Serving Harris, Brazoria, Fort Bend, Montgomery and Galveston Counties
HOUSTON
Volume 12 | Issue 1
Inside This Issue
January Edition 2022
How To Successfully Renew Your Medical Practice Lease By Ashley Cassel Senior Vice President Healthcare Advisory Services Transwestern Real Estate Services
Brain Stimulation Device Enables New Understanding Of OCD See pg. 10
INDEX Legal Matters........................ pg.3 Oncology Research......... pg.4 Hospital News....................... pg.8 Healthy Heart....................... pg.9 Financial Forecast.............pg.11
U.S. Adults’ Blood Pressure Levels Increased During The COVID-19 Pandemic See pg. 13
I
n 2022, the Houston Medical Office real estate sector expects to see increased demand, tightened supply, escalating operating expenses, and rising construction costs, resulting in higher rental rates. Weighted average asking rents climbed 3.3% during 2021’s second quarter landing at $28.46 per SF, a $1.51/Sf increase from the beginning of the year. Most submarkets saw rents increase, with the TMC, Pasadena, Tomball, and the Inner Loop posting the lion’s share of the gains. While the traditional office building vacancy is hovering around 30% in the post-covid world, Houston medical office properties only have a 12.3% vacancy rate. Rising construction costs and ongoing supply chain issues will hinder the ability of practices to relocate, making strategic renewal strategies a critical business focus for any medical business with 2022 lease expiration dates. Tenants still have leverage, though, as the cost to renew tenants is far less than backfilling them for Landlords, so keep these tips in mind for your upcoming lease expiration: Shop around. Before engaging
in any negotiating, make sure you’ve shopped around so you can speak intelligently to the market and availability. If you find that you’re
time to negotiate a new lease contract. Any construction project requiring a permit should budget it to take about six months, so for anyone looking to move, you need to look 9-12 months from your lease expiration date. Landlords are tuned into this as well, so if you wait too long to begin your renewal negotiations, they’ll likely know that it would be challenging to move in a short period of time. Be friendly. The saying that you catch more bees with honey is undoubtedly applicable to your building managers and landlord brokers. As the broker that does the most volume of lease renewals in our Texas healthcare portfolio, I can attest that we work harder for the tenants we have a good relationship with. Most brokers are paid on commission, so they are incentivized to get your deal done in the smoothest way possible. Knowing you have the same end goal, work with your landlord broker to find mutually
The real estate sector expects to see increased demand, tightened supply, escalating operating expenses, and rising construction costs, resulting in higher rental rates in a lease market with many options at lower rents than you’re currently paying, you’re positioning yourself for successful negotiating. Know your options. Do you have any lease renewal options in your current lease contract? If not, you should be aware that your landlord does not have to renew your lease, although they probably prefer to. If you’re in a competitive market like Clear Lake, The Woodlands, or the Heights, you will want to use a delicate balance for negotiating, so the landlord does not opt to lease your space to someone else. Start early. With the current market conditions and construction timelines, tenants need to allow a lot of
see Lease...page 14
PRSRT STD US POSTAGE PAID PERMIT NO 1 HOUSTON TX
Houston Medical Times
G LOBA L HE A LT H CON F E R E N C E
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G LOBAL H EALT H CO NFER EN C E
January 2022
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Houston Medical Times
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Legal Matters The Federal No Surprises Act – What Providers and Facilities Should Know By Michael P. Gennett, JD Polsinelli, PC
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he No Surprises Act of division BB of the Consolidated Appropriations Act, 2021 becomes effective on January 1, 2022 and creates requirements that apply to providers, facilities, and providers of air ambulance services, such as cost sharing rules, prohibitions on balance billing for certain items and services, notice and consent requirements, and requirements related to disclosures about balance billing protections. These provider, facility, and provider of air ambulance services requirements generally apply to items and services provided to individuals enrolled in group health plans or group or individual health insurance coverage, and Federal Employees Health Benefit plans. The requirements do not apply
to beneficiaries or enrollees in federal programs such as Medicare, Medicaid, Indian Health Services, Veterans Affairs Health Care, or TRICARE. Beginning January 1, 2022, providers and facilities must comply with the following requirements: 1. No ba lance bi l l i ng for outof-network emergency services Nonparticipating providers and nonparticipating emergency facilities: • Cannot bill or hold liable beneficiaries, enrollees or participants in group health plans or group or individual health insurance coverage who received emergency services at a hospital or an independent freestanding emergency department for a payment amount greater than the in-network cost-sharing requirement for such services. • Certain post-stabilization services are considered emergency services, and are therefore subject to this prohibition, unless notice and consent requirements are met. 2. No balance billing for non-
emergency services by nonparticipating providers at certain participating health care facilities, unless notice and consent was given in some circumstances Nonparticipating providers of non-emergency services at a participating health care facility: • Cannot bill or hold liable beneficiaries, enrollees or participants in group health plans or group or individual health insurance coverage who received covered non-emergency services with respect to a visit at a participating health care facility by a nonparticipating provider for a payment amount greater than the in-network cost-sharing requirement for such
