Mutual Fund Selection Checklist

The Cautious Physician

Staff Reporters

After today’s 777 point drop on the DJIA; 200 points on the NASDAQ; and 106 points on the S&P; a new bailout reconfiguration is being planned in Washington to avert another calamity going forward. Some say, the current strife was brought about – in large measure – by the financial system operating the way financial operators told us it was supposed to function.  The money is needed, we are told, to bail out the financiers who assured us – up until just a couple of weeks ago – that the system they operated was sound and would need no rescue. So, what really gives? Since no one knows for sure, MDs should do the following regularly:

  • Check your taxation issues. Review your tax returns every year. Review line 53 of the federal tax Form 1040. Total and divide by 12 to show your total tax paid, on average, each month. The result will show excessive taxes paid because of taxable interest, dividends, and capital gain. You will often do yourself a favor by discovering assets that have not been discussed.
  • Check with the mutual fund companies that you do business with to see if they have tax-managed portfolios.
  • Double-check your arithmetic, and don’t worry so much about taxes that you forfeit by mixing too many income-producing bonds in a portfolio looking for long-term growth.
  • Check the fund prospectus and statement to see how much buying and selling are going on inside the fund so you can at least be aware of this and be able to educate your clients.
  • Look at companies who “manage” money managers such as SEI and Lockwood Financial, etc.

Assessment

How true, false or parsed are the above perspectives?

Conclusion

Your comments are appreciated?

Related Information Sources:

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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

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Repeat Warning on Physician Blogs

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Understanding New-Wave Patient Privacy Risks

[By Staff Reporters]Blood Pressure Cuff

Many people are blogging these days, including physicians. Some say the rapidly expanding medium provides a great opportunity for doctors to better educate patients and the public about the practice of medicine.

Warning

But, others warn that medical or just personal opinion blogging, also presents new risks of breaching patient privacy. As blogs proliferate, some hospital privacy officers are considering policies that would provide professional standards for employees engaged in the activity, and protect their institutions from potential violations of HIPAA.

Ohio State Advice

In a recent Report on Patient Privacy [9/22/08], Julie Chicoine, compliance director at The Ohio State University Medical Center, offers the following pointers for physicians:

  • Be careful. “You should … write as if your patients, co-workers, colleagues, etc. are going to read your posting every day, and know that it came from you.
  • Focus on education and general medical principles. Avoid information that is too specific and situations that are likely to be identified by others in your local community.
  • Ask your malpractice carrier if they have issues with this topic.
  • Never post in the heat of passion. No matter what the circumstances, allow yourself a cooling-off period before logging on and sharing your concerns.
  • Blogs are not the appropriate forum for medical mistakes or hospital errors. Pursue those concerns through the appropriate administrative channels within the hospital.
  • Include a disclaimer that posts are not medical advice.

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.

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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The Pfizer Website

A Medication Safety Initiative

Staff Writers

Pfizer, Inc will be launching a website, now under beta construction, on medication safety to help consumers weigh drug risks and benefits. This is considered, by some, an unusual move in an industry often criticized as using marketing practices that oversell drug benefits and downplay risks.

Patient Advocacy

According to the Associated Press on September 16, Pfizer plans to promote the site by working with medical and patient advocacy groups, as well as with online advertising on websites targeting medical professionals and patients.

Assessment

The detailed future site will include sections written for patients and for health professionals, with plain-English explanations, engaging graphics and clips of video hosts discussing important points. It will also have a prominent link to information about how to report a drug side effect to Medwatch, the Food and Drug Administration [FDA] reporting program.

Conclusion

Your thoughts and comments are appreciated. Is it about time to launch this patient safety initiative; or far too late?

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

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Eli 2 Disclose

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Financial Transparency to Increase

[By Staff Reporters]

In a pharmaceutical industry first, Eli Lilly and Co. said it will begin disclosing how much money it paid to individual doctors for advice, speeches and other services.

placebo-pill

The drug company’s move comes as members of Congress push a disclosure bill in an effort to prevent such payments from improperly influencing medical decisions.

Read more: http://www.msnbc.msn.com/id/26858255

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.

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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Seeking Writers and Contributors

Business of Medical Practice [3rd edition]

Ann Miller; RN, MHA

Project Manager

MarcinkoAdvisors@msn.com

As readers of the Executive-Post may know, our textbook the Business of Medical Practice is a best seller http://www.springerpub.com/prod.aspx?prod_id=23759

Invitation

Accordingly, we wish to personally invite all subscribers to contribute to our third edition now in progress. New and prior chapter are still available for updating; for a low-effort but high-yield contribution. We have others ideas for this peer-reviewed publication, as well. 

Goal

Our goal is to help physician colleagues and medical executives benefit from nationally known experts as an essential platform for their success in the healthcare industry.  

Assessment

And so, please advise and thanks again for your consideration and possible contributions.

Conclusion

Feel free to email me 24/7 for more information about this peer-reviewed publishing opportunity.

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Healthcare Organizations: www.HealthcareFinancials.com

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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

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Hospital Charge Reports

Charging the Poor – More?

Staff Reporters

According to a new report from the Agency for Healthcare Research and Quality [AHRQ], on September 18, 2008, hospital charges increased in 2005 – the latest reporting period.

Charges; Not Actual Costs

Hospital charges – what patients are billed for their rooms, nursing care, diagnostic tests and other services; and not actual costs – jumped from $873 billion in 2005 to $943 billion in 2006.

www.HealthDictionarySeries.com

Data Summary and Survey Results

Between 2005 and 2006, hospital charges increased by:

  • $38 billion to $44 billion – 15 percent for people with no insurance.
  • $124 billion to $135 billion – 9 percent for Medicaid patients.
  • $411 billion to $444 billion – 8 percent for Medicare patients.
  • $272 billion to $287 billion – 6 percent for patients with private insurance.

Assessment

The steep increase occurred even though hospitals admissions increased only slightly, from 39.2 million to 39.5 million. And, it is interesting to note that charges for uninsured and Medicaid patients, those presumably least able to pay and/or protest, rose more than charges for those with private insurance or Medicare?

Conclusion

Your thoughts and comments are appreciated. Is this fair, not fair, an example of “reverse-charge” shifting, or something else?

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

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Adam Smith on Health Economics

A Fictional Interview

By Darrell Pruitt; DDSpruitt

Adam Smith, former 18th century Scottish economist, is with me in the cyber-world today.  He wrote his theories on economics around the time of the birth of our nation. His book, “An Inquiry into the Nature and Causes of the Wealth of Nations,” predates the word “capitalism” as well as “economist,” by several decades. 

Yet his common sense wisdom, like that of many post-Renaissance thinkers of his day, still stands tall and true against time. 

Welcome Mr. Smith:

Q: I have just a few questions that I was hoping you could help me with. The first question is one that is so basic, yet it causes more acute embarrassment than most doctors can tolerate.  I happen to have lifelong immunity to such silly feelings. 

Mr. Smith, why are professionals paid so much in comparison to other trades?  Please use the English you are comfortable with.

A: “We trust our health to the physician; our fortune and sometimes our life and reputation to the lawyer and attorney. Such confidence could not safely be reposed in people of a very mean or low condition. Their reward must be such, therefore, as may give them that rank in the society which so important a trust requires. The long time and the great expense which must be laid out in their education, when combined with this circumstance, necessarily enhance still further the price of their labour.”  [Smith (1776) Book I, Chapter 10]

http://www.econlib.org/library/Smith/smWN4.html#B.I,%20Ch.10,%20Of%20Wages%20and%20Profit%20in%20the%20Different%20Employments%20of%20Labour%20and%20Stock

Q: I’m glad you said that instead of me (someone in the room chuckles.)  For whatever reason, doctors in modern society have remained silent while stakeholders, who are not accountable to patients, crowded them away from the bargaining table.  To tell the truth, what you might call stakeholders’ unenlightened self-interest seems a lot like tyranny.  What can doctors do about it?  I know that in your day, organizing labour (oops, you got me doing it now) could get one quickly killed.  Since then labour movements have come and gone in American society.  What are your thoughts about unionized healthcare professionals?

A: “People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices. It is impossible indeed to prevent such meetings, by any law which either could be executed, or would be consistent with liberty and justice. But though the law cannot hinder people of the same trade from sometimes assembling together, it ought to do nothing to facilitate such assemblies; much less to render them necessary.”[ibid]

Comment: If I understand you correctly, Mr. Smith, you are saying that even though law should not deprive citizens of the freedom to assemble, which, by the way is now a civil right over here in the new world, the government would be wise to not render it necessary for professionals to do so because it would be impossible to prevent conspiracy against the public.  Let’s hope it doesn’t come to that. 

Now, let me show you evidence that our nation’s leaders, in an honorable effort to hold down the cost of healthcare for the common good, actually forgot that part of your lesson sometime over the last couple of centuries. It is thru a contrivance known as pay-for-performance [P4P}.

P4P

Pay for Performance (P4P), not known in your time, is one of the four cornerstone goals for healthcare reform that our President Bush described in his Executive Order.  He officially calls it “Aligning incentives so that payers, providers, and patients benefit when care delivery is focused on achieving the best value of health care at the lowest cost.”  I know you probably have never experienced the magic quality of “buzzwords” before, and the whole sentence is probably leaving with a dry mouth, wondering what “Aligning incentives” is really about.  Don’t feel bad.  This dialect of modern English is difficult for modern doctors to understand as well. 

To put it simply, Bush and his buddies put together an intricate artificial market system where the quality, price and demand will all be controlled by people other than doctors and their customers. 

Wait.  Please, don’t hang up on me.  I can completely understand why you don’t like it, Mr. Smith.  Get this:  I hear Stalin is pissed that Bush stole his idea of vertical collectivism.  I also think it smells a lot like borscht with turnips.  So, let’s move on.

Q: Finally, Mr. Smith, considering there is already unwanted and expensive interference in our nation’s healthcare system that eliminates natural competition between healthcare providers even before our nation turns to universal care, do you think it is unrealistic to imagine that a year from now consumers could demand black market dentistry rather than wait in lines for regulated dentistry?

A: “Particular acts of parliament, however, still attempt sometimes to regulate wages in particular trades and in particular places. Thus the 8th of George III prohibits under heavy penalties all master tailors in London, and five miles round it, from giving, and their workmen from accepting, more than two shillings and sevenpence halfpenny a day, except in the case of a general mourning.

Whenever the legislature attempts to regulate the differences between masters and their workmen, its counselors are always the masters. When the regulation, therefore, is in favor of the workmen, it is always just and equitable; but it is sometimes otherwise when in favor of the masters.”  [ibid]

Assessment

Damned counselors! 

Thank you; Adam Smith! 

Conclusion 

Your thoughts and comments on this artifice are appreciated.

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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

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Re-Managing Your IRA

Revisiting Retirement Planning, Yet Again!

Staff Reportersfp-book

In this time of Wall Street chaos, GNP economic recession and marketplace turmoil, doctors must realize that not all investments and related activities are appropriate in IRAs for tax, legal, and investment reasons. This philosophy is an old reminder from Richard B. Toolson who wrote the classic article “Which Assets Don’t Belong in an IRA?” 

