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Articles
Anthem pulling out of Quality Health First
Since 2009, Indianapolis-based Anthem has doled out $14.5 million in bonuses to physicians based on their scores in quality reports generated by Quality Health First.
Franciscan, American Health join new ACOs
Franciscan St. Francis Health and American Health Network continue to get deeper into the accountable care organization concept being promoted by the federal Medicare program under the 2010 health reform law.
SHORT: Obsolete laws, regulations stifle advance of ‘telehealth’
You might remember seeing Elroy Jetson sitting in front of a television in the Jetson home, with Astro, his trusty dog, and Jane, his mother, at his side, while the doctor appeared on the screen providing medical care to Elroy. This scene is no longer so futuristic.
Leader of fraud scheme pleads guilty to 20 counts
Michael Russell faces between 57 and 71 months in prison for defrauding an Indianapolis investor of $1.7 million. Two associates, Paul Bateman, a former City-County councilor, and Manuel Gonzalez, have pleaded not guilty and are set for trial Feb. 11.
Q&A
Dave Reed is president of the Healthcare Business Solutions group inside Bloomington-based Cook Medical Inc. Since 2007, his team of 18 full-time people—aided by about 60 others throughout Cook’s organization—has worked with hospital systems, distributors of medical products and group purchasing organizations to improve the efficiency of the business side of health care and to make sure new products contribute to that efficiency, as well as solving unmet medical needs.
Ex-councilor Bateman agrees to plead guilty to fraud charges
Paul C. Bateman Jr., a former Democrat city-county councilor, agreed to plead guilty Wednesday to 13 counts of money laundering and wire fraud for his part in defrauding an Indianapolis physician of $1.7 million.
HICKS: Middle class, education and income inequality
The United States has always had something like a middle class, but for most of our history it has been a distinction not necessarily dependent on income or wealth.
Once-thriving drug lab in turnaround mode
Two years ago, executives at AIT Laboratories “took their eye off the ball,” and watched the company’s business plummet 29 percent in value. Now, after two years of turmoil, the drug-testing lab says it’s poised to return to the double-digit rates of growth that made it a local star.
Marian med school oversubscribed
Marian University’s College of Osteopathic Medicine—only the second medical school in Indiana—will enroll 162 students this fall, about 8 percent more than it planned.
Company news
The Franciscan Alliance hospital system has signed a deal with Philadelphia-based health insurer Cigna Corp. to offer an accountable care plan to Cigna’s customers in the Indianapolis area. Mishawaka-based Franciscan will use the same accountable care organization it formed in 2011 to work with the federal Medicare program. That organization includes Franciscan hospitals in Carmel, Indianapolis and Mooresville, as well as 600 physicians in central Indiana. Franciscan and Cigna will rely heavily on case managers, who will help patients, especially those with chronic diseases, navigate the health system. The case managers will use Cigna data to identify patients in need of such attention and will in some cases refer patients to Cigna’s health management and wellness programs.
Warsaw-based DePuy Orthopaedics Inc. kept selling an artificial hip implant even after the doctors it paid as consultants on the product had begun abandoning it and after the product had failed an internal test, according to internal company documents disclosed in a legal case and summarized by The New York Times. DePuy, a subsidiary of New Jersey-based Johnson & Johnson, recalled the troubled hip implant, called the Articular Surface Replacement, or ASR, in 2010. The company has been the target of 10,000 lawsuits filed by patients who had to receive a second hip implant after the ASR failed. The device has been prone to shedding large amounts of metallic debris inside patients. DePuy’s own internal estimates show they expected the ASR to fail in 40 percent of patients within five years of their hip-implant surgery.