services, unless notice and consent requirements are met. 3. Disclose patient protections against balance billing • A provider or facility must disclose to any participant, beneficiary, or enrollee in a group health plan or group or individual health insurance coverage to whom the provider or facility furnishes items and services information regarding federal and state (if applicable) balance billing protections and how to report violations. Providers or facilities must post this information prominently at the location of the facility, post it on a public website see Legal Matters...page 14
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Houston Medical Times
Page 4
Oncology Research Texas Oncology Marks National Cervical Health Awareness Month By Christine Lee, M.D., Texas Oncology
O
nce a leading cause of cancer death in the United States, cervical cancer diagnoses and deaths have decreased dramatically in past decades and have now leveled off, largely due to prevention and early detection through routine Pap tests. January’s National Cervical Health Awareness Month raises awareness of good cervical health and early detection. If discovered and treated before the cancer spreads from the primary site, the survival rate for cervical cancer is 92% after five years. Despite greater awareness, an estimated 1,420 Texas women were expected to be diagnosed with the disease in 2021. Therefore, it is critical that women have a regular Pap test. Almost all cervical cancer cases
are caused by the human papillomavirus (HPV), a common sexually transmitted infection. Women who have had many sexual partners face an increased risk for HPV infection. However, not all women with the HPV infection will develop cancer. Other risk factors for developing cervical cancer include HIV infection, AIDS, a history of Chlamydia, long-term use of oral contraceptives, multiple childbirths, or women who have had a full-term pregnancy before age 20. Women who smoke double their risk of cervical cancer compared to nonsmokers. Cervical cancer may not come with warning signs in the early stages. However, symptoms and pain may be noticed as the disease worsens. Women should consult a physician for proper testing if any of the following symptoms are present: • Abnormal vaginal bleeding • Unusual vaginal discharge • Painful intercourse • Post-menopausal bleeding • Bleeding after intercourse • Pain in the pelvic area
• Bleeding or spotting between periods • Longer or heavier periods The Pap test is the most effective screening tool for cervical cancer. Women of average risk in their 20s should have a Pap test every three years, regardless of whether they have received the HPV vaccine. Women age 25-65 should have a Pap test and DNA HPV test every five years or only a Pap test every three years to screen for cervical cancer. The DNA HPV test, given in conjunction with a routine Pap test, may identify existing HPV infections that could lead to cervical cancer. The U.S. Preventive Services Task Force recommends another option to screen with the high-risk
human papillomavirus (hrHPV) test only every five years. Physicians may recommend that women have more frequent screenings if certain risk factors are present. Women over 65 should discuss previous test results and the risks and benefits of screening with their physician. Three vaccines to prevent the types of HPV infections that cause cancer are FDA approved for females age 9-26, depending on the vaccine. The vaccines may reduce a woman’s risk of cervical cancer, but HPV vaccines cannot protect against existing infections. see Oncology Research...page 14
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January 2022
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Built Around You
Houston Medical Times
Page 5
Houston Methodist Receives $25 Million to Expand Cancer Center Contribution Will Establish the Houston Methodist Dr. Mary and Ron Neal Cancer Center, Fund Research and Education And Provide Community Support
H
ouston Methodist has received a $25 million philanthropic gift from Dr. Mary and Ron Neal to expand the hospital system’s cancer center. This transformational commitment will support critical areas including translational research, attracting and retaining physician scientists focused on pioneering new cancer treatments and expanding the cancer center’s impact within the Greater Houston community and beyond. In recognition of their $25 million gift, the Houston Methodist Cancer Center will be renamed the Houston Methodist Dr. Mary and Ron Neal Cancer Center. The hospital system will raise an additional $12 million in matching funds, bringing the total philanthropic impact of this gift to $37 million. “Houston Methodist is humbled to have the support of Dr. Mary and Ron Neal to elevate the cancer center and build upon our legacy of excellence in
cancer research and treatment,” said Marc Boom, M.D., president and CEO of Houston Methodist. “Their gift plays an important role in advancing our leading medicine mission and bringing potentially life-saving cancer treatments to more patients throughout Houston and the nation.” The gift bolsters the ongoing research led by Jenny C. Chang, M.D., director of the Cancer Center and Emily Herrmann Presidential Distinguished Chair in Cancer Research. Dr. Chang’s groundbreaking research has significantly advanced cancer therapy with breakthroughs such as new targeted drugs that alter tumor immune landscape of triple negative breast cancer. “Upon our initial tour of the cancer center, my husband Ron and I knew we wanted to support the incredible work Dr. Jenny Chang and her team are doing to not only help those battling cancer, but also help advance new
