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    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].

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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.

    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”.

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Request Medical School Administrators Question PHP Authority to Prevent Future Medical Profession Brain Drain

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[Pediatric] Physician Health Programs

Langan MD[By Michael Lawrence Langan MD]

Physician Health Programs (PHPs) are now targeting medical students and the stories I am hearing are heartbreaking.   Medical students who do not fit the diagnostic criteria for psychological probl…

 Request Medical School Administrators Question PHP Authority to Prevent Future Medical Profession Brain Drain

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Today happens only once!

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In the end … We are guaranteed nothing

By Michael P. Jones MD

To fret over the past and put things off on the future only squanders today.

Be kind to yourself. Be kind to others. Become the person that you always wanted to be.

Look around and find the good things because they are out there.

When I can do that, my days are full and rich and satisfying, and I feel like I help make the lives of people around me better, too.

And in the end, that’s all that matters.

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ABOUT

Michael P. Jones is a gastroenterologist.

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EtG – The Rosie Ruiz of Bent Science and Bad Medicine

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BAD Medicine … and that is NOT “Good”

Langan MD[By Michael Lawrence Langan MD]

The original pitch to the medical boards for Etg  was done by ex-felon Greg Skipper who is one of the Federation of State Physician Health Program (FSPHP) “impaired physician” architect…

EtG–The Rosie Ruiz of Bent Science and Bad Medicine

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10 Reasons Why People Should Not Fear Digital Health Technologies

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Fear NOT!

By  Bertalan Mesko, MD PhD 

10 Reasons Why People Should Not Fear Digital Health Technologies

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Conclusion

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HDS

HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET

      Product DetailsProduct DetailsProduct Details

 

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Gay Doctor Coerced by Physician Health Program (PHP) into mandated 12-step treatment and monitoring for sex addiction: The slippery slope begins

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Langan MD[By Michael Lawrence Langan MD]

State Physician Health Programs – coercion, control and abuse. This anecdote concerning  a gay doctor’s revelation he liked his non monogamous lifestyle leading  to a forced acceptance of a &#… …

 Gay Doctor coerced by Physician Health Program (PHP) into mandated 12-step treatment and monitoring for sex addiction: The slippery slope begins

Conclusion

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Massachusetts Governor Charlie Baker Moves to Control Professional Boards

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But has the Medical Board made a Counter Move?

Langan MD[By Michael Lawrence Langan MD]

Governor Baker’s recent move to control professional boards seemed a promising step and I provided detailed documentation to the Director of Constituent Services at the Office of the C…

Massachusetts Governor Charlie Baker Moves to Control Professional Boards (But has the Medical Board made a Countermove?) 

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An Open Letter to Senator Elizabeth Warren Regarding Laboratory Developed Tests, Physician Health Programs and Institutional Injustice

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Langan MD[By Michael Lawrence Langan MD]

I can think of nothing more institutionally unjust than an unregulated zero-tolerance monitoring program with no oversight using unregulated drug and alcohol testing of unknown validity.   But that…

An Open Letter to Senator Elizabeth Warren Regarding Laboratory Developed Tests, Physician Health Programs and Institutional Injustice

Conclusion

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R.I.P. Donald Henderson MD

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By David E. Marcinko MBBS DPM MBA

Donald Henderson, an American doctor and public health official who led the successful global drive to wipe out smallpox in the 1960s and ’70s, credited with saving tens of millions of lives, has died. He was 87.

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[Donald Henderson MD]

http://www.msn.com/en-us/health/medical/da-henderson-doctor-who-eradicated-smallpox-dies/ar-BBvSTZe?ocid=U348DHP

smallpox-vaccination-scar

[Vaccination Scar]

Johns Hopkins Vaccine Initiative

Dr. Henderson was founder of The Johns Hopkins Vaccine Initiative [JHVI] which promotes collaborative and interdisciplinary  vaccine research,  education, and implementation efforts to improve health worldwide.

Assessment

The JHVI is a Johns Hopkins Bloomberg School of Public Health affiliate in my home town of Baltimore, MD. 

