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

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

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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.

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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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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

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

TWO INVESTING DIFFERENCES = TWO QUICK THOUGHTS

BY DR. DAVID EDWARD MARCINKO MBA MEd 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.”

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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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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

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RURAL HOSPITALS: Defined?

By Calvin Wiese MBA CPA CMP ®

Dr. David Edward Marcinko MBA CMP®

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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 ...

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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

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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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RURAL HEALTHCARE AREAS: State Uninsured Children Rates

In 2008-2009 and 2014-2015

By http://www.MCOL.com

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PODCAST: Social Determinants of Health

Turning Potential into Actual Value

By Erin Benson and Rich Morino

Social determinants of health can directly be used to improve risk stratification and care management initiatives. But first, it’s important to identify how to effectively use this data to get the most value for your members and organizations.

And so, we present a brief recap of the webinar: “Social Determinants of Health: Turning Potential into Actual Value,” sponsored by LexisNexis Health Care, with Erin Benson, Director Market Planning and Rich Morino, Director, Strategic Solutions.

This recap includes discussion of 5 categories of SDOH. Then, the full webinar discusses elements of success for social determinants of health and opportunities for health plans to leverage social determinants of health data to attain quality goals while managing cost and enhancing member experience.

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Physicians “FIRING” Patients?

ON TERMINATING PATIENT RELATIONSHIPS

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By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Just as it is an acceptable and reasonable practice to screen incoming patients, it is acceptable and reasonable to know when to end relationships. Termination criteria are numerous and varied. Although not exhaustive, the following are situations in which termination may be appropriate and acceptable:

  • Treatment noncompliance—The patient does not or will not follow the treatment plan.
  • Follow-up noncompliance—The patient repeatedly cancels follow-up visits or is a no-show.
  • Office policy noncompliance—The patient uses weekend on-call physicians or multiple health care practitioners to obtain refill prescriptions when office policy specifies a certain number of refills between visits.
  • Verbal abuse—The patient or a family member is rude and uses improper language with office personnel, exhibits violent behavior, makes threats of physical harm, or uses anger to jeopardize the safety and well-being of office personnel with threats of violent actions.
  • Nonpayment—The patient owes a backlog of bills and has made no effort to arrange a payment plan.

YOU'RE FIRED! How to Switch Real Estate Agents | Barb Has ...

It is an acceptable practice to end a patient relationship under most conditions. There are a few situations, however, that may require additional steps or a delay of the termination. According to The Doctors Company, Laura A. Dixon JD RN,the following circumstances fall into this category:

  • If the patient is in an acute phase of treatment, termination must be delayed until the acute phase has passed. For example, if the patient is in the immediate postoperative stage or is in the process of medical workup for diagnosis, it is not advisable to end the relationship.
  • If the practitioner is the only source of medical or dental care within a reasonable driving distance, he or she may need to continue care until other arrangements can be made.
  • When the practitioner is the only source of a particular type of specialized medical or dental care, he or she is obliged to continue this care until the patient can be safely transferred to another practitioner who is able to provide treatment and follow up.
  • If the patient is a member of a prepaid health plan, the patient cannot be discharged until the practitioner has communicated with the third-party payer to request a transfer of the patient to another practitioner.
  • A patient may not be terminated solely because he or she is diagnosed with AIDS/HIV.

When the situation with the patient is such that terminating the relationship is appropriate and acceptable and none of the restrictions mentioned above are present, termination of the patient relationship should be completed formally. The patient should be put on written notice that he or she must find another health care practitioner. The written notice should be mailed to the patient by regular and certified mail, return receipt requested. Keep copies of the letter, the original certified mail receipt, and the original certified mail return receipt (even if the patient refuses to sign for the certified letter) in the patient’s medical record.

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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: The Domestic Opioid Epidemic

A Post Pandemic OVERDOSE AND ADDICTION Update

By NIHCM Foundation

The opioid epidemic continues to devastate communities, with provisional data showing overdose death rates rising during the pandemic. Isolation and economic upheaval, as well as hindered access to treatment options and support systems, have increased the risk of addiction and relapse. These new pressures exist along with the stigma that often prevents people from receiving care for substance use disorder (SUD) and the ongoing need to adopt harm reduction strategies.

Speakers Discuss:

  • The latest federal priorities for addressing the overdose and addiction epidemic, including a focus on harm reduction efforts and ensuring racial equity in drug policy
  • Strategies for state agencies to meet existing and increasing SUD treatment needs
  • A health plan’s innovative approaches to expand SUD care through an in-home addiction treatment program and recovery coaches

Opioid use in Larimer County continues as drug becomes ...

ASSESSMENT: And so, this podcast / webinar further explores solutions to reduce overdose rates, with a focus on efforts to expand access to evidence-based recovery programs after the corona virus pandemic.

PODCAST / WEBINAR HERE: https://nihcm.org/publications/addressing-the-growing-overdose-and-addiction-epidemic?utm_source=NIHCM+Foundation&utm_campaign=f78ae3a137-05242021_Webinar_Archive&utm_medium=email&utm_term=0_6f88de9846-f78ae3a137-167744768

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Effect of Negative Credit Shocks on Hospital Quality

A STUDY OF the National Bureau of Economic Research

BY HEALTH CAPITAL CONSULTANTS, LLC


A recent study from the National Bureau of Economic Research (NBER) indicates that quality and patient outcomes suffer in hospitals that cannot maintain their relationships with banks and their lines of credit.

The NBER study measured quality and cost data in Medicare-certified hospitals from 2010 to 2016, during which banks were undergoing annual stress tests. Regulatory “stress tests” are annual assessments from the Federal Reserve, put in place after the Great Recession in 2008, to examine a bank’s ability to survive an impending economic crisis. (Read more…) 

ASSESSMENT: Your thoughts are appreciated.

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NHICs = Prepaid Preventative and Maintenance Health Care Networks

Emerging New MEDICAL BUSINESS Models 2.0

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Many folks feels that private preventative medical contracts may be one possible solution for those Americans going without healthcare; especially the young and healthy. Generally, and generically, they have a moniker like the “No Health Insurance Club”; or similar

Why?

Some pundits are leaning toward universal healthcare, or Medicare-4-All, which seems too socialized for others. Yet, private insurers continue to increase premiums, which prices healthcare out of reach for the average American. Employers can no longer float the cost of insurance so they pass it on to their employees. Patients aren’t the only ones being affected by the current state of healthcare. More and more doctors are going out of business and hospitals are cutting back due to escalating costs and payment defaults.

So, current remedies to this dilemma include major medical insurance policies for catastrophic events with high-deductibles to keep monthly premiums down, Medicaid, mini retail-clinics at grocery stores/pharmacies, and emergency room visits for common illnesses; as well as the PP-ACA.

Medical Maintenance

But, preventative healthcare and medical maintenance is not typically addressed. More than 90 percent of health related issues can be taken care of with preventative care and maintenance but only a small percentage of Americans currently enjoy the benefit of preventative healthcare. Healthcare economists are rethinking healthcare by offering an affordable alternative to traditional insurance options. NHICs, connect patients with participating board certified physicians that will treat and care for preventative healthcare needs for a one-time prepaid annual membership fee.

