Medical Executive-Post

Would You Retain a Bankrupt CFP® for Financial Advice?

Editors — Fri, 27 Jan 2012 00:16:17 +0000

ME-P Readers Respond

Sponsored by: www.CertifiedMedicalPlanner.com

According to colleague and financial advisor, Mike Kitces CFP®:

As the difficult economic environment continues, bankruptcy filings in the United States continue to occur at an elevated rate.

And it appears that financial planners are having their share of bankruptcies as well … requiring the CFP Board via their disciplinary process to adjudicate whether a CFP® certificant should receive a public letter of admonition, or has his/her marks suspended or revoked.

With a rising number of financial planner bankruptcies putting pressure on their disciplinary resources, the CFP Board has proposed a change to how it treats such bankruptcy situations. The upshot: a bankruptcy by a financial planner will no longer bar him/her from getting or keeping the CFP® marks. However, going forward, any bankruptcy by a financial planner will be publicly disclosed for the following 10 years on the CFP Board’s website.

Question: And so, as a doctor, nurse, management consultant or even another financial advisor, would you ever retain a Certified Financial Planner® who had declared bankruptcy?

VOTE AND OPINE

Take Our Poll

Assessment

Link: http://www.kitces.com/blog/archives/240-CFP-Board-Relaxes-Its-Position-On-Financial-Planner-Bankruptcies…-Sort-Of.html

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Please review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Healthcare Organizations: www.HealthcareFinancials.com

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Doctor – Are You Better than Average?

Editors — Thu, 26 Jan 2012 13:27:46 +0000

For Male Medical Professionals Only

Source: Frugaldad

Conclusion

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Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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The Cost of Technology Over The Decades

Editors — Thu, 26 Jan 2012 00:02:24 +0000

Plunging – Yet, Why Hasn’t Medical Care Followed Suit?

We are grateful to live in this century. For example, movies of the 1980′s have been more than intriguing over the course of the past few months, but times were obviously hard back then. Cell phones weren’t nearly as mobile as they are now, cassette players reigned supreme, and we could talk until blue in the face about hair. Walkman’s and cellular phones with their twenty inch antennas set the pace for this ease of access society we lived in; price tags and all.

Paying for this convenience was quite a task just a few decades ago, as a cell phone cost $4,000+, an Atari was the same price as a Wii, and an Apple 2 ran close to $3,000. We’re still keeping in mind that these products were quite the advancement in their day and age, but footing the bill was not something we’d be interested in today.

Source: http://pinterest.com/pin/304638252/

Assessment

So, why hasn’t the cost of healthcare come down over the same period?

Conclusion

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Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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January 2012 [Health] Plan Management Navigator

Editors — Wed, 25 Jan 2012 14:00:51 +0000

With 2012 Benchmarking Study Invitation

By Marco Georeno

Health Care Analyst

Dear Dr. Marcinko and ME-P Readers

At the risk of appearing overwhelmed with New Year’s enthusiasm, we think the attached edition of Plan Management Navigator is especially interesting:

1. We report on the cost decisions made by low cost Blue Cross Blue Shield plans. Low cost plans make decisions that differ from their higher cost peers. Hallmarks of these decisions include levels and distributions of expenses between functions, the levels and distribution of staff between functions, the levels of compensation and its distribution between functions and the distribution between functions, and levels of, non-labor expenses. Overall, low cost Blue Cross Blue Shield Plans have “tactical” administrative expenses that were $5.63 PMPM, or 29%, lower than their higher cost counterparts. These tactical expenses are all administrative expenses excluding medical management and sales and marketing.

2. We provide an update on the most recent operating and financial results for firms participating in our monthly Dashboard.

3. We invite appropriate ME-P readers to participate in the 2012 benchmarking study. Participation is very timely given that the weak economy is placing great pressure on commercial enrollment, creating the risk that administrative expenses could be a source of negative operating leverage.

Assessment

A more detailed version of this analysis is available to licensed users of Blue Cross Blue Shield Sherlock Expense Evaluation Report (SEER). Please call us for further information if you have an interest.

Link: Navigator Late January 2012

Sherlock Company

mgeoreno@sherlockco.com

Ph: 215-628-2289

Fax: 215-542-0690

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: http://healthcarefinancials.wordpress.com/2007/11/11/advertise

On Political Financial Plans

Editors — Wed, 25 Jan 2012 00:03:50 +0000

From Republican Presidential Candidates

With less than a year away, the republican election machine is fired up and ready to go. Hot topics include the economy, housing, jobs, Medicare, Social Security, and all sorts of healthcare initiatives and regulations of interest to medical professionals.

