FloridaTrend.com, the Website for Florida Business


Entrepreneurs Aim to Capitalize on Healthcare Reform

THE NUMBERS: EMERGENCY CARE

  • Last year, patients nationwide spent an average of 4 hours and 3 minutes in emergency departments before being either discharged or admitted to the hospital. In Florida, the average is 4 hours and 26 minutes.
  • Miami-Fort Lauderdale-Pompano Beach led the nation in level of emergency room satisfaction in 2008.

THE NUMBERS: HEALTHCARE COSTS

  • The per capita amount spent nationwide on personal healthcare expenses in 2004 was $5,283. In Florida, the amount was 4% higher, $5,483.
  • 7.1% of Floridians did not seek medical care in 2005-06 because of cost, compared with 5.5% of Americans overall.
  • 10% of Floridians delayed care because of cost, compared with 7.7% nationwide.
  • 7.7% of Floridians did not purchase prescription drugs because of cost, compared with 7.1% nationwide.
  • 20.3% of Floridians do not have health insurance. Nationwide, the figure is 15.3%. Only two other states, New Mexico (21%) and Texas (24.1%) have higher percentages of uninsured residents.

Electronic Medical Records

A number of Florida firms are among those entering the wide-open marketplace for electronic medical records — computerized systems that can keep track of all of a patient’s records, from tests performed to drugs prescribed.

Doctor To create standards that head off a proliferation of incompatible systems, a non-profit group, the Certification Commission for Health Information Technology, certifies new electronic records products that meet industry standards.

Among the 200 firms with certified records products are Sage Health in Tampa, with a records system called Sage
Intergy EHR, along with Naples-based Allen Systems Group and Tampa-based NexTech Systems.

Chuck O’Neill
“The consumer is going to have to smarten up.”
— Chuck O’Neill
An essential part of enabling healthcare providers to share information will be setting up regional and community clearinghouses for the records — so-called health information exchanges. Physicians, laboratories, hospitals and other medical professionals will deposit records on an exchange’s central computer server, where a program will standardize the clinical data so that it can be accessed by all members of the exchange.

In Florida there are at least nine exchanges in various stages of development, with the Tallahassee-based Big Bend Regional healthcare Information Organization the furthest along in implementation.

Since last year, Melbourne-based Harris Corp. has been developing a National Health Information Exchange Gateway system that will let federal healthcare agencies and healthcare providers share information. The second phase of the project will create a more public system — something like a world wide web of healthcare information — that will let all types of healthcare providers participate.

THE NUMBERS: CHILDREN

  • 8.6% of deliveries in Florida are low birth weight (less than 5?pounds). Nationwide, the percentage is 8.1%.
  • The infant death rate per 1,000 births in Florida is 7.2. Nationwide, the rate is 6.8.
  • 70.6% — Florida mothers initiating breast-feeding at birth (33rd)
  • 15.2% of high school students were at risk of being overweight in 2007 and an additional 11.2% were overweight.
  • 62.3% of high school students did not participate in any physical education at school in 2007.
  • 22.1% of high school students ate five or more servings of fruits or vegetables each day during the past seven days.

Insurance

DoctorCompany: Avalon Healthcare, Tampa, approved to do business in 2005 by the Florida Office of Insurance Regulation

Trend: High-deductible policies

CEO: Chuck O’Neill, a co-founder of the company, was co-founder and director of Oxford Benefit Management.

Distinction: The first new healthcare plan approved to do business statewide in more than a decade

Customers: 10,000 individual and group members in the Tampa Bay area, southwest Florida and Broward and Palm Beach counties. Avalon plans to expand into the Orlando market but has decided not to do business in Miami-Dade and south Broward counties.

Customer Base: 80% of customers are individuals.

Features: Most popular plans have deductibles between $2,000 to $5,000, co-pays of $25 to $35 for a primary care physician, with Avalon paying 100% after the customer meets the deductible. A 35-year-old, male non-smoker in Pinellas County would pay about $111 per month for a plan with a $5,000 deductible, 100% co-insurance and drug benefits with no deductible. A plan with a $1,000 deductible, 80/20 co-insurance and drug benefits would cost about $156.

Economies: Avalon is more restrictive than most plans in working only with hospitals that will meet its cost requirements. HCA hospitals are not a part of its network, for example.

Revenue: Avalon expects to bring in premiums of $20 million this year, up from $9 million in 2008.

Business Plan: The company is looking for expansion capital.

THE NUMBERS: OBESITY

scale Of adults who are obese:

  • 68% are inactive
  • 45% have high cholesterol
  • 43% have high blood pressure32% have arthritis
  • 7% have diabetes
  • 17% smoke
  • 13% have cardiovascular disease

THE NUMBERS: RANKINGS

  • stethoscope6th — number of certified nursing homes: 658
  • 7th — nursing facilities receiving a deficiency for actual harm or jeopardy: 8.2%
  • 7th — high blood pressure among adults: 29.3%
  • 7th — high cholesterol among adults: 35.1%
  • 7th — number of certified nursing home residents: 68,580
  • 20th — cancer incidence: 470.9 per 100,000
  • 20th — percentage of Florida adults who smoke: 19.3%
  • 29thhealthcare as a percentage of total employment: 7.7%
  • 34th — obese adults: 22.9%
  • 37th — health spending as a percentage of gross state product: 2.8%
  • 40th — population with serious mental illness: 0.39 per 10
  • 40th — cancer death rate: 183.7 per 100,000 population

THE NUMBERS: DISEASES (State ranking)

  • stethoscope2nd — heart failure death rate: 7.3 per 100,000
  • 4th — prostate cancer incidence rate: 117.3 per 100,000
  • 6th — stroke hospitalization rate: 395.5 per 100,000
  • 9th — breast cancer incidence rate: 107.2 per 100,000
  • 13th — diabetes hospitalization rate: 158.2 per 100,000
  • 18th — colorectal cancer incidence rate: 48.5 per 100,000
  • 20th — melanoma incidence rate: 16.4 per 100,000
  • 28th — coronary atherosclerosis hospitalization rate: 421.7 per 100,000
  • 38th — lung cancer incidence rate: 73.9 per 100,000
  • 38th — cervical cancer incidence rate: 8.6 per 100,000

MEDICAL PRODUCTS

PediaVison's camera
PediaVision’s camera can be used to test children too young to read an eye chart. [Photo: PediaVision]

  • Service: Vision screening
  • Company: PediaVision, Lake Mary
  • CEO: David Melnik, who founded and later sold Kinetics, a developer of airport check-in kiosks and print-at-home ticketing software
  • Device: A digital camera licensed from Plusoptix in Nuremberg, Germany, takes a picture by projecting infrared light onto the patient’s retina.
  • Competitive Advantages: Patients are screened from three feet away, meaning the camera can be used to screen children too young to read an eye chart. Results are available immediately.
  • Capability: Detects myopia (near-sightedness), hyperopia (far-sightedness), astigmatism and other common eye defects.
  • Business Plan: PediaVision is targeting pediatricians, schools and charities that perform screenings at community centers, daycare facilities and shopping centers. A pediatrician pays about $10,500 for the PediaVision system and then $4 for each photo, with the cost per photo decreasing the more the pediatrician uses the camera. Patients might pay between $18 to $50.