In this NHIC model:

  • Patients make a one-time annual payment that is typically less than a one-month premium with traditional insurance.
  • Patients receive up to 12 office visits per year that also include immunizations, $10 or less in-office prescriptions, and additional services including blood tests.
  • No deductible, no co-pays, no premiums.
  • No surprise bills to patients.
  • Viable alternative to COBRA for employees disengaged from work.
  • Low cost option for the self-employed.
Yakima DentiFlex Membership Club | Your Dentist in Yakima, WA

The Doctors

What’s in it for the doctors? How about no insurance clerks, no need to snail mail medical insurance claims or use expensive electronic claims submission clearinghouse services, no bad debts or bad expense write-offs, no ARs; and fast cash.

ASSESSMENT: Your thoughts are comments are appreciated.

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Dictionary of Health Information Technology and Security

LINK: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

PHYSICIAN BRANDING: Post Corona Virus Pandemic

SELF-BRANDING IN THE MODERN ERA

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

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In 1987 the magazine Fast Company published an article authored by Tom Peters entitled “The Brand Called You.” Although some individuals may shy away from the concept of self-branding in actuality, many of the online social network sites such as Facebook become media by which we in fact brand ourselves.

In his article, Peter’s stated. “Regardless of position, regardless of the business we happen to be in, all of us need to understand the importance of branding. We are CEOs of their own companies: Me Inc. to be in business today, our most important job is to be head marketer for the brand called you.”

As a medical practitioner how do you differentiate yourself from others in your specialty and why should a new patient choose your practice above those of the others in the field?

Branding is about finding your big idea and building your identity and game plan around it. The bottom line: if you can’t explain who you are, and the value you bring to your practice in a short sentence or two, you have work to do.

According to Catherine Kaputa, a personal coach she suggests that there are the objective things: your credentials, the schools you went to, your years of experience, and your skill set, which represent what she refers to as hard power. Then there’s soft power: your image and reputation, your visibility in the community, your network of contacts, supporters and mentors. In today’s competitive marketplace, soft power plays a vital role in attracting people to you and your practice.

Standing Out

Peters suggests that everyone has a chance to stand out. Everyone has a chance to learn, improve, and build up their skills. Everyone has a chance to be a brand worthy of remark. Corporations spend millions of dollars creating and maintaining their distinct brand.

The Olympic Rings are representative of a brand which the International Olympic Committee guards zealously. Professional services firms such as McKinsey, foster self-branding among their employees. Major corporations have as employees those individuals who are smart, motivated and talented. Self-branding allows the employees to differentiate themselves from their peers. For one to engage in self-branding is first necessary to ask the question,

What is it that my practice does that makes it different?”

You can begin by identifying the qualities or characteristics that make you distinctive from your competitors-or your colleagues.

What have you done lately-this week-to make yourself stand out? What would your colleagues say is your greatest and clearest strength?

What would they say is your most noteworthy personal trait? As a practitioner does your customer get dependable, reliable service that meets his or her strategic needs?

In addition, ask yourself: “what do I do that adds remarkable, measurable, distinguished distinctive value.”

Branding For A Medical Practice & It's Importance ...

Business Cards

While we are on the topic of mass media look at your business card and check to see if it has a distinctive logo on it. Keep in mind that packaging counts.

Getting and using power, intelligently, responsibly, and powerfully are essential skills for growing your brand. One of the things that attract us to certain brands is the power they project. Power, is largely a matter of perception. If you want people to see you as a powerful brand, act like a credible leader.

Another technique advocated by Peters is developing loyalty among your patients. In addition, you yourself need to be loyal to your colleagues, your staff, patients and to yourself.

Another way in which you can begin to promote yourself is, with a personal visibility campaign; getting yourself on a panel discussion with signing up to make a presentation at a workshop. If you are a medical writer, try writing about the corona pandemic, or contributing a column on a regular basis to your local newspaper. Community newspapers and professional newsletters are always seeking articles to fill the space. Not only does it give you the opportunity to express yourself it also is an excellent means to expose your practice and your capabilities to a mass audience.

ASSESSMENT: Your thoughts are comments are appreciated.

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PODCAST: Is Doctor Culture Uncaring?

Dr. Robert Pearl’s Book from Moral Injury to Fee-for-Service … and More

Bricker - This Week Health

By Eric Bricker MD

Dr. Robert Pearl Was the CEO of the Permanente Medical Group from 1999 to 2017. Permanente is the Physician Group for all of Kaiser Permanente. It is the Largest Physician Group in America with 10,000 Doctors, 38,000 Staff and 5 Million Members.

EDITOR’S NOTE: Normally, book reviews are boring but this presentation from colleague Eric Bricker MD is well worth a watch.

PODCAST LINK: https://www.youtube.com/watch?v=omPqBq6_f-E

ASSESSMENT: Your thoughts are appreciated.

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***

Hospital Financial Price Transparency

New price transparency regulatory considerations for hospitals

By Lesley Pink Austin Barrington, David Lewis, John Pickering, and Mike Hamachek

As of January 1, 2021, regulations require U.S. hospitals to post to their websites all of their negotiated payment rates in one sprawling machine-readable file, although many hospitals may not meet the initial deadline. The aim of the regulation is to increase price transparency with the goal that such transparency will lead to increased competition, improved customer choice, and ultimately lower prices.

There will be challenges, though, to extract useful competitive information from the files.

See the source image

ASSESSMENT:

This article by Milliman professionals examines those challenges. 

Your thoughts are appreciated.

MORE:

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Major Issues Facing Healthcare in 2021?

Here are the major issues facing healthcare according to PwC

Will a health system battered by the pandemic emerge stronger in the year ahead? The annual report predicts challenges such as profitably merging virtual and in-person care, and capitalizing on new consumer- and clinician-facing digital health tools.

The far future of healthcare - FOHS Plenary 2 report - The ...

READ: https://www.healthcareitnews.com/news/here-are-major-issues-facing-healthcare-2021-according-pwc

ASSESSMENT: Your thoughts are appreciated.

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***

The CORPORATE PRACTICE of Medicine?

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

CORPORATE PRACTICE OF MEDICINE (CPM) LAWS

OK – I admit that I am not an attorney. But, approximately half of states in the U.S. have made it unlawful for practicing physicians to be employees of corporations. This ban on the corporate practice of medicine (CPM) is intended to keep medical professionals independent and free from financial pressures and influence.

Most states have made exceptions allowing physicians to become employees of not-for-profit organizations and sometimes hospitals. States such as California, Iowa, and Texas, have declined to allow hospitals to employ physicians, although even those states have special exceptions. Iowa hospitals may employ pathologists and radiologists, and Texas public hospitals and California teaching hospitals may employ physicians. Ohio has no ban on the corporate practice of medicine.

ASSESSMENT: Anyone can own a physician practice in Ohio.

QUERY: So, who does the aggrieved patient sue?

