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    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.

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CMS Value Based Purchasing for Drugs

CMS Proposed Rule Supports Value-Based Purchasing for Drugs

Courtesy: www.CertifiedMedicalPlanner.org

On June 19, 2020 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule regarding Medicaid Drug Rebate Program (MDRP) regulations, with the aim of lowering drug prices, increasing patient access, and encouraging innovation in the insurance and pharmaceutical industries.

This proposal is consistent with the Trump Administration’s Blueprint to Lower Drug Prices (Blueprint) released in May 2018, in which the administration highlighted its goal to “avoid excessive pricing by relying more on value-based pricing by expanding outcome-based payments in Medicare and Medicaid” and to “speed access to and lower the cost of new drugs by clarifying policies for sharing information between insurers and drug makers.”

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The proposed rule seeks to accomplish the Blueprint’s goals by reducing regulatory barriers that have previously prevented commercial plans and states from entering into value-based purchasing (VBP) arrangements with drug manufacturers.

Colleagues from Health Capital Consultants, LLC; explain.

ESSAY: DRUGS

Assessment: Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

Post-Coronavirus Physician Practice Acquisitions

Proceed with Caution

By Health Capital Consultants, LLC

As the coronavirus (COVID-19) global pandemic has wreaked havoc on the U.S. economy generally, and the healthcare industry specifically, the previously-active healthcare transactional environment has been largely stunted.

Despite (or perhaps because of) this economic turbulence, stakeholders expect that merger and acquisition (M&A) activity will soon resume with a vengeance. This potential opportunity, however, is not without pitfalls, due in part to the concern from stakeholders and regulators that well-capitalized entities may use this economic and public health crisis to prey on debilitated physician practices. (Read more…)

 

ASSESSMENT: Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

COVID-19 Forces Value-Based Reimbursement Model Revision

COVID-19 Forces Value-Based Reimbursement Model Revision

By Health Capital Consultants, LLC

***

On June 3, 2020, Seema Verma, the Administrator of the Centers for Medicare & Medicaid Services (CMS), announced in a Health Affairs article that CMS is providing significantly more flexibility for healthcare entities participating in CMS-sponsored value-based reimbursement (VBR) models for the duration of the COVID-19 pandemic.
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CMS has made a number of changes related to these models to provide added flexibilities to participating entities and to respond to participant concerns that VBR models will incur losses this year due to both the general disruption in operations and the greater expense associated with treating COVID-19 patients. (Read more…) 
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ASSESSMENT: Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

RETAIL BANKRUPTCIES 2020

Raging On

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On Immigrant Entrepreneurs and the USA

Shape the Start-Up Economy

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Monthly Percentage Change in Health Care Utilization

By Specialty – CIRCA 2019-2020

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ABSOLUTE versus RELATIVE RISKS IN MEDICINE

ABSOLUTE versus RELATIVE RISKS IN MEDICINE

Courtesy: https://lnkd.in/eBf-4vY
Understanding the Difference

ESSAY: https://lnkd.in/gTgjmTB

CMP® CURRICULUM: https://lnkd.in/eDTRHex
CMP® WEB SITE: https://lnkd.in/guWSApq

Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:


1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs


THANK YOU
***

ENTER A HEALTHCARE ENTREPRENEURIAL BUSINESS “DISRUPTOR” FOR 2020

ENTER A HEALTHCARE ENTREPRENEURIAL BUSINESS “DISRUPTOR” FOR 2020
Courtesy: https://lnkd.in/eBf-4vY

A New Initial Public Offering [I.P.O.]

On January 30, 2020, 1Life Healthcare, Inc. (One Medical) went public, opening at $14 per share, and closing at $22.07 per share. The innovative San Francisco-based direct primary care organization more closely resembles a technology start-up than a traditional healthcare organization.

LINK: https://lnkd.in/eZxrhtp

Their membership model service provides “seamless access” to primary medical care services at “calming offices,” 24/7 virtual care, and 21st century technology (e.g., a mobile application that allows patients to schedule appointments and message their providers).