Yet, funds in IRAs, if invested appropriately, can make a significant difference in securing a safe and comfortable retirement for any physician.

So, how are thing the same, or different today; and how shall we revisit the Individual Retirement Account [IRA] in today’s environment?

Prohibited Activities

A number of prohibited activities, including borrowing from the account, could result in adverse tax consequences, including losing the account’s tax-deferred status.

An IRA also cannot invest in collectibles such as art objects, antiques, or stamps under penalty of having the cost of the items considered a constructive distribution and subject to tax. IRA accounts also need to avoid Unrelated Business Taxable Income (UBTI), which may result from ownership of an interest in a partnership or “S” corporation or from purchasing securities on margin or borrowing to acquire real estate.

Arguable Activities

The author also advises against holding tax-free, tax-deferred, or tax-sheltered vehicles inside an IRA, such as municipal bonds, Series EE U.S. savings bonds, or variable annuities. Conversely, assets that are expected to generate the greatest relative pretax returns should be held in an IRA. This would include fixed-income investments expected to yield high returns, stocks with high dividend yields, stocks expected to be held short term, mutual funds that emphasize stocks paying high dividends, and mutual funds that expect to hold stocks short term.

Assets Outside IRAs

Investments in individual foreign securities or mutual funds that hold primarily foreign securities are ideally left outside IRAs in order to receive tax credits on the foreign taxes paid. These credits reduce the physician-investor’s tax liability on a dollar-for-dollar basis, subject to certain limits. If these securities are held inside an IRA, any taxes withheld by a foreign country merely reduce the IRA’s market value. The option of receiving a tax credit is not available.

IRA Checklists

What to have in an IRA:

Generally, assets that are expected to generate the greatest relative pretax returns, such as:

  • fixed-income investments expected to yield high returns,
  • stocks with high dividend yields,
  • stocks expected to be held short term,
  • mutual funds that emphasize stocks paying high dividends, and;
  • mutual funds that expect to hold stocks short term.

What not to have in an IRA:

  • collectibles (e.g., art objects, antiques, and stamps),
  • tax-free, tax-deferred, or tax-sheltered vehicles (e.g., municipal bonds, Series EE U.S. savings bonds, or variable annuities), and;
  • investments in individual foreign securities or mutual funds that hold primarily foreign securities.

Activities to Avoid in an IRA:

  • borrowing from the account, and;
  • creating unrelated business taxable income, which may result from ownership of an interest in a partnership or S corporation or from purchasing securities on margin or borrowing to acquire real estate.

Assessment

Informed physicians and their financial advisors can play a valuable role in managing IRAs in a way that maximizes the amounts available at retirement.

Conclusion

Your thoughts and comments are appreciated, as the above is sure to generate some controversy.

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

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When an ER – Is Not an Emergency Room

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About “InQuickER”

[By Dr. David E. Marcinko; MBA, CMP™]

[By Prof. Hope Rachel Hetico; RN, MHA, CMP™]dave-and-hope

Visits to emergency rooms climbed to a record high of 119.2 million in 2006, up from 115 million in 2005; with an average of 227 visits per minute, according to a new report from the Centers for Disease Control and Prevention [CDC]. So, it’s not surprising that InQuickER” is a new service of Emory-Adventist Hospital [EAH] in Smyrna, Georgia.

How it Works

According to the hospital’s website, patient may schedule his or her trip to the emergency room through an open access process that takes three steps.

1. Reserve an appointment time through the InQuickER website when emergency care for a non-life-threatening issue exists. The site shows the soonest possible time to be seen. You can either reserve that time or choose another time more convenient for you; up to 6 hours later than the first available time. All you need do is briefly describe the injury or illness, and the ER will waiting for you to arrive.

2. Time is saved by filling-out an online registration with medical history that includes allergies and current medications. This allows patient’s to bypass front-desk registration and go straight to a ready and waiting treatment room upon arriving.

3. A printable appointment confirmation slip, with driving directions, completes the online transaction.  

Guaranteed or it’s Free

Be seen in 15 minutes or less — or you don’t pay!

The cost for this premium service is $24.99. Of course, regular charges for diagnosis, treatment, consultants and admission may still apply. Online visitors are admonished to visit the website for additional terms and conditions.

The SIMPLE Button

The average time spent waiting for treatment in an emergency room in a United States is 3.2 hours. So, EAH wants to make life easier by allowing patients to wait in the comfort of their own homes. According to EAH, it’s really that simple.

But, is it really as easy as the SIMPLE button of retail giant, Staples, might suggest? Or, is this an economic operating-room, in-patient, or out-patient-poaching tactic?

Three Key Points

1. Patients don’t always know whether their conditions constitute an emergency.

2. What’s the optimal rate of “inappropriate” ER visits as the surgical analogy of appendicitis comes quickly to mind.

3. How harmful are inappropriate ER visits, as opposed to ER closure due to unfunded EMTALA or other initiatives?

Open-Access Scheduling

The concept of open-access scheduling is not new, and should be embraced more than it is by the medical community. Many feel the public is clamoring for it. But, is it appropriate for emergency room use? Or, is this an artifice just a clocked marketing gimmick.

And, what new term shall we give to “real emergency rooms?” Can the public even marginally discern the term’s meaning,  given the gross abuse of other potentially life saving healthcare mechanisms like 911 calls; as demonstrated by one Reginald Peterson, of Florida, who called the service – twice – because his spicy Italian Subway® sandwich was missing its sauce?

One also wonders how local hospital staff members, and surrounding primary care doctors, internists and related front line practitioners; as well as walk-in and retail-clinics feel about this service; competitive threat or community boon? Is the idea of a non-emergent – emergency – an oxy-moron; muck like the term “jumbo-shrimp”?

Patient Computer Access?

Do the usual homeless, tired, hungry and mentally deranged patients typically seen in inner city ERs have computer access, or “homes to wait in comfort?”

And, wasn’t the managed care revolution, with its no and low-cost copays supposed to put an end to “ER-squatters?”

Assessment

We believe this business strategy will work because of its affluent location, in North-West Atlanta. It will save the ER money and earn income for the hospital. Suburban patients and soccer moms will also love it. But, as young students, we worked in the ER admissions departments of the old Cook County Hospital in Chicago; and Pennsylvania Hospital on Pine Street in Center-City Philadelphia [City of Brotherly Love]. And, we don’t think the scheduling concept would work there; then or now; nor here at Grady Memorial Hospital in Atlanta. Please opine and comment.  

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.

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Seeking Physician Clients?

Direct to Physician [D2P] Advertising

Did you know that our Research & Development suggests the average 47 year old physician earns $187,000 annually, and will amass a corpus of $5.5 million at retirement?

Moreover, more than 50,000 mature physicians control more than $5 million, right now.

If you want a piece of this lucrative market, you must promote your advisory firm, financial products and management services directly to them on the Executive-Post: www.HealthcareFinancials.wordpress.com

  • Receive medical management information for FAs, RRs, RIAs, BDs, MBAs, CLUs, CFAs, JDs, wealth managers, and CFPs™, etc.
  • Get and contribute free tips to help increase doctor referrals.
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  • Submit articles to promote your brand and expertise to EP readers.
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Free Market Dentistry

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“Common Sense” 

By Darrell Pruitt DDS

Perhaps my ideas about the Internet, and the American Dental Association [ADA], which I have mentioned before are still too ahead of their time to be easily accepted by most dentists.  When dentists grow accustomed to thinking in a certain way towards the structure of leadership in our professional organization, tradition causes many of them to assume that the system must be right. This is why my arguments, when first examined, create an outcry in defense of the status quo. It will take time rather than reason to convert some loyalists from tradition to transparency.

Internet Flattens Communications

The revolutionary Internet communication which I hope will occur between leaders of the American Dental Association and member dentists is, in a way, the hope of the entire nation. And, that I am the author of messages, shared either directly or through a friend-of-a-friend, is unnecessary to the public. It is the doctrine itself that is important, not the author.  It is appropriate for me to assure you that I am not in any way connected to any business other than my practice of dentistry, and I have no affiliations with any political party.  My staff and my patients hold me to the influence of reason and principle every day.

The Grip on HHS

Insurers have such an unfair grip on Health and Human Services [HHS] that it is easy for a dentist to confound insurance with government, and to feel that there is little distinction between them.  They are different.  They have different origins.  Insurance was founded as free market business based on peoples’ fears of unexpected catastrophes, while our government was founded for protection of citizens from things like avarice. 

The first is a patron to a fearful public; the latter is a punisher who strategically incites fear. They make a symbiotic team to coordinate intrusion while boasting to consumers that by working together they guarantee the highest quality care from the best dentists at incredibly low prices.

Free-Market Pressures

The natural pressures of free-market are ideal influences for both industry and consumers in any society.  Interference in patient-dentist relationships by government, even where necessary, is a tangible cost that patients have to bear. 

Our patients accept increases in fees caused by our government because they trust that government regulation is in everyone’s interest and not to the advantage of any one industry over another, and is well worth the added expense to dental bills.  Even though mandates are expensive, funded or not, this is the best we can hope for from their judicious use. 

***

retro dental exam room

***

HIPAA 2003

However, mandates founded on political favors, such as the changes that were made to the HIPAA when it was amended in 2003, are intolerable.  Who will now protect healthcare providers and their patients from the avarice of insurers?  When leadership of the American Dental Association defiantly favors the same position as government, our calamity is heightened by the fact that they squander professional credibility by misleading us into accepting NPI numbers which will furnish the means by which our businesses will suffer.

Dental Transparency

The light of day never exposed a more worthy cause than transparency in dentistry.  Our predecessors, those who taught us our ethics and who decades ago provided the best business model available for the American Dental Association, should be respected for what they accomplished in forming the ADA. 

Assessment

Virtually the entire world still respects American dentistry. The struggle with transparency in a profession is not limited to dentistry.  It is also not just local in its reach; nor will it be viewed by future American healthcare providers as merely a contemporary phenomenon which was a concern for a day, or a month, or a year, or an age. Internet communication in dentistry is like a growing apple tree.  Any damage done to the sapling now will become an ever more consequential wound for posterity.  

Note: “Common Sense” is modeled after Thomas Paine’s pamphlet.

Conclusion

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***

CRS Report for Congress

Enforcement of the HIPAA Privacy and Security Rules

By Darrell K. Pruitt; DDS

I recently came across the “CRS (Congressional Research Service) Report for Congress – Enforcement of the HIPAA Privacy and Security Rules,” updated on August 11, 2008.

http://assets.opencrs.com/rpts/RL33989_20080811.pdf

ADA News Online 

If those responsible for American Dental Association publications were paying attention, someone would have posted a link to the report more than a month ago on ADA News Online.  Was an editor asleep on the job or something?  I think members need to know important information like this as soon as news breaks.  The ADA has both the technology and the capability of serving members much more responsibly.

ADA Lobbyists 

The cover sheet to the report says that the report is “Prepared for Members and Committees of Congress.”  Dentists need to know what their representatives are being told by stakeholders and their lobbyists.  By the way, where are the ADA lobbyists?  Quite frankly, it is my opinion that they are not earning their pay unless they work for basement bargain prices – which they don’t.