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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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ON ABUSIVE MEDICAL TREATMENT OR HEALTH CARE SERVICES

ABUSIVE TREATMENTS OR MEDICAL SERVICES

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

According to the Dictionary of Health Economics and Finance, healthcare abuse is the activity where someone overuses or misuses services. And; the Center for Medicare and Medicaid Services [CMS] states that: “although some of the practices may be initially considered to be abusive, rather than fraudulent activities, they may evolve into fraud.”

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

In the case of healthcare abuse, this may occur when a physician sees the patient for treatment more times than deemed medically appropriate. If there are reported issues or actions from other sources, such as the National Practitioner Data Bank [NPDB] or a medical board, a health insurance program can take that opportunity to review healthcare providers’ activities.

ASSESSMENT: Most insurance or managed care participation agreements allow for this type of scrutiny.

QUERY: But, what if the patient, or care-giver, is the culprit?

BIZARRE: https://www.msn.com/en-us/news/crime/woman-subjected-adopted-daughter-to-unnecessary-feeding-tube-wheelchair-hundreds-of-medical-appointments-authorities/ar-AAKBjVx?li=BBnb7Kz

MUNCHAUSEN SYNDROME BY PROXY: https://www.webmd.com/mental-health/munchausen-by-proxy

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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: Artificial Intelligence in Health Care Today

Transforming Health care ETHICALLY

By Stanford Online

[Drs. Serena Yeung and Matthew Lungreen]

Artificial intelligence has the potential to transform healthcare, driving innovations, efficiencies, and improvements in patient care.

WHITE-PAPER LINK: https://www.healthit.gov/sites/default/files/jsr-17-task-002_aiforhealthandhealthcare12122017.pdf

But, this powerful technology also comes with a unique set of ethical and safety challenges.

LINK: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

So, how can AI be integrated into healthcare in a way that maximizes its potential while also protecting patient safety and privacy? 

In this session faculty from the Stanford AI in Healthcare specialization discuss the challenges and opportunities involved in bringing AI into the clinic, safely and ethically, as well as its impact on the doctor-patient relationship.

They also outline a framework for analyzing the utility of machine learning models in healthcare and will describe how the US healthcare system impacts strategies for acquiring data to power machine learning algorithms.

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

***

NASEM Recommends a Primary Care Physician to Every American

By HEALTH CAPITAL CONSULTANTS, LLC


On May 4, 2021, the National Academies for Sciences, Engineering and Medicine (NASEM) released a major report expressing a dire need to improve primary care in the U.S. 

Since January 2020, an extensive committee within NASEM has worked to develop an implementation plan that will reopen the discussion of improving primary care as a means to improving overall health and achieving health equity.

(Read more…)

Primary Care|Global Events|U.S.A|Europe|Middle East|Asia ...

ASSESSMENT: Your thoughts are appreciated.

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GENERATIONS OF VALOR

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REMEMBER AND GIVE THANKS

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The Business of Medical Practice [3rd. edition]

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Health Dictionary Series of Administrative Terms

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SPONSOR: http://www.CertifiedMedicalPlanner.org

To keep up with the ever-changing healthcare industrial complex, we must learn new definitions and re-learn old terminology in order to correctly apply it to practice. By aggregating the most up-to-date abbreviations, acronyms, definitions and terms, the Health Dictionary Series offers a wealth of information to help understand the ever-changing terms-of-art in healthcare today.

Each 10,000 item handbook is essential for doctors, nurses, benefits managers, financial advisors/planners, and insurance agents, CPAs, and administrators; as well as graduate and under graduate students and professors. Our goal to for each dictionary to be designated as a Doody’s Core Title.

Dictionary of Health Insurance and Managed Care

With more than 10,000 definitions, 4,000 abbreviations and acronyms, and a 3,000 item oeuvre of resources, readings, and nomenclature derivatives, this dictionary covers the Medicare, managed care and Medicaid, private insurance, Veteran’s Administration and PP-ACA language of the entire health and long-term care insurance sector.

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Dictionary of Health Economics and Finance

Health economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, mathematics, the actuarial sciences, stochastics and statistics, salary reimbursements, physician payments, compensation and forecasting are all commingled arenas.

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Dictionary of Health Information Technology Security

There is a myth that all healthcare stakeholders understand the meaning of information technology jargon. In truth, the vernacular of contemporary systems is unique, and often misused or misunderstood. Moreover, emerging Heath Information Technology (HIT) thru the HITECG initiatives; in the guise of terms, definitions, acronyms, abbreviations and standards; often puts the non-expert in a position of maximum uncertainty and minimum productivity.

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FOREWORDS

[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD] 

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Congress Ignores Doctor Shortage?

By Bonner R Cohen

Congress bypassed an opportunity in recently enacted COVID-19 relief bills to significantly increase the number of Medicare-funded residency positions at hospitals.

In the last package, which amounted to $1.4 trillion in government spending and was signed by President Trump on December 31, lawmakers set aside $120 million for 1,000 new physician training slots over the next five years. There was a more ambitious bill on the table that would have added 15,000 residencies over the next five years, but it failed to make it into the giant year-end coronavirus relief package.

“The increase of 1,000 slots is a good first step but a far cry from what is needed,” said David Balat, director of the Right on Health initiative at the Texas Public Policy Foundation.

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READ: https://heartlanddailynews.com/2021/02/congress-ignores-doctor-shortage/

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

***

PODCAST: The Covid 19 Pandemic and Mental Health

Including Substance Use Issues

By Dr. David E. Marcinko MBA CMP© and staff reporters

The COVID-19 pandemic has spurred—and aggravated—a range of mental health and substance use issues in the United States.

In this episode of Critical Point, Milliman’s Stoddard Davenport discusses the rising demand for mental health services and how different populations are being affected. Stoddard also highlights recent statistics on the topic and what the road ahead may look like for mental health in America.

PODCAST LINK: https://www.healthcaretownhall.com/?p=10186

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Community Mental Health Programs and Resources: https://medicalexecutivepost.com/wp-content/uploads/2019/05/mental-health-dr.-marcinko.pdf

Social Determinant of Health: https://www.healthsharetv.com/content/webinar-recap-social-determinants-health-turning-potential-actual-value

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Your thoughts are appreciated.

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PODCAST: How are Hospitals Doing after the Pandemic?

The Pandemic is Ending?

How Are Hospitals Doing?

Interview with Brian Peters 

Rich Helppie brings back Brian Peters, the CEO of The Michigan Health and Hospital Association to talk about the current state of Covid-19; what we may have gotten right, what we may have gotten wrong and how to move forward.

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EDITOR’S NOTE: I first met Rich in B-school, when I was a student, back in the day. He was the Founder and CEO of Superior Consultant Holdings Corp. Rich graciously wrote the Foreword to one of my first textbooks on financial planning for physicians and healthcare professionals. Today, Rich is a successful entrepreneur in the technology, health and finance space.
-Dr. David E. Marcinko MBA CMP®

****

PODCAST: https://richardhelppie.com/brian-peters/

ASSESSMENT: Your thoughts are appreciated.