Source: totalbankruptcy.com

Assessment

How has your opinion on the above changed now that there are only four contenders left?

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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Broadening the Strategic Value of Integrated Medical Provider Management‏

Editors — Tue, 24 Jan 2012 13:15:13 +0000

How Health Plans Can Create Scalable and Competitive Products that Enable Affordable and High-Quality Care

By Sam Muppalla – Vice President, McKesson Health Solutions Network Performance Management

[Part 6 in a 6 part series]

Over the past few weeks, I’ve covered a lot of ground in this ME-P series of six essays. We looked at the pressures on health plans and the ways in which those pressures are forcing a new dynamic in how the plans create new, scalable competitive products that enable affordable, high-quality care. We talked about some of the innovations that leading health plans are bringing to the areas of product, network, care model and reimbursement designs.

The pilot initiatives in these areas continue to show positive results. The next level of scaling requires an integrated and automated approach to enable health plans to deploy, manage and maintain these innovations in a much more rapid fashion. This all has to be done without increasing health plan costs while delivering new value to a health plan’s customers, providers and members.

Affordable Care Can be Achieved

It is our position at NPM that achieving this alignment will deliver affordable care. Additionally, through this alignment, health plans will gain a competitive and cost savings leadership position. Through collaborative and independent research with our health plan partners, we have identified three main areas of competitive and cost savings leadership. The potential cost savings of achieving alignment are impressive. For example, working with a regional Blues plan with three million members, the potential cost savings due to achieving an integrated approach to network design were projected to be:

Administrative Cost Savings [Total Potential Annual Savings = $13 million to $25 million]

Provider data administration cost reductions: $5 million to $10 million
Provider outreach cost reductions: $0.75 million to $1.25 million
Contract management cost reductions: $1 million to $3 million
Administrative reimbursement cost reductions: $3 million to $5 million
Provider service cost reductions: $1.5 million to $2.5 million
Credentialing cost reductions: $1.5 million to $3 million

Medical Cost Savings [Total Potential Annual Savings = $45 million to $100 million]

Streamlined member health advocacy: $5 million to $10 million
Pay for Performance: $15 million to $40 million
Network design and performance improvements: $25 million to $50 million

Provider IT Cost Savings [Total Potential Annual Savings = $.5 million to $2.5 million]

Redundant system consolidations: $0.25 million to $2 million
IT change management cost reductions: $0.25 million to $0.5 million

The total aggregated annual potential for savings is between $59 million and $127 million.

Some Final Thoughts

In 2009, the National Health Expenditure (NHE) rose to $2.5 trillion or 17.6 percent of the Gross Domestic Product (GDP) with private health insurance accounting for 32 percent of the NHE. Yet all of this spending is not translating into any measure of higher quality care as the World Health Organization (WHO) also ranks the U.S. as 72nd in overall level of health in the world. To affect high-quality, affordable care, health plans must be able to harness innovative product, network, care model and reimbursement designs. Network design is the critical element that will orchestrate the operational scaling of innovation. Therefore, automation of network design and efficient implementation of it through end-to-end integration will be crucial to success of health plans in the post reform world.

Assessment

Thanks for taking the time to follow me, and the ME-P, on this journey. If you’ve joined us late in the discussion, fear not. We’ve collected all the related threads in the Unlocking Affordable Care by Aligning Products white paper, which you can download by visiting our website at http://ow.ly/7MFKb.

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: http://healthcarefinancials.wordpress.com/2007/11/11/advertise

A Nursing License Map

Editors — Tue, 24 Jan 2012 00:24:07 +0000

About Career Management in Nursing

This is a guide for picking a career in nursing. It covers the wide range of different options available to those interested in pursuing health care–someone considering the field for the first time might not know that there are so many different types of nursing degrees and nurse positions!

The text is clear, the color palette is consistent and not distracting, and the coverage of each potential path is comprehensive.

Critique

What is good is that visualizable data has been included: all of the text in red could be turned into a chart or graph showing the data instead of writing about it. This would give the guide a bit more visual intrigue and lighten it up a bit, too. Being inundated with large amounts of text is not much different from reading a list or manual–infographics make the data fun to read. A few examples of how the text might be visualized:

- The statistic about 78% of NCLEX-RN test-takers passing could be represented by using a thermometer, mock-up medical chart on a clip board, pencil or other related instrument and showing that 78% as a portion out of 100.

