Moffitt Cancer Center, JSA Healthcare named in Modern Healthcare's "best places to work"

Modern Healthcare just released its list of the 100 "Best Places to Work in Healthcare" for 2009 with a whopping 11 of those places in Florida. That's more than either California or Texas can boast. Here's the complete list.

And of those 11 Florida places to work, here are the "winners' from the Tampa Bay area. (Modern Healthcare says it will rank these 100 best next month. We'll revisit then.)

* H. Lee Moffitt Cancer Center & Research Institute, Tampa. The not-for-profit institution includes private patient rooms, the Southeast’s largest blood and marrow transplant program, outpatient treatment programs that record more than 272,000 visits a year, the Moffitt Research Center, The Moffitt Clinic at Tampa General Hospital and the Lifetime Cancer Screening & Prevention Center. (Photo: Moffitt's Vincent A. Stabile Research Building. St. Petersburg Timesphoto by Toni L. Sandys.)

* JSA Healthcare, St. Petersburg: Its facilities include 30 primary care practices in the greater Tampa Bay and Orlando areas under the JSA Medical Group name. In addition, JSA is affiliated with 49 other primary care  practices. Here's a lengthy list of JSA's owned medical groups.

Other nearby "best places to work" on the list include Doctors Hospital of Sarasota and Lakewood Ranch Medical Center in Bradenton,

-- Robert Trigaux, Times Business Columnist  

How Moffitt's operating rooms got more efficient, saved $8 million in first year

While the nation quarrels over healthcare options, H. Lee Moffitt Cancer Center and Research Institute is trying to make its medical services -- or at least its surgeries -- more productive. A new Business Week article looks at how Moffitt last year hired GE Healthcare Performance Systems, a consulting group owned by GE's $17 billion health-care unit charged with making Moffitt's operating rooms run more efficiently. (Photo: Surgery at Moffitt by Mike Pease of the St. Petersburg Times.)

The story says Moffitt surgeons, nurses, and anesthesiologists grew frustrated because just 13 percent of operations started on time. Not even half of the first surgeries of the morning began promptly. And it could take up to an hour to turn the room around between cases. The delays meant fewer operations, and caused nurses and anesthesiologists to work overtime quite regularly, according to the story.

The bottom line? Business Week reports Moffitt's hospital implemented a range of  GE recommendations in April. And in June, Moffitt surgeons performed 106 more cases than they had in June 2008. Says Business Week:

"Based on the patient flow improvements achieved in the first months of operation, Braulio Vicente (see photo), Moffitt's senior vice-president and chief operating officer, estimates that the center will gain more than 3,000 hours of operating room time. That's enough to perform 900 surgeries—and $8 million in savings within the first year."

Imagine how much could be saved if all hospitals went through similar rigorous reviews.

Here's the complete Business Week story.

-- Robert Trigaux, Times Business Columnist

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Cryo-Cell International's Walton: Rising stem cell competition from public cord blood banks

Haven't heard much in some time about an Oldsmar business that stores stem cells in the form of cryogenically frozen umbilical cord blood. The company is Cryo-Cell International whose stock hit a low of 40 cents earlier this year before crawling over a buck in May. It now trades around $2.20 a share and the small company's market cap is just under $26 million. Not a barn burner, but it's holding its own in, as the company's own CEO recently acknowledged, an increasingly competitive industry.

Mercedes Walton, Cryo-Cell board chairman, was recently interviewed in a lengthy Q&A by something called BioMedReports. She's served as a director since October 2000, as chairman since June 2002, as interim CEO from April 2003 through August 2005 and as the CEO since September 2005. She has a background in strategic consulting and earlier served as AT&T’s vice president-corporate strategy and business development. She graduated from Smith College and holds masters degrees from Harvard University and the Massachusetts Institute of Technology. Cryo-Cell paid her $146,000 last year. (Walton photo courtesy of Cryo-Cell.)

The interview with BioMedReports appears on the Seeking Alpha Web site. Here it is in its entirety but there was one question that generated some interesting responses from Walton.

BioMedReport: What are some of your biggest challenges?

Walton (edited to hit the highlights): Well, I think that the challenges for the cord blood banking industry in general relate to the overall state of the economy and it’s impact on discretionary consumer spending, and I think another related challenge has to do with the growing prevalence of public cord blood banks.

There are a number of public banks that are funded both at the state and the federal level, and families can actually donate their cord blood specimens to these public banks, and they become part of the public registry, so many families that don’t have the discretionary income to store privately opt for this public alternative. So, the competitive landscape is shifting in a way that public banking is a formidable competitor of private banks in today’s environment.

