The Average Day in the Life of a Nurse

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A Typical Work Day?

By the numbers, a typical work day can be similar for nurses all across the US.

The major difference lies within salaries earned by nurses, which directly correlates to the certification or degree any given nurse may hold. Nurses with a Bachelor of Science in Nursing (BSN) degree earn a higher income than do Registered Nurses (RN). Those who advance their careers with a graduate degree in nursing earn an even higher salary.

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Assessment

The increased demand for highly qualified nurses is evident by the rising increase of pay earned each year by nurses with advanced degrees. A larger number of degree holding individuals within the industry benefits patients as well as nurses.

Conclusion

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More Year-End Tax 2014 Planning Insights for Medical Professionals

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Timing of charitable gifts, and type of property contributed, can be important

By Perry D’Alessio CPA www.DaleCPA.com

perry-dalessio-cpa

Charitable contributions should be timed so as to obtain the maximum tax benefits, either in 2012 or 2013. If a taxpayer, like a physician, plans to make a charitable contribution in 2013, s/he should consider making it this year instead if speeding up the deduction would produce an overall tax saving, e.g., because the taxpayer will be in a higher marginal tax bracket in 2012 than in 2013.

On the other hand, a taxpayer who expects to be in a higher bracket in 2013 should consider deferring a contribution until that year. This task is more difficult than in prior years because of uncertainty over future rates.

In making any sizeable charitable contributions, to the extent possible, clients should make the contributions in appreciated capital gain property that would result in long-term capital gain if sold. This way, a deduction generally is obtained for the full value of the property, such as shares of stock, etc., while any regular income tax on the appreciation in value is avoided. (However, for tangible personal property, this favorable treatment is only available if the donated item is related to the exempt purpose of the donee charity).

Observation:

If rates rise after this year, the tax savings on a later sale could be even greater.

It should be noted, however, that contributions of appreciated capital gain property generally are subject to a 30%-of-AGI (Adjusted Gross Income) ceiling, instead of the usual 50% ceiling, unless a special election is made to reduce the deductible amount of the contribution.

Observation:

Making the election will limit the donor’s deduction to the basis of the contributed property. In most cases, the election should be made only if the fair market value of the property is only slightly higher than the basis of the property.

IRA distributions to charity

Older taxpayers who plan to use individual retirement account (IRA) distributions to make charitable contributions should bear in mind that the favorable tax provision for doing so expired at the end of last year. That provision allowed taxpayers age 70 1/2 or older to take advantage of an up-to-$100,000 annual exclusion from gross income for otherwise taxable IRA distributions that were qualified charitable distributions. Such distributions weren’t subject to the charitable contribution percentage limits and weren’t includible in gross income. Since such a distribution was not includible in gross income, it would not increase AGI for purposes of the phase-out of any deduction, exclusion, or tax credit that was limited or lost completely when AGI reached certain specified levels.

To constitute a qualified charitable distribution, the distribution had to be made after the IRA owner attained age 70 1/2 and made directly by the IRA trustee to specified charitable organization. Also, to be excludible from gross income, the distribution had to otherwise be entirely deductible as a charitable contribution deduction under the Internal Revenue Code provisions, without regard to the charitable deduction percentage limits.

Even though a direct distribution from an IRA to a charity was not included in the taxpayer’s gross income, it was taken into account in determining the owner’s required minimum distribution (RMD) for the year.

Qualified Contributions

Qualified charitable contributions aren’t available for distributions made in tax years beginning after Dec. 31, 2011 While there has been some talk of an extending this provision, it is unclear whether it will make it in any such package and if it does, whether there would be a rule allowing January 2013 distributions to be treated as made on Dec. 31, 2012.

Thus, while IRAs may be a potential source of funds for making charitable contributions between now and year end, clients age 70 1/2 or older must be informed that using an IRA to make contributions will be more costly if the special break is not retroactively revived.

Recommendation: An eligible taxpayer interested in making a charitable contribution from his IRA directly to a charity, and who hasn’t yet taken his 2012 RMD from the IRA, should consider waiting until the end of the year to take the RMD.

Recommendation: An eligible taxpayer interested in making a charitable contribution from his IRA directly to a charity, and who hasn’t yet taken his 2012 RMD from the IRA, should consider waiting until the very end of the year to take the RMD. If the rules to see if qualified charitable distributions are revived.

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Historic Gas Prices versus Major Events

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A 45 Year Journey

Source: www.DaveManuel.com

Assessment

Update as of 9 a.m. on Oct. 6, 2012: Record high gas prices were set across Southern California. For example, in Los Angeles County, the price of a gallon of regular unleaded was $4.66 and just a penny less in Orange County.

Click here to read more.

Dr. Marcinko with a McLaren F1 — unadorned, undisguised and entirely unofficial

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CEOs Support Higher Taxes and Debt Solution

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Campaign to Fix the Debt

By Children’s Home Society of Florida Foundation

The nonpartisan Committee for a Responsible Federal Budget in cooperation with former Sen. Alan Simpson and former White House Chief of Staff Erskine Bowles has created a “Campaign to Fix the Debt.”

Bowles and Simpson were co-chairs of the National Commission on Fiscal Responsibility and Reform. They proposed a bipartisan budget solution at the request of President Barack Obama.

The CEOs Gather

On October 25, over 100 CEOs gathered at the New York Stock Exchange to support a comprehensive budget solution similar to that proposed by the Bowles-Simpson Commission. One of the commission members was Honeywell Chairman and CEO David Cote. He stated, “The U.S. has an opportunity to not only fix our debt issue and have an economic recovery, but we can also be a model for the world and how to deal with debt. What it really comes down to is if we still have the political will to be a great country.”

Cote continued to emphasize that it is important to develop a comprehensive solution. This solution will include “higher revenue, reduced entitlement spending, reduced discretionary spending, and investment in infrastructure and math and science.”

Congressional Leaders

Congressional leaders from both parties responded to this public proclamation by leaders of many of America’s largest corporations. The Senate Democratic leadership indicated that it believes part of the solution involves tax increases on individuals with higher incomes. House Republican leaders continue to oppose these tax increases.

Sen. Bernie Sanders (I-VT) observed that it is important for corporate leaders to pay their “fair share” of taxes. He commented, “Our Wall Street friends might also want to show some courage of their own by suggesting that the wealthiest people in this country, like them, start paying their fair share of taxes.” Sanders noted that many large corporations use various tax provisions to reduce their taxes. In his view, this tax reduction has been a factor in the major deficit problems.

