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High Volume Medicare DRGs

[Staff Writers]

The ten highest volume Medicare DRGs represent about 30% of total Medicare patients. Each of these higher volume DRGs represent from about 2% to 6% of total Medicare volume. 

***

  DRG DRG Description % Total Rel Wt
1 127 Heart Failure & Shock 5.99 1.0234
2 089 Simple Pneumonia & Pleurisy Age>17 w/CC1 3.85 1.1447
3 014 Specific Cerebrovascular Disorders except TIA 3.18 1.2056
4 430 Psychoses 3.18 0.9153
5 088 Chronic Obstructive Pulmonary Disease 3.11 1.0067
6 209 Major Joint & Limb Reattachment Procedures, Lower Extremity 2.78 2.3491
7 140 Angina Pectoris 2.33 0.6241
8 182 Esophagitis, Gastroent & Misc Digest Disorders Age>17 w/CC1 2.09 0.7617
9 174 G.I. Hemorrhage w/CC1 2.07 0.9657
10 296 Nutritional & Misc Metabolic Disorders Age>17w/CC1 1.93 0.9313

Source: Health Care Financing Administration [CMS] 2005

Conclusion

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Cash Based Compensation Medical Practices

Business Model Related to Concierge Medicine

Staff Writers 

A Cash Based Compensation (CBC) medical practice business model attracts patients who pay cash for desirable services, such as surgeons who dispense scar reducers or in areas such as pain relief, weight loss, aesthetic procedures, and natural health. 

Model Parameters 

According to consultant Michael Wallerstein, any well-rounded CBC program should include these parameters: 

  • existing patient demand;
  • low entry cost;
  • little marketing costs;
  • existing employees to administer the program;
  • office capacity; and an
  • operating plan. 

All Specialties Included

Even dentists and podiatrists who perform cosmetic and elective image enhancing services like teeth bleaching, veneer applications, vein reductions, toe shortenings and shoe appliances are amenable to CBC practices.  

Assessment 

With time and effort, profit for physician compensation may increase 10-20% annually by providing “wants”; rather than medical “needs.” 

Conclusion 

And so, what is your opinion of these new CBC medical practitioners; ethical physicians or medical merchants?  

Book Info: http://www.springerpub.com/prod.aspx?prod_id=23759

Institutional: www.HealthcareFinancials.com 

Linguistics: www.HealthDictionarySeries.com

 

Unlimited Marital Deduction

Understanding Physician Estate Planning

By Lawrence E. Howes; CFP™
By Joel B. Javer; CFP™
fp-book1

Under the unlimited marital deduction, virtually all transfers to a spouse, whether made during lifetime or at death, are tax-free.   

Tax Consequences 

However there is a tax consequence for leaving your entire estate to your spouse. 

Leaving everything to your spouse does not utilize your exclusion amount, which was $1,000,000 in 2003.   

However, under the Economic Growth and Tax Relief Reconciliation Act [EGTRRA] of 2001, the increased exclusion amount, formerly $1,000,000 is scheduled to increase to $3,500,000 in 2009 and expire in 2011. 

Assessment 

This has no effect after the first death, but when your spouse dies, the estate of the spouse will pay higher taxes.   

Conclusion 

Please opine and comment if you have ever considered or used this strategy; and what was the result? 

Book info: http://www.jbpub.com/catalog/0763745790/ 

Institutional: www.HealthcareFinancials.com 

Linguistics: www.HealthDictionarySeries.com