BISNOW’s MIAMI’S 2017 OUTLOOK & FORECAST FORUM

When: January 24, 2017

Where: Intercontinental Miami, Miami

Keynote conversations from some of Miami’s most prominent figures

This program consisted of a series of Moderated Keynotes covering some of the most pressing topics our City and Region face as we evolve from a world-class vacation destination to world-class metropolitan destination.

Wharton University 49th Global Forum

When: March 9-11 2017

Where: InterContential Hotel Miami

Sample Topics:

Executive Education Session – Global Impact of Tech Disruption and Immigration

Fireside Chat: Addressing the Skills Gap in the U.S. Labor Market and the Role of Higher Education

MAPPING MIAMI’S FINANCIAL FUTURE

Key South Florida Leaders Driving Entrepreneurial and Business Success

This half day forum will provide insights into key business leaders instrumental in shaping the business and entrepreneurial landscape in South Florida. The discussions will include commentary from successful women executives from diverse sectors along with an entrepreneurial panel sharing their personal journeys of business building. Also, key note thoughts from global executives and business networking will round out the program.

For more information click here

MDX invests in Miami’s transport infrastructure

Invest: Miami speaks with the Miami-Dade Expressway Authority

With five projects being executed and seven others in the pipeline, the Miami-Dade Expressway Authority (MDX) is rapidly enhancing Miami’s road infrastructure. MDX, the entity that manages, maintains and funds improvements to five local expressways, and is funded only by tolls collected on the Dolphin SR 836, Gratigny SR 924, Airport Expressway SR 112, Don Shula/SR 874 and Snapper Creek SR 878, is executing important projects in order to improve Miami’s traffic conditions.

Even though partnerships with other public entities such as the Miami-Dade Department of Transportation and Public Works (MDT) and the Florida Department of Transportation (FDOT) have been essential to executing some of the current projects, MDX has been able to embark on these new projects because of the improvement in its funding system. Instead of just 50% of drivers paying, now all users pay for the portion they drive. This, combined with funding through bonds, has allowed MDX to adopt sensible policies to tackle traffic in Miami-Dade.

“The increase in revenue is because of three reasons: Everyone pays their fair share for the use of the road, the economy has grown, and the population has increased, resulting in higher traffic volumes and improvements that MDX has already made allows for increased capacity on its expressways.” Louis Martínez, Chair of the MDX Board of Directors, stated in December 2016. “When we made changes to our system in 2014, we promised to construct improvements that would save travel time for our customers. We are ahead of schedule in fulfilling this promise,” he added.

One of MDX’s major projects, the SR 836 Modernization from NW 57th Avenue to NW 17th Avenue, will include a diverging diamond interchange, also called a double crossover diamond interchange. This is a type of diamond interchange in which the two directions of traffic on the non-expressway road cross to the opposite sides. The project is scheduled to be completed in summer 2018, almost at the same time as the MDX SR 836 Interchange Improvements at 87th Avenue, another project currently under construction, will finish. MDX explains that the main purpose of the project is to improve traffic operations and safety of the SR 836 and NW 87th Avenue Interchange. A significant improvement will be the addition of a new flyover ramp that will provide direct connection from westbound NW 12th Street to westbound SR 836. This improvement will substantially reduce the congestion at the intersection of NW 87th Avenue and NW 12th Street.

In an earlier stage is the SR 836 Improvements from 17th Avenue the Midtown Interchange, which is being constructed in partnership with the FDOT and is expected to start construction by the end of this year.

The MDX SR 874 Ramp Connector to SW 128 Street is currently underway. It will provide alternative expressway access to the area, reducing congestion and providing additional connectivity and mobility to the rapidly growing area of southwest Miami-Dade County.

Finally, MDX will produce the Dolphin Station Park and Ride Transit Facility in partnership with MDT and the FDOT. The transit facility will support the Department of Transportation and Public Works’ SR 836/Dolphin Expressway Express Bus Service, provide a terminus or stop for several local bus routes serving the Dolphin Mall and the cities of Sweetwater and Doral, as well as serving a potential future east-west commuter rail service on the CSX line.

Juan Toledo, Deputy Director and Director of Engineering commented, “Our projects are rooted in core principles of improving transportation by investing in key pieces of infrastructure improvements, introducing reliable and safe emerging technology, and providing different options within the transportation corridors.”

To read more about the Miami-Dade Expressway Authority’s work, visit their website at: http://mdxway.com

Healthy changes

Florida Blue Market President Penny Shaffer discusses the challenges and opportunities presented by the Affordable Care Act (ACA)

How has the ACA impacted the relationship between health care providers and insurance companies?

ACA focuses mostly on access and does not mandate enough changes on the delivery side, yet the only way to provide affordable access is to have the right payment model in place and share accountability among all the players. Rather than maintain the current fee-for-service model, we need to strive for better health outcomes. Florida Blue has established over seventeen Accountable Care Organizations (ACOs) across the state and 2,500 patient-centered medical homes, with over 4,500 physicians participating. These arrangements allow physicians and insurance companies to share analytics regarding a set of patients. Doctors are rewarded for their patients meeting certain health standards. keeping the focus on wellness more than illness.

