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

    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.

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

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Medical Practice Scheduling Issues

FOR DOCTORS AND PATIENTS, ALIKE

By Dr. David E. Marcinko MBA

Doctor Scheduling Issues

Nothing creates more distress for a new medical practice administrator than “holes”, or empty slots, in a physician’s appointment schedule. While doctors may complain about too much work and not enough time with patients, a corollary is the lack of production that accompanies such downtime.

This scenario is common in January-February [patient insurance deductibles not paid] and August-September [new doctors join existing practices]. An increase in new doctor days, and marginal native practice growth, usually mean space in the daily schedule.

Now, the natural tendency is to try and fill the day. And, it is best if the day is filled by increasing patient services acuity levels. However, a common, but ill-advised approach is to add time to existing patient appointments. So, when a practice accepts a new medical provider, creation of a checklist similar to the one below may be helpful.

LIST:

  1. List appointment types and expected length.
    2. Use booking or scheduling secretarial templates.
    3. Review the templates with booking secretary then make sure they’re followed.
    4. Allow for walk-in or ‘urgent’ visits.
  2. Rather than having a policy of scheduling days or weeks ahead, ask patients if they’d like to come in the same day.
  3. Some physicians have moved to open-access appointments that eliminate traditional time slots altogether. This should be tested short-term before instituting since it is not effective in all markets.
  4. Know your area and know your patient base. If you have a high “no show” rate, you may want to pad in additional access by double-booking on the hour. Certain payers also have members with historically high “no show” rates that should be taken into consideration.
  5. Give yourself at least 60 days to credential the new provider (if they will be billing under your TIN). Otherwise, they may be seeing patients free of charge for some payers where credentialing is not yet completed. Limiting them to self-pay, work comp, non-covered services or patients whose payers have issued a provider number may pose some scheduling obstacles.

The danger of open appointment slots is adding inefficiencies to a schedule by the pressure to fill time. Instead, look at organic practice growth [5-8% annually for a mature practice], the change in provider time and have realistic expectations for open time-slots in the first few years of new practitioner availability [see http://waittimes.blogspot.com, Wait Time & Delayed Care; a blog devoted to helping healthcare providers shorten wait times and improve patient flow].

Patuient Scheduling Issues

Most mature doctors follow a linear (series-singular) time allocation strategy for scheduling patients (i.e., every 15 or 20 minutes).  This can create bottlenecks because of emergencies, late patients, traffic jams, absent office personal, paperwork delays, etc.  Therefore, as proposed by Dr. Neal Baum, a practicing urologist in New Orleans, one of these three newer scheduling approaches might prove more useful. 

 1. Customized Scheduling

The bottleneck problem may be reduced by trying to customize, estimate or project the time needed for the patient’s next office visit. For example:  CPT #99211 (5 minutes), #99212 (10 minutes), #99213 (15 minutes), #99214 (25 minutes), or #99215 (40 minutes). Occasionally, extra time is need, and can be accommodated, if the allocated times are not too tightly scheduled.   

2. Wave Scheduling

Some patient populations do not mind a brief 20-30 minute wait prior to seeing the doctor.  Wave scheduling assumes that no patient will wait longer than this time period, and that for every three patients; two will be on time and one will be late. This model begins by scheduling the three patients on the hour; and works like this. The first patient is seen on schedule, while the second and third wait for a few minutes.  The later two patients are booked at 20 minutes past the hour and one or both may wait a brief time. One patient is scheduled for 40 minutes past the hour. The doctor then has 20 minutes to finish with the last three patients and may then get back on schedule before the end of the hour. 

 3. Bundle Scheduling

Bundling involves scheduling like-patient activities in blocks of time to increase efficiency.  For example, schedule minor surgical checkups on Monday morning, immunizations on Tuesday afternoon, and routine physical examinations on Wednesday evening, or make Thursday kid’s day and Friday senior citizens day. Do not be too rigid, but by scheduling similar activities together, assembly-line efficiency is achieved without assembly line mentality, and allows you to develop the most economically profitable operational flow process possible for the office. 

