Office Based EMR Cost Report

Posted on March 12, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

A Preliminary BC/BS Cost-Benefit Analysis

By Staff Reporters  Stethoscope

BlueCross-BlueShield of Massachusetts recently announced that it will not require physicians to install or use electronic medical records [EMRs] to participate in its new bonus program. The health plan came to the conclusion that the financial benefits of office-based electronic medical records systems are just not worth the cost to doctors.  

Little Office-Based Value 

Relying on information from past studies, the American Medical Association [AMA] estimated that office-based doctors see only 11 cents of every dollar saved through the use of information technology, according to AMNews reports. 

More Hospital Value 

But, the Massachusetts Blues did find value in health information technology [HIT] that physicians would need to use, as its own cost-benefit analysis concluded that computerized physician order entry makes financial sense in the hospital and enterprise-wide healthcare setting. 

Assessment 

The MA-Blues will require hospitals and health systems to install computerized physician order entry systems [CPOEs] by 2012, in order to participate in the bonus program.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to 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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 

Filed under: Information Technology | Tagged: , , , , , , , , , , | 1 Comment »

Lloyd M. Krieger; MD, MBA

Posted on March 12, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

FROM THE PREFACE

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors  

Insurance is an important part of all our lives. This is especially true for physicians, medical and healthcare executives.

For example, I currently have no fewer than 10 separate insurance policies associated with my plastic surgery practice. I understand very little about the policies other than that somebody at some point told me I needed each and every one of them, and each made sense when I bought it.   

  • Am I over-insured and thus wasting money? 
  • Am I under-insured and thus at risk for a liability disaster? 

I never really had the means of answering these questions, until now. 

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors is an essential textbook because it explains to physicians and insurance professionals the background, theory, and practicalities of medical risk management and insurance planning.  The insurance haze is lifted by-dual degreed editor, and Certified Medical Planner™Dr. David Edward Marcinko MBA, and his team of contributing authors. 

Doctors, like most people, tend to experience losses more intensely than gains, and evaluate risks in isolation.  So it’s no surprise that goaded physicians might prefer vehicles like the guaranteed minimum death benefit of variable annuities, or the assurance that comes with disability or long term care insurance, or traditional cash value life insurance policies, despite their decidedly higher costs and commissions.  

Similarly, physicians may enter denial mode and eschew the potential business impact of HIPAA and Balanced Budget Act risks; self referral risks; OSHA, DEA, EPA, OCR, P&C or managed care risks; managed care contract capitulation risks; employee, expert witness, peer review and on-call risks; and even educational debt load risks, among so many others. 

For real insurance professionals on the other hand, this is an exciting time to be practicing medical risk management, because there is much research and creative enlightenment occurring in academic and practitioner communities.  

But, one must be willing to abandon ancient thoughts and remain open to new ideas that identify and provide solutions to the contemporaneous problems of physicians.  

As an example of this epiphany, the economist Christian Gollier revisits the raison detra’ of insurance, by asking: should one even buy insurance since the industry itself is so skilled at exploiting human foibles? Although this emerging work is descriptive, it is not yet time tested since some of it aspires to be normative, as developing modern models of savings and consumption hint that insurance may deserve a smaller role in personal risk management than previously believed.

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors  fulfill its promise as a peerless tool for physicians wanting to make good decisions about the risks they face.  

It is also ideal for financial planners, insurance agents and healthcare business advisors wishing to re-educate and help doctors by adding lasting value to their client relationships.  

With time at a premium for all, and so much information packed into one well-organized resource, this book should be on the desk of every physician, or financial advisor serving the healthcare space.   

Simply stated, if you read this compelling text with a mind focused on the future, the time you spend will be amply rewarded. 

Lloyd M. Krieger; MD, MBA

Rodeo Drive Plastic Surgery

The Rodeo Collection

421 North Rodeo Drive

Beverly Hills, CA  90210

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

  Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)* 8

Filed under: Risk Management | Tagged: | 3 Comments »

Bars to Managed Care Lawsuits

Posted on March 12, 2008 by Dr. David Edward Marcinko MBA MEd CMP™

A Historic Review

 By Dr. Charles F. Fenton III; Esq.insurance-book1 

Historically, managed care companies have been afforded immunity from negligence and malpractice lawsuits. Several state and federal bars, including ERISA (Employee Retirement Income Security Act of 1974), have insulated managed care companies from liability relating to the treatment of patients.  

Likewise, managed care companies have historically been immune from malpractice committed by a health care member of its panel of providers.  

State Arena 

On a state laws basis, the Corporate Practice of Law often insulated managed care companies from such liability.

The theory underlying this protection was essentially uncomplicated; since corporations are prohibited under the Corporate Practice of Law Doctrine from practicing medicine, they should not be held liable for medical negligence and malpractice.  

Recent Updates 

However, in recent years, it has become apparent that managed care companies do in fact “practice medicine.”  These companies tell their panel of providers how to practice, whether it is in a generalized or specific field of medicine.

For example:  

  • They establish a formulary of approved drugs, limiting those medications available to their subscribers.
  • They review and then approve or deny needed medical care.
  • They create economic incentives for patients to be under treated or treated in a predetermined manner.
  • They effectively minimize referrals to specialists, often at the peril of the patient subscriber and the health care provider seeking that consultation.  

Federal Arena 

In the Federal arena, ERISA has been the primary deterrent to suits against managed care companies.  

Under the theory of Federal preemption, even the lowest Federal regulation takes precedence over any and all state laws. ERISA has however been described as possessing “Super-preemption.”

This term was coined to evince the special deference that courts have displayed to potential defendants who allege defensive protection based upon ERISA.  

In the past, most providers ran into the ERISA preemption when a health plan governed by ERISA was contrary to a state law, such as state anti-discrimination law (i.e., a state law prohibiting insurance payment discrimination based on degree).  

Assessment 

In this context, physicians should understand that liability claims, such as medical malpractice claims, are state law causes of action.  Since the Federal ERISA law trumps state laws, bringing a medical malpractice action against an ERISA entity is almost impossible. 

 Conclusion 

 Have you ever been involved in such an issue; and what was the outcome? Please comment.  

More info: http://www.jbpub.com/catalog/9780763733421

Institutional: www.HealthcareFinancials.com 

Product DetailsProduct DetailsProduct Details

Filed under: Health Law & Policy | Tagged: | 1 Comment »