How has the implementation of ACA created challenges for businesses in South Florida?

It makes affordability a challenge, particularly in South Florida. We are a community of small businesses. Today these businesses are trying to figure out where to go from here as a result of the law. Do they offer insurance or do they let employees go to the individual market where they could get a subsidy? Miami is arguably the most expensive setting for health care in the U.S. This is primarily due to our large aging population. This market has a high concentration of medical specialties, with fewer primary care providers. Moreover, Miami has one of the highest concentrations of Medicare fraud, which further drives up the cost of health care. Finally, we have a large uninsured population, which is in large part comprised of immigrants from countries with socialized medicine, and are therefore unaccustomed to having to procure insurance for themselves or their employees.

How would Medicaid expansion affect South Florida?

Nearly 700,000 people in Florida are in the coverage gap, meaning that they make too much for the state’s current implementation of Medicaid and too little to qualify for subsidies on the exchanges. The majority resides in South Florida, and inevitably we have to fix this gap.

At the state level, what policy developments will have the greatest bearing on health care in the near term?

New legislation would expand the availability of telehealth services, which would provide more convenient access to health care services, particularly to Floridians in rural areas or areas with physician shortages. Proposals to modify prior authorization rules and step therapy protocols must strike a balance between the management of medical costs and the treatment needs of the patient along nationally-recognized guidelines. Covering more South Floridians should result in lower health care costs as uncompensated care is decreased.

People-centered

Baptist Health South Florida President and CEO Brian E. Keeley discusses South Florida’s unique health care needs and strategies to tackle rising costs

What are the unique demographic and epidemiological trends in South Florida, and how have these driven growth in the health sector?

The most conspicuous trend is the same one driving growth on a national basis: people are getting older. I call it the demographic tsunami. Baby boomers are all turning 65, and the utilization of health care services for people over 65 is essentially twice as that for people under 65.

In South Florida, we also have a high percentage of uninsured individuals – around 30 percent. Hopefully, because of the Affordable Care Act (ACA), it will fall significantly. When people have insurance, demand goes up; without insurance, these folks don’t have access to, or they don’t use, health care services.

Epidemiologically, we see a higher incidence of diabetes here in South Florida relative to the national average. In part, this trend is informed by the area’s large Latin American and Caribbean population.

Miami-Dade’s growing international profile has created growth opportunities in medical tourism. How significant is medical tourism for Baptist Health?

Baptist Health does well in the international market, particularly when it comes to the Latin America and the Caribbean, where we focus our international outreach efforts. Patients from these countries come to Miami-Dade to seek medical treatment because of its proximity, and this market’s abundance of specialists that address the specific needs of this population. Our main focus in the international market, like the domestic market, is wellness and disease prevention. For Latin Americans, this means diabetes and obesity education because these diseases disproportionately impact the region. We provide diabetic educators and dialectologists for this purpose.

Because international patients tend to pay in full for their for their medical treatments, this segment generates significant revenues for area hospitals and other health care facilities engaged in medical tourism. Thus, although medical tourism comprises less than 5 percent of Baptist Health’s business, it probably contributes around 5 percent to our bottom line.

What are the key strategies necessary to care for a large contingent of international patients?

Baptist Health has one of the largest international programs in the U.S. We see around 12,000 patients a year, competing with the likes of the Cleveland Clinic and Johns Hopkins. We are long-term players in this space – we’ve been in it for 20 years. The reason we have been so successful is that, unlike other clinics that may provide service in multiple locales, our focus is honed on Latin America and the Caribbean. We know that market very well, and we benefit greatly from the high volume of direct flights to and from Latin America. In South Florida we have a large staff of bilingual and trilingual folks who can care for these patients, and we also have representatives working in various countries throughout the hemisphere.

What are the notable trends in health care-related employment in the South Florida market?

Our provider community has a very handsome and generous supply of specialists and a deficiency of primary care physicians. This situation contributes to higher utilization, as does excessive and unnecessary medical testing.

What are the greatest challenges facing South Florida’s health sector?

The real problem with health care in the U.S. is not quality, nor is it access – everyone has access because the federal government has the EMTALA (Emergency Medical Treatment and Active Labor Act). The problem is cost, and if left unchecked, I think we’re go-ing to bankrupt the country.

Fee for service, in my estimation, is the single number one foundational problem of cost. We have too many unnecessary surgeries and procedures – as high as 30 percent, which is a huge number – and it’s all driven by fee-for-service. Under this model, the more you do, the more you get paid. We’ve got the incentives misaligned. This is a cultural matter that needs to be changed.

How can rising costs be addressed? What are best practices from Baptist Health’s experience?

We have been successful in meeting our goal to reduce health care costs below the rate of inflation. This year saw the lowest rise in our 50-year history. Inflation was around 3.5 percent to 3.6 testing, whereas our admission costs increased by only 0.9 percent. This was not the result of one big change, but a thousand small ones.