***

 Patient Self Scheduling (Internet Based Access Management) 

The traditional linear patient scheduling system is slowly being abandoned by modern medical practitioners; an all venues (medical practices, clinics, hospitals and various other healthcare entireties). New software programs, and internet cloud applications, allow patients to schedule their own appointments over the internet. The software allows solo or individual group physicians with a practice to set their own parameters of time, availability and even insurance plans. Through a series of interrogatories, the program confirms each appointment. When the patient arrives, a software tracker communicates with office staff and follows the patients from check-in, to procedures, to checkout. Today, many hospitals have even abandoned the check-in or admissions, department. It has been replaced by access management systems.

Automated Medical Office Access Management Systems [Patient Check-In Kiosks]

According to a McLean report published in InfoTech,

“Today’s patients demand the same level of self-service convenience in healthcare that they do in other industries. Medical kiosks save money, reduce wait times, and significantly enhance the patient experience. The payback period for medical kiosks is often as short as 180 days”

Automated medical office access management [AM] or patient self check-in solutions provide a wide range of functionality including patient registration, insurance verification, and demographic-validation, electronically consent form completion, back-end scheduling, financial systems integration, real-time appointment re-scheduling, direction text mapping and way finding; and more.  Often, solutions can be individualized and integrated with HIT systems using HL7, XML, web and other standard data exchange protocols.

Open Access Patient Scheduling

A sub variant of the above is open-access patient self-scheduling, either in full or part. Benefits include reduced patient appointment wait times, matching and scheduling patients with physician, improved continuity of care, increased productivity per patient visits, higher physician compensation and higher net gains for medical offices and clinics.

Real Time Claim Adjudication

Real Time Claim Adjudication [RTCA] or expecting payment at the time of service is becoming the rule, not the exception, in the modern AM era. RTCA makes a medical practice more like other businesses.

Benefit of Automated Medical Office Access Management

  • Streamlines patient flow with focus on improved patient care
  • Real-time insurance verification
  • Capture credit/debit card information with funds verification
  • Improves office cash flow and collections
  • Provides patient payment receipts
  • Decrease accounts receivable [ARs]
  • Save time and office staff resources
  • Increases office return on investment [ROI]
  • Demographic capture and validation improve marketing
  • Continually improve office operations.

Vendors for the above AM processes include: Phreesia.com, KioHealth.com, MediSolve.Ca; VecnaMedical.com; MeridianKiosks.com; AppointmentDesk.com; and KioskMarketPlace.com; etc.

***

Five people are sitting in the waiting room of a doctor’s office. Some of the people look tense or upset, and others look completely relaxed.

More: Simple Steps to a Patient Registry: Ticket to Care Coordination, Quality Reporting and Pay for Performance

LINK: http://store.hin.com/Simple-Steps-to-a-Patient-Registry-Ticket-to-Care-Coordination-Quality-Reporting-and-Pay-for-Performance_p_0-3855.html#

Assessment: Your thoughts are appreciated.

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Five [5] Reasons to Govern Medical Provider Data

The Heart of the Health Care Enterprise

By http://www.MCOL.com

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The Role of “Pleasure” in Public Health

FEBRUARY 2020 AJPH

By Alfredo Morabia, MD, PhD

Editor-in-chief, AJPH

Dear Dr. David Marcinko,

***

This month, AJPH has a collection of articles on ending the HIV epidemic, population health and telemedicine services.

New! Enjoy the current issue of AJPH on your mobile device. Download the e-Reader or Kindle version today.

Here are a few of the many articles in the February 2020 issue:

***

· February 2020 Podcast “Is pornography the key to the sex education of teenagers?”

·  The Public Health of Pleasure: Going beyond Disease Prevention

·  Should Public Health Professionals Consider Pornography a Public Health Crisis?

· Indicators to Guide and Monitor Climate Change Adaptation in the US Pacific Northwest

· Addressing Health Disparities Through Deliberative Citizens’ Panels for Health Equity

·  Trends in E-Cigarette, Cigarette, Cigar, and Smokeless Tobacco Use Among US Adolescent Cohorts

·  State-Level Changes in Firearm Laws and Workplace Homicide Rates: United States

***

Also, don’t miss our just released supplement on Documenting and Addressing the Health Impacts of Carceral Systems. It’s full of timely and insightful articles on mass incarceration and related topics.