cancer treatments that will have t r e m e n d o u s Dr. Mary and Ron Neal impact in the future,” said Dr. Mary Neal, a retired obstetrician-gynecologist who practices part-time as a volunteer. “Since then, we’ve heard first-hand from patients who have benefited from the cancer treatment they’ve received at Houston Methodist. We have no doubt our commitment will further advance pivotal and innovative research beyond chemotherapy and radiation.” This transformational gift also will fund and retain three endowed chairs and corresponding research funds for early-stage investigative research and therapies, support recruitment and fellowship training and expand the depth of clinical trials across all community hospitals within Houston Methodist. Another component of the gift is dedicated to ongoing cancer
innovation efforts within the Center for Drug Repositioning and Development (CREDO). “Our vision for the Dr. Mary and Ron Neal Cancer Center is to grow our network of cancer physicians offering comprehensive care with the latest technologies and clinical trials so that patients across the region have the best access to cancer care,” said Chang. “While the gift from the Neal family will have direct impact for patients at the community level in areas that are often deserts for cancer care, my hope is that it will also propel our ongoing research and work to the national level toward NCI designation.” NCI-designated Cancer Centers see Methodist...page 14
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Page 6
Houston Medical Times
Why Does the Covid-19 Virus ‘Escape’ From Our Immune System? New Research Discovery Could Lead to Development of Therapies To Prevent Covid-19 Virus From Proliferating In The Human Body By Gracie Blackwell
T
he immune system is a complex network of cells and proteins that is designed to fight off infection and disease, especially those like the coronavirus, or SARS-CoV-2, that can cause numerous issues in the human body. Despite the immune system, many individuals are still at risk of being infected with the coronavirus, letting it replicate in the body and further transmitting to other individuals. The underlying mechanism of how SARS-CoV-2 escapes from the immune system has been poorly understood. However, researchers from the Texas A&M University College of Medicine and Hokkaido University have recently discovered a major mechanism that explains how SARS-CoV-2 can escape from the immune system and replicates in
January 2022
the human body. Their findings were recently published in the journal Nature Communications. “We found that the SARS-CoV-2 virus carries a suppressive gene that acts to inhibit human gene in the immune system that is essential for destroying infected cells,” said Koichi Kobayashi, MD, PhD, adjunct professor at the College of Medicine and lead author of the paper. Naturally, the cells in a human’s immune system are able to control virus infection by destroying infected cells so that the virus cannot be replicated. The gene that is essential in executing this process, called NLRC5, regulates major histocompatibility complex (MHC) class I genes, which are genes that create a pathway that is vital in providing antiviral immunity. Kobayashi and his colleagues discovered this finding back in 2012. “During infection, the amount
and activity of NLRC5 gene become augmented in order to boost our ability of eradication of viruses,” Kobayashi said. “We discovered that the reason why SARS-CoV-2 can replicate so easily is because the virus carries a suppressive gene, called ORF6, that acts to inhibit the function of NLRC5, thus inhibiting the MHC class I pathway as well.” Kobayashi, who holds a joint appointment as a professor at Hokkaido University in Japan, collaborated with Paul de Figueiredo, PhD, associate professor in the Department of Microbial Pathogenesis and Immunology at the College of Medicine, on this paper. Kobayashi and his team’s discovery shed light on the mechanism to how SARS-CoV-2 can replicate in
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the human body and can potentially lead to the development of new therapeutics to prevent the coronavirus from escaping the immune system and replicating in the body. Although the introduction of COVID-19 vaccines, such as the Pfizer and Moderna vaccines, can lower an individual’s chance of contracting the virus, there is currently no permanent therapy that can entirely prevent a human from contracting SARS-CoV-2. “We hope that this new discovery will allow us to develop a new drug that can block this gene so our immune system will be able to fight off the coronavirus for good,” de Figueiredo said.
Houston Medical Times
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Page 8
Hospital News Children’s Memorial Hermann Hospital Welcomes Second Facility Dog
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hildren’s Memorial Hermann Hospital has welcomed their second facility dog, Pilot, a 2-year-old black lab/golden retriever mix. Pilot will work alongside his canine colleague, Dexter, to assist pediatric patients while they’re in the hospital. Pilot has undergone extensive
training to interact with patients on specific, individual goals. His assigned facilitator, Renee Lee, is a Certified Child Life Specialist and has also received special training to work with Pilot. “While Pilot loves to do a lot of the things that normal dogs do, he still knows how to be a
Facility Dog Team
professional,” said Lee. “He can sit still, follow commands and be gentle with patients. We have already seen him making a difference in the lives and emotions of some of our youngest patients.” Pilot will have a number of responsibilities – making young patients feel more comfortable in the hospital, serving as a motivator to help patients achieve their goals, and distracting patients during procedures or episodes of pain. Established in February 2019, the Facility Dog Program at Children’s Memorial Hermann Hospital aims to advance psychosocial care provided to children during their hospitalizations. Pairing Certified Child Life Specialists with expertly trained dogs, provided free of charge
by Canine Companions, these working teams provide support during procedures, encourage ambulation and participation in rehab sessions, provide calm during episodes of pain, engage in play during long or repeated admissions and process new diagnoses and traumas with a furry friend by their side.