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***

Hospitals and Healthcare Organizations

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Why We Podcast Less and Read & Write More on the ME-P?

Why we remember more by reading – especially print – than from audio or video

By Naomi S. Baron

PREMISE: Recently, several readers of this Medical Executive-Post have asked why we have not embraced vlogging, podcasting and / or videos even more on our growing platform?

Professor Naomi S. Baron [unrelated] explains most eloquently.

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EDITOR’S NOTE: Dr. Naomi S. Baron does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond academic appointment. She is a Professor of Linguistics Emerita, at American University.

Dr. David E. Marcinko MBA CMP®

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LINK: https://theconversation.com/why-we-remember-more-by-reading-especially-print-than-from-audio-or-video-159522?utm_source=pocket-newtab

Your thoughts are appreciated.

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***

“Money Laundering” in Medical Practice?

2

By Dr. David Edward Marcinko MBA CMP©

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SPONSOR: http://www.CertifiedMedicalPlanner.org

MONEY LAUNDERING

Charges of money laundering may seem foreign to the practice of medicine. The term “money laundering” evokes visions of a suitcase of drug cash being brought into a legitimate business and being transformed into that business’s receipts and later tunneled through legal channels.

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

In medicine the route beings with receipt of a claim payment check (i.e., a check as opposed to the drug dealer’s cash). The check is then deposited into the professional corporation’s checking account. The funds are then paid to the physician in the form of wages. Those wages are then deposited into the physician’s personal checking account.

Those funds and other similarly situated funds are then accumulated until a check is written to pay for a new automobile. The money received from the alleged fraudulent insurance claim has successful been “laundered” into a hard asset (e.g., Jaguar XJL-V8 4 door luxury sedan).

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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THE ANATOMIC BASIS OF HUMAN PHYSIOLOGY AND BEHAVIOR?

BRAIN ANATOMY

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

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I am not a neurologist, psychologist, or psychiatrist. But, it is well known that emotional and behavioral change involves the human nervous system. And, there are two parts of the nervous system that are especially significant for holistic financial advisor; the first is the limbic system and the second is the autonomic nervous system. 

According to Dr. C. George Boerre of Shippensburg University of Pennsylvania, this is known as the emotional nervous system.

1. The Limbic System

The limbic system is a set of structures that lies on both sides of the thalamus, just under the cerebrum.  It includes the hypothalamus, the hippocampus, the amygdala, and nearby areas.  It is primarily responsible for emotions, memories and recollection. 

Hypothalamus

The small hypothalamus is located just below the thalamus on both sides of the third ventricle (areas within the cerebrum filled with cerebrospinal fluid that connect to spinal fluid). It sits inside both tracts of the optic nerve, and just above the pituitary gland.

The hypothalamus is mainly concerned with homeostasis or the process of returning to some “set point.”  It works like a thermostat:  When the room gets too cold, the thermostat conveys that information to the furnace and turns it on.  As the room warms up and the temperature rises, it sends turns off the furnace.  The hypothalamus is responsible for regulating hunger, thirst, response to pain, levels of pleasure, sexual satisfaction, anger and aggressive behavior, and more.  It also regulates the functioning of the autonomic nervous system, which means it regulates functions like pulse, blood pressure, breathing, and arousal in response to emotional circumstances. In a recent discovery, the protein leptin is released by fat cells with over-eating.  The hypothalamus senses leptin levels in the bloodstream and responds by decreasing appetite.  So, it seems that some people might have a gene mutation which produces leptin, and can’t tell the hypothalamus that it is satiated.   The hypothalamus sends instructions to the rest of the body in two ways.  The first is to the autonomic nervous system.  This allows the hypothalamus to have ultimate control of things like blood pressure, heart rate, breathing, digestion, sweating, and all the sympathetic and parasympathetic functions.

The second way the hypothalamus controls things is via the pituitary gland.  It is neurally and chemically connected to the pituitary, which in turn pumps hormones called releasing factors into the bloodstream.  The pituitary is the so-called “master gland” as these hormones are vitally important in regulating growth and metabolism.

Hippocampus

The hippocampus consists of two “horns” that curve back from the amygdala.  It is important in converting things “in your mind” at the moment (short-term memory) into things that are remembered for the long run (long-term memory).  If the hippocampus is damaged, a patient cannot build new memories and lives in a strange world where everything they experience just fades away; even while older memories from the time before the damage are untouched!  Most patients who suffer from this kind of brain damage are eventually institutionalized.

Amygdala

The amygdalas are two almond-shaped masses of neurons on either side of the thalamus at the lower end of the hippocampus.  When it is stimulated electrically, animals respond with aggression.  And, if the amygdala is removed, animals get very tame and no longer respond to anger that would have caused rage before.  The animals also become indifferent to stimuli that would have otherwise have caused fear and sexual responses.

Related Anatomic Areas

Besides the hypothalamus, hippocampus, and amygdala, there are other areas in the structures near to the limbic system that are intimately connected to it:

  • The cingulate gyrus is the part of the cerebrum that lies closest to the limbic system, just above the corpus collosum.  It provides a pathway from the thalamus to the hippocampus, is responsible for focusing attention on emotionally significant events, and for associating memories to smells and to pain.
  • The ventral tegmental area of the brain stem (just below the thalamus) consists of dopamine pathways responsible for pleasure.  People with damage here tend to have difficulty getting pleasure in life, and often turn to alcohol, drugs, sweets, and gambling.
  • The basal ganglia (including the caudate nucleus, the putamen, the globus pallidus, and the substantia nigra) lie over to the sides of the limbic system, and are connected with the cortex above them.  They are responsible for repetitive behaviors, reward experiences, and focusing attention. 
  • The prefrontal cortex, which is the part of the frontal lobe which lies in front of the motor area, is also closely linked to the limbic system.  Besides apparently being involved in thinking about the future, making plans, and taking action, it also appears to be involved in the same dopamine pathways as the ventral tegmental area, and plays a part in pleasure and addiction.

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2. The Autonomic Nervous System

The second part of the nervous system to have a particularly powerful part to play in our emotional life is the autonomic nervous system. 

The autonomic nervous system is composed of two parts, which function primarily in opposition to each other.  The first is the sympathetic nervous system, which starts in the spinal cord and travels to a variety of areas of the body.  Its function appears to be preparing the body for the kinds of vigorous activities associated with “fight or flight,” that is, with running from danger or with preparing for violence.  Activation of the sympathetic nervous system has the following effects:

  • dilates the pupils and opens the eyelids,
  • stimulates the sweat glands and dilates the blood vessels in large muscles,
  • constricts the blood vessels in the rest of the body,
  • increases the heart rate and opens up the bronchial tubes of the lungs, and
  • inhibits the secretions in the digestive system.

