JFK Neuroscience Institute

Edison, NJ, United States

JFK Neuroscience Institute

Edison, NJ, United States

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News Article | May 17, 2017
Site: www.prweb.com

PMMC, a leading revenue cycle management company, helped JFK Health complete a successful first year in the Comprehensive Care for Joint Replacement (CJR) program by providing bundled episode analytics and a collaboration strategy with its physicians to reduce spend and earn a repayment from CMS. PMMC provided JFK with actionable analytics so the organization could quickly evaluate spend performance among its post-acute care (PAC) providers and pinpoint the cost savings opportunities. By the completion of the first year, JFK Health finished $242,000 under the episode spend target and earned a repayment of $171,000 from CMS after the stop-gain limit was applied. “The data is what provides the insight for the hospitals to make decisions to hit the targets,” explained Steve Miller, Director of Managed Care at JFK. “We quickly realized by drilling the data down to the Service level that Skilled Nursing Facilities (SNF) were a cost strain. The PMMC model allowed us to identify the “sweet spot” between SNF length of stay and exceeding the stop gain”.” JFK Health decreased its length of stay by more than 50 percent -- from 21 to 10 days. The model, which requires hospitals to manage spend across the entire episode of care, is uncharted territory for many providers. An inherent challenge in this model is the need to build collaboration among the hospital and its physicians. To help build this collaboration strategy, PMMC consulted with the physicians at JFK Health. By presenting a transparent, third-party perspective supported by data, JFK’s physicians responded positively. “The relationship with a third-party like PMMC is unquantifiable. It made the process more transparent and really solidified the message of the need for collaboration,” added Steve Miller. Going forward into the second year of the program, JFK Health envisions its physicians being more engaged and taking more of a leadership role. JFK Health is one of approximately 800 hospitals required to participate in the CJR model, a five-year program intended to hold hospitals financially accountable for the quality and cost of a CJR episode of care and incentivizes increased coordination of care among hospitals, physicians, and post-acute care providers. With PMMC’s bundled episode analytics, hospitals can easily compare its own costs for the entire episode to CMS targets – as well as internal benchmarks – on a quarterly basis. PMMC provides high value revenue cycle software and services to improve the financial performance of healthcare organizations. Our software and expertise focuses on payment accuracy and identifying more revenue opportunities across the revenue cycle. PMMC helps hospitals identify underpayments and denials, increase price transparency, and manage bundled payments. Clients see, on average, a 10 to 1 return on investment with software and services. JFK Medical Center, an affiliate of JFK Health, is a 498-bed full-service, acute care hospital, and the adjacent JFK Johnson Rehabilitative Institute. Located in the heart of Edison, NJ, it has remained at the forefront of quality care in the region since its inception in 1967. Today, JFK accommodates more than 20,000 admissions, 3,000 births and 60,000 Emergency Room visits on a yearly basis. The Medical Center features a complete array of services, including general surgery, emergency medicine, mental health, orthopedics, maternity and pediatric care. It is home to two world renowned institutes: the JFK Neuroscience Institute and the JFK Johnson Rehabilitation Institute, as well as JFK Haven Hospice, JFK Imaging Center and the Center for Wound Healing. JFK Medical Center is proud to be rated the #1 stroke program in New Jersey and in the top 5% in the entire country. With a Gold Plus award for stroke care by the American Heart Association and a comprehensive and primary stroke center designation, our neuroscience program is unmatched with both neurological and rehabilitation services.