Assessment

Maya MacGuineas, Chair of the Committee for a Responsible Federal Budget, supported this bipartisan effort by the 100 CEOs. She stated, “The collective voice of these business leaders has helped shine a light on the fact that the debt is already affecting Americans where they work and live. We have listened to the CEO Council and heard the consequences of inaction – businesses aren’t investing in an uncertain economy and are slowing job growth to protect their employees. With the CEOs’ backing and the support of the over 280,000 person Grassroots Network, we believe we can successfully push for a comprehensive debt reduction deal.”

Editor’s Note: It is unusual for a bipartisan group of business leaders to be so public in support of both a budget solution and higher taxes. This willingness to place both spending and tax increases on the table is significant.

Conclusion

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Get Our New Medical Executive-Post Mobile Applications

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We Are Going Mobile – Now YOU Get Going!

By Ann Miller RN MHA

[Executive Director]

If you have one of the following mobile devices, you can download an app that lets you write posts, upload photos, edit your pages, and manage comments on our ME-P blog directly from your smart-phone device.

Assessment

Check out our hosts’ apps page to see the most current applications for your phone and desktop.

Noteworthy: If your phone is not one of the above, don’t worry – you can still use m.wordpress.com – a mobile version of our dashboard that lets you easily publish new blog posts and comments; so get started now!

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What Does a PQRS Really Measure?

And, What Does a PQRSMeasure Group Look Like?

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[By Staff Reporters]

At a basic level, a Physician Quality Reporting System [PQRS] is a program that pays medical providers for reporting outcomes on quality outcomes metrics for Medicare Part B patients.

Primary care and specialty care providers of all kinds can participate by selecting outcomes measures that are pertinent to their fields. There is something for most every specialty, even pathology and radiology.

For example, you may choose from a menu of outcome measures and pick those measures you want, or you can report on a predetermined group of measures that focus on a specific condition or situation, such as diabetes or perioperative care.

The CMS Document

According to the 655 page 2012 Physician Quality Reporting System Measure Specifications Manual for Claims and Registry Reporting of Individual Measures produced by CMS, here are some high-level descriptions of individual measures.

Assessment

Conclusion

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AICPA Gift and Estate Requests

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The American Institute of Certified Public Accounts Recommend

[By Children’s Home Society of Florida Foundation]

At a September 13th hearing of the House Committee on Small Business, Subcommittee on Economic Growth, Tax and Capital Access, Jeffrey A. Porter of the American Institute of Certified Public Accounts (AICPA) discussed recommended tax provisions to be considered in November.

A section of his testimony covered proposed gift and estate tax provisions:

1.  Generation Skipping Tax – AICPA requests that the technical GST  modifications passed in 2010 be made permanent.

2.  Estate and Gift Exemption – The $5 million exemption with indexing should be made permanent.  If a lower exemption is passed, there should be no recovery of gift taxes for transfers made in 2011 and 2012 with the larger exemption.

3.  Uniform Exemption Amount – The gift, estate and generation skipping tax exemptions should remain uniform to avoid undue complexity.

4.  Marital Portability – The option to permit use of the exemption of a prior deceased spouse should be made permanent.  Marital portability should also extend to generation skipping tax.

5.  State Tax Credits – Congress should reinstate a state tax credit.  Under the current system, many states have “decoupled” and the different federal and state systems have created undue complexity.

6.  Tax Liquidity – Revise the installment payment of taxes under Sec. 6166 and extend it to all types of business interest.

7.  Gift and Estate Brackets – Do not create gift and estate “cliff” brackets.  For example, a 15% and a 30% bracket could create great differences for taxpayers with moderately different-sized estates.

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The Challenges of Pricing Health Insurance for the 2014 Exchanges

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Expert Voices Essay – NIHCM Foundation

By Ann Miller RN MHA

The PP-ACA has introduced sweeping market changes that bring new uncertainty to the task of developing premiums for products to be offered in the health insurance exchanges beginning in 2014. The added complexity greatly increases the chances that these premiums will be off the mark.

In this essay, Alice Rosenblatt explains how actuaries set premiums, shows how key provisions of the ACA will affect their pricing for the October 2013 open enrollment period and describes what’s at stake if they don’t get it right.

Read more…

PDF: http://nihcm.org/images/stories/The_Challenges_of_Pricing_Health_Insurance_for_the_2014_Exchanges.pdf

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INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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More on Patient Centered Medical Homes

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A Road to Patient Satisfaction?

The rise in the medical home concept started over the last six years has been driven by the growing shortage of primary care clinicians and the increase prevalence of chronic diseases.

And, medical home adoption has risen from 49 percent in 2006 to 79 percent in 2009 to 86 percent in 2012, according to 95 healthcare companies who completed the sixth annual Healthcare Intelligence Network survey on Patient Centered Medical Homes (PCMH).

The Survey

When asked in 2006, only 33 percent of respondents were trying to establish a medical home.

However, by 2012, 52 percent have established medical homes for their populations including 59 percent of existing medical homes are now or soon will be part of an accountable care organization (ACO). With the rise of patient centered medical homes, ACOs and other emerging healthcare delivery models, healthcare organizations will need to engage patients in ways that increase quality, reduce cost and improve their overall healthcare experience.

Assessment

Healthcare Intelligence Network also created the infographic shown below to accompany the survey highlighting following key areas in medical home adoption from 2006 to 2012:

  • Top three ways to educate and engage patients in the medical home
  • Barriers to patient centered medical home adoption
  • Time for medical home conversion
  • Climbing of patient satisfaction rates
  • Top health IT tools adoption

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Understanding the Domestic Unemployment Numbers

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How Can Unemployment Be Going Down?

By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com

In an economy that isn’t exactly robust, how can unemployment be going down? The recent drop in the unemployment rate from 8.1% to 7.8% caught almost everyone, including me, by surprise. The GDP grew by only 1.5% in the first quarter, and its growth was under 2% for the last 12 years. To get the economy moving again we will need growth of 3% a year.

It isn’t surprising that many pundits were questioning the timing within minutes after the latest unemployment numbers were announced. After all, unemployment is one of the major issues in the Presidential election. Former General Electric CEO Jack Welch and several Fox News commentators even suggested the administration was cooking the books.

The BLS

I don’t believe the Bureau of Labor Statistics is manipulating unemployment data. The process of computing the data is straightforward and transparent. Two surveys go into projecting the unemployment rate, one covering 400,000 businesses and the other questioning 60,000 households. The surveys ask about the number of full-time and part-time employees, whether the part-time employees really want full-time employment, and whether those without a job have looked for a job within the last month.

Cooked Books?

But that doesn’t mean the books aren’t cooked. They are.

“The way the government derives the unemployment numbers has changed significantly over the last 30 years,” writes John Mauldin, editor of the economic newsletter Thoughts from the Frontline, in the October 8, 2012, issue. “Whatever administration is involved, the new equations for determining unemployment result in a lower unemployment rate than they would have if the 1980’s methodology were still in place.”

