priority.

Even with gubernatorial support, Tampa General CEO Jim Burkhart said Medicaid expansion won’t be an easy sell to state lawmakers.

“It’s going to be a pretty heavy lift because there are lots of people who think they know a different way, or don’t think we should do it at all, or only believe we should do it for people that don’t match up with what the federal government says you have to have in your criteria for the money to be made available,” he said. “At least discussion is ongoing. We’re hopeful it’ll continue and lead to something con-crete.”

Mississippi Gov. Phil Bryant, a Re-publican, has fi rmly said no, thanks. “For us to enter into an expansion program would be a fool’s errand,” in case Obam-acare is repealed or altered in a way that forces states to foot the bill,” he told the Associated Press. “We’d have no way to continue the coverage.”

While states continue to determine the best solution, ER visits are piling up. The average admission cost of an ER visit is roughly $4,600 versus the average cost of a visit to the free clinic valued at $77, said Stahlman, referring to 21,000 visits anticipated this fi scal year.

“Do the math on 21,000 visits last year, each valued at $77 ($1.6 million) versus $4,600 ($96.6 million),” she said. “The role of the free clinic is more critical than ever.”

built 65 years ago, we can assume that for many of us, the opening of a new hospi-tal in Leake County will be a once-in-a-lifetime event.”

The new facility replaces Leake County Memorial Hospital, which was owned and operated by the county gov-ernment. BHS purchased the existing facility in 2011 along with the county’s 44-bed nursing home and additional acreage of adjacent land with the intent of building a new hospital.

Weaver said the new facility rep-resents some three years of work and planning, including nearly 12 months of construction.

“I give the county credit for hav-ing the foresight to realize they needed a new hospital facility in their community and didn’t have the fi nancial resources to undertake it,” he said. “They were wise enough to partner with Baptist, and to-gether they shared this vision of providing a new hospital to serve this area.”

As a Critical Access Hospital (CAH), Baptist-Leake is certifi ed to receive cost-based reimbursement from Medicare. CAHs must be located in a rural area and be more than 35 miles away from an-other hospital. Baptist Medical Center in Jackson is the tertiary referral hospital for Baptist-Leake.

It, in turn, now receives patients who were previously served by four outpatient rural health clinics. The new facility con-solidates two of those into one large facil-

ity adjacent to the emergency room.“As a 15-room clinic, it’s large

enough to accommodate four providers at the same time,” Weaver said. “The clinic provides primary care and also of-fers extended hours like night and week-end coverage for people who can’t go to a doctor’s offi ce during standard business hours.”

Baptist-Leake also operates a small clinic for women’s services. Although the hospital does not accommodate deliver-ies, prenatal care and other women’s ser-vices are provided.

The hospital’s staff includes three pri-mary admitting physicians as well as fi ve employed nurse practitioners who staff the clinics. Another two family practice physicians are slated to join the staff in the coming years.

“We are really excited about them coming on board,” Weaver said. “These are both local folks who have gone to medical school and are in residency now. They will be returning to the community to practice.”

The existing medical staff as well as nursing staff and technicians all had an opportunity to provide input on the lay-out and design of the new facility, Weaver said.

The process, led by architects Dean and Dean/Associates, tapped that fi rm’s experience in designing critical access hospitals.

“One of the things unique about de-

sign in a hospital like this is having to ac-commodate smaller volumes of patients and staff,” Weaver said. “The nursing stations for our nursing unit and ER were purposefully constructed to be back-to-back, allowing us to share staff during peak and valley times in our patient cen-sus. That’s something you don’t have to think about in a larger hospital – but it’s very important in a smaller one.”

The hospital features a new 16-slice CAT scanner. It includes space to accom-modate the specialists who make weekly visits from Jackson to provide services like endoscopy, general surgery evaluation, podiatry and wound care. Baptist-Leake aims to expand services provided by visit-ing specialists in the months to come.

“We offer many of the same ameni-ties that you can get at any hospital in the Jackson area,” Weaver said. “But we have the advantage of being able to provide healthcare close to home. A lot of times, our services eliminate the need for mak-ing trips back and forth to the Jackson area. Especially for our elderly patients who may not drive or have transporta-tion, that offers a huge benefi t.”

