Using Deposits and Withdrawals to Rebalance Your Portfolio

Posted on July 9, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Benefits of portfolio rebalancing well documented

[By Lon Jefferies MBA CFP®] http://www.NetWorthAdvice.com

The benefits of rebalancing a portfolio are well documented. Constant and routine rebalancing forces a physician or any investor to lighten the portfolio positions that have recently performed well and use the resulting funds to buy more shares of the assets in the portfolio that have remained flat or even declined in value. In other words, rebalancing causes the investor to sell high and buy low.

Most financial professionals recommend rebalancing your portfolio at least once a year (I rebalance my clients’ portfolios on a semi-annual basis).

However, the tax status of an investment account can have a significant impact on a rebalancing strategy. While investments within a tax-advantaged account like a traditional or Roth IRA can be sold without tax implications, selling appreciated assets in a taxable investment accounts will create a capital gains liability.

Consequently, while rebalancing within a tax-advantaged account should be a no-brainer, investors should carefully consider the tax implications that may result from rebalancing a normal investment account.

***

[Routine Portfolio Rebalancing]

***

For this reason, investors should view every deposit to or withdrawal from a taxable investment account as a chance to rebalance. Depositing new money is a free opportunity to buy more of the positions in which the portfolio is underweight.

Example:

For example, suppose an investment account of $100,000 has a target asset allocation of 50% stocks and 50% bonds ($50,000 invested in both). After a year in which stocks made 10% and bonds were flat, the portfolio would consist of $55,000 of stocks and $50,000 of bonds, for a total account balance of $105,000. If at this point the investor would like to invest an additional $5,000, the entire contribution should be placed in bonds, bringing the actual portfolio allocation back to 50% stocks and 50% bonds ($55,000 in each).

Of course, this same strategy can be implemented regardless of the size of the additional contribution. If the investor wanted to contribute $10,000 in year two, the total account value would be $115,000 ($105k current balance + $10k new money). In order to get back to our 50% stock and 50% bond targets, we would want $57,500 in each position. With $55,000 already invested in stocks, we would only want to invest $2,500 of the new money into stocks and place the remaining $7,500 into bonds, bringing both portions of the portfolio up to their targets.

Taking withdrawals from a taxable investment account should also be viewed as an opportunity to rebalance. Rebalancing via withdrawals may not be free as it is when rebalancing is done when new funds are deposited because appreciated assets are likely sold, creating a tax liability. However, when a withdrawal is taken from a taxable account, it is still wise to sell overweight asset categories to produce the funds needed for the distribution.

Example:

Let’s return to our previous example of a 50% stock and 50% bond target portfolio that had grown to $55,000 of stock and $50,000 of bonds. If the investor then wanted to withdraw $10,000, he could take the entire distribution out of bonds which would allow him to free up the amount needed without creating a tax liability. However, the resulting portfolio would consist of $55,000 of stocks and $40,000 of bonds – a ratio of approximately 58% stocks and 42% bonds.

This is a significantly more volatile portfolio than the target 50% / 50% portfolio. For example, in 2008 a portfolio that consisted of 50% large cap stocks and 50% long term government bonds lost -7.16%. Meanwhile, a portfolio of 58% stocks and 42% bonds lost -11.93% over the same period – a 66.6% increase in volatility.

Alternatively, I’d suggest using the $10,000 withdrawal to rebalance the portfolio, bringing the resulting $95,000 portfolio back to 50% stocks and 50% bonds ($47,500 in each). Of course, to do this, the investor would liquidate $7,500 of stocks and $2,500 of bonds. Although this could potentially create a small capital gains tax liability, this is a tax bill that will need to be paid at some point anyhow, and the investor will maintain a portfolio with the target amount of volatility.

Further, remember that the long-term capital gains rate (which applies to any capital assets held for over a year) is a favorable tax rate. For single filers with a taxable income of less than $37,450 and joint filers with a taxable income of less than $74,900, the capital gains tax rate is actually 0%!

Additionally, for single filers with a taxable income of between $37,450 and $406,750 and joint filers with a taxable income of between $74,900 and $457,600, the capital gains tax rate is only 15%. Consequently, the investor can likely rebalance the portfolio back to the target allocation via the withdrawal while incurring only a nominal tax bill.

***

Assessment

While rebalancing provides a significant increase in investment return over long time periods, tax implications should be considered when determining whether or not to rebalance a taxable investment account. However, depositing money to or withdrawing money from these accounts provides a favorable opportunity to obtain the return premium rebalancing creates while minimizing tax implications.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time!

Dr. Neil Baum MD [Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana]

http://www.CertifiedMedicalPlanner.org

Enter the CMPs

Filed under: Investing, Portfolio Management, Risk Management | Tagged: Deposits and Withdrawals, Investing, investing portfolio management, Lon Jefferies MBA CFP®, rebalancing portfolio | 2 Comments »

Life Science Startups Rising

Posted on July 8, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Life Science Startups Rising in the UK

Stephen Chambers spent 22 years in some of the most innovative companies in life science as the director of gene expression and then as a co-founder of his own company.

Here’s his story

Today he runs SynbiCITE, the UK’s synthetic biology consortium of 56 industrial partners and 19 Academic institutions located at Imperial College in London.

Stephen and SynbiCITE, just launched the world’s first Lean LaunchPad for Synthetic Biology program.

*******

By Steve Blank

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Career Development, Research & Development | Tagged: business incubators, Life Science Startups Rising, Stephen Chambers, Steve Blank, SynbiCITE | 3 Comments »

David Belk MD Announces New Website [True Cost of Healthcare.net]

Posted on July 8, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A Site Re-Design

[By David Belk MD]

Here’s the new website with a whole new look that’s been redesigned by Modern Creations: http://truecostofhealthcare.org

There are three new sections:

The first is a study of the prices of brand name medications. It shows that the price pharmacies in the US pay for brand name drugs have gone up an average of 40% in 2 1/2 years. That’s about 18 times the rate of inflation.