The mission of AJPH is to advance public health research, policy, practice and education. Toward that goal, the journal also produces monthly podcasts available in English, Spanish and Chinese at ajph.org. The monthly podcasts also are on iTunes and Google Play.

Be on the lookout for more timely research from AJPH, and consider subscribing or becoming an APHA member for full access.

Thank you and Happy New Year 2020

AJPH

 

Alfredo Morabia, MD, PhD

Editor-in-chief, AJPH

@AlfredoMorabia

@AMJPublicHealth

 

WANT TO JOIN A PRIVATE MICRO-NETWORK?

THE FUTURE VALUE IS IN “WHO” WE CONNECT !

By Dr. David E. Marcinko MBA

Forget amassing “likes”, “smiles”, “winks” or cultivating your online persona. Micro-Networks are all about being your true authentic self with just a select and carefully curated few people; and that’s it! No social influencers, marketers or viral posts. Just micro-segmentation!

THINK: Family members, professional colleagues, neighbors and close friends; sport or class-mates, and co-workers or faculty members in small distinct groups. There is no “network” as you occupy the space with just these people. The total number of participants is pre-determined; 25, 50, 100, 175, 250; etc. And, when reached, the only way to add new members is for existing members to drop out.

“The Vital Few … Not the Trivial Many.”

QUERY: Would you join a micro-network? What cohort of members?

Please comment.

QUERY: Would you pay a small membership surcharge? How much?

Please comment.

ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

***

Tell Us the Issues Affecting your Medical Practice, Clinic, Wellness Center or Hospital

Join Our Mailing List

[By staff reporters]

Tell us about the issues affecting your medical practice, clinic, hospital, wellness center, or healthcare organization in 2020.

We are conducting a brief survey to learn more about the key issues affecting your healthcare entity, and how they impact your outlook for the coming year.

Just send in your thoughts on the survey form below.

 

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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Ending Childhood Obesity on “Fat” Tuesday

Join Our Mailing List

A Fat Tuesday Message in 2020

[By Staff Reporters]

More than a decade ago, First Lady Michelle Obama kicked off a campaign to try to end childhood obesity within a generation.

Of course, with the impending Lenten season about to start, the timing could not be more prescient for a re-dedication to this goal.

Let’s Move

The campaign to end obesity is called: “Let’s Move“; local to Savannah, GA.

https://www.prlog.org/12621769-enmarket-raised-15000-for-the-partnership-for-healthier-america-to-help-end-childhood-obesity.html

***

ME-P Mardi Gras Mask on Fat Tuesday

***

MORE: https://medicalexecutivepost.com/2018/03/02/us-childhood-obesity-trends/

ADULTS: https://medicalexecutivepost.com/2016/03/25/an-obesity-pic/

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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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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Is This a “Minsky Moment”

Of STOCKMARKET Bear Markets

Update Courtesy: http://www.CertifiedMedicalPlanner.org

28,992.41 ▼ -227.57

A Bull market is one of rising stock prices, while a Bear market is the opposite. More specifically, a Bear market is defined as a drop of 20% or more from its high, and can vary in duration and severity. While a Bull market has no such threshold.

Whither the Bear? 

Typically, bear markets are associated with declines in an overall market or index like the S&P 500, but individual securities or commodities can be considered to be in a bear market over a sustained period of time – typically two months or more.

ESSAY: https://medicalexecutivepost.com/2018/12/22/stocks-and-sectors-in-bear-territory/

Now, a Minsky moment is a sudden major collapse of asset values which is part of the credit cycle or business cycle. Such moments occur because long periods of prosperity and increasing value of investments lead to increasing speculation using borrowed money

ESSAY: https://medicalexecutivepost.com/2018/11/16/what-is-a-minsky-moment/

And so, what is a physician-investor to do in a bear market?

9,576.59 ▼ -174.38 -1.79%

ESSAY: https://medicalexecutivepost.com/2016/03/18/doctors-and-bull-and-bear-markets/

mm

MORE: https://realinvestmentadvice.com/the-return-of-the-minsky-moment/

Your thoughts and comments are appreciated.

BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

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