The Changes

One of the more bizarre changes in the unemployment rate calculation is that people are not considered unemployed unless they have looked for a job in the last 30 days, even if they currently receive unemployment benefits. Mauldin says there are probably many people who haven’t looked for a job in the last 30 days and that most, if not all, of them would consider themselves unemployed. “If you’re not disabled and you’re receiving unemployment or welfare benefits I think you should be counted as unemployed,” he says. He estimates our actual unemployment rate is well over 12%, which doesn’t take into account the 50% of college graduates who are underemployed.

Don’t Blame Obama

Before you blame the Obama administration for the dumbing down of the unemployment rate, this is the same way the Bush administration calculated unemployment.

It’s the same story with the Consumer Price Index, which the government has continually tweaked to give the illusion of a lower CPI than if the 1980’s formula was used.

ShadowStats.com, run by John Williams, calculates the current unemployment and inflation rates using the formulas from the 1980’s. According to that methodology, Williams calculates the unemployment rate (U-6) is 15% and the CPI is 9%.

Regaining Jobs?

The economy has currently regained about half of the jobs lost in the Great Recession of 2008-2009. According to the Liscio Report, it will take another 40 months to reach the level of employment we had prior to the recession. That is if we don’t have another recession, which is doubtful. If all the tax increases slated for January 1 go into effect, the Congressional Budget Office says GDP will shrink 2.9%, which guarantees a recession.

Assessment

So, what was behind the fall in the unemployment rate this month? According to Mauldin, the entire drop came from an increase in part-time workers. He says, “That such significant numbers of people can only find part-time work is not a sign of a strong and growing economy.”

When we look a little deeper, maybe the latest unemployment numbers aren’t such a surprise after all.

Conclusion

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What Does Health Reform Mean for You?

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Ideas Changing the World

By National Center for Policy Analysis [NCPA]

Although the third presidential debate last night centered on foreign affairs, the PP-ACA seems to be the moniker of the Obama Presidency.

And so, here is a slide-show and white paper [updated September 2012] from the NCPA on what health reforms means for you.

Slide show MSFT-ppt link: What-Does-Health-Reform-Mean-for-You_Presentation

White paper .pdf link: What-Does-Health-Reform-Mean-for-You-A-Consumers-Guide

About the NCPA

The National Center for Policy Analysis is a public policy research organization that develops and promotes private alternatives to government regulation and control.

Conclusion

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About Small Business Micro-Loans

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Change the World with Twenty Bucks

Microloans have been helping out around the world for years: see Kiva.

In one instance, the recipient was selected for a loan under $100. Although only about 70% of the loan was repaid, it was accompanied by a thank-you letter from the SB recipient, who was so grateful, that the money was paid back just after the designated time period. And, the fact is that most microloans are paid back in-full.

Assessment

Small business is how most citizens of third-world countries make a living.

Supporting business and growth by supplying microloans is an import thing. But, to personally help keep a sustainable source of food on the table for these families is the real satisfaction that all medical professionals should experience – at least once – on some level of participation.

Conclusion

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Our Healthcare Referral System is Broken

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About the Management Process

[By Staff Reporters]

Our healthcare referral system is broken, according to Referral MD. The firm reviews some of the key factors that contribute to this system.

The Paper Trail

The following infographic highlights a key pain point in the healthcare referral system management process that despite healthcare providers adopting an EMR system, they are still utilizing paper.

A large percentage of processes in healthcare involve documents and forms that must be scanned and stored outside their existing EMR system such as records from referring physicians, patient consent forms, patient instructions, insurance authorization, etc.

Assessment

With so much paper still floating around, opportunities for HIPAA violations increase with as high as 86% of mistakes made in the healthcare industry stem from administrative activities.

Conclusion

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Is Federal Tax Reform Even Possible?

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More On the National Commission on Fiscal Responsibility and Reform

By Children’s Home Society of Florida Foundation

In 2010, the National Commission on Fiscal Responsibility and Reform considered possible options for reforming the income tax system. The bipartisan commission was co-chaired by former Senator Alan Simpson and former White House Chief of Staff Erskine Bowles.

Bowles-Simpson

The Bowles-Simpson tax solution involved a substantial reduction in the rates by limiting itemized deductions or converting them to tax credits.

In response to the Simpson-Bowles proposal and those from members of Congress and presidential candidates, the Senate Finance Committee leadership met with the Joint Committee on Taxation (JCT). Committee Chair Max Baucus (D-MT) and ranking member Orrin Hatch (R-UT) requested a study by JCT of various tax reform options.

The JCT experiment discussed options if various tax expenditures were repealed. Based on the JCT analysis, there was only a small reduction in rates possible. However, other commentators noted that the JCT study did not consider all of the base-broadening strategies.

In response to the JCT study, Simpson and Bowles issued a joint statement and noted, “Nothing in the JCT analysis changes our belief that it is possible for tax reform to reduce rates and produce additional revenues if policy makers are willing to make the tough choices to eliminate or scale back tax expenditures.”

The Simpson-Bowles proposal showed a potential to reduce rates to 8%, 14% and 23% if there is a drastic reduction in other tax expenditures. The nonpartisan Committee for a Responsible Federal Budget (CRFB) also responded to the JCT study.

The Committee for a Responsible Federal Budget Responds

The CRFB analysis indicated that the Simpson-Bowles commission strategy could work if there is partial or total elimination of tax expenditures. Another CRFB analysis also indicated that there was a 2005 Treasury study by the President’s Advisory Panel on Tax Reform that claimed a combination of base-broadening and rate reduction is possible.

Assessment

CRFB staff noted, “Although these two analyses differ in some respect, both show that the full elimination of all tax expenditures would allow the top tax rate to fall to 23% while still putting aside more than $1 trillion for deficit reduction.”

Editor’s Note: Your editor and this organization take no specific position on these tax reform strategies. The proposed major rate reduction plans all require significant limits on itemized deductions. Most strategies also tax capital gains at 28%. These changes will be difficult to pass during the major tax reform expected in 2013.

Conclusion

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

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October is Financial Planning Month

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We Don’t Plan to Fail – But We Often Fail to Plan

Assessment

Doctors – Do not let this happen to you:

Link: http://www.msn.com/en-us/news/national/business-icons-who-went-broke/ss-BBa4MR9

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Remembering “Black Monday” 1987

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The 1987 Stock-Market Crash by the Numbers

The worst one-day crash in stock trading took place 25 years ago on October 19th 1987. So, here’s a look back at Black Monday, on its quarter-century anniversary.