- Since there are 2.6 million RNs in the United States, and it’s said that that is the largest population of any health care occupation, it could be fun to see how many dentists, medical doctors, surgeons, etc. there are in comparison. These numbers could together be represented on a line chart as a heart monitor, or perhaps with different colored scrubs representing each occupation (either as a bar chart or having a portion of each of them shaded according to population).

Assessment

As a guide, we’d give this an A, as it’s very informative. But, it would benefit from the addition of more data before we could grade it as an excellent infographic.

Source: http://nursinglicensemap.com/pathways-in-nursing-infographic/

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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Self-Directed IRAs for Medical Professionals

Editors — Mon, 23 Jan 2012 13:00:17 +0000

Eschewing Limited Investment Choices

By Rick Kahler CFP® MS ChFC CCIM

Most people, and medical professionals, with Individual Retirement Accounts [IRAs] open them with a bank or brokerage firm (the custodian) that limits what investments can go into the account. These custodians typically limit your investments to stocks, bonds and mutual funds with firms where they have distribution agreements.

The Self-Directed IRA

A little-known option that allows owners of an IRA to have unlimited control of the investments they can hold is the self-directed IRA. Assets permitted in self-directed IRAs include real estate, promissory notes, mortgages, tax lien certificates, US gold coins, and private placement securities.

For example, I have clients who use self-directed IRAs to hold promissory notes, mortgages, and contracts for deed. The IRA acts like a bank by making a loan (secured by real estate) to a non-related party. They can often earn 5% to 10% returns. Of course, there is also a significant risk of having to foreclose on the loan and losing a portion of the investment.

But, before you jump into a self-directed IRA, you need to do some homework. When you make an investment in a self-directed account, you are on your own. The custodian does little more than be sure your documents are in order. It’s up to you to do your own due diligence on the merits of the investment.

Beware the Unscrupulous Promoters

Self-directed IRAs are proving to be such a magnet for unscrupulous promoters of dubious investment schemes that the SEC has issued an investor alert warning owners against fraudulent promoters. The best advice is the old axiom, “if it sounds too good to be true, it probably is.”

Tips and Pearls

That said; Ed Slot, publisher of the IRA Advisor, has some tips for self-directed IRA owners:

Be sure the investment is allowed in an IRA. Life insurance, collectables, numismatic coins, and S-corporation stock are not allowed.
Don’t partner with or purchase anything from a “disqualified person,”—a spouse, child, grandchild, or someone acting in a fiduciary role for the IRA.
If you sell real estate held in a traditional IRA, gains will be taxed at ordinary income rates when the proceeds come out of the IRA instead of as long-term capital gains. Gains on real estate held in Roth IRAs, however, come out tax-free.
Don’t think putting your business into an IRA could allow profits to grow tax-free. The Unrelated Business Income Tax is levied on a business owned by a tax-exempt entity like an IRA.
The IRS prohibits a “disqualified person” from running or occupying any business or investment owned by your IRA. You or your extended family cannot farm land owned by your IRA. You cannot occupy, even for a day, a property owned by your IRA. Doing so nullifies your IRA and makes it completely taxable.
Investment real estate in an IRA might be best owned free and clear of any financing. The Unrelated Debt-Financed Income tax applies to mortgage loans. Also, personally guaranteeing a loan is a prohibited transaction that nullifies your IRA.
You must value the assets of the IRA annually. This is a no-brainer for stocks, bonds, and mutual funds, but for real estate it may mean paying for costly annual appraisals.
Real estate owned in an IRA must generate enough cash flow to pay all its expenses. Writing a personal check for repairs or loaning money to the IRA are prohibited transactions that make the IRA fully taxable.
Holding illiquid investments in a self-directed IRA poses a problem when you reach 70½ and must begin taking distributions.

Assessment

Self-directed IRAs can be a great tool to bolster retirement income, when used properly. Just be sure you consider all the pitfalls before taking the plunge.

Conclusion

And so doctor, your thoughts and comments on this ME-P are appreciated. Please review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: http://healthcarefinancials.wordpress.com/2007/11/11/advertise

Some Money Saving Tips for Millennial Doctors

Editors — Mon, 23 Jan 2012 01:10:56 +0000

And All Young Medical Professionals

Young doctors, nurses and healthcare administrators always want to be hip with the latest tech gadgets. Unfortunately, they are also the age group with the least money and the most college, graduate or medical school debt. So, the goal of this infographic is to help find a happy medium that allows them to maintain a lifestyle while saving some money.

