
As a former Dean and appointed University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA 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; 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.
Professor David Marcinko was a board certified surgical fellow, hospital medical staff 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 drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].
Dr. David E. 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. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.
Later, Dr. Marcinko was a vital and recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.
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.
Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.
Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.


FINANCIAL STATEMENTS
This is a great essay by David Cummings. So, let’s now put a medical spin on the topic
Since a start-up medical practice has no historical financial information, simplified Pro Forma production logs, or statements, are forecasted for 2-3 years. They demonstrate the best care, worst case and most likely financial scenarios. Computerized spreadsheets are ideal for this task. Other relevant financial information may be included as needed.
Pro Forma (Production Log) Statement
A simple daily production log is shown below, with variance recordings. It may be used on a pro-forma estimated, or on-going concern, basis.
However, the more sophisticated Profit and Loss (P&L) Statement is a better measure of office performance than the log, for a given period of time
Pro Forma Net Income (Profit & Loss) Statement
By allocating a practice’s profit or loss into operating groups, the investor can isolate profitable revenue centers and isolate unprofitable costs drivers. These are then identified in the Net Income Statement (NIS). In certain managed care contracts, an analysis to identify unit or per dollar revenues, gross profits and/or gross margins, is vital. Certain non-cash expenses (i.e., depreciation, amortization and deferred taxes) are then deducted from revenues to determine overall net income.
Pro Forma Cash Flow Statement
The Statement of Cash Flow (SCF) is the lifeblood of any medical practice. It projects estimated cash flows by month, quarter and year, along with the anticipated timing of cash receipts and disbursements. The office’s bills and obligations are paid out of cash flow, not net income. It is very important for accrual based accounting practices; especially in terms of Medicare, Medicaid, MCOs, PPOs and HMOs producing insurance payment time delays and other aged accounting methodologies. Cash flow reflects the internal generation of fund available to investors.
Pro Forma Retained Earnings Statement
The Statement of Retained Earnings explains the changes in a practice’s retained earnings over the reporting period.
Pro Forma Balance Sheet
The Balance Sheet (BS) forecasts the financial condition of an office at a singular point in time. It projects the ability to meet financial obligation and the capacity to absorb financial setbacks without becoming insolvent.
Finally, there are other miscellaneous considerations when estimating financial statements. For example:
• Business and service revenues may be seasonal in some areas of the country.
• What percentages of revenues come from: Medicare, Medicaid, MCOs, HMOs, PPOs or traditional indemnity insurance plans?
• What are the revenue and cost positions relative to peers? The industry?
• What are the potential costs and paid-up expenses possible in the future?
• What credit analysis is used to screen potential-private patients?
Dr. David Edward Marcinko MBA CMP™ MBBS [Hon]
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The fall of tech unicorns not imminent, despite claims to the contrary
Worldwide, more than 208 unicorns and 21 decacorns represent industries as varied as retail, health tech and enterprise technology infrastructure. Some 40 percent of the 80 new unicorns and one decacorn that sprang up in 2015 came from outside the United States, which shows that high-value startups now are more global.
http://venturebeat.com/2016/01/18/there-are-now-229-unicorn-startups-with-175b-in-funding-and-1-3b-valuation/
Dr. David Marcinko MBA via VentureBeat
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START-UPS
I do believe that start-up plans can succeed in the current market environment. Having said this, failures have been common. My favorite model for successful startups are new health plans serving Medicare Advantage members that are linked to health systems.
To be successful any health plan has to offer lower costs, higher perceived value and overcome distribution barriers. MA plans linked to health systems offer the possibility of lower costs through integrated care, a “halo of quality” from the associated health system and, since the MA product is sold to the individual market, is intrinsically beyond the confines of the employer-based market.
Realizing success depends on excellence in execution. Effective execution requires either the rethinking of the health system’s business model, or at least a commitment that the health plan should maintain operating its integrity. That there have been many failures among health system sponsored plans indicates that this is easier said than done.
Douglas Sherlock CFA
[Senior Health Care Analyst]
Sherlock Company
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