Pre-Noon Patient Discharges

Improving Emergency Department Flow
Dr. David Edward Marcinko; MBA, CMP™

Publisher-in-Chief

We all know that hospitals across the US are struggling to figure out how to get patients through the emergency department [ED] quickly, safely and efficiently.

In fact, this and related issues were eloquently and contemporaneously addressed by Dr. Robert Wachter of UCSF [Average Time of Discharge: Why a Hospital is Not a Hilton]. Link: www.thehealthcareblog.com/the_health_care_blog/2008/03/average-time-of.html].

I also opined as an occasional ED, but more frequent, hospital admitter [Of Hospitals and Hotels]. Link: https://healthcarefinancials.wordpress.com/2008/04/05/of-hospitals-and-hotels

The problem, of course, has been institutionally endemic for the past thirty years, or so.   

New Study

Now, a new study suggests that one way to get patients through the ED is to make more inpatient beds available by seeing that inpatients are discharged before 12 noon.

Much like the hotel industry, this is but one of several low-cost solutions recommended by the American College of Emergency Physicians [ACEP] to cut down on ED boarding.

Assessment

Duh! Like we didn’t think of that one before?

Conclusion

Your comments and experienced opinions are appreciated?

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Subscribe Now: Did you like this Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Practice Valuation Report Reviews

Understanding a Medical Practice Appraisal

Dr. David Edward Marcinko; MBA, CMP™

By Hope Rachel Hetico; RN, CPH, MHA, CMP™

Much has been written, and much has been said about the goals, objectives, reasons, techniques and methodology used in professional medical practice appraisals, at the Medical Executive-Post.

And, even more actionable information is presented in our institutional 1,200 pages, 2-volume print guide Healthcare Organizations [Financial Management Strategies] http://www.stpub.com/pubs/ho.htm

In fact, this quarterly subscription journal, modestly priced at $525/year, contains more than 200 pages devoted to many sub-topics of this fluctuating and important practice management and financial endeavor. And, increasingly such detailed material is needed in the changing healthcare economic milieu http://www.stpub.com/pdfs/toc_ho.pdf

But, as a quick overview of a valuation report regardless of etiology, this checklist is an indispensable tool when pro-actively contemplating – or retro-actively reviewing – any medical practice appraisal engagement or practice worth analysis https://healthcarefinancials.wordpress.com/category/practice-worth

  

Valuation Report Review Checklist

Yes

 

No

 

Does the report contain the following minimum criteria?

 

 

 

 

1.

A clear description of the practice valuation assignment

 

 

 

a.

The medical practice assets being valued

 

 

 

 

 

  i.

A description of the practice or medical partnership

 

 

 

 

 

 ii.

The size of the holdings

 

 

 

 

 

iii.

The restrictions or rights attached to the assets

 

 

 

 

 

b.

The purpose and intent of the practice valuation

 

 

 

 

 

c.

The valuation date(s)

 

 

 

 

 

d.

The standard of value being used (e.g., fair market value, fair value)

 

 

 

 

 

 

 

2.

A description of:

 

a.

The healthcare entity or medical pratice

 

  i.

The form of the practice

 

 

 

 

 

 ii.

The history of the practice

 

 

 

 

 

iii.

The services, specialty, markets, demographics and patients

 

 

 

 

 

 

 

iv.

The practice’s management

 

 

 

 

 

 v.

The practice’s major assets [tangible and intangible]

 

 

 

 

 

b.

The health industry and the local and general economy

 

  i.

Outlook for the local economy and the health industry

 

 

 

 

 

 ii.

Sensitivity to seasonal, specialty or cyclical factors

 

 

 

 

 

iii.

Marketplace competition

 

 

 

 

 

3.

Financial analysis

 

a.

Analysis of the practice’s financial statements

 

 

 

 

 

b.

Adjustments to financial statements with explanations

 

 

 

 

 

c.

Assumptions used in preparing economic projections

 

 

 

 

 

d.

Comparison of practice performance relative to other specialties in its industry

 

 

 

 

 

 

 

4.

Valuation methodology

 

a.

Description of methodologies used and discussion of reasons for using them

 

 

 

 

 

 

 

b.

Description of uses of discounts

 

 

 

 

 

c.

Discussion of how capitalization rates and multiples of earnings were determined and used

 

 

 

 

 

 

 

5.

Assumptions and limiting conditions

 

a.

Statements of fact are true and correct

 

 

 

 

 

b.

The valuation is the appraiser’s personal, unbiased, professional analyses, opinions, and conclusions

 

 

 

 

 

 

 

c.

Statement by appraiser that he/she has no personal interest in the property being valued

 

 

 

 

 

 

 

d.

Statement by appraiser that he/she relied on information supplied and did not verify it beyond the given

 

 

 

 

 

 

 

e.

Valuation report is valid for the valuation date and purpose only

 

 

 

 

 

 

 

f.

Not contingent on the outcome or disposition of the valuation

 

 

 

 

 

Does the report contain a logical progression leading to a conclusion?

 

 

 

 

Is the report signed by the appraiser?

 

 

 

 

 

 

 

 

 

Does the report include the credentials of the appraiser?

 

 

 

 

 

Conclusion

Remember, this is only the minimum data for analysis. And, although there are many reasons to have your medical practice appraised, and three major types of valuation engagements to obtain, the end result matters little if it is not read and understood within the context of its’ enterprise-wide applications. Therefore, your thoughts, opinions and experiences are appreciated?   

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Subscribe Now: Did you like this Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Professionally Managed Portfolios and Mutual Funds

Advantages and Disadvantages for Physician Investors

[By Staff Writers]

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The following briefly summarizes the advantages and disadvantages of professionally managed portfolios and mutual funds according to size and taxation factors.

Portfolio Size

A major factor that impacts the selection process is the size of the physician-investor’s portfolio. For example, is there a size at which it makes more sense to use managed portfolios?

Except for large portfolios [>$3 – 5 million dollars, USD], mutual fund portfolios can meet most physician investors’ needs. Investors who need substantial individual attention should also consider managed portfolios (perhaps in conjunction with funds or ETFs to add additional asset classes).

Income Tax Consideration

Professionally managed portfolios often offer the physician greater control over the timing of taxable transactions.

For example, at the end of the tax year, it may be appropriate to defer capital gains that would otherwise incur, or conversely, the doctor may wish to accelerate recognition of capital losses.

Mutual funds do not allow physicians or other individual investors to influence the timing of these types of transactions. On the other hand, private portfolio managers are often sensitive to a client’s specific income tax planning needs.

In addition, mutual funds are required to distribute 95% of capital gains recognized during the year. These gains are taxable to shareholders of record on the date of the capital gains distribution, even if the shareholder did not benefit from the gains.

For example, a doctor-shareholder who invests in a mutual fund near the end of the year may pay taxes on gains that were incurred earlier in the year when the fund manager was required to sell securities to raise cash for the purpose of redeeming shares of other investors.

***

***

Assessment

The problem is accentuated in long-term bull markets, where the recognized gains in one year result from an income tax basis to the fund that was established in past years, when the find manager bought securities at very low prices. Private portfolios have the advantage that clients normally are not penalized for events that occurred before they invested with a portfolio manager.

MORE: Vehicles

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:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

 

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