HEALTHCARE POLICY: Blog and Internet Sources of Gravitas

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

REFERENCES

https://mises.org/library/mayo-clinic-and-free-market

http://www.kevinmd.com/blog/2017/08/problem-free-market-health-care.html

http://www.healthsharetv.com/content/dr-zeke-emanuel-history-healthcare-reform-us

https://www.pointnurse.com/blog/do-you-have-a-healthcare-blockchain-strategy/

http://thehealthcareblog.com/blog/2017/05/06/not-really-insurance-the-pre-existing-condition-debate/

https://specialdocs.com/learn-concierge-medicine-model

http://www.kevinmd.com/blog/2017/04/health-care-right-privilege-cant-answer.html

http://www.healthissocial.com/

http://www.msn.com/en-us/money/markets/brave-new-world-of-bitcoins-what-they-are-and-how-to-buy-them/ar-AAoWUza?li=BBnbfcN

https://www.pointnurse.com/blog/do-you-have-a-healthcare-blockchain-strategy/

http://www.kevinmd.com/blog/2017/06/golden-era-medicine-never-coming-back.html

http://mdwhistleblower.blogspot.com/2016/02/concierge-medicine-is-it-ethical-or.html

http://www.msn.com/en-us/money/healthcare/americas-health-care-crisis-is-a-gold-mine-for-crowdfunding/ar-BBCxjbU?li=BBnbfcN

http://www.msn.com/en-us/money/companies/the-company-behind-many-surprise-emergency-room-bills/ar-AAoKYCK?li=BBnbfcN

https://studymatescom.wordpress.com/

http://thehealthcareblog.com/blog/2017/04/08/is-healthcare-a-right-a-privilege-something-entirely-different/

http://www.kevinmd.com/blog/2017/07/moral-assassination-physicians-must-stop.html

http://www.kevinmd.com/blog/2017/01/emphasize-public-health-medical-education.html

http://thehealthcareblog.com/blog/2017/04/06/hobsons-wrong-answer/

http://thehealthcareblog.com/blog/2017/05/19/is-health-privacy-a-human-right/

http://www.kevinmd.com/blog/2016/12/must-temper-unregulated-free-market-philosophy-health-care.html

http://www.kevinmd.com/blog/2017/06/slow-death-private-practices.html

http://thehealthcareblog.com/blog/2017/06/23/a-primer-for-conservatives-health-insurance-is-not-really-insurance/

http://www.kevinmd.com/blog/2017/06/doctors-pr-problem.html

http://www.kevinmd.com/blog/2017/06/doctors-cops-can-fight-mistrust-way.html

http://www.msn.com/en-us/health/healthtrending/did-a-1980-letter-help-spark-the-us-opioid-crisis/ar-BBBKkM4?li=BBnb7Kz

http://alertandoriented.com/

http://www.sheknows.com/health-and-wellness/articles/1030383/crowdsourcing-health-care

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

CONTACT: Ann Miller RN MH

[Executive Director]

MarcinkoAdvisors@msn.com

***

How to THRIVE in Private Independent Medical Practice, Today?

ORDER TEXTBOOK: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

THANK YOU

***

PODCAST: Direct Employer Contracting for Medical Services

Employers Can Enter Into Direct Contracts with Doctors, Hospitals and Other Healthcare Facilities for Medical Services for Members of Their Employee Health Plan.

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Texas CEO Magazine 2016 Economic Forecast: Dallas - Texas ...

BY ERIC BRICKER MD

Reimbursement Typically Takes the Form of a Bundled Payment or a Lower Rate of Fee-for-Service.

Employers with Greater Than 500 Employees Tend To Engage in Direct Contracting.

Mid-Market Employers with a High Concentration of Employees in One Geographic Area Tend to Engage in Direct Contracting as Well.

The Employer Frequently Uses an Independent TPA to Process the Claims for the Direct Contract.

Also, the Employee Health Plan Changes the ‘Benefit Level’ Such that Care at the Direct Contract Facility is Often at $0 Out-of-Pocket Cost for the Member.

Engaging the Plan Members with Navigation Services is Helpful to Make the Experience Integrated with the Overall Health Plan Offerings.

YOUR THOUGHTS ARE APPRECIATED.

CITE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

THANK YOU

***

40 Years – MICROSOFT Corp.

Microsoft's biggest moments throughout the years in a chart

https://images.routledge.com/common/jackets/amazon/978148224/9781482240283.jpg

ASSESSMENT: Your thoughts are appreciated.

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

THANK YOU

***

“HOSPITALS AND HEALTH CARE ORGANIZATIONS”

INSTITUTIONAL Foreword WITH Comprehensive Review AND FREE PREVIEW

Walmart’s Push to Create Healthcare ”SUPER CENTERS”

Walmart’s Push to Create Healthcare ”Super Centers”

Health Capital Consultants - Healthcare Valuation


Walmart, the world’s largest retailer, opened the first Walmart Health in 2019 with the main goal of helping to meet the healthcare needs of the communities they serve. After opening six locations in almost two years, Walmart is looking to operate a total of 22 standalone clinics by the end of 2021. 

This Health Capital Topics article will review Walmart Health’s approach to delivering primary care, the communities into which it is expanding, its partnerships it is developing in the healthcare sector, and the competitive landscape in which it operates. (Read more…) 

Citation: https://www.r2library.com/Resource/Title/0826102549

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

***

The Next-Generation of “Anti-Millionaire” Doctors

“$1 Million Mistake: Becoming a Doctor”

See the source image

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

CBS Moneywatch published an article entitled “$1 Million Mistake: Becoming a Doctor” Aside from the possibility that devoting one’s life to helping others might be considered a mistake, medical student Dan Coleman was struck by the “$1 million” figure.

Before medical school, he worked in the pharmaceutical industry and even turned down a hefty promotion to his education as soon as possible, rather than defer for a year or two. But, his financial calculations made it fairly obvious that, including benefits, bonuses, and potential promotions, his medical decision was not a $1 million mistake, but was more like a $1.3 million dollar disaster. Still; he opined:

Yet, even today, as we stare down the barrel of the Affordable Care Act, being a doctor is a very desirable job. We may not be famous, but we will be well-respected. We may not be rich, but we will certainly live comfortably. We may work a lot, but we will never be out of work. To future doctors, the young and impecunious, the anti-millionaires, tuition is a mere afterthought. All that matters is the MD.

Source: http://in-training.org/medical-students-the-anti-millionaires-4361

Millionaire Interview 81 - ESI Money

OVER HEARD IN THE MEDICAL STUDENT’S LOUNGE

“We are medical students.
We are young, proud, and righteous.
We have made the hard choice (medicine), but we have cleared the high hurdle (getting into school).


We know healthcare is a difficult, imperfect art, but we are devoted.
We arm ourselves with the weapons of knowledge and compassion, prepared to defend against the onslaught of trauma, disease, and time.
We are here to the bitter end, for our patients and ourselves.
And above all, we know the cost of our choice.

And if we’re lucky, it will stay under 6% interest through graduation”.

Daniel Coleman

[Georgetown University School of Medicine]

First-year Student

Your thoughts are appreciated,

THANK YOU

***

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

ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

***

SPONSOR: iMBA Inc.

INSTItute of Medical Business Advisors, Inc.

center

About the Institute of Medical Business Advisors, Inc

The Institute of Medical Business Advisors, Inc provides a team of experienced, senior level consultants led by iMBA Chief Executive Officer Dr. David Edward Marcinko MBA CMP™ MBBS [Hon] and President Hope Rachel Hetico RN MHA CMP™ to provide going contact with our clients throughout all phases of each project, with most of the communications between iMBA and the key client participants flowing through this Senior Team.  iMBA Inc., and its skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research and support staff of CPAs, MBAs, MPHs, PhDs, CMPs™, CFPs® and JDs to maintain a thorough and extensive knowledge of the healthcare environment. The iMBA team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.

The iMBA Inc project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients.  Over the years, our industry specialization has allowed iMBA to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available.  iMBA Inc’s specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the public health, health economics, management, administration, and financial planning and consulting fields.  iMBA Inc’s information resources and network of healthcare industry textbook resources enhanced by our professional consultants and research staff, ensure that the iMBA project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

CONTACT: Ann Miller RN MH

[Executive Director]

MarcinkoAdvisors@msn.com

770-448-0769

***

The Economic Value and Pricing of “Personalized and Precision” Medicine

PRECISION MEDICINE

By Tomas J. Philipson

DEFINITION: Personalized medicine, also referred to as precision medicine, is a medical model that separates people into different groups—with medical decisions, practices, interventions and/or products being tailored to the individual patient based on their predicted response or risk of disease

CITE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

We discuss the economic value of personalized medicine and the optimal pricing of the combination products involved. We build on previous work of Egan and Philipson (2015) who stress a link between rational adherence in health care and the value of personalized medicine. Personalized medicine converts experience goods to search goods by speeding up the learning process relative to trial and error. This explains the emergence of personalized medicine in cancer care as well as the timing of this emergence. It also predicts greater innovation-and merger incentives from Disneyland style two-part pricing of the combination products.

Personalized Medicine - Personal Medicine - Medicine ...

READ: https://www.nber.org/system/files/chapters/c13997/c13997.pdf

Your thoughts are appreciated.

THANK YOU

***

PODCAST: First Rules of Population Health

One of the 1st Rules of Population Health is That 5% of the Population Generates 50% of Total Healthcare Costs

Image result for eric brikker

BY ERIC BRICKER MD

However, That 5% of High-Cost Claimants is a Heterogenous Population

2.5 Percentage Points of the 5% Are Claimants That Were Either High-Cost Claimants the Previous Year with On-Going Complex Medical Situations or Generated Claims Related to Chronic Diseases Such as Diabetes or Multiple Sclerosis.