One of its most important effects is causing the adrenal glands (which sit on top of the kidneys) to release epinephrine (adrenalin) into the blood stream.  Epinephrine is a powerful hormone that causes various parts of the body to respond in much the same way as the sympathetic nervous system.  Being in the blood stream, it takes a bit longer to stop its effects, and may take some time to calm down again

The sympathetic nervous system also takes in information, mostly concerning pain from internal organs.  Because the nerves that carry information about organ pain often travel along the same paths that carry information about pain from more surface areas of the body, the information sometimes get confused.  This is called referred pain, and the best known example is the pain in the left shoulder and arm when having a heart attack.

The other part of the autonomic nervous system is called the parasympathetic nervoussystem.  It has its roots in the brainstem and in the spinal cord of the lower back.  Its function is to bring the body back from the emergency status that the sympathetic nervous system puts it into.

Some of the details of parasympathetic arousal include some of the following:.

  • pupil constriction and activation of the salivary glands,
  • stimulating the secretions of the stomach and activity of the intestines,
  • stimulating secretions in the lungs and constricting the bronchial tubes, and;
  • decreases heart rate.

The parasympathetic nervous system also has some sensory abilities:  It receives information about blood pressure, levels of carbon dioxide in the blood, etc.

There is actually another part of the autonomic nervous system that is not mentioned too often: the enteric nervous system.  It is a complex of nerves that regulate the activity of the stomach. 

For example, if you get sick to your stomach with a new financial advisory client – or feel nervous butterflies with your first patient encounter as a doctor- you can blame the enteric nervous system.

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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***

PODCAST: Have You Received Your COVID-19 Vaccine, Yet?


Have you gotten your COVID-19 vaccine yet?

Haven’t gotten your COVID-19 vaccine yet? Now’s your chance! Find a COVID-19 vaccine provider near you quickly and easily with the redesigned Vaccines.gov website. Vaccines.gov COVID-19 vaccines are the best way to protect yourself and your loved ones from COVID-19 — and an important tool to help us get back to normal.

And remember, the vaccine is available at no cost to you at doctor’s offices, clinics, hospitals and retail pharmacies across the country.

Already vaccinated? That’s great! Visit CDC.gov to see the activities you can do safely when you’ve been fully vaccinated.
"I got mine. Be next." with smiling woman image. Linked to video.

PLAY PODCAST VIDEO: https://www.youtube.com/watch?v=6aPihNXV_wQ#utm_campaign=20210519_cvd_prv_gal_v1&utm_content=english&utm_medium=email&utm_source=govdelivery

Note: Bring your red, white, and blue Medicare card (or Medicare Number) when you go to get your vaccine.

Sincerely,

The Medicare Team

***

The “Zero-Based Budget” for Physicians?

Zero-Based Budget

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By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org


A zero-based budget means you start with the absolute essential expenses, and then add expenses from there until you run out of money. This is an extremely effective, yet rigorous exercise for most medical professionals and can be used personally or at the office.

Guess what your first personal financial item should be?

That’s right, retirement plan contributions. Then your mortgage and other debt payments, and other required fixed expenses. From the office perspective, the first budget item should be salary expenses, both your own and your staff.

Operating assets and other big ticket items come next, followed by the more significant items on your net income statement.

Some doctors even review their P&L statements quarterly, line by line, in an effort to reduce expenses. Then add discretionary personal or business expenses that you have some control over.

P&L: https://medicalexecutivepost.com/2008/03/18/net-income-pl-statement/

Do you run out of money before you reach the end of the month, quarter, or year? 

Then you better cut back on entertainment at home or that fancy new, but unproven piece of office or medical equipment.  This sounds Draconian until you remind yourself that your choice is either a) entertainment now but no money later, or b) living a simpler lifestyle now as you invest so you’re able to enjoy yourself at retirement.

Risks: https://medicalexecutivepost.com/2017/10/18/on-retirement-planning-risks/

Zero-Based Budgeting: The Ultimate Guide - MintLife Blog

Why?

When you were a young doctor, it may have been a difficult trade-off. But at mid-life, you’re staring ultimate retirement in the face.

ASSESSMENT: Your thoughts are appreciated.

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THANK YOU

***

PODCAST: How Financial Advisors Can Achieve Success in the Medical Marketplace 2016-2021 and Beyond!

Vicki Rackner MD --- Selling to Doctors - Experts

By Vicki Rackner MD

PODCAST LINK: https://www.bing.com/videos/search?q=vicki+rackner&docid=608036072061497500&mid=08727E5CFAC1C7A88A5A08727E5CFAC1C7A88A5A&view=detail&FORM=VIRE

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BEST PRACTICES: https://www.targetingdoctors.com/blog/adopt-physicians-best-practices

MD PANDEMIC CLIENTS: https://www.targetingdoctors.com/

E-MAIL MARKETING: https://medicalexecutivepost.com/2014/11/30/12-email-marketing-tips-for-mds-and-fas/

SELLING DOCTORS: https://medicalexecutivepost.com/2015/05/06/doctors-rethink-selling/

EDITOR’S NOTE: I first met Vicki Rackner MD FACS a few years ago. day. She is the founder of Thriving Doctors.  Vicki calls on her personal experience as a practicing surgeon, clinical faculty member at the University of Washington School of Medicine and serial entrepreneur, to help financial advisors thrive. We appreciate her contributions to the ME-P.

-Dr. David Edward Marcinko MBA CMP©

[Certified Medical Planner©]

***

ASSESSMENT: Your thoughts are welcomed.

Enter the CMPs

cmp

THANK YOU

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The CERTIFIED MEDICAL PLANNER® Online Designation Program is Now Automated

[By Staff Reporters]

The concept of a self-taught and student motivated, but automated outcomes driven classroom may seem like a nightmare scenario for those who are not comfortable with computers.

Now everyone can breathe a sigh of relief, because the Institute of Medical Business Advisors just launched an “automated” final examination review protocol that requires no programming skill whatsoever.

Enter the CMPs

cmp

In fact, everything is designed to be very simple and easy to use. Once a student’s examination “blue-book” is received, computerized “robotic reviewers” correct student assignments and quarterly test answers. This automated examination model lets the robots correct tests and exams, while the students concentrate on guided self-learning.

SplitShire-

http://www.CertifiedMedicalPlanner.org

Assessment

According to Eugene Schmuckler PhD MBA MEd, Dean of the CERTIFIED MEDICAL PLANNER® professional designation and certification program,

“This option allows the modern adult-learner save both time and money as s/he progresses toward the ultimate goal of board certification as a CMP® mark holder.”

The trend is growing and iMBA, Inc., is leading the way.

imba inc

THANK YOU

TEXTBOOK LINK: 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

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REAL ESTATE Investing for Physicians?

OVER HEARD IN THE ADVISOR’S LOUNGE

Real Estate and Physicians

What I see in my accounting practice is that significant accumulation in younger physician portfolio growth is not happening as it once did. This is partially because confidence in the equity markets is still not what it was; but that doctors are also looking for better solutions to support their reduced incomes.

For example, I see older doctors with about 25 percent of their wealth in the market, and even in retirement years, do not rely much on that accumulation to live on. Of this 25 percent, about 80 percent is in their retirement plan, as tax breaks for funding are just too good to ignore.

