US SENATE: Averts Government Shutdown?

Senate passes last-minute deal to avert government shutdown


The Senate on Thursday afternoon just passed a deal party leaders reached late Wednesday to avert a government shutdown that would have affected hundreds of thousands of federal workers and slammed an economy still struggling to recover from the pandemic, all with just hours left to stave off a crisis.

READ: https://www.msn.com/en-us/news/politics/senate-passes-last-minute-deal-to-avert-government-shutdown/ar-AAP0mXN

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US Senate Passes Bill for Nearly $250 Billion in Science Funding | The  Scientist Magazine®

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PODCAST: Surescripts Explained

Gate Keeper for Electronic Prescribing

BY DR. ERIC BRICKER
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PODCAST: Medicare and Nursing Home / Long Term Care

By CMS

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

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INDEPENDENT DENTAL PRACTICE: Start-Up Costs?

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imba inc

BY THE INSTITUTE OF MEDICAL BUSINESS ADVISORS, Inc.

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

How much will it cost you to start a dental practice – with Business Plan? 

There are many costs to consider to set up a successful dental practice. Note that the following values are not the exact amount but an average of setting up a dental practice:

  • Purchase price – this includes valuation fees of between $1,000-4,500, solicitor fees of between $4,000 – 17,000, accountancy and bank fees of around $3,000, and bank solicitors, which can be up to $3,500. Many of these can be reduced or obliterated.
  • Materials – $40,000
  • Lab fees – $36,000
  • Staff costs – $82,000
  • Other costs (associates fees) – [$245,000 – $295,000]
See the source image

Other Factors

  1. “Big” Tech – Many startup doctors want to include CBCT or CAD/CAM or 3D printing in their startup, any of which can add $25,000-$175,000. In other situations, waiting is the best option.
  2. Cabinetry Preferences – Costs for cabinetry can range from $5,000 to $175,000.
  3. Practice Management Software (PMS) – Pricing will range from a few thousand dollars to $25,000; OR none at all.
  4. Mechanical Delivery – Typically referred to as chairs, lights, and units, this category of dental equipment costs will range between $5,000 and $100,000 based on your startup plans.

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

Vision – Ignore the so-called “experts” who will try to create a cookie-cutter model for your equipment costs. That is the thinking of corporate dentistry. You want a customized private practice vision that allows you to create a model matching your standards. Prioritize your vision, so your values and philosophy will lead your dental equipment budget and purchasing decisions. Your equipment budget will be—and should be—customized.

BUSINESS PLAN: https://medicalexecutivepost.com/2017/08/17/business-plan-for-creatives-and-doctors/

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PODCAST: “Un-Accountable” Healthcare Quality

BOOK REVIEW

By Dr. Eric Bricker MD

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MEDICAL ETHICS: https://medicalexecutivepost.com/2021/05/28/medical-ethics-managing-risk-is-a-component-of-caring/

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PODCAST: Healthcare, the Digital Eco-System and the Stock Market?

By Rajeev Ronanki

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Investment guru Jim Cramer says buy stocks along the digitization of everything”.

But – Even Healthcare?

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

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Tele-Health Financial Expansion

BY HEALTH CAPITAL CONSULTANTS, LLC

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Additional $20 Million Directed to Rural Telehealth Expansion

It has been well documented that the COVID-19 pandemic resulted in unprecedented increases in telemedicine utilization across the U.S. However, rural providers and patients, as evidenced by their lower rates of telemedicine usage during this time, have not been able to take advantage of the opportunities provided by telemedicine to the same extent as urban providers.

On August 18, 2021, the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services (HHS) announced the latest attempt to ameliorate this issue – the distribution of nearly $20 million to 36 recipients for the purpose of strengthening telehealth services in rural and underserved communities and expanding innovation and quality. (Read more…)

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

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PODCAST: NCQA and HEDIS [Health Effectiveness Data Information Set]

90 NCQI MEASUREMENTS

BY ERIC BRICKER MD

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of U.S. health plans to measure performance on important dimensions of care and service. More than 190 million people are enrolled in health plans that report quality results using HEDIS.

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HEDIS Explained - BHM Healthcare Solutions

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

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The National Committee for Quality Assurance is an independent 501 nonprofit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation.

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

MORE: https://www.dhcs.ca.gov/provgovpart/Documents/6422/NCQAAccreditationOverview-1-21-20.pdf

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Qualit8 | Pulse8 | Revolutionizing Healthcare Analytics Platform

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PODCAST: https://www.ahealthcarez.com/how-hedis-quality-scores-work

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What is Financial CARRIED INTEREST?

A TAX LOOPHOLE?

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Carried interest, or carry, in finance, is a share of the profits of an investment paid to the investment manager in excess of the amount that the manager contributes to the partnership, specifically in alternative investments (private equity and hedge funds).

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

In small businesses that are not blind pools, such as single property real estate, the investment manager often funds the business prior to the formation of the partnership. It is a performance fee, rewarding the manager for enhancing performance. The structure also takes advantage of favorable tax treatment in the United States.

However, critics of carried interest want it to be reclassified as ordinary income – not capital gains – to be taxed at the ordinary income tax rate. Private equity advocates argue that the increased tax will subdue the incentive to take the kind of risk that is necessary to invest in and manage companies to profitability.

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What is the carried interest tax loophole?