And so, here is a report from colleagues over at Health Capital Consultants, LLC.
ESSAYhttps://lnkd.in/gVqDVR4
Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
THANK YOU
****

Some Father’s Day Facts

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Happy Father’s Day from the ME-P

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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:

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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™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Social Determinants of Mental Health

SDoMH

[Staff reporters]

As mental illness and chronic health conditions become more common, leaders are looking at upstream solutions that can improve overall well-being by addressing social determinants of mental and physical health.

For example, the Blue Cross Blue Shield of Michigan Foundation is providing over $125,000 in grants for community organizations working with vulnerable populations, including children and adults suffering from mental illness, homeless adults and families that are struggling financially.

And, health plans including Blue Cross Blue Shield of Tennessee and Horizon Blue Cross Blue Shield of New Jersey are integrating care to ensure people can access behavioral health treatment through their primary care providers.

Assessment

Your thoughts are appreciated

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MENTAL HEALTH WHITE PAPER

Mental Health DR. MARCINKO

Invite Dr. Marcinko

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On Sexual Violence Against Women

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The Hard Truths

International Women’s Day – March 8th – is a day that celebrates the achievements of women, but also raises awareness of the struggles and barriers to equality that still exist worldwide.

Sexual violence against women is a serious abuse of women’s human rights, and an injustice experienced by women around the world. On International Women’s Day 2012 ActionAid is saying NO to violence against women.

Assessment

Sexual violence against women is a serious abuse of women’s human rights, and an injustice experienced by women around the world. The infographic above aims to highlight the reality of sexual violence and the different ways that women – children, adolescents and adults – can be affected by sexual violence throughout their lives. The first step to change is education, so let’s share the hard truths about sexual violence.

Source: actionaid.org.au

Racism in Medicine: racistConclusion

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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The Economic Burden of Injuries and Violence

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For 2013

By. Dr. David E. Marcinko

By http://www.MCOL.com

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I’m not a psychologist, psychiatrist or expert on violence, terrorism or mass shootings, etc. But, I am heart broken over events this weekend in Dayton, OH and ElPaso, TX.

However, I have been speaking, publishing and wrting about medical work place violence for almost two decades. Now, while perhaps an under-researched topic, not in the public zeitgeist, it certainly is a subset noted by the FBI [2.7%].

And so, here is a review of the economic burdens of violence for 2013. The extent to which they may, or may not, relate to this Bloody Suday Weekend in Dayton OH and ElPaso, TX is left to the reader.

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ImageProxy

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NOTE: The ME-P can only speculate how this healthcare workplace violence information from a public safety expert, applies to the recent spate of national violence – regardless of venue – or how any lessons learned are applicable in this case; or not.

MORE: WV 1

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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[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd.  Edition]

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Book Dr. Marcinko for your Next Seminar!

Book Marcinko

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Book Speaker Dr. David E. Marcinko CMP® MBA for your Next Medical, Pharma, Hospital, University or Financial Services Seminar or Personal and Corporate Coaching Sessions 

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Dr. David Edward Marcinko, editor-in-chief, is a next-generation apostle of Nobel Laureate Kenneth Joseph Arrow PhD, as a health-care economist, insurance advisor, financial advisor, risk manager, and board-certified surgeon from Temple University in Philadelphia.

In the past, he edited eight practice-management books, three medical textbooks and manuals in four languages, five financial planning yearbooks, dozens of interactive CD-ROMs, and three comprehensive health-care administration dictionaries.

Internationally recognized for his clinical work, he is a past endowed chair; professor of health economics, finance and public health policy management; and distinguished visiting professor of surgery as a Bachelor of Medicine–Bachelor of Surgery (MBBS) degree recipient from Marien Hospital in Aachen, Germany.

He provides litigation support and expert witness testimony in state and federal court, with medical publications archived in the Library of Congress and the Library of Medicine at the National Institutes of Health.