For starters, we’ve found that slashing cable and sticking with Netflix or some cheap web streaming service is a great way to save. Some also love cooking their own food. Outside of phones, TV, and food, there is a lot of other room to save.

For example, simply cutting out unnecessary items and being more frugal with your spending can produce results. Before we buy ‘wants’, we should think about how badly we want it and how long it will last. A lot of money can be saved just by buying the right brand of a product. Good quality and cheap maintenance can save tons in many products (cars, electronics, household appliances). Stay smart, save money.

Assessment

The American Institute of CPAs and the Ad Council created this Infographic as part of its national public service campaign, Feed the Pig to encourage young doctors and all millennials [aged 25-34] to take control of their finances and make saving money a part of their daily lifestyle.

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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On Open Letter to Dental Economics

Editors — Sun, 22 Jan 2012 13:20:33 +0000

Fun on a Slow Day [will that be paper or electrons?]

By Darrell K. Pruitt DDS

As anyone following the ME-P knows by now, Dental Economics’ officials have been suspiciously unhelpful in locating experts capable of responding to concerns about the cost and safety of EHRs in dentistry – quite the opposite.

The CR Foundation

In addition, Dr. Gordon Christensen’s CR Foundation has also suspiciously avoided discussion of EDRs with this dentist. Nevertheless, I’m certain that like most other EDR stakeholders, employees of DE and CRF at least secretly agree that this consumer has tolerated good ol’ boy behavior in the marketplace far longer than any vendor anywhere else in the free world could ever expect – no matter how important.

Dentrix, too!

At some point, Dental Economics, CR Foundation and Dentrix will either have to answer at least one dentist’s sincere questions about EDRs or censor me from their Facebooks. Over time, not-anonymous censorship would be second only to anonymous censorship as the worst possible choice. If I’m given the opportunity, I’ll prove it.

As readers can tell, sometimes on slow days, even silence from rude people who profit off of my profession irritates me – causing me to want to grab them by the attentions. I’m feeling especially itchy today, so I also posted the following on Dental Economics Facebook:

Dear Dental Economics:

If the AMA finally admits that EHRs are a poor substitute for thinking, don’t you agree it’s time for shy stakeholders in dentistry to accept ownership of their products’ weaknesses? And for other stakeholders to either help me or get out of the damn way?

“EHRs Linked to Errors, Harm, AMA Says — Clinicians can introduce errors when they copy and paste sensitive patient data into electronic health records, according to AMA research.”

http://www.informationweek.com/news/healthcare/EMR/232400325

Or, do you think if dentists remain silent like good little professionals, those who profit from EDRs and related advertisements will suddenly become honest with our patients? I’m not that optimistic. I think if interoperable EDRs are ever to succeed, dentists must pester the unresponsive leaders even while hangers-on would shield them for their own selfish reasons. For example, dentists are unlikely to ever read in Dental Economics the following hints of the imminent failure of EHRs in dentistry: 96% of EHR systems have been breached in the last 2 years and the frequency of breaches rose 32% in the last year – costing over $6.5 billion. The fantasy is over, DE. It’s becoming increasingly difficult for even stakeholders to get giddy about EDRs.

Once the high risks of identity theft from dental offices can no longer be suppressed by stakeholders, our patients’ trust will be forever lost – just to protect the most selfish of people in the healthcare industry from accountability.

Where are you Dentrix?

And what’s the opinion of your CRF investigators, Dr. Gordon Christensen? Are EDRs cheaper than paper dental records or not? As you know, a few months ago your former CEO stated in an article on Dentistry iQ that EDRs offer dentists a “high return on investment,” yet failed to produce evidence supporting his incredible claim.

http://www.dentaleconomics.com/index/display/article-display/2974000845/articles/dental-economics/volume-101/issue-10/features/digital-dentistry-is-this-the-future-of-dentistry.html

Regardless of an institution’s reputation and market share, deceiving doctors and patients for personal gain is just wrong.

Since the misleading statement from the influential CEO has never been corrected, his lie which is still featured on Dentistry iQ continues to harm naïve dentists and clueless patients – but not without the help of 8 Dental Economics editors who voted the CEO’s article as a tie for the “Most important story for the dental profession in 2011.”

http://www.dentistryiq.com/index/display/article-display/9721317527/articles/dentisryiq/hygiene-department/2011/12/best-of_2011_articles.html

Assessment

Way to go, Dental Economics editors! Any of you have enough confidence to discuss why you chose the former CEO’s article? I think your readers would like to hear your reasons. I certainly would. What could it hurt?