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TAXATION: https://www.taxpolicycenter.org/briefing-book/what-carried-interest-and-how-it-taxed

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PODCAST: On Covid Pandemic Hospital Costs

FOR EMPLOYERSEMPLOYER SPONSORED HEALTH PLANS

BY ERIC BRICKER MD

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PODCASTS: Avoid 5 Marketing Mistakes Financial Advisors Make Engaging Doctors & More!

Our ME-P MARKETING Colleague

By Vicki Rackner MD

Have you been frustrated in your efforts to attract, engage and serve doctors? In this episode, colleague Dr. Vicki Rackner shares 5 common mistake financial advisors make; with more.

PODCAST: https://www.listennotes.com/podcasts/the-academy-of/avoid-the-5-mistakes-l65YVT4UP3S/

PODCAST: https://www.youtube.com/watch?v=Dr5GXKRd3Xg

PODCAST: https://www.youtube.com/watch?v=W0SGlL0UzXE

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PODCASTS: JEFF BEZOS and Altos Longevity Labs?

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REPORTEDLY FUNDING ANTI-AGEING VENTURES TO CHEAT DEATH

“Not Today – Death”

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death

By Alma Fabiani

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Jeff Bezos is allegedly investing in Altos Labs, a biological reprogramming tech company currently looking into a variety of methods that could help reverse the ageing process,

Bezos is said to have a fairly long-standing interest in longevity research. But although Altos Labs has so far managed to recruit some impressive names in the biological reprogramming sector, as well as some pretty big investors, its research still needs a lot of work before it can ever be applied to humans.

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PODCAST: https://www.lifespan.io/news/lifespan-news-altos-labs/

PODCAST: https://www.sciencetimes.com/articles/33399/20210913/jeff-bezos-wants-to-live-forever-why-is-he-cheating-death-anyway.htm

MORE: https://www.technologyreview.com/2021/09/04/1034364/altos-labs-silicon-valleys-jeff-bezos-milner-bet-living-forever/

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

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

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PODCAST: How Health Insurance Became America’s Biggest Hustle

BY ENTREPRENUER MD AND ROBERT PEARL MD

In this episode the Entrepreneur MD is joined by Dr Robert Pearl, MD, to talk about his latest book Uncaring and the need to stand up against the current healthcare model.

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

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Robert Pearl, MD: How Health Insurance Became America’s Biggest Hustle

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PODCAST: Why Insurance Carriers Want MEDICARE-FOR-ALL

WHY M-4-A?

BY ERIC BRICKER MD

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

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PODCAST: About Professor Uwe Reinhardt

HEALTHCARE ECONOMIST

By Eric Bricker MD

Uwe Reinhardt PhD was a Princeton Healthcare Economist Who Passed Away in 2017. He Was Possibly the Most Well Known Healthcare Economist in America and Even the World.

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

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RIP: https://medicalexecutivepost.com/2017/11/16/r-i-p-uwe-reinhardt-phd/

Obituary: https://theincidentaleconomist.com/WORDPRESS/UWE-REINHARDT-GIANT-MENSCH-KNIFE-TWISTER/

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What is a Financial CDO and CMO?

Collateralized Debt ObligationS

versus

COLLATERALIZED MORTGAGE OBLIGATIONS

https://healthcarefinancials.files.wordpress.com/2018/06/david-edward-marcinko.png

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

A collateralized debt obligation (CDO) is a type of structured asset-backed security (ABS). Originally developed as instruments for the corporate debt markets, after 2002 CDOs became vehicles for refinancing mortgage-backed securities (MBS).

Like other private label securities backed by assets, a CDO can be thought of as a promise to pay investors in a prescribed sequence, based on the cash flow the CDO collects from the pool of bonds or other assets it owns. Distinctively, CDO credit risk is typically assessed based on a probability of default (PD) derived from ratings on those bonds or assets.

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

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Collateralized Debt Obligation (CDO) - Assignment Point

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Collateralized Mortgage Obligation

A CMO is a debt security backed by mortgages. These mortgage pools are usually separated into different maturity classes called tranches (from the French word for “slice”). The securities were issued by private issuers, as well as the Federal Home Loan Mortgage Corporation (Freddie Mac). As the mortgages were usually government-guaranteed, CMOs usually carried AAA ratings until their current financial meltdown. The early versions of CMOs were known as “plain vanilla,” but recent developments gave us PACs (planned amortization certificates) and TACs (targeted amortization certificates); among too many others. They were all variations on how principal repayments in advance of maturity date were treated.

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

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CMO vs CDO | What is the difference between them? - Fintelligents

RELATED: https://medicalexecutivepost.com/2011/07/06/merrill-lynch-investigated-for-cdo-deal-involving-magnetar/

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PODCAST: Medicare Part D [Rx Drugs]

LATE ENROLLMENT PENALTY CALCULATIONS

Medicare – CMS

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

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What Exactly is a Financial DAO?

A decentralized autonomous organization

DR. DAVID EDWARD MARCINKO FACFAS MBA CFP MBBS [Hon] [Executive Summary] -  PDF Free Download

BY. DR. DAVID EDWARD MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

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What is DAO - Decentralized Autonomous Organizations

A decentralized autonomous organization (DAO), sometimes called a decentralized autonomous corporation (DAC), is an organization represented by rules encoded as a computer program that is transparent, controlled by the organization members and not influenced by a central government. A DAO’s financial transaction record and program rules are maintained on a blockchain. The precise legal status of this type of business organization is unclear.