News Article | October 28, 2016
Site: www.prweb.com

PMMC, a leading revenue cycle management company, was selected by JFK Health for bundled payments analytics to manage the costs for the Comprehensive Care for Joint Replacement (CJR) Model. JFK Health, a non-profit health organization based in Edison, NJ, is located in one of the metropolitan statistical areas required to participate in CJR – meaning the hospital is accountable for managing the episode costs for hip and knee replacements across the entire continuum of care. PMMC is providing JFK with powerful analytics and predictive modeling so the organization can quickly evaluate performance in the CJR program and make the necessary adjustments with post-acute care (PAC) Providers in order to earn a repayment from Centers for Medicare and Medicaid Services (CMS) for managing costs below the target price. “We need to be able to react quickly and PMMC’s analytics enables us to do that,” said the Director of Managed Care at JFK. “The data provided by CMS is difficult to analyze and does not allow us to make business decisions quickly enough.” With PMMC ONLINE ANALYTICS, JFK can easily compare its own costs for the entire episode to CMS targets – as well as internal benchmarks – on a quarterly basis. The organization has set a goal of earning a repayment from CMS when payments are reconciled at the end of the first year of the program. In addition to the benchmark data, JFK will use predictive modeling to more effectively manage its patient care pathways. This is a customized approach that allows JFK to model different scenarios across the continuum of care to identify the most cost effective clinical pathway while maintaining a high quality of care. “Predictive modeling is not a ‘cookie-cutter’ approach and is truly a customized solution for us,” added the Director of Managed Care. Internally, the health system has taken the necessary steps to ensure success in CJR by establishing a steering committee to lead the strategy and setting up controls to track costs. Additionally, JFK has engaged and collaborated with its physicians to gain buy-in for becoming a “center of excellence” in joint replacement. The combination of internal strategy and collaboration with external data will standardize the entire process and position JFK to succeed in the CJR program. PMMC provides high value revenue cycle software and services to improve the financial performance of healthcare organizations. PMMC’s unique combination of software with 30 years of revenue cycle expertise reveals greater financial accuracy and missed revenue opportunities in the areas of underpayments and denials, pricing transparency, and value-based reimbursement – resulting in a 10 to 1 client return on investment. JFK Medical Center, an affiliate of JFK Health, is a 498-bed full-service, acute care hospital, and the adjacent JFK Johnson Rehabilitative Institute. Located in the heart of Edison, NJ, it has remained at the forefront of quality care in the region since its inception in 1967. Today, JFK accommodates more than 20,000 admissions, 3,000 births and 60,000 Emergency Room visits on a yearly basis. The Medical Center features a complete array of services, including general surgery, emergency medicine, mental health, orthopedics, maternity and pediatric care. It is home to two world renowned institutes: the JFK Neuroscience Institute and the JFK Johnson Rehabilitation Institute, as well as JFK Haven Hospice, JFK Imaging Center and the Center for Wound Healing. JFK Medical Center is proud to be rated the #1 stroke program in New Jersey and in the top 5% in the entire country. With a Gold Plus award for stroke care by the American Heart Association and a comprehensive and primary stroke center designation, our neuroscience program is unmatched with both neurological and rehabilitation services.


Previtera M.L.,JFK Neuroscience Institute | Previtera M.L.,Seton Hall University | Sengupta A.,JFK Neuroscience Institute
PLoS ONE | Year: 2015

Clinical data show that disease adversely affects tissue elasticity or stiffness. While macrophage activity plays a critical role in driving disease pathology, there are limited data available on the effects of tissue stiffness on macrophage activity. In this study, the effects of substrate stiffness on inflammatory mediator production by macrophages were investigated. Bone marrow-derived macrophages were grown on polyacrylamide gels that mimicked the stiffness of a variety of soft biological tissues. Overall, macrophages grown on soft substrates produced less proinflammatory mediators than macrophages grown on stiff substrates when the endotoxin LPS was added to media. In addition, the pathways involved in stiffness-regulated proinflammation were investigated. The TLR4 signaling pathway was examined by evaluating TLR4, p-NF-κB p65, MyD88, and p-IκBα expression as well as p-NF-κB p65 translocation. Expression and translocation of the various signaling molecules were higher in macrophages grown on stiff substrates than on soft substrates. Furthermore, TLR4 knockout experiments showed that TLR4 activity enhanced proinflammation on stiff substrates. In conclusion, these results suggest that proinflammatory mediator production initiated by TLR4 is mechanically regulated in macrophages. © 2015 Previtera, Sengupta.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Previtera M.L.,JFK Neuroscience Institute | Previtera M.L.,Seton Hall University | Peterman K.,JFK Neuroscience Institute | Shah S.,JFK Neuroscience Institute | Luzuriaga J.,JFK Neuroscience Institute
Annals of Biomedical Engineering | Year: 2015

Infiltrating leukocytes are exposed to a wide range of tissue elasticities. While we know the effects of substrate elasticity on acute inflammation via the study of neutrophil migration, we do not know its effects on leukocytes that direct chronic inflammatory events. Here, we studied morphology and motility of macrophages, the innate immune cells that orchestrate acute and chronic inflammation, on polyacrylamide hydrogels that mimicked a wide range of tissue elasticities. As expected, we found that macrophage spreading area increased as substrate elasticity increased. Unexpectedly, we found that morphology did not inversely correlate with motility. In fact, velocity of steady-state macrophages remained unaffected by substrate elasticity, while velocity of biologically stimulated macrophages was limited on stiff substrates. We also found that the lack of motility on stiff substrates was due to a lack of lipid rafts on the leading edge of the macrophages. This study implicates lipid rafts in the mechanosensory mechanism of innate immune cell infiltration. © 2014, Biomedical Engineering Society.