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Speaker: If you need a moderator or speaker for an upcoming event, Dr. D. K. Pruitt and Dr. David E. Marcinko MBA – Publisher-in-Chief of the Medical Executive-Post – are available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: http://healthcarefinancials.wordpress.com/2007/11/11/advertise

Chief Medical Officer [CMO] Search

Editors — Sun, 22 Jan 2012 00:01:07 +0000

A Major Teaching Hospital

By Julie Vetter – Associate Consultant

Dear Dr. Marcinko and ME-P Physician Executives

One of the top 15 major teaching hospitals in the country is seeking a Chief Medical Officer [CMO] to serve as the clinical strategist to drive improvement in hospital and system-wide services, and quality measures. The CMO will be instrumental in integrating primary and specialty physician initiatives, as well as aligning cultures in preparation for health care reform.

St. John Providence Health System

A member of St. John Providence Health System, which is a part of Ascension Health, Providence Hospital & Medical Center is recognized by Thomson Reuters and a recipient of the prestigious Everest Award for quality improvement. In addition to responsibilities at Providence, the CMO will be a member of the senior leadership team for Providence Park Hospital, a state-of-the-art, 200-bed facility recently built in 2008.

Assessment

If your ME-P readers have any interest or recommendations, I would be happy to provide more detail:

Cejka Executive Search

4 CityPlace Dr., Ste. 300
St. Louis, MO 63141
314.236.4407 Office
jvetter@cejkasearch.com
http://www.cejkaexecutivesearch.com

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: http://healthcarefinancials.wordpress.com/2007/11/11/advertise

The Human SubWay Map

Editors — Sat, 21 Jan 2012 19:50:27 +0000

Systems Anatomy Under our Skin

This underskin is an infographic that traces the routes of eight different systems within the body (Digestive, Respiratory, Arterial, etc.), and highlights the major connection points.

Source: just-sam.com

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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The Americans with Disabilities Act and Deaf Patients

Editors — Sat, 21 Jan 2012 00:06:47 +0000

Interpreting … the Interpreter

Ask-an-Advisor

QUERY:

I understand that as doctors we need to accommodate the disabled and follow the ADA of 1990. In the case of hearing-impaired patients, it is our cost to have an interpreter present.

But, for example, is the doctor able to dictate what interpreter will be used or does the patient decide who will be interpreting? As far as the charge for the services of the interpreter, how is the appropriate fee set?

It takes about twenty minutes for us to see a hearing-impaired patient. We are told from the interpreting service that it is their policy to charge us for a minimum of two hours.

Any thoughts?

Assessment

Link: http://www.ada.gov/pubs/ada.htm

Conclusion

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An Integrated Approach to Healthcare Network Alignment and Scalable Innovation‏

Editors — Fri, 20 Jan 2012 13:20:41 +0000

More on Healthcare Network Design and Automation

Part 5 in a 6 part series

By Sam Muppalla – Vice President, McKesson Health Solutions Network Performance Management

Previously, on this ME-P, I wrote about the barriers to alignment across product, network, care and reimbursement innovations. And, yes, I teased you with the three-word preview of what was to come this week: Integrated Building Blocks. The idea of building blocks lies at the heart of an approach to achieving alignment and scaling innovation, so let’s dive in.

Unlocking potential administrative, IT and medical savings — while also creating sustainable alignment of the innovation engines — requires various building blocks be in place as a sound foundation for network design and implementation. These building blocks deliver the required functionality in the most efficient manner. When these building blocks are utilized in an integrated fashion, the current barriers are removed and innovation alignment is achieved.

Four Essential Building Blocks

There are four essential network design automation building blocks that comprise the foundation for innovation: networks, contracting, reimbursement and engagement.

Each of these building blocks enables capabilities by delivering necessary functionality within and across the spectrum of network design. Reaching levels of maturity with this capability unlocks additional value and alignment.

Networks

The network building block enables health plans to differentiate and compete. The purpose is to differentiate their value for each customer segment by aligning the product and care model designs with the underlying network designs. It ensures network performance by facilitating the selection of appropriate providers into networks and the alignment of provider reimbursement with network design objectives. It enables networks to be mapped to member-facing and provider-facing products. The provider-facing products can be used for contracting and provider rate differentiation. The member-facing products can be aligned with benefits and serve as steerage targets for benefit designers.

