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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

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    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

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The NPI Debate Heats Up

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Questionable Benefits for Providers

[By Darrell Pruitt; DDS]pruitt

I really hate lies!

Even though I have been a member of the American Dental Association [ADA] for 26 years, and intend to remain a member for the rest of my life, I cannot stand by silently any longer while my professional organization uses lies and/or deception to trick trusting members into volunteering for NPI numbers. 

Now, to see what I mean, please read what the ADA tells dentists about the benefits of the NPI number http://www.ada.org/prof/resources/topics/npi.asp

  • 1. Once implemented across the entire health care industry, the NPI will be accepted by all dental plans as a valid provider identifier on electronic dental claims and other standard electronic transactions.
  • 2. Dentists will not have to maintain multiple, arbitrary identifiers required by dental plans, nor will they have to remember which number to use with which dental plan.
  • 3. NPIs introduce an important element of standardization to electronic transactions that should improve transaction acceptance rates.   

Questionable Benefits Review

See what I mean? Now let’s review:  

  • 1. Number one clearly benefits only insurers and number three is unwashed tyranny.  The smell of sweet buzzwords counter-balancing the odor of the verb “should” immediately revealed to me traditional PR hucksterism … and I’ve seen better. The NPI number, which is conveniently necessary for electronic transactions, will only make it cheaper for insurers to deny claims.  I think anyone can see that denials will increase for natural, bottom line reasons.
  • 2. That leaves benefit number two – reduction of ID numbers – as dentists’ last hope of a return on investment in the voluntary NPI.  And, ROI could take a while.  In the first place, how much do multiple identification numbers actually slow dentistry production in a computerized dental office?  Why don’t we get silly?
  • 3. Of all things, for the ADA to list simplification as a benefit of the NPI is embarrassing, but here is what will make a few ADA leaders avoid each other in the halls of Headquarters next week. Even though the promise of simplification is lame, it is technically the only benefit the NPI number lends dentists and their patients.

Enter the AAFP

Here now, is some fresh bad-news for certain ADA leaders and members who trusted their advice. 

In an article that was posted yesterday on the American Academy of Family Physicians (AAFP) website, it looks like CMS reneged on simplification.

http://www.aafp.org/online/en/home/publications/news/news-now/practice-management/20080829keep-ptans.html

PTANS 

“Notice to physicians: Hold on to your Medicare Provider Transaction Access Numbers [PTANs], also known as legacy numbers which were to have been retired after the mandatory use of National Provider Identifier [NPI] numbers on May 23.” CMS has found another use for those old PTANs.”

Imagine that.  Instead of eliminating all of those identifiers as promised, the NPI is just one more number to add to the hard drive.

Assessment

Regardless, patients don’t suffer harm from all this, right?  Wrong. 

I’ll describe harm from HIPAA, the biggest blunder in the history of dentistry, and medicine, next time. 

Conclusion

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Health Insurers Secrets

Seven Things you don’t Know about Health Insurance

By Staff Reporters

“Myth Busters”

Wrapped up in all the noise these days are myths on health insurance that were perhaps once true – or maybe never were.

So, here’s a look at seven things you probably didn’t know about your health insurer.

Link: http://articles.moneycentral.msn.com/Insurance/InsureYourHealth/7SecretsOfHealthInsurers.aspx

Conclusion

Your thoughts are appreciated; especially from insurance agents, industry insiders and medical providers; please opine and comment.

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

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Healthcare Stock Performance

Doing Well by Doing Good – To Date in 2008

By Staff Reporters

According to Anne Zieger of FierceHealthFinance, healthcare stocks are doing well.

The Standard & Poor’s Benchmark

With healthcare facing some of its biggest financial challenges in years, particularly a growth in bad debt and slides in federal reimbursement, you wouldn’t think that industry stocks would be doing too well.

An Illogical Market

As usual, however, the market has followed its own logic, bringing several healthcare stocks to high points and pushing up the overall value Standard & Poor’s healthcare stocks average by 4.4 percent (compared with a 7.9 percent drop in the overall index). 

Meanwhile, mutual funds focused on healthcare are up 6.84 percent over the past three months, according to Morningstar, the only category of stock funds in positive numbers during this period.

Big Pharma and Biotechnology Driven

And, San Francisco Chronicle analysts say that rising healthcare stock performance is driven more by biotechs and big-pharma than provider companies. Their strong performance is partly due to improved performance by the stocks themselves, but also due to investors running away from finance and energy as well. 