HIPAA 

The very first sentence of the report reminds us what the HIPAA Rule of 1996 was supposed to be about before it was quietly amended in 2003:  “The Health Insurance Portability and Accountability Act of 1996 (HIPAA), directed HHS to adopt standards to facilitate the electronic exchange of health information for certain financial and administrative transactions.”  (P.L. 104-191, 110 Stat. 1936 (1996), codified in part at 42 U.S.C. §§ 1320d et seq.)

That sounds benign, and the next paragraph even sounds benevolent.  It promises reduced administrative costs for providers (doctors) as well as payers (insurance companies) through simplification of administration.

“Part C of HIPAA requires ‘the development of a health information system through the establishment of standards and requirements for the electronic transmission of certain health information.’ Such standards are required to be consistent with the objective of reducing the administrative costs of providing and paying for health care.”

HHS Simplification 

The report expands on the HHS meaning of “simplification” under the topic:  “The HIPAA Administrative Simplification Enforcement Rule” (CRS-8):  “The Privacy Rule permits any person to file an administrative complaint for violations. An individual may file a compliant with the Secretary if the individual believes that the covered entity is not complying with the administrative simplification provisions.”

Less Administration?

What was that?  Did you notice what happened?  Doctors were promised less administrative costs through simplification, and then suddenly the CRS Report advertises to politicians that simplification is actually meant to help disgruntled constituents.  Modern payback can be delivered using HIPAA inspectors instead of lawyers and nuisance suits.  It not only simplifies scaring the water out of doctors, but it is cheaper (more accessible) for consumers when revenge is taxpayer-funded.  For those providers expecting good news, I’m afraid promises once again took second seat to votes.

So if the simplification actually does not apply to providers, what are doctors left with?  Responsibilities; of course via “Responsibilities of Covered Entities,” (CRS-9):  “Covered entities are required to provide records and compliance reports to the Secretary to determine compliance, and to cooperate with complaint investigations and compliance reviews.”

Secretarial Action

Since there is a good chance that the HIPAA responsibilities will make a few covered entities angry, someone, probably a seasoned OSHA inspector, had the foresight to create a rule to take care of that potential problem as well.  “Secretarial Action,” (CRS 9):  “Finally, the Rule includes a provision that prohibits covered entities from threatening, intimidating, coercing, discriminating against, or taking any other retaliatory action against anyone who complains to HHS or otherwise assists or cooperates in the HIPAA enforcement process.” 

Enter PWC

That means, providers would do well to be kind to HHS-contracted PriceWaterhouseCoopers inspectors as they search through office computers for evidence.  For dentists, if you offer the contract worker a cup of coffee “with a whole lot of sugar,” be sure you are smiling.  For one thing, they will probably be working on commission soon.  And remember, it is a felony to intentionally contaminate someone’s drink, even before HHS starts adding up penalties.

Civil Money Penalties 

Which brings us to “Civil Money Penalties,” (CRS 10):  “Once a penalty has become final, the Secretary is obligated to notify the public, state, and local medical and professional organizations; state agencies administering health care programs; utilization and quality peer review organizations; and state and local licensing agencies and organizations.”

The NPI Number

Remember the voluntary but permanent NPI number, FOIA-disclosable data and the NPPES? This is where the modular HIPAA plan comes together to form a club-like weapon of intimidation.  If HHS determines that a dentist steps out of line, the Secretary is obligated to let everyone know about the HIPAA infraction for the common good – using the Internet.  That will keep the future doctors down on the farm. or anywhere else but med school.  What are we doing to our grandchildren’s access to quality healthcare, friends?

Common Complaints

Here are the most common complaints:  “HIPAA Enforcement Activity,” (CRS 14):

“According to HHS, the compliance issues most frequently investigated were for [1] impermissible use or disclosure of protected health information, [2] lack of adequate safeguards for protected health information, [3] lack of patient access to his or her protected health information, [4] the disclosure of more information than is minimally necessary to satisfy a particular request for information, and [5] failure to have an individual’s authorization for a disclosure that requires one.”

How Much Info is Enough? 

I think we may be reading a mistake in the document concerning item number 4: “the disclosure of more information than is minimally necessary to satisfy a particular request for information.”  Wow!  How is a provider to know how much is just enough information, and not too much?  Have doctors been sending insurance companies telephone books out of frustration? 

Perhaps doctors think that even if all this sounds tedious, time consuming, expensive and otherwise heavy in liability, HHS isn’t interested in solo practitioners.  PWC inspectors are going after the big players simply because patient complaints are more than likely being filed against impersonal hospitals, pharmacies and insurance companies.  Not doctors.

Vague Statements 

Doctors are sometimes wrong: “The covered entities most commonly required to take corrective action by HHS, in order of frequency, include private practices, general hospitals, outpatient facilities, health plans, and pharmacies.”  Even though the statement is 180 degrees vague, I think the author means to say that private practices are hit most frequently.

Assessment 

Now, as a bookend to this opinion piece, let me repeat the 1996 purpose of HIPAA:  The Health Insurance Portability and Accountability Act of 1996 directed HHS to adopt standards to facilitate the electronic exchange of health information for certain financial and administrative transactions.” 

Conclusion

It sounds hollow now; but your thoughts and comments are appreciated from all covered-entities, not just the dentists.

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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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Such a “Sleazy” Company

About Delta Dental

[By Darrell K. Pruitt; DDS]

pruitt

“A contract provision that holds dentists to Delta’s maximum allowed fee for non-covered services will affect all of Delta’s Premier and Preferred Provider Organization participating dentists throughout the country by January 2011″ (my emphasis).

“Delta Caps Rates Nationally for Two Networks”

I copied the line from an American Dental Association News online article by Arlene Furlong’s article is titled “Delta caps rates nationally for two networks.”

http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=3218

This means that if a Delta preferred provider wishes to make up for the profit lost from providing Delta customers 25% discounts on dentistry, doing more cosmetic dentistry will no longer help keep the doors open.  Delta is telling its providers that it will demand discounts on everything for its customers. 

Discount Factor Costs

How much does a 25% discount cut into a dentist’s pay?  Overhead in dental practices typically run about 65%.  Do the math.  If the net profit is 35%, and Delta knocks off 25% the dentist’s fee; that means the dentist takes a 70% cut in pay to treat Delta patients.  How happy do you think dentists are to see Delta patients who show up for appointments? You guessed it.  Delta Dental preferred providers are disagreeable already, according to Doctor Oogle (www.doctoroogle.com), a Patient Driven Referral Site [PDRS]. 

The Delta Dental Rankings

To see how Delta Dental preferred providers rank in patient satisfaction against all other dentists, pick a few names off of Delta’s list and see where they fall on DR. Oogle’s ranking.  I recently saw such a study involving Austin, Texas dentists from almost a year ago.  The Delta dentists’ ranks averaged 206 out of 297 Austin dentists listed on the site.  That is the bottom 30%.  One could say the 70% cut in pay buys Delta Dental clients dental work from the most unpopular 30% of dentists; interesting coincidence.

Cogent Thoughts 

Think about this way: In a little more than two years, if a dentist’s practice consists entirely of Delta Dental patients, the doctor cannot raise fees at all.  What makes leaders of Delta think they can get away with tyranny in the land of the free? 

Furlong further writes: “Tom Dolatowski, Delta’s vice president of marketing and communication, estimates that some 75 percent of dentists nationally are participating in the Delta Dental Premier plan, while some 25-30 percent are participating in the Delta Dental PPO plan.”

That’s how; effective sales techniques

Delta Dental is Simply a Sleazy Company. 

This spring, at the Southwest Dental Conference in Dallas, Delta Dental employees encouraged me and other dentists to apply for NPI numbers.  NPI application forms were prominently displayed in Delta’s booth.  The Delta saleswoman who covers the east side of Fort Worth, my neighborhood, said, “You don’t want to wait until the last minute.  May 23rd is the [final] deadline.”  (The deadline had been delayed a few times).

Then she and other Delta employees emphatically agreed that the NPI number will soon become a licensure requirement for all Texas dentists anyway.  That is an unethical and unlawful lie – condoned, if not encouraged by the leaders of Delta Dental to enhance corporate profits using deception.  Everyone knows that the NPI number helps nobody but insurance companies.

Assessment 

There is no question that Delta Dental desperately wants dentists to volunteer for NPI numbers.  When a dentist applies for the number it gives Delta permission to mine the uninformed dentist’s “Freedom of Information Act-disclosable” data from dental claims.  Delta will use its proprietary algorithms to rate the dentist. Then Delta will display the dentist’s value to society on an Internet website. This way Delta can direct its clients to the best neighborhood dentists according to Delta’s preferences – but not necessarily the patients’. 

The fact that Delta’s customers generally don’t like Delta’s dentists means that the last thing Delta wants published is patients’ opinions – like those in DR. Ogle.

Conclusion 

In my opinion, Delta Dental is such a sleazy company. What is your opinion?

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.

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Healthcare Industry Prognostications

The PWC Report

By Staff Writers

A recent study by PriceWaterhouseCoopers [PWC] suggests that 2008-09 could be a big period for the healthcare sector with structural changes that could alter the industry. These include alterations to hospital Medicare reimbursement, further IRS pressure on non-profit hospitals, the growth of the retail clinic market and the continued emergence of consumer-directed healthcare, according to the PWC Health Research Institute [HRI].

Predictions

For example, with CMS changing the way it pays hospitals – adding 200 diagnosis codes for severity while refusing to pay for some medical errors and “never-events”, some hospitals will see less income, while others more. The firm also predicts that the retail clinic sector will continue to expand, that the FDA will boost drug and medical device safety standards, and that the IRS will bear down hard on non-profit hospitals to prove that they’re providing adequate community benefits.

Assessment

Health economic Sustainable Growth Rate [SGR] prognostications also suggest that the present path of Medicare reimbursement can not be sustained; with harsh cutbacks like 20% physician payment reductions, threatened.

Conclusion

Since these predictions will be spurred, in part, by the shift in political power triggered by November’s presidential election; your thoughts are appreciated?

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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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How to Hire a Medical Accountant

Seek Healthcare Specificity

Staff Reporters

Use these 25 questions to educate yourself about accountants. And, use this 25-point checklist on how to pick a good healthcare focused CPA. It can be a powerful list for any medical professional and might help you bring in extra money, immediately.

Other Areas

In the areas of estate planning and financial planning, it is essential that doctors have a good team of financial professionals. This usually involves, at the very least, a CPA, an attorney, and a fiduciary focused financial advisor [maybe].

CPAs

If you are a CPA for docs, use this list as a reference for your doctor-clients. By bringing up the concept of due diligence on your own, it strengthens your position and makes a perfect opportunity to ask for referrals. You may also want to use this list as a newsletter insert or advertisement of some sort. Put a brief notice at the top of the list stating that doctors should ask their CPAs these questions, and if they need someone who fulfills these requirements, you would be glad to meet with them to discuss the questions.

Financial Advisors

As an FA, use this list as a networking tool. Refer your clients to a competent CPA who you already do business with or would like to do business with. When you refer clients to a good CPA, you open the opportunity for him or her to return the favor. Send this list to your existing clients at tax time as a neutral third party to help them find a good CPA (they already have a good financial advisor—you).