A well-known example, intended for venture capital funding, was The DAO, which launched with $150 million in crowdfunding in June 2016, and was nearly immediately hacked and drained of US$50 million in cryptocurrency. The hack was reversed in the following weeks, and the money restored, via a hard fork of the Ethereum blockchain: the Ethereum miners and clients switched to the new fork.

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

MORE: https://www.msn.com/en-us/money/topstocks/what-is-a-dao/ar-AAOIpjw?li=BBnb7Kz

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PODCAST: Radiology and Healthcare Mis-Communication

BY ERIC BRICKER MD

$128 Billion of Radiology Imaging Studies Are Performed Each Year in America and Unfortunately They Exemplify Healthcare Miscommunication.

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PODCASTS: More Dialysis Center Investigative Reporting

DaVITA and FRESENIUS

By Eric Bricker MD

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Your comments are appreciated.

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

MORE

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What Exactly is a PONZI SCHEME; etc?

AND OTHER INVESTING SCAMS!

By Dr. David E. Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

A Ponzi scheme (/ˈpɒnzi/, Italian: [ˈpontsi]) is a form of fraud that lures investors and pays profits to earlier investors with funds from more recent investors. Recall Bernie Madoff.

More: https://medicalexecutivepost.com/2010/06/04/the-madoff-circle/

The scheme leads victims to believe that profits are coming from legitimate business activity (e.g., product sales or successful investments), and they remain unaware that other investors are the source of funds. A Ponzi scheme can maintain the illusion of a sustainable business as long as new investors contribute new funds, and as long as most of the investors do not demand full repayment and still believe in the non-existent assets they are purported to own.

Link: https://en.wikipedia.org/wiki/Ponzi_scheme

A pyramid scheme is a business model that recruits members via a promise of payments or services for enrolling others into the scheme, rather than supplying investments or sale of products. As recruiting multiplies, recruiting becomes quickly impossible, and most members are unable to profit; as such, pyramid schemes are unsustainable and often illegal.

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

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How to Spot and Protect Yourself From Investment Fraud

Pyramid schemes have existed for at least a century in different guises. Some multi-level marketing plans have been classified as pyramid schemes.

And, there are MANY other schemes in the financial services sector.

MORE: https://www.msn.com/en-us/money/other/are-you-about-to-be-the-victim-of-a-ponzi-scheme/ar-BB1cqabu?li=BBnb7Kz

Front Running: https://medicalexecutivepost.com/2018/02/06/what-is-front-running/

Churning: https://medicalexecutivepost.com/2021/07/23/churning-front-running-and-pumping-dumping/

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

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PODCAST: APPEALS Traditional [Original] Medicare

BY CMS

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The HISTORY of Messenger RNA

A Tangled History of mRNA

Hundreds of scientists had worked on mRNA vaccines for decades before the coronavirus pandemic brought a breakthrough.

By Elie Dolgin

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Messenger RNA Medicines | Translate Bio | mRNA Therapeutics

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LINK: https://www.nature.com/articles/d41586-021-02483-w?utm_source=pocket-newtabBy

RELATED: https://www.msn.com/en-us/health/medical/pfizer-biontech-say-covid-19-vaccine-is-safe-for-young-children-generates-immune-response/ar-AAODfco?li=BBnb7Kz

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What is the US DEBT CEILING?

IN BRIEF

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Invite Dr. Marcinko | The Leading Business Education Network for Doctors,  Financial Advisors and Health Industry Consultants

By Dr. David E. Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

What is the domestic national debt ceiling? 

A cap on how much the US government can borrow to finance its operations. 

  • It was introduced during World War I so that Congress wouldn’t have to approve every bond issuance by the Treasury Department as it had done previously—freeing up more time for name-calling. 
  • The debt ceiling has been suspended dozens of times over the years, including 3x during the Trump administration. 

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

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Debt Ceiling: Definition, Current Status

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Without suspending the debt ceiling, the US wouldn’t be able to borrow money to pay its bills—and things would get ugly if that happened. The federal government would have to slash spending for programs like Medicaid, local governments would find it harder to borrow, and financial markets could go haywire.

In short, a failure to act would “produce widespread economic catastrophe,” Treasury Secretary Janet Yellen wrote in the Wall Street Journal. 

Important note: The debt ceiling doesn’t account for new spending, like the $3.5 trillion proposal the Democrats have on the table. Instead, it’s about spending Congress has already authorized, such as paying out Social Security. Over the years, the debt ceiling has become a “political weapon,” according to the AP, as each party tries to blame the other for their spending habits and for heaping more debt on the US. 

IRS: https://home.treasury.gov/policy-issues/financial-markets-financial-institutions-and-fiscal-service/debt-limit

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

Product Details

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

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The AUTUMNAL SOLSTICE and WORLD GRATITUDE DAY 2021

By Dr. David Edward Marcinko MBA

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World Gratitude Day is a timely opportunity to give your employees their deserved props—beyond an ordinary thumbs-up emoji. And, how you celebrate the day is limited only by your imagination.

Some people write thank you notes to those they appreciate. Some make a point of having “gratitude dinners” with family members. And others start a gratitude journal in which they record what they’re grateful for.

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Dignity Health

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We’re all human, and at Workhuman, they get that. Workhuman’s employee recognition solution, Social Recognition, helps foster employee appreciation—something that strengthens teams, reduces turnovers, and drives business forward.

Yep, a little “Thank you” goes a long way.