HOWEVER, the Other 2.5 Percentage Points of the 5% Are Claimants That Generated Zero or Almost-Zero Claims in the Previous 12-Months.

They Essentially ‘Blow Up’ Out of Nowhere.

This Video Describes the 4 Categories of These High-Cost Claimants:

1) Previously Known and Prolonged High Costs

2) Previously Known and Episodic High Costs (that no longer continue)

3) Previously Unknown and Prolonged High Costs

4) Previously Unknown and Episodic High Costs (that no longer continue)

Learn the Clinical Diagnoses That Make Up Each Category and the Secret of Which Groups to Target and Why.

Your thoughts are appreciated.

THANK YOU

***

On Finding PHYSICIAN FOCUSED Financial Advice?

OVER HEARD IN THE DOCTOR’S LOUNGE

Michigan Association of Osteopathic Family Physicians ...

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

edwin

[Middletown, Ohio, USA]

ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

THANK YOU

***

PODCAST: Hospital Employee Roles [Nurses, Med Techs, Clerks and More]

So You, Your Family and Friends Can Have a Practical Understanding Should You or They Ever Be Hospitalized

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BY ERIC BRICKER MD

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Learn the Roles of 1) Nurses, 2) Charge Nurses, 3) Shift Coordinators, 4) Techs and 5) Clerks in a Hospital So You, Your Family and Friends Can Have a Practical Understanding Should You or They Ever Be Hospitalized

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Nurses on General Medical and Surgical Floors Typically Have a 4:1 Patient to Nurse Ratio During the Day and an 8:1 Patient to Nurse Ratio Overnight.

Nurses in the ICU Typically Have a 2:1 or 1:1 Patient to Nurse Ratio.

Nurses on a Floor or Unit Have a ‘Charge Nurse‘ Who is the Head Nurse for the Floor for That Specific Shift.

Those Charge Nurses Then Collaborate with the Shift Coordinator Who is a Very Senior and Experience Nurse Who Coordinates All the Patient Beds for a Particular Division at a Large Hospital (e.g. All Medicine Patients vs. All Surgical Patients) or for the Entire Hospital If It Is a Smaller Hospital.

Medical Techs Provide Support Roles in Patient Rooms Such as Checking Vitals, Blood Glucose Finger-Sticks, Etc.

The Clerk Sits at the Nurses Station for the Floor and Typically Answers the Call-Button for Each of the Patient Rooms During the Day in Addition To Their Administrative Responsibilities.

Your thoughts are appreciated.

THANK YOU

***

SIMPLE: The “50-30-20” Budget Rule of Thumb

Try the 50/30/20 rule OF WANTS, NEEDS AND SAVINGS

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

There are varying opinions on how much of your total income should go toward savings and retirement goals each month. Moreover, the answer is likely to vary, depending on your full financial profile.

But if you’re looking for some basic KISS guidelines, consider applying the 50-30-20 rule, a budgeting method that allocates 50% of your income to essentials, like rent and bills, 30% to discretionary spending and 20% to savings.

Citation: https://www.r2library.com/Resource/Title/0826102549

Image shows a pie chart broken up into 50%, 30%, and 20%. Title reads: "The 50/30/20 Budgeting Rule." Under 50% says "Needs: groceries, housing, utilities, health insurance, car payment." Under 30% reads: "Wants: shopping dining out, hobbies." Under 20% says "Savings"

Your thoughts are appreciated.

THE RULE: https://www.thebalance.com/the-50-30-20-rule-of-thumb-453922

THANK YOU

ZERO BASED BUDGET: https://medicalexecutivepost.com/2021/05/24/the-zero-based-budget-for-physicians/https://medicalexecutivepost.com/2015/07/02/can-doctors-achieve-financial-independence-without-budgeting/

EPI BUDGET FACTS: https://www.epi.org/resources/budget/budget-factsheets/

NO BUDGETS: https://medicalexecutivepost.com/2015/07/02/can-doctors-achieve-financial-independence-without-budgeting/

HOUSEHOLD BUDGET: https://medicalexecutivepost.com/2013/10/07/on-setting-your-household-budget-ugh/

***

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

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

***

MEDICAL ERRORS: Incidence and Prevelance

Robert James Cimasi

Todd A. Zigrang

Health Capital Consultants - Healthcare Valuation

“Knowing is not enough; we must apply. Willing is not enough; we must do. Goethe [1]

As developments in research and technology have advanced medical practice, the improved ability to diagnose and treat patients has led to an increased volume of medical assessments and procedures performed. However, these increases in the volume of procedures performed by physicians have led to an increase in both the risk of harm to patients and the exposure to liability for physicians.[2] Today, most healthcare services are delivered not by individual Marcus Welby type of physicians,[3] but through a group practice, healthcare organization, or hospital system. While there are numerous advantages to physicians providing care as employees of a healthcare enterprise, some of the unintended consequences exhibited under physician employment arrangements (e.g., diminishing physician autonomy, patient quotas, and limited time to spend with patients) have led to an increase in the potential for patient harm and subsequent physician liability.[4]  Additionally, as the overlap between the scope of practice for physicians and non-physicians continues to increase, the complexities of malpractice liability, which may jeopardize the licenses of both the supervising physician and the non-physician professional, may similarly increase.[5] The result of these increased risks, medical errors, disgruntled patients, and changing scopes of practice has produced an environment that is ripe for malpractice litigation.[6] 

Numerous studies and examinations of the reality of medical errors demonstrate the varied nature and causes contributing to these errors, and the need for the medical malpractice system.  The 2000 Institute of Medicine’s (IOM) landmark report, entitled, “To Err is Human: Building a Safer Health System,” conservatively estimated that in 1997, “at least 44,000 and perhaps as many as 98,000 Americans die in hospitals each year as a result of medical errors.”[7] Moreover, the IOM report noted that out of 30,000 discharges at 51 randomly selected New York hospitals in 1984, adverse events occurred in 3.7% of all hospitalizations or (1,110 hospitalizations), with 58% of adverse events (approximately 644 hospitalizations) caused by preventable medical errors, and 27.6% of adverse events (approximately 306 hospitalizations) caused by negligence.[8]  In addition to medical errors, more than one million serious medication errors occur every year in U.S.[9] As observed in The Leapfrog Group’s study, one adverse drug effect (ADE) adds, on average, $2,000 to the cost of a hospitalization, which totals over $7.5 billion per year nationwide.[10]

Other studies have updated the figures relied upon in the IOM report. In 2010, the Office of Inspector General (OIG) estimated that approximately 13.5% of hospitalized Medicare beneficiaries experienced adverse events during their hospitalizations, 44% of which were deemed preventable by independent physician reviewers.[11] Within this estimate, the OIG subdivided the adverse events into four clinical categories:

  • Events related to medication – 31%;
  • Events related to ongoing patient care – 28%;
  • Events related to surgery or other procedures – 26%; and,
  • Events related to infection – 15%.[12]

A 2013 study published in Journal of Patient Safety combined the OIG’s estimate with the estimates of three other studies[13] relating to the prevalence of medical errors to conclude that over “210,000 preventable adverse events per year…contribute to the death of hospitalized patients,” with numerous additional errors shortening patients’ lifespans and causing other harms.[14]

The debate surrounding medical errors focuses not only on the number of adverse events in hospitals and deaths due to these adverse events, but also the causes of these adverse events.  Although the 2000 IOM report is widely cited for its estimate of deaths due to medical errors,[15] the report also provided one of the first arguments that many medical errors “could likely have been avoided had better systems of care been in place,” framing the medical error debate not solely on “incompetent or impaired providers” but also on the process of care delivery.[16] These process improvements can center on infrastructure as well as policies and procedures regarding the provision of medical care. The same IOM committee that published the 2000 report released a second report in 2001 entitled, “Crossing the Quality Chasm: A New Health System for the 21st Century,” which advocated for widespread change in overall structures and processes in the healthcare environment as a means to preventing medical errors and improving quality, and listed six “aims” for high quality care: safety; effectiveness; efficiency; equity; timeliness; and, patient-centeredness.[17]  However, a 2013 IOM report entitled, “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America,” noted that, 12 years later, these six aims still had not been achieved, and attributed the “fragmented, uncoordinated, and diffusely organized” infrastructure of the U.S. healthcare delivery system to the lack of systemic processes in place.[18] Specifically addressing outpatient enterprise structures, a 2011 study on adverse drug events (ADEs) in ambulatory care settings noted the potential for infrastructure improvements to support the reduction of medical errors, stating that “as health information technology becomes more widespread in ambulatory health care delivery… automated surveillance for (adverse drug events) will become more feasible.”[19]

The OIG has provided similar guidance to healthcare providers regarding the relationship between structure and quality. In its revised guidance to nursing homes, the OIG recommended that nursing facilities can “promote compliance by having in place proper medication management processes,” such as utilizing a consultant pharmacist and continually training staff in proper medication management.[20]  Nevertheless, criticism still exists regarding the processes utilized by healthcare providers to reduce medical errors. In its 2010 report on adverse events suffered by Medicare beneficiaries, the OIG recommended that the Centers for Medicare & Medicaid Services (CMS) “influence hospitals to reduce adverse events through enforcement of the conditions of participation” in Medicare, which includes sanctioning physicians through the peer review process.[21] Other studies have advanced the OIG’s claim a step further, arguing that “the hospital peer-review system has widespread failures that permit negligent care by physicians.”[22]