Attorneys

As an attorney, use this list the same way a financial advisor or account would—to network with the top CPAs and MDs in town. You can make it a standard piece in your mailings or newsletters once a year. When you start giving leads to other financial professionals, it will open up referrals that will be beneficial to your business.

Certified Medical Planner®

And, if you are a CPA, FA or attorney, be sure to promote your hard-won credentials for healthcare specificity; like the Certified Medical Planner® designation, for example.

 25 Questions to Ask Your Future Accountant

  1. What designations or credentials do you have?
  2. Are you in practice full-time?
  3. How many years of experience do you have in tax practice?
  4. Do you do all your returns by computer?
  5. What are your fees, and do you have a schedule that I can see?
  6. Can you provide references from other businesses similar to my own?
  7. Do you use any checklists to maximize my deductions?
  8. How soon do you return calls from clients?
  9. Do you teach any tax courses or have you written for any tax publications?
  10. Are you conservative, aggressive, or somewhere in the middle?
  11. What review process do you use in order to ensure a quality product?
  12. Do you specialize in taxes?
  13. What percentage of your practice relates to taxes?
  14. What other accounting services do you personally perform?
  15. May I look at your tax library?
  16. What do you do after tax season?
  17. How often do you take tax courses?
  18. What is your attitude toward audits?
  19. How do you treat gray areas?
  20. Have you ever been disciplined by the IRS, the SEC, or any accounting society?
  21. How many other clients like myself do you have?
  22. Do you offer pre-year-end tax planning as part of your tax service? If so, is there      an extra fee for this?
  23. Are you generally familiar with current health law and managed care policy?
  24. Do you offer any tax planning during the year?
  25. Can you give me a recent tax planning tip or tax change that may benefit me?

Finally, and most importantly of all; how do all of the above synergize into medical and healthcare specificity, for me?

Assessment

As you likely now realize, this list is not for CPAs only; but as a due diligence reminder for most fiduciary financial advisors professionals or attorneys who wish to work with doctor clients; “often the most difficult clients in the business.”

Disclosure

Dr. David E. Marcinko MBA, our Publisher-in-Chief and former CFP®, is founder of the online CMP® program in healthcare economics, management and finance for advisors www.CertifiedMedicalPlanner.com

Conclusion

Your thoughts, opinions and comments are appreciated.

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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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The “Balance-Billing” Conundrum

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Doctors versus Patients

Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]dr-david-marcinko1

Recently, it was reported to the public that millions of patients are paying medical bills they don’t actually owe after being confused about the practices of “balanced billing.” .

Formal Definition

According to the Dictionary of Health Insurance and Managed Care – and others – balance billing [BB] may be defined as:

“The practice of a physician, medical clinic, hospital, ASC or medical provider billing a patient for all charges not paid for by an insurance company or healthcare plan. Balance billing is generally prohibited by managed care plans”.

The story in Business Week, on page 40 by Chad Terhune in the September 8, 2008 issue, goes on to discuss how it’s illegal for doctors, hospitals or labs to bill patients for the difference if they deem the insurance payment too low, but that it happens routinely to the tune of $1 billion each year.

And, healthcare journalist Sarah Arnquist similarly noted the practice with more patient BB horror stories in The Health Care Blog [THCB], a policy and political e-periodical not unlike this Executive Post in format; but not content.

Not a New Problem

However, long before the threatening horror-stories first ran about doctors aggressively pursing collections, maybe even as much as a two decades ago, our network of physicians, attorneys, insurance and risk management experts have been writing about this situation in both peer-reviewed and non-peer-reviewed print and traditional publications.

So, the conundrum is not really a new one. In fact, Medicare first prohibited BB, in 1991. But, its ferocity; pitting patient against doctor, might indeed be an emerging issue. And, it is deeply distasteful on many levels. 

Managed Care Contracts

Over the years, managed care has replaced usual, customary and reasonable [UCR] fee-for-service [FFS] medicine with a contracted fee-schedule.  Essentially under managed care, an MD can “charge” just about anything s/he might want, but the managed care organization (MSO) will only reimburse up to its maximum contractual allowance as determined by a previously set fee schedule; known as a managed care legal-contract.

In other words, medical providers have pre-accepted a fee schedule and have agreed and been contracted to accept “payment-in-full” for services rendered. And, the greater the difference between the MD charge and the allowable reimbursement, the more the MD will eventually write off as artificially inflated accounts receivables [ARs].

Therefore, there is no “balance-bill” to pay [sans fine print specials, out-of-network provider and venue clauses, etc].

insurance-book8

Physician Mindset

Yet, the balance billing mindset continuers by some, especially older, doctors and patients! Why mature docs and patients? It’s because the current and next-generation of doctors, and patients, never practiced or worked in a FS environment, and know little of it?

Now, this might occur benignly; but more often than not today – and in my experience as a multiple-hat wearing medical provider, insurance agent, physician-executive and health economist – it occurs maliciously and greedily; pitting the doctor against patient.

Of course, a common physician defense ploy is the cry: “I didn’t know it was wrong” – or – “my staff was doing the balance-billing; not me.”

Staff Education and Training

So, the doctor’s medical staff is an extension of the physician. And, the physician can become vicariously liable for staff transgressions.

Furthermore, several federal regulations, including HIPAA, the False Claims Act, and OSHA have specific staff training requirements. Failure to provide the required training not only subjects the physician to the risk of employee transgression, but also to the risk of administrative discipline for failure to conduct proper training of staff.

Patient Mindset 

Now, since most patients receive health insurance their employers, it seems odd that some remain so naive about this conundrum; ethics aside. I mean, managed care has been around for almost 20 years now, and its risks and benefits are well known. Contract-medicine did not begin yesterday.

And so, where have such gullible patients been living? In a hole void of newspapers, magazines, TVs and the internet? What about their neighbors, gossip, HR advisors or benefits departments at work? I know of Corporate America, and have participated in several educational programs where employees are informed of their duties and responsibilities in this managed care contracted world. 

And so, at the risk of sounding harsh, I often wonder where have these souls been?

In other worlds; naiveté has a price and if you don’t look out for yourself; who will ultimately look out for you? No one! So, get a clue, already! It’s 2008; not 1988.

The Offensive Plan

As a patient, if this occurs to you, as it did to me when I once visited an out of state optometrist who tried to BB me while on vacation, you might consider the following pre-emptive strike. Forewarned is forearmed and it is far better to play offense, than defense, with these aggressive and greedy docs:

  • Read and understand your managed care plan contract. Know your duties and responsibilities. Follow the rules.
  • Privately inform your medial provider that you are aware of the “contract-medicine” concept.
  • Confidently tell the provider to put the BB invoice in writing, under his personal signature.
  • Whisper to him/her you will fax it to your employer, third-party payer, attorney, IRS, OIG, DOJ and/or insurance commissioner for a collegial second-opinion check.

Finally, once the problem has been resolved, politely inform the provider that true BB is illegal; and suggest that if your health plan’s compensation is too low, he/she should not re-enlist on the plan.

dhimc-book1

Outcome

This was all I had to do, as the flustered provider apologized to me, citing personal and staff ignorance. Of course, I then told him of my credentials and my doubt about his “excuse”; but was willing to give him “benefit-of-doubt” this time. No harm-no foul, I reckoned.

Assessment

By personality – maternal side – I tend to employ the passive-aggressive posture of conflict resolution. So, always be knowledgeable but respectful, polite and most of all ‘umble; just like David Copperfield’s fictional character, Uriah Heep.

And, although there will always  be miscreant doctors who try to game-the-system, according to David McKalip MD, Chair, Council on Medical Economics [CME] for the Florida Medical Association [FMA], “A free market with price transparency, quality accountability and private contacting between patient and doctor, is the answer” to the unfortunate balance-billing conundrum.

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.

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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Seeking Writers and Contributors

Business of Medical Practice [third edition]

Ann Miller; RN, MHA

Project Manager

As readers of the Executive-Post may know, our textbook the Business of Medical Practice is a best seller.

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Accordingly, we wish to personally invite all subscribers to contribute to our third edition now in progress. New and prior chapters are still available for updating; for a low-effort but high-yield contribution. We have others ideas for this peer-reviewed publication, as well. 

Our goal is to help physician colleagues and medical executives benefit from nationally known experts as an essential platform for their success in the healthcare industry.  And so, please advise and thanks again for your consideration and possible contributions. Feel free to email me 24/7 for more information MarcinkoAdvisors@msn.com

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Quality Improvement Initiatives

We Want to Hear from You!

Dr. David Edward Marcinko; MBA CMP™

Publisher-in-Chief

Hope Rachel Hetico; RN, MHA, CMP™

Managing Editor

Our Questions

As new-wave publishers, we value the personal opinions of our complimentary Executive-Post readers.

And, as traditional contributing editors, we also value opinions on our 2 volume, 1,200 pages, premium-print periodical, Healthcare Financials [Journal of Financial Management Strategies] www.HealthcareFinancials.com for institutional subscribers; $535/year.

And so we ask, regardless of venue, do you agree or disagree with what you read in these publications? And, what would you like to read or learn more about?   

Your Answers

Have your voice be heard by sending a letter, opinion or comments on topical suggestions to Executive-Director, Ann Miller RN MHA at: MarcinkoAdvisors@msn.com

Assessment

“Our goal is to augment iterative innovation, and see the health economics sector through your eyes. Otherwise, unlike gravity, our goal of a vibrant interactive professional-sticky-network just won’t happen.”

Conclusion

Remember; “What doesn’t get measured – does not get improved. Help us to improve!

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Paging Doctor Oogle

Patient Driven Referral Sites [PDRSs]

By Dr. Darrell K. Pruitt; DDS

By Staff Writers

It is clear to some practitioners that Internet-based consumerism is the future of medicine; as well as dentistry. 

Regardless of the increasing number of complaints about managed care’s malevolent business model, managed care medical and dental plans are already wilting under the heat of transparency as well as the stifling economy. Market share continues to fall because of Adam Smith-like competition. 

These days, consumers are talking like a small town. Dentistry is no exception in the healthcare space. 

Enter Doctor Oogle

Doctor Oogle is a web 2.0 platform, built on a social architecture of national participation where patients post comments and opine about participating providers; nice or nasty. According to the site, it also offers a public database of dentists with patient feedback about dental practitioners. One can also read reviews, ratings, and recommendations; select a practitioner or schedule an appointment.

Ad-Driven Contrast of PDRSs

In contrast to WebMD, Servicegrades.com or other Patient-Driven Referral Sites (PDRS), which sell dentists ad space, DR. Oogle is completely uninfluenced by paid advertisements because there are none.  Participating dentists pay a flat monthly fee.

Defining Dental Quality 

If we can agree that in dentistry [perhaps more than medicine] patient satisfaction is an important measurement of quality care, DR. Oogle is a natural measuring tool just begging to be used by patients holding preferred provider lists.  In addition, DR. Oogle has the largest database of patient ratings of any other PDRS.

Dollar-Based Dental Benefits 

As businesses pull-back from expensive dental and medical insurance, some providers encourage owners to replace it with a fair and simple dollar-based benefit system; like Direct Reimbursement [DR] instead of intentionally confusing procedure-based benefits. This is akin to a concierge medical practice.