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AUTUMNAL EQUINOX 2021

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The Seasons, the Equinox, and the Solstices

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Today, in 2021, the autumnal equinox will also take place at 3:21 p.m. EDT and marks the moment the sun’s rays are shining directly on the equator. It’s called the equinox because daytime and nighttime are equal lengths. The winter solstice, which occurs on Dec. 21, will be the shortest day of the year and marks the start of winter.

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WHAT AR YOU THANKFUL FOR?

MORE: https://www.daysoftheyear.com/days/world-gratitude-day/

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PODCAST: Understanding Your Medicare Choices

ORIGINAL MEDICARE, PART C, MEDIGAP AND YOU

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

BY MEDICARE – CMS

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Why the Stock Markets CRASHED TODAY [9/20/21]?

Feel Free to Add to the Our Growing List of Reasons!

BUT REMEMBER THAT CORRELATION IS NOT CAUSATION

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BY DR. DAVID E. MARCINKO MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Chart: The Worst Stock Market Crashes of the 21st Century | Statista

THE LIST GOES ON

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China’s Evergrande Project Giant Contagion Jitters

Global and International Market Meltdowns

Crypto-Currency and Gas Price Tumbles

Depressed Automobile Rentals and Used Car Prices

Lowering US Treasury Bond Yields

US Debt Ceiling Risks and Looming Federal Shutdown

Travel Bans with Mask & Vaccine Debates During the Corono-Virus Pandemic

The $3.5 Trillion Dollar Senate Bill

Politics and Potential Federal Tax Law Changes

The National Park, Pacific North-West and California Wild Fires

The Weather, Flooding, Tornadoes, Hurricanes and Tropical Storms

Southern Border Immigration Crisis

A Dearth of Micro-Chips

Quadruple Witching Friday

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CORRECTION? https://www.msn.com/en-us/money/markets/the-odds-of-a-20-correction-in-stocks-are-rising-as-the-market-transitions-to-the-next-stage-of-its-cycle-morgan-stanley-warns/ar-AAODytg

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Feel free to add to our list.

Is this the start of a cyclical bear market?

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

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

MORE: https://medicalexecutivepost.com/2007/11/25/of-bull-and-bear-markets/

EVERGRANDE: https://www.msn.com/en-us/money/markets/evergrande-s-debt-crisis-has-jolted-the-stock-market-here-s-why-everyone-s-suddenly-worrying-about-china-s-2nd-largest-property-developer/ar-AAODW0q

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

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The “BACK-DOOR” & MEGA Roth IRA?

A conversion can get you into a Roth IRA—even if your income is too high

By Dr. David E. Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

If you’re a physician looking to get ahead on planning for retirement, you’re likely familiar with individual retirement accounts, or IRAs. An IRA is a tax-advantaged vehicle that helps you grow your retirement savings. Roth IRAs are particularly attractive, because you don’t pay taxes on withdrawals in retirement.

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

There’s one problem: you can’t contribute to a Roth IRA directly if you make above a certain income. A backdoor IRA, though, can solve your problem by allowing you to convert a traditional IRA into a Roth.

Here’s how it works:

First, place your contribution in a traditional IRA—which has no income limits.

Then, move the money into a Roth IRA using a Roth conversion.

But make sure you understand the tax consequences before using this strategy.

Review Roth IRA income limits

See the source image

How a MEGA Backdoor Roth Works

The mega backdoor Roth allows you to put up to $38,500 in a Roth IRA or Roth 401(k) in 2021, on top of the regular contribution limits for those accounts. If you have a Roth 401(k) at work (and the plan allows for the mega option as described below), generally you can choose whether the final destination of your mega contributions is the Roth 401(k) or a Roth IRA. If your employer offers only a traditional 401(k), then your mega contributions would end up in a Roth IRA.

Here’s a quick summary of what you need to have in place for the ideal mega backdoor Roth strategy:

  • A 401(k) plan that allows “after-tax contributions.” After-tax contributions are a separate bucket of money from your traditional and Roth 401(k) contributions. About 43% of 401(k) plans allow after-tax contributions, according to a 2017 survey of large and midsize employers by consulting firm Willis Towers Watson.
  • Your employer offers either in-service distributions to a Roth IRA — that is, you can take money out of the 401(k) plan while you’re still working at the company — or lets you move money from the after-tax portion of your plan into the Roth 401(k) part of the plan. If you’re not sure, ask your human resources department or plan administrator.
  • You’ve got money left over to save, even after maxing out your regular 401(k) and Roth IRA contributions.

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

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PODCAST: The Four [4] Parts of Medicare

UNDERSTAND AND KNOW THE DIFFERENCE: A, B C & D

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

BY MEDICARE – CMS

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SPEAKING ENGAGEMENTS and PODCASTING SEMINARS

AT YOUR SERVICE

Dr. David Edward Marcinko is Speaking Up

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 and podcasts 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.

SAMPLE TOPICS: https://healthcarefinancials.files.wordpress.com/2009/02/imba-inc-firm-services.pdf

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Recognizing the Differences between Healthcare and Other ...

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

CONTACT: Ann Miller RN MHA

EMAIL: MarcinkoAdvisors@msn.com

Phone: 770-448-0769

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

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PODCAST: “New York Times” Article on Hospital Price Transparency

Learn WHY Hospital Prices Are Kept SECRET

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BY ERIC BRICKER MD

The New York Times Posted an Article Explaining Hospital Prices for Patients on Private Insurance Plans Such as Blue Cross, United Healthcare, Cigna and Aetna.

Your comments are appreciated.

