With all of the attention paid to health reform, Medicaid and Medicare, one area of clinical need largely has been ignored: dentistry. Lack of access to this critical service is widespread, and the results can be devastating for both children and adults.

Many programs are trying to fill the gap, but the challenge is daunting.

http://www.hhnmag.com/hhnmag/HHNDaily/HHNDailyDisplay.dhtml?id=2540006049

Darrell – Is this really true?

Mary

Trusted, engaging mobile and web apps that help you connect with the best health information and care.

At the company’s Web site, users post questions and doctors post brief answers. The service is free, and the doctors aren’t paid. Instead, they engage in game like competitions, earning points and climbing numbered levels. They can also receive nonmonetary awards — many of them whimsically named, like the “It’s Not Brain Surgery” prize, earned for answering 21 questions at the site.

http://www.healthtap.com

Hope R. Hetico RN MHA

Last month, Wellpoint and Aetna outlined their new compensation plans. Now, UnitedHealth, the largest U.S. health insurer, becomes the latest carrier to say it is overhauling its fees for medical providers.

http://online.wsj.com/article/SB10001424052970203315804577211660010608608.html

Frederick

According to writer Daniel Bukszpan, adults over 50 have levels of experience and reliability their younger counterparts don’t. Both of these are factors that people look for when seeking financial advice, which makes a job as a financial advisor ideal for them.

“Youth is a liability for financial salespeople as it is in most business milieux, because clients have less confidence in young people,” says Seth Rabinowitz, lead consultant for the management consulting firmSilicon Associates. “Older people generally are less apt to take risks and to recommend risky strategies.”

http://money.msn.com/baby-boomers/10-new-careers-after-age-50

So, forget about real knowledge. No experience needed; really! Just be old.

Clairmont

A new study finds that while a majority of doctors believe they should disclose significant medical errors to patients, some won’t for fear of being sued. The results appear in the February issue of the journal Health Affairs. Researchers conducted the poll in 2009, and 1,891 doctors answered anonymously.

The results revealed that 66% completely agreed that they should fully disclose all significant medical errors to patients. The survey also reports that 89% of doctors did not tell a patient something untrue over the past year. But when asked if they have not disclosed a mistake because of worries that they would be sued, 20% replied that they have withheld information over the past year.

Source: Ashok Selvam, Modern Healthcare [2/8/12]

We’ve reached the end of an era of unquestioned trust in EHR stakeholders’ promises. Bipartisan threats will probably begin soon.

As the going price for stolen medical identities climbs along with cost of HIPAA compliancy, public fear of identity theft helps push providers well beyond the reach of obsolete EHR sales pitches, and you can forget about Bush’s 2014 deadline for interoperability. Without Americans’ support, his harmful, costly, naïve mandate is no better than a self-limited attempt at tyranny in the land of the free that our grandchildren can hardly afford.

In the past, when I challenged dedicated EHR stakeholders with questions concerning the growing problem of data breaches of patients’ medical histories, more than one assured me that while they personally have nothing in their boring record to hide from anyone, they completely agree that an exposure of personal information can be traumatic for certain people, but that patients’ embarrassment doesn’t justify holding up the universal adoption of life-saving EHRs – which not only solve sloppy handwriting problems, but also survive hurricanes better than paper records. Presidential candidate Newt Gingrich used to say, “Paper kills.” But not so much anymore.

When I pressed stakeholders a little harder, of the few who stayed in the discussion, some would typically discount public fear of identity theft from doctors’ computers as largely irrational, alarmist, and even Luddite – pointing out that occasional breaches of social security numbers and birthdates had all but become an accepted tradeoff for progress in healthcare, and that rising numbers of identity thefts “haven’t slowed down the growth of online banking…. So get over it.”

Then this fall, the Ponemon Institute revealed the growing problem with medical identity theft that previously had only rarely been mentioned in the media. Most people who are sharp enough to make a living at EHR sales are also smart enough to recognize that the giddy salad days of comparing the dangers of stolen socials with imperceptively altered medical histories will never return.