In an attempt “to improve patient safety by encouraging voluntary and confidential reporting of events that adversely affect patients,”[23] The Patient Safety and Quality Improvement Act (PSQIA) of 2005, effective January 19, 2009, established a voluntary reporting system for medical errors.[24] Under PSQIA, to address provider fear that “patient safety event reports could be used against them in medical malpractice cases or in disciplinary proceedings,”[25] confidentiality provisions regarding the protection of “patient safety work product” were established.[26]Patient safety work product” includes any information that is collected while reporting and analyzing a patient safety event,[27] i.e., “a process or act of omission or commissions that resulted in hazardous health care conditions and/or unintended harm to the patient.[28] Under PSQIA, Patient Safety Organizations (PSOs) are charged with collecting and analyzing data under the supervision of the Agency for Healthcare Research and Quality (AHRQ).[29]

Despite the numerous attempts and strategies to curtail the prevalence of medical errors, no definitive answer exists as to whether medical errors are properly attributable to process or physician errors on a large scale. If it were determined that most medical errors are mistakes from breakdowns in processes of care rather than the negligence of physicians, improving and implementing new and effective process controls may best reduce medical errors – and the resulting incidence of medical malpractice cases.[30] However, to date, the healthcare industry and the U.S. tort system are far from reaching this conclusion, leaving the tort system – as well as malpractice insurers and their physician insureds – to continue to grapple with this uncertainty.

https://media3.s-nbcnews.com/j/newscms/2016_18/1524261/errors_fd53fca207ac4622017a0b55e1dcb951.nbcnews-ux-2880-1000.png

[1]       “Crossing the Quality Chasm: A New Health System for the 21st Century,” Institute of Medicine, National Academy of Sciences, 2001, front matter.

[2]       “Overview of Medical Errors and Adverse Events,” By Maité Garrouste-Orgeas, et al., Annals of Intensive Care, Vol. 2, No. 2 (2012), p. 6.

[3]       “Healthcare Valuation: The Financial Appraisal of Enterprises, Assets, and Services,” Vol. 1, By Robert James Cimasi, MHA, ASA, FRICS, CVA, CM&AA, Hoboken, NJ: John Wiley & Sons, 2014, p. xiii.

[4]       “Health Law: Cases, Materials, and Problems, 7th Edition,” By Barry R. Furrow, Thomas L. Greaney, Sandra H. Johnson, Timothy Stoltzfus Jost, and Robert L. Schwartz, St. Paul, MN: West Publishing Company, 2013, p. 507.

[5]       “Licensure of Health Care Professionals,” In “Health Care Law: A Practical Guide, Second Edition” By Scott Becker, Matthew Bender Co., 1998, § 16.02[4], p. 16-23.

[6]       “Health Law: Cases, Materials, and Problems, 7th Edition,” By Barry R. Furrow, Thomas L. Greaney, Sandra H. Johnson, Timothy Stoltzfus Jost, and Robert L. Schwartz, St. Paul, MN: West Publishing Company, 2013, p. 506-507.

[7]       “To Err is Human: Building a Safer Health System,” Institute of Medicine, National Academy of Sciences, 2000, p. 26. The IOM study extrapolated data from the 1984 New York study, as well as a 1992 study from Colorado and Utah to the number of hospitalizations in 1997 to estimate the number of deaths due to medical errors in 1997. The report authors note that these extrapolations may be low because the studies:

  1. Considered only those patients whose injuries resulted in a specified level of harm;”
  2. Imposed a high threshold to determine whether an adverse event was preventable or negligent;” and,
  3. Included only errors that are documented in patient records.”

“To Err is Human: Building a Safer Health System,” Institute of Medicine, National Academy of Sciences, 2000, p. 31.

[8]       “To Err is Human: Building a Safer Health System,” Institute of Medicine, National Academy of Sciences, 2000, p. 30.

[9]     “Fact Sheet: Computerized Physician Order Entry,” The Leapfrog Group, March 3, 2009; “To Err is Human: Building a Safer Health System,” By Institute of Medicine, 2000, p.1.

[10]     “Leapfrog Hospital Survey Results,” The Leapfrog Group, 2008, p. 3.

[11]     “Adverse Events in Hospitals: National Incidence among Medicare Beneficiaries,” Office of Inspector General, November 2010, p. 15, 22.

[12]     “Adverse Events in Hospitals: National Incidence among Medicare Beneficiaries,” Office of Inspector General, November 2010, p. 15.

[13]     “‘Global Trigger Tool’ Shows That Adverse Events in Hospitals May be Ten Times Greater Than Previously Measured,” By David C. Classen et al., Health Affairs, Vol. 30, No. 4 (2011); “Adverse Events in Hospitals: Case Study of Incidence Among Medicare Beneficiaries in Two Selected Counties,” Office of Inspector General, December 2008, http://oig.hhs.gov/oei/reports/OEI-06-08-00220.pdf (Accessed 2/17/15); “Temporal Trends in Rates of Patient Harm Resulting from Medical Care” By Christopher P. Landrigan, MD, MPH, et al., New England Journal of Medicine, Vol. 363, No. 22 (November 24, 2010).

[14]     “A New, Evidence-Based Estimate of Patient Harms Associated with Hospital Care” By John T. James, PhD, Journal of Patient Safety, Vol. 9. No. 3 (September 2013), p. 125.

[15]     “How Many Die From Medical Mistakes in U.S. Hospitals?” By Marshall Allen, National Public Radio, September 20, 2013, http://www.npr.org/blogs/health/2013/09/20/224507654/howmanydiefrommedicalmistakesinushospitals (Accessed 12/3/14).

[16]     “To Err is Human: Building a Safer Health System,” Institute of Medicine, National Academy of Sciences, 2000, p. 30.

[17]     “Crossing the Quality Chasm: A New Health System for the 21st Century,” Institute of Medicine, National Academy of Sciences, 2001, p. ix, 25.

[18]     “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America,” Institute of Medicine, National Academy of Sciences, 2009, p. 134.

[19]     “Adverse Drug Events in U.S. Adult Ambulatory Medical Care,” By Urmimala Sarkar et al., Health Services Research, Vol. 46, No. 5 (October 2011), p. 1527.

[20]     “OIG Supplemental Compliance Program Guidance for Nursing Facilities,” Federal Register Vol. 73, No. 190 (September 30, 2008), p. 56837.

[21]     “Adverse Events in Hospitals: National Incidence among Medicare Beneficiaries,” Office of Inspector General, November 2010, p. 32.

[22]     “A New, Evidence-Based Estimate of Patient Harms Associated with Hospital Care”, By John T. James, PhD, Journal of Patient Safety, Vol. 9. No. 3 (September 2013), p. 127.

[23]     “Patient Safety and Quality Improvement Act of 2005,” Agency for Healthcare Research and Quality, http://archive.ahrq.gov/news/newsroom/press-releases/2008/psoact.html (Accessed 3/5/15).

[24]     “Health Information Privacy: Understanding Patient Safety Confidentiality,” U.S. Department of Health and Human Services, http://www.hhs.gov/ocr/privacy/psa/understanding/index.html (Accessed 3/5/15); “Patient Safety and Quality Improvement; Final Rule,” Federal Register, Vol. 73, No. 226 (November 21, 2008), p. 70732.

[25]     “Patient Safety and Quality Improvement Act of 2005,” Agency for Healthcare Research and Quality, http://archive.ahrq.gov/news/newsroom/press-releases/2008/psoact.html (Accessed 3/5/15).

[26]     “Patient Safety and Quality Improvement: Final Rule” Federal Register, Vol. 73, No. 226 (November 21, 2008), p. 70734.

[27]     “Patient Safety and Quality Improvement: Final Rule” Federal Register, Vol. 73, No. 226 (November 21, 2008), p. 70739.

[28]     “Patient Safety and Quality Improvement: Final Rule” Federal Register, Vol. 73, No. 226 (November 21, 2008), referring to footnote 7 in “Patient Safety and Quality Improvement: Proposed Rule” Federal Register, Vol. 73, No. 29 (February 12, 2008), p. 8113.

[29]     “Understanding Patient Safety Confidentiality” U.S. Department of Health and Human Services, http://www.hhs.gov/ocr/privacy/psa/understanding/index.html (Accessed 3/5/15).

[30]     “To Err is Human: Building a Safer Health System,” Institute of Medicine, National Academy of Sciences, 2000, p. 30.

Your thoughts are appreciated.

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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***

TAX DEDUCTIONS: Home Ownership Simplified

Take Full Advantage Of These Tax Deductions

DR. DAVID EWARD MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

The housing market is HOT right now. Lumbar and wood is expensive. Inflation is emerging. So, owning a home can be very lucrative. Seriously, owning a home can not only give you a cheaper monthly payment than renting but in many cases, the tax benefits make the decision a no-brainer.

Citation: https://www.r2library.com/Resource/Title/0826102549

Home ownership falls for first time in a century - Telegraph

Here are a few of the larger deductions that you need to be sure to take:

Interest you pay on your mortgage: If you own a home and don’t have a mortgage greater than $750,000, you can deduct the interest you pay on the loan. This is one of the biggest benefits to owning a home versus renting–as you could get massive deductions at tax time. The limit used to be $1 million, but the Tax Cuts and Jobs Act of 2017 (TCJA) reduced the limit and made some clarifications on deducting interest from a home equity line of credit.

Property taxes: Another awesome benefit to owning a home is the ability to deduct your property taxes. Before TCJA, the rules were a little more flexible and you were able to deduct the entirety of your property taxes. Now things have a changed a bit. Under the new law, you can deduct up to $10,000. The deduction for state and local income taxes was combined with the deduction for state and local property taxes, too.