Link: http://www.financial-planning.com/gallery/fp/Crash-of-87-by-the-numbers-2681426-1.html?ET=financialplanning:e11960:86235a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=fp_alert_101912

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Doctors’ Use of For-Profit Algorithms Considered UnSportsManLike Conduct

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On Protecting Medical Coding Jobs

By Darrell K. Pruitt DDS

The US government moves quickly to protect tedious upcoding jobs from being taken over by upcoding software.

Medical Billing and Coding for Dummies

In coding expert Karen Smiley’s July 2012 book, “Medical Billing and Coding for Dummies,” she writes: “It really does pay to be a certified medical biller/coder, no matter what designation you choose to pursue. Surveys conducted by the AAPC [American Academy of Professional Coders] indicate that coder salaries have continued to increase despite economic downturns. One possible reason for this is that getting payers to pay claims is becoming increasingly difficult.”

Call me cynical, but to me, her defense of the coding profession confirms that healthcare’s increasing demand for highly-paid coders (who have nothing to do with directly providing care to patients) is artificial, and originates with an administration which complicates providers’ payments in order to create new, high-paying jobs in the HIT industry – quietly adding to the cost of healthcare to cosmetically boost employment figures before an election. Who ultimately pays the bill for all non-productive healthcare costs?

Amazon Morphs

Less than 3 months following the appearance of “Medical Billing and Coding for Dummies” on Amazon for under $25 (paperback), EMR software suddenly changed or morphed the entire game, and the administration reacts by changing the rules to protect political investments.

Similar to algorithmic trading’s proven advantage over low-tech investors on Wall Street, the computation capabilities of modern EMRs allegedly provide an unfair advantage to doctors and hospitals, and at taxpayers’ expense – according to HHS and Justice Department officials.

Enter Eric Holder and Kathleen Sebelius

“On Monday [September 24], Attorney General Eric Holder and HHS Secretary Kathleen Sebelius sent a strongly worded letter warning that the Obama administration will not tolerate hospitals’ attempts to ‘game the system’ by using EHR systems to boost Medicare and Medicaid payments.” – iHealthBeat, September 26, 2012.

http://www.ihealthbeat.org/articles/2012/9/26/stakeholders-react-to-warning-on-use-of-ehrs-for-upcoding.aspx#ixzz29fYzjPUH

This was followed by an article posted yesterday, also on iHealthBeat titled, “Mostashari To Launch Review of Using EHRs for ‘Upcoding,’”

http://www.ihealthbeat.org/articles/2012/10/17/mostashari-to-launch-review-of-using-ehrs-for-upcoding.aspx#ixzz29fDElIKL

Enter the NCHIT

“National Coordinator for Health IT Farzad Mostashari MD plans to launch an internal review to determine whether electronic health record systems are prompting some health care providers to overbill Medicare by selecting higher-paying treatment codes, a process known as ‘upcoding,’ the Center for Public Integrity reports.”

Apparently, it only recently occurred to lawmakers that the EMRs they promote greatly simplify Medicare’s intentionally tedious and time-consuming reimbursement requirements mentioned by Karen Smiley – making profits much easier for providers without having to hire even more staff just to get paid for work done long ago. In addition, the alleged upcoding software threatens to eliminate the need for recently-graduated coding professionals – whose education was backed by ARRA stimulus (taxpayer) money. While our nation’s leaders might wink at institutional investors’ highly-profitable algorithmic trading on the stock market, unemployed coding specialists with outstanding college loans would only increase the potential embarrassment for the administration should doctors and hospitals be permitted to computerize billing decisions – leading to payment for services previously given away because they weren’t worth the hassle and expense of documentation!

Assessment

Unlike investors playing the stock market, according to Medicare’s emerging rules, doctors’ use of algorithms to increase profits is considered unsportsmanlike conduct. With the election only days away, can you blame them?

Conclusion

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Physician Advisors: www.CertifiedMedicalPlanner.org

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Seven Goals for Healthcare Disruption

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What’s possible with healthcare and how it might be achieved?

The following infographic created by IOM highlights that despite recent advances in healthcare as the system continues to fall short of its potential.

So, what’s possible for healthcare?

Assessment

These 7 disruptive goals and how they might be achieved by adopting practices that are currently in use in by other industries include:

  1. Use Information Technology More Effectively
  2. Create Systems to Manage Complexity
  3. Make Health Care Safer
  4. Improve Transparency
  5. Promote Teamwork & Communication
  6. Partner With Patients
  7. Decrease Waste & Increase Efficiency

Conclusion

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Practice Management: http://www.springerpub.com/product/9780826105752

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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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How Much Will a Ticket Raise Your Car Insurance Rates?

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GMAC Survey Results

Be careful out there! A GMAC survey revealed that 1 in 5 drivers would not pass the written driver’s test if they took it today.

And, getting a ticket will raise your car insurance rate, but by how much?

Reckless Driving

We found that reckless driving triggers the highest hike — an average increase of 22 percent — yet many drivers aren’t even sure what constitutes reckless driving? Depending on state laws, reckless driving can be defined as: driving over 80 mph, driving too fast for weather conditions, knowingly driving in a way that endangers others.

Assessment

Above, we present 14 common traffic violations, along with the average percent increase to car insurance premiums.

Brought to you by: www.insurance.com

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

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Important Notice from the Office of the National Coordinator for Health Information Technology‏

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On behalf of the Office of the National Coordinator for Health IT

By JJ Minder joseph.minder@ketchum.com

Hello ME-P,

As I’m sure you’re aware, the Office of the National Coordinator for Health Information Technology (ONC) launched its brand new website HealthIT.gov last August. The website is designed to be the leading national resource on health information technology (health IT).

Link Update Notice

We see that the Medical Executive Post website currently links to ONC’s old policy site HealthIT.hhs.gov from the post titled: “Asking Uncle Sam…Why Health IT.”

Content currently on the HealthIT.hhs.gov site will be removed and merged to the new site by November 1st, 2012. We wanted to give you prior notice so you will be able to replace this link with a link to our new site HealthIT.gov

Assessment

We really appreciate you changing the link address to HealthIT.gov.

Please feel free to contact me at joseph.minder@ketchum.com if you have any questions or comments.

Best,

JJ Minder [Ketchum PR]

Contractor to the Office of the National Coordinator for Health IT (ONC)

(202) 835-9461

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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

Conclusion

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

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Why the USA Must Address Rising Healthcare Costs Now!

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Spending expected to increase from 25 to 40 percent by 2037

[By Staff Reporters]

Rising healthcare costs is exploding with the cost of healthcare currently outpacing inflation with federal health spending expecting to increase from 25 percent to 40 percent by 2037 equivalent to 25 percent of the American economy. With the country still in a recession and all the changes in healthcare reform has brought the issue as one of the hot topics for the fall’s presidential election.