For patients recovering from stroke, amputations, traumatic injuries and other

acute-care issues, Baptist-Leake is able to provide a swing bed program during their transition to home or to a skilled nursing facility.

The new hospital also includes an-other special new feature – a cafeteria, something the old facility didn’t have. Operated by Valley Foods, it serves pa-tients and visitors as well as the general public.

The moving process itself took some 30 days, with all the patients transferred by ambulance on a single day.

“Transitioning the emergency room was one aspect we had to coordinate care-fully,” Weaver said. “Since you have to provide continuous service, we literally closed the ER at 7 a.m. on the morning of Dec. 15 and opened the new ER at 7:01.”

As of January, BHS had not fi nalized plans for what will become of the old hos-pital facility.

“In today’s environment, virtually every rural hospital in Mississippi needs to be replaced,” Weaver said. “This in-vestment represents Mississippi Baptist Health Systems’ commitment to this community and to trying to ensure that healthcare continues to be accessible for the residents of Leake County.”

Baptist Health Systems Opens New Hospital in Carthage, continued from page 1

What’s Happening, continued from page 7

Online Event CalendarTo submit or view local events visit the Mississippi Medical News website.

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MS SW130271 MS Med News.indd 1 3/11/13 2:50 PM

By JULIE PARKER

During a critical time when free and charitable clinics for the uninsured in the United States are closing at a record pace, one nonprofit healthcare provider has adopted an unduplicated, recognized national model so highly regarded that its principal leaders were invited in 2012 to the White House as part of a delegation to discuss national intervention strategies for the uninsured.

Founded in 1997 by Rev. William S. Barnes, PhD, Shepherd’s Hope has grown into a network of five free clinics in Cen-tral Florida that’s remained not only vi-able, but is flourishing.

“We’re unaware of any free clinic in the country that takes the elaborate array of multi-faith, community, hospitals, and clinical and lay volunteers and weaves them all together with no one group’s agenda superseding the mission,” said Marni Stahlman, CEO of Shepherd’s Hope. At least in Florida, the nation’s fourth most populous state with 18 mil-lion residents and the highest percentage of adults 65 and older, “no other model has the intricate system of primary and secondary disciplines in place to provide the delivery of high-quality, compassionate patient-centered care

to this medically underserved and un-insured segment of the population.”

Responding to Community Needs

Even though the original mission of Shepherd’s Hope was to serve the urgent health needs of the uninsured who were living at 200 percent or below the federal poverty guidelines, Shepherd’s Hope has morphed into the role of secondary/spe-cialty care clinical provider.

“Over the last few years, we’ve seen a new mix of individuals who find them-selves entering the safety net community for healthcare services for the first time in their lives,” said Stahlman. “Some were even previous donors! Now they’re stand-ing in line, telling us, ‘I’ve never not had a doctor, I have no idea what to do.’ We’ve become the alternative to the emergency department, hoping to mitigate the finan-cial impact to our community.”

For the last two fiscal reports ending June 30, Shepherd’s Hope has experi-enced a 22 percent increase in patient vol-ume, providing 16,973 patient visits and medical services in 2012-13, and nearly 21,000 patient visits and medical services in 2013-14. Based on trends, the free clinic expects patient volume to climb to 24,000 for the 2014-15 fiscal year.

Roughly one-third of Shepherd’s Hope urgent care patients return for sec-ondary specialty care services.

“For example, we might have a fe-male patient with upper respiratory prob-lems who hasn’t had a mammogram in eight years,” said Stahlman. “We’ll refer them for a screening with our partners. Then if a breast cancer diagnosis is made, they’re referred to our other specialty partners.”

A Very Busy LandscapeCentral Florida is already one of the

nation’s busiest metropolitan areas for ur-gent and emergency care. According to a 2014 Modern Healthcare report, the na-tion’s busiest emergency room is Florida Hospital, with 206,800 visits to emer-gency departments at Florida Hospitals in Altamonte, Apopka, Celebration Health, East Orlando, and Kissimmee – and Win-ter Park Memorial Hospital.

Orlando Regional Medical Center accounted for the nation’s fifth busiest ER, covering emergency departments at the Arnold Palmer Hospital for Children, University of Florida (UF) Health Cancer Center, Dr. P. Phillips Hospital, Lucerne Hospital, South Seminole Hospital and the Winnie Palmer Hospital for Women & Babies.