That said, transitioning away from the fee-for-ser-vice model is key. We are very patient-focused, while fee-for-service is not. It is not only an excessive and costly model, but also deteriorates the quality of care. We want to pay our doctors in capitation – providing them incentives for promoting good health outcomes and keeping their focus on wellness and prevention. To ensure we appropriately leverage the doctors, we complement them with highly trained nurse practitioners along with dieticians and physical therapists. We have been hiring a high number of primary care physicians to bring balance to a system that is so specialist-heavy.

We have been experimenting with a number of alternative care models that cater to the needs of the patients. For instance, they open early and close late, so as to eliminated their having to go to urgent care or the emergency room “after hours” for minor symptoms simply because their doctor’s office was not open.

What is Baptist Health’s strategy for growth and expansion?

Baptist Health is the fastest-grow-ing organization in South Florida and the largest private employer, providing jobs to 16,000 people. When people look at our growth, they say, “well, you have all of these hospitals,” but in fact, our growth has been on the outpatient side! We have 50 outpatient centers and buildings – that’s quietly how we have been expanding.

We are transitioning from a high-cost environment, anchored by acute care hospitals, to one based in outpatient care, which is the bulk of our business today.

From here, the next transition is to the doctor’s office, where we will grow primary care, and eventually back to the home, as advances in telemedicine – both on the technology and regulatory sides – continue.

In 2014, we finalized plans to build a $430-million world-class cancer treatment and research center, which will have the latest technology, including proton therapy. The center will conduct, not just bench, but also phase II and phase III – or translational – research. We are building a hotel for cancer patients and family members, and a wellness center too. This is the largest project we’ve undertaken. There are only 18 such facilities in the world – none in South Florida, Latin America or the Caribbean. Once the center opens, local patients and those from Latin America will not need to go to New York or Houston for treatment.

Atlanta investor sells 28 metro houses for $3.2 million

A metro Atlanta investor just made another major sale this year.

Kennesaw, Ga.-based Kinloch Partners LLC sold 28 single-family homes to Atl 2 SF LC LLC, a San Francisco-based 643 Capital LLC and San Francisco-based Street Lane Homes LLC owned company, for $3.2 million dollars.

The homes, located in Southwest Fulton County and DeKalb County, were all purchased and renovated by Kinloch Partners since 2014 and are currently providing positive cash flow from rental income, the company said.

Kinloch co-founder Bruce McNeilage said the consumer demographics indicated there was a significant need for rental homes in the area.

Atlanta Business Chronicle reported in August Kinloch sold 42 single-family homes located in Southwest Fulton County, North Clayton County and Dekalb County for $4.72 million to Jeff 1 LLC, an Austin-Texas based Main Street Renewal LLC and Amherst Holdings LLC owned company.

Atlanta Business Chronicle reported in July 2015 that Kinloch Partners would invest $10 million in existing single-family homes in Atlanta south of Interstate 20.

Kinloch Partners first entered the Atlanta market in August 2011.

The Atlanta Opera mixes the old with the new for the 2017–18 season

The Atlanta Opera will offer a mixture of the tried-and-true classics and the experimental in its 2017–18 season beginning in November with a new production of Richard Wagner’s iconic The Flying Dutchman, and including a world premiere opera.

The opera announced its next season today, which will include four mainstage operas at the Cobb Energy Performing Arts Centre and two others in its Discoveries series at other locations.

“This will be a season that represents the company’s strategic direction,” Tomer Zvulun, the opera’s general and artistic director, said in a press release. “The company’s mission is to create the highest quality operatic and theatrical programming that re-imagines the classics and introduces new works. This season does just that.”

The mainstage season will include The Flying Dutchman, Donizetti’s The Daughter of the Regiment (starting February 24), Bizet’s Carmen (starting April 28, 2018) and Sondheim’s Sweeney Todd: The Demon Barber of Fleet Street (starting June 9).

In addition, the opera will present The Seven Deadly Sins by Bertolt Brecht and Kurt Weill, which will be directed by Brian Clowdus, Serenbe Playhouse’s artistic director. That opera will open in October as part of the Discoveries series at a location to be named.

The second show in that series will be a world premiere by composer Jake Heggie and librettist Gene Scheer called Out of Darkness: Two Remain at the Theatrical Outfit in April 2018. Based on the lives of Holocaust survivors, the opera will feature Tom Key, the Theatrical Outfit’s artistic director, in a singing role.

“The response to our Discoveries series so far has been overwhelming, which has given us the confidence to offer extended runs of The Seven Deadly Sins and Out of Darkness,” Zvulun said. “Audiences have truly appreciated the opportunity to experience rarely seen productions in unique environments. The sold out performance of Maria de Buenos Aires and Mozart’s The Secret Gardner this season, demonstrated that.”

Look for ArtsATL’s in-depth interview next week with Zvulun, where he will discuss the new season and the future direction of the Atlanta Opera.