Today, as if to punctuate the end of an era of discounting public fear, Rick Kam, President and CEO, ID Experts and Christine Arevalo, director of healthcare identity management, ID Experts posted “A glimpse inside the $234 billion world of medical ID theft.”

http://www.govhealthit.com/news/glimpse-inside-234-billion-world-medical-id-theft

“With its serious health risks, medical identity theft is far more dangerous than the more well-known consumer or financial identity theft. When a victim’s records are merged with a thief using the same identity, for instance, that record becomes ‘polluted,’ and the victim may be denied treatment or be misdiagnosed based on this inaccurate information. In addition, patients may be denied life insurance or billed for services not rendered. “

The authors then listed a few real-world examples to illustrate danger that has been ignored by unresponsive stakeholders for far too long:

- In Oregon, a pregnant woman delivered a baby addicted to crack using another woman’s social security number—and then abandoned the baby. Police arrested the victim and put her children into protective custody.

- A hospital’s billing department notified a pregnant woman in Washington that someone had used her social security number to be treated for a crack overdose at the ER of the same facility where she was about to deliver her baby.

- A patient in Texas used a California man’s medical identity to obtain radiation treatment and other care. When the thief’s records and the patient’s records merge, healthcare providers will think the patient has a condition he doesn’t have.

- One woman used her sister’s medical ID to receive treatment for a serious sports injury. When chronic problems arose, she was denied coverage for further treatment because there was no record of her initial treatment.

- Another woman couldn’t get physical therapy following neck surgery because a Miami clinic that she had never visited claimed her insurance benefits had been maxed out.

- A teenager was denied the opportunity to give blood because the Red Cross flagged her social security number as belonging to a person who had tested positive for HIV. Another person had used her social security number at a free AIDS clinic in another state, and the clinic did not ask for physical copies of identification.

————

I first warned of medical identity theft in a guest column written for WTN News on October 18, 2006 titled “Careful with that electronic health record, Mr. Leavitt.”

http://wistechnology.com/articles/3407/

Two days later, HHS Secretary Michael Leavitt was in Las Vegas to hand down to the ADA House of Delegates the nation’s bipartisan long term plans for dentistry during the national ADA convention. By the time he walked to the podium, my column appeared as his first news hit when one googled his name. It remained number one for several days following the convention.

I like to think I am the reason that the Cabinet Secretary was especially pissed at the nation’s dentists when he threatened to sick his MBAs on us. (See “Health standard setting: ‘If the DDSs don’t do it, the MBAs will’” – ADA News, October 20, 2006).

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=2177

We have recently discovered that Leavitt’s favorite MBAs work for the W.K. Kellogg Foundation, and they intend to eliminate finicky consumers’ unscientific choices in dentists. Well-meaning people who know a lot about algorithms but little about the business of dentistry intend to replace Adam Smith’s 17th century ideas of competition with a computerized, gestalt rewards system tuned for cost-effectiveness based on dental claims data. Garbage in – garbage out. Let the games begin!

It looks like the MBAs are every bit as cruel as the Secretary of Health and Human Services promised us over 5 years ago.

D. Kellus Pruitt DDS

Federal investigators are warning physicians who allow healthcare firms to use their Medicare provider numbers that the doctors can be held liable for any fraudulent bills the firms submit on their behalf. Physicians can legally re-assign their Medicare payments from the CMS to outside organizations by filling out Form CMS-855R. However, HHS’ inspector general’s office is warning physicians to use “heightened scrutiny” to ensure that the entities receiving their payments are legitimate providers or suppliers of healthcare items and services.

The warning to Medicare doctors was prompted by a spate of eight settlements in which physicians were accused of violating the Civil Monetary Penalties Law after re-assigning their Medicare provider numbers to the firms in exchange for receiving medical directorships with the companies, the OIG Alert from HHS’ inspector general’s office said. “We thought it might be helpful to remind physicians to exercise caution when re-assigning Medicare payments,” an inspector general’s office spokesman said.