What I do see is that about 50 percent of senior physician wealth is in rental real estate, both in a private residence that has a rental component, and mixed-use properties. It is this that provides a good portion of income in retirement.

So; could I add dialog about real estate as a long term solution for retirement?

Yes, as I believe a real estate concentration in the amount of 5 percent is optimal for a diversified portfolio, but in a very passive way through mutual or index funds that are invested in real estate holdings and not directly owning properties.

Today, as an option, we have the ability to take pension plan assets and transfer marketable securities for rental property to be held inside the plan collecting rents instead of dividends.

Real estate holdings never vary very much, tend to go up modestly, and have preferential tax treatment due to depreciation of the property against income.

YOUR THOUGHTS ARE APPRECIATED.

GLEASONS GIVE A KID A DREAM | gleasonsgiveakidadream

Perry D’Alessio, CPA
[D’Alessio Tocci & Pell LLP]

THANK YOU

***

PODCAST: Medicare Advantage Plans [Insurance Company Goldmine]

Medicare Advantage PART C

Insurance Carriers Want Medicare-For-All to Happen?

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By Eric Bricker MD

A Commonwealth Fund Study Found Insurance Carrier Revenue from Medicare Advantage Plans Increase 5X More Than Revenue from Employer Sponsored Health Plans.

In Fact, Government Sources (Medicare Advantage, Medicaid Managed Care, ACA/Obamacare Plans) Make Up More Revenue ($213B) for the 5 Largest Insurance Carriers Than Revenue from Employers ($148B).

Government Payers Are the New Cash Cow for Health Insurance Companies.  
And so, Medicare-Advantage-for-All May Happen … Because Insurance Carriers WANT It to Happen.

PODCAST: A Commonwealth Fund Study Found Insurance Carrier Revenue from Medicare Advantage Plans Increased 5X More Than Revenue from Employer Sponsored Health Plans.

Your thoughts are appreciated.

THANK YOU
***

Homeless Youth in the USA


A Vulnerable PopulationInfographic

By NIHCM Foundation

Each year, an estimated 4.2 million youth and young adults experience homelessness in the United States. Every night, thousands of young people experience homelessness without a parent or guardian – going to sleep without the support and stability of a family or a home.

Among homeless youth, 40% identify as LGBTQ and they have more than twice the risk of being homeless than their heterosexual peers. This infographic explores youth homelessness, risk factors for becoming homeless, the health toll associated with being homeless, and what can be done to address this crisis.

Image result for Homeless Youth Cartoon

LINK: https://nihcm.org/publications/homeless-youth-a-vulnerable-population?utm_source=NIHCM+Foundation&utm_campaign=a2653f1422-050421_Homeless_Youth_Infographic&utm_medium=email&utm_term=0_6f88de9846-a2653f1422-167744768

dumpster

DUMPSTER DIVING

Your thoughts are appreciated.

THANK YOU

***

In Defense of Employed Physicians

The History of Managed Care

Episode 91: Dr. Michel Accad - How Did Medicine Go Wrong?

By Michel Accad, MD

EDITOR’S NOTE: Dr. Accad practices internal medicine and cardiology in San Francisco.

***

I wish to make one clarification and one prediction regarding employed physicians.

The clarification is this:  There is a common misconception that if healthcare operated under free market conditions, it would primarily be a cottage industry of solo practices and of small physician-owned hospitals.  Such operations would not develop the capabilities of large healthcare entities that we commonly associate with central planning.

See the source image

ASSESSMENT: In reality, however, the opposite would be the case.

LINK: http://alertandoriented.com/in-defense-of-the-employed-physician/

[Related article: One hundred years of managed care]

Your thoughts are appreciated.

THANK YOU

***

Non-Traditional Physician Compensation Models

Creative Compensation Models

"Advisors Only" | The Leading Business Education Network ...

BY DR. DAVID EDWARD MARCINKO MBA CMP®

A Review of Some Newer Compensation Models

http://www.CERTIFIEDMEDICALPLANNER.org

CMP logo

Today, whether independent or employed, physicians can pursue several creative compensation models, other than fee-for service reimbursement based on Current Procedural Terminology [CPT®] codes, not popular a few decade ago:

  • Pay-for-Performance Initiatives [P4P]: According to Mark Fendrick, MD and Michael E. Chernew, PhD, instead of the one size fits all approach of traditional health insurance, a “clinically-sensitive” cost-sharing system that supports co-payments related to evidence-based value for targeted patients is emerging. In 2014, for example, there were a number of changes to Medicare’s pay-for-performance programs [personal communication]. These value-based payment modifiers will show up in physicians’ paychecks in few years, and will be expanded to practices with 10 or more eligible professionals. The program, mandated by the Affordable Care Act, assesses a provider’s quality of care and costs, and increases Medicare payments for good performers and decreases them for bad ones. And, doctor performance will be reflected in adjustments to 2016 payments. As much as 2% of Medicare payments will be at risk in 2021 based on physician performance in 2019. It was only 1% for 2015, which was based on doctors’ 2013 performance.
  • Physician Quality Reporting Initiative Model.  The Centers for Medicare and Medicaid Services [CMS] paid out more than $40 million in monetary incentives to medical providers who reported data on quality of care delivered between July 2020 and December 2020; as part of its PQRI. Under the PQRI, healthcare providers who participated received bonuses of 1.5 percent of their total CMS payments during the reporting period.
  • Direct Reimbursement Payment Model:  A Health Reimbursement Arrangement (HRA) is a tool which is used to provide direct reimbursement by an employer for qualified medical expenses.  The HRA is an employer-established benefit plan, and contributions to the plan may only be made by the employer.  The HRA can be used in conjunction with any insurance plan, including a high-deductible plan. Qualified reimbursements made under the HRA are tax-deductible for the employer, and the payments are not counted as income for the employee.  Any balance in an HRA can generally be carried over to the next year.  This plan allows for flexibility and tailored to meet the particular needs of both employers and employees in a tax-advantaged manner.  From the physician’s perspective, increasing use of HRAs poses new challenges.  Payment for services in the medical office may be required of the patient/employee before reimbursement from the employer occurs.  These extra steps can easily result in delayed payment or non-payment to medical providers who are not prepared to work with this model of reimbursement.  The provisions for this model are outlined in IRS publication 969, http://www.irs.gov/pub/irs-pdf/p969.pdf.
  • Concierge Practice Model:  The concept of concierge medicine (CM), also known as retainer medicine, first emerged in Seattle, Washington in the 1990’s. With CM, the physician charges an annual retainer fee to patients.  The fee usually ranges from $1,000 to $20,000 per year, and the number of patients in a practice is usually limited to a few hundred.  In return, patients receive increased levels of access and personalized care. This often includes same day appointments, extended visit times, house calls, and 24/7 access to the physician by pager and cell phone. An annual executive physical is often included, as well as an increased emphasis on preventive care.  Many physicians choosing this type of practice model do so for lifestyle and control reasons, although the average income for a successful CM primary care physician is higher than that of a typical primary care physician. .
  • Global Healthcare Model: American businesses are extending their cost-cutting initiatives to include offshore employee medical benefits, and facilities like the Bumrungrad Hospital in Bangkok, Thailand (cosmetic surgery), the Apollo Hospital in New Delhi, India (cardiac and orthopedic surgery) are premier examples for surgical care. Both are internationally recognized institutions that resemble five-star hotels equipped with the latest medical technology. Countries such as Finland, England and Canada are also catering to the English-speaking crowd, while dentistry is especially popular in Mexico and Costa Rica. Although this is still considered “medical tourism,” Mercer Health and Benefits was recently retained by three Fortune 500 companies interested in contracting with offshore hospitals and The Joint Commission [TJC] has accredited 88 foreign hospitals through a joint international commission. To be sure, when India can discount costs up to 80%, the effects on domestic hospital reimbursement and physician compensation may be assumed to increase downward compensation pressures.
  • Locum Tenens Practitioner Model: Locum Tenens (LT) as an alternative to full-time employment is enjoying a comeback for most specialties. Some younger physicians enjoy the travel, while mature physicians like to practice at their leisure. Employment factors to consider include: firm reputation, malpractice insurance, credentialing, travel and relocation expenses (which are negotiable). However, a LT firm typically will not cover taxes [NALTO.org and http://www.studentdoc.com/locum-tenens.html%5D

