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

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

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Understanding Efforts to Promote Lower-Cost Physicians

May Be Based on Misleading Profiles – According to Rand Study

By Staff Reporters

It is increasingly common for insurance plans to encourage patients to receive care from physicians who keep medical costs lower. However, this ethos may be based on unreliable estimates of doctor performance and may not achieve the intended savings, according to a new RAND Corporation press release and study.

PR Link: http://www.rand.org/news/press/2010/03/17/?ref=homepage&key=t_doctor_cash

About the Study

Funding for the study was provided by the U.S. Department of Labor. Other authors of the study are Elizabeth A. McGlynn PhD of RAND, Dr. Ateev Mehrotra of RAND and the University of Pittsburgh School of Medicine, and J. William Thomas of the University of Southern Maine.

About Rand Health

RAND Health, a division of the RAND Corporation, is the nation’s largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics. RAND Health is the developer of COMPARE (Comprehensive Assessment of Reform Efforts), a one-of-a-kind online resource that provides objective analysis about national health care reform proposals. Visit www.randcompare.org to learn more.

Conclusion

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Senior Public Health Official [Dr. Howard Frumkin] is Reassigned

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In Wake of Congressional Inquiries

By Joaquin Sapien, ProPublica – January 22, 2010 5:56 pm EDT

Dr. Howard Frumkin, the embattled director of a little-known but important division of the Centers for Disease Control and Prevention, has been reassigned to a position with less authority, a smaller staff and a lower budget.

Agency for Toxic Substances and Disease Registry

Frumkin had led the CDC’s Agency for Toxic Substances and Disease Registry (ATSDR) and the National Center for Environmental Health since 2005. For the past two years he had endured scathing criticism from Congress and the media for ATSDR’s poor handling of public health problems created by the formaldehyde-contaminated trailers that the government provided to Hurricane Katrina victims. The agency, which assesses public health risks posed by environmental hazards, also was criticized for understating the health risks of several other, less-publicized cases.

Internal CDC e-Mail

An internal CDC e-mail sent by Frumkin on Jan. 15 and obtained by ProPublica said he was leaving his position that day and would become a special assistant to the CDC’s director of Climate Change and Public Health. His old job will be temporarily filled by Henry Falk, who led ATSDR from 2003 to 2005. In the e-mail, Frumkin praised his staff and described more than 20 ATSDR accomplishments during his tenure. They include strengthening the agency’s tobacco laboratory and creating the Climate Change and Public Health program.

A Change of Function

A CDC spokesman said Frumkin’s transfer shouldn’t be considered a demotion but rather a change of function and responsibilities that the CDC’s director, Dr. Thomas Frieden, said would benefit both the agency and Dr. Frumkin, who is a recognized expert on climate change. But Frumkin’s authority has been sharply reduced, even though his salary won’t change. Previously, he oversaw two departments with a combined budget of about $264 million and 746 full-time employees. Now he will be an assistant to the director of a new program that has a budget of about $7.5 million, five full-time employees and five contractors, two of whom are part time. Through a CDC spokesman, Frumkin declined a request to be interviewed for this story.

US capitol

A 2008 ProPublica Report

In 2008, ProPublica reported [1] that Frumkin and others failed to take action after learning that ATSDR botched a study [2] on the trailers provided to Katrina victims. The Federal Emergency Management Agency used the study to assure trailer occupants that the formaldehyde levels weren’t high enough to harm them. ATSDR never corrected FEMA, even though Christopher De Rosa, who led ATSDR’s toxicology and environmental medicine division, repeatedly warned Frumkin that the report didn’t take into account the long-term health consequences of exposure to formaldehyde, like cancer risks. Frumkin eventually reassigned De Rosa to the newly created position of assistant director for toxicology and risk analysis. De Rosa went from leading a staff of about 70 employees to having none. He has since left the agency and is starting a nonprofit that will consult with communities close to environmental hazards.

The involvement of Frumkin and ATSDR in the formaldehyde debacle was the focus of an April 2008 Congressional hearing held by a subcommittee of the House Science and Technology Committee. A report [3] by the subcommittee’s Democratic majority, released that October, concluded that the failure of ATSDR’s leadership “kept Hurricane Katrina and Rita families living in trailers with elevated levels of formaldehyde … for at least one year longer than necessary.”

About six months after the report came out, the same panel, the Subcommittee on Investigations and Oversight, held another hearing [4] that touched on other problems at ATSDR.

Flawed Data

Before that hearing, the Democrats on the subcommittee released a report [5] that revealed other cases in which the agency relied on scientifically flawed data, causing other federal agencies to mislead communities about the dangers of their exposure to hazardous substances.