The other two new pages examine Medicare supplemental policies as well as Part D and Advantage programs:

The page on supplemental policies is an expansion of the blog I wrote 2 years ago on the subject. It answers just about any question you might have about what Medicare covers and how much you would expect to pay if you have Medicare and need medical treatment

***

David Belk, M.D., Announces New Website

***

Assessment

Feel free to tell me what you think of it. Also, I’m sending this message from my new email address – truecostofhealthcare@gmail.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

“Navigating a course where sound organizational management is intertwined with financial acumen requires a strategy designed by subject-matter experts. Fortunately, Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies provides that blueprint”

—David B. Nash MD MBA Jefferson Medical College, Thomas Jefferson University, PA

Filed under: Drugs and Pharma, Health Economics, Health Insurance, Healthcare Finance | Tagged: David B. Nash MD, David Belk MD, healthcare costs, medical inflation, medicare, truecostofhealthcare.org | 4 Comments »

On Medical Inflation Rising [Managed Care vs Reference Based Pricing]

Posted on July 7, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Beating Medical Trends

[By William Rusteberg]

www.RiskManagers.us (click on WEBLOG)

Medical inflation continues to rise at a rate above the growth rate in the economy. Facing rate increases year after year, plan sponsors, with their financial backs to the wall, have historically resorted to cost shifting. These continued failed attempts to control costs have driven some to seek alternate means to restore pricing sanity to health care. To many, the cost of health insurance can mean the difference between profit and loss.

The Problem

Understanding the cost of health care is directly related to what we agree to pay, more and more employers are questioning managed care contracts upon which their health care costs are based. Many are discovering the truth for the first time. Secretive contracts between health care givers and third party intermediaries contain provisions that guarantee continuous and systematic cost increases. Shared savings side agreements and other schemes found in the health industry economic chain help fuel raging health insurance costs.

Known as medical trend, cost increases have proven to be consistent and predictable. The expected rise in the cost of medical services over time is expressed as an annual percentage increase and is an important element in underwriting future risk. Medical trend is a dominant cost driver in rate making. The annual compounding effect can double or triple health care costs in just a few years.

“For managed care plans, the medical care inflation part of trend is a function of the changes in provider reimbursement rates that are negotiated. To the extent that such negotiations entail factors such as outliers and provider bonuses, the trend rate may be materially more than simply the weighted average increase in fees.” Kevin Gabriel, MBA, FSA, MAAA, Chief Actuary of Sierra Berkshire Associates, Inc.

Photo of hands of businesspeople during discussing

The Solution

Moving away from managed care contracts, more and more employers are embracing a myriad of reference based pricing models. These models can vary in scope and reach; however all share certain common characteristics in conformance with prudent business practices. Price transparency and claim benchmarking are key elements.

In 2007 – 2008 we approached several of our clients to suggest something different to control costs. The concept was simple. Eschew managed care contracts in lieu of claim benchmarking off multiple data points such as Medicare reimbursement rates. Removing managed care contracts, i.e, PPO, and paying providers quickly, fairly and directly had an immediate impact on claim costs.

After 15 months we performed a study by running 100% of claims back through the prior PPO network reimbursement rates. This exercise proved a net savings of 43% above and beyond the PPO discounts we would have otherwise experienced. Instead of doing the same thing year after year, our clients did something different and it worked.

It has been seven years since our first client exited the managed care world. Subsequently more clients have embarked on the same journey, most with equally good results. None have returned to the world of managed care.

The Evidence

Skeptics may ask “How have your clients fared over time? Have they won the battle against medical trend?” The answer may be found by reviewing the experience of four of our clients who have been on a reference based pricing model for five years or more.

Our study is based on actual paid, mature medical claims through succeeding plan years starting in the first year on reference based pricing benchmarked off the prior year under a managed care plan. All claims above stop loss levels have been excluded.

This abbreviated analysis does not recognize changing demographics and plan changes. For example the leveraging effect of higher deductibles will increase trend factors. Of particular importance it should be noted that plan changes occurred in each case through improved benefits supported by claim savings. This study includes medical claims only.

One must understand that medical trend is just one of the factors used to calculate renewal rates for health plans and stop loss insurance. Each year carriers set their own trend level based on various factors, including the current health care inflation rate, analysts’ forecasts and their own experiences. However, our clients are self-funded and thus bear most risk with actual trend directly affecting costs without the benefit of pooling to any significant degree.

“Over the past several years, trend rates have consistently run 8-10% nationally, though certain regions have seen significantly higher or lower figures. Prescription drug trends (which are a component of this) have been more volatile. In the early 2000’s these trends were above 15%. They then fell back to single digit levels. But they have now returned to the teens.” – Kevin Gabriel, MBA, FSA, MAA

In comparing our client’s experience with average medical trend, we relied upon Heffernan Benefit Advisory Services – 2013 Trend Report; Historical Trend Factors. Based on this report, we are using 9.615% as average annual medical only trend factor.

Political Subdivision – 400 Employee Lives

This case has been on RBP for 7 years. They experienced poor claim years in 2010 and 2012. In 2012, for example, there were 14 large claims that approached or exceeded $125,000. Medical PEPM for 2014 and 2015 (to date) is less than 2008. Benefits have been improved; no deductible or co-insurance features with all benefits subject to co-pays only. Funding increase over seven years has been 15.6% or 2.23% per year.

Beating Medical Trends

Public School District – 900 Employee Lives

This case has demonstrated a consistent downward claim trend. Current PEPM (2015) is less than 2008-2009. No benefit reductions. Some benefit improvements. Plan funding has remained essentially static for the past five years.

Beating Medical Trends

Medical Industry – 280 Employee Lives

Plan year 2012-2013 experienced an outlier year with several large claims and 34 pregnancies. Current medical PEPM is 16% higher than under managed care plan in 2008-2009, representing a 2.66% increase per year (sans outliers). This illustrates that higher utilization and outlier claims will result in increasing cost which would occur under either managed care or RBP model. However, RBP trend factor continues below industry benchmarks.

Beating Medical Trends

Retail Business – 818 Employee Lives

This case has consistently been well below medical trend. Current medical PEPM is significantly lower than plan year 2008-2009. This case has not raised plan contributions in seven years.