And, dentistry may be more susceptible to consumer influences, than whole-body medicine for a variety of reasons; for example:

  • costs of dental treatment are a small fraction of hospitalization,
  • emergencies are not generally life threatening, even if painful, and,
  • patients readily recognize bad dentistry [sometimes even as it is being performed].

Welcomed Transparency

Some dentists – and doctors – opine that managed care dentistry [medicine] is simply dentistry [medicine] provided by the lowest bidder – with little to no quality control – an unethical/specious business foundation that ultimately leads to the abandonment of patients’ interests.  Of course, this is not a new hue and cry against managed care precepts. 

DIY Studies

And so, in a recently received, and anonymous, do-it-yourself DR. Oogle study; one researcher was shocked at how much the listed dentists were disliked by their customers [patients]. Of course, there are statistical wrinkles: 

  • Maybe these lower rated dentists are not as bad as the reviews describe.
  • Is it possible that a few vocal people who expect discounts are impossible to satisfy?
  • How fair is that to a young dentist – just trying to scrape by anyway possible?
  • What dentist can maintain professionalism indefinitely in the financially thank-less environment of managed care? 
  • What about the future? 

Even if a preferred provider goes bankrupt trying to maintain professional standards, he or she remains sadly unappreciated.  Discount dentistry [medicine] comes at a tremendous price.

Assessment:

Collaborative healthcare 2.0 is the philosophy where patients, providers, and payers interact collaboratively and competitively in order to enhance quality medical services at value-driven prices in the most appropriate venue and time.

Dr. Oogle is an imperfect tool that in many respects seeks to further this goal.

Nevertheless, although metering tools will undoubtedly improve going forward, caring and competent dental professionals need not fear them. All others beware of patient empowerment and transparency.  

Conclusion:

You thoughts and opinions are appreciated. Please comment on Dr. Oogle and/or related doctor evaluation methods. [PDRSs].  Or, discourse on the increasingly transparent healthcare ecosystem in general.

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Certificate of Need Legislation

Proposing New CON Barriers-to-Entry

By Staff Reporters

Certificate of Need [CON] laws, regulations, and licensure stipulations are known as Barriers to Entry [B2E] hurdles; and have been removed by many states after decades of utilization. For example Montana, Georgia and others have recently removed them, or currently are critically re-examining their CON laws.

The Mundy Proposal

Pennsylvania State Rep. Phyllis Mundy (D-Luzerne) testified at a recent House Insurance Committee [HIC] hearing on her legislation to re-establish a state Certificate of Need (CON) program for medical equipment as a way to rein in skyrocketing health care costs. Citing the three diagnostic imaging centers near her Kingston home as an example of market saturation, Mundy urged colleagues to require health facilities to justify the need for expensive medical equipment. The Mundy bill also would ban physicians from self-referring patients for procedures at outpatient facilities they have financial interests in, which she said invariably leads to more procedures being done at the facilities.

Purposes and Reasons  

According to the September 4thTimes-Tribune, Mundy believes that the proliferation of specialized clinics, imaging centers and surgical centers in communities is one reason health care costs are escalating. Her legislation would re-establish a state regulatory program that was in effect from the 1970s until 1996, requiring a health care facility to apply to the PA State Health Department for a certificate to start or expand services with costly technology.

Assessment

Allied health professionals are increasingly being accepted and recognized by payers and patients as a legitimate alternative to traditional providers and services [more providers equate to more facilities].

And so, can one really wonder about any new legislation to re-establish CON laws that were first in-acted and then disregarded, more than two decade ago. Moreover, is more legislation and health law policy needed, above and beyond Stark I, II and III?

Conclusion

Your thoughts on this dichotomy are appreciated; is it real or perceived; local, regional or national?  And, is the aphorism ”doctors would sell Christmas tress if Medicare reimbursed them” true, or even fair.  Please opine and comment.

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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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HO-JFMS-CD-ROM

www.HealthcareFinancials.com

 

Growing Your Practice with E-P

Free Marketing Tips in the Executive-Post

Staff Writers

Receive free tips to help you increase your referrals, boost your practice revenue, and attract the patients, and physician clients, you want – plus submit your toughest marketing, health economic and finance questions to us and receive answers from the Executive-Posts’ experts.

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We will deliver free tips that will help you:

  • Boost your patient and doctor referrals
  • Train your staff to convert more patients and clients
  • Fight back against aggressive medical and financial- services competitors
  • Bring in more cash-paying patients and physician clients
  • Get patients, and doctors, to say “yes” to your care plan or professional recommendations;
  • and more.

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Health Care Complaints versus Compliance

Medical Quality Confusion Reigns

By Dr. David Edward Marcinko; MBA, CMP™

Doctors, medical staff, healthcare administrators and patients can often get confused regarding what issues need reporting through their compliance mechanisms [terminology and definitions].

www.HealthDictionarySeries.com

For example, some staff members may think that every “complaint” should get reported through the system. Since the focus of this program is geared more to concerns of fraud and abuse, the staff needs to be educated about what should be reported and what should not.

Smaller Practices

In small healthcare organizations, education on “compliance-related” issues could be part of regular staff meetings or individual meetings with the compliance coordinator. Staff knowledge of the organization’s expectations can be reinforced on a consistent basis. This will avoid issues that larger organizations have been having, where the compliance hotlines have been used for customer complaints and labor issues.

Assessment

If a healthcare entity notices that inappropriate issues or complaints are being brought up through the compliance program, leadership should respond by evaluating the reasons why this is occurring and look at putting in actions to correct the confusion.

Conclusion

We hope you will opine on our concepts of health administrative definitional-stability concerning complaints versus compliance; please comment.

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How Doctors Get Paid

It’s all about Flow [Part 1]

By Dr. David Edward Marcinko; MBA, CMP™dr-david-marcinko

[Publisher-in-Chief]

Most patients don’t have a clue about how doctors get paid; it’s not by magic.

Yet, a number of different steps occur during the processing of a medical claim as can be seen in the flow chart below. Each step within the process can be mapped out and each is subject to claim payment-or-claim abortion or rejection.

The steps can also be subjected to a number of variables, depending on a number of different factors including staff competency, time, outside vendors, information management, management decisions in general, or regulatory requirements.

Flow Chart

Of course, any one of these points could lapse, causing the entire process to break down. Like treating patients, when the process has no variables, the end result is very predictable, such as in the flow chart below. When there are variations the end results can be very different.

Treatment is Only the Beginning

Doctor gets the chart

Doctor evaluates patient

Doctor documents visit

Doctor marks billing slip

Doctor gives slip to patient

Patient gives slip to billing clerk

Billing clerk enters information into computer

Office staff submits claim to insurer

Third party payor/Insurance company receives claim

Insurer adjudicates claim

Reimbursement transmitted (electronic or mail) to practice

Reimbursement entered (posted) into practice management system by office staff. 

There are two things that you need understand in order to implement an efficient compliance program.

1] The first is the processes needed to run the organization and the desired outcome of those processes.

2] And second, if the process needs improvement, what can be done to make the process function better?

Office Efficiency Checks

Most small medical and dental practices or clinics have a number of checks and balances in place to control variation.

In an example of an inefficient operation, one practice had the physician-executive open every envelope that came into the office. This was done because of a concern that if someone else did it, then something could go missing.

However, the doctor would then turn the mail over to the payment posting person, who would enter claims into the system. Sometimes the person who entered the claims would become busy with other duties and would not be able to enter claims for a couple of days. This proved to be an inefficient method of managing the billing process for the organization.

Assessment

A possible solution is to have one person in the front office to open the mail, organize the contents based on who needs to deal with the information (such as claims, refusals, or requests), and then distribute them accordingly.

More on how physcians get paid.

Part 2: https://healthcarefinancials.files.wordpress.com/2010/02/how-doctors-get-paid-in-2010.pdf

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.

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***

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Invite Dr. Marcinko

Emerging Healthcare 2.0 Initiatives

Join Our Mailing List

Questions to Consider

Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Hope Rachel Hetico; RN, MHA, CMP™

[Managing-Editor]dave-and-hope4

Although not always prone to professional introspection, we nevertheless had the recent occasion to ponder the future of the emerging initiative [healthcare business model or philosophy] known as healthcare 2.0.

But, of course, before any discussion begins we must operatively define our terms.

Definitions

Ever since the term “web 2.0” was used in 2004, there has been an inordinate amount of chatter about what web 2.0 really is and its true impact. No one’s really defined it clearly, but we think the web evolution essentially falls into 3 generations:

Web 1.0 – information is communicated from a company [medical practice or hospital] to its customers [individuals or patients]. This is your basic B2C or [business-to consumer] website. The web becomes one big encyclopedia of information by aggregating all these information repositories.

Web 2.0 – information is communicated between company and individuals AND collaboratively between and among individuals. And so, if web 1.0 was a book, web 2.0 is a live discussion.

Healthcare 2.0 – Scott Shreeve MD of Cross Over Health defines healthcare 2.O as:

 “A New concept of healthcare wherein all the constituents (patients, physicians, providers, and payers) focus on healthcare value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.”

Questions to Consider:

And so, we offer these questions to consider about Healthcare 2.0:

  • How are Web 2.0 technologies like social networks, wikis, podcasts, blogs and micro-blogs, mash-ups and online communities like this Executive-Post changing the face of the healthcare industry?
  • How are hospital systems, ASCs, medical clinics and physician practices evolving as a result of rapid technological change? 
  • How can health plans evolve in the face of emerging challenges with the help of new technologies and new thinking?
  • What will come of the recent controversies over genetic testing, the human genome project and 23andMe for example, and the privacy of patient data?
  • How does transparent financial and reimbursement data impact the competitive scene?
  • How does transparent physician and hospital quality information affect the competitive scene?
  • Where does the hype over social networks and user-generated content end and the reality begin?
  • Does the initiative enhance or detract from traditional medical care delivery models?
  • Does the initiative enhance or detract from new-wave concierge or retail medical modes?
  • Is this positive or negative for patients, providers, payers and venues?

Healthcare 3.0

Soon it will not be information anymore; it will be intelligence – artificial or virtual intelligence. You’d interact with it almost like another person. The web won’t just blindly do what we tell it do to, it’ll think for you.

Web 3.0 presents some amazing opportunities in healthcare. For example, imagine being able to be diagnosed by your computer or have your toilet run a SMAC 10 or SMAC 20 on you? Imagine going to Costco®, scanning a barcode with your web-enabled phone, and being instantly notified that your purchase is HSA-eligible.

One day, you’ll type into some (probably Google-like Chrome) search engine or MSFT interface:

“I want to find a podiatric surgeon who’s done at least 100 ankle fusions, who operates on Saturdays near my house, who takes my insurance at XYZ surgery center, who has never been sued, and enjoys playing the flute.”

Voi-la! – Your results would be back with an offer to set up an appointment.

Assessment

Anyway, we digress and don’t have to worry about healthcare 3.0 just yet. Let’s get back to 2008 and see where healthcare is with 2.0.

The primary question really is: where on the web do you go to interact with others about healthcare-related topics? And,is the digital workforce leading, or lagging, in the adoption of social and AI computing for healthcare?

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.

