Greene’s recognition honored his educational activities that serve to maintain, develop or increase the knowledge, skills, professional performance and relationships a physician uses to provide services for patients and the public.

Established in 1968, the AMA Physician’s Recognition Award today stands as the most widely accepted award for recognizing physician CME achievement.

In addition, Greene emphasizes the importance for physicians to promote good general health and active community service.

“Continuing to learn the newest techniques and strategies to treat diseases of the lung and heart allows me to help ensure the highest quality of care possible for my patients,”  says Greene.

Greene is a board-certified cardiothoracic surgeon and co-founder of Brevard Cardiothoracic Surgeons in Melbourne, Florida.

Most recently Dr. Ronaldson served as the CEO for MIMA, guiding the strategic direction for the multi-specialty independent physician practice. In addition, Dr. Ronaldson maintained his interventional cardiology practice, which he began in 1986. Dr. Ronaldson, who was elected to the MIMA Board of Directors in 1998, most recently served as the group’s CEO since 2010. Prior to his role as CEO, he served as the Chief Financial Officer for 12 years. Under his leadership, Dr. Ronaldson helped to build the MIMA physician group to over 120 physicians, 30 physician extenders, and 700 support professionals. MIMA currently serves patients from 16 locations throughout south Brevard.

“Health First has enjoyed an established relationship with Dr. Ronaldson through his years as a member of the Health First Holmes Regional Medical Center’s Medical Staff and in his role on the MIMA acquisition,” said Steve Johnson, President/CEO of Health First. “We are honored to have such a seasoned physician leader join Health First as the senior executive for the Health First Medical Group. His proven leadership and the unanimous support of his appointment from both physician groups make him the ideal candidate to build this impressive physician entity for our integrated delivery system.”

Dr. Ronaldson has served on the Medical Staff for Health First Holmes Regional Medical Center since 1989. From 1992 to 1999, he served on the Advisory Board of The Heart Center for the hospital. Prior to moving to Brevard, Dr. Ronaldson was an attending cardiologist for the Bay Pines VA Medical Center at theUniversityof South Florida in Tampa. He also served as an Associate Professor of Clinical Medicine for the University of South Florida.

Dr. Ronaldson conducted his internship in pediatrics and internal medicine at Staten Island Hospital on Staten Island, and served as Chief Resident at St. Vincent’s Medical Center, also on Staten Island. Dr. Ronaldson then completed his fellowship in cardiology at the University of South Florida– Bay Pines VA Medical Center in Tampa. He then moved to Brevard to join the Medical Staff of Health First Holmes Regional. He resides in Melbourne Beach with his wife. The Ronaldsons have three children.

Chief Operating Officer named
Health First has also named Loretta Jo Powell as the new Chief Operating Officer for the Health First Medical Group. Ms. Powell will begin her duties January 14, 2013, reporting directly to Dr. Ronaldson. She comes to Health First from the University Medical Group (UMG) for the Greenville Hospital System inGreenville, SC, where she served as the Administrator of Management Service Organization since 2008.

In her role as Administrator for UMG, she led all aspects of practice management, physician compensation, market/business development, payer contracting/reimbursement, revenue cycle analysis, and customer service and management leadership for 700 multi-disciplinary providers in 135 locations. Ms. Powell joined the Greenville Hospital System in 1993 as the Medical Associates Department Manager.

In 2006, she was named the UMG Director of Operations, where she managed operations for surgery, medicine, orthopedic, OB/GYN, behavioral, neurosurgery, geriatrics, and pediatrics departments. Ms. Powell began her hospital system career in Denver and Indianapolis, working for West Pines Hospital and Arbor Psychiatric Hospital respectively in marketing and business development positions.

“We are fortunate to bring Ms. Powell to Brevard as our Chief Operating Officer,” said Johnson. “She has extensive experience and expertise in leading a large physician group, with proven results in organizational consolidation, achievement of cost efficiencies, implementation of performance standards systems and managerial audits, compliance and safety initiatives, as well as oversight of physician revenue cycles.”