Beating Medical Trends

Conclusion

Managed care has failed. Medical costs continue to soar. Providers are charging more and we continue to agree to blindly pay up through secretive contracts negotiated by vested interests. Medical trend has, and continues to be, consistently at double digits or close to it.

Cost plus insurance / reference based pricing is a proven method to maintain and even improve comprehensive coverage while at the same time keeping costs reasonable, predictable and consistent. Industry sources estimate reference based pricing plans represent 10% market share and rising. An east coast hedge fund, seeking opportunities in reference based pricing models, predicts reference based pricing will gain 60% market share within the next five years.

“What moves things is innovation. But it’s not easy to innovate in stagnant, hyper-regulated, captured sectors” – Max Borders (www.fee.org) Cost shifting under the Affordable Care Act will continue to fail to control costs.

Reference Based Pricing represents the last frontier in innovation to control health care costs in a tightly regulated and controlled market.

Plan sponsors can reasonably expect to reduce their health care costs below medical trend without benefit reductions or cost shifting of any kind.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

—David B. Nash MD MBA Jefferson Medical College, Thomas Jefferson University, PA

Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: healthcare costs, Managed Care vs Reference Based Pricing, medical inflation, William Rusteberg | 3 Comments »

Doctors Going Granular on Investment Risk

Posted on July 6, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

It is Not What You Think!

[By Lon Jefferies MBA CMP® CFP®]

A new logic has been surfacing amongst the top minds in the financial planning industry.

Many of my favorite financial authors – Warren Buffett, Josh Brown, Nick Murray, Howard Marks, and others – have proposed the need to redefine the word “risk.”

“Risk” vs “Volatility”

Most investors and financial advisors tend to utilize the words “risk” and “volatility” interchangeably. We measure how risky a portfolio is by examining its potential downside performance.

For example, we review how much a similar portfolio lost during 2008 or when the tech bubble popped in 2000-2002. When doing this, we are really talking about volatility rather than risk. Volatility – usually measured by standard deviation – reflects how much a portfolio is likely to increase or decrease in value when the market as a whole fluctuates. Risk, however, is quite different.

Two Threats

Josh Brown characterizes risk as the possibility of two threats:

The possibility of not having enough money to fund a specific goal, which includes the possibility of outliving your money
The possibility of a permanent loss of capital.

Example:

In a dramatic example of how volatility is different from risk, consider a retiree with a $10 million portfolio who only spends $50,000 a year. Next, assume the investor experiences a two-year period in which during the first year his portfolio loses 50% of its value and in year two the portfolio earns a 100% return. Thus, after year one the portfolio would only be worth $5 million and after year two it would again be worth $10 million.

Clearly, this is a very volatile portfolio that is subject to a wide range of potential performance outcomes. However, is this portfolio truly risky to the investor? According to Mr. Brown’s first factor, the portfolio is not risky because the investor will have enough money to fund his $50k per year retirement regardless of whether his portfolio is valued at $10 million or $5 million. Additionally, the portfolio is also not risky according to the second factor in that the investor didn’t experience a permanent loss.

Investors tend to view stocks as risky assets because their returns have a large standard deviation (variation from a mean). Similarly, we tend to view money market equivalents such as CDs and savings accounts as very safe investments because their returns have less dispersion, and consequently, are more predictable.

However, rather than considering stocks to be risky and cash equivalents to be safe, it would be more accurate to consider stocks an investment with high volatility and cash to be a holding with low volatility.

***

What is the difference?

Suppose it is determined that you need an average rate of return of 6% over time to achieve your retirement goals. Historically, over a sufficiently significant period of time, stocks have returned an average of about 10% per year while cash equivalents have returned about 3% per year. Consequently, if these averages continue in the future, you actually have a very low chance of reaching your retirement goal of not outliving your money if you place money in the “safe” investment of a cash equivalent, while you would actually have a high probability of reaching your retirement goal if you place money in a more volatile basket of stocks.

By this metric, cash is actually the more risky investment because investing in it would increase the probability of outliving your funds. Meanwhile a basket of stocks, if given enough time to achieve its historically average rate of return, is actually the safer investment as it gives you a higher probability of not outliving your nest egg. Thus, while a portfolio of stocks will almost certainly experience more short-term volatility, over an extended period of time it very well may be a safer investment for ensuring your retirement goals are met.

Further, Mr. Brown proposes that the muddying of definition between risk and volatility is something a portion of the financial service industry has done on purpose. Brown suggests that the easiest way to sell someone a product is to first convince them they have a need. If hedge fund managers, insurance agents, and annuity salesmen can make consumers believe that volatility is equal to risk, and that since their products minimize volatility they must also minimize risk, they can achieve more sales.

However, even if an annuity can eliminate downside volatility, if it limits potential return to an amount that is insufficient to achieve the investor’s long-term goals, the investment is still more risky than an investment with more short-term volatility but a higher probability of long-term success.

***

Assessment

Next time the market goes through a correction, remember that the drop in your portfolio’s value is a reflection of the potential volatility your portfolio is capable of experiencing. Yet, recall that as long as you don’t sell your assets and suffer a permanent loss of your investment capital, you can allow the market time to recover and achieve its historical rate of return.

Doing so will ultimately make your investment strategy less risky than utilizing investment options that experience less volatility because it maximizes the probability you will eventually achieve your long-term financial goals.

More:

Some Academic Views of Financial “RISK” Tolerance

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional.

Parin Khotari MBA [Whitman School of Management, Syracuse University, New York]

http://www.CertifiedMedicalPlanner.org

Enter the CMPs

Filed under: Financial Planning, Investing, Portfolio Management | Tagged: Howard Marks, Investing, Josh Brown, Lon Jefferies MBA CFP®, Nick Murray, physician investors, risk and volatility, Warren Buffett | Leave a comment »

FREE WHITE PAPER [Is Medical Practice a New Asset Class?] from iMBA, Inc.

Posted on July 5, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Is Medical Practice a New Asset Class Under MPT?