Conclusion

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US State Healthcare Price Transparency Laws

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REPORT CARD: Healthcare Incentives Improvement 

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Salary Negotiation Skills for Doctors & Hospitalists

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As well as Nurses, Allied Healthcare Providers … and the Rest of Us

  • By Dr. David E. Marcinko MBA
  • By Dollars Direct

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Much More:

Physician 2.0 Recruitment

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Recent EHR News

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1-darrellpruitt

Recent EHR News

By Darrell K. Pruitt DDS

“Cerber ransomware decryption tool was available for 1 day before hackers rendered it useless – The authors of Cerber fixed the flaw in the ransomware’s code that made decryption possible.” By India Ashok for International Business Times, August 18, 2016.

http://www.ibtimes.co.uk/cerber-ransomware-decryption-tool-was-available-1-day-before-hackers-rendered-it-useless-1576662

“HIPAA Breach Case Results in Record $5.5 Million Penalty.” By Aldrin Brown for MSP Mentor, August 18, 2016.

http://mspmentor.net/msp-mentor/hipaa-breach-case-results-record-55-million-penalty

“HIT Costs Rose 40% Per Physician Since 2009.” By Christine Kern, contributing writer, Health IT Outcomes, August 19, 2016.

http://www.healthitoutcomes.com/doc/hit-costs-rose-per-physician-since-0001

Kern:  “Healthcare organizations are facing serious financial challenges as they are forced to convert their practices and patient records to digital formats.”

“Office for Civil Rights to Increase Investigations of Smaller HIPAA Breaches.” By National Law Review, August 19, 2016

http://www.natlawreview.com/article/office-civil-rights-to-increase-investigations-smaller-hipaa-breaches

NLR:  “HHS Office for Civil Rights will cast a wider net and increase its investigations into smaller HIPAA privacy breaches starting this month. OCR announced a new initiative to increase its efforts examining breaches that affect fewer than 500 individuals. OCR Regional Offices already investigate every reported breach affecting 500 or more individuals, and will continue to do so, but now they will intensify efforts to scrutinize smaller breaches.”

“2016 is the year to Go Paperless’ – Stop putting it off, going paperless can save you tens of thousands of dollars.” By Larry Emmott for Emmott on Technology, August 19, 2016.

http://emmottontechnology.com/

Conclusion

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On MACRA

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By ACR and AAN

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MACRA-the-Big-Idea

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MACRA

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Conclusion

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What is Fin-Tech?

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The Definition

cropped-dem

By Dr. David E. Marcinko MBA

Fintech is a portmanteau of financial technology that describes an emerging financial services sector in the 21st century.

Originally, the term applied to technology applied to the back-end of established consumer and trade financial institutions. Since the end of the first decade of the 21st century, the term has expanded to include any technological innovation in the financial sector, including innovations in financial literacy and education, retail banking, investment and even crypto-currencies like bitcoin.

BREAKING DOWN ‘Fintech’

The term financial technology can apply to any innovation in how people transact business, from the invention of money to double-entry bookkeeping. Since the internet revolution and the mobile internet revolution, however, financial technology has grown explosively, and fintech, which originally referred to computer technology applied to the back office of banks or trading firms, now describes a broad variety of technological interventions into personal and commercial finance.

Fintech’s Expanding Horizons

Already technological innovation has up-ended 20th century ways of trading and banking. The mobile-only stock trading app Robinhood charges no fees for trades, and peer-to-peer lending sites like Prosper and Lending Club promise to reduce rates by opening up competition for loans to broad market forces. Technologies being designed that should reach fruition by 2020 include mobile banking, mobile trading on commodities exchanges, digital wallets (like Apple (AAPL) and Google’s (GOOG) developing mobile wallet systems), financial advisory and robo-advisor sites like LearnVest and Betterment, and all-in-one money management tools like Mint and Level.

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New Tech in Fintech

In the olden days, individuals and institutions used the invisible hand of the market – represented by the signaling function of price – to make financial decisions. New technologies, like machine learning, predictive behavioral analytics and data-driven marketing, will take the guess work and hocus pocus out of financial decisions. “Learning” apps will not only learn the habits of users, often hidden to themselves, but will engage users in learning games to make their automatic, unconscious spending and saving decisions better. On the back end, improved data analytics will help institutional clients further refine their investment decisions and open new opportunities for financial innovation.