For example, an ATSDR report about water contamination at Camp Lejeune, a Marine Corps base in North Carolina, said the chemically tainted drinking water didn’t pose an increased cancer risk to residents there. The report was used to deny at least one veteran’s medical benefits for ailments that the veteran believed were related to the contamination. A month after the subcommittee hearing, ATSDR rescinded [6] some of its findings, saying it didn’t adequately consider the presence of benzene, a carcinogen that it found in the water. Eight months later, the agency said it would modify another report that was criticized at the hearing, about a bomb testing site in Vieques, Puerto Rico. For decades, the U.S. military used the site to test ammunition that contained depleted uranium and other toxins. In a 2003 report, ATSDR said that heavy metals and explosive compounds found on Vieques weren’t harmful to people living there. But Frumkin decided to take a fresh look at those findings because ATSDR hadn’t thoroughly investigated the site.

Assessment

Subcommittee investigators acknowledged that Frumkin inherited many of the problems in the report from previous ATSDR directors — the original Vieques and Camp Lejeune reports were both done before Frumkin was named director in 2005. But the investigators said he was aware of the agency’s problems and did little to fix them unless he was under political pressure. A CDC spokesman said that Frumkin’s reassignment had nothing to do with the congressional inquiries.

“Americans should know when their government tells them that they have nothing to worry about from environmental exposure that they really have nothing to worry about,” Rep. Brad MillerHouse Science and Technology Committee, D-N.C., the subcommittee’s chairman, said in a statement to ProPublica regarding Frumkin’s reassignment. “The nation needs ATSDR to do honest, scientifically rigorous work. There are many capable professionals at ATSDR who are committed to doing just that.”

Conclusion

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About the Covestor Mutual Fund Portfolio Sharing Service

Certified Medical Planner

What it is – How it works

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Covestor, with offices in New York and London, is a web platform started by entrepreneurs Perry Blancher, Richard Tachta and Simon Veingard http://www.covestor.com. Their belief was that salaried mutual fund managers have no monopoly on investment talent and shouldn’t have a lock on the rewards that come with investment success. As financial services, and online netizens, they also believed in democratizing the investment management industry and helping proven self-investors compete with the large institutions. This is known as the power of “crowd-sourcing.” All core philosophies seem to be shared by this ME-P.

What it is

According to their website, Covestor is both a portfolio sharing service for proven self-investors and for those wishing to track them; where data is private, secure and anonymous. With Covestor, one can coat-tail successful investors and follow their real trade activity. Or, have their moves auto-traded for you by Covestor Investment Management. Members can also keep track of their investments andBuild a free track record comparable to professional mutual funds. Members earn fees for their hard work, and Manage a model that their clients can mirror thru shared management fees.

Profit Sharing Investors

Covestor investors sharing portfolios include professionals, full time amateurs and industry specialists. They are a serious bunch with an average reported portfolio size of over $200,000 (excluding cash). Positions are typically held in over 5,000 different equities; are based in 50 countries and span the full range of ages, backgrounds and styles.

Issues

As a doctor-investor, health economist and former certified financial planner, there are at least three issues needed to be raised about this firm.

The first is SEC/NASD/FINRA rules and applicable SRO and state regulations for brokers, RIAs, FAs and related others? The status of suitability versus fiduciary accountability for ERISA regulated plans is also questioned. The third [and least important] is the potential negative impact on traditional financial services “professionals.”

In other words, is this another example of how technology will flatten the “intermediary curve” and reduce the profit of middle sales-men and sales-women? Oh! What about medical specificity for our target audience?

www.CertifiedMedicalPlanner.org

Assessment

I am sure there are other issues as well. Your thoughts and comments on this ME-Pare appreciated; especially from financial services “professionals”, lawyers and FAs, etc, Give em’ a click and tell us what you think http://www.covestor.com?

Conclusion

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As the Health Care Vote Passes

Another Troubling Insurance Story

By Marian Wang, ProPublica – March 17, 2010 2:03 pm EDT

[picapp align=”none” wrap=”false” link=”term=health+insurance&iid=8337843″ src=”c/e/5/3/President_Obama_signs_baf7.JPG?adImageId=11734822&imageId=8337843″ width=”380″ height=”484″ /]

Reuters filed a stunning report [1] recently about a health insurance company that targeted policyholders with HIV to drop their coverage. It opens with the case of Jerome Mitchell:

Patient Jerome Mitchell

Previously undisclosed records from Mitchell’s case reveal that [health insurance company Fortis [now known as Assurant Health] had a company policy of targeting policyholders with HIV. A computer program and algorithm targeted every policyholder recently diagnosed with HIV for an automatic fraud investigation, as the company searched for any pretext to revoke their policy. As was the case with Mitchell, their insurance policies often were canceled on erroneous information, the flimsiest of evidence, or for no good reason at all, according to the court documents and interviews with state and federal investigators ….