Get your FREE White Paper

SPONSOR:

http://www.CertifiedMedicalPlanner.org

Valuing the Private Practice Physician’s Quintessential Alternative Financial Investment

By Dr. David Edward Marcinko MBA CMP™

As we know, the investment industry and Modern Portfolio Theory [MPT] strives to make optimal ‘allocations’ into different ‘asset classes’; according to some defined risk tolerance level or efficient frontier.

Equities, fixed income, property, private equity, emerging markets and so, are all ‘asset classes’, into which physician investors and mutual fund or portfolio managers will make an allocation of their total funds under management. It is quite proper for them to do this as they seek to balance the risk and potential returns for their own; ME, Inc., or other clients’ money.

And, by creating a “new” asset class, this concept opens the door to significant capital flows; advisory and management fees. Hence; the unrelenting innovation of Wall Street, and its’ commission driven and fee-seeking mavens, is unending.

The Social Security Example:

This concept may be illustrated using Social Security as an example.

Wall Street opines, if you’re not counting on Social Security benefits as a part of an overall asset allocation strategy, you may be missing out on bigger gains in a retirement portfolio. Those of this ilk say that retirement investors should consider the value of their Social Security as a portion of their fixed-income investments …. Others believe it may be too risky.

***

The Portfolio Shift

Generally, adopting this strategy would mean shifting a big portion of investible assets out of bonds and into stocks and into the hands of money managers, stock brokers and wealth managers for a fee; of course. This is akin to those financial advisors who rightly or wrongly goaded clients to not pay off a home mortgage and instead reposition the free cash flow into a rising; and then falling; market. Of course, there are detractors, as well as proponents of this emerging financial planning philosophy.

For example, Jack Bogle, founder of the Vanguard Group, often cites his penchant for basing one’s asset allocation on age. (If you’re 40 years old, you have 40% of your investments in fixed income and 60% in equities. By the time you’re 60, you’ve got 60% in fixed income, 40% in equities).

Now, let’s again consider Social Security, citing a physician with $300,000 in an investment portfolio, and capitalizing the stream of future payments. If the $300,000 is all in equity funds, even equity-index funds, and $300,000 in Social Security, you are already at 50/50″ fixed income versus equities.

The next step is a conversation as this the nexus of where Social Security meets risk management. So, how will the doctor feel when market goes up and down? Some may believe the concept, but not enjoy the inevitable more fluctuating self-directed 401-k, or 403-b plan. One must be comfortable with taking on a larger stock position.

Sources:

Andrea Coombes; MarketWatch, September, 2013.

Others experts, like Paul Merriman, opine that Social Security is not an asset class and the idea is fundamentally flawed and should not be a part of anyone’s portfolio.

***

Why?

As classically defined, a portfolio is composed of financial assets. A financial asset is something that can be sold. Social Security cannot be bought and sold. Because of that, it has a market value of zero.

Therefore, since a medical practice can be bought or sold, the definitional decision is left up to the informed reader, modern physician or financially enlightened financial advisor; or Certified Medical Planner™.

Source:

Paul Merriman, MarketWatch, November 2013
Enter the CMPs

Order NOW!

To help you decide if medical practice is indeed an asset class – and how much a practice may be worth – and how to valuate a practice – request your free white paper using the order form below.

Courtesy

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Filed under: Career Development, Investing, Practice Worth, Touring with Marcinko | Tagged: Andrea Coombes, Dr. David Marcinko, Is Medical Practice an Asset Class ?, Modern Portfolio Theory, Paul Merriman, Social Security as an Asset Class?, stock diversification | Leave a comment »

DOCs – Declare your INDEPENDENCE Day!

Posted on July 5, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By Pamela Wible MD via Ann Miller RN MHA

***

9 out of 10 doctors wouldn’t recommend medicine as a profession

Why?

***

Here are a few factoids.

Pages in U.S. tax code: 74,608
Pages of Medicare regulations by which physicians must abide: > 132,000
Current number of diagnostic and procedure codes doctors must know: 17,000
Number of codes docs are responsible for with new guidelines in October: >140,000.
Percent of working hours doctors spend on non-patient-related paperwork: 22 percent
Percent of working hours doctors spend on patient-related paperwork: > 60 percent
Percent of time doctors spend looking at computers instead of patients: 40 percent
Percent of working hours new doctors spend face-to-face with patients: 12 percent
Which is how many minutes per patient: 8

Assessment

Maybe that’s why over 1 million Americans will lose their doctors to suicide this year.

More:

Join me this July 4th weekend to declare your independence

LINK: https://www.youtube.com/watch?v=VDF0kJpVpXw&feature=player_embedded

LINK: youtube https://www.youtube.com/watch?v=VDF0kJpVpXw?feature=player_detailpage&w=640&h=360

Filed under: "Doctors Only", Career Development, Risk Management, Videos | Tagged: Pamela Wible MD, physician suicide | 1 Comment »

A Mid-Year Update on Physician Compensation

Posted on July 3, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Medscape Compensation Report

By Vicki Rackner MD

A 2015 Medscape Compensation Report sheds light on physicians’ earning potential.

Here are some key findings from a survey of 20,000 physicians in 26 specialties:

Orthopedists ($421,000) and cardiologists ($376,000) are still the top earners among physicians.
Physicians in private practice earn significantly more ($329,000 for specialists) than do employed physicians ($258,000 for specialists), despite the trend toward employment.
Male physicians earn more ($284,000) than their female counterparts ($215,000).
North Dakota and Alaska ($330,000) are the top-paying states for physicians, while Rhode Island ($217,000) and Maryland ($237,000) are the lowest-paying.
9% of physicians have concierge or cash-only practices, the same percentage as last year, while ACO participation continues to grow.

Assessment

However, it’s not what you make that’s important; it’s what you keep. Click here to read a blog post about the Myth of the Rich Doctor that addresses the disconnect between income and wealth.

***

More:

So, what are your thoughts about physicians’ potential to enjoy financial independence?

ABOUT

Vicki Rackner MD is an author, speaker and consultant who offers a bridge between the world of medicine and the world of business. She helps businesses acquire physician clients, and she helps physicians run more successful practices. Contact her at (425) 451-3777

Will single-payer really reduce administrative waste?