Tax incentives for energy-efficient upgrades: While most of the tax incentives for making energy-efficient upgrades to your home have gone away, there are still a couple worth noting. You can still claim tax deductions on solar energy–both for electric and water heating equipment, through 2021. The longer you wait, though, the less money you’ll get back. Here’s the percentage of equipment you can deduct, based on time of installation:

Between January 1, 2017, and December 31, 2019 – 30% of the expenditures are eligible for the credit
Between January 1, 2020, and December 31, 2020 – 26%
Between January 1, 2021, and December 31, 2021 – 22%

ASSESSMENT: But, is now the best time to buy a home? Your thoughts are appreciated.

Rent V. Buy: https://medicalexecutivepost.com/2017/03/14/the-apartment-rent-vs-home-buy-decision/

MDs: https://medicalexecutivepost.com/2012/02/15/is-home-renting-for-chumps/

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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***

PODCAST: “Inelastic” Demand in Healthcare

Economic Implications of Pain Suffering and Imminent Death?

Inelastic Demand in Healthcare: Economic Implications of Pain, Suffering and Imminent Death.

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By Eric Bricker, MD

Inelastic Demand Occurs When the Quantity Demanded for a Good or Service Does NOT Change When the Price Changes.

Citation: https://www.r2library.com/Resource/Title/0826102549

Consequently, When the Supply of a Healthcare Service is Limited, then the Price Goes Up … Way Up, Since the Quantity Demanded Does Not Change.

Examples of Inelastic Demand with Limited Supply in Healthcare Are:

1) Emergencies

2) Patented Medications for Diseases That Have No Other Alternatives

3) Doctor Specialties Where the Patient Has No Choice in the Services Such As Radiologists, Anesthesiologists and Pathologists

The High-Cost Claimants with Inelastic Demand Drive the Majority of Healthcare Costs for a Group.  They Generally Fall into 3 Diagnosis Categories: 1) Orthopedics, 2) Cardiovascular and 3) Cancer.

Orthopedics Should Be the 1st Priority for Lowering Healthcare Costs for a Population … While Demand May be Inelastic, Usually There is Choice and Not a Limited Supply of Orthopedic Services.

Efforts in Orthopedics Should Focus on Increasing Choice, Such as Free Travel to Centers-of-Excellence with Bundled Pricing.

Cardiovascular Care and Cancer Care Tend to Have Inelastic Demand AND Limited Supply. Therefore, the Best Way to Lower Healthcare Costs in These Areas is Through Prevention.

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

***

HOSPITALS and Health Care Organizations

Management Strategies, Operational Techniques, Tools, Templates and Case Studies

Tex Book Review

Drawing on the expertise of decision-making professionals, leaders, and managers in health care organizations, Hospitals & Health Care Organizations: Management Strategies, Operational Techniques, Tools, Templates, and Case Studies addresses decreasing revenues, increasing costs, and growing consumer expectations in today’s increasingly competitive health care market.

Offering practical experience and applied operating vision, the authors integrate Lean managerial applications, and regulatory perspectives with real-world case studies, models, reports, charts, tables, diagrams, and sample contracts. The result is an integration of post PP-ACA market competition insight with Lean management and operational strategies vital to all health care administrators, comptrollers, and physician executives. The text is divided into three sections:

  1. Managerial Fundamentals
  2. Policy and Procedures
  3. Strategies and Execution

Using an engaging style, the book is filled with authoritative guidance, practical health care–centered discussions, templates, checklists, and clinical examples to provide you with the tools to build a clinically efficient system. Its wide-ranging coverage includes hard-to-find topics such as hospital inventory management, capital formation, and revenue cycle enhancement. Health care leadership, governance, and compliance practices like OSHA, HIPAA, Sarbanes–Oxley, and emerging ACO model policies are included. Health 2.0 information technologies, EMRs, CPOEs, and social media collaboration are also covered, as are 5S, Six Sigma, and other logistical enhancing flow-through principles. The result is a must-have, “how-to” book for all industry participants.

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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***

What is EISOPTROPHOBIA?

NOW YOU SEE ME – NOW I DON’T WANT TO SEE MYSELF

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By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

DEFINITION: Eisoptrophobia  is the fear of mirrors or, more specifically, of seeing your own reflection in a mirror. Looking into a mirror can cause people with eisoptrophobia shame or distress.

The term is derived from the Greek “eis” and “optikos”. Even though the sufferers know their fear is irrational, they experience excessive anxiety when they look into the mirror.

ASSESSMENT: Your thoughts are appreciated.

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ORDER DICTIONARY: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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***

What is the “5-100” Insurance Rule?

THE 5 -100 “Policy” Rule 

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

With any universal life insurance policy (and certainly all variable life policies), fluctuating rates of return, the actual timing of the premium payments, and potential internal policy changes by the insurance company, all contribute to results that will probably differ substantially from the original illustration. 

See the source image

RULE: The 5 – 100 Rule states that as a result of accounting for these elements, all initial projections of cash value beyond 5 years, will necessarily be 100 percent incorrect when compared to actuality. 

A prudent policy owner should therefore keep on top of any changes and react accordingly.  If a policy owner ignores his/her policy for even 5 years, any adverse changes could be so drastic as to make rectifying them very costly.

Citation: https://www.r2library.com/Resource/Title/0826102549

Your thoughts are appreciated.

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

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

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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***

DICTIONARY: Health Insurance and Managed Care

GLOSSARY OF TERMS

ORDER HERE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

THANK YOU

***

MEDICARE: Safe Harbor Regulations

Medicare “Safe Harbor” Regulations

Invite Dr. Marcinko | The Leading Business Education ...

The Medicare Safe Harbor rules were passed in an effort to identify areas of practice that would not lead to a conviction under the anti-fraud statute.  The Safe Harbor regulations provide for eleven areas where providers may practice without violating the anti-fraud statute. 

CITE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

Areas of safe practice under these regulations are briefly highlighted below:

  • Large Entity Investments – Investment in entities with assets over $50 million. The entity must be registered and traded on national exchanges.
  • Small Entity Investments – Small entity investment entities must abide by the 40-40 rule.  No more than 40% of the investment interests may be held by investors in a position to make referrals. Additionally, no more than 40% of revenues can come through referrals by these investors.
  • Space and Equipment Rentals – Such lease agreements must be in writing and must be for at least a one year term. Furthermore, the terms must be at fair market value.
  • Personal Services and Management Contracts – These contracts are allowable as long as certain rules are followed. Like lease agreements, these personal service and management contracts must be in writing for at least a one-year term, and the services must be valued at fair market value.
  • Sale of a medical practice – There are restrictions if the selling practitioner is in a position to refer patients to the purchasing practitioner.
  • Referral services– Referral services (such as hospital referral services) are allowed. However, such referral services may not discriminate between practitioners who do or do not refer patients.
  • Warranties – There is certain requirements if any item of value is received under a warranty.
  • Discounts – Certain requirements must be met if a buyer receives a discount on the purchase of goods or services that are to be paid for by Medicare or Medicaid.
  • Payments to Bona Fide Employees – Payments made to bona fide employees do not constitute fraud under the Safe Harbor Regulations.
  • Group Purchasing Organizations – Organizations that purchase goods and services for a group of entities or individuals are allowed; provided certain requirements are met.
  • Waiver of Beneficiary Co-Insurance and Deductible – Routine waiver would not come under the safe harbor.

A physician’s actions that come under the Safe Harbor Regulations will not violate the Medicare Fraud and Abuse Statutes.  However, the provider must still abide by the Stark amendments and must also abide by applicable state law.

STARK UPDATE: https://medicalexecutivepost.com/2018/08/03/cms-to-review-stark-law-relevance-once-again/

Your thoughts are appreciated.

THANK YOU

***

ORDER TEXTBOOK [3rd]: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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PODCAST: The Income and Substitution Effects in Healthcare Finance

Important Economic Concepts to UNDERSTAND

Texas CEO Magazine 2016 Economic Forecast: Dallas - Texas ...

BY ERIC BRICKER MD

One of Their Applications Pertains to the Impact on Time Spent Working Vs. Time Spend on Leisure if a Healthcare Worker’s Pay is Changed.

DEFINITION: The INCOME EFFECT States That If a Worker’s Pay is Decreased, They Will Work More Hours to Maintain the Same Income. Conversely, If a Worker’s Pay is Increased, They Will Work Fewer Hours and Still Maintain the Same Income.

Citation: https://www.r2library.com/Resource/Title/0826102549

A Real-World Example of the Income Effect is When Medicare Decreased Reimbursement for Echocardiograms and as a Result, Decreased Cardiologists’ Pay. Accordingly, Cardiology Practices Increased the Number of Patients They Saw Per Day to Make Up for the Lost Pay and Maintain Their Income.

The SUBSTITUTION EFFECT States That Work and Leisure Time Have OPPORTUNITY COSTS for Each Other.

If a Worker’s Pay Goes Up, then the Opportunity Cost for Leisure (i.e. Not Working) Also Goes Up and the Worker Will Work MORE, Not LESS. Conversely, If a Worker’s Pay Goes Down, then the Opportunity Cost for Leisure Goes Down and the Worker Will Work LESS, Not MORE.

Whether the Income or Substitution Effect Dominates Depends on the Person and the Situation.

THE POINT: In the World of Fee-for-Service Reimbursement, a Decrease in Doctor Pay Per Service May Result in Doctors Providing More Services In Order to Maintain Their Income… Nullifying Any Cost-Savings.