Key Drivers of Rising Healthcare Costs

Hospital care and physician/clinical services combined account for half (51%) of the nation’s health expenditures sparking debates on how healthcare spending can be controlled. Some of the key drivers of rising healthcare costs are:

  • Prescription Drugs/Technology – Pharma is usually the biggest culprit associated with rising healthcare costs; however, medical technology has also been cited as a driver to an increase in overall healthcare spending. Cutting edge technology and drugs can fuel healthcare costs due to development costs and services.
  • Rise in Chronic Diseases – Baby boomers getting older, longer life spans, and the epidemic rates of obesity create an expensive dilemma for the healthcare system. Efforts have increased with the adoption of accountable care and healthcare technology to provide tools for chronic disease management while lowering costs.
  • Administrative Costs – 7% of health care expenditures are estimated to go toward for the administrative costs of government health care programs and the net cost of private insurance (e.g. administrative costs, reserves, taxes, profits/losses).

The Infographic

  • The below infographic, created by The Center for American Progress and featured by Compliance and Safety provides a snapshot of the current state of the American healthcare system
  • This infographic outlines several important statistics relevent to the healthcare spending debate including:
  • The U.S spends 2.5x more on healthcare per capita than other wealthy countries, but yet scores far below these same countries in average life expectancy.
  • The growth rate of healthcare spending far exceeds the growth of our national economy and wages
  • On average, current healthcare premiums cost the American family 16% of their gross income.

A Few Queries to Consider

  • How will ACA affect healthcare spending?
  • Can the adoption of Health IT (e.g. chronic disease management tools, patient remote monitoring, mobile health, and others) improve quality of care without increasing healthcare spending?
  • What role should individual states play in controlling costs?
  • How do we effectively address the low income families?

Assessment

This Infographic highlighted the rising healthcare costs and what could be bought with the $2.8 trillion dollars that Americans spend on healthcare yearly.

Related Links

References:

  1. Congress of the United States, Congressional Budget Office;Technological Change and the Growth of Health Care Spending, January 2008.
  2. Centers for Disease Control and Prevention. Rising Health Care Costs Are Unsustainable. April 2011.
  3. Recent opinions/ reports have focused on the viability of a single-payer system in the U.S. W.C. Hsiao’s article “State-based single-payer health care- as solution for the United States?” explores potential adoption among states, and R. Feldman explores unregulated markets vs. single-payer systems in “Quality of care in single-payer and multipayer health systems.”
  4. Martin A.B. et al., “Growth In US Health Spending Remained Slow in 2010; Health Share of Gross Domestic Product Was Unchanged from 2009,” Health Affairs, 2012.
  5. http://www.kaiseredu.org/Issue-Modules/US-Health-Care-Costs/Background-Brief.aspx#footnote8

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Pre-2014 Medicaid Expansion for the PP-ACA

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States Acceptance – Cost and Savings Factors

Link: http://www.healthcarefinancenews.com/infographic/infographic-factors-consider-medicaid-expansion

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The Potential for Major Tax Reform in 2013

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Romney and Schumer Talk Taxes

By Children’s Home Society of Florida Foundation

Members of both parties made speeches on this past October 9th that focused attention on taxes. While there undoubtedly will be discussion of tax provisions in the upcoming November congressional session, the focus of the two speeches this week by Presidential Nominee Mitt Romney and Sen. Chuck Schumer (D-NY) was potential major tax reform in 2013.

Mitt Romney’s Tax Plan

Mr. Romney explained his principal proposal on taxes to reduce the top rate from 35% to 28%. Because the goal is for the plan to be “tax neutral,” the total revenue to be raised should not change from the current amount. The Romney proposal intends to limit itemized deductions to produce a lower top rate and maintain the existing level of tax revenue.

The major itemized deductions are for state and local taxes, home mortgage interest, health insurance and charitable giving. Mr. Romney suggested that a cap of $17,000 on itemized deductions could be one acceptable option.

On a national media news program, Romney was asked whether he would consider reducing the charitable deduction and the home mortgage deduction. He stated, “I can tell you, with regards to the deductions you described – home mortgage interest deduction and charitable contributions – there will, of course, continue to be preferences for those types of expenses.”

In subsequent discussions with news media, aides to the Romney campaign indicated that the cap on deductions could be negotiated to a higher level such as $25,000 or $50,000. All of the final provisions of a tax bill would be subject to negotiation with both parties in Congress.

Romney campaign aides also mentioned other potential options. There could be a percentage cap on itemized deductions similar to the percentage limits for charitable deductions. Another option would be a conversion of some of the itemized deductions to credits.

During the Vice-Presidential debate on October 11, nominee Paul Ryan (R-WI) stated that the tax rate reduction from 35% to 28% could be accomplished without increasing middle-class taxes. He stated that the current levels of taxes paid by upper-income and middle-income Americans could be retained. Vice President Joseph Biden did not agree with this statement and suggested that the current progressivity of the tax system would suffer under the Romney proposal.

Senator Schumer’s Tax Plan

Senator Chuck Schumer (D-NY) spoke on October 9 and discussed in detail both personal and corporate tax reform.

Schumer stated that the tax reform would be quite different from the last comprehensive tax bill in 1986. That bill was negotiated by House Ways and Means Chair Dan Rostenkowski (D-IL), Speaker of the House Tip O’Neill (D-MA) and President Ronald Reagan. Schumer noted, “Our needs today are different compared to 1986, and we cannot take the same approach we did then.”

He observed that the 1986 bill was revenue neutral. However, because the current national debt is “approximately 73% of GDP” and approximately double the debt level of 1986, Schumer indicated that any tax reform must also lead to higher revenues.

Three Legs

The Schumer plan would start with corporate tax reform. This would be revenue neutral. The rate would be reduced from the current 35% by limiting depreciation and other corporate deductions. A lower overall corporate rate is essential in competing with other nations. All other industrialized nations now have lower corporate rates than the United States. Schumer believes that a lower corporate rate will assist in job creation.

Schumer then discussed three options for personal income tax reform.

1. First, he reviewed the proposals such as a reduction to a 25% top rate accompanied by very limited itemized deductions. He noted that the Joint Economic Committee, a nonpartisan group that assists Congress, estimates that this plan would lead to a tax increase for many taxpayers. Couples with incomes over $100,000 would pay $2,681 in higher taxes.

2. Second, the Simpson-Bowles plan from the Bipartisan Debt Commission appointed by President Obama suggested reducing the top rate to 28% through changing many of the deductions to credits. This plan would also involve a tax increase for couples with incomes over $100,000 in the amount of $1,000.

3. Schumer then explored his third approach. He suggested that it is important to protect some tax expenditures, such as those for college education, retirement savings, mortgage interest, charitable deductions, and state and local tax deductions.