Cheers to 50 Years: Memorial Hermann Memorial City Medical Center Celebrates Golden Anniversary
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emorial Hermann Memorial City Medical Center, a mainstay of the Memorial Villages and trusted healthcare provider of residents in Greater and West Houston, turned 50 this year. Built in 1971 by Joe Johnson, the pioneer developer of the Memorial City area and founder of MetroNational, Memorial City General Hospital opened with less than 100 beds and one professional office building. Over the next 20 years, the hospital expanded its offerings with the addition of Gynecology, Cardiology, General Surgery, Cardiac Surgery, Oncology and Radiation Therapy. It also expanded its footprint with two new wings and a second professional office building. In 1994, the hospital merged with Memorial Healthcare, ultimately becoming part of the Memorial Hermann Health System (Memorial Hermann) in 1997. “Providing quality health care has been part of the Memorial
January 2022
City goal of a city-within-a-city since its inception.” said Jason Johnson, Vice President and Chairman of MetroNational. “We are overwhelmed with pride for the amount of growth, both in the size and quality of services, in the medical center over the past 50 years, and we look forward to what is to come in the future.” T o d a y , M e m o r i a l H e r m a n n Memorial City Medical Center is nestled in the heart of West Houston. Anchored by the 33-story Memorial Hermann Tower, the campus boasts 1,400 affiliated medical staff physicians representing more than 100 medical specialties, 1,800 employees, 444 licensed
hospital beds and nationally recognized, high-quality care previously found only in the Texas Medical Center. “We are proud to have deep roots in Memorial,” said Paul O’Sullivan, CEO of Memorial H e r m a n n Memorial City. “In a sense, we have grown up alongside this c o m mu n it y, expanding our services and specialties to keep pace with its needs.” In the last five years the medical center received numerous local and national awards highlighting its commitment to superior quality and safety including the Bernard A. Birnbaum, MD, Quality Leadership Award
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for Complex Teaching Medical Centers, Magnet® recognition for Excellence in Nursing, The Quality Texas Foundation’s Texas Award for Performance Excellence, and a Top 100 Hospital by IBM Watson Health (formerly Truven Health Analytics). It also added an Amputation Prevention Center and a Neuro Acute Care Unit, as well as a Structural Heart Program before the pandemic changed the course of the healthcare landscape. “Memorial Hermann Memorial City has progressed and developed in so many ways since its founding in 1971, but one thing has remained the same - our commitment to this community,” added O’Sullivan. “While the last 18 months have certainly proven that a lot can change in a short period of time, our mission to improve the health of those we serve is more focused than ever.”
Houston Medical Times
Healthy Heart New Look at Nutrition Research Identifies 10 Features Of A Heart-Healthy Eating Pattern By The American Heart Association
T
he American Heart Association has outlined 10 key features of a heart-healthy eating pattern in a new scientific statement emphasizing the importance of overall dietary pattern rather than individual foods or nutrients. These features can be adapted to accommodate individual food likes and dislikes, cultural traditions and whether most meals are consumed at home or on-the-go, according to the statement, “2021 Dietary Guidance to Improve Cardiovascular Health,” published in the Association’s flagship journal Circulation. The statement reflects the latest scientific evidence on the benefits of heart-healthy eating throughout life and that poor diet quality is strongly associated with an increased risk of cardiovascular disease and death. “We can all benefit from a heart-healthy dietary pattern regardless of stage of life, and it is possible to design one that is consistent with personal preferences, lifestyles
and cultural customs. It does not need to be complicated, time consuming, expensive or unappealing,” said Chair of the scientific statement writing group Alice H. Lichtenstein, D.Sc., FAHA, senior scientist and director of the Cardiovascular Nutrition Team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston. 10 features of a dietary pattern to promote heart health: • Balance food and calorie intake with physical activity to maintain a healthy weight • Choose a wide variety and eat plenty of fruits and vegetables to get a full range of nutrients from food rather than supplements • Choose whole grains and other foods made up mostly of whole grains • Include healthy sources of lean and/or high-fiber protein such as plant proteins (nuts and legumes), fish or seafood, low fat or non-fat dairy, lean cuts of meat and limit red and processed meats • Use liquid non-tropical plant oils
such as olive or sunflower oils • Choose minimally processed foods as much as possible • Minimize intake of beverages and foods with added sugars • Choose or prepare foods with little or no salt • Limit alcohol consumption: if you don’t drink, do not start • Apply this guidance no matter where food is prepared or consumed The dietary guidance also discusses several challenges that can make it harder to adopt or maintain a heart-healthy diet, including: • Widespread dietary misinformation from the Internet • A lack of nutrition education in grade schools and medical schools • Food and nutrition insecurity – an estimated 37 million Americans had limited or unstable access to safe and nutritious foods in 2020 • Structural racism and neighborhood segregation, whereby many communities with a higher proportion of racial and
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ethnic diversity have few grocery stores but many fast-food outlets • Targeted marketing of unhealthy foods and beverages to people from diverse racial and ethnic backgrounds through tailored advertising efforts and sponsorship of events in those communities. On an individual level, the new statement reinforces a 2020 American Heart Association statement for health care professionals that encouraged routine assessment of patients’ dietary quality and inclusion of this information in the medical record so there is follow-up at the next appointment. For more information visit heart.org
January 2022
Houston Medical Times
Page 10
Brain Stimulation Device Enables New Understanding Of OCD
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team of researchers surgically implanted brain stimulators in patients with severe obsessive-compulsive disorder (OCD) to not only treat their disabling symptoms but also – for the first time – to simultaneously record and wirelessly stream brain signals. All five patients, whose OCD symptoms were severe and resistant to conventional therapy, have enjoyed significant improvement. In addition, the novel recordings have helped explain the relationship between brain activity and OCD symptoms. Their findings were recently published in Nature Medicine. Katie suffered from debilitating OCD for years. After enduring a health crisis in 2014, her symptoms became unbearable. Her fear of contamination immensely grew to the point where she
A
To qualify for deep brain stimulation (DBS), you must have severe, chronic, treatment-resistant OCD. As different treatments failed her, Katie was determined to rid herself of the hopelessness. Her urgency to regain a normal life led her to participate in this study. “We carefully look at the records to make sure the patients have had adequate medication trials, as well as OCD-specific behavioral therapy to qualify as treatment-resistant,” said Dr. Wayne Goodman, D.C. and Irene Ellwood Chair in Psychiatry and professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine. “We want to make sure that a wide range of appropriate non-surgical therapies have been tried before proceeding with DBS.”