Greenwood-based Elona Biotechnologies Inc., which has been trying to bring a generic version of insulin to market, is running out of cash and struggling to find new investors. The company told Greenwood officials of its financial troubles earlier this month, which prompted the Greenwood Redevelopment Commission to vote Jan. 17 to declare Elona in default on $8.4 million of economic development incentives the city gave the company in 2010. Wendy Brewer, an attorney for the Greenwood Redevelopment Commission, said one potential investor in Elona wants the company’s exposure under the incentive programs altered as a condition of investing in Elona. “We’re continuing to talk to them,” Brewer said, adding that the company’s finances dictate that a decision be made in a couple of weeks. Greenwood loaned $6.4 million to help Elona build a 50,000-square-foot, $28 million insulin-production plant in Greenwood and hire 70 workers. The city also gave Elona $1.5 million to help it win approval for its insulin from the U.S. Food and Drug Administration and $500,000 for equipment. So far, Brewer said, Elona has made no progress on its jobs commitments. Elona, founded by a former Eli Lilly and Co. scientist, has made its business doing contract drug manufacturing for other firms. But its growth plans hinged on making a generic version of insulin, something that was not allowed in the United States until the 2010 passage of the Patient Protection & Affordable Care Act. That law called for a pathway for “biosimilar” versions of biotech drugs, including insulin. As it stands now, a drug such as Lilly’s Humulin insulin faces no generic competition even though its patent expired in 2001. Nearly a year ago, the FDA issued draft guidance on “biosimilar” drugs that indicated it would require additional clinical trials of a biosimilar drug. That means a company like Elona would have to spend significant money to test its drug in patients before the FDA would declare it similar to an existing insulin. Calls to Elona founders Ron and Donna Zimmerman were not returned Tuesday morning.
WellPoint Inc. ended the year on a high note, posting fourth-quarter sales and profit that exceeded Wall Street’s expectations. The Indianapolis-based health insurer earned $464 million, or $1.51 per share, in the three months ended Dec. 31, a 38-percent leap from the same quarter a year earlier. Excluding investment gains and one-time charges, WellPoint would have earned $1.03 per share. On that basis, analysts were expecting 95 cents per share. Membership in WellPoint’s health plans shot up nearly 8 percent in the fourth quarter to more than 36 million nationwide. That represented a net gain of more than 2.6 million customers. The increase was entirely attributable to WellPoint’s $4.9 billion acquisition of Virginia-based Amerigroup Corp., which added 2.7 million members in Medicaid plans. But the Blue Cross Blue Shield insurer on Wednesday gave analysts a conservative forecast for 2013, due in part to a daunting list of expenses it could face. WellPoint will spend roughly $300 million this year preparing for coverage expansions under the health care overhaul coverage and changes to its Medicare Advantage business. The insurer also expects to spend as much as $125 million integrating Amerigroup into its business, and it says it could take hits from flu claims, possible cuts to Medicare funding and an increase in health care use. Counting those expenses, WellPoint expects to earn at least $7.60 per share in 2013 compared to the $8.18 per share it earned last year.
St. Vincent Health will add air medical service at Rush Memorial Hospital in Rushville. The new StatFlight helicopter base, scheduled to open in late April or early May, will be St. Vincent's fourth helicopter base in Indiana. The others are located in Anderson, Danville, North Vernon and West Lafayette. St. Vincent contracts with PHI Air Medical LLC to operate its StatFlight air medical service.
The Community Health Network hospital system has created a new partnership with Indianapolis-based Lutheran Child and Family Services to provide treatment for children who have experienced trauma and are dealing with behavioral challenges. Indianapolis-based Community will help Lutheran manage the behavioral health services for children and adolescents at Lutherwood, a youth residential treatment facility, and Trinity House, a transitional group home for young men. The collaboration also will include community-based programs previously managed separately under Indianapolis-based Gallahue Community Mental Health Center and Lutheran. Lutheran will continue to offer spiritual care programs of its own for children and their families. Community serves more than 25,000 behavioral health patients each year. Its behavioral health unit employs more than 600 physicians, psychologists, advance practice nurses, psychiatric nurses, therapists, counselors, life skills specialists and care managers.
People
Suzanne Clifford has been named executive vice president of behavioral health at Community Health Network, beginning Feb. 25. She replaces Eric Crouse, who is retiring after nearly 34 years at Community. Clifford most recently has led Inspiring Transformations Inc., an Indianapolis-based consulting firm she founded that focused on the delivery of mental health and substance abuse care. Before that, Clifford was director of the Indiana Division of Mental Health and Addiction, and also served stints at Eli Lilly and Co. and General Motors Corp. She holds a bachelor’s in industrial and systems engineering from The Ohio State University and an MBA from Indiana University.
St. Vincent Health has appointed Dr. Craig Wilson chief medical officer of St. Vincent Medical Center Northeast, which is adding 50 inpatient beds and will change its name to St. Vincent Fishers Hospital on April 8. Wilson will remain executive director of hospitalist services at St. Vincent Indianapolis Hospital. Wilson completed his medical degree at the University of Queensland, Australia.
The Indiana Medical Device Manufacturers Council appointed Peggy Welch as its executive director, effective immediately. Welch was a Democratic state legislator from Bloomington for 14 years and works part time as an oncology nurse at the Indiana University Health Bloomington Hospital.