These constructs, in conjunction with each other, enable productization of care model and payment innovation. For example, a health plan could define a “Medical Home Network” that consists of medical homes and supporting providers in a given geography. It could then enable PCMH-specific reimbursement (e.g., PMPM capitation + Fee For Services (FFS) for preventive services + P4P for EBM) by defining a provider-facing product and associating specific reimbursement policies with that provider product. Additionally, it could also define a member-facing product (e.g., PPO Value) which combines the medical home network with the general market PPO network. This in turn will allow the health plan to define a benefit extension which gives a 10 percent premium reduction to members who use Medical Home Network providers for their primary care. In short, a health plan is now able to monetize its care innovation (PCMH), align benefit design to network design for steerage, and align its provider payment with member incentives (around preventive services), while incenting higher quality care (P4P).

The network building block also achieves administrative cost leadership through comprehensive provider data governance and automation of core provider processes.

Contracting

The contracting building block is designed to enable health plans to reduce contract administrative costs while increasing provider payment accuracy. It optimizes the management of the provider contracting lifecycle through the automation of contract authoring, offering negotiating and acceptance while ensuring the standardization of terms and policies. This building block achieves reduced medical expenditure driven by contract standards adherence, reduced claims mis-payments, and increased speed to market for new payment innovations. It also can support rules-based enforcement of network level reimbursement guidelines to ensure consistent network performance.

Reimbursement

The reimbursement building block enables health plans to maximize the effectiveness of their medical expenditures by paying for value versus volume and by incenting team-based performance. It is the single source of truth for all forms of reimbursement including traditional claims pricing, episodes of care, shared savings, capitation and P4P. This building block enables the mixing and matching of reimbursement methodologies to incent optimal provider performance. It supports a modeling engine to analyze the financial impact of reimbursement and contract changes. It incorporates network-aware provider/contract selection for claims pricing intake. This is a rules driven, high performance service that leverages provider relationship information to select the right provider, the right governing contract and the right reimbursement model for each incoming claim. Additionally, it includes provider transparency services that enable health plan provider portals to support online pricing lookups and reimbursement status/detail inquiries for providers. These services can be extended to support provider performance scorecards and benchmarks.

Engagement

The engagement building block is designed to increase collaboration and participation. It enables meaningful engagement among health plans, providers and members in order to improve health outcomes and reduce costs. This building block achieves reduced administrative and service costs, increased member participation and adherence, increased provider satisfaction and adoption of care/payment initiatives, and the enablement of collaborative/integrated care delivery models such as PCMH and ACO.

Utilizing flexible, automated and integrated building block capabilities is the key to sustainable success that not only unlocks the promise of affordable care to customer segments but also delivers on reduced administrative, medical and IT costs. Incorporating information technologies that can facilitate, if not altogether replace, the manual interactions will be an important part of every organization’s evolution.

Assessment

Next week, in our final part 6 of this series, we’ll wrap up this discussion with a look at some of the potential savings health plans could achieve through alignment and an integrated approach to network design. The potential savings are not slight, so stay tuned. As always, if you just don’t want to wait for next week, visit our website and download the entire Unlocking Affordable Care by Aligning Products white paper; it’s available now.

Conclusion

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

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Financial Planning for Physicians

Editors — Fri, 20 Jan 2012 00:18:24 +0000

A Handbook for Doctors and their Financial Advisors

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Book Review and Summary

Financial Planning for Physicians and Advisors describes a personal financial planning program to help doctors avoid the perils of harsh economic sacrifice.

It outlines how to select a knowledgeable financial advisor and develop a comprehensive personal financial plan, and includes important sections on: insurance and risk management, asset diversification and modern portfolio construction, income tax and retirement planning, and medical practice succession and estate planning, etc.

When fully implemented with a professional’s assistance, this book will help physicians and their financial advisors develop an effective long-term financial plan.

Order now: http://www.jblearning.com/catalog/0763745790/

###

Are Physicians Really Going Broke?

Editors — Thu, 19 Jan 2012 13:33:16 +0000

Am I Prescient, Lucky or Just an Observant Trend Reporter?

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

A few years ago I was involved in a Physician’s Money Digest report that showed the average physician reader (ie, 47 years old and $184,000 in annual income) would need about $5.5 million to retire. This was in 2007-08, right before the infamous financial “meltdown”.