-- Robert Trigaux, Times Business Columnist

How's Florida doing? Ten ways to compare its state of unemployment

Wake up and good morning. We know Florida's economy is still hurting, though there are a few signs of life out there. But one of the key ways to measure how we're doing is to see how other states are doing at the same time. So, using Bureau of Labor data just out, let's compare:

1. The largest over-the-month (July 2009 vs. June 2009) decrease in the level of employment occurred in California (-35,800), followed by North Carolina (-26,400) -- what's up Tarheels? -- Florida (-25,200) and Illinois (-13,000). (Mississippi's shown above, down 6,300, because it's a higher percentage decline than Illinois' decrease.)

2. The largest over-the-month increases in employment occurred in New York (+62,100), Michigan (+38,100) -- what happened to the auto crisis? -- Texas (+37,900), Tennessee (+15,600), and the District of Columbia (+13,200).

3. Fifteen states and the District of Columbia reported jobless rates of at least 10.0 percent in July.
Michigan continued to have the highest unemployment rate among the states, 15.0 percent. Florida and Tennessee are tied in 9th place with 10.7 percent unemployment rates. The U.S. average unemployment rate is 9.4 percent.

4. Over the year, 45 states experienced "statistically significant" changes in employment -- all decreases. The largest job losses occurred in California (-760,200), Florida (-401,100), Illinois (-286,500), Michigan (-280,800), Ohio (-254,700), Texas (-222,500), North Carolina (-221,900), and Georgia (-205,900).

5. One year ago, in July 2008, Florida's unemployment rate was 6.3 percent. It rose 4.4 percentage points in one year to 10.7 percent. Twelve states, led by Michigan, reported higher percentage point increases in unemployment than Florida over the past year.

6. Florida employed 7,354,800 in July 2009. It employed 7,380,000 in June 2009, and 7,755,900 in July 2008. That's a decline of 401,100 jobs over the past year.

7. In construction, Florida employed 427,700 in July 2009. It employed 429,900 in that field in June 2009 and 506,600 in July 2008. That's a decline of 78,900 construction jobs over the past year.

8. In manufacturing, Florida employed 329,300 in July 2009. It employed 331,000 in that field in June 2009 and 371,600 in July 2008. That's a decline of 42,300 manufacturing jobs over the past year.

9. In leisure and hospitality jobs, Florida employed 904,600 in July 2009. It employed 901,900 in that field in June 2009 and 945,000 in July 2008. That's a decline of 40,400 leisure and hospitality jobs over the past year.

10. And finally, let's end on a more upbeat note. In education and health services -- good news! -- Florida employed 1,048,900 in July 2009. It employed 1,046,500 in those fields in June 2009 and 1,043,500 in July 2008. That's an increase of 5,400 education and health services jobs over the past year.

-- Robert Trigaux, Times Business Columnist

With double-digit healthcare plan price hikes on the way, will pay gains be trimmed to pay for it?

Brace yourself-- especially those of you with frozen or even reduced salaries and wages. Another healthcare bill's about to smack you in the wallet.

Health care costs are expected to increase on average 10.5 percent in the next 12 months, says Aon Consulting, which tracks healthcare cost trends. Aon said it surveyed more than 60 leading health care insurers representing more than 100 million insured individuals.

The results? Not encouraging: Healthcare costs are projected to increase by:

* 10.4 percent for HMOs

* 10.4 percent for POS plans

* 10.7 percent for PPOs

* And 10.5 percent for CDH plans.

These hikes are slightly lower than one year ago, when HMO cost increases were 10.6 percent and POS plans were 10.5 percent. PPOs and CDH plan increases remain steady with last year's hikes.

Said John Zern, Aon Consulting's U.S. Health & Benefits Practice director: "While we're seeing a slight decrease in the trend rates, it's still at double digits, and this year, it's compounded by a struggling economy, lower wage increases, and in some cases, salary freezes."

Here's Aon's press release offering more details.

And here's the curve ball, thrown by Joseph Antos, an economist with the Washington, D.C.-based American Enterprise Institute for Public Policy Research. Antos, who was not involved with the Aon study, suggests companies could deal with rising health care costs by limiting pay increases. Antos told the AP:

"Employer contributions are not gifts, they're part of total compensation. And if you end up having a more expensive health benefit that your employer pays most of, that means that your wages aren't going to up as fast as they would have."