Healthcare stocks have also been pushed up by foreign investors with strong currencies, who have been on the prowl to take over U.S. companies with below-expected valuations.

The Gainers

Big gainers among the S&P 500 include generic drug-maker Barr, Amgen, Varian Medical Systems and King Pharmaceuticals. 

On the other hand, it’s not all good news in this sector, as several managed care companies have lost value, including UnitedHealth Group and Aetna.

Assessment

Of course, hospital companies like HMA and Tenet haven’t done well, lately.

Conclusion

You thoughts and comments are appreciated; especially from wealth managers, financial professionals, insiders or investment advisors.

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23 and Me

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Personal DNA Analysis and Reporting 

[By Staff Reporters]

Ever wondered why you were left-handed and your sibling or parent wasn’t?

A not-so-new new company, 23andMe, provides an analysis of DNA, where you can learn more about yourself, your immediate family and even your ancestry.

Target Markets

Those who would be especially interested in this personal genome service include:

Methodology

Customers [sic patients] submit a small saliva sample that is processed using a proprietary custom DNA chip. The resulting data is then presented on a secure website using interactive tools that offer information about ancestry, inherited traits and disease risk.

Board of Directors

This is no lightweight company. It technology founders include:

  • Linda Avey
  • Anne Wojcicki
  • Esther Dyson

While its’ medical advisors are:

  • Uta Francke; MD [Professor of Genetics and Pediatrics, Stanford University].
  • Itsik Pe’er; PhD [Assistant Professor of Computer Science, Columbia University].
  • Peter A. Underhill; PhD [Senior Research Scientist, Stanford University].

Assessment

You can also better understand your genetic tendencies for things like obesity or health issues.

There is even an interactive blog: http://spittoon.23andme.com

Users can find other members with similar genetic makeup and start discussions. And, it is $999 to order a kit for the DNA test. 

Conclusion

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Healthcare Focused Tax Attorneys

Avoiding the “Managed Care Ripple Effect”

By Dr. David Edward Marcinko; MBA, CMP™

The healthcare industrial complex represents a large and diverse industry, and the livelihood of other synergistic professionals who advise doctors depend on it as well. These include tax and estate attorneys who themselves wish to avoid the collateral ripple effects of the current healthcare debacle.

Lawyer as Financial Planner

As a tax, estate planning or bankruptcy lawyer, you already know that almost every legal magazine around has articles or advertisements proposing that you become a financial planning professional or business consultant to your physician clients.

Moreover, lawyers of all stripes are being pushed toward interdisciplinary alliances by encroachment on their turf by the Big Four accounting firms. With audits of publicly held companies now a commodity, the giant accounting firms are getting more of their revenues from consulting, and that puts them into direct competition with attorneys, MBAs, actuaries and other management and financial service professionals.

Avoiding a Medical Career

Of all careers, you know how absolutely onerous it is to practice medicine today, and are finally thankful that you did not take that career route many years ago.

So, like your neighbor the accountant, you begin to explore that potential of developing a service line extension to your legal practice, in order to assist your medical colleagues who have been hit on hard economic times. In fact, you soon realize that more than 90,000 trust, probate and estate planning attorneys like yourself are interested in pursuing financial planning in the next decade. Sure, you know it’s difficult to get a CLU or variable annuity license, or become a Certified Financial Planner™ (CFP), but earning your law degree was no cinch either.

And, you reckon, advising physicians has got to be easier than law, or less stressful than the corporate lifestyle of your MBA trained brother-in-law, right?

So, you set out to stretch your legal horizons and explore the basic legal nuances of those topics not available in law school when you were a student.  Things like medical fraud and abuse; managed care compliance audits and Medicare recoupments; OSHA, HIPAA and EPA standards; anti-trust issues; and managed care contract dilemmas or de-selection appeals.

Assessment

What a brave new world the legal profession has become! Even the American Bar Association’s commission on multi-disciplinary practice has recommended that lawyers be permitted to share fees and become partners with financial planners, money managers and other similar professionals.

As a real life example, the venerated Baltimore brokerage firm of Legg Mason Inc. teamed-up a few years ago, with the Boston law firm of Bingham Danna, LLC, to create one of the first marriages between a law and securities firm.  