would not allow anyone in her home and she would obsessively deep clean her house. She recalls a time where she spent 17 hours in her bathroom, cleaning it endlessly, compulsion after compulsion, unable to stop. “OCD is so frustrating because you understand rationally that this doesn’t make sense, but the fear that something bad could happen to someone I loved outweighed the rational side of it,” Katie said. “Once it was all-encompassing, I tried different therapies: a partial hospitalization program, hours of intensive exposure response prevention therapy and different medications. Through all of that, the OCD just grew until I was completely debilitated by it.”
The DBS device was surgically implanted in five study participants by Dr. Sameer Sheth, associate professor of neurosurgery, Cullen Foundation Endowed Chair, McNair Scholar, and vice chair of research in the Department of Neurosurgery at Baylor. During electrode placement in the brain, patients were awake part of the time while answering questions about how they felt when the stimulation was turned on. This information allowed the research team to finetune the positioning of the electrodes in the brain. After surgery, patients visited Goodman at least once a month for optimization of
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see Stimulation...page 13
Houston Medical Times
Financial Forecast Financial Challenges for Gig Workers By Grace S. Yung, CFP Midtown Financial Group, LLC
T
he COVID-19 pandemic brought about numerous changes, including a significant number of people having to work from home or remotely, or losing their jobs altogether. Because of this, many have turned to the “gig” economy to generate a part-time or full-time living. The gig economy is “a labor market that is characterized by the prevalence of short-term contracts or freelance work as opposed to permanent jobs.” Some examples of gig workers include:
Unfortunately, the number one reason why most bankruptcies occur in the United States is due to the inability to pay high medical bills and/or loss of income because of time lost from work. Similarly, a large percentage of freelance and independent workers do not carry disability insurance. This coverage will pay out a pre-set amount of “income” if an insured is deemed unable to work due to a covered illness or injury. Without disability insurance, you run the risk of depleting savings and/or having to pay living expenses using high-interest credit just to get by – and this can have a negative impact on your savings / retirement funds. In addition to lack of insurance coverage, gig economy workers are less likely to have access to an employer-sponsored retirement plan, like a 401(k). Because of that, they
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• Graphic designers • Freelance writers • Drivers (Uber or Lyft) • Massage Therapists According to Upwork’s “Freelance Forward: 2020” study of the U.S. independent workforce, roughly 59 million Americans performed freelance work between September 2019 and 2020, representing 36% of U.S. workers. Although having your own business can provide you with a number of incentives, such as more control over your schedule and the ability to set your own pay rate, there are also some areas where gig workers can face financial hurdles. The most prevalent of these can include: • Lack of adequate health and disability insurance • No employer-sponsored retirement plan While individual health insurance coverage can be pricy, the alternative is having to pay for most – or even all – of your care out-of-pocket.
can miss out on a number of key benefits, such as tax-deferred savings, pre-tax contributions (which can lower income tax in the years when deposits are made), and employer matching contributions – which is oftentimes thought of as “free money.” Further, having a good solid estate plan could provide you with a number of benefits, too, such as allowing another individual the right to make decisions for you in case you are no longer able to do so yourself, and ensuring that your assets end up with those that you intend, as versus having the state choose the recipients for you. Many people are under the misconception that estate planning is only for the ultra-wealthy. But this is not the case. In fact, estate planning can be even more important for those who do not have a significant amount of assets, as survivors could endure see Financial Forecast...page 14
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Houston Medical Times
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U.S. Adults’ Blood Pressure Levels Increased During The COVID-19 Pandemic The COVID-19 Pandemic Is Associated with Higher Blood Pressure Levels Among Middle-Aged Adults Across the U.S., According To New Research Published Today In The American Heart Association’s Flagship Journal Circulation.