In order to protect these tax expenditures, Schumer proposed increasing the top rate to 39.6%. He points to a Congressional Research Service report that states tax cuts “do not appear correlated with economic growth.” If that report is correct, Schumer claims that increasing the rates on upper-income persons will not harm the economy.

A major part of the solution in the view of Schumer is to increase the tax rate on capital gains. A substantial portion of the benefit of the 15% rate on long term capital gains accrues to upper-income persons. Schumer indicates that the capital gain rate should not increase to 39.6%, but should be substantially above the present 15%.

In summary, the Schumer solution involves three elements:

  1. Reduce tax expenditures by limiting itemized deductions.
  2. Increase the top rate to the 39.6% that existed under President Clinton.
  3. Increase the long term capital gain tax rate.

Schumer suggests that a “grand bargain” is possible between the two parties. It would include the higher taxes suggested under his plan together with the entitlement reforms that have been proposed by the other party.

Editor’s Note: Your editor and this organization take no position on the Romney and Schumer tax proposals. It is now probable that there will be a major effort towards tax reform in 2013. While there will be discussion of taxes during the November session, the majority of tax changes are likely to be passed by Congress in 2013.

Conclusion

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

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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Vinod Khosla’s Controversial Thoughts on Health Innovation Video [Exit the Doctors]

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Will technology replace doctors?

[By ME-P Staff Reporters]

Here is a video encore presentation of Silicon Valley investor Vinod Khosla‘s controversial interview with Thomas Goetz from last month’s Health Innovation Summit where he likens modern healthcare to witchcraft and says technology will replace 80% of doctors.

Video link: http://www.hitconsultant.net/2012/09/15/vinod-khosla-thoughts-health-innovation/

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.

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

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The High Cost of HIPAA Violations

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A Review of Serious Penalties

The Health Insurance Portability and Accountability Act (HIPAA) was instituted in order to protect the personal health information held by covered entities, including doctors, pharmacies and health insurance companies.

The Violations

A HIPAA violation can cost an individual or entity millions of dollars in fines and can even land those responsible in prison.

Assessment

In this HIPAA infographic, we detail some of the most serious penalties ever dished out by the federal government and break down the various fines that are on the table for noncompliance.

Conclusion

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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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Who Won the Vice Presidential Debate [Opinion Poll]?

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A ME-P Voting and Opinion Poll

Who Won the Vice Presidential Debate Last Night?

Assessment

The pressure is on: http://firstread.nbcnews.com/_news/2012/10/10/14340705-first-thoughts-the-pressure-is-on?lite&gt1=43001

Conclusion

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

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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How Hospital Billing Impacts the Patient Experience

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It’s About … the Invoice

By Staff Reporters

Here, Connance visually shows how hospital billing process is directly correlated to the patient experience.

Assessment

Patients who encounter problems with their physician’s billing office are less likely to recommend that physician/clinician to others.

www.BusinessofMedicalPractice.com

Conclusion

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How Physicians Can Make the Patient Experience a Priority

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Connection Makes the Difference – A Collaborative Shift in Bedside Manner?

Healthcare 2.0 is all about connecting. Take your pick: you can communicate via blogs, tweets, IMs, wikis, or social networks. And then, of course, you can opt for just plain old face-to-face dialogue.

The Communication Explosion

According to ME-P experts and Business of Medical Practice textbook contributors Mario Moussa PhD and Jennifer Tomasik MA, on the face of it, the explosion of communication options seems like a very good thing indeed.

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In the most basic ways, human beings need connection. Without the give and take of social interaction, our health suffers. In extreme situations—in solitary confinement or similar conditions—the brain almost completely shuts down.

What We Can Learn from Terry Anderson

The journalist Terry Anderson was held hostage in Lebanon from 1985 to 1992, enduring months at a time of almost complete isolation. In his memoir Den of Lions, Anderson described the catastrophic result: “The mind is a blank…. Where are all the things I learned, the books I read, the poems I memorized? There’s nothing there, just a formless, gray-black misery. My mind’s gone dead.”

The Link Between Social Connection and Good Health

On the positive side, studies have established a link between social connection and good health. (Even contact with people you dislike is better than having no contact at all). The same goes for the relationship between doctor and patient: data show that when the relationship is satisfying, it has tangible health benefits.

For example, when patients have a positive emotional connection with their doctors, they remember a higher percentage of care-related information and even experience significantly better physiological outcomes.

The Conversation

And the way doctors converse with patients—apart from the actual content of the conversations—has an equally powerful effect:

Do you want your patient’s nagging headaches to go away?

Discuss their expectations and feelings, in addition to the neurological facts. This is much more effective than sticking to the facts alone, since a strong psychological bond is strong medicine.

Do you want your medical advice to be followed?

Draw your patient into conversations about treatment. The research shows that engagement makes a difference.

Assessment

Is there an analogy here for financial advisors and medical management consultants?

Conclusion

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A Review of Social Security Benefits

A Bird in Hand May Not Give Maximum Benefits

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By Rick Kahler MS CFP® ChFC CCIM

“A bird in the hand is worth two in the bush.”

That may be good advice for pheasant hunters, but it isn’t necessarily great financial advice for trying to decide when to file for Social Security benefits.

A Social Security Review in [Very] Brief

Social Security pays your full benefit amount at your full retirement age (FRA). Depending on your birth year, this is around age 65 to 67. You can choose to take a lesser amount beginning at age 62 or wait until age 70 and receive a greater amount.

Many people want to grab that bird in the hand by filing at age 62. The most common reason I hear for this choice is, “Why should I wait till age 66 or 70 to collect benefits? I might not even be around by then. There are no guarantees about how long I’ll live.”

Obviously, knowing when we can expect to die would be really helpful in making Social Security decisions. If you are going to leave the planet at age 70, you would be ahead to start receiving your Social Security benefit at age 62. For every year you will live past 62, however, the odds increase that delaying your benefit to the FRA or even age 70 is the wiser financial decision.

Are You Terminal?

Unless you have a terminal illness, you will most likely be better off to wait until age 70 to begin receiving your benefits. Here’s why:

  1. First, if you are still working between age 62 and your FRA, any earnings above the $14,160 limit will reduce your Social Security benefit by one dollar for every two dollars earned.
  2. Second, the average monthly check you receive by waiting till age 70 is 66% more than what you receive at age 62. If your benefit at full retirement age is $1,000, at age 62 it is around $750, but if you wait until age 70 it is probably closer to $1,250. On average, if you will live 15 to 20 years past age 62 you are ahead to wait until 70 to start receiving your benefits. And if you are alive at age 62 and don’t have a terminal illness, the odds are that you will live another 15 years.

Of course, Social Security benefits are also indexed to inflation. This advantage is much greater than it might appear. For example, if inflation averages 3.5% a year, your benefit check will double in 20 years. If your initial monthly benefit at age 66 is $1,000, by the time you’re 86 it will have doubled to $2,000.