Both hospital systems, along with Central Florida Regional Hospital, are Shepherd’s Hope’s primary partners. Last year, the trio of healthcare networks pro-vided the free clinics with nearly $22 mil-lion of in-kind contributions and services. Many of the more than 500 volunteer doctors, physician assistants, nurse prac-titioners and nurses at a Shepherd’s Hope clinic nightly are coming from work as an employee at one of these hospitals.

“The average admission cost of an ER visit is roughly $4,600,” Stahlman pointed out.

“We reported roughly 21,000 patient visits and medical services last year, where we didn’t charge patients anything. Those visits are valued at $77. Do the math on that ($1.6 million), versus $4,600 times 21,000 ($96.6 million), you can easily see why it’s a good investment for Shepherd’s Hope to be here. Our hospital partners get it right away.”

Momentum has prompted other healthcare providers to jump on board. In 2014, Shepherd’s Hope initiated a pilot project to attract more pediatric providers.

“Only about 8 percent of our popu-lation is 18 and under,” Stahlman ex-plained. “It’s not because they don’t come; it’s because we don’t have enough pedi-

Shepherding a FlockHow Shepherd’s Hope bucked trend with innovative healthcare model and thriving network of free clinics



diology and endocrinology.That collaboration is allowing children

and families in the region to stay close to home for higher levels of care. The new clinic is located at Journal Business Park off South Green Street.

Children’s of Mississippi, part of UMMC, encompasses all pediatric services available at UMMC and its Batson Children’s Hospital and at clinical sites throughout Mississippi, including the new clinic in Tupelo.

UMMC hopes to continue increasing access to pediatric subspecialists by locat-ing additional physicians in Tupelo.

UMMC’s added presence in Tupelo fol-lows the September 2014 move of NMMC’s pediatrics unit from the main hospital to its Women’s Hospital at 4566 S. Eason Blvd. The move relocated inpatient services for women and children under one roof, said Ellen Friloux, NMMC administrator for wom-en and children’s services. It also provided more room to grow pediatric services.

On Jan. 2, UMMC began providing pe-diatric hospitalist services at NMMC Wom-en’s Hospital. The pediatric hospitalist, Dr. Jana Sperka, consults with pediatric patients in the Emergency Department and provides hospital care for children on the pediatrics unit. Sperka completed her pediatric resi-dency training at East Carolina University and a fellowship in critical care at the Medi-cal College of Wisconsin.

A second full-time pediatric hospitalist will join the staff this summer. NMMC pe-diatricians will continue to care for babies in the nursery, and neonatologists care for fragile newborns in the Neonatal Intensive Care Unit.

UMMC subspecialty pediatricians now treating patients in Tupelo in affiliation with NMMC include Dr. Jessica Sparks Lilley, a pediatric endocrinologist and faculty mem-ber at UMMC and Batson Children’s Hospi-tal; and Dr. Salwa Morcos Gendi, a pediatric, fetal and congenital cardiologist also on the UMMC faculty. Drs. Lilley and Gendi are re-locating their clinic practice from NMMC’s East Tower to the new location on Service Drive.

Lilley established a full-time practice in Tupelo in January 2014 and treats children with diabetes and other endocrine condi-tions, such as disorders related to growth and puberty.

A Belmont native and Mississippi State University graduate, Lilley joined UMMC in July 2013 as an assistant professor after completing a fellowship in pediatric endo-crinology at Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nash-ville. She earned her medical degree from Vanderbilt University School of Medicine and completed a residency in pediatrics at Children’s Hospital of Philadelphia, Pa.

Her honors include an American Heart Association Epidemiology Tahoe Fellow-ship, the 2010 Children’s Hospital of Penn-sylvania Pediatric House Staff Humanitarian Award and the Women in Endocrinology’s Young Investigator Award. In 2011 she won the Pennsylvania Academy of Dermatology Outstanding Service Award for her advoca-

cy work on sun safety in children following her own melanoma diagnosis six years ago.