-- Robert Trigaux, Times Business Columnist

Study: Florida family health premiums up 3.7 times faster than earnings in past decade

Family health care premiums rose an estimated 3.7 times faster than earnings for Florida’s workers from 2000 through 2009, according to a report issued today by the consumer health organization Families USA. In that 10-year period, family health insurance premiums rose by 98.1 percent, while median earnings rose by only 26.7 percent.

"Rising health care costs threaten the financial well-being of families in Florida and across the nation," says Ron Pollack, Families USA executive director. "If health care reform does not happen soon, more and more families will be priced out of the health coverage they used to take for granted."

Families USA is a Washington-based advocacy group for universal healthcare. The study's key findings, out this morning, include:

* For family health coverage provided through the workplace in Florida, the average annual health insurance premium (employer and worker share of premiums combined) in the 2000-2009 period rose from $6,812 to $13,497—an increase of $6,685, or 98.1 percent.

* Between 2000 and 2009, the median earnings of Florida’s workers rose from $22,753 to $28,836—an increase of $6,083, or 26.7 percent.

These price hikes, of course, occurred at the same time that employees receiving “thinner coverage”— coverage that offers fewer benefits and/or that comes with higher deductibles, copayments, and co-insurance. Other employers have cut costs by placing limits on which employees are eligible for coverage or by eliminating coverage for spouses and children of employees. As a result, Florida families are paying more but receiving less in health coverage. Here's the entire report.

-- Robert Trigaux, Times Business Columnist 

Healthcare compensation survey: Lincare, Wellcare execs are big winners

Wake up and good morning. It's one big payday after another for some Tampa Bay area executives in the healthcare field. According to just published Modern Healthcare magazine's annual nationwide compensation survey, the big winners in executive pay for 2008 include John P. Byrnes, CEO of Clearwater-based home oxygen provider Lincare Holdings, who moved up to the top spot among specialty-care providers thanks to the largest gain in 2008 from exercising stock options of any CEO on the list. His total compensation was $11.7 million.

Byrnes earned the top spot among specialty providers because he had the highest proceeds in 2008 from exercising stock options, at nearly $8.5 million. Byrnes can thank his long tenure at Lincare, having become its CEO in January 1997 and joining the board of directors in May of that year, Modern Healthcare said. Byrnes declined to comment for the magazine story.

Another winner in the survey was Todd Farha (in photo), the former CEO of Tampa's WellCare Health Plans. According to Modern Healthcare, for less than one full month at the helm in 2008, Farha took home $3.5 million, largely by cashing out stock options before he left the company. Farha received no severance or golden parachute when he left WellCare, according to company filings, and got just $17,223 at his time of exit, in unused vacation pay. He still managed to spend $16,000 in housing and car expenses in New York in January before his resignation, according to company financial statements, Modern Healthcare reported.  (Farha photo by Ken Helle of the St. Petersburg Times.)

Farha still could receive up to 130,000 unvested company shares under a 2005 agreement, provided he meets certain criteria, which likely will be determined by the outcome of pending state and federal investigations. Farha was replaced by Heath Schiesser as the company's top executive three months after the FBI raided WellCare's Tampa headquarters in October 2007. (And this last line, clarified from the original posting): Schiesser earlier this summer announced plans to leave Wellcare once the board of directors has selected a successor.

-- Robert Trigaux, Times Business Columnist

Study sheds light on 'best' and 'worst' Tampa Bay area hospitals for key patient care

Wake up and good morning.

How do you know which hospital to choose for such critical care issues as heart attacks, heart failure and pneumonia? A new analysis is out that sheds some light nationally -- and even within the Tampa Bay area -- on the good and no-so-good hospitals.

The key, of course, is knowing this information in advance so an emergency does not make the choice of hospital for you. (Photo courtesy of Brandon Regional Hospital.)

Too many people die needlessly at U.S. hospitals, according to a sweeping new Medicare analysis showing wide variation in death rates between the best hospitals and the worst. The data are compiled by the federal government's Center for Medicare and Medicaid Services (CMS) and cover a three-year period from mid-2005 to 2008. The agency also has supplied the information to the hospitals included and posted them on a government Web site called Hospital Compare. USA Today also has massaged this data and made it friendly to use here.

So let's cut to the chase. Of those hospitals in the national analysis, which ones in the Tampa Bay area are the "best" (meaning lowest) or "worst" (meaning highest) based on the percentages of patient deaths for heart attacks, heart failure and pneumonia?

* Heart attack deaths. Best: Morton Plant Hospital in Clearwater (12.2 percent). Worst: Memorial Hospital of Tampa (20.8 percent) and Seven Rivers Regional Medical Center in Crystal River (20.1 percent).