And … Another Reason!

Financial planner and writer Michael Kitces has pointed out another reason to delay receiving Social Security benefits. The risks and rewards of delaying benefits are not equal when you consider the break-even point. This is the age, typically 77, when your total benefit from filing at age 62 equals your total benefit from filing at age 70. He says, “While the risks of delaying benefits and dying early are limited, the upside is potentially far greater.”

If you give up one year of early benefits, you risk losing that amount only if you don’t live to age 77. But you receive double that one year of benefits if you live to age 83, and you triple it if you live to 89. “The penalty for not living to life expectancy is modest, while the benefit for outliving life expectancy is tremendous,” Kitces says.

Assessment

It’s important to look at all the numbers, including your own probable life expectancy, before  you decide to file at age 62. If you settle too easily for that bird in the hand, it may turn out to be a turkey.

Conclusion

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On Financial Institutional Fraud

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About Accounting Fraud

Definition: Any act or attempt to falsify an accounting statement for financial gain.

A clear example of accounting fraud is the act of deliberately overpricing a company’s assets in order to drive up its share price.

Another example is filing bankruptcy to avoid debt, rather than because of financial hardship.

One of the biggest accounting frauds in history occurred during the Enron scandal in 2001.

Conclusion

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Who Won the First Presidential Debate?

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Mitt or Barack? A Voting and ME-P Opinion Poll

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Can Nanotechnology Re-Engineer Us?

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Human versus Enhanced Human

From: http://www.Keithley.com

Assesment

Linkhttp://www.keithley.com/knowledgecenter/How-Nanotechnology-Could-Reengineer-Us

Conclusion

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Is Walking Away from A Mortgage Ever OK?

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One Doctor Asks the ME-P

The scourge of foreclosures has brought a lot of moral issues to light. So, Dr. Jones from Las Vegas asks, is it OK to simply stop paying your mortgage?

The answer you get depends on who you ask and what the circumstances are. If you’ve never thought much about this question, you may soon. There are so many mortgages going into foreclosure that it may soon happen to you or someone you know. And even those who don’t go through foreclosure may still be vulnerable to terrible mortgage conditions.

How Bad Is the Foreclosure Rate?

The epidemic of foreclosures is worse than you would believe. Since 2005, there have been 2.5 million foreclosures. In July of 2010, the foreclosure rate went up 6 percent over the same month a year earlier.

Are You Underwater?

If you owe more on your house than your house is actually worth, you may feel like you’re underwater. With excess borrowing against equity and falling home prices, this situation has reached epidemic proportions. It isn’t just a few people in this situation or even a few million people. One quarter of all families are underwater, with negative equity in their own homes.

The states with the worst numbers of people underwater are Florida, Wisconsin, Nevada, California and Arizona. By far, the worst state for this situation is Nevada. In Nevada, 65 percent of borrowers owe more on their mortgage than their house is worth.

  • What should homeowners do in this situation?
  • Should they continue to pay?
  • Or, do you think they should they simply chuck it all and stop all payments?
  • Would you?

What Do People Think About Walking Away From a Mortgage?

If you have already formed an opinion about whether it’s OK to ditch a mortgage or not, you’re not alone in being opinionated. Everyone has an opinion on this, from renters to homeowners and from the young to the old.

In total, 25 percent of renters think it’s okay to walk away from a mortgage. Homeowners aren’t as hip to ditching, though. Among those who own homes, only 17 percent think it’s OK to stop paying.

Is It a Moral Issue?

Some homeowners believe that whether or not to pay is a moral issue. Their own ethics come into play, telling them that someone who signed a contract should see it through, regardless of how home prices have fallen. The mortgage industry loves that—they are really playing up the idea that paying is a moral obligation.

Assessment

What people believe about this issue often comes down to their age and gender.

To see what age groups and genders believe it’s OK to walk away, review the above graphic. And, men and women aren’t as far apart on this issue as you may think. Many people of both genders believe that if your financial circumstances are dire, it may be OK to ditch that mortgage. What about medical professionals? Do you agree with your peers? Click on the graphic to see.

Conclusion

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Presidential Debate Prep – Why Doctors Need to Understand Mitt Romney’s Tax Policy

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The 2012 Presidential Election

By Andrew D. Schwartz, CPA

The conventions have passed and the presidential debate season is upon us. And the 2012 Presidential Election is just a few months away. Let’s take a look at Mitt Romney’s tax policy based on information posted on his campaign’s official website www.mittromney.com.

Extend the Bush Tax Cuts:

If Congress doesn’t act by the end of the year, the 2001 Bush tax cuts will expire on December 31st causing tax rates across the board to increase. According to Mitt Romney:

While the entire tax code is in dire need of a fundamental overhaul, Mitt Romney believes in holding the line against increases in marginal tax rates. The goals that President Bush pursued in bringing rates down to their current level— to spur economic growth, encourage savings and investment, and help struggling Americans make ends meet—are just as important today as they were a decade ago. Letting them lapse, as President Obama promises to do in 2012, is a step in precisely the wrong direction. If anything, the lower rates established by President Bush should be regarded as a directional marker on the road to more fundamental reform.

Eliminate Taxes on Investment Income for People Earning Below $200k:

Romney’s Tax Policy includes a provision to cut taxes for taxpayers earning less than $200k. Let’s see what the Romney Campaign calls the Middle-Class Tax Savings Plan:

As with the marginal income tax rates, Mitt Romney will seek to make permanent the lower tax rates for investment income put in place by President Bush. Another step in the right direction would be a Middle-Class Tax Savings Plan that would enable most Americans to save more for retirement. As president, Romney will seek to eliminate taxation on capital gains, dividends, and interest for any taxpayer with an adjusted gross income of under $200,000, helping Americans to prepare for retirement and enjoy the freedom that accompanies financial security. This would encourage more Americans to save and to invest for the long-term, which would in turn free up capital for investment flowing back into the economy and helping to facilitate economic growth.

Implement Tax Simplification:

Promising tax simplification is nothing new. When I started practicing accounting in 1987, President Reagan had just signed the huge Tax Reform Act of 1986 into law. That Tax Act really complicated the tax code, and it has continued to become increasing more complex over the past 25 years. Remember Steve Forbes? He ran two presidential campaigns on his Flat Tax Platform.

Here is Romney’s spin on tax simplification:

In the long run, Mitt Romney will pursue a conservative overhaul of the tax system that includes lower and flatter rates on a broader tax base. The approach taken by the Bowles-Simpson Commission is a good starting point for the discussion. The goal should be a simpler, more efficient, user-friendly, and less onerous tax system. Every American would be readily able to ascertain what they owed and why they owed it, and many forms of unproductive tax gamesmanship would be brought to an end. Conversely, tax reform should not be used as an under-the-radar means of raising taxes. Where reforms that simplify the code or encourage growth have the effect of increasing the tax burden, they should be offset by reductions in marginal rates. Washington’s problem is not too little revenue, but rather too much spending.