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ccording to the American Heart Association, nearly half of American adults have high blood pressure, a leading cause of heart disease, and nearly 75% of all cases remain above the recommended blood pressure levels. Stay-at-home orders were implemented across the U.S. between March and April 2020 in response to the COVID-19 pandemic. This resulted in a shift to remote health care for numerous chronic health conditions including high blood pressure and had a negative impact on healthy lifestyle behaviors for many people. “At the start of the pandemic, most people were not taking good care of themselves. Increases in
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blood pressure were likely related to changes in eating habits, increased alcohol consumption, less physical activity, decreased medication adherence, more emotional stress and poor sleep,” said lead study author Luke J. Laffin, M.D., co-director of the Center for Blood Pressure Disorders at the Cleveland Clinic in Cleveland, Ohio. “And we know that even small rises in blood pressure increase one’s risk of stroke and other adverse cardiovascular disease events.” For this analysis, researchers accessed de-identified health data from an employee wellness program (included employees and spouses/partners) to assess changes
in blood pressure levels before and during the COVID-19 pandemic. The data included nearly a half million adults across the U.S., average age of 46 years, 54% women, who had their blood pressure measured during an employee health screening every year from 2018 through 2020. Participants were categorized into four groups: normal, elevated, stage 1 hypertension and stage 2 hypertension based on the current American Heart Association blood pressure guidelines. The researchers compared monthly average blood pressures between 2018 and 2019 and blood pressure measures in January through March 2019 to January through March 2020 (pre-pandemic). They then reviewed blood pressure changes comparing April to December 2020 (during the pandemic) to April to December 2019 (pre-pandemic). The analysis found: • During the pandemic (April to December 2020), average
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increases in blood pressure each month ranged from 1.10 to 2.50 mm Hg higher for systolic blood pressure (the top number in a blood pressure reading that indicates how much pressure the blood is exerting against the artery walls with each contraction) and 0.14 to 0.53 mm Hg for diastolic blood pressure (the bottom number in a blood pressure reading indicates how much pressure the blood is exerting against the artery walls while the heart is resting, between contractions) compared to the same time period in 2019. see Blood Pressure...page 13
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Page 13
The Framework Kelsey-Seybold Opens New Greater Heights Clinic on 610 North Loop Freeway Clinic Expands Access To Coordinated, Evidence-Based Care Serving Houston’s Greater Heights Area Residents
K
elsey-Seybold Clinic opened a new, 22,000-square-foot clinic on the 610 North Loop near the intersection of U.S. Highway 290. Kelsey-Seybold Clinic – Greater Heights represents another significant investment in the Houston community. Kelsey-Seybold Clinic – Greater Heights is located at 1900 N. Loop W., Houston, Texas 77018, and occupies the entire fourth floor. This new location will serve new and current patients living in Greater Heights, Garden Oaks, Oak Forest, and other communities located along the North Loop. Greater Heights Clinic has room for up to 10 providers and offers
Stimulation Continued from page 10 DBS therapy during simultaneous brain recordings. In between visits, patients used a tablet application developed by Brown University researchers to collect brain recordings during daily activities at home. “What is unique about this device is that it not only stimulates, but it can record brain activity,” said Sheth. “Our goal is to understand what those brain recordings are telling us and to train the device to recognize certain patterns associated with specific symptoms. The better we understand the neural signatures of health and
Blood Pressure Continued from page 12 Before the pandemic, blood pressure measures were largely unchanged when comparing study years. • Higher increases in blood pressure measures were seen among women for both systolic and diastolic blood pressure, among older participants for systolic blood pressure, and in younger participants for diastolic blood pressure. • From April to December 2020, compared to the pre-pandemic time period, more participants
comprehensive primary care for adults. “Kelsey-Seybold is expanding across the Greater Houston area, and the Heights and surrounding areas are dynamic and thriving. Having lived in the area for more than 10 years, I’m excited to be able to care for the people living in my community,” said Courtney Sutherland, M.D., M.B.A., Managing Physician, Kelsey-Seybold Clinic – Greater Heights. “Kelsey-Seybold is known across the region for quality care that’s evidence-based – the kind of care that everyone deserves. Now, this type of care will be more convenient for residents in the Greater Heights area and surrounding communities.” Patients visiting the Greater Heights Clinic have access to an on-site pharmacy, laboratory, X-ray, and other diagnostic testing services, as
From L to R: Tatiana Mickens, RMA; Shifat Khan, Nurse Practitioner; Candace Rivers, CMA; Puja Gandhi, MD, Internist; Javaughn Nelson, Administrative Coordinator; Courtney Sutherland, MD, Managing Physician; Tyrone Johnson, Clinic Administrator I; Xuyen Phan, MD, Family Medicine; Markisha Bates, RN, Supervisor; Tiorra Ross, MD, Pediatrician; Katherine Torres, RN, Stephanie Gonzalez, Ambulatory Services Representative II.