PODCAST: The Income and Substitution Effects Are Important Economic Concepts to Understand in Healthcare Finance.

Your thoughts appreciated.

THANK YOU

***

ME-P Speaking Invitations

Dr. David E. Marcinko is at your Service

thumbnail_IMG_1663.edit1

Dr. David Edward Marcinko MBA CMP® enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.

These have included lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, keynote lectures at city and statewide financial coalitions, and annual keynote lectures for a variety of internal yearly meetings.

His talks tend to be engaging, iconoclastic, and humorous. His most popular presentations include a diverse variety of topics and typically include those in all iMBA, Inc’s textbooks, handbooks, white-papers and most topics covered on this blog.

CONTACT: Ann Miller RN MHA

MarcinkoAdvisors@msn.com

Ph: 770-448-0769

Abbreviated Topic List: https://healthcarefinancials.files.wordpress.com/2009/02/imba-inc-firm-services.pdf

Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

THANK YOU

***

NEWS ALERT: SCOTUS Rules to Leave ACA in Place

BREAKING NEWS!

On June 17, 2021, the Supreme Court of the United States (SCOTUS) released its long-awaited ruling on the fate of the Patient Protection and Affordable Care Act (ACA). In a 7-2 ruling, the majority (written by Justice Stephen Breyer) found that the two individual and 18 state plaintiffs did not have standing, stating

the plaintiffs…failed to show a concrete, particularized injury fairly traceable to the defendants’ conduct in enforcing the specific statutory provision they attack as unconstitutional. They have failed to show that they have standing to attack as unconstitutional the Act’s minimum essential coverage provision.” 

By ruling on the question of standing, the Court did not have to proceed to, and rule on, the issue of the constitutionality of the Individual Mandate.

The Court reversed the Fifth Circuit’s ruling with respect the standing issue, vacated the ruling, and remanded the case with instructions to dismiss.

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A more robust discussion of the majority’s opinion and the procedural history of this case will be included in the June 2021 issue of Health Capital Topics.
(Read the ruling here)

ASSESSMENT: Your comments are appreciated.

THANK YOU

***

PODCAST: Physician WEDDING Costs

 The Economics of Weddings for Medical Professionals

The average wedding costs about $ 25,525 and medical professionals often spend much more.

Destination Weddings - Dynamic Roadshow

QUERY: Do you want a big wedding party for your family and friends, or an earlier retirement for yourself?

PODCAST: https://www.youtube.com/watch?v=XQBRHJ7aGbM

Your thoughts are appreciated.

THANK YOU

***

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

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

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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HOSPITAL EMPLOYER PROVIDED TRANSPORTATION BENEFITS

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

COST COMPARISONS

Example 1: Dr. Kurt purchases an automobile for $15,000.

His hospital business use is 80% and he drives 20,000 total miles per year.  Operating costs for the year, including gasoline, oil, insurance, maintenance, repairs, and license fees, are $4,000. If Kurt owns the car for five years, ownership will cost $35,000 ($4,000 x 5 = $20,000, $20,000 + $15,000 = $35,000), or $7,000 per year. For, each personal use mile costs $1.75 (100% -80% = 20%, 20% x 20,000 miles = 4,000 miles, $7,000/4,000 miles = $1.75). Kurt’s employer reimburses him 34.5 cents per mile for the business-related miles. As a result, the business use of the car is only partially reimbursed (16,000 business miles x 34.5 cents = $5,520).  

However, the business usage costs Kurt $5,600(80% of $7,000). Kurt subsidizes the employer 9.25 cents per mile ($7,000 – $5,520 = $1,480, $1,480 /16,000 = 9.25 cents). Kurt’s total cost of ownership is $1.84 per mile, or $36,850 ($1.88 x 20,000 personal miles over the five-year life).

1

Example 2: Dr. Ben uses a hospital employer-provided vehicle 4,000 miles per year in 2003.

He reimburses the employer 34.5 cents per mile. His cost for five years is $6,900 (5y x 4,000 = 20,000 miles, 20,000 miles x 34.5 = $6,900).

Beginning on January 1st 2013, the standard mileage rates for the use of a car (also vans, pickups or panel trucks) were:

  • 56.5 cents per mile for business miles driven
  • 24 cents per mile driven for medical or moving purposes
  • 14 cents per mile driven in service of charitable organizations

Note the dramatic contrast, from the employee’s perspective, between the above two examples, of the company reimbursing the employee for business use of his personal car, versus the employee reimbursing the company for personal use of the vehicle.

The business, medical, and moving expense rates decrease one-half cent from the 2013 rates.  The charitable rate is based on statute.

Source: http://www.irs.gov

2

ASSESSMENT: Your updated thoughts in modernity are appreciated.

ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

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***

PODCAST: Tele-Health Benefits Everyone!

State of Telehealth in USA vs EU 2015 - Intersog eHealth

DEFINITION: Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions.

Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.

CITE: https://medicalexecutivepost.com/2021/06/03/dictionary-of-health-information-technology-and-security-2/

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Telehealth Benefits Everyone!




Rich talks with veteran Telehealth executive, C.J. Mark about the growth of Telehealth in the last decade. They discuss the issues surrounding Telehealth, and how Covid has accelerated the importance of remote medical care.

PODCAST: https://richardhelppie.com/cj_mark/

ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

***

SAMPLE: New Physician Letter of Employment Contract

ABOUT | DAVID EDWARD MARCINKO

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

SAMPLE NEW PHYSICIAN LETTER OF EMPLOYMENT INTENT

Dear Dr. [Name of Physician]

On behalf of [Name of medical practice or clinic] (hereinafter called the “practice”), this letter sets out a proposed agreement for your initial employment in Dr. [Name of physician]’s medical practice. After both you and Dr. [Name of physician] have agreed upon all issues related to your employment, a formal physician employment agreement will be prepared for your review and signature.

1.   Term: You will be an employee of the practice for an initial [Duration]-month period starting [Month, Date, Year]. Should you and the practice want to proceed past this initial employment period, an offer of co-ownership may be made to you as described in item nine below.

      Your employment with the practice will essentially be “at will,” since you or the practice may voluntarily terminate it at any time upon 30 days’ written notice to the other. However, the following are conditions under which the practice may terminate your em­ployment immediately: (a) upon your death or disability for three (3) consecutive months; (b) upon the suspension, revocation, or cancellation of your right to practice medicine in the State of [State]; (c) if you should lose privileges at any hospital at which the practice regularly maintains admission privileges; (d) should you fail or refuse to follow reasonable policies and directives es­tablished by the practice; (e) should you commit an act amounting to gross negligence or willful misconduct to the detriment of the practice or its patients; (f) if you are convicted of a crime involving moral turpitude, including fraud, theft, or embezzlement; and (g) if you breach any of the terms of your employment contract.

2.   Compensation: Your salary for the initial 12-month period will be $[dollar value] and $[dollar value] in the second 12-month period, each year payable in monthly installments. You will also be enti­tled to an incentive bonus calculated as follows: [Percentage] % of your collected production when such collections exceeds $[dollar value] in the first year and $[dollar value] in the second year. The bonus each year will be calculated and paid on a semiannual basis. You will also be entitled to receive a one-time signing bonus of $[dollar value] if you sign your employment contract before [Month, Date, Year].

      A portion of your compensation may be paid for by proceeds received from [Name of hospital] under the terms and conditions of a hospital recruitment agreement. The parties to this agreement will be the hospital and the practice only. However, forgiveness of any advances made by the hospital will be directly contingent upon the length of time you remain with the practice. Therefore, should your employment terminate for any reason, the practice will re­quire you to repay to it any amounts the practice repays the hospi­tal, in no matter what form, per the terms and conditions in the hospital recruitment agreement. [Note: Use this if the practice signs a hospital recruitment agreement with the hospital.]

3.   Benefits: In addition to your base compensation and incentive bo­nus, the practice will pay for the following: (a) health insurance, (b) malpractice insurance, (c) continuing medical education (CME) costs, (d) medical license fee, (e) board certification exam fee, (f) reasonable cellular phone costs, and (g) a pager. You will also be entitled to a moving cost allowance for relocating to [Location.] You will be entitled to two weeks of paid vacation, 10 working days as paid sick leave, and four days paid time off for CME or the board certification exam.

4.   Disability Leave: In case of absence because of your illness or injury, your base salary will continue for a period not exceeding 30 days per calendar year, plus any unused vacation time and sick leave. You will be entitled to any incentive bonus payments that may be due to you as collections are received on your prior production. Absence in excess of 30 days would be without pay. Unused sick leave cannot be carried over to succeeding years, nor will it be paid for at any time.

5.   Exclusive Employment: As an employee, you will be involved full-time in the practice and you may not take any outside employ­ment during the term of your employment agreement without the practice’s written approval. However, you will be entitled to keep compensation from honorariums, royalties, and copyrights if ap­proved by the practice in writing. If the practice does not give approval, then the income from such activities shall remain the property of the practice.

6.   Termination Compensation:  Should your employment terminate for any reason, you will be entitled to accrued but unpaid base compensation, earned but unpaid incentive bonus, and unused va­cation leave.

7.   Non-Solicitation: During the course of your employment, the prac­tice will introduce and make available to you its contacts and refer­ring physician relationships, ongoing patient flow, general hospital sources, business and professional relationships, and the like. Since you have not been in private practice in the area previously, you acknowledge that you currently have no established patients following you. If there should be a termination, the practice will not restrict your ability to practice medicine in the area; however, it will require you to enter into a nonsolicitation agreement in which you agree not to solicit the employees of the practice nor its patients to follow you into your new medical practice. [Note: Insert Covenant Not to Compete here, if applicable.]