Dr. Nahid Shahrooz has joined the newly established Franciscan Physician Network Dermatology Specialists. Formerly associated with Shahrooz Dermatology and the Indianapolis Institute for Plastic Surgery, she specializes in the surgical removal of skin tumors, cancers and lesions. Shahrooz earned her medical degree at Mashad Medical School in Iran.
Dr. Janice Bilby has joined Franciscan Physician Network Greenwood Parke Family Medicine. Bilby received her undergraduate degree in biology from Ball State University and her medical degree from the Indiana University School of Medicine.
Community taps Walgreens for health reform help
In the era of health care reform, hospitals will face two new challenges: They will need to run higher-volume, lower-margin businesses, and they’ll be on the hook financially for what patients do even when they’re not receiving health care. Community Health Network’s new partnership with Walgreens’ Take Care Clinics is designed to help address both issues.
Hospitals paying big to snag surgeons
Across the four largest hospital systems in central Indiana, six physicians received more than $1 million in compensation in 2011 while two others received more than $900,000 and nine others received $700,000 or more, according to the hospitals’ most recent reports to the IRS.
Fraud victim files civil suit against ex-councilor
An Indianapolis physician who lost $1.7 million in a fraud scheme orchestrated in part by former Democratic City-County Councilor Paul C. Bateman Jr. has sued Bateman and two associates in Marion Circuit Court. The civil lawsuit comes as a criminal trial stemming from the case begins in U.S. District Court for the Southern District of Indiana.
Q&A
Don Kelso is executive director of the Indiana Rural Health Association. The trade group is trying to help its members navigate the changes coming from health care reform and the financial pressures being created by federal budget cuts. The association recently launched a service for its members called SuiteStats, which is data-management software to help hospital executives identify areas ripe for cost-cutting.
Company news
Indiana University Health Physicians added 39 doctors from the division of gastroenterology and hepatology at the IU School of Medicine. The group was founded in 1958 and is consistently ranked as one of the top 20 programs nationally. IU Health Physicians now employs more than 1,000 doctors. The group, which also includes five nurse practitioners, offers care at IU Health University Hospital, Wishard Health Services and the Richard L. Roudebush VA Medical Center, and will soon expand to IU Health North and IU Health Saxony hospitals. They also see patients in satellite offices in Batesville, Carmel, Greenfield, Greensburg, Lebanon, Martinsville, McCordsville and Zionsville.
Elona Biotechnologies Inc., a drugmaker trying to launch a generic version of insulin, says it has found a solution to its default on more than $8 million in economic development loans and incentives from the city of Greenwood. Elona announced Feb. 6 that it has reached an agreement under which the company will be acquired by a group of private investors. It did not disclose the names of the investors or the amount of financing. "While terms of the transaction are confidential, Elona will receive sufficient funds to correct its default situation with the city of Greenwood, hire management and scientific talent to move the company forward, and proceed with clinical trials to support the registration of its generic human insulin under development for the treatment of diabetes," the company said in a prepared statement. An executive team of pharmaceutical industry veterans with extensive experience will join Elona as staff or consultants, the company said. The company told Greenwood officials of its financial troubles in late January. That information prompted the Greenwood Redevelopment Commission to vote to declare Elona in default on $8.4 million worth of economic development incentives the city approved for the company in 2010. The city loaned $6.4 million to help Elona build a 50,000-square-foot, $28 million insulin production plant in Greenwood and hire 70 workers. The city also gave Elona $1.5 million to help it win approval for its insulin from the U.S. Food and Drug Administration and $500,000 for equipment.
Eli Lilly and Co. said it is halting testing of an experimental drug for rheumatoid arthritis because the studies show the medicine is not effective. The decision to stop testing the therapy, called tabalumab, in rheumatoid arthritis wasn’t based on safety concerns, the Indianapolis-based drugmaker said Feb. 7 in a prepared statement. Lilly said it will continue to develop the drug as a treatment for lupus. In December, Lilly said it was stopping one of three late-stage rheumatoid arthritis studies of tabalumab after it failed to provide a benefit. Lilly then analyzed the other two studies and determined the drug was unlikely to help patients. The setback comes as Lilly, counting on sales of new medicines to revive growth, faces generic competition to schizophrenia drug Zyprexa, which generated $5 billion in annual revenue before losing patent protection in October 2011.