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

MORE: https://medicalexecutivepost.com/2021/06/02/hospital-financial-price-transparency/

PODCAST #2: https://medicalexecutivepost.com/2021/05/19/podcast-price-transparency-in-healthcare/

THANK YOU

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What is the KIDDIE TAX?

VITAL FOR PHYSICIAN PARENTS TO UNDERSTAND

By Dr. David E. Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Do your children have income-generating assets in a custodial account?

If so, be sure you understand the so-called kiddie tax.

This law was passed to discourage wealthier individuals from transferring assets to their children to take advantage of their lower tax rates. The kiddie tax has seen many iterations but current rules tax a minor child’s unearned income—including capital gains distributions, dividends, and interest income—at the parents’ tax rate if it exceeds the annual limit ($2,200 in 2021).

The Kiddie Tax - Baker Holtz

The tax applies to dependent children under the age of 18 at the end of the tax year (or full-time students younger than 24) and works like this:

  • The first $1,100 of unearned income is covered by the kiddie tax’s standard deduction, so it isn’t taxed.
  • The next $1,100 is taxed at the child’s marginal tax rate.
  • Anything above $2,200 is taxed at the parents’ marginal tax rate.

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

So – If your child also has earned income, say from a summer job or legitimate work in your medical office or practice, the rules become more complicated.

To learn more, see IRS Publication 929

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TODAY: “Quadruple Witching” Expiration [Hour] Day

BEWARE THE STOCK MARKETS TODAY

By Dr. David E. Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Markets: While yesterday was somewhat of a snoozefest on Wall Street, today should be more interesting. In a quarterly event known as “quadruple witching,” stock options, index options, stock futures, and index futures all expire on the same day, which can produce fireworks.

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

HISTORY

The phrase quadruple witching brings to mind stories that begin, “It was a dark and stormy night…” or folkloric visions of witches flying chaotically on broomsticks across the brightness of a moon.

In the context of investing, quadruple witching also refers to possible chaos but chaos in the financial markets. Such chaos can erupt due to four different types of contracts on financial assets expiring on the same day. The quadruple witching hour is the last hour of the trading session on that day. The question is whether investors can make abnormally robust profits on quadruple witching days due to market fluctuations.

What Is Quadruple Witching?

Quadruple witching refers to four days during the calendar year when the contracts on four different kinds of financial assets expire. The days are the third Friday of March, June, September and December. The assets on which the contracts expire on that day are stock options, single stock futures, stock index futures and stock index options. Options contracts also expire monthly. Futures contracts expire quarterly.

Because all four types of contracts expire on the same day, the quadruple witching day usually sees a heavier volume of trading. This is why the reference to chaos is made about this witching day. Market volume is increased partly due to offsetting trades that are made automatically. Volume on quadruple witching days has increased roughly two-thirds of the time since 2005.

See the source image

Recent Quadruple Witching Expiration Day

On June 18, 2021, a quadruple witching day, a near-record volume of single-stock equity options was set to expire at the end of the day in the amount of $818 billion. As a result, a near-record of single stock open interest of about $3 trillion stood on June 18, 2021. Open interest refers to how many contracts are open during any given point during the day. It is an important metric for traders to watch since a large amount of open interest can move the value of the underlying stock.

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PODCASTS: Surgery Safety Checklists

ATUL GAWANDE MD

Medical Culture

BY ERIC BRICKER MD

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

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What is the IRS RULE of 55?

ON Retirement PLANS AND Planning

By Dr. David E. Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Taking a distribution from a tax qualified retirement plan, such as a 401(k), prior to age 59 1/2 is generally subject to a 10 percent early withdrawal tax penalty.

However, the IRS rule of 55 may allow you to receive a distribution after attaining age 55 (and before age 59 1/2 ) without triggering the early penalty if your plan provides for such distributions.

What is the rule of 55? https://www.experian.com/blogs/ask-experian/what-is-the-rule-of-55/

The distribution would still be subject to an income tax withholding rate of 20 percent, however. (If it turns out that 20 percent is more than you owe based on your total taxable income, you will get a refund after filing your yearly tax return.)

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

It’s important to note that the rule of 55 does not apply to traditional or Roth IRAs.

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what is the IRS rule of 55?

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PODCAST: Lessons for [physician] Investors: The Trial of Theranos Founder ELIZABETH HOLMES

By Bertalan Meskó, MD PhD

Wofür R&D Jahre benötigt, braucht künstliche Intelligenz wenige Minuten“

Elizabeth Holmes has no idea how much damage she has done with Theranos. As I often wrote, for digital technologies to gain ground and become part of our everyday lives, we need not only technological solutions but a cultural paradigm shift. Holmes rolled a massive rock in front of it.

Similarly, Facebook’s data privacy practices do not increase people’s confidence in the company’s products. All the scandals that have surrounded the social network could backfire when Facebook wants to step into healthcare – and this is exactly what we wrote about in our latest article, Is There A Place For Facebook In Healthcare? In it, we looked at what Facebook currently does in medicine and evaluated whether those are viable ways to follow in the future.