8.   Employee-Only Status: During the term of your employment, you will not be required to contribute any money toward the practice’s equipment or operations, but likewise your work will give you no financial interest in the assets of the practice. However, the prac­tice intends to offer you the opportunity to buy into the ownership of the practice as set forth in item 9 below.

9.   Ownership Opportunity: At the end of your employment period, the practice will evaluate your relationship and may offer you the opportunity to become a co-owner in the practice (or enter into an office-sharing relationship). This offer is not mandatory and is at the total discretion of the practice. Should an offer not be tendered for some reason, the practice will wait until the end of your next 12-month employment period to decide whether to tender an offer of co-ownership.        If an offer of co-ownership is made, Dr. [Name of physician] will discuss with you the following: (a) what percentage of the practice you will be allowed to acquire, (b) how best to value such interest, and (c) how you will pay for the acquisition of such interest. The practice hopes to achieve mutually agreeable solutions to these ownership issues.

We hope this offer meets with your approval. If so, please contact Dr. [Name of physician] as soon as possible. This letter is not intended to be a legally binding agreement; it is, rather, a tool to be used to prepare your formal physician employment agreement. If you should have any questions, please do not hesitate to contact myself or Dr. [Name of physician] at your convenience.

Sincerely,

Atlantic Physicians Group

MEDICAL GROUP PRACTICE, LLC

Lantana FLA

ASSESSMENT: Your thoughts are appreciated.

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

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

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

THANK YOU

***

PODCAST: How New Technologies Are Predictably Spread and How it Applies to Healthcare

BY ERIC BRICKER MD

[Book Review]

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The Technology Adoption Lifecycle Was Explained in Geoffrey Moore’s Famous Book ‘Crossing the Chasm.

If You Are a Healthcare Entrepreneur or Innovator Your MUST Understand and Apply the Technology Adoption Lifecycle.

It States that Disruptive Innovation (i.e. Innovations that Require Behavior Change) Is Not Evenly Adopted Across a Population.

Rather, People Segment Themselves into Sub-Groups That Adopt the New Innovation Differently. To Whit:

**************

Early Adopters Love Tinker and Like New Innovations Just Because They Are New. Early Adopters Tend to Not Be Price-Sensitive.

Pragmatists Have a Specific Problem that the New Innovation Will Solve and If They See Other People Using It, They Will Use It Too. Pragmatists Are Somewhat Price-Sensitive.

Conservatives Would Rather Not Adopt the New Innovation, but if it is Already Built-in to Something They Already Buy, Then They Will Be More Likely to Use It. Conservatives are Very Price Sensitive.

Skeptics Will Never Adopt the New Innovation.

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To Spread a New Innovation, One Must Cross the Chasm Between the Early Adopters and Pragmatists With a ‘Niche‘ and ‘Bowling Pin‘ Strategy.

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

***

New “MEDICAL SPECIALTIES” 2.0

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

GLOSSARY OF PRACTITIONER TERMS?

Each generation of doctors and medical professionals is extraordinarily complex, bringing various skills, expertise and expectations to the modern medical work environment. Determining the best method to unite such diverse thinking is one of the many challenges faced by physician executives and healthcare leaders today.

And, as linguistic evolution occurs, the nomenclature of hospitalist was followed by that of intensivist, proceduralist and nocturnalist, etc [www.MedInnovationBlog.com and Personal communication Richard L. Reece MD].

Is it any wonder that many medical leaders and executive in the Baby Boomer generation find themselves at a loss? The days of functional leadership are gone and suddenly, no one cares about the expertise of the Baby Boomers or how they climbed the corporate ladder, in medicine or elsewhere. Leadership in the new era is no longer about command-control or dictating with intense focus on the bottom line; it is about collaboration, empowerment and communication. And, it is not about titles and nomenclature; it is about lifestyle choice.

What else drives these new-wave specialists?

The answer, of course, is the next-generation of physicians and their emerging new medical business and practice models, which include:

  • “Ambulists” are doctors that travel locally, have no, or only a sparse physical office presence of their own. They sporadically provide services that are additive to traditional practice models [i.e., endocrinologist in a large family medical office with many diabetics]. 
  • “In-Situ” physicians regularly provide services that are complimentary to existing traditional practice models [i.e., dentists or podiatrists in a medical practice].
  • “Laborists” are obstetricians that do not wish to be on-call. First begun in Cape Cod and other Massachusetts hospitals, such obstetricians work regular shifts for the sole purpose of delivering babies.
  • “Locum Tenens” doctors travel around the country as itinerants [i.e., cruise ships] as temporary substitutes for another the same specialty.
  • “Officists” remain in their own physical practice, and rarely see patients in the hospital, nursing home, patient home, out-patient facility, etc.
  • Finally, “dayhawk physicians” mimic the “nighthawk physician” model where radiologists in remote locations read films in the middle of the night as cash-strapped hospitals often find it cheaper to outsource with better services and more timely interpretations in many cases.

Your thoughts are appreciated.

THANK YOU

***

OVERHEARD IN THE FINANCIAL ADVISOR’S LOUNGE

On Asset Protection FOR PHYSICIANS

From my perspective, asset protection is a team sport, and lawyers rely on financial advisers all the time to spot issues for clients. We do not all share the opinion that non-lawyers are incapable of giving good advice.

J. Chris Miller JD

Alpharetta, GA

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

THANK YOU

***

PODCAST: Soap-Box Opera of Healthcare Reform?

By Carolyn McClanahan MD CFP

Your thoughts are appreciated.

THANK YOU

***

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

***

HUMANITARIAN WISDOM IN PATIENT CARE AS AN ETHICAL AND MORAL IMPERATIVE!

AND … RISK MANAGEMENT TOOL?

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BY DR. DAVID EDWARD MARCINKIO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

To start, let us all recall the Canadian physician Sir William Osler MD, one of the founders of Johns Hopkins Hospital in my hometown of Baltimore Maryland, and where I played stickball in the parking lot as a kid. He left a sizeable body of wisdom that has guided many physicians in the practice of medicine. So, allow me to share with you some of that accumulated wisdom and the quotes that have served me well over the years.

From Dr. Osler, I learned the art of putting myself in the patient’s shoes. “The motto of each of you as you undertake the examination and treatment of a case should be ‘put yourself in his place.’ Realize, so far as you can, the mental state of the patient, enter into his feelings.” Osler further stresses that we should “scan gently (the patient’s) faults” and offer the “kindly word, the cheerful greeting, the sympathetic look.”1

“In some of us, the ceaseless panorama of suffering tends to dull that fine edge of sympathy with which we started,” writes Osler in his famous essay “Aequanimitas.”2 “Against this benumbing influence, we physicians and nurses, the immediate agents of the Trust, have but one enduring corrective — the practice towards patients of the Golden Rule of Humanity as announced by Confucius: ‘What you do not like when done to yourself, do not do to others.’”

Medicine can be both art and science as many physicians have discovered. As Osler tells us, “Errors in judgment must occur in the practice of an art which consists largely of balancing probabilities.”2 Osler notes that “Medicine is a science of uncertainty and an art of probability” and also weighs in with the idea that “The practice of medicine is an art, based on science.”3,4

Osler emphasized that excellence in medicine is not an inheritance and is more fully realized with the seasoning of experience. “The art of the practice of medicine is to be learned only by experience,” says Osler. “Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone can you become expert.”5

Finally, some timeless wisdom on patient care came from Osler in an address to St. Mary’s Hospital Medical School in London in 1907: “Gain the confidence of a patient and inspire him with hope, and the battle is half won.”6

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Osler has also imparted plenty of advice on the business of medicine. In “Aequanimitas,” Osler says there are only two types of doctors: “those who practice with their brains, and those who practice with their tongues.”7

In a valedictory address to medical school graduates at McGill University, Osler suggested treating money as a side consideration in a medical career.8 “You have of course entered the profession of medicine with a view of obtaining a livelihood; but in dealing with your patients let this always be a secondary consideration.”

“You are in this profession as a calling, not as a business: as a calling which exacts from you at every turn self-sacrifice, devotion, love and tenderness to your fellow man,” explains Osler in the address to St. Mary’s Hospital Medical School.6 “Once you get down to a purely business level, your influence is gone and the true light of your life is dimmed. You must work in the missionary spirit, with a breadth of charity that raises you far above the petty jealousies of life.”

It is not easy for doctors to combine a passion for patient care, a knowledge of science and the maintenance of business, according to Osler in the British Medical Journal.9 “In the three great professions, the lawyer has to consider only his head and pocket, the parson the head and heart, while with us the head, heart, and pocket are all engaged.”

While some aspects of practice may fall short or be devoid of appropriate financial remuneration, the giving of one’s time, expertise and experience in improving patient outcomes and the quality of their lives may be the greatest gift. “The ‘good debts’ of practice, as I prefer to call them … amount to a generous sum by the end of each year,” says Osler.9

And so, as you practice medicine and reflect on your career, always remember the words and wisdom of Dr. William Osler, and keep patient welfare as your first priority.

References

1. Penfield W. Neurology in Canada and the Osler centennial. Can Med Assoc J. 1949; 61(1): 69-73

2. Osler W. Aequanimitas. Chapter 9, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 159

3. Bean WB. William Osler: Aphorisms, CC Thomas, Springfield, IL, p. 129.

4. Osler W. Aequanimitas. Chapter 3, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 34

5. Thayer WS. Osler the teacher. In: Osler and Other Papers. Johns Hopkins Press, Baltimore, 1931, p. 1.

6. Osler W. The reserves of life. St. Mary’s Hosp Gaz. 1907;13 (1):95-8.

7. Osler W. Aequanimitas. Chapter 7, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 124

8. Osler W. Valedictory address to the graduates in medicine and surgery, McGill University. Can Med Surg J. 1874; 3:433-42.