Chokroverty S.,JFK Neuroscience Institute | Chokroverty S.,Seton Hall University
Sleep Medicine Clinics | Year: 2015

Restless legs syndrome (RLS) mimics cannot always be differentiated from RLS/Willis-Ekbom disease (WED) based on 4 essential criteria; hence, a fifth criterion has recently been established. RLS comorbidities may provide us important clues for understanding the neurobiology of RLS/WED. Iron-dopamine connection, hypoxia pathway activation, and dopamine-opioid interaction are important pathophysiological mechanisms in RLS; this knowledge is derived from our understanding of RLS associations with a variety of medical, neurologic, and other conditions. Clinicians must formulate an RLS differential diagnosis based on history and physical examination, but laboratory tests may sometimes be needed to arrive at a correct diagnosis. © 2015 Elsevier Inc.


Previtera M.L.,JFK Neuroscience Institute | Previtera M.L.,Seton Hall University
Cellular and Molecular Bioengineering | Year: 2014

Regulation of the immune system has been heavily investigated from a biological perspective due to the biological nature of inflammatory stimulants and pathogens. However, more studies have shown that biophysical cues generated by normal physiological events or diseases regulate the immune system. In fact, a new paradigm is emerging in which data shows that normal physiological mechanical stimuli suppress inflammation whereas pathophysiological mechanical stimuli trigger inflammation. In this review, evidence supporting this paradigm is provided. Specifically, physiological and pathophysiological mechanical stimuli are described, the effects of mechanical stimuli on innate and adaptive immune system function are discussed, and the mechanotransduction pathways that regulate white blood cell behavior are explained. By understanding both the biological and physical stimulants that regulate the immune system, novel and more effective drugs can be developed that reduce inflammation. © 2014 Biomedical Engineering Society.


PubMed | JFK Neuroscience Institute
Type: Journal Article | Journal: Annals of biomedical engineering | Year: 2015

Infiltrating leukocytes are exposed to a wide range of tissue elasticities. While we know the effects of substrate elasticity on acute inflammation via the study of neutrophil migration, we do not know its effects on leukocytes that direct chronic inflammatory events. Here, we studied morphology and motility of macrophages, the innate immune cells that orchestrate acute and chronic inflammation, on polyacrylamide hydrogels that mimicked a wide range of tissue elasticities. As expected, we found that macrophage spreading area increased as substrate elasticity increased. Unexpectedly, we found that morphology did not inversely correlate with motility. In fact, velocity of steady-state macrophages remained unaffected by substrate elasticity, while velocity of biologically stimulated macrophages was limited on stiff substrates. We also found that the lack of motility on stiff substrates was due to a lack of lipid rafts on the leading edge of the macrophages. This study implicates lipid rafts in the mechanosensory mechanism of innate immune cell infiltration.


PubMed | JFK Neuroscience Institute
Type: Journal Article | Journal: PloS one | Year: 2015

Clinical data show that disease adversely affects tissue elasticity or stiffness. While macrophage activity plays a critical role in driving disease pathology, there are limited data available on the effects of tissue stiffness on macrophage activity. In this study, the effects of substrate stiffness on inflammatory mediator production by macrophages were investigated. Bone marrow-derived macrophages were grown on polyacrylamide gels that mimicked the stiffness of a variety of soft biological tissues. Overall, macrophages grown on soft substrates produced less proinflammatory mediators than macrophages grown on stiff substrates when the endotoxin LPS was added to media. In addition, the pathways involved in stiffness-regulated proinflammation were investigated. The TLR4 signaling pathway was examined by evaluating TLR4, p-NF-B p65, MyD88, and p-IB expression as well as p-NF-B p65 translocation. Expression and translocation of the various signaling molecules were higher in macrophages grown on stiff substrates than on soft substrates. Furthermore, TLR4 knockout experiments showed that TLR4 activity enhanced proinflammation on stiff substrates. In conclusion, these results suggest that proinflammatory mediator production initiated by TLR4 is mechanically regulated in macrophages.

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