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them.
—Dr. Jason Dyken MD MBA

[Dyken Wealth Strategies, Gulf Shores, Alabama]

Filed under: Career Development, Health Economics, Surveys and Voting | Tagged: doctor compensation, Medscape Compensation Report, Mid-Year Update Physician Compensation, physician salary, Vicki Rackner MD | 5 Comments »

Update on Health Insurance Coverage in the USA

Posted on July 2, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By Poverty Level in 2014

By http://www.MCOL.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them.

Jason Dyken MD MBA [Dyken Wealth Strategies, Gulf Shores, Alabama]

I have read these texts and used consulting services from the Institute of Medical Business of Advisors, Inc., on several occasions.

MARSHA LEE; DO [Radiologists, Norcross, GA]

Filed under: Financial Planning, Health Insurance, Healthcare Finance, Risk Management | Tagged: Dyken Wealth Strategies, Financial planning MDs, Health Insurance Coverage, Jason Dyken MD MBA, Marcia Lee DO, Risk management MDs | 3 Comments »

Can Physicians Achieve their Financial Independence [Day] Without Budgeting?

Posted on July 2, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A New Twist on an old Holiday Tradition

[By Rick Kahler CFP® MS ChFC CCIM]

Doctor – Here’s a new twist on an old Resolution: If you want to give yourself the security of financial independence, try budgeting the way many wealth accumulators do.

The secret? They don’t budget!

Your first reaction might be, “Of course these people don’t budget! They have so much money, they don’t need to.”

That may be true for some of those who have money today, but I’m referring to people who want to remain wealthy or those who are “wealth accumulators.” These are people who don’t start out with money, but who build up significant wealth over time.

Live on Less

Many successful wealth accumulators, and too few medical professionals, don’t follow a detailed budget in the traditional sense. Instead, they develop the habit of living on less than they make. They do this by setting clear priorities. Here is how it works:

The List

1. Out of every dollar earned, take taxes out first. If you receive a paycheck from an employer, this is done for you. On any earnings where taxes aren’t withheld, estimate the amount of tax you’ll owe and stick it into savings.

2. Take out 15% to 30% to invest for your future. When you’re just starting out, you may have to begin with a much lower percentage, but begin and be consistent. Research tells us if you have 30 years until retirement and you plan to live for 30 years after retirement, you need to save 17% of your salary to maintain the same standard of living upon retirement. When you get a raise, contribute two-thirds of it to your investments and use one-third for increasing your lifestyle. If you want to become financially independent, this step is essential.

3. Save another 10% to 20% for emergencies and short-term needs like vacations, Christmas, and replacing vehicles. Again, you may have to start with a lower percentage, but begin with whatever you can, and be consistent.

4. Take out 5% to 10% for giving.

5. Live on the rest. Pay the bills as they come in, and use what’s left over for discretionary lifestyle spending.

Sounds simple, right? Of course, “simple” isn’t necessarily the same as “easy.” By now, if you’ve done the math, you can see that following this plan means living on as little as one-half to even one-third of your gross earnings.

***

Image processed by CodeCarvings Piczard ### FREE Community Edition ### on 2013-05-29 19:30:54Z | http://piczard.com | http://codecarvings.com

Image permission to the ME-P and iMBA Inc., and processed by CodeCarvings Piczard at piczard.com

***

Assessment

If you’re living from paycheck to paycheck, just barely managing to pay the bills, the idea of living on half of what you make goes beyond absurd. It probably seems impossible. It may, in the short term, be impossible.

Yet there are ways to live on less than you earn, even if to begin with it’s only a little less. Share a cheap apartment with a roommate. Drive an old car that you don’t have to make payments on. Eat at home. Buy used furniture and second-hand clothes. Get a temporary second job solely for the purpose of building up some savings.

What is most important is developing the pattern of living on less than you make. Fostering a frugal mindset is absolutely essential if you want to achieve financial independence. When you commit to saving first—even if you can only save a small amount—you have made one of the wisest financial decisions you can ever make.

This non-budgeting spending style takes away much of the pressure of trying to follow a rigid budget. There’s no need to keep track of envelopes or categories. You’ve made the hard decisions first, and you get to spend everything in the checkbook.

Budgeting without a budget can turn you into a wealth accumulator. It works because you take your future off the top.

The Author

Rick Kahler, Certified Financial Planner®, MS, ChFC, CCIM, is the founder and president of Kahler Financial Group in Rapid City, South Dakota. In 2009 his firm was named by Wealth Manager as the largest financial planning firm in a seven-state area. A pioneer in the evolution of integrating financial psychology with traditional financial planning profession, Rick is a co-founder of the five-day intensive Healing Money Issues Workshop offered by Onsite Workshops of Nashville, Tennessee. He is one of only a handful of planners nationwide who partner with professional coaches and financial therapists to deliver financial coaching and therapy to his clients. Learn more at KahlerFinancial.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

From the Publisher

“One needs to have the right words, and to use seemingly everyday terms in a way that economists and healthcare financial experts speak. Simply put, my suggestion is to refer to the Dictionary of Healthcare Economics and Finance frequently, and ‘reap'”.

–Thomas E. Getzen, PhD Executive Director, International Health Economics Association (iHEA) Professor of Risk, Insurance and Healthcare Management The Fox School of Business-Temple University Philadelphia, Pennsylvania

Filed under: Financial Planning | Tagged: Achieving Financial Independence Without Budgeting, budgeting, rick kahler, Year's Resolution | 2 Comments »

Finding Value in an Overpriced Stock Market

Posted on July 1, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Behind the Ugly Red Door

By Vitaliy Katsenelson CFA

I am about to write a quarterly letter to clients, telling them that despite all the giddiness in the stock market, we are in Value Investor Second Hell. This is not the first hell; that one is reserved for value traps — stocks that look cheap based on past earnings but whose earnings are about to disappear, whereupon the stocks will permanently decline.

***

The second hell is when you cannot find value. I recently read a study that said the difference in valuation between the cheapest stocks (the lowest 10 percent of the market) and the rest of the market is the smallest it has been in more than 20 years. Of course, the market overall is very pricey; finding undervalued stocks in this environment has become increasingly difficult.