9. Osler W. Remarks on organization in the profession. Brit Med J. 1911; 1(2614):237-9.

10. Jacobs. AM: PMNews, April, 2015.

ASSESSMENT: Your thoughts are appreciated.

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

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***

On DISPOSABLE and Other “Next-Gen” Credit Cards

Touring with Marcinko | The Leading Business Education ...

BY DR. DAVID EDWARD MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

‘Chip & Pin’ Technology

Disposable credit cards are the newest innovation to help reduce fraud and assumed identity scams on e-commerce based websites. As with traditional credit cards, these cards are numbered, but used only once. Then, electronically they are erased so that there is nothing left in the merchant’s database for hackers to steal.

But, in 2014, Congress began looking at new ways to keep personal credit card information safe after several high-profile security breaches at some of America’s top retailers.

WHY? Current credit cards use easy to hack magnetic strip technology from the 1960s. Many consumers want more secure “pin & chip” cards which have been in use in Europe for years. Even though micro-chip technology costs billions to implement, merchants are moving in that direction as they issue new cards to consumers. Most modern polls show nearly half of all people surveyed are extremely concerned about the safety of their personal credit card information.

Burner Cards: Similar to a burner phone or “throwaway” social media account, burner credit cards are temporary, virtual credit cards that are not your “main” credit card. The bank or burner card app will give you a temporary number that links back to your main credit card which you can use for online purchases.

An ANonymous Credit Card provides an extreme degree of privacy and prevents the tracking of your expenses by a spouse, people with bad intentions or government monitoring agencies. It is important to realize that there are plenty of legitimate reasons for wanting to buy something discreetly through an Anonymous Credit Card.

Credit Card Mistakes to Avoid

No number has as far-reaching an impact on your money as your credit scores.

Here are some obstacles, physicians and all of us, should dodge on the road to financial security:

  • Don’t pay for a credit card repair service.
  • Don’t miss a payment.
  • Don’t max out your card.
  • Don’t take a cash-advance.
  • Don’t skip using your cards.
  • Don’t chase interest rates.
  • Don’t apply for several credit cards all at once.
  • Don’t co-sign a loan.
  • Don’t spread our car or mortgage payments.

Citation: https://www.r2library.com/Resource/Title/0826102549

Denied Credit

If you are denied a credit card, you have the right to obtain a credit report free from the agency which denied you. Your request must be made in writing and within thirty-sixty days. Consumer credit is governed by the Fair Credit Reporting Act (FCRA).  The regulations are issued by and enforced by the Federal Trade Commission. Certain states offer consumers additional rights.  Credit reporting agencies are referred to as a “consumer reporting agency”.

ASSESSMENT: Your thoughts are appreciated.

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

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

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

THANK YOU

***

PODCAST: The Future of Healthcare Looks to Medicare’s Past?

See the Future of Healthcare By Looking to Medicare’s Past

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Texas CEO Magazine 2016 Economic Forecast: Dallas - Texas ...

BY DR. ERIC BRICKER MD

***

Desire for a Healthcare ‘Safety Net’ Goes Back Almost 100 years to President F.D.R. and His “New Deal

FDR Was Able to Pass Social Security, but He Also Wanted a Healthcare Safety Net Too.

Presidents Truman and Kennedy Also Wanted a Federally-Funded Healthcare Safety Net.

LBJ Carried the Torch of the Healthcare Safety Net. He Was Able to Have Medicare Legislation Passed in 1965 by Combining 3 Separate Proposals and Acts:

1) Hospital Insurance

2) Doctor Insurance That Was Voluntary

3) the State-Administered Kerr-Mills Act 

Hospital Insurance Became Medicare Part A. Doctor Insurance Became Medicare Part B. The Kerr-Mills Act Became Medicaid.

Presidents Carter and Clinton Also Wanted to Expand the Healthcare Safety Net. President Obama Expanded the Healthcare Safety Net with Passage of Obamacare. President Biden is Seeking to Expand the Healthcare Safety Net Too.

The Arc of Government-Funded Healthcare Stretches Back Almost 100 Years and Will Inevitably Result in the Full Government Payment for Healthcare in America.

It’s Not a Question of If, But When.

Implication: United Health Group is Making Many Acquisitions to Become a Vertically Integrated Healthcare Company to Position Itself as a Major Government Contractor for the Eventual Federal Takeover.

PODCAST: https://www.youtube.com/watch?v=OAh7Rl7w1wM

Your thoughts are appreciated.

THANK YOU

***

ASK A FINANCIAL ADVISOR? About Company “Vesting”

A YOUNG PHYSICIAN INQUIRES ABOUT NON-PUBLIC COMPANY SHARES AND VESTING?

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QUESTION: I am a physician and work for a startup healthcare IT company with shares in a non-public company that vests over time. What does that mean, and will the shares only be worth something if we go public or are acquired?

Shelly from Boston, MA

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ANSWER: In most cases, startups dangle equity compensation over employees like a just-out-of-reach cupcake in front of a treadmill. Vesting means some condition needs to be met before you fully own your shares, whether it’s staying at the company for a period of time, reaching a target valuation, or both.

Once your shares have fully vested, you’d think you can finally cash in. But that’s not always the case. It’s a hassle to sell private company shares because there are far fewer buyers compared to selling shares in a publicly traded company. 

If you want to sell your stake before the company goes public, you can ask the execs at your company to buy back your shares. If they say no—and they might, because once they let one employee sell, it’s hard to turn down others—you need another buyer, like an outside investor.

There are eBay-like marketplaces for selling private company shares, but it’s not like posting a picture of your old iPod and offering free shipping. You can only sell to accredited investors (aka hedge funds and other rich folks), and your company needs to authorize the sale. 

It’s way easier to sell your shares if and when your company goes public or is acquired by another company.

Thanks for the query.

Citation: https://www.r2library.com/Resource/Title/0826102549

***

ASSESSMENT: Your thoughts are appreciated.

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

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

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

THANK YOU

***

PODCAST: “Real ACOs Haven’t Been Tried Yet!”

What is an Accountable Care Organization?

DEFINITION: ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings.

Citation: https://www.r2library.com/Resource/Title/0826102549

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QUESTION: What happens when you’re a healthcare policy wonk and the pilot study for your pet program has failed miserably? 

ANSWER: You declare “Success!” in the editorial pages of the New England Journal of Medicine and demand that the program become nationwide and mandatory. I kid you not.  This is exactly what happens.

Thankfully, Anish Koka is vigilant and explains the blatant obfuscations and manipulations that the central planners engage in to have their way.

***

And so, In this video, Anish and colleague Michel Accad, MD, will reveal the machinations, take the culprits to task, and discuss pertinent questions regarding health care organization: 

  • Does “capitation” reduce costs? 
  • Do employed physicians necessarily utilize fewer resources? 
  • What happens when a HMO and a traditional fee-for-service health system operate side-by-side in a community?
BMC and Accountable Care - Boston Medical Center

Enjoy!

PODCAST: http://alertandoriented.com/real-acos-havent-been-tried-yet/

Your thoughts are appreciated.

THANK YOU

***

PODCAST: What is the “Diluted” Stock Effect?

WHAT IT IS – HOW IT WORKS

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

The lowering of the book or market value of the shares of a company’s stock as a result of more shares outstanding. A company’s initial registration may include more shares than are initially issued when the company goes public for the first time.

Later, an issue of more stock by a company (called a “primary offering,” distinguished from the “initial public offering”) dilutes the existing shares outstanding. 

Also, earnings-per-share calculations are said to be “fully diluted” when all common stock equivalents (convertible securities, rights, and warrants) are included. “Fully diluted” numbers are used in analysis when there is a likelihood of conversion or exercise of rights and warrants.

CITE: https://www.r2library.com/Resource/Title/0826102549

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How does dilution affect my shares? | Startupxplore Blog

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PODCAST: https://duckduckgo.com/?q=Dilutive%22+Stock&t=newext&atb=v275-2&iax=videos&ia=videos&iai=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DtjQzJ7GY0GY

ASSESSMENT: Your thoughts are appreciated.

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

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

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***

A FRUSTRATED PHYSICIAN ASKS: How Much Insurance is Enough?

OVER HEARD IN THE DOCTOR’S LOUNGE

Image result for Doctor Lounge Signs

I currently have no fewer than 10 separate insurance policies associated with my plastic surgery practice. I understand very little about the policies other than that somebody at some point told me I needed each and every one of them, and each made sense when I bought it. But, I often wonder:  

  • Am I over-insured and thus wasting money? 
  • Am I under-insured and thus at risk for a liability disaster? 

I never really had the means of answering these questions …. Until Now!

Lloyd M. Krieger; MD MBA

[Beverly Hills, CA]

***

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

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

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

***

COVID-19 Financial Resources for Physicians

Bhagwan Satiani, MD, MBA, DFSVS, FACHE, FACS

Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA

Jessica L. Bailey-Wheaton, JD

ABSTRACT

The appropriate focus in managing the COVID-19 pandemic in the United States has been addressing access and delivery of care to the population affected by the outbreak. All sectors of the U.S. economy have been significantly affected,including physicians. Physician groups of all specialties and sizes have experienced the financial effects of the pandemic.Hospitals have received billions of dollars to support and enable them to manage emergencies and cover the costs of the disruption.