Insurance companies have long engaged in the practice of “rescission,” whereby they investigate policyholders shortly after they’ve been diagnosed with life-threatening illnesses. But, government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV.

The Three Minute Rule

A South Carolina judge who ruled on the case noted that in the meeting in which the rescission committee [2] reviewed Mitchell’s case and decided to cancel his policy, there were more than 40 other customers whose cases were up for review, and “an average of three minutes or less” was spent per customer. Assurant Health told Reuters [1] it doesn’t comment on individual customer claims, while a spokesman added the company disagreed with “certain of the court’s characterizations of Assurant Health’s policies and procedures.” 

Link: http://www.propublica.org/ion/blog/item/as-health-care-vote-nears-another-troubling-insurance-story

Assessment

As the story notes, it’s not just this one insurance company that has been engaging in aggressive rescission. In California, state regulators fined five major health insurance providers—Health Net, Anthem Blue Cross, Blue Shield of California, PacifiCare and Kaiser Permanente—for dropping more than 6,000 sick policyholders. The terms of those settlements, reached in 2008 and 2009 [3], have yet to be implemented in most cases, according to news reports [3] from last week.

Industry Indignation Index: 39

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Need a New Career in Dentistry – Become a Consultant

Or – Maybe Just a Hobby

By Darrell K. Pruitt; DDS

One might ask how much knowledge of dentistry is required before a person is qualified to call oneself a “dental practice management consultant” – beyond maybe being able to spell HIPAA with only one P, and Hippocrates with two.

Meet Jill Coon, Inc

An anonymous management consultant who works for Jill Coon, Inc of Florida posted this brave suggestion on the company Facebook today:

“Why not take 3 max anterior PA’s and 1 mandibular PA once a year with bitewings to check for caries in front teeth? We actually bill insurance for 3 PA’s not 4. Hygiene production just increased!”

My Translation 

Here is a translation of her question from dental-speak to English:

“Why don’t dentists take routine x-rays of front teeth like they do for back teeth, when doing so increases hygiene production and payments from the insurance companies?”

[Dental team members, please sit on your hands for this one].

Bonus Round 

Bonus question: Can anyone think of any reason why one might not want additional routine x-rays – even if insurance pays for it at 100% (of usual and customary fees)?

Hint: It can be trickier to avoid irradiating the thyroid when taking anterior x-rays than while taking routine bitewing x-rays.

Assessment 

I’ll be back soon with the tricky opinion I will have posted on Jill Coon, Inc Facebook. It will be her first if nobody beats me to it.

http://www.facebook.com/home.php#!/pages/West-Palm-Beach-FL/Jill-Coon-Inc/125510596754?v=wall&ref=mf

Conclusion

Is there anyone out there with almost no knowledge of dental care who wants to match wits with a sales rep for a consulting company that “specializes in dental insurance billing and treatment planning for dental practices”?

Industry Indignation Index: 47

How about it – HHS Secretary Kathleen Sebelius, JD?

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About Guardian24/7 Premium Global Concierge Medical Care

What it is – How it works

[By Staff Reporters]

According to their website and TV infomercials, the principals of www.Guardian247.com developed the medical systems and protocols for the President of the United States [POTUS], senior White House officials and members of the President’s cabinet to ensure the best possible medical care anywhere in the world.

Today, the convergence of telemedicine technologies and reliable telecommunications has enabled a business model for this same level of service to be brought to the private sector – for the first time.

Telemedicine Enabled

Utilizing state of the art telemedicine broadband capability, and pre-positioned medical equipment, a team of former White House physicians administer services that are purportedly nearly as effectively as if they were on location, saving hours of time and anxiety for routine medical needs – and possibly saving a life in an emergency situation.

Like an Emergency Room

The company favors a core concept known as A ReadyRoom™ that is an installation of medical equipment, supplies and medications pre-placed and installed in a client’s primary residence and/or remote vacation home, jet or yacht. Custom-tailored to the needs and the client and his/her family and location, the ReadyRoom’s™ state of the art technology allows Guardian’s physicians to direct the proper use of the medicine, supplies and equipment either via telephonic or through advanced video teleconferencing links. The model is reminiscent of an emergency room; always on-call, available for use and expensive.  

Assessment

For those who recognize that their most important asset – is their health –  this company has a serious concierge medicine type solution that is not available to the masses. As CEO of Guardian 24/7, Jonathan Frye leads the company’s efforts to provide presidential-level medical care to clients; anywhere and anytime.

Conclusion

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