***

To adapt, you need to understand that there are two types of value stocks. The first are statistically cheap — their cheapness stares you in the face. This breed is quickly becoming scarce; even Hewlett-Packard Co. and Xerox Corp. are now found in growth investors’ portfolios. But before I talk about the second type of value stocks, let me tell you how my wife and I bought our house.

***

It was 2005. The housing market in Denver, just as in the rest of the U.S., was getting bubbly. Our family was about to grow, though we did not know it yet. We had sold our condo and were renting month to month and thus were under no pressure to buy a house, but we were keeping our eyes peeled for the right one at the right price. It was a nine-month journey. We even made some offers (usually below the asking price), which the sellers laughed at. They were right; their houses sold above the asking prices in just a few days.

***

I vividly remember how we finally found our house — and I have to admit it was entirely my wife’s doing. We were flipping through photos of house listings that met our criteria. We stumbled on a picture of an ugly green house with a bright red garage door, which had been on the market for six months. I made a snarky comment that this house would be on the market for another six months and was about to click to the next, but my supersmart wife said, “Wait.” She skipped all the pictures of the ugly outside and zeroed in on the photos of the interior of the house.

***

To my great surprise, this ugly duckling was ugly only on the exterior and had been completely redesigned inside. It was a perfect house for us. Since it had been on the market for a long time, the seller was willing to accept our low offer. I, like everyone else who did not buy this house for six months, was turned off by an ugly outside (which could be easily corrected with some paint) and failed to look deeper.

***

Back to the stock market. The other breed of value stocks are the ones with “ugly green paint jobs and bright red garage doors,” the ones that look unappealing from the outside and aren’t even cheap, at least not according to the statistics at everyone’s fingertips. Often, backward-looking statistics don’t capture such companies’ true earnings power, as it has yet to show itself. These are the stocks you should patiently seek out, especially in today’s value-deprived environment.

***

A stock that comes to mind is Micron Technology, a maker of memory chips. Micron has destroyed more capital over the years than Communism and Socialism combined. To be fair, it was not Micron’s fault: Its profitability — or lack thereof — was determined by its industry. Micron was a large player in a very fragmented business that Asian governments thought was strategic to the development of their countries, and so they subsidized their local companies. The memory industry was ridden with overcapacity. But nothing transforms an industry better than a financial crisis. The 2008–’09 global recession weeded out the weak players, and Micron bought the last one, Elpida Memory, in 2013 on the cheap, almost doubling its revenues.

***

Now the DRAM industry has only three players: Micron, Samsung and SK Hynix (a South Korean version of Micron). NAND memory (used in flash and solid-state drives) has the same competitors plus SanDisk Corp. Barriers to entry are enormous — a new entrant would have to spend billions of dollars on R&D and then tens of billions on factories. Therefore this cozy, oligopolylike industry structure is unlikely to change. Samsung, the largest player in the space, has an extra incentive to keep chip prices high because they give it a competitive advantage against Apple and, more important, against low-end Chinese smartphone makers that have to buy memory at market prices.

***

Gross margins of all memory companies have been gradually rising and still have significant room to grow. If Micron achieves its target margin level, in the mid to high 40s, its earnings will hit $4 to $6 per share in a few years, giving it a modest price-earnings ratio of 4 to 5 times. This is one cheap “ugly green paint job, bright red garage door” stock.

***

ABOUT

Vitaliy N. Katsenelson, CFA, is Chief Investment Officer at Investment Management Associates in Denver, Colo.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

I have read these texts and used consulting services from the Institute of Medical Business of Advisors, Inc., on several occasions.

MARSHA LEE; DO [Radiologist, Norcross, GA]

Filed under: Investing, Portfolio Management | Tagged: DRAM industry, Micron, NAND memory, Samsung, SanDisk Corp, SK Hynix, Vitaliy Katsenelson CFA | 1 Comment »

Stanford Health Care Will Test Digital Device Claims

Posted on June 30, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

New Silicon Valley Startup – What the Doctor Ordered?

[By staff reporters]

A century ago, Sigmund Freud developed the radical idea that there is a lot more going on inside our heads that we know.

Today, many doctors (and patients) still stick by his groundbreaking theory.

But, it comes with a problem. As neuroscientist Eric Kandel notes in his book The Age of Insight, “psychoanalysis suffered from a serious weakness: it was not empirical and was therefore not amenable to experimental testing.”

***

http://www.gereports.com/post/112786788335/what-the-doctor-ordered-new-silicon-valley

***

Channel Surfing

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register.

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

It is fitting that Dr. David Edward Marcinko, MBA, CMP™ and his fellow experts have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizations that physicians, nurse-executives, administrators, institutional CEOs, CFOs, MBAs, lawyers, and healthcare accountants can follow to help move healthcare financial fitness forward in these uncharted waters.
—Neil H. Baum, MD, Tulane Medical School

Filed under: Book Reviews, Information Technology, Research & Development | Tagged: Eric Kandel, Stanford Health Care, The Age of Insight | Leave a comment »

More on Physician Suicide

Posted on June 28, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

The Role of Hopelessness, Helplessness and Defeat

Michael Lawrence Langan, M.D.

Boston, Massachusetts

Disrupted Physician

Although no reliable statistics yet exist, anecdotal reports suggest a marked rise inphysician suicide in recent years. From the reports I am receiving it is a lot more than the oft cited “medical school class” of 400 per year.

This necessitates an evaluation of predisposing risk factors such as substance abuse and depression, but also requires a critical examination of what external forces may be involved. What acute and cumulative situational and psychosocial factors are involved in the descent from suicidal ideation to planning to completion? What makes suicide a potential option for doctors and what acute events precipitate and trigger the final act?