Ms. Powell obtained her Bachelor of Science degree in Social Work at Anderson University in Anderson, IN. She received her Master of Business Administration degree from Webster University in Greenville, SC.

And the reason this program can deliver such services is attributable to one key element: volunteer health providers. To date the clinic has 80 licensed health providers - doctors, nurses, nurse practitioners, dentists, hygienists and the like - donating their time and talents to provide care to the uninsured of Brevard County.

However, as positive as this sounds, there is one major concern. According to Executive Director Paul Ringenberger, “The demand for adult dental care is tremendous. We have four in-house dentists and a dozen satellite location dental providers, but we are only scratching the surface. We need more retired dentists to come join us here at the clinic in Palm Bay. We really need these dentists to get back in the game.”

Volunteer providers receive sovereign immunity protection and the satisfaction of tackling one of Brevard County’s premier health issues: dental care for the uninsured and indigent. In fact, last year the Brevard Health Care Forum, a consortium of health programs in the county, identified dental care for the indigent as a top priority. “We knew going in that dental care was going to be our biggest challenge. We have the facility and equipment, but now we need retired dentists and hygienists to come be a part of the solution. And we promise they’ll get the same benefits our current team receives - an abundance of hugs from very grateful patients,” adds Ringenberger.

Even retired dentists and hygienists without active licenses can participate as the state provides a limited license for those volunteering at a non-profit community clinic. To volunteer, or find out more information about SCVIM, please contact:

Irene Theriault, dental office manager at 603-988-9958 or 321-914-0915, or email Irene at iftscvim@gmail.com

Visit the SCVIM website to complete the Volunteer Applicatio: www.spacecoastvolunteersinmedicine.org

“Our Auxiliary would like to attract 200 to 300 people to serve as volunteers,” said Marcia Phillips, director of volunteer services for Health First Holmes Regional Medical Center and Palm Bay Community Hospital.  “We have a great need for volunteers right now due to seasonal fluctuation and growing demand in our community.  Volunteering at the hospital is a truly rewarding experience because you can really see first-hand how you’re making a difference in the lives of people.”

After completing a special training class, volunteers are able to choose their hours and areas of interest.  To find out how to become a volunteer at one of these Health First Hospitals, please call 321-434-8519.

“Health First is pleased to make this acquisition announcement,” said Steve Johnson, President/CEO of Health First. “As Health First moves to enhance its Integrated Value Based Delivery Network in order to increase patient quality, safety and the patient experience, this acquisition enables Health First to strategically align physicians who share the same vision and philosophies. By joining our physician groups, Health First will be able to reduce costs to those we serve. ”

According to James Ronaldson, M.D. and CEO of MIMA, this strategic alignment makes sense to better serve the patients in the community. “By combining our resources under one organization, patients will have access to a stronger, more unified network of primary care physicians, specialists, sub-specialists and ancillary services that can address all levels of medical care for the patients we serve.”

Once the acquisition has been approved by appropriate legal and governmental agencies, the Health First Medical Group, which will begin operation in mid-February 2013, will be comprised of approximately 250 physician providers. Locations of these physician offices will provide easy access and patient-focused health care.. Once completed, Health First will employ more than 7,500 employees across Brevard.

“The decision to create the Health First Medical Group should signal to Brevard County residents that these physicians and their staffs are focused on providing them with excellent, compassionate, and high-quality care, and that we are prepared for the increasing obligation to improve the lives of those we serve in Brevard County,” said Johnson.

The integration of these two physician groups has begun, under the guidance of a strategic consulting firm that has expertise in specialized acquisitions, and is expected to take between 18 to 24 months. Communication will begin immediately to inform patients of the new physician alignment. The transition to Health First Medical Group is expected to be seamless to current and future patients.

Myrbetriq, pronounced Meer-Bet-Rick, became available for women on the Space Coast in October. Unlike previous medicine-based treatments, Myrbetriq promotes bladder storage rather then fighting signals for bladder emptying. Mybetriq targets a specific receptor on the bladder, which relaxes the bladder muscle.

“OAB impacts each individual differently so it is important to have a variety of treatment options available,” said James Raders, MD. “Participating in the introduction of Myrbetriq is only one area where Zipper Urogyn is addressing the need to pursue more overactive bladder treatment options.”