Take care,
Berci
Bertalan Meskó, MD PhD
The Medical Futurist

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MORE: https://www.cnbc.com/2021/09/10/the-lessons-for-investors-from-the-trial-of-theranos-founder-elizabeth-holmes.html?utm_source=The+Medical+Futurist+Newsletter&utm_campaign=f5b0ff1b6b-EMAIL_CAMPAIGN_2021_9_14&utm_medium=email&utm_term=0_efd6a3cd08-f5b0ff1b6b-399696053&mc_cid=f5b0ff1b6b&mc_eid=40fee31c25

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PODCAST: United States Health Spending by Race & Ethnicity (2021)

CULTURE IN HEALTHCARE

Culture is a factor to consider with healthcare. Depending on the culture they may seek alternative treatment such as homeopathic and treatment they have been raised with in their country Some cultures will get medications from their country because they believe in their medical system more then what is offered.

BY IHME

Creating a culture of health - Sedgwick

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Dr. Joseph L. Dieleman, Associate Professor in the Department of Health Metric Sciences at the University of Washington, is the lead author of the study “US Health Care Spending by Race and Ethnicity, 2002-2016,” published August 17, 2021 in the Journal of the American Medical Association

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PODCAST: https://www.youtube.com/watch?v=xbkSZmB-3f8&t=171s

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PODCASTS: FDA Pharmaceutical Industry Ties

CONFLICTS OF INTEREST?

The New York Times Had an Excellent Article on the FDA on September 2, 2021.

The Article Described How the FDA Began Receiving Funding from the Pharmaceutical Industry Itself to Pay for FDA Employee Salaries in 1992–a Potential Conflict-of-Interest. Subsequently, a Study Found that 1/3 of Drugs Approved by the FDA Were Found to Have Safety Problems from 2000 -2010. Another Potential Conflict-of-Interest is Number of FDA Regulators Who Leave Their Positions to Take High-Paying Jobs at Pharmaceutical Companies.

By Eric Bricker MD

FDA rescinds emergency authorization for COVID-19 antibody treatment  bamlanivimab | TheHill

PODCAST:

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ORAL HEALTH AND EQUITY

BY NIHCM

INFO-GRAPHIC
Gum disease remains one of the most prevalent chronic diseases in the United States with 46% of adults over 30 showing symptoms. Although significant improvements have been made to improve oral health in America, many people still experience barriers to preventive or essential dental care.

Black Americans, Latinos, and Native Americans, as well as low-income populations, children and pregnant women are at greater risk of oral health diseases. The disparities experienced by these populations have only been exacerbated by the pandemic. 

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Image result for caries

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In this infographic highlights the challenges to achieving optimal oral health and identifies opportunities for advancing health equity moving forward. 

INFO-GRAPHIC: https://nihcm.org/publications/oral-health-health-equity?utm_source=NIHCM+Foundation&utm_campaign=901307447a-Oral_Health_Infographic_091421&utm_medium=email&utm_term=0_6f88de9846-901307447a-167744768

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PODCAST: What is SMART BETA?

REALLY SMART -OR- NOT REALLY

By Dr. David E. Marcinko MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Smart beta investment portfolios offer the benefits of passive strategies combined with some of the advantages of active ones, placing it at the intersection of efficient-market hypothesis and factor investing.

Offering a blend of active and passive styles of management, a smart beta portfolio is low cost due to the systematic nature of its core philosophy – achieving efficiency by way of tracking an underlying index (e.g., MSCI World Ex US). Combining with optimization techniques traditionally used by active managers, the strategy aims at risk/return potentials that are more attractive than a plain vanilla active or passive product.

An independent voice on smart beta

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

Originally theorized by Harry Markowitz in his work on Modern Portfolio Theory (MPT), smart beta is a response to a question that forms the basis of MPT – how to best construct the optimally diversified portfolio. Smart beta answers this by allowing a portfolio to expand on the efficient frontier (post-cost) of active and passive. As a typical investor owns both the active and index fund, most would benefit from adding smart beta exposure to their portfolio in addition to their existing allocations.

Financial beta: https://medicalexecutivepost.com/2021/05/12/so-what-is-financial-beta-granularly/

Assessment: The smart beta approach is an arguably perfect intersection between traditional value investing and the efficient market hypothesis. But, is it worth the cost?

More: https://www.bloomberg.com/opinion/articles/2018-06-08/smart-beta-performance-isn-t-worth-the-cost

ALPHA versus BETA Podcast: https://youtu.be/dP_23vKJ3HQ

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The TRI-PHASIC Road from Medical Practice to Retirement Planning for Doctors

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Determining Your Retirement Vision

There’s an aspect to retirement that many physicians do not plan for … the transition from work and practice to retirement.  Your work has been an important part of your life.  That’s why the emotional adjustments of retirement may be some of the most difficult ones.

For example, what would you like to do in retirement? Your retirement vision will be unique to you. You are retiring to something not from something that you envisioned. When you have more time, you would like to do more traveling, play golf or visit more often, family and friends. Would you relocate closer to your kids?  Learn a new art or take a new class? Fund your grandchildren’s education? Do you have philanthropic goals? Perhaps you would like to help your church, school or favorite charity? If your net worth is above certain limits, it would be wise to take a serious look at these goals. With proper planning, there might be some tax benefits too. Then you have to figure how much each goal is going to cost you.

If have a list of retirement goals, you need to prioritize which goal is most important. You can rate them on a scale of 1 to 10; 10 being the most important. Then, you can differentiate between wants and needs. Needs are things that are absolutely necessary for you to retire; while wants are things that still allow retirement but would just be nice to have.