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iMBA, Inc Seminar Topics

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[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

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

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

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[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd.  Edition]

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Discover the Best [Medical Risk Management and Insurance Planning] Practices of Leading CMPs®

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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™  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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“BY DOCTORS – FOR DOCTORS – PEER REVIEWED – FIDUCIARY FOCUSED”

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SAMPLE: 21. Practice Risks

MORE: Risk Mgmt Leadership

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The New “Fiduciary” Rule

 Really? Whose side is your financial advisor on?

 

 

 

 

 

By Rick Kahler CFP®

If it weren’t already hard enough to understand whose side your financial advisor is on, it got more complicated on June 9, 2017. As of that date, all financial advisors who sell products are required to forego any sales agenda and give advice that would benefit their clients or customers (called “fiduciary advice”).

Does this sound too good to be true? It is!

This rule only pertains to rollovers into an IRA from a qualified plan like a 401(k), and only to the investment recommendations for that IRA account.

Any other account is still fair game for stuffing full of high-commission and high-fee products that mainly benefit salespeople and their companies.

Also, in case you think your IRA is now protected from high-cost products, there’s one more catch. Salespeople are not required to look out for your best interests if they explain to you how and why they intend to give advice that instead primarily benefits themselves and their brokerage company.

While this new law will probably confuse consumers more than it helps, it may be a first step toward something larger.

Here is the sad truth

Most Americans believe they already receive objective, fiduciary advice. The overwhelming odds are that they don’t.

You face odds of ten to one that your advisor is a salesperson who is not required to put your financial interests first. Most Americans purchase their investments from the half a million brokers who earn commissions if they can convince you to buy an expensive alternative to the thriftier, better-performing investment options on the market. That’s more than ten times the number of advisors who adhere to a fiduciary standard. Government research estimates that consumers lost $17 billion a year to conflicted advice in the recommendations related to retirement plans made by brokers and sales agents posing as advisors.

The bottom line is that at best, only one out of every ten financial advisors puts your interests first. The actual number of real fiduciary advisors may actually be even lower than this discouraging figure.

A Study

A mystery shopper study in the Boston area found that only 2.4% of the “advisors” it surveyed (most were almost certainly brokers) made what most would consider to be fiduciary recommendations.

On the other side, 85% advocated switching out of a thrifty portfolio with excellent funds into something a bit more self-serving.

The Brokerage industry

The brokerage industry—that is, the larger Wall Street firms, independent broker-dealer organizations and life insurance organizations—repeatedly fought the fiduciary rule in court, arguing, in some cases, that their brokers and insurance agents shouldn’t be held to this standard. The courts refused to block the rule.

It gets worse

Brokers are held to a sales standard, but it’s a very low one that is appropriately known as “compliance.” They are required to “know their customer” and to make investment recommendations that would be “suitable” to someone in that customer’s circumstances.

In addition, a new study found that 8% of all brokers have a record of serious misconduct, and nearly half of those were kept on at their firms even after getting caught.

Assessment

There is one simple way to determine whether you’re working with somebody you can trust. Ask your advisor directly to provide a written and signed one-page statement that he or she will act in your best interests.

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If the broker hems and haws, hold onto your wallet or purse. Chances are any recommendations you receive will cost you money, a cost only disclosed somewhere deep in the fine print of whatever agreement you sign. If the advisor signs the statement, chances are you will receive fiduciary advice. 

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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HOW THE “FIDUCIARY CONUNDRUM” DEFIES PHYSICS?

And … How We Can Fix It

By Dr. David Edward Marcinko MBA MEd CMP®

www.CertifiedMedicalPlanner.org

The Rules As I Understand Them

Securities industry Regulations and Regulators recognize that (registered) investment advisors give advice, while stock brokers sell brokerage products. Thus, the Series 65 license is required to become a financial advisor, while Series 7 licensed stock-brokers are not (and cannot) be fiduciary advisors.

So, advice is subject to a fiduciary duty, while product sales (brokerage) activity is not. The ratio of fiduciary advice to brokerage sales is about 1:99. So, what does that tell you?