ASSESSMENT: Your thoughts are appreciated.

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“Buy Now – Pay Later” Changed Retail Consumerism

Health care and rent are next?

[By Terry Nguyen staff reporters]

Emerging fintech apps are looking to apply this lending model to sectors, from health care to travel to rent. Sure, people are growing acclimated to dividing their purchases into four easy payments, even applauding the option to do so.

But no matter how you frame it, the pitfalls of these plans seem to be, unfortunately, just more debt.

18-24's Owe £225 to Buy Now Pay Later Schemes - AI Global ...

Buy now, pay later providers Klarna, Afterpay, and Quadpay spent years slowly infiltrating the retail market. The pandemic has accelerated their popularity among all sorts of online brands

READ LINK: https://www.vox.com/the-goods/2021/5/11/22429014/buy-now-pay-later-pandemic-expansion?utm_source=pocket-newtab

ASSESSMENT: Your thoughts are appreciated.

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PODCAST: Price Transparency in Healthcare

David Balat

By David Balat

In this BRI Virtual Event Series, David Balat of Free2Care, talks about Price Transparency in Healthcare, right here.

PODCAST VIDEO: https://www.youtube.com/watch?v=W3iOIA1qziM

EDITOR’S NOTE: David Balat is the director of the Right on Healthcare initiative at the Texas Public Policy Foundation and founder of the patient-physician coalition, Free2Care. He has broad experience across the healthcare spectrum with special expertise in healthcare finance. He is a former congressional candidate in Texas’ 2nd Congressional District and a seasoned hospital executive with more than 20 years of healthcare industry leadership and executive management experience.

Dr. David E. Marcinko MBA

[Editor-in-Chief]

***

CMS Rule: https://medicalexecutivepost.com/2020/11/29/cms-final-rule-brings-transparency-to-healthcare-industry/

Related: https://medicalexecutivepost.com/2021/03/25/hospital-price-transparency-2021/

Physician POV: https://medicalexecutivepost.com/2019/09/09/physician-perspectives-on-price-transparency/

More: https://medicalexecutivepost.com/2021/02/01/hospitals-and-price-transparency/

Your thoughts are appreciated

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PODCAST: Healthcare Artificial Intelligence, Machine Learning and Natural Language Processing

PODCAST ON UnitedHeathcare Group Annual Report

Dr. Eric R. Bricker, Internist in Dallas, TX | US News Doctors

By Eric Bricker MD

An Annual Report from UnitedHealth Group Says United is Going Drive Growth by Using AI and Machine Learning to 1) Help High Risk Patients, 2) Assist Patients with Multiple Chronic Diseases, 3) Partner with Providers and 4) Be More Patient-Centric.

Some More Concrete Examples of How AI and Machine Learning Can Be Used in Healthcare and Health Insurance Are:

1) Better Underwriting of Risk

2) More Highly Focused Prior Authorization

3) Cherry-Pick the Individual Health Insurance Market

However, the Execution of AI’s and Machine Learning’s Finding Requires Human Behavior Modification–an Almost Impossible Task for Any Insurance Carrier to Accomplish Because of Their Low Credibility with Patients, Doctors and Nurses. Without Credibility and Trust, All the AI and Machine Learning in the World Will NOT Change People’s Behavior.

PODCAST LINK: https://www.youtube.com/watch?v=c9knoA30sD4

Disclaimer: Dr. Bricker is the founder of Texas Family Insurance – an independent insurance agent that sells Oscar Health.

ASSESSMENT: Your comments are appreciated.

THANK YOU
***

The Biden Tax Plan “Dissected” on Tax Day 2021

Biden Tax Plan: Details & Analysis | Tax Foundation

NOT JUST A POLL TAX?

LINK: https://taxfoundation.org/joe-biden-tax-plan-2020/

PDF FILE: https://files.taxfoundation.org/20201109095935/Details-and-Analysis-of-President-Elect-Joe-Bidens-Tax-Plan.pdf

The Bidentax plan includes the following payroll tax, individual income tax, and estate and gift tax changes.

It imposes a 12.4 percent Old-Age, Survivors, and Disability Insurance (Social Security) payroll tax on income earned above $400,000, evenly split between employers and employees.

ASSESSMENT: Your thoughts are appreciated.

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***

Clue-Less Physicians and Taxes

OVER HEARD IN THE DOCTOR’S LOUNGE

Dr.s' Lounge دكتورز لونج - Identity Design by YaStudio

A PHYSICIAN POLL

[IRS Tax Day – May 17, 2021]

“I read a poll on SERMO (a doctor-only web forum) asking what percentage of income was paid in taxes. The lowest option was <20%.  I thought it ridiculous since I make about an average salary and paid about 8% in Federal tax, 3.5% in payroll tax, and 4% in state income taxes. So, I spoke up about it. 

After a few days of correspondence, it became evident that most doctors have no idea what they pay in taxes, or that they pay far too much in taxes.  For example, of 58 responses on the poll, I was the only one who paid less than 20% in taxes.  Keep in mind that more than half of doctors make less money than I do.

I found it hilarious that 4 doctors thought they paid more than 50% in taxes.  I can’t quite figure out how to pull that off; even if you are single, make a ton of money, take a standard deduction, are self-employed, and pay ridiculous state and local income taxes. Really … more than 50%!  You’re either mistaken or stupid … hopefully; just mistaken.

Or is the problem simply that doctor’s have no idea what their effective tax rate is”?

DJ. Morgane DO

[Internal Medicine]

Your thoughts 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

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Physician Recruitment and Executive Search Firms

Facts about Physician Recruiters and Executive Search Firms

May Launches the Busy Season

By Dr. David E. Marcinko MBA CMP®

CMP logo

Sponsored: http://www.CertifiedMedicalPlanner.org

1) If you are job hunting, you should send your resume to recruiters

Different recruiters know about different positions. They do not usually know about the same ones. This is particularly true with retained firms. By sending your resume out widely, you will be placed in many different confidential databases and be alerted of many different positions. If you send your resume to only a few, it may be that none you send to will be working with positions which are suited for you. Throw your net widely.