Depression and Substance Abuse no Different from General Population

The prevalence of depression in physicians is close to that of the general population1,2 and, if one looks critically at the evidence based literature, substance abuse in medical professionals approximates that of the…

View original post 4,094 more words

Filed under: iMBA | 4 Comments »

Why I Love Amazon.com but Won’t Buy Its Stock

Posted on June 28, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By Vitaliy Katsenelson CFA

You should look at your portfolio and want to throw up a little — this is how one value manager described what a true, die-hard value investor’s portfolio should look like. The two stocks I wrote about in my latest article — American Eagle and Aéropostale — have a tendency to elicit that unpleasant reflex in many investors today.I’m not writing this article as a pitch for those stocks (though, to be clear, my firm does own them) but to reinforce the lesson I have learned from past indecisions. If you want to buy a retailer selling clothes and shoes — items that are subject to fashion and weather risks — you want to buy them when they have missed their latest trend, when their financials look ugly and when the risks have already played out. One thing I like about these apparel retailers is that teens will shop there for just a few years. If a retailer screws up with one crop of kids, they get a second chance, because there is another crop coming right along. (The JCPenney crowd is not as forgiving. See “What I Learned from the JC Penney Fiasco .”)Also, unlike for the Best Buys and RadioShacks of the world, the Internet is not a significant threat to teen clothing retailers. Parents get sick of their kids driving them crazy at home on weekends — plus, let’s be honest, when your kids get to be teenagers, you are definitely not cool anymore. There is, however, an amicable solution: Drop the kids off at the shopping mall — a large, relatively secure enclosed space with video cameras and security personnel, with a movie theater, inexpensive fast food and a lot of retailers.

As I am writing this, I’m realizing that this is a quintessentially American phenomenon. The public transportation system is not really well developed in the U.S., and distances are large. Dropping off your kids at the mall pretty much ensures that they’ll still be there when you come back for them. And before the movie but after they have filled their bellies with French fries … you guessed it, the kids go to Aéropostale or American Eagle. Kids go there to kill time.

Growing up in Russia, which in many respects was a lot like Europe, we walked (there were wide sidewalks along the streets) and took public transportation. These were the times before the nightly news was allowed to talk about real local crime, and my parents were not really worried about safety on the streets, though if I was really, really late coming home, my mom still called the hospitals. I don’t know if Russian parents still feel the same way about letting their kids roam the streets today.

On a separate but related topic, for the past year, since we got Amazon Prime, I’ve been hooked on shopping on Amazon.com . I have bought things there that I never thought I would. We just bought a bunk bed for the kids. I read all the positive and, most important, the negative reviews. The bed was delivered to my door, and I did not have to pay for shipping. If I had bought it at Ikea, I would have had to either pay for delivery or load and unload boxes into and out of our minivan. But what is amazing about Amazon is how easy it is to deal with them and return things that don’t work out.

A few weeks ago we bought a foam mattress. It was vacuum-sealed, so when we opened it and removed the plastic it expanded to double the size of the original packaging. However, the mattress had an unpleasant smell that had not gone away after a week of airing. So I had a mattress that I couldn’t stuff back in the original box to return. I went on Amazon’s website — I didn’t even bother calling them but hit the “chat” button. Ten minutes later my problem was solved. A service truck (not UPS or FedEx) would pick up my mattress as is, without the original packaging, and it would not cost me a dime.

My wife was not very happy with me for buying this mattress and having to return it. But I reminded her to just imagine how much money and time we’d have wasted if we’d bought at a traditional retailer — we would have had to pay for delivery (a cost we wouldn’t recoup) and then pay again for delivery back to the store.

Amazon Prime is an ingenious idea. For a bit less than $100 a year, I receive free shipping on any item — no limits or constraints. This also buys my loyalty to Amazon. (Yes, my loyalty is that cheap!) I don’t even think about checking prices with other retailers — I know that with them I won’t get free shipping (both ways), incredible selection, the reviews of other buyers, absolutely pain-free customer service and competitive prices. Also, Amazon already has my work and home addresses and my credit card information. So Amazon Prime has done something that you wouldn’t think is possible: It has created online loyalty.

This new loyalty presents me, as an investor, with an interesting dilemma: What do I do about Amazon’s stock? Answer: absolutely nothing. It is incredibly difficult to value Amazon shares. Today they trade at 90 times next year’s earnings. I can definitely see how Amazon’s sales will grow over time, but because the company is not focused on making money, I have no idea whether that bright future is already priced in or not. Investors are forgiving Amazon for not making money today because at some point it will start to. It will stop investing in new product categories, it will raise its prices, and customers will be forgiving. So they may have a workable strategy.

But here is what I have learned over the years. You don’t have to own all the great companies. You can just enjoy their products and services until they stumble. They always do. Wall Street love affairs are like Hollywood marriages; they’re not forever. Look at Apple . I have always loved their products (I have owned every single iPhone), but I waited until I could buy the stock on my own terms, when I could value it and have a margin of safety. The same applies to electric car–maker Tesla Motors. My next car will probably come from them, but I’ll wait patiently for Tesla’s stock to become reacquainted with the concept of gravity.

ABOUT

Vitaliy N. Katsenelson, CFA, is Chief Investment Officer at Investment Management Associates in Denver, Colo.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

BOOK REVIEW

This is an excellent book. It is all inclusive yet easy to read with current citations, references and much frightening information. I highly recommend this text. It is a fine educational and risk management tool for all doctors and medical professionals.

DR. DAVID B. LUMSDEN; MD, MS, MA

[Orthopedic Surgeon-Baltimore, Maryland]

Filed under: Investing | Tagged: Aéropostale, Amazon, Vitaliy Katsenelson CFA | 1 Comment »

Talking about End-of-Life Care

Posted on June 27, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

The Importance of … EOL Care

[By Samantha Wanner]

***

Important Topic

Despite the topic’s importance, only 27% of Americans report having talked with their families about end-of-life care. The best way to make your medical wishes known is to create an advance directive and share it with your family and your doctor.

An advance directive is actually two legal documents that enable you to plan and communicate your end-of-life wishes. When you create your advance directive, you are being proactive about your medical care and sparing your loved ones from having to make difficult medical decisions in a time of crisis.

Don’t wait for a crisis. Create your advance directive, share copies with your loved ones and doctor and keep your copy in an accessible location others can find.

***

Channel Surfing

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

Give your loved ones peace of mind.