A Contentious and Complicated Issue

This issue is so contentious and complicated today that lawyers are needed to define each and every term, engagement, transaction, brokerage or advisory contract, etc. It is far too amazingly contorted and complicated for most; including me; and we have even discussed the industry machinations and political double-talk on this ME-P previously; from some vary sharp industry experts, too.

The Fiduciary Conundrum

The “work-around” for these rules is industry “dual-registration”. Simply put, just get licensed to do both; as I did. Charge a commission when selling stuff and charge a fee for advice. And ideally, do both at the same time; while getting paid for both sides.

As a naïve luddite, I learned this little truism in financial planning school decades ago, and as a doctor and fiduciary for my patients at all times, almost vomited.

Of course, there were more sophisticated students in our classes who regurgitated the standard industry opinion: “We’ll give the client a financial plan for free IF we can sell commissioned products.”

Ideally this meant a fat and fully commissioned wrap account, whole-life insurance policy, LTCI policy; etc. Or, sell products and collect fat ongoing, and often unrecognizable AUM fees [fee-only], too!

From the stock broker-advisor’s POV, it was “Heads I win – tails you loose” for the client. Now, you know why I am a former or reformed certified financial planner.

The Physics Split

Know that as a pre-medical college student years earlier, I leaned about the Werner Heisenberg Uncertainty Principle, in physics class.

Of course,  true Advice – is not Sales …  and Sales is not Advice. Both should never be; simultaneously. So, let’s ditch dual registration and decide which to pursue … and then proceed accordingly. Both sales and advice have risks and benefits to client and producer; both have advantages and disadvantages to both; as well.

WHY? Just like the Werner Heisenberg Uncertainty Principle; it shouldn’t [shan’t] be both; at once.

NOTE: In quantum mechanics, the Heisenberg uncertainty principle is any of a variety of mathematical inequalities asserting a fundamental limit to the precision with which certain pairs of physical properties of a particle, known as complementary variables, such as position x and momentum p, can be known simultaneously.

So, in physics, I can tell you where you are -OR- how fast you are going; but not both. Thus, if it is product sales; it is not advice.

Today, since “dual registration” is still allowed, my suggestion to clients is to seek a fiduciary in all matters 24/7/354; get it in writing, and try  to avoid arbitration and “best interest” or BICE clauses! Run from [fee-based and fee-only] AUM fees, too.

PS: I am not against Series #7 representatives and product sales. Salesmen/women often provide a valuable service and should be appropriately compensated. I only object when fees, costs, charges and commissions are duplicative, excessive and/or not fully disclosed to the client. Since excessive is an arbitrary term; full disclosure is the key ingredient.

Assessment

So – How am I wrong, mistaken and/or what did I miss? Do tell! Should We – Can We – Ditch Dual Registration [DDR]?

Oh! In the future, I also hope that State fiduciary standards will potentially cover both non-ERISA and ERISA situations, and employee plan participants will have access to full discovery rights, the one thing the industry fears most.

But, that’s a discussion for another day and time.

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. https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Contact: MarcinkoAdvisors@msn.com

BOOKS

https://www.crcpress.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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™

https://www.crcpress.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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RISKY CORONA VIRUS ACTIVITIES

Rankings

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Interesting ranking of risky activities in terms of catching covid as ranked by four Public Health physicians (Dr. Matthew Sims, Dr. Dennis Cunningham, Dr Mimi Emig, Dr Nasir Husain) from Michigan.

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Healthcare Spending Distribution

CIRCA: 2018

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ASSESSMENT: Your comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

Healthcare and the Pandemic

Click to access AMCP-ACHP-Consumer-Polling-Data.pdf

National Call Your Doctor Day – 2020

June 9, 2020

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On Finding Physician-Focused Financial Advice

OVER HEARD IN THE DOCTOR’S LOUNGE

Courtesy: www.CertifiedMedicalPlanner.org

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[On Finding Physician-Focused Financial Advice]

The financial planner is a like juggler, trying to keep a variety of balls simultaneously in the air.  Each aspect of practice becomes critical, just as action is needed. 