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:

 

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Determining Medical Fees

Reflecting Worth and Reality

By Dr. David Edward Marcinko; MBA, CMP™dem2

Despite changes in insurance models, a healthcare provider’s fees should reflect what the doctor feels his or her services or procedures are worth. The type of insurance that the patient has should not play an influencing factor in either the fee determination or services rendered. 

Additionally, fees should not vary based on the patient’s insurance type, or what the patient’s managed care contract determines is the maximum payable allowance.

Deterring Factors

Determining a professional fee for a given service takes into account many factors including the professional work performed, non-clinical work performed, unusual skills required, time for service, practice expenses (e.g., staff salaries and benefits, disposable items, rent, utilities, etc.), risk, as well as direct (surgical global care) and indirect (communicating with other health professionals, laboratory finding evaluation, review of x-rays, etc.) follow-up care.     

Provider Determined

In establishing professional fees, the operative phrase is “provider determined.” While the input from knowledgeable experienced staff is certainly desirous, the ultimate responsibility for determining fees rests on the shoulders of the healthcare professional providing the service.  Of course, the medical treatment administered, and for which reimbursement is sought, is assumed to be performed on the basis of medical necessity and effectiveness.

The Import

So why are reasonable fees and reimbursement for services important?

Well, medicine is a business whether physicians like to admit it or not.  Businesses that are not profitable do not remain businesses for long. Today, most healthcare professionals will admit they are working harder, more hours, seeing more patients to maintain practice revenues.  Even so, in many cases, expense increases are outpacing revenue increases.  In an age of managed care, even Marcus Welby, MD would have to work harder. 

Getting Started

Actually reviewing the annual Medicare rules and regulations found in the year ending Federal Register is a good place to start.  That issue printed between November 1 and December 15 of each year lists all the CPT® codes and their Centers for Medicare and Medicaid Services (CMS) (formally Health Care Financing Administration-HCFA) determined relative value units (RVUs).  The RVUs are procedure comparable. 

Case Example:

You can assume if, for example, a free muscle flap procedure using microvascular techniques is valued at 68.65 total RVUs, it would be relatively more complicated procedure than a simple repair of a small laceration at a total 4.34 RVUs.  You would price your procedure fees accordingly. 

Generally, if a managed care allowance exceeds what you have billed; your fee is unreasonably low.  The true test of reasonableness is your comfort (emotional as well as economic) level in charging the cash patient the same fee.  If you feel it is in the “reasonable” range, and you are not consistently writing off 98% of your charges, it probably is reasonable.  Under a managed care fee schedule, the service billed amount generally only has significance when the fee charged is less than the contract allowance. 

Assessment

In that case, the MCO allowance is reduced to the lesser amount billed.  The physician’s fees should not be lower than the highest contractual reimbursement rate.

Conclusion

Your informed opinions and comments are appreciated. How do you determine professional medical provider fees?

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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

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Medicare Benefits Report

2007 Payment Services Review

Staff Reporters

In 2007, benefit payments for the four parts of Medicare totaled $426 billion and allocated as follows:

Part A: Hospital Insurance = 41% (includes home health which is partially funded under Part B)

  • Hospital Inpatient = 30%
  • Skilled Nursing Facilities = 5%
  • Home Health = 4%
  • Hospice = 2%

Part B: Supplemental Medicare Insurance = 28%

  • Physicians and other suppliers = 20%
  • Hospital Outpatient = 4%
  • Other Part B benefits = 4%

Part C: Medicare Advantage (private health plans) = 18%

Part D: Prescription Drug Benefit = 12%

  • Payments to Drug Plans = 7%
  • Low-Income Subsidy Payments = 4%
  • Payments to Union/Employer-Sponsored Plans = 1%

Note: Does not include administrative expenses such as spending for implementation of the Medicare drug benefit and the Medicare Advantage program. Total is net of $8.1 billion in recoveries for 2007.

Data Source: Congressional Budget Office, Medicare Baseline, March 2008.

Publication: Medicare Spending and Financing Fact Sheet; September 2008. The Kaiser Family Foundation.

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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

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Medical Coding Definitions

Understanding CPT® Methods

By Patricia Trites; PhD

www.HealthcareFinancials.com

The American Medical Association Physicians’ Current Procedural Terminology manual (commonly known as the CPT® manual) is the recognized coding manual used by healthcare providers to bill third party payers.

CPT Codes

No quantitative values are assigned the CPT® codes contained within the CPT® manual.  Each third party payers determines a value, whether a direct dollar or unit value, for each CPT® code.  Each CPT® code represents a service, procedure, test, or study. 

The CPT® manual attempts to define each of the codes specifically by individual descriptive phrases, and generally utilizing guidelines, rules, and definitions related to code groupings: medical, surgical, pathological, and diagnostic services.  Third party payers develop for internal use additional protocols, guidelines, rules and definitions.

Assigned Values

The value assigned to each CPT® code is based on a determined amount of work, practice expense and risk inherently bundled into the service or procedure.  Each procedure or service is further defined as a body of work made up of multiple lesser components all valued within the main CPT® code. 

Case Example:

As an example, if the surgical lengthening of a leg tendon is the main procedure to performed, it would be assigned a unique CPT® code. Within the tendon lengthening code definition and assigned value would be included (bundled or “packaged”) seemingly obvious lesser procedures available to the surgeon in achieving the ultimate goal of the tendon lengthening. These lesser procedures include the incision itself, retraction of vital structures, tying off small vessels, suturing the tendon in a lengthened position, closing the soft tissue in layers, suturing the skin, application of a dressing, and application of a posterior splint. 

Modifications

While some surgeons in a particular case may not need to tie off small vessels because no vessels interfered with the surgical exposure, or maybe they had to tie off two more vessels than they usually have to do, or they may elect not to apply a posterior splint, or the procedure takes twenty minutes more because a required instrument falls on the floor and needs to be re-sterilized, the overall code value of the tendon lengthening procedure does not change. 

Essentially with the exception of minor modifications, one way or another, the main procedure remains essentially the same. Those minor modifications or variations in technique would be included in what would be called the global surgical description and allowance. Not all potential secondary or minor procedures need to be performed to fully reimburse the primary procedure.

Billing Fragmentation

The fragmentation, breakdown or unbundling of the main or primary procedure through the billing of each secondary procedure is billing abuse at best, intentional double billing at worse. Bundling is also addressed in the Correct Coding Initiative [CCI] issued by the Centers for Medicare and Medicaid Services [CMS]. This is a quarterly publication that lists the procedures and/or services that cannot be billed on the same day for the same patient.

Assessment

Healthcare providers intentionally billing unbundled services may be committing fraud or abuse.

Conclusion

Your thoughts and comments are appreciated.

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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

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Seeking CMO in Iowa

St. Luke’s Hospital

By Sue LeGrand

St. Luke’s Hospital, a prominent and award-winning 560-bed hospital in Cedar Rapids, Iowa is seeking a Chief Medical Officer due to the retirement of their current CMO. St. Luke’s Hospital is part of the Iowa Health System, one of the top 25 integrated delivery systems in the United States.

St. Luke’s was named a Top 100 Heart Hospital and Press Ganey named St. Luke’s a 2007 Success Story for outstanding patient satisfaction results.  Also in 2007, St. Luke’s received the Iowa Recognition for Performance Excellence silver award. This is Iowa’s premier award recognizing high performance management principles.

This CMO opportunity is rich with challenging and attainable priorities.  As part of the President’s Council, the CMO be the liaison with the 400-physician medical staff comprised of employed physicians, private practice physicians, members of the Iowa Health Medical Group and contracted physician groups.

Qualifications include board certification, experience as a physician leader in a hospital environment, quality management, medical staff relations, and an excellent clinical background.

If you are interested in learning more, please reply to this message and attach a copy of your current CV / resume, or contact me below:

Sue LeGrand
800/678-7858 ext. 63458
314/863-3631 Fax
slegrand@cejkasearch.com

CEJKA SEARCH
4 CityPlace, Ste 300
Saint Louis, Missouri 63141
http://www.cejkasearch.com

Advantages of IMAs

A Doctor’s Case against Mutual Funds

By Dr. David Edward Marcinko; MBA CMP

Publisher-in-Chief

The case against Mutual Funds [MFs], and in favor of Individually Managed Accountants [IMAs]:

  • No unrealized capital gains
  • The ability of the physician-investor to dictate or organize a portfolio around current stocks
  • The manager is not obliged to buy additional securities, no matter how much money pours in
  • The physician’s portfolio is not subject to a pooled mentality
  • A physician-investor can own a specified number of securities without over diversifying
  • Lower fees and Lower commissions as portfolio grows
  • Ongoing customization in step with world trends
  • Hands-on or hands-off philosophy, as the investor prefers
  • Custom diversification blend-in strategies for low-basis stocks
  • Individual doctor recognition as to tax consequences.

Assessment

How true, false or parsed are the above perspectives?

Conclusion

Your comments are appreciated?

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

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Dentists, HIPAA, IT and Reform

Healthcare Reform and Presidential Candidates 

[Surprising Obama and McCain]

By Darrell K. Pruitt; DDS

pruitt

Some readers of the Medical Executive-Post may wonder why a dentist’s opinions on healthcare reform should be given space on a website that is about the personal business, management, finance and economics of healthcare. 

Like Lab Animals

Even though dentistry is only around 5% of the healthcare market; when it comes to government/insurance regulation using the one-size-fits-all micromanagement model of MBAs and politicians – dentists are your lab animals. So, hear me squeal! 

HIPAA Hurts

Our nation’s leaders could learn sobering lessons about how their rules affect healthcare by observing how they affect dentists.  As businesses, dental practices are naturally much less complicated than medical practices. 

For one thing, dentists maintain only a few thousand active patient charts, whereas family physicians may have three to ten-thousand.  This is because physicians see forty or more patients a day.  Dentists, whose work involves intricate, but routine hands-on procedures in unpredictable mouths, may see ten patients in a busy day – eighteen if one counts checking hygiene patients. 

Sans Bottlenecks 

In dentistry, patient bottlenecks have never occurred in the clinical setting, even when burdened by modern, strategically complicated insurance hoops.  It takes just as long today to pull a tooth as it did in 1960. 

Actually, considering the OSHA mandate of the late ‘80s, defensive medicine and non-productive paperwork such as the meaningless HIPAA privacy release that patients have signed without reading since 2003, dentistry takes a lot more time than it used to. 

Thank goodness patients never take the time to read what they sign or dentistry would take even longer.

Pulling teeth will never be faster than it was a hundred years ago when x-rays, as well as surgical-grade alloys became available. Back then dentists were never delayed by the wait for onset of anesthesia. For a closely related reason, experienced patients didn’t want dentists piddling around indecisively using cold steel. 

Of Peg-Boards and Ledgers 

For decades, the busiest of medical and dental practices ran efficiently using only pegboards, ledger cards and lots of carbon paper, yet the staff still seemed to have time to ask patients about their families. The business of dentistry is so simple that even today some dentists choose to run their practices without the aid of a computer at all – thereby eliminating the unproductive expense of being a covered entity. 

Always remember this: there is nothing holding down the cost of being HIPAA compliant, and doctors with small, three-and-a-half employee businesses will be held to the same standards as hospitals with large staffs and a fondness for busywork – busywork that demands department budgets that include overtime pay.  HIPAA fits a sole-proprietor dental practice like socks on a rooster. 