Fintech Users

Who uses fintech? There are four broad categories: 1) B2B for banks and 2) their business clients; and 3) B2C for small businesses and 4) consumers. Trends toward mobile banking, increased information, data and more accurate analytics and decentralization of access will create opportunities for all four groups to interact in heretofore unprecedented ways.

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:

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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CMS Reveals MACRA Rules

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A CMS … Proposal

[By Andy Salmen]

The Centers for Medicaid and Medicare Services (CMS) have finally released the much anticipated unveiling of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rule proposal.

The goal of this rule is to establish key parameters for the new Quality Payment Program, a framework that includes the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). These two paths for compliance allow doctors more flexibility in achieving compliance.

MIPS

MIPS scores clinicians based measures and activities chosen by physicians and is based on their specialty. MIPS would basically streamline and combine three of the different programs that currently exist under Medicare. These programs are Physician Quality Reporting System, the Value-Based Modifier Program, and the ‘Meaningful Use’ of electronic health records.

There will be four performance categories for clinicians (clinicians include physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, etc.) to be scored on. These performance categories are:

  • Quality
  • Advanced Care Information
  • Clinical Practice Improvement Activities
  • Cost

APMs

CMS proposed implementing an Advanced Payment Models (APM) pathway, allowing eligible clinicians to become “qualified participants”. This means that eligible clinicians will be able to earn statutorily specified incentives for participation.

CMS predicts most providers to initially opt for MIPS. It is expected that participation in APMs, both number of physicians and number of payment models, will grow over time, as this program will qualify clinicians for financial bonuses in exchange for taking the risks associated with providing “coordinated, high-quality care”, according to CMS. 

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Conclusion

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More on Long Term Care Insurance

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LTCI

By Rick Kahler MSFS CFP®

Rick Kahler MS CFP

Knowing how long you may live is an important variable to consider in putting together a successful retirement plan. Many online sites can give you a scientific estimate of your life expectancy; one that I recommend is livingto100.com. When I retook the evaluation recently, I was surprised that my life expectancy had increased from 93 to 98.

In an instant I related to one of the greatest fears of older Americans: outliving your sources of income.

The greatest financial risk for depleting retirement resources is an unexpected and lengthy stay in a long-term health care facility, like a nursing home or an assisted living center. Not surprisingly then, “What do you think about long term care insurance (LTCI)?” is one of the questions I often hear.

LTCI is a difficult product to analyze and recommend. It has existed in some form for 40 years, but the industry seems to exist in a continual state of disarray. Low interest rates, low lapse rates, and rising longevity have driven premiums high enough that sales of the insurance have declined 70% from their high in 2002.

The “Guarantee”

Exacerbating the problem is that most LTCI companies issued policies with “guaranteed” premiums.

According to a report by Michael Kitces at kitces.com, just a small variation in actuarial assumptions can have a significant impact on premiums. He says “it’s estimated that as little as a 1% change in interest rates correlates to a 15% required change in premiums to keep an LTC insurance policy actuarially sound. Having a 1% lapse rate instead of a 5% lapse rate can increase future claims for an insurer by as much as 50%.”

As a result, Kitces notes, LTCI providers have struggled to be profitable. In some cases, companies were unable to honor their original prices and had to request permission from state insurance departments to increase premiums on existing policies by as much as 85%. Premiums for new policies have gone even higher.

Simply stated, a guaranteed premium LTC policy needs to be priced high enough to provide a cushion against these variables or the company may be unable to regain profitability with rate increases later.

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One way of addressing this challenge is to eliminate any aspect of a “guaranteed” premium and make long-term care insurance premiums more flexible. One flexible premium policy envisions paying dividends similar to a participating life insurance policy issued by a mutual insurance company. Kitces notes, “To the extent that future claims (or the insurance company’s investment returns) turn out to be better than the original (conservative) projections, the ‘excess’ results will be returned to the policy owner in the form of either an “Insurance Credit” or an “Interest Credit”, to help reduce future premiums.” One such policy is currently priced 20 to 30% under traditionally priced policies with “guaranteed” premiums.

Naturally, there is no guarantee a flexible premium policy will end up costing less than the traditional polity with a guaranteed premium. Probably the biggest concern is the conflict of interest a shareholder-owned company will face in deliberately refunding any savings in the form of dividends to the policy holders. This conflict does not exist with a mutual insurance company, where the owners of the company are the policy holders.

