Updated on: December 18, 2019

Honoring Hirsch’s Heroes for the Holidays

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Original story posted on: December 16, 2019

EDITOR’S NOTE: Every holiday season since 2015, Dr. Ronald Hirsch has recognized healthcare professionals who, in his judgment, have rendered outstanding service to the industry. In a time-honored tradition, he announces his honorees on the Monitor Mondays weekly Internet radio broadcast. This year, during the most recent broadcast, Dr. Hirsch described why he selected the following: Alex Ogedegbe, Nina Youngstrom, and Anita Dunham. What follows is a summary of his remarks, and here is a list of previous honorees.

First up is Dr. Alex Ogedegbe. He is the medical director of physician advisor services at Riverside Health in Newport News, Va. He is my hero because of his activity on the RAC Relief user group.

Alex started his career as a physician advisor in January 2018, and since that time, he has liberally used the user group to post questions and case scenarios that many physician advisors face on a regular basis. His activity, of course, benefitted him at that moment but also benefitted the almost 1,900 members of the group. I am sure many of those members are at the same or similar stages of their careers, trying to figure things out, and having Alex posts such scenarios will help them when the same things happen at their hospital. Thanks, Alex, for helping to make RAC Relief so helpful to everyone.

My next hero is Nina Youngstrom. Nina’s title is the editor of the Report on Medicare Compliance, a weekly newsletter published by HCCA, the compliance organization. But that title is deceptive. An editor reads through someone else’s writings and fixes grammar and punctuation. What Nina actually does for the newsletter is everything. She finds the topics and researches them, develops contacts and industry insiders, performs the interviews, and then writes the whole newsletter. And no matter the topic, it’s clear from her writing that she actually understands the nuances and knows how to present it to make it understandable for all her readers. And she does this week in and week out; when she finishes one week’s newsletter, she immediately has to start on the next. Her motto should be that “compliance with regulations is not optional,” but with a weekly newsletter, sleep often is. Thank you, Nina, for your dedication.

Last but not least is my third hero, Anita Dunham, the system director of care management at Regional Health in Rapid City, S.D. Regional Health is a client of R1, so I first visited there in 2017. I figured, with a city population of under 75,000, I’d find a small community hospital. Boy, was I wrong. With 371 beds, their main hospital provides state-of-the-art medical care to half of South Dakota. And although her title is system care management director, she also oversees the system’s dialysis services and all long-term care services. She hired a new physician advisor and molded him into a professional who has amazing respect from the medical staff. When I met with her case managers without her present, they could not stop heaping praise on her. She presented at a recent national conference, and after her presentation, she got on-the-spot job offers, but Regional Health is her forever home. So for being an absolutely amazing person in every way, thank you, Anita.

Previous years honorees include:

2015
Guy Higgins at Infirmary Health- called out a RAC for improper practices

Dr. Roy Baker at Self Regional- took on the Medicare Advantage plans for their egregious denial processes

Dean Baker- economist- called out UHC for lying about the financial effects of the health exchanges

2016
Ian Mattis at Novitas (now at Penn State health)- excellent resource to get accurate Medicare information

Dr. Juliet Ugarte Hopkins at ProHealth- for setting an excellent example of a burgeoning physician advisor

Dr. Michael Salvatore at Beebee Medical Center- ability to provide levity at the times when our frustration with CMS and the payers was at its worst.

2017 
Dr. Vinay Prasad at OHSU – author of Ending Medical Reversal, stressing the importance of evidence proving a medical intervention actually works

Dr. Jen Gunter at Kaiser Northern CA- wielding the lasso of truth, calling out medical quackery

Dr. Eddie Hu at UNC- at the time president of ACPA and a darn smart guy

2018
International Consortium of Investigative Journalists- produced amazing expose on the hidden dangers of implanted devices

Dr. Erica Remer- a CDI expert who wisely always advises “just tell the truth”

Chuck Buck- well, you know why

Ronald Hirsch, MD

Ronald Hirsch, MD, FACP, CHCQM-PHYADV, CHRI, FABQAURP is vice president of the Regulations and Education Group at R1 Physician Advisory Services. Dr. Hirsch’s career in medicine includes many clinical leadership roles at healthcare organizations ranging from acute-care hospitals and home health agencies to long-term care facilities and group medical practices. In addition to serving as a medical director of case management and medical necessity reviewer throughout his career, Dr. Hirsch has delivered numerous peer lectures on case management best practices and is a published author on the topic. He is a member of the Advisory Board of the American College of Physician Advisors, a member of the American Case Management Association, and a Fellow of the American College of Physicians. Dr. Hirsch is a member of the RACmonitor editorial board and is regular panelist on Monitor Mondays.

The opinions expressed are those of the author and do not necessarily reflect the views, policies, or opinions of R1 RCM, Inc. or R1 Physician Advisory Services (R1 PAS).

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