If you change jobs, it is also wise to send follow-up letters to the recruiters and alert them of your new career move. Many search firms follow people throughout their careers and enjoy being kept up-to-date. It is a good idea to have your resume formatted in plain text so you can copy and paste it into email messages when requested to do so. Then, follow up with a nicely formatted copy on paper by postal mail.

Some estimate that only 1% to 3% of all resumes sent will result in actual job interviews. So, if you only send 50 resumes, you may only have less than 2 interviews, if that many. Send your resume to as many recruiters as you can. It is worth the postage or email time. Generally, recruiters will not share your resume with any employer or give your name to anyone else without obtaining your specific permission to do so. The recruiter will call first, talk to you about a particular position and then ask your permission to share your resume with that employer.

2) Your resume will be kept strictly confidential by the executive search firm.

It is safe to submit your resume to a search firm and not worry that the search firm will let it leak out that you are job hunting. Recruiters will call you each and every time they wish to present you to an employer in order to gain your permission. Only after they have gained your permission will they submit your name or resume to the identified employer. The wonderful aspect of working with search firms is that you can manage your career and your job search in confidence and privacy.

3) Fees are always paid by the employer, not the job candidate.

Recruiters and search firms work for the employer or hiring entity. The employer pays them a fee for locating the right physician for the job opening. This is important to remember, in that when you interact with executive recruiters, you are essentially interacting with an agent or representative of the employer. Recruiters are more loyal to employers than they are to job candidates because they work for the employer. This should not present a problem, but, should cause you to develop your relationship with the recruiter with the same integrity and professionalism that you would with the employer.

Recruiters are paid fees in one of two ways – retainer fees or contingency fees. This is an important distinction and will affect your process with both the employer and the recruiter. Some employers prefer working with contingency firms and some with retained firms. Both are respected by employers and useful in your job search, but, the two types of firms will not be handling the same positions with the same employers simultaneously.

A “retained recruiter” has entered an exclusive contract with an employer to fill a particular position. The retained recruiter, then, is likely to advertise a position, sharing the specifics of the position, location and employer openly. The retained firm feels a great obligation to fulfill the contract by finding the best person for the job.

A “contingency recruiter” on the other hand, usually does not have an exclusive relationship with the employer, and is only paid a fee if the job search is successful. Often, if the employer uses contingency firms, there will be more than one contingency firm competing to fill a certain position. As a job hunter, if you are sent to an interview by a contingency firm, you may find that you are competing with a larger number of applicants for a position. Generally, retained firms only send in from 3 to 5 candidates for a position.

Recruiters will be paid fees equal to about 25% to 35% of the resulting salary of the successful candidate plus expenses. This does not come out of the job candidate’s salary. This is paid to the recruiter through a separate relationship between the employer and the search firm. This may seem like a large fee, but, keep in mind that recruiters incur a great many expenses when searching for successful job candidates. They spend enormous amounts of money on computer systems, long distance calls, mail-outs, travel and interviews. Recruiters work very hard for these fees. Employers recognize the value of using recruiters and are more than willing to pay recruiters the fees. All you have to do is contact the recruiter to get the process moving. 

4) Not all medical recruiters work only with physicians.

Some search firms work exclusively with physicians or in healthcare, while others may work in several fields at once. Some of the larger generalist firms will have one or more search consultants that specialize in healthcare. It is important for you, as a job hunter, to assess the recruiters’ knowledge of your field. If you use industry or medical specialty buzz words in describing your skills, experience or career aspirations, you may or may not be talking a language the recruiter understands fully. It is wise to explore fully with the recruiter his understanding of your field and area of specialization.

5) Recruiters and search consultants move around.

Recruiters, like many professionals, move to new firms during their careers. Often you will find that recruiters will work at several firms during their careers. Since it is much more effective to address your letters to a person rather than “to whom it may concern”, it is smart for job hunters to have accurate and up-to-date information about who is who and where, since this can change frequently. Search firms also move their offices, sometimes to another suite, street or state. If you have a list of recruiters that is over one year old, you will certainly waste some postage in mailing your resumes and cover letters. Many of your mail-outs will be returned to you stamped “non-deliverable”, unless you obtain an up-to-date list. A resource, like the Directory of Healthcare Recruiters is updated very frequently, usually monthly [www.pohly.com/dir3.html].

6) Most search firms work with positions all over the country.

If you are from a particular state, and want to remain in that state, don’t make the mistake of only sending your resume to recruiters in your state. Often the recruiters in your state are working on positions in other states, and recruiters in other states are working on positions in your state. This is usually the case. Very few recruiters work only in their local area, most work all around the US and some internationally. Regardless of your geographic preference, you should still send your resume to all the healthcare recruiters. If you really only want to remain in your area, you can specify that preference in your cover letter.

7) Recruiters primarily work with hard to fill positions or executive positions.

Some recruiters specialize in clinical positions for physicians, managed care executive positions, healthcare financial positions or health administration positions. Others may specialize in finding doctors, nurses or physical therapists. Generally, an employer does not engage a recruiter’s assistance in filling a position unless it is hard to fill. Sometimes employers will engage search firms to save them the valuable time of advertising or combing through dozens of resumes.

A Career in Medical Recruiting - The Campus Career Coach

ASSESSMENT

Contingency recruiters tend to work with more mid-level management and professional positions, but, this is not always the case. Retained firms generally work with the higher level clinical or administrative positions.

One thing you will be assured of is that if a recruiter is working on a position that means that the employer is willing to pay a fee. That usually means that the position is a valued position and one worth closer inspection on your part. Even in healthcare, with certain exceptions, our economy is an “employer’s market”. This means that employers receive a deluge of resumes for their open positions. Increasingly, employers are using recruitment firms to handle their openings and schedule the interviews because employers simply do not have the manpower or time to handle the many resumes they receive.

Therefore, if a job hunter is submitted by a recruiter, that job hunter has a great advantage over all other applicants.

Your thoughts are appreciated.

Product Details

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EDITOR’S PRIVILEGE: The Pandemic and Going Mask-Less

EDITOR’S POINT OF PRIVILEGE

This week, for the first time in a year, I took a walk without wearing a mask. It was all going great until I saw a woman walking her dog approach me. She was wearing a mask, and my body instinctively moved to cross the street to give her space. It made me realize that we’ve been living in fear of other humans, which is pretty sad.

Pandemic-era habits die hard, but I’m confident we can once again re-wire our brains to view other people not as biological vectors for disease, but as … people, just with germs.

So, here’s to hoping this summer, we’ll learn to come together as quickly as we learned to distance.

DAVID EDWARD MARCINKO

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Topics: https://medicalexecutivepost.com/wp-content/uploads/2009/02/imba-inc-firm-services.pdf

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