Currently, Zipper Urogynecology is seeking participants for a research study for overactive bladder. The purpose of the research is to evaluate the effectiveness of investigational laser therapy in the treatment of overactive bladder in women. Eligible participants must be women over the age of 21, meet the American College of Obstetricians and Gynecologists (ACOG) definition of overactive bladder and urinary frequency and have failed to respond to non-invasive treatments for the underlying disorder or have declined other treatment.

Zipper Urogynecology Associates is the largest freestanding female pelvic medicine and reconstructive surgery practice in the United States. The practice accepts most major insurances including Medicare and Health First. The office is located at 1130 South Harbor City Blvd. in Melbourne, Florida. Contact them at 321.674.2114 or visit www.ZipperUrogyn.com.

ROCKLEDGE, FL —  Health First has announced that Sean J. Gregory has been named as the new President of Health First Holmes Regional Medical Center in Melbourne, FL.  He began his new duties on November 5.

Gregory will manage the strategy and business development for Health First’s 514-bed tertiary hospital in Melbourne.  He will also oversee revenue and growth planning, service line growth and development, capital budget, physician relations, and overall planning and strategy for the hospital.  Gregory will work closely with Health First Executive Vice President (EVP), Chief Operations Officer (COO) J. Stuart Mitchell and the hospital’s operational team to ensure that the highest quality and safety is provided for all patient experiences and outcomes.

“Sean has a true collaborative nature and his energy and enthusiasm will help him to build strong working relationships with Health First Associates and Medical Staff, as well as with leaders in our community,” said J. Stuart Mitchell, Health First EVP, COO. “Sean has extensive experience in the health care field and is an exceptional choice to lead Health First Holmes Regional Medical Center in the coming years,” said Mitchell.

Gregory most recently served as Vice President, Strategy and Business Development for Exempla Healthcare — a regional health network with three hospitals, a large multi-specialty physician group, and several sub-acute services in Denver, CO. In that role, he launched new product lines and locations, created multiple service operational enhancements, and achieved the organization’s highest operating margin and income in its 13-year history. While at Exempla Healthcare Gregory also developed joint venture partnerships in hospice, long-term care facilities, respiratory care,oncology, as well as home care, surgery centers, and rehabilitation services.

Prior to that position, Gregory served seven years with SSM Health Care (SSMHC) — a 15-hospital Catholic health care system based in St. Louis, MO. In 2009, Gregory was named Network Vice President, Network Development for SSM St. Louis. In that role he led business development, rural outreach, SSM Emergency Care, real estate, and Medical Staff development across the SSM St. Louis system — a seven-hospital health network, with annual net revenues in excess of $1.4 billion.  At SSM St. Louis he also served as a key executive during one of the organization’s most profound periods of rapid performance improvement in operating income, growth, and employee satisfaction. With a focus on program development, improved customer services, and sales and marketing efforts, he led a 12% increase in the system’s Emergency Department admissions over the prior year.

He joined SSMHC in 2004 as Area Director, Strategy and Business Development, where he led a $4 million annual improvement in operating income, directed strategic planning and new venture development, and achieved market share 30% higher than SSM’s overall market share.In 2008, Gregory became the Network Vice President, Growth and Development for SSM St. Louis North Region. He was responsible for leading the strategy, growth, and specialty program operations across four hospitals, with more than 100 employed physicians, several outpatient facilities, and annual net revenues in excess of $600 million.

Prior to joining SSMHC, Gregory served in leadership roles at Wake Forest University, Baptist Medical Center, and Louis A. Weiss Memorial Hospital, and as a consultant for The Riner Group—a firm that provided strategic planning and operational counsel to physician practices.

Gregory earned his Bachelor of Business Administration degree in Finance from Texas A&M University in College Station, TX. He also holds Masters degrees in Human Resource Management/Organizational Development as well as Health Administration — both from Washington University, St. Louis, MO.

Jim Barfield
President CEO and co-owner of Luke & Associates, Inc.