Lifestyle Preservation

Now, that’s if they planned to have the same lifestyle after retirement as in the years just prior to retirement. In other words, to live on 80% of pre-retirement income, my doctor colleagues would need about $4.4 million. Although that isn’t exactly loose change, the average PMD reader at the time, had a head start, with a net worth of $1.1 million. By maxing out on retirement plans, we reckoned the average reader could be in shouting distance of the goal by age 65.

Although the figures were daunting, they were a wakeup call to the fact these doctors, now age 52-53, still needed to save more aggressively to be able to finance the retirement they were working toward. But since then, their home worth and practice value, savings, investment and retirement accounts are probably down in 2012; as is their net worth. Down - and I mean way down!

Link: http://www.physiciansmoneydigest.com/issues/2005/92/3951

Fast Forward to 2012

Today, some pundits posit that doctors in America are harboring an embarrassing secret: Many of them are going broke. This quiet trend and seeming reality, which is spreading nationwide, is claiming a wide range of casualties including family physicians, cardiologists and oncologists. Sadly, it is a trend that I have professionally observed and personally seen.

Link: http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. And, no doubt, these are all true reasons – in part. But, some experts counter that doctors’ lack of business acumen is also to blame.

So, that’s why we started our physician focused financial planning firm www.MedicalBusinessAdvisors.com - and - our online educational program for their managerial consultants and financial advisors www.CertifiedMedicalPlanner.com These firms were conceived and launched more than a decade ago; to much derision and haughtiness at the time. Not some much today, however! Why?

Assessment

A decade ago, Forbes magazine ran an article about doctors making six figure salaries and still wanting a medical union to bargain collectively. This was a bit difficult for the average man or woman in the street to imagine about such learned professionals, formerly considered affluent and a cut above the rest. So, where is medical union clout today? Where is MD salary clout? And, where is physician net worth now – and in the future? Doctor – what’s in your wallet?

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Are doctors really going broke? Are they OWS…ers? Was I prescient, lucky or just an observant reporter of this trend, early on? Please review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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The Prescription [Rx] Drugs Most Marketed to Doctors

Editors — Thu, 19 Jan 2012 00:58:00 +0000

An Infographic

This ME-P comes to us from Appature, a Seattle based company that provides a cloud based healthcare marketing tool.

Upon submission of this infographic, the folks at Appature had the following to say:

Appature Inc, a Seattle-based software company that makes marketing tools for the healthcare industry, just launched its first infographic about Prescriptions Most Marketed to Doctors in the healthcare industry! Our infographic breaks down the ins and outs of which prescriptions are most marketed to doctors, to which prescriptions have the greatest sales ($5.3 Billion!) and even patient sentiments regarding a doctor’s prescribing habits. By reading this infographic, we hope that readers will get a little peek inside the intricate inner-workings of the infamous pharmaceutical industry! As TIME magazine highlights, “…the pharmaceutical industry is – and has been for years – the most profitable of all businesses in the U .S.”

Conclusion

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On e-Claim Only Dental Plans

Editors — Wed, 18 Jan 2012 11:49:31 +0000

About their Hidden Costs - I’m Talking PHI Breaches

By D. Kellus Pruitt DDS

If the rumor is true about Bluebell Ice Cream’s “e-claim-only” dental benefit plan that is to go into effect in March, how many in the east-central Texas town of Brenham (pop. 16,000) will be properly warned about the danger to themselves, their families and Bluebell officials’ reputations because of reckless policy?

Transmissions Risks

Each time their dentists send an electronic dental claim (e-claim) over the internet to insurance employees in Chicago as a favor to a patient – and especially the insurer – the Bluebell employee’s digital medical identity which is worth fifty bucks on the black market, rides along to destinations unknown. It’s my guess that very few Bluebell employees are yet aware of the increasing risk of medical identity theft from dentists’ e-claims – much less given the opportunity to opt out of the risk by simply visiting a dentist who still uses the telephone, fax and US Mail.

Security Risks Growing

It certainly won’t improve my popularity with 9 out of 10 dentists for saying this, but risks of identity theft from HIPAA-covered dental offices are climbing daily. In the introduction to a recent interview with Larry Ponemon, chairman and founder of the Ponemon Institute, GovernmentIT.com editor Tom Sullivan ominously described the ever-increasing risk of a massive “data spill” of perhaps millions of patients’ protected health information (PHI):

“The street value of health information is 50 times greater than that of other data types. Even worse, the healthcare industry is among the weakest at protecting such information. With organized criminals trying to steal medical IDs, sloppy mistakes becoming more commonplace, mobile devices serving as single sign-on gateways to records and even bioterrorism now a factor, healthcare is ripe for some a wake-up call – one that just might come in the form a damaging ‘data spill.’” (See: “Q&A: How a health ‘data spill’ could be more damaging than what BP did to the Gulf.”