However, many vascular surgeons are under great financial pressure because of the postponement of all non-emergency procedures. The federal government has announced a myriad of programs in the form of grants and loans to reimburse physicians for some of their expenses and loss of revenue. It is more than likely that unless the public health emergency subsides significantly, many practices will experience dire consequences without additional financial assistance.

The authors have attempted to provide a concise listing of such programs and resources available to assist vascular surgeons who are small businesses in accessing these opportunities.

Health Capital Consultants - Healthcare Valuation

WHITE PAPER: https://www.healthcapital.com/researchmaterialdocuments/publishedarticles/Journal%20of%20Vascular%20Surgery%205.8.20.pdf

Your comments are appreciated.

THANK YOU

***

ORDER BOOK: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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WHITHER THE CERTIFIED MEDICAL PLANNER™ MARKS?

Wither the CERTIFIED MEDICAL PLANNER™ Professional Certification?

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DEAR INVESTMENT ADVISORS, CPAs, FINANCIAL PLANNERS, FINANCIAL ADVISORS & INSURANCE AGENTS

We believe that:

If you do not have a market niche; you are not deeply informed
If you are not deeply informed; you can’t different yourself
If you can’t differentiate yourself; you can’t differentiate price
If you can’t differentiate price; you have no market power
If you have no market power; you have no unique knowledge
If you have no unique knowledge; you have fewer profits

If you have fewer profits; you are not likely a CMP™

CMP

PROGRAM CURRICULUM: Enter the CMPs

POPULAR BOOKS: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

Dean Gene Schmuckler PhD MBA MEd CTS
http://www.CertifiedMedicalPlanner.org

THANK YOU

***

PODCAST: The Hidden War for Patients and Money

The Role of Referrals and Patient Volume in Healthcare Finance

Patient Referrals are BIG Business for Hospital Systems

Hear the Story of How UMass Memorial Health Care Specifically Targeted Referring Physicians

BY ERIC BRICKER MD

Your thoughts are appreciated

THANK YOU

More on Referral Leakage: https://medicalexecutivepost.com/2015/04/24/medical-provider-network-referral-leakage/

***

Product Details

TEXTBOOK ORDER: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

***

Financing LONG-TERM CARE Needs?

AGING AND RETIREMENT

Long-term care (LTC) may not be the first thing individuals or couples think about as they approach retirement, but the costs for those who needs it can disrupt and derail retirement security. A good plan for long-term care requires many decisions over an extended period of time, and well before retirement.

In this article, Milliman consultant Robert Eaton discusses the major considerations and options for financing LTC needs in retirement.

***

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

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

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

***

State of the Medical Professional Liability Market?

A Hardening Market Arrives Just in Time TO GREET the GLOBAL Pandemic

The year 2019 marked a turning point for the medical professional liability (MPL) insurance industry. Reserve releases declined to less than 5% of premium. Insurers projected a combined ratio over 120% on 2019 earned business. Frequency increased for many writers and the trend in indemnity severity was above inflation. In response, insurers began to take rate action, manifesting in growth in direct written premium that exceeded inflation for the first time since 2005.

Despite significant underwriting losses, the MPL industry returned double its net income for the year as dividends to policyholders. Policyholder dividends show little sign of declining as the MPL industry remains well-capitalized and able to fund policyholder dividends with investment income.

And so, to learn more about the current state of the MPL market, read this article by Susan Forray and Chad Karls.

.PDF FORMAT: https://www.milliman.com/-/media/milliman/pdfs/articles/industry-update-2q-2020.ashx

ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

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

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***

What is Corporate “BOOK VALUE” & “PAR VALUE”?

TWO INVESTING DIFFERENCES = TWO QUICK THOUGHTS

BY DR. DAVID EDWARD MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

BOOK-VALUE: Cost of capital assets minus accumulated depreciation for a healthcare [corporation], or other organization.

The net asset value of a [healthcare] companies common stock. This is calculated by dividing the net tangible assets of the company (minus the par value of any preferred stock the company has) by the number of common shares outstanding.

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PAR VALUE: For common stock, the value on the books of the corporation. It has little to do with market value or even the original price of shares at first issuance.

The difference between par and the price at first issuance is carried on the books of a corporation as “paid-in capital” or “capital surplus.”

***

See the source image

ASSESSMENT: Your thoughts are appreciated.

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

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INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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***

PODCAST: Corporate Practice of Medicine Laws

Dictate Doctors Cannot Work for Corporations?

Texas CEO Magazine Eric Bricker 1 - SO 14 - Texas CEO Magazine

ERIC BRICKER MD

These Laws Were Put Into Place So Doctors Would Not Put Shareholders Before Patients and So Corporations Would Not Interfere with Doctor Judgement.

Corporate Practice of Medicine Laws are at the State-Level, NOT the Federal Level.

Each State Has Their Own Exceptions Such as 1) Doctors Can Work for Companies That Are Owned by Other Doctors and 2) Doctors Can Work for Hospitals.

However, Private Equity Firms Have Been on a Physician Practice Buying Binge.

Private Equity Firms Bought 355 Physician Practices from 2013 – 2016.

Two of the Largest Purchases Were KKR‘s Purchase of Envision’s 25,000 Doctors for Almost $10 Billion and Blackstone‘s Purchase of Team Health’s 20,000 Doctors for $6 Billion.

QUERY: If Corporate Practice of Medicine Laws Say that Doctors Cannot Work for a Corporation, How are Private Equity Purchases of Physician Practices Legal?

This Video by Colleague Eric Bricker MD Explains
https://www.youtube.com/watch?v=2epmk4_-kUI

***
Your comments are appreciated.
THANK YOU

***

Wither DROP-IN Group Medical Appointments?

THE RE-EMERGING RE-VOLUTION!

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

HISTORY

DIGMAs (Drop-In Group Medical Appointments) are medical office appointments with a patient’s physician that take place in a supportive group setting. The model, developed in 1996 by Kaiser Permanente psychologist Dr. Ed Noffsinger, is a combination of an extended medical appointment with the patient’s own physician and effective group learning and support.

The group consists of the physician, a behavioral health professional, and patients from the physician’s panel. DIGMAs are best suited for routine appointments. Unfortunately, the nascent concept was met with mockery and great derision after the PP-ACA era.

PRANKSTERS: https://medicalexecutivepost.com/2016/01/31/group-drop-in-doctor-visits-evolving/

Today, after the pandemic and with the rise of tel-health and tele-medicine, Shared Medical Appointments (SMAs), also known as Group Medical Visits [GMVs], are again a growing topic of discussion among providers and health economists, looking for ways to increase access to care and improve efficiency. The group visit format is also getting more attention in recent years as a strategy to add value for the patient. They typically involve up to a dozen patients or so and offer various efficiencies as well as benefits of shared discussion and experiences.

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See the source image

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Behavioral Changes

Moreover, physicians and medical providers know that simply telling patients what to do often does not improve their health. The basic premise of DIGMAs, SMAs and GMVs is to build more patient engagement and inspire lasting behavior change by offering patients the opportunity to share their personal experiences not only with their provider but also with other patients dealing with similar issues.

NEWER REALITY: https://www.hqontario.ca/Portals/0/Documents/qi/learningcommunity/Roadmap%20Resources/Advanced%20Access%20and%20Efficiency/Step%205/pc-nha-group-medical-appointments-manual-en.pdf#:~:text=DIGMAs%20%28Drop-In%20Group%20Medical%20Appointments%29%20are%20medical%20appointments,that%20take%20place%20in%20a%20supportive%20group%20setting.

BILLING: https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/group-visits.html

QUERY: Might this be an approach for tele-health visits as well as rural healthcare, etc.

ASSESSMENT: Your thoughts are comments are appreciated.

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RURAL HOSPITALS: Defined?

By Calvin Wiese MBA CPA CMP ®

Dr. David Edward Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

A Distance Definition

A rural hospital is defined as a hospital serving a geographic area ten or more miles from the nexus of a population center of 30,000 or more

More specifically, a rural hospital means an entity characterized by one of the following:

·Type A Rural Hospital — small and remote, has fewer than 50 beds, and is more than 30 miles from the nearest hospital.

·Type B Rural Hospital — small and rural, has fewer than 50 beds, and is 30 miles or less from the nearest hospital.

·Type C Rural Hospital — considered rural and has 50 or more beds.

Citation: https://www.r2library.com/Resource/Title/0826102549

As rural hospitals close, millions of Americas live ...

Your thoughts are appreciated.

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ON RURAL HEALTHCARE PROVIDERS

Executive Order Expands Tele-Medicine to Ease Burden

By Health Capital Consultants, LLC

On August 3, 2020, President Donald Trump signed an executive order aimed at expanding access to care through two avenues: telemedicine and eased financial burdens on rural providers.

Health Disparities Continue to Plague Rural Areas

And so, our colleagues for this Health Capital Topics article will discuss the executive rule and the subsequent agency actions on these fronts.

READ: https://www.healthcapital.com/hcc/newsletter/08_20/HTML/EXEC/convert_executive_telemedicine_access_expansion_8.20.20.php

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

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PROCEDURES: Rural v. Urban Hospitals

Appreciating the Number of Procedures Done per Hospitalization

By http://www.MCOL.com

JOURNAL RURAL HEALTH: Rural hospitals are not associated with worse postoperative outcomes for colon cancer surgery: https://onlinelibrary.wiley.com/doi/full/10.1111/jrh.12596

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Hospitals

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ASSESSMENT: Your thoughts are appreciated.

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