The rise in the cost and affordability of health care in the U.S. continues to be a concern. In 2010, 18 percent of the U.S. economy was devoted to health care. The U.S. spent $8,402 per person on health care. Half of all spending was used to treat 5 percent of the population.  Approximately 22 percent of all spending was used to treat 1 percent of the population – those with expenses above $51,951. Adults 65 and older experience the highest health care spending -$9,744 per person in 2009.

Impacts of the Patient Protection and Affordable Care Act (ACA)
The Patient Protection and Affordable Care Act (ACA) was signed into law in March 2010 and upheld by the Supreme Court in July 2012. The ACA is intended to reduce the number of uninsured and reduce the overall costs of health care. It provides incentives—subsidies, tax credits and fees—to employers and individuals to increase the number of people covered by insurance.

The law also includes a number of other elements intended to improve health care outcomes and streamline health care delivery. It requires insurance companies to cover all applicants and offer the same rates regardless of pre-existing conditions or gender.

The ACA will require significant government-provided financial assistance to low- and middle-income people so they can afford health insurance and share the costs. It establishes standards for private health insurance, consisting of the minimum benefits for health insurance, cost sharing limits on benefits and rules to provide access to people with pre-existing health conditions without increasing premium costs. As a result, the cost of insurance coverage will be significantly reduced for many people with lower-income or pre-existing health care needs and will be required for everyone.

The cost of health care insurance is much different than the cost of health care
It’s important to understand that the price we pay for health care, either out-of-pocket or through insurance, is not the actual cost. It is the price our insurance companies are billed and includes the providers’ costs for labor, overhead, general and administrative costs and profit. Even non-profit providers put additional charges for reserves instead of profit.

And prices can vary for the same procedures. An article in the August 27 edition of the Wall Street Journal discusses these inconsistencies. Here is one example:

“After David Hubbard underwent a routine echocardiogram at his cardiologist’s office last year, he was surprised to learn that the heart scan cost his insurer $1,605. That was more than four times the $373 it paid when the 61-year-old optometrist from Reno, Nevada had the same procedure at the same office just six months earlier,” the journal reported.

In this case, Dr. Hubbard’s cardiologist’s practice had been bought by a local hospital system. Did the purchase of the practice truly justify an increase in the price billed which is four times the price for the same procedure performed in the same office and by the same people only six months earlier?

What are the reasons for high costs?
The Henry J. Kaiser Family Foundation report, “Health Care Costs: A Primer,” published in May, attempts to explain the continued high cost of health care. It reports that one of the reasons is due to the continued improvements and new technology. Another reason is our aging population and the prevalence of chronic diseases (diabetes, hypertension, etc.).

Another reason for high costs, according to the report, is the fact that insurance coverage has increased, and will continue to increase as a result of the ACA. Government subsidies will impact cost levels and cost growth. Tax subsidies for health insurance and public coverage reduce the cost of health care to the individuals, which encourages them to use more of it.

The report also explains that we pay a lower share of our health care expenses than we previously did. Between 1970 and 2010, the share of personal health care expenses paid directly by consumers dropped from 40 percent to 14 percent.

The last reason cited by the report is unnecessary spending. In fact, an article in the Journal of the American Medical Association, published March 14, states that 20 percent or more of all health care expenditures are due to various forms of waste, including overtreatment, failures of care coordination, failures of care delivery, administrative complexity, pricing failures and fraud and abuse.

Will the ACA reduce health care costs?
In my opinion, not likely. Despite the cost-reducing provisions in the ACA, system-wide health care costs are still projected to rise faster than the national income for the foreseeable future. There will also be a major increase in the use of the health care system because of increased health care insurance coverage.

The patient is not the customer — the insurance companies become the true paying customer. The way our system works now, there is no incentive for providers to reduce the price to the consumer since insurance companies pay the bill. There is no incentive for competition. The patient does not have an incentive to seek out more reasonable prices without compromising quality. The only exception is when the patient will have to pay large out-of-pocket expenses.