Tom Sullivan - Editor [December 05, 2011]

http://govhealthit.com/news/qa-how-health-data-spill-could-be-worse-what-bp-did-gulf?page=0,0

According to Dr. Ponemon:

“The basic issue, when you think about data theft not data loss – because it’s hard to know whether that lost data ultimately ends up in the hands of the cybercriminal and all of these bad things occur – but in the case of identity theft, the end goal has been historically to steal a person’s identity, and just like getting a financial record, getting a health record probably has your credit card, debit card, and payment information contained in that record.”

Of Credit Cards … and More!

But that’s not all. Credit cards are just chump change. He continues:

“The financial records are actually lucrative for the bad guy, but the health record is actually much, much more valuable item because it not only gives you the financial information but it also contains the health credential, and it’s very hard to detect a medical identity theft. What we’ve found in our studies is that medical identity theft is likely to be on the rise and, of course, there’s an awareness within the healthcare organizations that participate in our study that they’re starting to see this as more of a medical identity theft crime. It’s not just about stealing credit cards and buying goodies, it’s about stealing who you are, possibly getting medical treatment and, therefore, messing up your medical record.”

Dr. Ponemon suggests that the victim may not know about the theft until he or she “stumbles on something that alerts them their medical identity was stolen.” Perhaps something like death following anaphylactic shock from a medication that was once digitally highlighted as “Allergic to.” Understandably, Ponemon adds that respondents recognized altered medical histories as an emerging threat they believed was affecting the patients in their organizations. Such danger for dental patients is almost non-existent if their dentists simply don’t put PHI on office computers.

Should a data breach of Bluebell Ice Cream employees’ identities occur in Brenham or Chicago, which is more likely than not, the fact that electronic dental records do nothing to improve the quality of dental care won’t make Brenham citizens any happier with local Bluebell officials.

Conclusion

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

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About Pancreas Cancer Survival Rates

Editors — Wed, 18 Jan 2012 00:29:35 +0000

Still Not Improving

Here is an infographic to highlight the main statistics about pancreatic cancer that are unknown – you know, less than 3% of people who are diagnosed will live to see five years post-diagnosis?

Assessment

The tree maps showing the difference between death rates and funding for the different forms of cancer is also interesting

Source: Pancreatic Cancer UK

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

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Are We Finally Lifting the Secret IRS Veil on Un-Paid Taxes?

Editors — Tue, 17 Jan 2012 13:11:05 +0000

The Tax Gap Increases to $450 Billion

By Children’s Home Society of Florida Foundation

By Dr. David Edward Marcinko MBA, CMP™

Each year the IRS conducts a survey to determine the amount of unpaid taxes. The “tax gap” is defined as the amount of taxes that are owed by taxpayers but not paid on time.

2006 Results

For the year 2006, revised figures released this week showed that the tax gap increased. The previous estimate of the 2006 tax gap was $345 billion but it increased to $450 billion. The “net tax gap” is a smaller number that reflects the ability of the IRS to collect some of the unpaid taxes. When the additional $65 billion in taxes collected later is subtracted from the $450 billion, the net tax gap is $385 billion. The net tax gap number increased from $290 billion in 2001 to the larger number by 2006.

Tax Compliance Level

The compliance level for taxpayers remains 83.7%. This indicates that the majority of Americans are continuing to calculate and pay their taxes correctly.

Sen. Max Baucus (D-MT) is Chairman of the Senate Finance Committee. He responded to the IRS survey by noting,

“This report shows that closing the tax gap needs to be a major focus of tax reform. An improved tax code that’s simple and fair to all Americans will help close the tax gap, boost our economy and create jobs.”

Editor’s Note:

Both Sen. Baucus and House Ways and Means Committee Chair Dave Camp (R-MI) have been conducting hearings that will lead to major tax reform in 2013. For the vast majority of Americans who pay their fair share of taxes, it is beneficial if Baucus and Camp are able to simplify the tax system and reduce the tax gap. More effective collection of revenue decreases the need to raise taxes on those who are currently paying their fair share.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What is the tax-gap for medical professsionals? Please review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

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