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    As a Distinguished University Professor and Endowed Department Chairman, Dr. David Edward Marcinko MBBS DPM MBA MEd BSc CMP® was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.

    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; Oglethorpe University and Atlanta Hospital & Medical Center in GA; and Aachen City University Hospital, Koln-Germany. He is one of the most innovative global thought leaders in health care entrepreneurship today.

    Professor Marcinko was a board certified physician, surgical fellow, hospital medical staff Vice President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010, by PM magazine. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics and trade publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

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Understanding the Impact of Regulations, Laws, and Healthcare Reform

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Consequences of the Accountable Care Act [PP-ACA]

By Dr. David Edward Marcinko MBA CMP


Dr David E Marcinko MBAThere is a fair amount of activity that will take place in the next 24 months in response to ICD-10 transition, healthcare reform, Accountable Care Act (ACA), meaningful use compliance and its financial incentives, and other regulatory issues that will require system or software upgrades to support the new efforts.

Some ACA Examples

As an example, The Affordable Care Act is sure to significantly alter reimbursement structures and delivery of care.

Below are several areas that will be affected:

  •  With the projected increase in patient volumes, the associated cost of about 62% will emanate from Medicare cuts: $162 Billion through reducing fee-for-service Medicare payments; $136 Billion from setting Medicare Advantage rates based on Fee-for-Service payments; and $36 Billion from cutting hospital Medicare/Medicaid disproportionate share.
  • Compliance reviews will be increased through the Recovery Audit Contractors (RACs) where Centers for Medicare and Medicaid Services (CMS) expect to obtain $2.9 Billion in additional savings. With the RAC in place, hospitals and providers need to increase their focus and attention in improving documentation quality and validating medical necessity to substantiate their reviews.
  • Reduced payments for readmissions and Medicare penalties for poor outcomes can and will affect the bottom line for both hospitals and providers in the future.
  • By 2015, more than 19 million uninsured will receive coverage and in 2016, another 11 Million uninsured will be insured.  This will create more patients per hospital/provider and will require more full-time equivalents to support the revenue cycle process of registration, documentation, billing and collection.
  • With the ICD-10 conversion will create a more complex requirement for documenting diagnoses and will require software modifications for hospitals and providers as well as significant training.


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2 Responses

  1. How much is the ObamaCare penalty?

    Starting in 2014, if you do not have health coverage, you will be penalized when you file your tax return the following year.

    For an individual, the fee is a minimum of $95, or 1 percent of adjusted income — whichever is greater. For a family, the minimum penalty can’t be more than $285 — but it can go as high as 1 percent of adjusted family income.

    Within two years, there’s quite a jump. In 2016, the penalty is $695 for every adult, and the minimum penalty for a family is capped at $2,085.

    However, it can be as high as 2.5 percent of the family income — whichever is greater.

    Dr. David Edward Marcinko MBA CMP™



  2. Healthcare Additions in Budget Law Pleasantly Surprise Providers

    Congress’ long-awaited budget deal, passed before dawn last Friday, serves as the most significant piece of healthcare legislation since President Donald Trump took office. The extensive healthcare package, hammered out largely behind closed doors in the Senate, in many ways took Washington by surprise.

    Among its provisions were an extra four years of funding for the Children’s Health Insurance Program, a repeal of the Affordable Care Act’s Independent Payment Advisory Board, and a provision to accelerate the closure of what’s known as the Medicare Part D “donut hole” for seniors.

    Source: Susannah Luthi, Modern Healthcare [2/9/18]


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