Assessment

Still, the potential benefits look interesting enough that taking a hard look at a flexible premium LTCI policy makes sense. Long-term health care is one of the aspects of aging that most of us don’t want to think about but many of us will need. While LTCI is not for everyone, considering it is a worthwhile part of financial planning for retirement. 

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:

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Connecting Healthcare Fraud Schemes with Fraudsters

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And  … their Leaders

By http://www.MCOL.com

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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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 Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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VOTE ME-P: Health Activist Award Nominations from WEGO

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Give Back to Those Who Inspire You

Who are some of the outstanding Health Activists who enrich the lives of others by sharing their experience, knowledge and strength?

David and Hope

[Medical Executive-Post]

David E. Marcinko MBBS DPM FACFAS MBA MEd BSc CMP®

Nominate US for a WEGO Health Activist Award

VOTE HERE:

WEGO Health Activist Awards

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The Regulatory Capture of American Medicine by the Drug and Alcohol Testing, Assessment and Treatment Industry

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Regulatory Capture?

Langan MD

[By Michael Lawrence Langan MD]

Regulatory capture is a form of government failure that occurs when a regulatory agency created to act in the public interest, instead advances the commercial or political concerns of special interest groups that dominate the industry or sector it is charged with regulating and introduced in an article by George J. Stigler in 1971 entitled The Theory of Economic Regulation. The main idea of the article can be summarized in Stigler’s (1971: 3) affirmation that:

“…as a rule, regulation is acquired by the industry and is designed and operated primarily for its benefits.”

The Regulatory Capture of American Medicine by the Drug and Alcohol Testing, Assessment and Treatment Industry

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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:

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Are Paper MRs Safer than EMRs?

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Paper is Safer!

1-darrellpruitt[By Darrell K. Puitt DDS]

“Ransomware Attacks Can’t Hide from HIPAA Anymore – Hospital and health system executives are on notice: Come clean about ransomware attacks as early as possible or be prepared to face sanctions.”

By Scott Mace, for HealthLeaders Media, July 19, 2016.

http://www.healthleadersmedia.com/technology/ransomware-attacks-cant-hide-hipaa-anymore#

Dean Sittig, a clinical informatics professor at University of Texas Health Science Center and the Houston UT-Memorial Hermann Center for Health Care Quality and Safety, tells HealthLeaders,

The new HHS guidance is going to really ratchet up people’s attention, because now you’re also talking about big fines from the government, as well as the effects of the ransomware.”

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ext

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Show Me the Money?

“Survey: Nearly Three Quarters of Physicians Say They Haven’t Seen ROI From Electronic Records.”

By Matt Goodman: [Dallas/Fort Worth Healthcare Daily, July 21, 2016]

http://healthcare.dmagazine.com/2016/07/21/survey-nearly-three-quarters-of-physicians-say-they-havent-seen-roi-from-electronic-records/

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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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Product Details

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Forcing Investment

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Erik Hare

[By Erik Hare]

After the Dust Storm

The dust is settling. After the various panics that rocked the early part of the year, mainly due to a slow-down in China and the developing world as a whole, Brexit put another shock to the system…

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investing

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Forcing Investment

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Best Times to Buy a Used Car

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Automotive Advice for Teens  and Young Adults

By Amanda Scherer

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00n0n_bhEquNHGvP3_600x450

Best Times to Buy a Used Car

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Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Macro-Economic Mid-Year Update

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Last Week’s Headlines

By Michael Green [TGA Capital Management]

www.tgacapitalmanagement.com

Businesses are paying more for goods and services as the Producer Price Index increased 0.5% in June, the largest increase in a year, according to the Labor Department. Higher energy costs pushed the increase. Since businesses usually pass on increases in the cost of goods and services, it’s likely consumer prices will increase as well, driving inflation upward.

