Becker's ASC Review

96 HEALTHCARE NEWS What makes Minnesota one of the best states to practice By Ariana Portalatin M edscape has frequently ranked Minnesota as one of the best states for physicians to practice in its annual list based on a number of factors. What makes the state an attractive place for healthcare workers? Medscape ranks states according to compen- sation, health system performance, happi- ness in and outside of work, and physician burnout, among other measures. Minnesota was listed in the top five states for four out of the past five years. Minnesota was viewed highly in terms of over- all livability and health system performance. Average compensation for Minnesota physi- cians in 2020 was $244,720. Although it has a high percentage of burnout, Minnesota has been ranked as having the lowest malpractice rates and ranked highly for well-being, public health and higher education levels. William Nicholson, MD, is a hospitalist at M Health Fairview and vice president of medical affairs for Fairview's St. John's Hos- pital, Woodwinds Hospital and St. Joseph's Campus. Dr. Nicholson said he advocates for the state to be the best not only in his role at Fairview, but as a member of the Minnesota Medical Association and chair of the organi- zation's political action committee. "We try to elect lawmakers who are more in tune with what patients need and what it means to have a great health system and we've done pretty well at that in Minnesota," Dr. Nichol- son said. "Minnesota has a long tradition of politicians and leaders in healthcare who get it. ey understand that it's not about winning the argument. It's about getting the outcome for the patient that matters at the end of the day." Dr. Nicholson also attributed the success of hospitals and Minnesota's overall livability to the "Minnesota Miracle" of 1971, a series of reforms passed by state officials to improve several key areas, including education, in- frastructure and taxes. is, he said, has had long-term effects still seen today. "As a physician, you see the end pathway of unsafe living, pollution, education [and] socioeconomic gaps. It's not just nice and pretty to live in a city that has great public spaces and high-quality schools that are well supported and robust cultural activities," Dr. Nicholson said. "We see it as protective of our patients and something that makes our practices better, not only because it prevents illness, but because when someone gets ill we know that there are resources that will support them." Marc Gorelick, MD, president and CEO of Minneapolis-based Children's Minnesota, said the medical device industry in Minne- sota is attractive to physicians as well. According to the Minnesota Department of Employment and Economic Development, implantable cardiac pacemakers, mechani- cal heart valves and implantable infusion pumps are just a few devices to come out of the state, which also ranks highly for the number of device patents per 1 million peo- ple. Manufacturing employment is also four times more concentrated than the national average, with nearly 32,700 employees. "We have a thriving medical device industry here in the Twin Cities region that is, I would argue, second to none," Dr. Gorelick said. "at makes it an attractive environment because there is that spirit of always wanting to innovate and drive improvements in health- care. ose are some of the things that make this a place where people can be happy to work in healthcare as physicians or other providers." Dr. Gorelick added that two major aspects that attract physicians to practice in Min- nesota are the number of top performing hospitals and the collaboration between hospital systems. "We have a long history of health systems working together to collaboratively address things around overall quality of care, patient safety and, more recently, issues of health equity," Dr. Gorelick said. "at spirit of collaboration runs deep here and is also an attractive environment for somebody who wants to practice and wants to see the popu- lation of the state thrive." n DOJ joins false claims lawsuits against Kaiser By Ayla Ellison T he U.S. Department of Justice announced July 30 that it intervened in six False Claims Act complaints alleging Kaiser Foundation Health Plan and other affiliates of Oakland, Calif.-based Kaiser Permanente submitted inaccurate diagnosis codes for its Medicare Advantage members to receive higher reimbursements. The allegations against the Kaiser affiliates were originally brought under the qui tam, or whistleblower, provisions of the False Claims Act. The lawsuits al- lege Kaiser pressured physicians to create addenda to medical records after patient visits to add diagnoses that patients did not have or were not ad- dressed during the in-person visit. The additional codes allegedly resulted in Kaiser receiving higher Medicare reimbursements, according to the Justice Department. Kaiser disputes the allegations. "We are confident that Kaiser Permanente is compliant with Medicare Ad- vantage program requirements and we intend to strongly defend against the lawsuits alleging otherwise," the system said in a July 29 statement. "Our medical record documentation and risk adjustment diagnosis data submitted to the Centers for Medicare & Medicaid Services comply with applicable laws and Medicare Advantage program requirements. Our policies and practices represent well-reasoned and good-faith interpretations of sometimes vague and incomplete guidance from CMS. For nearly a decade, Kaiser Permanente has achieved consistently strong performance on Risk Adjustment Data Valida- tion audits conducted by CMS. With such a strong track record with CMS, we are disappointed the Department of Justice would pursue this path." The following Kaiser affiliates are named in the lawsuits: Kaiser Foundation Health Plan, Kaiser Foundation Health Plan of Colorado, The Permanente Medical Group, Southern California Permanente Medical Group and Colo- rado Permanente Medical Group. n

• Cover