The Economics of Choice 

Here is another important difference.  For a considerable amount of dental care, one might delay the purchase of a home entertainment center to chew comfortably.  For serious medical care, one might forgo a home to stay alive.  Almost all acute, health-threatening dental emergencies can be quickly solved in an outpatient manner with a simple extraction that costs less than $200, and available in almost any neighborhood.

HIPAA

From a dentist’s perspective, the Health Insurance Portability and Accountability Act [HIPAA] was never about portability.  Oh, I could tell you stories; couldn’t we all.  And, considering how many electronic health records have been fumbled under HIPAA, accountability is a cruel joke as well.  That leaves the original 1996 HIPAA Rule stripped down to HIA – the Health Insurance Act; transparency at last.

The Four Cornerstones

A year ago, President George Bush signed an Executive Order that centered on four “cornerstone” goals to help bring about a systematic approach for measuring quality and value in health care, and for making that information publicly available. They are:

  • Connecting the system through the adoption of interoperable health information technology;
  • Measuring and making available results and outcomes on the quality of health care delivery;
  • Measuring-Transparency and making available information on the price of health care items and services; and,
  • Aligning incentives so payers, providers and patients benefit when all are focused on achieving the best care-value at the lowest unit-cost

The last three cornerstones, Measuring, Measuring-Transparency and Aligning are dependent on providers volunteering for the first – Connecting.  Even though dentists were intended to be included in Bush’s plans for healthcare reform, connecting with dentists never happened – especially for dentists who did not volunteer for an NPI number – which gives stakeholders a legal right to Measure, Measure-Transparency and Align. 

Or, as my dad, a furniture maker, used to say, “Measure twice, cut once (and for your own sake do not get personally involved in the machinery).”

Assessment

As a dentist who has observed physicians methodically lose control of doctor-patient relationships to stakeholders who hold payments for ransom, I say that if this is interoperability, I hope it never connects to my sheet metal file cabinets full of paper.  HIPAA has nothing to offer but expense and liability.

Mark my words. History will show that HIPAA was exposed as a national failure in dentistry first, and that the presidential candidates still don’t know. 

Won’t presidential candidates Barack H. Obama and John S. McCain be surprised! 

Conclusion

Politicians never consider dentistry. Though it is unfortunate and very expensive, it is nothing new. Stick around. I have other issues, as well, and am not bashful. Of course, your thoughts, opinions and comments are appreciated.

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Investment Policy Statements

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In Physician’s Money Digest

By Dr. David Edward Marcinko; MBA, CMP™

By Hope Rachel Hetico; RN, MHA, CMP™

dave-and-hope8

It is well known that some physicians have a reputation for being poor investors—buying as the market peaks, selling as the market bottoms, and easily trusting brokers, agents, or other commission-driven salespeople.

A portfolio strategy or reasoned wealth building discipline often seems absent. While those physicians are heading in the right direction by creating a portfolio, it is important for them to also develop a strategy for that portfolio to ensure it stays on track with their investment goals.

This document is known as an Investment Policy Statement [IPS], and our take on it was recently published in Physician’s Money Digest.

We now extend the concept to our ME-P readers for their review and consideration. 

Read more: http://www.pmdlive.com/Article.cfm?ID=4473 Search term: Marcinko

November 2006 Physician’s Money Digest

9780763733421

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.

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***

 

Launching iGuard.org

Institute for Safe Medication Practices

Staff Reporters

A new patient-oriented Web site is scheduled for release this fall to reduce mix-ups over drug names.

The ISMP

The Web site is a partnership of the nonprofit Institute for Safe Medication Practices, and online health service www.iGuard.org, which will send users email alerts about drug-name confusion.

Dug Mix-Ups Not Rare

According to an Associated Press report on September 2nd, nearly 1,500 commonly used drugs have names so similar to at least one other medication that they’ve already caused mix-ups.

Patient Harm

And, according to a major study by the U.S. Pharmacopeia, at least 1.5 million Americans are estimated to be harmed each year from a variety of medication errors, and name mix-ups are blamed for a quarter of them.

The Food and Drug Administration [FDA] – which currently rejects more than a third of proposed names for new drugs because they’re too similar to old ones – is preparing a pilot program that would shift more responsibility to manufacturers to guard against name confusion.

The Site

According to the website, iGuard.org is a healthcare service initiative that helps monitor the safety of medications (including prescription drugs, over-the-counter drugs, nutritional supplements and herbal extracts).

iGuard.org reportedly will help patients stay safer by:

  • Checking the safety of medications, and screening for drug-drug and drug-disease interactions.
  • Alerting members and doctors (optional) as important safety information arises for medications.
  • Provide accessible medication summaries for healthcare teams.
  • Help patients learn and share treatment satisfaction and side effect information within its social community.

Assessment

The goal of the site is to spell-out how to better test for potential mix-ups before companies seek approval to sell their products.

Conclusion

Your thoughts and comments are appreciated.

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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Report on Hospital Risks

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An IOM Review for Us All

[By Staff Reporters]

Hospitals manufacture miracles by the millions. But, they can also be hazardous to your health.

IOM Report

According to the Institute of Medicine [IOM], a non-profit organization chartered by the US National Academy of Sciences, at least 1.5 million Americans fall prey to hospital error every year.

And, these mistakes aren’t exactly minor either; as between 40,000 and 100,000 people die every year because of shoddy handiwork, including surgical mishaps and drug mix-ups.

Drug Problems

One big problem is that hospital patients may get the wrong drug one time out of five times [20%], according to a study by Auburn University. The death toll from these mistakes is at least as bad as that from car accidents or breast cancer, and may be as bad as that from strokes.

Infections

Another 100,000 people die because of infections from hospital-bred [nosocomial] bacteria that are resistant to one or more of the antibiotics doctors use to kill them off, according to the Center for Disease Control [CDC]. Some of those might be prevented by more hand washing or other precautions.

Assessment

Of course, medical provides, health economists, advisors, administrators and Executive-Post subscribers are familiar with these mistakes; but the public may not be – until now!

And so, this is your chance to learn what the public is reading about this vital issue from Forbes.  

Link: http://health.msn.com/health-topics/articlepage.aspx?cp-documentid=100214300&gt1=31036#

You may be surprised, and dismayed!

***

telehealth

***

Channel Surfing the ME-P

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

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.

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

Call for “Executive-Post” Content

Seeking Expert Contributors

The Executive Post at www.HealthcareFinancials.com is currently calling for medical professionals, financial advisors, financial services professionals, accountants, health economists and related CXOs, medical administrators, managers and healthcare business organizations around the world to contribute content to www.HealthcareFinancials.wordpress.com

Call for Editors

The Executive-Post aims to inspire a new generation of doctors, advisors, nurses, accountants, medical and financial professionals, and healthcare administrators and CXOs by allowing unprecedented numbers of individuals the ability to contribute to the well-being of the healthcare industrial complex and humanity. The goal is to create an invaluable clearinghouse for all the best related information that cuts across disciplines, socio-economic status and geography to provide valuable medical business information to anyone, anywhere, at any time.

The Executive-Post website is continually evolving and was officially launch in late 2007. It is maintained by the Institute of Medical Business Advisors, Inc, in Atlanta, Ga. Most content created on the Executive-Post is freely licensable under the GNU Free Documentation License (GFDL). Contact us for advertising details.

Print Edition Healthcare Journalism

If you would like to “step-up-your-game” and be considered as a peer-reviewed print contributor to the third edition of: The Business of Medical Practice [Advanced Profit Maximizing Techniques for Savvy Doctors]; just contact Ann at MarcinkoAdvisors@msn.com There are many chapter topics still available.

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Executive Medical Director Opportunity

Suburban Hospital Healthcare System

By Rachel Polhemus

We are conducting a search to recruit an Executive Director, Premier Physician Group [PPG] for Suburban Hospital Healthcare System located in Bethesda, MD.

Attached is a copy of the position specifications along with general information about the community and organization. 

Link: suburbanhospexecdir

If you have an interest in the position after your review of the information, please let me know at your earliest convenience.  If I do not have an updated resume or curriculum vitae, please email (mailto:rachelp@wittkieffer.com), fax or mail one to me.

I hope to have the opportunity to assist you.

Rachel Polhemus
[Witt/Kieffer]

7201 Wisconsin Ave.
Suite 675N
Bethesda, MD 20814
(301) 654-5070
(301) 654-1318 Fax

http://www.wittkieffer.com  

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The Healthcare Whistleblowers

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A New DOJ Report

[By Staff Reporters]

According to the Deportment of Justice [DOJ], $9.3 billion was recovered from health care providers accused of defrauding the states and federal government the past decade.

The Study

The department ramped up efforts in the 1990s to combat healthcare fraud by using private citizens with insider knowledge of wrongdoing. They now initiate more than 90 percent of the department’s lawsuits focusing on fraud in health care, and receive between15 percent and 25 percent of the amounts recovered.

The Results

According to an Associated Press report on September 2, of the $9.3 billion recovered between 1996 and 2005, whistle blowers got more than $1 billion. And, while the number of claims dropped in recent years, recovery amounts have soared – jumping from about $10 million a case in 2002 to $50 million by 2005.

Assessment

The reason for this up-tick was the late addition of pharmaceutical manufacturers to the list of defendants.

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.

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Welcome RealDealDocs™

About RealDealDocs™

Meet a New Executive-Post Sponsor

We’re a group of lawyers and business professionals with a passion for life. Whether it’s heading up to the mountains or down to the beach, or building an innovative company in an important new space, we’re enthusiasts, as one of the recent additions to our team so aptly put it.

We’ve taken this enthusiasm and brought it to RealDealDocs™. As professionals at some of the leading companies in the United States, we all recognized throughout our careers that one of the challenges associated with negotiating and drafting deals is finding language that you know the guy down the hall or across the country has already thought of and would be perfect for what you’re working on, if only you could find it. Everyone from huge professional firms to individual professionals have been trying to solve this problem, but the challenge has been two-fold: 1) finding a huge, centralized library of documents to access (so there’s plenty to choose from); and 2) the fact that this information needs to be profiled, not just full text searchable, because full text search alone just isn’t good enough to find exactly what you’re looking for.

That’s where the innovation behind RealDealDocs™ and its parent product the RealPractice™ Suite of products comes in.

What Makes RealDealDocs™ Unique?

Over the past eight years, we built a proprietary, patented categorization engine which efficiently organizes huge libraries of professional documents, including deal agreements and litigation work product. We combined it with a blazing fast full text search engine and refined it by reviewing the results over millions of professional documents. Importantly, we have also presented this application in an easy to learn search interface so that users can figure out how to get to the information the first time they use it. So whether you’re trying to find an example of an employment agreement for a financial executive at a bank in North Carolina or an obscure pricing clause for a supply agreement out of Asia, you’re going to quickly be able to figure out how to find it.

The RealPractice™ Suite has been adopted at many of the largest professional corporations in the world for their internal document collections, and it is used by tens of thousands of professionals every month. Now we’ve applied this technology to millions of documents that we’ve pulled from public records. These documents have been drafted for companies both large and small by many of the top law firms from around the world. Anyone can access these documents; if only they knew where to find them and they were properly organized. The result is RealDealDocs™, which has been rapidly adopted by lawyers, investment bankers, consultants and professionals at companies of all sizes.