well as an extensive referral network of Kelsey-Seybold specialists with offices at neighboring clinics, including River Oaks, Tanglewood, Memorial City, and Memorial Villages, which will open in summer 2022. “Our providers and staff are thrilled to finally be here in our new facility, caring for patients living in the Greater Heights area and surrounding communities,” said Tyrone Johnson, Clinic Administrator, Kelsey-Seybold Clinic – Greater
Heights. “Kelsey-Seybold is focused on not only delivering quality care to patients, but also being a good steward of the communities we serve. We look forward to seeing patients in the clinic and connecting with them as a supportive member of this incredible community.” The new Kelsey-Seybold Clinic – Greater Heights location was designed by architects at Powers Brown Architecture. Gamma Construction was the general contractor.
disease, the greater our chances of using DBS to successfully treat challenging brain disorders like OCD.” “We were able to analyze over 1,000 hours of brain recordings, synchronized with symptom ratings. The Brown team was responsible for analyzing that data to try to establish a relationship between the recorded brain signals and how the patient is feeling,” said Dr. Nicole Provenza, lead author, recent Brown biomedical engineering doctoral graduate and current postdoctoral fellow in the Department of Neurosurgery at Baylor. Katie, who had the surgery over a year ago, felt immediate changes in the way her brain processed OCD after stimulation was turned on. Since her
surgery, she spends more time with her loved ones again and feels hope for a future that is not ruled by OCD. “Before the surgery, I felt truly hopeless. I felt that I was at the end and didn’t know how I could keep trying to survive this. The amount of pressure felt so massive, I just felt like I was crumbling underneath it and there was no way out. The surgery and device have changed my life. I have hope again and am starting to do the things I love,” Katie said. “Thanks to Katie and the other patients’ efforts completing daily recordings at home, we were able to identify candidate trends between brain activity and OCD symptom severity,” said Dr. David Borton, associate
professor of biomedical engineering at Brown University. “In the future, these biomarkers could be used to enable adaptive DBS systems that are able to automatically adjust stimulation levels in response to fluctuations in symptoms.” “In addition to advancing DBS therapy for cases of severe and treatment resistant OCD, this study has the potential for improving our understanding of the underlying neurocircuitry of the disorder,” Provenza said. “This deepened understanding may allow us to identify new anatomic targets for treatment that may be amenable to novel interventions that are less invasive than DBS.”.
(26.8%) were re-categorized to a higher blood pressure category, while only 22% of participants moved to a lower blood pressure category. “From a public health perspective, during a pandemic, getting vaccinated and wearing a mask are important. However, the results of our research reinforce the need to also be mindful of chronic health conditions such as the worsening of blood pressure,” Laffin said. “Even in the midst of the pandemic, it’s important to pay attention to your blood pressure and your chronic medical conditions. Get regular exercise, eat a healthy diet, and monitor your
blood pressure and cholesterol. See your doctor regularly to learn how to manage your cardiovascular risk factors.” The study authors are following up on these results to find out if this trend continued in 2021, which may indicate a forthcoming wave of strokes and heart attacks. “Unfortunately, this research confirms what is being seen across the country – the COVID-19 pandemic has had and will continue to have long-reaching health impacts across the country and particularly related to uncontrolled hypertension,” said Eduardo Sanchez, M.D., M.P.H., FAAFP, FAHA, the American Heart Association’s chief medical
officer for prevention. “These results validate why the American Heart Association’s National Hypertension Control Initiative (NHCI) is critically important. With a particular emphasis on historically under-resourced communities in the United States, the comprehensive program supports health care teams at community health centers through regular blood pressure management training, technical assistance and resources that include the proper blood pressure measurement technique, self-measured blood pressure monitoring and management, medication adherence and healthy lifestyle services.”
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January 2022
Page 14
Lease
Houston Medical Times
opportunity for tenants to review their current situation and make any necessary improvements or adjustments to their lease space. If your space is working great for your practice, you’re already ahead. If your practice needs to expand, downsize, renovate, relocate,
or shut down, renewal time is the ideal opportunity to assess your changing needs. Following the guidance above will hopefully ensure the process with be as smooth and stress free as possible.
understandable language) of the good faith estimate of the expected charges, expected service, and diagnostic codes of scheduled services. • The good faith estimate must include expected charges for the items or services that are reasonably expected to be provided in conjunction with the primary item or service, including items or services that may be provided by other providers and facilities. 6. Ensure continuity of care when a provider’s network status changes • A health care provider or facility that ends a contractual relationship with a plan or issuer and has a continuing care patient must generally: − Accept payment from the plan or issuer (and cost-sharing payments) for a continuing care patient at the previously agreed to payment amount for up to 90 days after the date on which the patient was notified of the change in the provider’s network status. − Continue to adhere to all
policies, procedures and quality standards imposed by the plan or issuer for such items or services as if the contract were still in place. 7. Improve provider directories and reimburse enrollees for errors • Any health care provider or health care facility that has or has had a contractual relationship with a plan or issuer to provide items or services under such plan or insurance coverage must timely submit changes to the provider directory information and reimburse enrollees who relied on an incorrect provider directory and paid a provider bill in excess of the in-network cost-sharing amount. The federal No Surprises Act will effectively try to lower health care costs for consumers by prohibiting surprise billing and bill balancing by out-of-network health care providers. In certain circumstances, it will supersede state laws but it will also exist in addition to existing state laws regulating out-of-network providers where it is applicable.
