Florida’s Health Care System Ranked 48th In The Nation

Florida ranks No. 48 in a new ranking of state health care systems (and the District of Columbia) published by The Commonwealth Fund, a private foundation that works to achieve better better health care access for low-income Americans, the uninsured, minorities, young children and elderly adults. 

Overall, the state’s health care system worsened since last year’s ranking. Deaths from suicide, alcohol and drug use increased during the period studied, according to the report, which contributed to the drop in ranking. The portion of people 64 and younger without insurance, meanwhile, improved.

 

Source: Sarasota Magazine

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WellCare To Acquire Meridian For $2.5 Billion

WellCare Health Plans, Inc. (NYSE: WCG) announced that it has entered into a definitive agreement to acquire Meridian Health Plan of Michigan, Inc., Meridian Health Plan of Illinois, Inc., and MeridianRx, a pharmacy benefit manager (PBM), (collectively, “Meridian”) for $2.5 billion in cash. The transaction is expected to close by the end of 2018, subject to customary closing conditions, including regulatory approvals.
Meridian expects to generate more than $4.3 billion in total revenue in 2018. As a result of this transaction, WellCare will diversify its Medicaid portfolio through the addition of Michigan, where Meridian has the No. 1 Medicaid market position; deepen its Medicaid business in Illinois; and acquire an integrated PBM platform.
Meridian is one of the largest privately held, for-profit managed care organizations in the U.S. and serves approximately 1.1 million Medicaid, Medicare Advantage (MA), integrated dual-eligible and Health Insurance Marketplace members as of May 1, 2018 in Michigan, Illinois, Indiana and Ohio. With a high-performing culture, Meridian has dedicated more than 20 years to providing compassionate and quality care to its members as demonstrated by achieving high quality ratings from the widely respected National Committee for Quality Assurance (NCQA) for its Medicaid health plans in Michigan and Illinois.

“Meridian is a well-performing health plan, and WellCare and Meridian share a similar commitment to serving our members through a comprehensive, integrated approach to healthcare,” said Ken Burdick, WellCare’s CEO. “This transaction strategically aligns with our focus on government-sponsored health plans, will strengthen our capabilities and growing business, and will meaningfully advance our growth agenda.”

“WellCare’s unwavering commitment to improving the lives of its members makes it an ideal partner,” said David B. Cotton, CEO of Meridian. “Our similar missions, values and goals, combined with WellCare’s dedication to providing an unparalleled member experience, including access to high quality healthcare, were key factors in our decision.”

Meridian has approximately 508,000 Medicaid members in Michigan and 565,000 Medicaid members in Illinois as of May 1, 2018.1 Upon closing, WellCare will have the No. 1 Medicaid membership market share in Michigan and Illinois, increasing its leading market position from four to six states. WellCare will also expand its MA business through the addition of Meridian’s 27,000 MA members in Michigan, Illinois, Indiana and Ohio.1 In addition, as a result of this transaction, the company will add an integrated PBM platform that provides a wide range of services and product offerings to both Meridian’s members and third parties.

Financial Benefits and Transaction Details

The transaction is expected to produce $0.40 to $0.50 of accretion to WellCare’s adjusted earnings per share in 2019, $0.70 to $0.80 of accretion in 2020, and $1.00+ of accretion in 2021, inclusive of $30 million to $40 million in synergies that will ramp up over the next few years and exclusive of one-time transaction-related expenses of $75 million to $85 million and cumulative integration-related expenses of $50 million to $60 million.
WellCare expects to fund the transaction through a combination of cash on hand, the company’s undrawn $1.0 billion revolving credit facility, and, subject to market conditions, new debt of $600 million to $1.0 billion and new equity of $800 million to $1.2 billion. The transaction is not contingent upon financing, and WellCare has secured $2.5 billion in committed bridge financing.
Source: Florida Trend
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The Healthcare Sector Embraces Micro-Design

The past five years have seen a shift in healthcare toward leaner facilities design. For example, more micro-hospitals –small-scale inpatient facilities with eight to 15 short-stay beds-are popping up these days in an industry dominated by megahospitals. Nineteen states and counting now have at least one micro-hospital.
In addition to hospital downsizing, a shift in senior living toward smaller communities is taking place, and, due to consumer demand and rampant retirement insecurity, there’s an anticipated shift toward micro-sizing individual units within assisted living facilities.