* Heart failure deaths. Best: Brandon Regional Hospital (8.9 percent) and Morton Plant North Bay Hospital in New Port Richey (9 percent). Worst: Manatee Memorial Hospital in Bradenton (15.2 percent).

* Pneumonia deaths. Best: Largo Medical Center (8.9 percent). Worst: Manatee Memorial Hospital in Bradenton (14.6 percent).

There's a ton of other useful information -- including an analysis on hospital readmissions (high readmission rates suggest hospitals did not fix the patient problems in the first place). Check it out.

For example, just south of Tampa Bay, Sarasota Memorial Hospital was No. 2 in the country with the lowest readmission rate for heart attacks (15.4 percent), No. 5 in readmission for pneumonia (13.8 percent) and ranked in the top 100 in low readmission rates for heart failure.

-- Robert Trigaux, Times Business Columnist

Indecipherable health coverage: Why Tampa's Thomas Bosso's fighting fees

Wake up and good morning. Read any fine print lately? Ever really read your health insurance policy? And if you have courageously read it, would it really make any difference in actually understanding what it says?

Well, some senior members of Congress think something needs to be done about it. They are exploring legislation that would force insurers to provide "coverage facts" boxes similar to the nutrition information that appears on food packages.

Deciphering health insurance policies is explored in today's Wall Street Journal  (subscription required), which comes with a tale of a Tampa man who found out the hard way that health plans are often impenetrable and the limits of coverage obscure.

According to the Journal, Tampa real estate broker Thomas Bosso, 56, bought a plan from Assurant Inc. two years ago partly because he thought everything would be covered completely after he paid a $3,500 annual deductible, which is the amount a person has to lay out before the insurer starts paying for care. (Photo courtesy of Thomas Bosso.)

Instead, he told the Journal, he's been peppered with unexpected bills for thousands of dollars tied to a knee-replacement surgery last December. He hired Healthcare Advocates Inc., a Philadelphia firm that represents consumers on insurance issues, to help him fight the fees. Said Bosso:

"It's like you need to go to Harvard to understand what your insurance company is going to pay or not pay. It's ludicrous."

Hmmm. Sound familiar? Bosso told the Journal he never read the full 76-page description of his plan before he picked it, but relied on a summary and an insurance agent's advice. As for Assurant -- or simply insert the name of your health insurance firm here -- it says it "strives to provide clarity so that our customers can make informed coverage decisions."

-- Robert Trigaux, Times Business Columnist

Clearwater's Lincare called 'poster child' for companies vulnerable to healthcare cuts ahead

Wake up and good morning. So what's a rare and public gathering of hedge fund managers officially called? A gaggle? A pod? A mistake?

Jokes aside, New York City was the setting for the Ira W. Sohn Investment Research Conference. It's a charity event that invites accomplished hedge fund managers who rarely speak to the public to riff on the economy and tout investing ideas. Proceeds from the event go to groups that fight pediatric cancer and other illnesses. Kiplinger's, the personal finance publication, was there to cover it along with other news outlets.

We're interested because Clearwater company Lincare, a major healthcare provider of oxygen and respiratory services -- and a business adept at ignoring the local news media -- got some arguably unwanted attention at the hedge fundfest. (Photo: Lincare headquarters by Joseph Garnett Jr. of the St. Petersburg Times.)

As Barron's notes in its current issue, the performance of nearly all the picks presented at last year's conference was dismal. Perhaps that explains why so few of last year's speakers came back for another go-around this year, reports Kiplinger's.

At the New York event, says Kiplinger's, was Jim Chanos of Kynikos (which means cynic in Greek) Associates, described as "the short seller who famously uncovered fraud at Enron in 2001." Chanos had a bone to pick with health-care companies. "There's a new sheriff in town," Chanos said, referring to President Obama. He thinks the administration views health care as a right that should be available to all citizens. Therefore, the government will squeeze profitability out of for-profit education and health-care companies. (Photo courtesy of Kynikos Associates.)

Chanos called Lincare (ticker: LNCR) "the poster child" of the type of company that will suffer as the administration seeks to curb health-care costs.

It's not as if Lincare is booming at the moment, anyway. In the first quarter of 2009, Lincare revenues were $371.7 million, down from $415.4 million for the first quarter of 2008. And net income for the first quarter was $26 million compared to $58.2 million for the first quarter of 2008. The cause? "Dramatic reductions," said Lincare, in Medicare reimbursement for the company's primary product lines, brought about by the implementation on Jan. 1 of previously enacted legislation.

Chanos apparently sees little reason those types of Medicare trims won't continue under Obama.

-- Robert Trigaux, Times Business Columnist