Some of the activities of operating a successful financial planning practice generally attract more attention than others, such as marketing and advertising, closing engagements, and office administration.  Because product review, selection and implementation are often related to advisor compensation, they attract a great deal of the financial juggler’s concentration. 

But, the heart of financial planning, niche advice, often receives little attention.  Not because it is unimportant, it just doesn’t seem immediately and predictably urgent.  Here, that ball does not seem to be dropping so rapidly. 

However, retaining clients and receiving referrals from other professionals is very dependent on the quality of the advice delivered.  And, the first line of protection from practitioner liability exposure is to not deliver incorrect or incomplete advice. 

But, where does the financial advisor turn for ideas and organized research in the healthcare sector?” 

Edwin P. Morrow; CFPTM, CLU, ChFC, RFC

[Middletown, Ohio, USA]

Your thoughts are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1https://lnkd.in/ezkQMfR

2 – https://lnkd.in/ebWtzGg

3 – https://lnkd.in/ewJPTJs

THANK YOU

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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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. 

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 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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Product DetailsProduct Details

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On Being a Doctor

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Dr. Fauci Speaks on Social Distancing

Getting Back to Work

By: http://www.CertifiedMedicalPlanner.org

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Your comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

PHYSICIAN HEAD-HUNTER RISKS

PHYSICIAN HEAD-HUNTER RISKS

Courtesy: www.CertifiedMedicalPlanner.org

Any time an executive search firm makes the following claims you should push back and try to get more information before assuming it’s the truth. While some can deliver, others can’t – and it’s up to you to figure out which ones are sincere.

LINK: https://www.springerpub.com/dictionary-of-health-economics-and-finance-9780826102546.html

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So, here some potential misleading statements and/or lies told to physician-executives in the hiring process:

  1. There’s great opportunity for advancement
  2. Our bonus structure will double your income
  3. Your job and schedule is protected and won’t change it.
  4. You’ll get extensive on-boardig and training.
  5. We’ll hire you some help when it gets busy.
  6. Once you fix this problem/department/project, etc., you’ll get to work on something new and exciting.

TEXTBOOK: https://lnkd.in/ebWtzGg

Assessment: Your comments are appreciated.

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BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ezkQMfR

2 – https://lnkd.in/ewJPTJs

THANK YOU

***

The MD SALARY “versus” NET-WORTH CONUNDRUM

A Graphical Power-Point Presentation

Courtesy: https://lnkd.in/eBf-4vY

“Of the 125 medical schools in the USA, only one of them to my knowledge offers a class related to saving or investing money.”
– William C. Roberts, MD

Private Banker Jorge Russe; MBA CMP™ explains in this PPT Presentation on Net Worth; NOT Income.

ESSAY: https://lnkd.in/eGArJR2

CMP® CURRICULUM: https://lnkd.in/eDTRHex

Assessment: Your comments are appreciated.

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BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
THANK YOU
***

WHAT IS THE VELOCITY OF MONEY?

It’s the Rate of [Physician] Circulation and Consumption

Courtesy: https://lnkd.in/eBf-4vY

The VM is a measure of the number of times that the average unit of currency is used to purchase goods and services within a given time period. The concept relates the size of economic activity to a given money supply. This speed of money exchange is one of the variables that determine inflation.

VM is the ratio of gross national product (GNP) to a country’s money supply. The more often money changes hands, the greater the level of commerce. The VM is determined by money supply, interest rates, inflation, commerce and the Federal Reserve.

LINK: https://lnkd.in/eZxrhtp

Physicians, like most consumers, tend to hold less money as interest rates and inflation increase, and therefore the velocity of money increases.

ESSAY: https://lnkd.in/e6TvuVM

VM is reduced when people increase money holdings in periods of low interest rates and low inflation; the opposite when rates and inflation are high.

CMP® CURRICULUM: https://lnkd.in/eDTRHex

Assessment: Comments appreciated.

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BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ewJPTJs
THANK YOU
***

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