Smaller Footprint, Lasting Impression

Micro-hospitals are fully licensed hospitals that meet a need not met by urgent care centers or freestanding emergency departments, neither of which offers inpatient care. Looking to fill a niche, micro-hospitals generally offer services in accordance with community needs.
Micro-hospitals have been described as “no-frills” facilities and are often positioned as a way to cut healthcare costs. At the same time, they offer patients the promise of a premium experience through personalized care. Industry experts claim that the smaller hospital format fosters patient satisfaction and better outcomes.

A Real House, Not a Warehouse, for Seniors

Seniors these days don’t want to live in what has been labeled as “geezer ghettos,” nor will they settle for institutional-looking living facilities. Increasingly, assisted living services are being offered in residential care facilities, located in converted homes with onsite or live-in caretakers and anywhere from two to 10 residents. They provide for a homey environment within a traditional neighborhood. Moreover, a smaller community and care-provider-to-resident ratio allow homes to cater to distinct needs and demographics, such as shared dietary restrictions or religious affiliations.
A new pilot project at The University of Southern Indiana is advancing the idea of “aging in community,” which recognizes that seniors who have special housing requirements don’t want to be segregated from the rest of society or warehoused in institutional settings. The MAGIC Project will create a multi-ability, multi-generational, inclusive community (MAGIC) housing model shared by college students and older adults. The project starts with a MAGIC Model House on or near campus and will eventually develop a model framework for building multi-generational, inclusive communities. The concept for a pod-type MAGIC community could be implemented on a university campus or in a community setting.

Downsizing in a Big Way

It wasn’t long ago that “bigger is better” was the prevailing trend in assisted living facility design. Between 2006 and 2009, the number of apartments in assisting living communities decreased from a nationwide average of 63 to 54, reflecting a practice of combining two units to accommodate residents who preferred larger living spaces. At that time, one-bedroom units surpassed studios as the preferred ALF floorplan, allowing residents to keep more of their belongings, which made them feel more at home.
A decade later, feeling “at home” may not hold the same appeal. A 2014 report from the Joint Center for Housing Studies at Harvard University found that the majority of seniors over 50 live in single-family suburban homes. And though the aging-in-place movement would have them stay there as long as possible, what happens in a lot of cases is seniors end up being stuck and isolated in large homes with yards they can no longer maintain, in car-dependent locations past the point when they can safely drive.
The need for accessibility and connectivity may drive a shift toward micro-apartments (generally under 400 square feet) in assisted living facilities located in urban or urbanist environments. Less space and stuff to take care of translates into more leisure time and, potentially, higher activity levels and more engagement. Aligning assisted living and micro-living makes sense not only in terms of engagement but also affordability.
Source: GlobeSt.
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Florida Hospital To Build Free-Standing Emergency Department In Northeast Lakeland

Plans are on the drawing board to open a free-standing emergency department in early 2020 on the property that Adventist Health System/Florida Hospital bought last year alongside Interstate 4 just west of Florida Polytechnic University.
Construction is expected to start in early 2019, according to Mike Schultz, chief executive officer of the West Florida Division of Adventist Health.
Demographic and population growth analyses are underway to determine whether to build a 12-bay or 24-bay emergency department, he said.

“We are in the process of planning a 10-year trajectory” that eventually is expected to include a full-scale hospital, Schultz said.

Adventist, a faith-based, nonprofit health care organization, is headquartered in Altamonte Springs and has 46 hospitals in nine states. In Florida, it owns 27 hospitals, and although it has hospitals across Central Florida, none is in Polk County. It also operates two stand-alone emergency departments in the Tampa area, three in the Orlando area and has plans to build three more within two years in the West Division area (Lakeland, Brandon and West Chase).
A stand-alone emergency department is a lower-cost entry into the Polk County market than a full-scale hospital, Schultz said.

“A hospital requires a certificate of need from the state, but an emergency department does not,” Schultz said. “We can present for a hospital later on when there is a proven need for in-patient beds.”

In August, Adventist Health paid $14,750,100 for three adjacent tracts of land totaling 104.1 acres between the interstate and University Boulevard in northeast Lakeland.

“The idea behind the purchase was anticipation of the rapid growth everyone sees coming to the Orlando and Tampa corridor along I-4,” said Schultz, who noted the tract has plenty of space for expansion into a full-service hospital.

Emergency Department

“All our free-standing EDs (emergency departments) are built in similar fashion and vary between 12 and 24 beds,” said Richelle Hoenes-Ahearn, director of corporate communications Florida Hospital, West Florida Division.