with a gynecologic oncologist and radiation oncologist to determine specific treatment needs. There are several treatment options for cervical cancer including chemotherapy, radiation therapy, targeted therapy, immunotherapy, surgery, and palliative care. Each method may be used
alone, or in combination with other treatments. Researchers are making advances against cervical cancer. For now, regular screenings, awareness, and healthy lifestyle choices, such as eating well and exercising regularly, are the best tools to reduce risk.
diagnosing and treating cancer. The Neal’s philanthropic gift will elevate the current research done at the cancer center and help with retaining talent to accelerate Houston Methodist’s pursuit of NCI-designation. Longtime supporters of Houston Methodist, Dr. Mary and Ron Neal have
a history of championing cancer research and treatments guided by Dr. Jenny Chang and other key medical initiatives at Houston Methodist. The Neal family’s previous gift to support cancer immunotherapy research was spurred by Dr. Chang’s passion to bring new life-saving treatments to patients faster.
Bases Covered? Working in the gig economy can have both advantages and drawbacks. Continued from page 11 The freedom to choose your own hours and pay rate can oftentimes come at the financial hardship if the unexpected cost of inadequate healthcare coverage were to occur. and fewer options to save for retirement. Do You Have All Your Financial Narrowing down the proper
strategy can differ, from one person to another. Therefore, it is recommended that you discuss your specific situation with a Certified Financial Planner who can help you identify any of the “gaps” in your current plan.
Continued from page 1 agreeable terms for the building owner and you. Lease renewal time is an
Legal Matters
Continued from page 3 (if applicable) and provide it to the participant, beneficiary or enrollee in a timeframe and manner outlined in regulation. 4. No balance billing for air ambulance services by nonparticipating air ambulance providers • Providers of air ambulance services cannot bill or hold liable beneficiaries, enrollees or participants in group health plans or group or individual health insurance coverage who received covered air ambulance services from a nonparticipating air ambulance provider for a payment amount greater than the in-network cost-sharing requirement for such services. 5. Provide good faith estimate in advance of scheduled services, or upon request for uninsured (or self-pay) individuals • The provider or facility must provide notification (in clear and
Oncology Research Continued from page 4 Women diagnosed with cervical cancer should consult
Methodist
Continued from page 5 meet the rigorous standards for transdisciplinary, state-of-the-art research and clinical care and focus on developing new approaches for preventing,
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Page 15
WHOSE INTERESTS does your malpractice insurer have at heart?
Yet another Texas medical liability insurer has transitioned from focusing on doctors to focusing on Wall Street. This leaves you with an important question to ask: Do you want an insurer that’s driven by investors? Or do you want an insurer that’s driven to serve you—one that’s already paid $120 million in awards to its members when they retire from the practice of medicine? Join us and discover why delivering the best imaginable service and unrivaled rewards is at the core of who we are.
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Life’s Simple
HOW TO EAT BETTER CREATE A HEALTHY DIETARY PATTERN
1
3
TIPS FOR SUCCESS WATCH CALORIES Eat only as many calories as you use up through physical activity. Understand serving sizes and keep portions reasonable.
ENJOY
COOK AT HOME
LIMIT
Take control over the nutritional content of your food by learning healthy preparation methods.
LOOK FOR THE HEART-CHECK trans fat and partially hydrogenated oils (found in some commercial baked goods and fried foods)
AVOID
2
LEARN THE SALTY SIX
READ NUTRITION LABELS Nutrition Facts
8 servings per container Serving size 2/3 cup (55g) Amount per serving
Calories
230 % Daily Value*
Total Fat 8g Saturated Fat 1g
10% 5%
Trans Fat 0g Cholesterol 0mg Sodium 160mg Total Carbohydrate 37g Dietary Fiber 4g
Learning how to read and understand food labels can help you make healthier choices. When you have more than one choice, compare nutrition facts. Choose products with lower amounts of sodium, saturated fat and added sugars.
0% 7% 13% 14%
Total Sugars 12g
LEARN MORE AT HEART.ORG/MYLIFECHECK AND HEART.ORG/EATSMART Includes 10g Added Sugars Protein 3g
20%
10% Vitamin 2mcg Heart Association, Inc., © Copyright 2019DAmerican a 501(c)(3) not-for-profit. All rights reserved. Unauthorized use prohibited. Citations available upon request.5/19 DS14545 Calcium 260mg
20%
Iron 8mg
45%
Potassium 235mg
January 2022
foods that can be part of a healthy eating plan.
6%
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Limit the amount of sodium you eat each day. Learn the Salty Six. These common foods can be loaded with excess sodium: Breads & Rolls Pizza Sandwiches Cold Cuts & Cured Meats Soups Burritos & Tacos