Here is a mid year economic summary:

  • In fact, consumer prices did increase in June–just not at quite the same rate as producer prices. The Consumer Price Index rose 0.2%, following the same increase in May and a 0.4% gain in April. Over the last 12 months, the CPI has increased 1.0%. Excluding the volatile food and energy components, consumer prices still increased 0.2% in June and 2.3% from a year earlier.
  • Consumers continue to spend as retail sales increased in June, jumping 0.6% from the previous month and 2.7% ahead of last June. This follows a 0.2% (downwardly revised) increase in May. Excluding autos and gas, household spending climbed 0.7% from May. Output excluding autos remained the same as the prior month. This report, coupled with increases in consumer and producer prices, provides optimism for the economy over the summer months.
  • The manufacturing sector experienced a noticeable uptick in June, as industrial production increased 0.6% after falling 0.3% in May. Manufacturing output rose 0.4%, largely due to an increase in motor vehicle assemblies. June’s gain is the largest monthly increase since November 2014.
  • The number of job openings decreased by 345,000 to 5.5 million on the last business day of May, according to the Job Openings and Labor Turnover Survey (JOLTS) report from the Bureau of Labor Statistics. April’s rate was 5.8 million. May’s job openings rate is the lowest of the year. The quits rate was unchanged at 2.0% as workers continue to remain at their present jobs. It’s important to remember that June’s employment situation report showed significant improvement on the labor front.
  • U.S. import prices rose 0.2% in June from May, largely due to a spike in petroleum prices. Exports also increased in June, rising 0.8% following increases of 1.2% in May and 0.4% in April. The 2.4% rise in export prices for the second quarter of 2016 was the largest three-month advance in export prices since the index rose 2.7% between February and May 2011.
  • The Treasury Department reported a $6.3 billion budgetary surplus in June, following May’s $52.5 billion deficit. However, over the first nine months of the fiscal year, the deficit is up almost 27%, at $400.9 billion, over the same period last year ($316.4 billion).
  • Largely influenced by the immediate negative impact of the Brexit vote, the Index of Consumer Sentiment fell from 93.5 in June to 89.5 in July.
  • In the week ended July 9, the advance figure for seasonally adjusted initial unemployment insurance claims remained level at 254,000, unchanged from the prior week’s level. The advance seasonally adjusted insured unemployment rate remained at 1.6%. The advance number for seasonally adjusted insured unemployment during the week ended July 2 was 2,149,000, an increase of 32,000 from the previous week’s revised level.

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:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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The Next Economy 2.0

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Erik Hare

[By Erik Hare]

An Eight Point Plan

The beauty of election season is that every citizen has an opinion and they get to voice it. Because we are a Democratic Republic, it’s usually up to the candidates running to propose very specific…

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economic freedom

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The Next Economy – An 8 Point Plan

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Part B Reimbursement for Drugs to Change in Physician Offices

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Part B Reimbursement for Drugs to Change in Physician Offices

OLYMPUS DIGITAL CAMERA

By Susan Theuns, PA-C, CPC, CHC

CMS has proposed a new Part B drug payment model that may adversely affect your bottom line.

How?

Beginning in August, 2016, CMS may be applying a new methodology geared toward reducing profits on expensive drugs.  The current model is average sales price (ASP) plus 4% — it is advertised as ASP plus 6% but then a 2% sequestration is applied so it is net 4%. On drugs that cost more than $480, the percentage will be reduced more since the percentage may be the same but the actual dollar amount increases above their comfort threshold. So, the reimbursement proposal will be for less than the ASP + 6%.

Bad news

Part of the study will be at the current methodology and the second arm will be at ASP plus 2.5% plus a daily fee of $16.80. Of course, these will be subject to the 2% sequestration as well. This is a cost saving study for CMS that narrows the margin of profitability for the providers. Unlike relative value unit methodologies, there is no overhead built into pass-through drug reimbursement so it becomes critical that providing Part B reimburseable drugs  is not a loss leader for providers.  This makes where you purchase your drugs one of the most important parts of the process. Be sure to get pricing from distributors or manufacturers direct at or below ASP, also figuring into the equation the shipping costs when ordering.

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Good news

The good news is that exclusions for the new methodology are flu, pneumonia, and hepatitis B vaccines as well as drugs in short supply, those used for end stage renal disease, and drug infused durable medical items. Bundled drugs are also excluded but are currently included in the visit/procedure so no real change there.  It will be interesting to see what the outcome of this trial methodology reaps.