And so, if you want in on the challenge, and bucks, you’d better acquire at least a working knowledge of healthcare administration, or perhaps help craft some new case law, or assist your doctor-clients in some fashion; otherwise, you will remain a legal document producer.

Disclaimer: Dr. Marcinko, a court approved expert witness and former Certified Financial Planner™, is also founder of the Certified Medial Planner™ program for all fiduciary consultants in health economics, financial planning and medical practice management www.CertifiedMedicalPlanner.com

Conclusion

Your thoughts are appreciated; please opine? Is this new industry concept a viable one?

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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

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Dental Managed Care Survey

Delta Dental Plans Association (DDPA)

By Darrell K. Pruitt; DDS

The common sense truth about managed-care dentistry was recently confirmed by Delta Dental data mining.

Preliminary Oral Care Report

Concerning what one can do to assure the best oral care for oneself or one’s family; allow me to share some significant news about research that has not yet been formally published.

On the morning of August 14 2008, less than two weeks ago, a representative for Delta Dental Plans Association (DDPA) revealed the results of an in-house study that confirms that remaining with the same dentist for the long term prevents fillings.

The 2008 National Dental benefits Conference

It was during the first day of the 2008 National Dental Benefits Conference in ADA Headquarters in Chicago that Maxwell H. Anderson DDS, the dental affairs advisor for DDPA, located in Oak Brook Illinois, announced that by data mining their proprietary dental claims over 11 years, Delta uncovered evidence-based information revealing that clients who change dentists regularly are likely to receive more fillings than those who stay in consistent “dental homes” where they are content.

Dr. Anderson told the audience of about a hundred dentists and dental industry representatives that “The greatest hazard to teeth is changing dentists.”

A Righteous Finding

I find it remarkable, as well as noble, that a managed care insurance company like Delta, based on preferred provider lists that are valid for only 12 months at a time, would voluntarily reveal findings that can only bring harm to their business model.

However, when one thinks about it, Delta’s results clearly make sense. If a patient or family of patients is comfortable with a dental team, they are more likely to keep their check-up appointments as well as take better care of their teeth at home. And, consequently, enjoy better health.

Perhaps Delta came to the righteous conclusion that to hide such landmark findings would be unethical?

Assessment

How do preferred-provider lists cause more fillings?

When dentists can rely on a dental care broker like Delta Dental for new patients, there is an inherent absence of accountability that occurs when guided by the invisible hand of competition in the marketplace, naturally. That is an undeniable fact. Managed care dentistry is dentistry by the lowest bidder with no quality control; also an undeniable fact.

Note: Dr. Pruitt, an attendee of the 2008 National Benefits Conference on August 14 and 15 in ADA Headquarters, is the sole proprietor of a fee-for-service dental practice in Fort Worth, Texas. He represents only himself for the benefit of dental patients. His name cannot be found on any preferred provider list. Report posted with permission.

Conclusion

Your thoughts and suggestions are appreciated. Are this dentist’s “facts” and quality assessment true; please opine and comment?

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

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Coming Healthcare Worker-Shortage

It’s All in the Demographics

[A New AAHC Report]

[By Staff Reporters]

Current domestic policies will not avert a US health work-force crisis, according to a new report released by the Association of Academic Health Centers [AAHCs]. Moreover, it recommends developing a national planning body to unite efforts to slow/end work-force shortages.

The Report

The association’s report, “Out of Order, Out of Time: The State of the Nation’s Health Workforce,” points to a long and growing list of challenges. These include projected shortages in primary care and nursing; as the baby-boomer wave of retiring physicians and increasing medical needs of the growing elderly population exacerbate.

Lifestyle Preferences

Also, as reported in the American Medical News, on August 25, other issues fueling shortages of health-care workers include lifestyle preferences (regular work hours and family), economic disparities, rising medical school debt loads, and a dwindling pool of medical school faculty, with fragmented health care work-force policymaking.

Assessment

If this all isn’t enough to discourage new entrants from joining the healthcare industry, the plummeting value of present-day small-to-medium sized private medical practices just might.

In fact, our Publisher-in-Chief, Dr. David Edward Marcinko was recently interviewed by the American Medical News on this very topic. And, the un-edited version of that interview will appear in an upcoming issue of the Medical Executive-Post, shortly after AMNews publication.

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Conclusion

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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

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