Source: Joe Carlson, Modern Physician [2/18/12]

Every quarter, physicians and other investors are tempted to replace underperforming managers with those who have recently outperformed. However, some opine that the problem is those decisions often aren’t made based on research and forward-looking expectations.

http://www.fa-mag.com/online-extras/9835-when-not-to-fire-a-money-manager-a-consultants-perspective.html

What do you think?

Dr. David Edward Marcinko MBA
[Editor-in-Chief]

The Sarbanes-Oxley law, also known as SOX, cleaned up corporate accounting. It provides hope for how the new financial regulatory law, Dodd-Frank, could work.
Thanks for this post.

Joe

Physician ratings improved in 2011, according to the “Annual Report Card on Patient Satisfaction,” compiled by research firm DrScore, which based its findings on 36,000 online surveys completed by patients last year.

Overall doctor ratings increased .5 percent, reported DrScore, and low ratings decreased by more than 2 percent since 2010.

http://www.physbiztech.com/news/patients-look-mix-short-wait-times-and-long-doctor-visits

Duh! So, how much did this “common-sense” survey cost?

Chuck

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Individuals who meet eligibility criteria and successfully complete the “live” CMP™ online program 12 month course of study, are designated a Certified Medical Planner™ professional from iMBA Inc.

And today, there’s never been a better time to distinguish your-self with the most sought after credential in the financial planning, management and advisory space for doctors and all medical professionals!

Ann Miller RN MHA
http://www.CertifiedMedicalPlanner.com
[Executive-Director]

Did you know that some health plans are now offering tiered provider plans?

For example, in Boston, the Tufts Your Choice plan has a $1500 deductible for Mass General and a $500 deductible for BMC. This delegates the choice to the consumer in a way that should survive contract law.

Any thoughts?

Amy

Most older adults would rather live out their lives in their own homes, rather than in a nursing home.

http://health.msn.com/health-topics/caregiving/10-surprising-ways-to-avoid-nursing-home-care

Learn how that may be possible and affordable. Why? I have never seen, or worked in, a NH where I would like to live?

Dr. David Edward Marcinko MBA
[Publisher-in-Chief]

Although Democrats have pushed to permanently replace the Medicare physician payment formula as part of extending a package of expiring tax cuts, a senior Democrat indicated Tuesday that a permanent fix was unlikely. Sen. Max Baucus (D-MT), the senior Democrat on the panel negotiating the tax package, downplayed the likelihood of permanently replacing the Medicare sustainable growth-rate formula when asked about it after the group’s fourth meeting. “That would be my preference but this is the art of the possible,” he told reporters when asked about a permanent SGR replacement.

Members of the two parties appeared far apart on using any version of three House-passed proposals to pay for the SGR fix and other provisions of the legislation that were discussed Tuesday. Those so-called offsets included raising Medicare premiums for high-income enrollees and requiring insurance exchange enrollees who receive premium subsidies to pay back more of that assistance if their incomes increase during the year.

Source: Rich Daly, Modern Healthcare [2/7/12]

Bad news, John. Your criticism of Delta Dental has been censored by an anonymous California Dental Association employee.

Even though Delta cut payments to California dentists this summer, the CDA censored the link to the KMOV Channel 4 article you posted on their Facebook, titled “Delta Dental’s extraordinary executive pay and perks.”

http://www.kmov.com/community/blogs/news-4-investigates-daily-briefing/Delta-Dentals-extraordinary-executive-pay-and-perks-138584994.html

Rather than permit California dentists to read an investigative report about Delta executive’s questionable business practices, here’s the latest news approved by the CDA as worthy of members’ attention: “Deals and a chance to win an iPad – booth #430 at CDA, California Dental Association Spring Meeting.” – from Dental Tribune America, May 13, 2011. Who knows how many dentists have been censored by the CDA and other renegade ADA affiliates?

https://www.facebook.com/pages/California-Dental-Association/112303385447601?sk=wall

Other than deleting dentists’ criticism of Delta and other favored stakeholders, I don’t think the CDA moderator has to mess with the Facebook much at all. Even CDA members have no recourse when she exercises her anonymous power. Having a job where she cannot be held accountable for insulting even those whose dues pay her salary sounds like wickedly unethical fun to me.