For more information, visit:

ABOUT:

Susan Theuns, PA-C, CPC, CHC, is the administrative director of physician practices at MedStar Union Memorial Hospital in Baltimore, Maryland. In addition to her certifications, she holds degrees in Allied Health, Business Management and Leadership & Education. Theuns serves as a national advisor and is a contributing author for The Business of Medical Practice, 3rd edition. She is a member of the Baltimore, Maryland, local chapter.

Conclusion

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 Product Details

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Japan – Down the Rabbit Hole

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Erik Hare

[By Erik Hare]

On Japan

For all we complain about low growth and dimming prospects here in the US, it’s a problem that has plagued the developed world. If anything, we’re doing quite well, thank you. Europe is still strug…

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rabbit

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 Japan – Down the Rabbit Hole

Conclusion

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A Distracted Driving Video

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By Amanda Scherer

#PutDownthePhone 

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#PutDownthePhone – Canada Distracted Driving Video

Conclusion

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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

The Dragon Bleeds

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Erik Hare

[By Erik Hare]

SNAPSHOT – Money is fleeing China

That’s hardly news, since it’s been happening for well over a year now. More accurately, money is now seriously fleeing China – at a rate which shows how little confid…

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camera

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The Dragon Bleeds

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:

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Odds you will live out your last years in a SNF?

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More On Medicaid Elder Care

Rick Kahler MS CFP

By Rick Kahler MSFS CFP®

If you’ve ever visited someone in a nursing home, chances are you walked out afterward vowing, “I’m never going to end up in a place like this.” That vow is one most of us would make. Keeping it, however, is another matter.

Let’s consider some facts

What are the odds you will live the last years of your life in a skilled care facility (nursing or assisted living home)?

About 14 percent of all people over age 64 have two to three chronic conditions that negate their ability to live independently. According to the U.S. Bureau of the Census, 5 percent of people over age 65 live in nursing or assisted living homes and 25 percent of them will spend some time in one. The chance of a stay in a nursing home increases 1.4 percent a year from age 65 on. Almost 50 percent of those over age 95 live in nursing homes.

While staying in the comforting surroundings of our homes is what most of us would prefer, just saying so isn’t going to make it happen. Unless you have a written plan and the finances to carry out that plan, the chances are high you will not be able to afford living in your home once you need daily assistance of some type.

The problem is that spending your last years in a nursing home is expensive, too. At rates of around $7,000 to $12,000 a month, it is very easy to spend $250,000 or more during the last years of one’s life. While this is doable if you have the money, it becomes a financial disaster if you have a spouse and spend through your estate in your last years. In this case, the first one to die wins at the expense of the survivor.

More U.S. Census Bureau Data

According to the U.S. Census Bureau, 70 percent of Americans age 65 and over have a household net worth of just $344,870. If one spouse enters a skilled care facility there is a real threat that the other will run out of money to fund living expenses, relying only on Social Security.

Once someone’s assets are spent down, Medicaid will begin paying for nursing home costs. This may mean changes such as moving to a facility that accepts Medicaid and out of a private room into a shared room. It also may mean waiting for a bed to become available.

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The Short Version

The “short version” of the law is that Medicaid begins paying once assets are spent down to $2000. However, there are provisions meant to protect the non-institutionalized spouse from destitution. Some of the couple’s assets are exempt from being spent down for nursing home care.

Example:

In South Dakota, for example, the spouse may keep half of the combined assets up to $119,220. Other exempt assets generally include personal possessions, one vehicle, equity up to $552,000 in the couple’s personal residence, prepaid funeral plans, and assets that are considered “inaccessible”. There are also limits on monthly income from pensions. The numbers above are for South Dakota; all of these limits vary by state so be sure to research your own state’s laws.

Assessment

Obviously, planning for long term care is vitally important, and it needs to be done well before the event that sends someone to a skilled care facility. Unfortunately, those events are often sudden and impossible to predict. The sad reality is that very few people plan ahead—even those who do financial planning in other areas. Many elders have a deep resistance to doing end-of-life planning.

That is sad, because the less planning you do, the more limited your options become. 

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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:

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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A Smaller Government is a Peaceful Government

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Erik Hare

[By Erik Hare]

Small is Peaceful

A long weekend needs a repeat – this one from a year ago that leads into some of the reforms that should be talked about through the election cycle much more than candidates wives and mistres…

A Smaller Government is a Peaceful Government

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:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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