Free-standing emergency departments are staffed and equipped to care for patients in the same fashion as emergency departments attached to hospitals and must have CT scans, ultrasound, X-ray and on-site laboratory, Hoenes-Ahearn said. They treat patients for life-threatening illnesses or injury, such as heart attack, extreme fever, head injury or loss of limb, she added.
Patients with major trauma will still have to be transported to a Level I trauma center — in Central Florida, those are Tampa General Hospital and Orlando Regional Medical Center — or a Level II trauma center — in Central Florida, those are Lakeland Regional Health, Osceola Regional Medical Center in Kissimmee and Bayfront Health in St. Petersburg.

Hospital Projection

When Adventist representatives approached Lakeland city commissioners in July about the prospect of building a hospital within city limits, their proposal was a 200-bed facility.
That is still the size projected for when Adventist moves to the hospital-building stage, Hoenes-Ahearn said.
For comparison purposes, Heart of Florida Regional Medical Center in Haines City is licensed for 193 beds and Lake Wales Medical Center for 160 beds.
The hospitals closest to the Adventist property — Lakeland Regional Health, at about 9 miles away, and Winter Haven Hospital, at about 12 miles away — are licensed for 859 beds and 519 beds, respectively.

“We grew out of Orlando; that was our hub and base for 100 years,” Schultz said. “We merged with a major health system in Tampa in 2011, University Community Health, so we grew in that market. We have been in Avon Park for probably 25 years. It was not intentional to not be in Polk County before this. But as we see the population growth along the I-4 corridor, we feel the need to be there for residents who choose Florida Hospital.”

Nearby, Florida Hospital/Adventist operates hospitals in Celebration, Zephyrhills, Wesley Chapel, Carrollwood, Land O’Lakes, Apopka, Avon Park/Sebring, Wauchula and Altamonte Springs.
This year, Adventist purchased hospitals in Dade City and Ocala from the large, national for-profit chain Community Health Systems, which has been selling off hospitals nationwide in an attempt to improve its financial outlook.
Schultz said that Adventist has not been in negotiations to buy either of the CHS-owned hospitals in Polk County — Heart of Florida or Lake Wales Hospital.

Competitor’s Response

Steve Nierman, president of Winter Haven Hospital, said in a statement Florida Hospital’s plan does not affect the strategy of BayCare Health System in Polk County.

″Our strategy is mission-driven and carried out through our three hospitals, Bartow Regional, Winter Haven and Winter Haven Women’s, as well as through the many BayCare Medical Group practices, outpatient lab facilities, BayCare Urgent Care Centers and BayCare Home Health,” Nierman said. “We also continue to add convenient access with our Publix partnership, opening a Walk-In Care center at the south Lakeland Lake Miriam Square Publix in March, and another at the Haines City Mall next week.”

“Polk residents have many options for their health care needs,” Nierman said. ” Our role is to listen to those needs and make decisions based on them.”

Representatives from Lakeland Regional Health did not respond to a request for comment Thursday.
Source: News Chief
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2 Rival Healthcare Providers To Build Hospitals In Same Florida City

After a nine-month process, an administrative law judge approved construction proposals from two rival healthcare organizations — clearing the way for both providers to build a hospital in Venice, Fla., according to the Sarasota Herald-Tribune.
Here are nine things to know.
1. The law judge approved Sarasota (Fla.) Memorial’s proposal for a 90-bed hospital and Venice Regional Bayfront Health’s proposal for a 210-bed replacement facility.
2. The Florida Agency for Health Care Administration previously approved the construction projects for both organizations in December 2016. Less than a month after state approval, both healthcare organizations submitted a challenge against the other’s proposal.
3. The hearing about the projects took place in summer 2017, with weeks of testimony and more than 180 lengthy legal filings from each side. The judge’s ruling ended the nine-month legal battle.
4. In an 89-page order, Judge W. David Watkins upheld the state agency’s decision to approve both applications.
5. In his ruling, Mr. Watkins wrote that Sarasota Memorial’s evidence pointed to a need for the 90-bed hospital “based on the proposed service area’s growing population, SMH’s existing patient base in the proposed service area, and the need to improve geographic and financial access for service area residents who are currently traveling great distances to access inpatient services at the SMH main campus.”
6. Additionally, Mr. Watkins said Venice Regional’s project will allow for additional services in Venice, including a heart valve replacement program and enhanced neurosurgical and stroke care.
7. Both systems released statements about being pleased to move forward with construction.
8. The judge’s decision sends the case back to the Florida Agency for Health Care Administration for final approval. The state agency is expected to affirm its earlier approval.
9. The battle between the two systems over care delivery in south Sarasota County has been publicized for more than five years, according to the report. The saga began when Sarasota Memorial moved to open an urgent care facility a mile from Venice Regional.
Source: Becker’s Hospital Review
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