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

Recent studies indicate there are three phases in retirement, each with a different spending pattern [Richard Greenberg CFP®, Gardena CA, personal communication]. The three phases are:

  1. The Early Retirement Years. There is a pent-up demand to take advantage of all the free time retirement affords. You can travel to exotic places, buy an RV and explore forty-nine states, go on month-long sailing vacations. It’s possible during these years that after-tax expenses increase during these initial years, especially if the mortgage hasn’t been paid off yet. Usually the early years last about ten years until most retirees are in their 70’s.
  • Middle Years. People decide to slow down on the exploration.  This is when people start simplifying their life.  They may sell their house and downsize to a condo or townhouse.  They may relocate to an area they discovered during their travels, or to an area close to family and friends, to an area with a warm climate or to an area with low or no state taxes.  People also do their most important estate planning during these years.  They are concerned about leaving a legacy, taking care of their children and grandchildren and fulfilling charitable intent. This a time when people spend more time in the local area.  They may start taking extension or college classes.  They spend more time volunteering at various non-profits and helping out older and less healthy retirees. People often spend less during these years. This period starts when a retiree is in his or her mid to late 70’s and can last up to 20 years, usually to mid to late-80’s.
  • Late Years. This is when you may need assistance in our daily activities.  You may receive care at home, in a nursing home or an assisted care facility.  Most of the care options are very expensive.  It’s possible that these years might be more expensive than your pre-retirement expenses.  This is especially true if both spouses need some sort of assisted care. This period usually starts when the retiree is their 80’s; however they can sometimes start in the mid to late 70’s.

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Planning Issues – Early Career

If early retirement is a major objective, start thinking about activities that will fill up your time during retirement.  Maintaining your health is more critical, since your health habits at this time will often dictate how healthy you will be in retirement.

Planning Issues – Mid Career

If early retirement is a major objective, start thinking about activities that will fill up your time during retirement.  Maintaining your health is more critical, since your health habits at this time will often dictate how healthy you will be in retirement

Planning Issues – Late Career 

Three to five years before you retire, start making the transition from work to retirement. 

  • Try out different hobbies;
  • Find activities that will give you a purpose in retirement;
  • Establish friendships outside of the office or hospital;
  • Discuss retirement plans with your spouse.
  • If you plan to relocate to a new place, it is important to rent a place in that area and stay for few months and see if you like it. Making a drastic change like relocating and then finding you don’t like the new town or state might be very costly mistake. The key is to gradually make the transition.

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PODCAST: How Medical Prior-Authorization Really Works

Pre-Certification Works OR Doesn’t Work

BY ERIC BRICKER MD

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What is an INHERITED IRA?

VITAL INFORMATION FOR ALL MEDICAL PROFESSIONALS

By Dr. David E. Marcinko MBA CMP

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

The Inherited IRA

An IRA in which distributions continue after the primary beneficiary’s death.

For an IRA to be inherited, the primary beneficiary must have already been receiving the required minimum distribution; the distributions either continue or are re-calculated based upon the secondary beneficiary’s life expectancy.

If the secondary beneficiary is the widow(er) of the primary beneficiary, she/he may roll over the inherited IRA into her/his own IRA without penalty.

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

And, it gets even more complicated!

MORE: https://www.bankrate.com/retirement/inherited-ira-rules/

IRS: https://www.irs.gov/retirement-plans/plan-participant-employee/retirement-topics-beneficiary

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

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PODCAST: INELASTIC Healthcare Demand Explained

BY ERIC BRICKER MD

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

MORE: https://medicalexecutivepost.com/2019/11/10/ricardian-derived-demand-economics-in-medicine/

Your comments are appreciated.

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The DUPONT Decomposition Equation for ROI

D.D.E. FOR HOSPITALS AND HEALTHCARE ORGANIZATIONS

DEM blue

By Dr. David E. Marcinko MBA CMP

[Editor-in-Chief] http://www.CertifiedMedicalPlanner.org

According to the Dupont Decomposition Equation – which involves the conglomeration of net operating income, revenues, expenses and average operating assets – ROI and economic profit is increased in three prioritized ways:

  1. Cost and expense reductions.
  2. Revenue increases [Rev]
  3. Reduced average operating assets [AOO]

Note: ROI = NOI / Rev X Rev / AOO

Cost and expense reductions

Although many hospitals have reduced expenses, postponed projects and put clinical or information technology projects on hold because of the MU conundrum, this may be unwise and quality may suffer. And, mental health care programs are almost always the first cost center to be reduced in tough times.

Upgrades today, especially with concurrent marketing and advertising promotions, may well be considered a strategic competitive advantage, and at bargain basement prices for those with cash or credit. This cost reduction is easy because it gives the biggest buck-bang in the ROI equation, and is the first line of ROI augmentation by savvy administrators and CEOs. It is also intuitive and wholly “wrung-out” in the marketplace, to date.

Revenue increases

On the other hand, revenues can usually be only incrementally increased by improving services like emergency care, urgent care, wellness, out-patient and/or surgical departments. This is the more difficult part of the equation and yields a positive, but lesser return in the ROI equation.

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

DuPont Formula: Learn More At Accounting Play

Three Modern Collections Rules for Hospitals

The following medical practice procedures will markedly increase upfront office collections:  

  • Train staff to handle exceptions. What is your policy if the patient payment is significant? Will you allow 25% payments—one today and three over the next three months? Communicate your policy to all staff. What will you do if a patient shows up without an insurance card? There will be other exceptions. Train employees to call the appropriate practice-management contact when an exception does not fit in the categories you provide and make sure those managers are responsive.
  • Understand that not everyone will shine in collections. The value of this new front-desk function should be reflected in job descriptions and wages. Track staff performance and hold employees accountable for collection goals. The most successful practices collect in the 90% range.
  • Provide professional signage that states your basic policy. “Payments are due at time of service.” Avoid typewritten, lengthy explanations taped to walls or desks that look like clutter.