John, it’s simply impossible for well-meaning dentists like you and me to quietly discourage such rudeness from CDA employees when their cowardly bosses choose to hide from those they serve. So we must speak as loudly as it takes to get the good ol’ boys’ damn attention. It’s not only swell sport, but it’s the Hippocratic thing to do.

With such amplification in mind, I was going to re-post the link to the KMOV article on the CDA Facebook to give her something to do this afternoon. Then I discovered that some time ago, she had already banned me from posting anything at all. Just like any badly-treated American consumer, I wanted to go over the employee’s head by demanding her name and the name of her supervisor. However, reclusive and unaccountable CDA officials are thinking ahead. They’ve strategically eliminated all their contact information from the internet – sort of like sitting in a corner with their fingers in their ears singing loudly, “La-la-la-la.”

Wal-Mart employees aren’t as rude as CDA employees because for one thing, they wear name badges.

D. Kellus Pruitt DDS

As the U.S. healthcare industry struggles with implementing the federally mandated upgrade to the ASC X12 Version 5010 standard for electronic claims and other administrative communications, the Accredited Standards Committee has announced it’s putting a hold on work on a successor standard.

“After meeting with healthcare industry stakeholders and assessing the current and planned healthcare industry initiatives, ASC X12 will not recommend its 6020 Type 3 Technical Reports (TR3s) to the Designated Standards Maintenance Organizations (DSMO) for consideration of adoption under the Health Insurance Portability and Accountability Act (HIPAA),” the committee stated in a news release. “ASC X12 doesn’t typically make decisions such as this until after final publication; however, it believes the healthcare industry is better served at this time by a reassurance that the 5010 implementations will have time to mature before another version is recommended for adoption.”

Source: Joseph Conn, Modern Healthcare [2/7/12]

It is wonderful to hear financial advice that isn’t cloned, regurgitated Suze Orman babble (not that there is anything wrong with that …).

David K. Luke, MIM
Financial Advisor

In a move that defies conventional wisdom, Hahnemann University Hospital in Philadelphia, PA, is replacing less expensive workers with people who are paid more.

Michael Halter, the hospital’s chief executive officer said a pilot study done on one nursing unit found that using all registered nurses to care for patients instead of a combination of nurses and nursing assistants led to higher-quality care, and greater patient and nurse satisfaction.

http://www.philly.com/philly/health/20120207_Hahnemann_boosts_use_of_registered_nurses_in_bid_to_improve_care.html

Any thoughts?

Claudia RN

Because of important regulatory changes now in effect for mutual fund investors, investment firms must report cost basis details to the IRS for all mutual funds (excluding money market funds) you acquire on or after January 1, 2012, and later sell in taxable (nonretirement) accounts.

They will begin reporting this information to the IRS in 2013 (for the 2012 tax year) and will also continue reporting it to you, the investor.

What is cost basis?

Cost basis is generally the price you pay for your shares. The price includes reinvested dividends and capital gains, as well as any transaction fees. Cost basis is used to determine gains and losses on any shares that you sell in taxable mutual fund accounts.

So it’s important for all physician investors to give consideration to which method is the most appropriate for your tax situation before you sell shares. The available methods are:

Average cost. Calculates the average cost per share for each share you own. This remains the Vanguard default for mutual funds.

First in, first out (FIFO). Shares with the oldest acquisition date are sold first.

Specific identification (SpecID). When you sell shares (or lots), you tell us which ones to sell, determining your capital gain or loss.

Good luck!

Dr. David Edward Marcinko MBA, CMP®
http://www.CertifiedMedicalPlanner.com

Hospitals are coming under fire for using private health and financial records to target affluent or privately insured patients, according to Kaiser Health News and USA Today.

http://www.kaiserhealthnews.org/Stories/2012/February/06/Hospitals-Mine-Patient-Records.aspx

Frances