The price of individual health care must be paid by someone. It is not free. The ACA requires each individual to carry health insurance. If they cannot afford to pay for it, the government will. The cost of health care is now going up because of the increase in taxes necessary for the government to implement and administer the ACA. Who pays the taxes? We do.

Will Dr. Hubbard receive his next echocardiogram at the original price of $373 six months ago or the new price of $1,605? I expect it to be much higher.

Irfan Imami, MD, and vascular surgeon atTEPASVeinCenter, says the majority of patients who have varicose veins are eventually diagnosed with venous reflux disease, a diagnosis that can be dangerous to a patient’s health.

“The legs are made up of a network of veins; healthy leg veins contain valves which open and close to assist the return of blood back to the heart.  Patients with venous reflux disease have diseased veins which restrict blood flow,” said Dr. Irfan Imami.

“What was initially considered only a cosmetic concern is now a health concern,” added Imami.

According to Imami, this restriction can cause blood to pool in the legs and lead to symptoms such as pain, swelling, swollen limbs, leg heaviness and fatigue; skin changes, skin ulcers and varicose veins.  Also known as ‘venous insufficiency,’ the condition affects nearly 50-percent of women, and the majority of individuals who are on their feet or do heavy lifting for prolonged periods of time.

Additional risk factors can include family history, obesity, hormonal changes, sun exposure, multiple pregnancies and previous DVT’s (otherwise known as deep vein thrombosis), or blood clots.

For more information on the ‘free’ varicose vein consultation program, contact TEPASVeinCenterat 321-733-1901 to schedule an appointment. TEPAS Healthcare is located at 1140 Broadband Dr. Melbourne, FL 32901.

ROCKLEDGE, FL —  Health First announced that ­Eddy (Ed) L. Hannah has joined the organization October 29 as the new Chief Nursing Officer (CNO) and Vice President (VP), Patient Care Services at Health First Holmes Regional Medical Center.  Hannah will replace Bonnie Rudolph, who is retiring as the system’s CNO after 24 years with Health First.  Hannah will report to J. Stuart Mitchell, Health First Executive Vice President (EV), Chief Operations Officer (COO).

Hannah will serve in a dual role: CNO of the Health First system and VP, Patient Care Services for Health First Holmes Regional Medical Center. He will be responsible for the planning, organization, and delivery of effective, efficient and high-quality patient care across the entire Health First system.  He will work with Health First executives, physicians, and clinical leadership in setting the vision and direction for patient care services, as well as developing and implementing an enhanced philosophy and model of care that will be implemented throughout the system.  Hannah will also work together with management, Medical Staff, and clinical areas in planning, promoting, and conducting organization-wide performance improvement activities.  Additionally, he will also be responsible for ensuring that Health First achieves successful strategic priorities for clinical, operational, and financial outcomes.

Prior to joining Health First, Hannah served as Vice President (VP) – Patient Care Services & Quality/Chief Nursing Officer (CNO) for Boca Raton Regional Hospital, a 400-bed, not-for-profit acute care hospital in Southeast Florida. He originally served there as a member of a senior management team contracted by the hospital’s Board of Directors to improve clinical and operational results. In 2010 he moved into the full-time role of VP – Patient Care Services & Quality/CNO.  As VP he was responsible for acute care Nursing, Pharmacy Services, Respiratory Care, inpatient Rehab, Infection Control, Nursing Informatics, Dialysis, Patient and Guest Relations, Food & Nutritional Services, Environmental Services, and performance improvement and excellence (Quality Resource Management).  He also worked closely with several area Nursing colleges on collaborative projects.

“Ed Hannah is a seasoned executive in all areas of clinical practice and administration,” said J. Stuart Mitchell, Health First EVP and COO.  “He will be instrumental in developing a strategic and focused approach to nursing operations throughout our Health First system.”

Hannah is a Registered Nurse (RN) in both Tennessee and Florida. He has completed Certification in Nursing Administration Advanced (CNAA), Team Specialist Certification from North Carolina State University, and Strategies for Successful Nursing Management at The Wharton School of Business.  Hannah also serves as a member of the Adjunct Faculty for Florida Atlantic University, Palm Beach Atlantic University, and Nova Southeastern University.