Broker Compensation for Debt-Based Securities

Understanding Commission Methods for Selling Investments

By Staff Reporters

steveBrokers earn commissions on debt instruments based on the spread, or markup, between the price at which the broker can secure the bond and the price at which it is sold.

Bond Funds

In the case of bond funds, the fund charges a management fee and/or an expense fee. There may or may not be a load, or commission, paid to a broker.

Assessmentdhimc-book10

For more terminology information, please refer to the Dictionary of Health Economics and Finance.

www.HealthDictionarySeries.com

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Understanding HMO Negotiation Tactics

Tricks Often Used Against Doctors

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

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

[Publisher-in-Chief and Managing Editor]dave-and-hope6

It is well known that stakeholders of the healthcare industrial complex often have different, and divergent, interests. Intra-as well as inter-stakeholder competition occurs; as well.

The Friends-Enemies [“Frenemies”]

For example, several decades ago, the authors were often at odds at the payer negotiation table.

He was managing partner of a large private medical practice, ASC and later PPMC. First, she was the representative of a national DME vendor, healthcare system and later, private insurance payer.

The Tactics

The following trick negotiating tactics can be used to gain an advantage over your opponent, or they can be used against you to your disadvantage. The key is to recognize them immediately:

1. Deliberate deception with phony facts about contracts, providers, patients, venues, demographics, prices, utilization rates or services.  Some MCO’s may even offer a fee-for-service fee schedule as enticement into the plan. Then, fees are dramatically reduced once the initial enrollment period has elapsed.

2. Ambiguous authority regarding negotiating intentions or power. One the deal is done and a firm agreement has been made, the other side announces that they must take the agenda to a higher authority for final approval and another shot at your resistance. 

3. Avoid stressful personal situations before beginning the negotiating process. Don’t negotiate when sick, your personal life in shambles, your children or spouse is sick or when you feel too mentally exhausted or “psyched out”.

4. Personal attacks can be in the form of verbal abuse or simply loud talking, avoidance of eye contact or asking you to repeat yourself, endlessly. Extremely offensive to most physicians, and increasingly used today, is the phrase “remember doctor, you are an over supplied commodity”.  Now ask yourself, do you really want to be on a plan that doesn’t respect your profession?  

5. The “good guy-bad guy” routine is a psychological tactic where one partner appears to be hard nosed and the other appears more yielding. Small concessions result which, upon repetition, become larger in aggregate.

6. The “take it or leave it” tactic can be easily avoided by knowing your BANTA [Best Alternative to a Negotiated Agreement]. More formally, this is known as a unilateral contract of adhesion.

7. Escalating or increasing demands occur when the opponent increases his demands or reopens old demands. Call their bluff on this one by pointing it out to them and replying that you are aware of its use.

Assessment

Always remember, today’s enemy – may be tomorrow’s ally.

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Military Health System Records

Expanding PHR Pilot Testing

By Staff Reporterscomputer-hardware2

According to Paul McCloskey, on April 08, 2009, the Military Health System [MHS] will extend its test of personal health records at Madigan Army Medical Center in Tacoma, Wash., to two additional health care venues in an attempt to test the technology in larger populations and more diverse care settings.

MiCare PHR Focus

The new projects will focus on using the MiCare Personal Health Record [PHR] as a tool for care coordination and a mechanism for patients to share health records across a mix of military and commercial providers and payer organizations, according to Col. Keith Salzman, chief of informatics at Madigan, which is hosting a pilot test of MHS’ MiCare PHR.

Assessment

Link: http://govhealthit.com/articles/2009/04/08/phr-pilot-testing.aspx?s=GHIT_140409

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