Mitt Romney also wants to eliminate the Death Tax and repeal the Alternative Minimum Tax. You can read Mitt Romney’s complete Tax Policy atwww.mittromney.com/sites/default/files/shared/TaxPolicy.pdf

President Obama’s Rebuttal:

There actually isn’t very much information about Obama’s tax policy on his campaign’s official website. Check out The President’s Record on Taxes available at: www.barackobama.com/record/taxes?source=issues-nav and all you will find is mention of the Buffett rule and these four bullet points:

  • President Obama has cut taxes for middle-class families and small businesses. One of the first things he did in office was cut taxes for 95 percent of working families. He has also signed 18 tax cuts for small businesses and extended the payroll tax cut for all American workers and their families, putting an extra $1,000 in the typical middle-class family’s pocket.
  • For too long, the U.S. tax code has benefited the wealthy and well-connected at the expense of the vast majority of Americans. A third of the 400 highest income taxpayers paid an average rate of 15 percent or less in 2008.
  • That’s why President Obama proposed the Buffett Rule, asking millionaires and billionaires to do their fair share. But if you’re one of the 98 percent of American families who make under $250,000 a year, your taxes won’t go up.
  • The President has asked Congress to take action to reform our tax code and close tax loopholes for millionaires and billionaires, as well as hedge fund managers, private jet owners, and oil companies.

President Obama’s official campaign site also includes a link to a report that pokes holes in the Romney Tax Policy, available at:www.taxpolicycenter.org/UploadedPDF/1001628-Base-Broadening-Tax-Reform.pdf.

Which Candidate’s Tax Policy Makes the Most Sense?

Tough question. What makes it tougher is that the President doesn’t write the laws. Instead, the President’s job is to sign bills that have been passed by Congress into law. Even so, having an understanding of the tax philosophy of the country’s two presidential candidates is probably a prudent idea.

Assessment

As an interesting exercise, check out President Obama’s views on taxes from the prior election cycle in our article called What’s The Tax Plan, Man? included in ourOctober 2008 Newsletter, and compare his suggestions from 2008 to what’s been enacted during his first term. A few of the items that he proposed during his previous campaign, including raising the Social Security taxes on people earning more than $250k and implementing a “Make Work Pay” tax credit, have come to fruition during his first term in office.

Conclusion

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Gold as an Investment Option for Medical Professionals?

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Gold in That There IRA

By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com

Here in the Black Hills, home of the historic Homestake Mine, we know a gold rush when we see one. The last few years have tempted investors to take part in a modern gold rush. The precious metal is thought of as a safe harbor for investment capital during times of economic and political unrest and chaos.

Holding Gold

There are many ways to own gold, including holding an interest in it via a financial medium like a mutual fund or an Exchange Traded Fund (ETF). Those who want gold as protection against political or economic turmoil, though, probably are thinking of owning physical gold.

Since Americans’ savings and investing rates are so low, most folks don’t have any extra funds to put into gold. Their only investment vehicle may be an IRA. Yet IRAs are specifically excluded from owning collectibles, metals, and coins.

There are exceptions, however: U.S. gold coins minted by the U.S. Treasury, or bullion bars or coins of a fineness of 995 parts per 1,000. Several non-U.S. minted gold coins meet that standard. The key here is that the coins or bars must be in the physical possession of a qualified trustee. That means gold you stash in a safe or bury in the back yard does not qualify.

Most banks, brokerage firms, or mutual fund companies are not interested in holding physical gold, so finding a qualified trustee can be difficult. You must do a reasonable amount of due diligence to be sure the trustee you find is really trustworthy.

The Trustee 

A trustee needs to arrange for the shipping, handling, and storage of your gold. For this reason, you will certainly pay much higher fees than you would for normal stock, bond, and cash investments. The fees can amount to hundreds or thousands of dollars annually.

Even if you are willing to pay the high fees, first ask yourself, “What’s the point?” The reason most folks want to own physical gold or silver is to have “real” money available in case of an economic crisis or political uprising. How does owning physical gold in an unknown location that may be thousands of miles from you fulfill that requirement? Wouldn’t owning an ETF like GLD actually accomplish the same thing, only without the high costs? Yes, it would.

If you want to own gold, my strong suggestion is to own the GLD ETF and avoid all the high fees. The total cost of purchasing GLD is probably about $10.

Other Options 

Other options are mutual funds that purchase gold mining stocks, which is probably a better way to participate in the gold market. This is because of the leverage factor. In a rising market, the cost of mining gold is much lower relative to the market value of the gold. So if a mining company pays $1,000 to mine an ounce of gold and can sell it for $1,500, the company—and you, as an owner of its stock—make $500 per ounce. Gold could stay at that same price for a year and your company would continue to make a 33% gross profit.

However, if you owned the physical gold and it stayed at the same price for a year, your profit would be 0%. You would only make that same $500 profit if the gold appreciated from $1,500 to $2,000 an ounce.

Assessment 

Of course, the reverse is also true. If gold turns downward, you will stand to lose much more owning the mining company than the physical gold. That’s why I recommend owning gold, like any other asset, only as part of a diversified portfolio of investments.

Conclusion

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Top 20 Most Popular eMRs

A Review of Some Software Solutions

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As the deadline for implementation in the US draws near, talk of electronic medical records (EMR) and electronic health records (EHR) software is a hot topic at the doctor’s office lately.

These systems assist medical practitioners in the creation, storage, and organization of electronic medical records, including patient charts, electronic prescriptions, lab orders, and evaluations (just to name a few common features).

While the terms “EMR” and “EHR” are often used interchangeably, EMR solutions allow for patient information to be shared within one health care organization, whereas EHR solutions allow for health-related records to be shared across multiple organizations.

Assessment

Above is a look at some of the most popular options in both categories, but to see a comprehensive list, visit the EMR Software Directory.

Conclusion

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Events-Planner: October 2012

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Events-Planner: OCTOBER 2012

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

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 175,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily. And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention.

So, enjoy the Medical Executive-Post and this monthly Events-Planner with our compliments.

A Look Ahead this Month – And now, the important dates:

  • October 01-03: FRA Sub-Advised Forum. Philadelphia, PA
  • October 02-04: SRI Annual Conference. Uncasville, CT
  • October 16-19: CHIME Forum. Indian Wells, CA
  • October 21-24: MGMA Annual Conference. San Antonio, TX
  • October 23-23: SIFMA Annual Conference. New York, NY

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