Reduced average operating assets

Finally, any delay in updating facilities – while easy and may reduce operating assets – there is little ROI advantage and profit potential. Of course, facility asset upgrades mean borrowing funds through tax-exempt bonds – the main source of debt for most hospitals – and is currently difficult or impossible in this climate. Loans from banks, private investors, angels, venture capitalists or other financial institutions are similarly difficult to obtain. Thus, this part of the equation may often be neglected; as is the case now.

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Pass ALL PODIATRY BOARD Certification Examinations!

Electronic Study Guides and A.I.

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ALL NEW AND IMPROVED STUDY GUIDE SOFTWARE !

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[Versions 2.0]

As we complete our first quarter-century of service to the podiatric community, it is only fitting to update our colleagues of the extreme changes taking place in the individual board exam testing space.

Some of these changes are perfunctory with little practical impact; while others are so profound as to cause extreme consternation in the practitioner community writ-large.

For example:

Nomenclature:

  1. FROM: American Board of Podiatric Surgery -TO- American Board of Foot and Ankle Surgery.
  2. FROM: American Board of Primary Podiatric Medicine and Orthopedics -TO- American Board of Foot and Ankle Medicine and Orthopedics.
  3. FROM: ORAL questions -TO- “oral” computerized Clinical Pathology Conference-like queries
  4. FROM: American Board of Podiatric Medical Specialities -TO- American Board of Medical Specialities, in Podiatry.
  5. FROM: Non-Competitive MOC Exams -TO-Competitive MOC Re-Cert Tests.
  6. FROM: Solely DPM crafted exams to professional psychometric designs by PhDs, computer scientists, and E.Eds.

ABPS Statistics: ABPS Statistics

SURGERY FOR FOOT & ANKLE — Advance Foot & Ankle Care

Testing Dynamics:

  1. The Surgery Certification and Qualification tests now rely less on rote memorization and more on applied cognitive content, and may be very different from any other test you have ever taken, to date [ie., multiple choice or fill-in-the-blank].
  2. The Primary Medicine and Orthopedics Certification and Qualification tests now rely less on rote memorization and more on applied cognitive content, and may be very different from any test you have ever taken, to date [ie., multiple choice or fill-in-the-blank].
  3. Traditional human ORAL questions have been usurped by [non-human] computerized Clinical Pathology Conference [CPC] queries; AKA: Computer Based Testing [CBT] or Clinical Scenario Questions [CSQs].
  4. American Board of Medical Specialities now includes over a dozen general categories; including podiatry.
  5. The Re-Certification tests for Maintenance of Certification [MOC] now rely much less on rote memory, as in the past; and more on deeply experiential content. It is also becoming more competitive, to-date.
  6. So-called “wrong” questions by-design are called psychological “stressor questions” and are used to evoke emotional volatility and waste precious time. So, BEWARE!. Moreover; the so-called “points-to-pass” AND “points-to-fail” philosophy may be re-emerging.

More Here: FARC Promo.Psychometrics

This is the dynamic PODIATRY PREP difference [Unique Competitive Advantage] between our customized Study Guide File Programs with customized board exam preparation content, and the static general “off-shelf” books or Web guides of the past; and/or traditional CEU educational seminars.

SAMPLE QUESTIONS: Traditional Rote ISTITUTIONAL RESIDENCY Questions versus Experiential and Cognitive Styled INDIVIDUAL PRACTITIONER [CBT/CBS] Formats

PRACTITIONERS: Be sure to specify the target exam and customize your own personal study guide, today.

Pilon Fractures: pilon fractures

Hallux Rigidus: HALLUX.LIMITUS.RIGIDUS.SURGERY

AKIN: 3[1][1].AKIN.OSTEOTOMY

CHEVRON: 5[1][1].CHEVRON.MODIFICATIONS

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PODCAST: Healthcare Customer Service is Terrible!

WHY?

BY ERIC BRICKER MD

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What is the “SAVER’S CREDIT”?

By Dr. David E. Marcinko MBA CMP®

CMP logo

Sponsor: http://www.CertifiedMedicalPlanner.org

The saver’s credit is a tax credit that’s intended to promote retirement savings among low- and moderate-income workers. It can reduce an eligible taxpayer’s federal income taxes when they save in a qualified retirement plan. It may be especially useful to medical students, nurses, interns, residents and fellows.

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IRS Releases Plan Limits for 2020 - Montgomery Retirement Plan Advisors

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In 2021, the maximum credit is worth $1,000 for individuals and $2,000 for married couples filing jointly, although it phases out for higher earners. To qualify for the credit, individuals must have an adjusted gross income of $32,500 or less. The income threshold for married couples is $65,000.

Because the credit is non-refundable, eligible taxpayers are able to use it to effectively reduce their tax bill to zero – but it cannot provide them with a tax refund.

IRS: https://www.irs.gov/retirement-plans/plan-participant-employee/retirement-savings-contributions-savers-credit

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

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PODCAST: On State Health Insurance Commissioners

Not so Hot!

BY ERIC BRICKER MD

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RELATED: https://ocgnews.com/former-georgia-insurance-commissioner-jim-beck-convicted-of-fraud/

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

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