Over the next several months, we’ll be adding new features to RealDealDocs™, including a distinct forms library on top of all of the final agreements pulled from fully negotiated and completed deals and consolidating additional informational resources. We welcome you to contribute any thoughts or suggestions you may have, as that’s the best way for us to continue to incorporate the best thinking of professionals from across the United States and around the world. We hope you enjoy!

Practice Technologies – A History of Excellence

RealDealDocs™ is a division of Practice Technologies, Inc. Established in May, 2000, and based in Venice, California, Practice Technologies, Inc. is a company of lawyers, business professionals and legal technologists who’ve pioneered a task-based approach to information retrieval, whether that information resides inside a firm, in the public domain, or in our own proprietary database.

Practice Technologies’ clients include many of the top law firms and professional corporations in the world. For more information, we encourage you to visit our website at www.PracticeTechnologies.com.

 

If you are interested in licensing our products for your department or firm, please contact our Sales Department for more information.

310.395.8830 ext 810
866.877.3770 ext 810 Toll Free
sales@RealDealDocs.com

 

What is the SIMPD?

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Promoting a Direct-Medicine Business Model

By Staff Reporters

LibraryThe Society for Innovative Medical Practice Design (SIMPD) is an organization of physicians promoting a direct financial relationship with their patients in order to restore the integrity of the patient-physician relationship.

It is their mission to ensure that physicians and patients retain the right to design and implement practices that enhance the effectiveness, efficiency, service, and value of healthcare www.SIMPD.org

 

Goals and Objectives

  • Educate individuals, employers, and physicians about why returning to a system where doctors work for patients, not insurance companies nor the government, is the only feasible way to control escalating healthcare costs.
  • Equip established physicians with the means to convert their practice to a direct pay model and help those who already operate a direct practice to grow.
  • Convince lawmakers that the only cure to our broken medical payment system is to redefine health insurance and allow doctors to work for our patients, instead of insurance companies and the government.

Assessment

SIMPD Members believe that direct medical practices are possible in most markets.  Local demographics will dictate the structure of each individual practice. 

Some colleagues call direct medicine the next generation of concierge medical practice. They suggest this is not just healthcare for the rich as portrayed by the media.  But, it is a significant component of the cure to our broken healthcare system. What do you think?

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.

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SEC Rule 151-A and Insurance Agents

NAFA Criticizes the SEC

Staff Reportersinsurance-book

Insurance agents without securities licenses won’t be able to sell index annuities under this new proposed rule.

NAFA Opines

The National Association of Fixed Annuities (NAFA) recently took a firm stand against the Security & Exchange Commission’s (SEC) proposed Rule 151A, which would regulate index annuities as securities rather than as insurance products.

Insurance-Securities Hybrid Product

NAFA said in a statement issued in July that it “strongly disagrees with the SEC proposal and will pursue all available avenues of recourse,” including taking legal recourse, if required.

Assessment

NAFA Says Nix SEC Rule 151A.

Conclusion

In other words, if Rule 151A is adopted, insurance agents without securities licenses would not be able to sell Index Annuities [IAs].  IAs are investment products that combine both fixed income investments and equity index options so as to be able to leverage opportunities in both.

Please comment and opine; especially insurance agents, investment advisors and financial planners.

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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Retail Banking Today

Ten Things your Bank and/or Banker Won’t Tell You

Staff Reporters

From: Smart Money

Do you assume that your bank serves your best interests? Do you believe that a big bank’s products are better than a smaller bank? Do you think that that your online bank account information is accurate or secure? If so, think again!

And don’t ever believe everything your bank, or banker, tells you.

Review

As readers of the Executive-Post know; medical, dental, allied healthcare and administration students of all stripes are increasingly in school-debt these days.

Assessment

Therefore, we trust this basic, but important, report will be reviewed by medical practitioners and administrators of all ages. Don’t let the bankers add to your economic misery.

Link: http://articles.moneycentral.msn.com/Banking/BetterBanking/10ThingsYourBankWontTellYou.aspx

Conclusion

Your comments are appreciated.

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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Medically-Focused Insurance Agents?

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 insurance agents who themselves wish to avoid the collateral ripple effects of the current healthcare debacle.

The Name Game

As a registered health underwriter, insurance counselor, long term care or life insurance agent, it seems that almost every insurance agent is also acquiring a general securities license, or CFP®, in addition to the CLU or ChFC after their name.

The Transition

Currently, about 240,000 life insurance agents, down from more than one million in 1965, are being pressured to move toward financial planning, as distribution of insurance products over the Internet spreads like wildfire.

Meanwhile, the same insurance and investment companies that are knocking on your door are also courting the medical professionals with their practice enhancement programs.  Even if you are not interested in going into the financial planning business, you have seen the status of the American College erode of late, even as your own business has declined because of the World Wide Web and various discounted insurance companies.

More Competition

And, in the eyes of your former golden-goose doctor-clients, you may have become a charlatan with the recent mortgage, insurance and banking industry collapse of 2008. Now, it seems as though everyone is clamoring for a piece of your insurance business and cloaking it in the guise of the contemporary topic of the day; medical practice risk-management and financial planning.

If you think this is an exaggerated statement; think again? More than a decade ago, an October 1997 survey conducted by Deloitte & Touche Consulting Group of New York, found insurance agents ranked last in having the trust of a wide selection of the public! The insurance debacle today only exacerbates this opinion.  

Regaining Trust

But, how do you regain this lost trust, and what about this new entity known as managed care. How do you learn about it at this stage in your career?

What ever happened to whole-life insurance; or traditional indemnity health insurance, with its deductibles, co-payments and 80/20 patient responsibility? It was so easy to sell, provided good coverage and the agent made a nice profit.

As an insurance agent, all you want to know is, can I still sell insurance and make a living?  Like all struggling collateral advisors, you find yourself asking, how do I “talk the talk, and walk the walk”, in this new era of insurance, transparency and liability turmoil?

Assessment

Slowly, as you read about the Certified Medical Planneronline educational program, you become empowered with knowledge and ideas for new insurance product derivatives that actually provide value to your physician clients www.CertifiedMedicalPlanner.com

After the proscribed course of study, you are no longer just an insurance salesman, but a trusted risk-management advisor and Certified Medical Planner™ for the healthcare industry. You have avoided the “managed care ripple effect.”

Disclaimer: Dr. Marcinko, a former insurance agent and Certified Financial Planner, is Founder of the Certified Medial Planner program for all fiduciary consultants in health economics, finance and medical practice management.

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.

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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

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
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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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Events-Planner: September 2008

SEPTEMBER 2008

Staff Writers

“Keeping track of important health economics and financial industry meetings, conferences and summits”

A Look Ahead this Month

September 1: Print Edition Healthcare Journalism: If you would like to “step-up-your-game” and be considered as a peer-reviewed print contributor to the third edition of: The Business of Medical Practice [Advanced Profit Maximizing Techniques for Savvy Doctors]; just contact Ann at MarcinkoAdvisors@msn.com There are many chapter topics still available. 

Sept 4: Medical Provider Network Congress for Health Plans; Financial Research Associates, Atlanta, GA.

Sept 4-7: National Conference on Pain for Frontline Practitioners; www.painweek.org 

Sept 7: The Forum 2008: DMAA -The Care Continuum Alliance, Hollywood Fla.

Sept 10-13: American Orthotic and Prosthetic Association National Assembly; Chicago, Ill www.aopanet.org

Sept 9-12: World Medical Tourism and Global Health Congress; San Francisco.

Sept 10-17: AHRQ 2008 Conference; Bethesda, Md.

Sep 11: Delivering Vital Health Information to the Public; Columbia, Mo.

Sept 14: Third Annual World Congress Leadership Summit on Healthcare Revenue Cycle Innovations, World Congress, Las Vegas, NV.

Sept 14-16: 18th Annual HFMA California Fall Conference; Hyatt Regency Newport Beach, Newport Beach, CA.

Sept 17: Modernize Patient Assistance Programs, Institute for International Research, Washington, DC.

Sept: 18-19: JCAHO and JCRs’ Annual Infection Control Conference, Chicago, Ill.

Sept 18-20: 14th Northwest Podiatric Foundation; Wynn Las Vegas Resort and Casino, NV.

Sept 19: SCF Arizona Medical Provider Seminar-Worker’s Compensation, Radisson Woodlands Hotel; Flagstaff | 602-631-2513 lbrott@scfaz.com

Sept 25-27: Clinical Orthopedic Society Meeting; Annapolis, MD www.cosociety.org

Sept 25-29: Annual Wound Care Congress; Kissimmee, FL www.woundcarecongress.com

Sept 28-Oct 1: ESRI Health GIS Conference; Washington, D.C.


Please send in your meetings and dates for listing in the next issue of our Events-Planner.

MarcinkoAdvisors@msn.com

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

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Meet a Sponsor

Foot and Ankle Research Consortium, Inc.

Date: September 1, 2008

PRESS RELEASE: FARC, Inc

Atlanta, Georgia USA

The Executive-Post at www.HealthcareFinancials.com is now proudly sponsored, in-part, by the Foot and Ankle Research Consortium, Inc.

FARC is a leading provider of CD-ROMS, books and e-learning tools for orthopedic and podiatric medicine and surgery of the foot, ankle and leg. Since 1992, FARC has been producing the most effective and innovative method of preparing for all Podiatry and Orthopedic Surgery related board examinations; written and oral – qualified and certified. This includes, among others:  

  • The American Board of Podiatric Surgery [ABPS]
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  • The American Board of Primary Podiatric Medicine [ABPOPPM]
  • The American Podiatric Medical Specialties Board [APMSB]
  • The American Board of Lower Extremity Surgery [ABLES]
  • The National Board of Podiatric Medical Examiners [Parts II and III of PMLexis].  

And, FARC now includes the latest information for all Board Re-certification Examinations, C.Ped and Diabetic Wound Care/Infection and Ulcer Management.

Purchase – Prepare – Pass

For more information, please visit: www.PodiatryPrep.com

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HIPAA Rules and Dentistry

A Survey of Dentists [Pilot Study]

By Darrell Pruitt; DDS

A survey of 18 dentists was performed using the Internet as a platform. The dentists were presented with ten HIPAA compliancy requirements followed by a series of questions concerning their compliancy as well as the importance of the requirements in dental practices.

Frustration with the tenets of the mandate, as well as open defiance is evident by the written responses.  In addition, it appears that a dentist’s likelihood of satisfying a requirement is related to the dentist’s perceived importance of the requirement.

Even though this is a limited pilot study, there is convincing evidence that more thorough investigation concerning the cost and benefits of the requirements need to be performed before enforcement of the HIPAA mandate is considered for the nation’s dental practices.

Excerpt:

Dr. Gerald Daniel seems to have captured many of the dentists’ feelings about the HIPAA Rule when he lamented, “We try to comply, however many times I feel every government agency in the country wants to run my practice without regard to the problems, expense or aggravation it causes the health provider.”

READ IT HERE: hipaa-survey-dentists4

GRAPHS: hipaa-survey-graphs1

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:

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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