Tag Archives: health journalism

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In Florida and everywhere, a big shift is underway. It’s changing the way we go to the doctor.

Jewell Hamilton, left, and Andre Curry attend the front desk at Florida Blue in Tampa, where consumers can get wellness checks in addition to buying insurance. [MARTHA ASENCIO RHINE | Times]

By Justine Griffin for the Tampa Bay Times 

The health care business in Florida and across the nation is the midst of monumental change as insurers, hospital chains and even retailers begin to venture outside their traditional roles.

Hospitals are getting into the insurance end of the business. Insurers, along with drug stores, are delivering front-line health care.

And consumers, confronted with blurring lines and a host of new options, may need a scorecard to keep up. The shifting ground continues to change where and how they go to the doctor.

BayCare, which operates 15 hospitals in Tampa Bay and the surrounding area, next month will become the second health system in the state to sell Medicare Advantage plans, the privately offered insurance policies through which many people receive their Medicare benefits.

Two other chains, Florida Hospital and Orlando Health, are providing HMO insurance plans to thousands of Disney employees this year, with hopes of expanding the model to include other employers.

Meanwhile insurance companies, from Florida Blue to UnitedHealth, are gobbling up physicians practices and creating large networks of doctors offices that offer clinical services under new company banners.

And retailers like CVS and Walgreens continue to push more toward the front lines of health care, offering online doctors’ visits and an expanding list of other medical services.

It all adds up to an industry in the middle of a shake out, executives and experts say, with players on all edges trying to stay relevant by expanding what they do.

“This is a trend that’s been emerging over the last five years,” said Peter Young, a hospital consultant. “It’s increasing each year as providers discover that they need to move up the food chain.”

Driving many of the changes is the Affordable Care Act, which helped usher in a shift in thinking about the cost of health care. Hospitals are penalized more often by insurance companies and the government when patients have more frequent stays. The focus now, Young said, is keeping patients out of the emergency room.

“What we’re seeing is that ER visits are flattening or declining all over America as health systems begin to focus on prevention,” he said. “They are redirecting non-emergent people to urgent care, and urgent care is perfect for that. That’s also why you see CVS and Walgreens getting into and expanding their clinic business.”

Read more here. 

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Lyme disease is on the rise in Florida, but experts don’t know why

Lyme disease cases are up across the nation, but notably in states like California and Florida, where the disease has not been an issue in the past. The disease comes from bacteria carried by ticks like this one that get it by feeding on an infected animal. Inftected ticks can then transmit it to humans through bites. [Times files]

By Justine Griffin for the Tampa Bay Times 

When Jackie Dube found circular rashes with bullseye points on her stomach, she went to the hospital. Doctors told her she had an allergic reaction to flea bites.

A year later, she became seriously ill. Flu-like symptoms and chronic joint pain would continue on and off for years until she’d eventually be diagnosed with Lyme disease. More than a decade after her misdiagnosis, the 37-year-old Pinellas Park resident says she suffers “flair ups” from Lyme disease annually.

“In the beginning, doctors told me it was psychosomatic, that all of this was in my head,” Dube said. “After years of hearing that, but dealing with my eyes swollen shut, a dislocated jaw and shoulder, fistulas in my thighs, I was finally tested for Lyme and was positive.”

Dube is one of a growing number of Floridians who suffer from Lyme disease, part of a nationwide increase that has researchers stumped.

Historically concentrated in New England, the disease has mostly been a seasonal issue in warmer months when ticks are prevalent in wooded areas. But data collected by Quest Diagnostics, a national clinical laboratory, found increasing Lyme disease cases in all 50 states, with a significant rise in places like California and Florida. Until recently, those two large states have never been associated with high rates of the disease.

“As things get warmer, one would think that the ticks would migrate more north, to Canada, not necessarily to Florida,” said Dr. Harvey Kaufman, senior medical director at Quest. “We’re seeing a rise in cases in Canada and in Florida, but with Florida we’ve got to think of a reason other than climate change.”

While the number of diagnoses in Florida is comparatively small, the steep increase in cases has triggered some concern. Last year, according to Quest, 501 cases of Lyme disease were reported in the state — triple the number five years ago and a spike of 77 percent since 2015.

About 30,000 cases nationwide are documented each year by the Centers For Disease Control and Prevention, but the agency admits many go unreported.

In 2015, researchers from Johns Hopkins estimated that Lyme disease costs the U.S. health care system up to $1.3 billion a year.

“The CDC has some older data that shows that the blacklegged tick is spreading into more parts of the U.S., so that’s likely one explanation for the rise,” Kaufman said. “But Lyme disease has really taken off in the last several years. There is generally more awareness of Lyme disease in places like Florida where you see ticks year-round because there’s no winter freezing.”

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HIV is on the rise in Florida and young people don’t seem to care

Robert Marquez of Tampa was diagnosed with HIV at 18. He didn't know much about the disease at the time, but quickly did his research. "It didn't make me feel better," said Marquez, now 20. "But it gave me hope." [BRONTE WITTPENN | Times]

By Justine Griffin for the Tampa Bay Times 

Robert Marquez was 18 when he got the news that would change his life forever.

He was HIV positive.

“I knew nothing about it outside of it being a ‘gay disease’ like my conservative parents and pastor said about it,” said Marquez, now 20. “But now, I know that’s not true. It can affect anyone. But it’s also possible to live a long, normal life.”

His case is one example of a double-edged reality that has raised concern among advocates as HIV makes an unwelcome comeback in Florida. While the stigma has lifted somewhat and effective treatments have lessened much of the danger, the disease no longer presses on the public consciousness like it once did.