Gendi established a full-time practice in Tupelo last summer and has more than 28 years’ experience and extensive training in non-invasive imaging. She completed a pediatric cardiology fellowship at Rush Uni-versity Hospital and holds a master’s degree in cardiovascular medicine and a medical degree in cardiovascular medicine from Cairo University School of Medicine in Cai-ro, Egypt. She also completed residencies in internal medicine and cardiology and an echocardiography fellowship at Cairo Uni-versity Hospital.

Gendi worked as a pediatric cardiolo-gist and oversaw the congenital echocar-diography lab at Hamad Medical Center in Doha, Qatar. She completed a residency in combined medicine and pediatrics at Hurley Medical Center in Flint, Mich., and earned a master’s degree in clinical research from Rush University.

Family Medicine Welcomes PotterJeffrey N. Potter, MD, recently joined

Hattiesburg Clinic Family Medicine.Dr. Potter received his

medical degree from Jeffer-son Medical College in Phil-adelphia, Pa., and served a family practice internship and residency at Harrisburg Hospital in Harrisburg, Pa.

Dr. Potter is board certified by the American Board of Family Medicine. He is a member of American Academy of Family Physicians and the Pennsylvania Academy of Family Physicians. He joins William R. Arnett, MD; Ronald A. Bullock, MD; Valerie N. Evans, MD; and Matthew D. McClain, MD.

Baptist welcomes new nephrologist to staff

Baptist Memorial Hospital-Golden Tri-angle welcomes new nephrologist Angela M. Riley, MD to its medical staff. Dr. Riley has recently joined Nephrology Associ-ates, in Columbus.

Originally from Madi-son, Miss., Dr. Riley received her bachelor’s degree in biology from Belhaven College in Jackson. She earned her medi-cal degree from the University of Tennes-see College of Medicine in Memphis. She completed an internal medicine residency, served as chief resident and concluded with a fellowship in nephrology all at the Univer-sity of Tennessee Health Science Center in Memphis.

Dr. Riley is board certified in both in-ternal medicine and nephrology. She is a member of the Renal Physician Association, the National Kidney Foundation and the Mississippi Medical Association.

Dr. Riley and her husband Kerry have two children.

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GrandRounds

atric clinical volunteers. We approached Nemours in late July to streamline a pro-cess for uninsured children to get required school physicals at Shepherd’s Hope. With no primary medical home of their own, over two days, our two teams saw 108 children at two locations. That’s re-markable.”

Last October, Shepherd’s Hope and Sand Lake Imaging aligned for a Pink Oc-tober initiative, which garnered 219 free mammograms.

And while other free and charity clinics across the country are floundering because of funding shortfalls and what some experts view as the misperception of universal healthcare, Shepherd’s Hope augments its operating budget with three successful, community-rooted annual fun-draising events – Call to Hope Breakfast in April, Celebrity Golf Classic in July, and Famous Faces Masquerade Ball in Octo-ber.

“We’re very grateful for the support of the local physician and practitioner community,” she said. “Their support makes us very distinctive.”

Shepherding a Flock, continued from page 9

Hospitals Join to Form New Regional Healthcare Delivery System

Six hospitals in the Jackson/Vicksburg region, all affiliated with Community Health Systems, have formed a single regional healthcare system, Merit Health. The mem-ber hospitals have been known as Central Mississippi Medical Center in Jackson, River Oaks Hospital and Woman’s Hospital in Flowood, Crossgates River Oaks Hospital in Brandon, Madison River Oaks Medical Center in Canton and River Region Health System in Vicksburg.

The hospitals will join forces to share best clinical practices for quality care, achieve operational efficiencies, create or-ganizational scale to enable the addition and expansion of important services, and expand access to primary and specialty care across the central Mississippi region. The combined system has more than 1,200 licensed beds, 3,300 employees and 1,800 physicians on active medical staff.

The six hospitals included in the new health system have been meeting the needs of their respective communities for many years. By joining forces, the hospitals will have the scale to expand and improve services, while bringing about operational efficiencies.

New signage is going up, and each hospital had celebration events.

NMMC, UMMC Collaborate To Advance Pediatric Services

A new pediatric clinic in Tupelo offered by the University of Mississippi Medical Center through a collaboration with North Mississippi Medical Center is providing care to children in subspecialties that include car-

Dr. Angela M. Riley


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