Sunday, March 27, 2016

Dr. Kwon's Excel ER Facility Won't Lower Healthcare Costs


Bulldozers broke ground at the corner of Sherwood Way and Southland Boulevard for Excel ER, a freestanding emergency room.  Excel ER operates 24 hours a day, 365 days a year in four Texas communities.

The Texas Legislature paved the way for freestanding emergency rooms with a bill passed in 2009, however government payors, Medicare and Medicaid, do not reimburse freestanding ER's for care provided.  Excel ER serves people with private health insurance and/or significant personal financial resources.

San Angelo patients will have a learning curve to navigate as they consider the appropriate place to have their crisis healthcare needs met.  Insured patients in San Angelo are used to seeing their primary care doctor or being referred to urgent care, if the wait to see their doctor is too long.  The ER decision, if not directed by their health plan, meant choosing between Shannon Medical Center and San Angelo Community Medical Center.  Area insured citizens will have other options.

In the words of President Christopher Kwon, M.D., Excel ER's value proposition is not lower costs, according to the Tyler Morning Telegraph.  

“Excel ER offers virtually the same rates as traditional hospital-based ERs,” Kwon said. “Urgent care centers do not treat the same level of emergencies as a hospital ER and freestanding ER’s, so their costs would naturally be different.” 
A local businessman said the Excel ER lot was purchased at a significant premium.  His words, "Never before has anyone paid so much for commercial real estate in San Angelo acre for acre."

Wheelhouse Development LLC is behind the commercial real estate side of Excel ER.  Wheelhouse is based in Lubbock and has a one person board, Brady Collier.  Maybe the Wheelhouse Development team knows something grizzled San Angelo businessmen don't.  Time will tell in regard to San Angelo commercial land values.

City of San Angelo Development Corporation documents show a $1.7 million price tag for the Excel ER project.  That price cannot include state of the art digital x-ray, CT scanner, ultrasound and medical laboratory equipment.  Total project costs are certainly a multiple of the $1.7 million amount listed.

Excel ER's value comes from a mixture of time and luxury.  Tyler Morning Telegraph reported:

“The main difference between our new facility and a hospital ER is that our patients are seen by a board-certified emergency doctor within minutes of coming through our doors, while it may take a much longer period of time for that same patient at a hospital ER,” Kwon said.
Kwon said Excel ER patients are seen by an ER doctor in five minutes or less in a television interview.  This compares to 17 minutes for SACMC and 23 minutes for Shannon's Emergency Department, a level 3 trauma center.

Midland Reporter Telegram highlighted:

While most patients spend little time in Excel ER’s lobby/waiting area, it has been designed with a four-star hotel ambience, so a patient’s family will feel more comfortable and at ease during what can be a stressful time.
Katy, Texas based Kwon is the sole board member for Excel ER. He's also listed as one of three board certified ER doctors for Excel's Weatherford site.  Excel partnered with ER physician groups, Leading Edge Medical Associates in East Texas and Code 3 Emergency Physicians in Weatherford.  Kwon also set up North Texas ER I LLC in Weatherford.


It's not clear who Kwon will partner with for emergency physician services in San Angelo.  I can't imagine anyone from Shannon or Community being involved, but I've been surprised before by actions taken by local folk.

Excel ER represents a myriad of corporate entities wanting to siphon patients with health insurance from area hospital emergency departments.  Taking the cream off the top will not decrease health care costs in our community.  It may make a few people, like Brady, Collier, Dr. Kwon and their partners, lots of money.  It's the new wheeling and dealing health care landscape.  In the end it will cost us all more.

Note:  While not the subject of this piece another freestanding ER by Neighbors Emergency Center is also underway.  Development Corporation documents show that project at $1.3 million.

Update 8-21-16:  The Standard Times ran a story on freestanding ER's but failed to mention either of our two new local sites.

Update 10-13-16:  The Standard Times story on Neighbors freestanding ER showed local hospitals playing nice with the new guys in town.  Excel ER is the next to open.

Saturday, March 12, 2016

Ross Tells Radio Host MedHab is FDA Approved


MedHab CEO Johnny Ross spoke with the host Richard Diaz of National Running Network on BlogTalkRadio.  Ross said at the 25:40 mark:

Ross:  "From the clinical side of things in healthcare we are miles ahead of anybody else.  I believe we're pretty far ahead in this space as well sports performance."

Host:  "You have FDA approval on your products, right?

Ross:  "I do and we're probably going to start, they're Class 1 devices.  Right now we're negotiating with some major institutions to do some three or four month studies.....    The way we manufacture RPM2 it's identical to the way we manufacture our healthcare product....   When a person gets a pair of PRM2 inserts they meet FDA quality standards.  The difference between the two is the app and how we make it work through the smart device."
FDA approval is big news.  It's not on MedHab's website which remains under construction.  Garnering FDA approval was a critical hurddle for MedHab to start its promised production site in San Angelo.  San Angelo's City Council gave MedHab a $3.6 million economic development incentive package in January 2012 for up to 227 jobs.  The deal became official in August 2012.  The Standard Times reported:

"The San Angelo operation will serve five functions: final assembly of products, technical support, a patient call center, distribution and quality assurance," the release states.

San Angelo Mayor Alvin New, who is on the MedHab's board of directors, said the company, which can produce a maximum of 227 jobs covered by the tax incentives, could bring in money from out of town.

"It's a manufacturing facility, so it's the primary type of job we would like to have," New said. "It's not recirculating money."
Hopefully MedHab's exciting news will be forthcoming to Development Corporation board members and elected City Council officials.

Near the close of the programs the host asked Ross about his running and biking.  Ross said he has a road bike and added:

"I do a lot of riding out in West Texas where our facility is and the roads are kind of rough out there."
He also offered $100 off on RPM2 shoe inserts to the host's friends. It will be interesting to learn what's news and what's sales talk. There is a difference.

Note:  MedHab sponsors the National Running Network.

Update 7-22-16:   Another "news report" suggests MedHab's footbed product is FDA approved.

Sunday, March 06, 2016

City's Capital Improvement Project List Includes New Emergency Item

One can hardly view a San Angelo City Council meeting without encountering holes left from past councils.  The March 1 Council meeting revealed several craters, both around emergency communications.  The Capital Improvement Program (CIP) discussion indicated the city's new emergency dispatch system would not work with the Fire Department's emergency alert program.  The vendor has an interface for the company that provides the means to alert San Angelo firefighters of a call, just not one old enough to meet the city's antiquated needs.

In telling the story Police Chief Tim Vasquez informed Council how technology improved while their predecessors refused to update the city's emergency systems capabilities.  When a critical emergency system is still in place when the vendor stopped maintaining it in 2006, something is wrong.

The city is paying the price for decades of under investment in street and water infrastructure.  Police department staff used streets as a defense for not knowing the city would need to spend another $500,000.

There is another option.  The city can pay the vendor to write an interface to it's 1980's era technology.  Council will take this up in their strategic planning session on Tuesday, March 8.  I look forward to watching the event on the city's YouTube channel.  It will be the first televised planning session since 2013.

Council members highlighted how the public needs to voice their concerns and priorities now for elected officials to take them into consideration.  For the last two years Council was not open in their strategic planning deliberations.  The 2014 planning session was held out of town, while the 2015 session occurred at Fort Concho.  Neither were recorded for the public to view and weigh in on with their council representatives.

It would behoove the city to share their deliberations openly ff council truly wants public input and comment.  It's been a two year wait.  Those who watched the March 1 Council meeting received a "to be continued" notice on the surprise $500,000 fire department expenditure.  Good news, it's only a week's wait away.