That and a lack of public information have contributed to a rise in cases among a new generation of young people who never knew the fear that HIV evoked in earlier times.

Florida continues to rank at or near the top nationally for HIV diagnoses, with Pinellas and Hillsborough counties among the regions that are considered hotbeds of activity. And local health officials say they are seeing more cases among people in their early teens to early 20s.

“Yes, HIV is more manageable these days, but it’s on the rise again. Younger people are being diagnosed and don’t seem to understand the consequences or know the history of the stigma behind HIV and AIDS,” said Lorraine Langlois, CEO of Metro Wellness & Community Centers, a network of health care facilities that specialize in LBGTQ services around Tampa Bay.

While state health officials typically don’t release HIV data in real time, many available numbers support what advocates say they are seeing in their centers.

According to the Florida Department of Health, the number of HIV diagnoses:

• Increased 8 percent statewide among people of all ages from 2014 to 2016.

• Shot up 20 percent from 2007 to 2016 for people in their 20s across the state.

• Rose significantly over the same nine years for people in their 20s in Tampa Bay. The increase was 28 percent in Pinellas and Pasco counties, and 23 percent in Hillsborough County.

Nationally, people ages 13 to 24 accounted for 21 percent of all new HIV diagnoses in the U.S. in 2016, with most of those occurring among those who are 20 to 24, according to the Centers for Disease Control and Prevention.

Many of them are not using condoms, a problem that has only worsened in the last decade. In a CDC survey last year, only 54 percent of sexually active high school students said they used condoms the last time they had intercourse, down from 61 percent in 2007.

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The future of Tampa Bay hospital care looks a lot like Apple and Amazon

Renderings show the improvements coming to St. Joseph's Hospital in Tampa. The hospital, part of the BayCare system, is planning a $126 million, six-story tower that will add 30 private rooms on each level. It's just a slice of the massive investments currently in the works as local hospitals work to keep up with demands from growing population, advances in technology and changing patient preferences. [Courtesy of BayCare]

By Justine Griffin for the Tampa Bay Times

Tampa Bay residents have more say than ever in how they go to the doctor.

Patients can chat with a physician from their phones, or from a computer screen at a grocery or drug store kiosk. Urgent care clinics and freestanding emergency rooms are proliferating across the region. And many hospitals are undergoing multi-million dollar upgrades, with amenities like private rooms, to accommodate a rising tide of patients.

The future will bring even more convenience, according to CEOs of the Tampa Bay area’s largest health care organizations.

In recent interviews, they described a health care landscape that is changing rapidly to keep up with population growth, new technology, changing patient preferences and government rules designed to keep people out of the hospital. More than one likened their new, evolving approach to the way companies like Apple and Amazon have changed the retailing world.

Hospitals and their offshoots will be more “consumer centric,” they said.

“Retail ready” is how Tampa General Hospital CEO John Couris described it, using Apple as the model.

“Their stores are cool, we like going online through their products,” he said. “There might be phones out there that can do more stuff than the iPhone, but we pay Apple because their network is reliable. It’s a real relationship, and that’s something we’re trying to create in health care now.”

The key will be adjusting as customer expectations change, said Tommy Inzina, CEO of BayCare, which operates 15 hospitals in Tampa Bay and surrounding areas.

An example: “Years ago, it was very common for a patient to have a roommate,” he said. “With patients paying more money out of their own pockets for health care now, they don’t want a roommate anymore.”

What makes Tampa Bay and Florida unique in some ways is that the population is still growing. That’s the main driver of new construction and renovations, which nearly all of the major hospital systems in Tampa Bay are investing in right now, said Jay Wolfson, a professor with USF Health.

A particular focus will be on “the Medicare, commercially insured and cash-paying parts of that market,” he said. “For patients, it should mean more access and choice. And while the physical brick-and-mortar acquisitions and expansions under brand names continues, each of the corporate health care powerhouses in our community are very busy developing virtual care systems and will expand dramatically in the years ahead to include home-based care management and marketing so that ‘visits’ to the doctor or hospital will be less necessary.”

Like retailers, they’re learning that convenience is key.

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A transgender man in search of hormone therapy, he turned to Planned Parenthood

After leaving Pasco County to attend Florida Gulf Coast University, Kasey Fraize received hormone therapy through Planned Parenthood. The resulting changes made him more comfortable as a transgender man and inspired him to become active on campus, teaching fellow students about transgender issues. "I struggled to find my place here at first," he says. "There's a huge gap between the students. So I wanted to fill it." [OCTAVIO JONES | Times]

By Justine Griffin for the Tampa Bay Times

Kasey Fraize wasn’t afraid any more.

One day early in his freshman year at Florida Gulf Coast University, he entered the campus wellness center intent on finding ways to fit in.

“I walked right up to the desk and asked what kind of resources they had for the transgender community,” Fraize, now 20, recalls. “She handed me a dusty old pamphlet that was so bad.”

It used the scientific but sometimes negatively charged term “hermaphrodite” to describe transgender people.

The moment propelled Fraize to get involved, and to prod his new school toward a better understanding of students like him. But he says it never would have been possible without help from an unexpected source.

Planned Parenthood, best known for reproductive health services including abortions, had just started a program to offer hormone therapy at many of its Florida health centers. Fraize discovered the program, and got a prescription for testosterone from a Planned Parenthood doctor not far from campus.

After struggling to find acceptance back home in Pasco County, where some still call him “Cassandra,” the therapy brought welcome changes to his body and helped him feel more like himself.

He got a job at FGCU’s wellness center and began to host forums about the transgender community and other issues. This year, he ran for a seat in student government.

“Maybe it was the hormones,” Fraize says, “but I was on a mission.”

Read more here.