Would they know what you want if you couldn’t talk? Do you know what you would want near the end of life? Find your own answers. Then open the conversation with the people you love. You are giving everyone a priceless gift.

More About End of Life Planning

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

BOOK REVIEW

Physicians have more complex liability challenges to overcome in their lifetime, and less time to do it, than other professionals. Combined with a focus on practicing their discipline, many sadly fail to plan for their own future. They need trustworthy advice on how to effectively protect themselves, families and practice, from the many overt and covert risks that could potentially disrupt years of hard work.

Fortunately, this advice is contained within RISK MANAGEMENT, LIABILITY INSURANCE, AND ASSET PROTECTION STRATEGIES FOR DOCTORS AND ADVISORS [BEST PRACTICES FROM LEADING CONSULTANTS AND CERTIFIED MEDICAL PLANNERS™]. Written by Dr. David Edward Marcinko, Nurse Hope Rachel Hetico and their team of risk managers, accountants, insurance agents, attorneys and physicians, it is uniquely positioned as an integration of applied, academic and peer-reviewed strategies and research, with case studies, from top consultants and Certified Medical Planners™. It contains the latest principles of risk management and asset protection strategies for the specific challenges of modern physicians. My belief is that any doctor who reads and applies even just a portion of this collective wisdom will be fiscally rewarded. The Institute of Medical Business Advisors has produced another outstanding reference for physicians that provide peace of mind in this unique marketplace! In my opinion, it is a mandatory read for all medical professionals.

DAVID K. LUKE; MS-PFP, MIM, CMP™

[Net Worth Advisory Group, Inc – Sandy, Utah]

Filed under: Estate Planning, Retirement and Benefits | Tagged: End of Life Care, end of life planning, Estate Planning | 2 Comments »

The “White Coat Investor” PodCast

Posted on June 25, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. James Dahle MD – White Coat Investor

Dr. James Dahle, editor of www.whitecoatinvestor.com and the rising star of physician financial advice and straight talk about success was kind enough to share his time and expertise with us and talked to us about:

What got him so interested in getting a financial education and why he shares that knowledge with other docs
How med students can minimize student loan debt and why that is so important
Insurance and why it is imperative that you have the right kind
The importance of creating profitable habits for your success

***

Click here to listen to this episode

***

Assessment

His new book is The White Coat Investor: A Doctor’s Guide to Personal Finance and Investing.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Physicians who don’t understand modern risk management, insurance, business and asset protection principles are sitting ducks waiting to be taken advantage of by unscrupulous insurance agents and financial advisors; and even their own prospective employers or partners. This comprehensive volume from Dr. David Marcinko, and his co-authors, will go a long way toward educating physicians on these critical subjects that were never taught in medical school or residency training.

JAMES M. DAHLE; MD, FACEP

Filed under: Investing, Portfolio Management, Videos | Tagged: financial education, James Dahle MD, student loan debt, whitecoatinvestor | 1 Comment »

The Third Industrial Revolution Will Be Crowd-Sourced and Digitized

Posted on June 25, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Meet Your Maker

[Staff reporters]

Henry Ford was fond of saying that “nothing was particularly hard if you divided it into small jobs.” He followed his own advice, built world’s first assembly lines that cranked out 15 million Model Ts, and left his competitors in the dust. Engineers are now taking Ford’s advice to the extreme and breaking down the factory to bits and bytes.

“Software, data and analytics are changing what we can make in ways I couldn’t imagine when I left school,” says Christine Furstoss, global technology director at GE Global Research. “It’s more than 3-D printing jet engine parts from a digital file, which we already do. We can build a factory that can make itself better. We call it the Brilliant Factory.”

Furstoss spent a recent Tuesday afternoon at the White House, where President Obama announced that he would open two new innovation institutes to boost advanced manufacturing in the U.S. The first one, in Chicago, will focus on digital manufacturing and design innovation.

The other, in Detroit, will experiment with light-weight materials. “It’s all about growing a new generation of workforce,” Furstoss says. “The next manufacturing revolution can be an American revolution.”

***

http://www.gereports.com/post/77834521966/meet-your-maker

***

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Research & Development | Tagged: Brilliant Factory, Christine Furstoss, GE Global Research, Third Industrial Revolution | 3 Comments »

On Foreign Bank Account Reporting

Posted on June 24, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

F.B.A.R.

[By Perry D’Alessio CPA] Perry@dalecpa.com

The FBAR law has been in effect for almost 20 years, however only in the past 5 years the IRS and FINRA have started to enforce the law.

Any individual who owns or has a signatory authority in a foreign account which had a balance of $10,000 or more at any point during the year must disclose basic information about the account. FBAR not only covers bank accounts, but also brokerage, life insurance and other accounts that carry cash value.

Traditionally FBAR information returns have been filed with the IRS, but starting in 2014 Finra has taken over the responsibility for handling these returns reported on form 114.

***

[FBAR returns are due on June 15th, however in 2015 the deadline has been extended to June 30th to provide relief to taxpayers who need additional time to gather required information]

***

Assessment

Penalties for failure to disclose such information can be as high as $10,000 per account or 5% of the highest account balance. These returns if filed timely do not result in any tax liability, however the penalties imposed are not taken lightly by the authorities.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Accounting, Taxation | Tagged: FBAR, Foreign Bank Account Reporting, Perry D'Alessio CPA | Leave a comment »

Milliman Medical Index [CPI June 2015]

Posted on June 24, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By Javier Sanabria

The price of medical care boosts Consumer Price Index June 2015

A sharp rise in medical care prices contributed to a recent increase in the Consumer Price Index (CPI).

Although economists and healthcare experts have not clearly identified the reasons for the spike, the 2015 Milliman Medical Index (MMI) indicates that prescription drugs are driving medical costs upward.

MMI co-author Chris Girod offers some perspective in this CNBC article.

***

The so-called medical care index, maintained by the Bureau of Labor Statistics, rose 0.7 percent in April, “its largest increase since January 2007,” the BLS wrote in a report issued Friday. The BLS report comes three days after the large actuarial and consulting firm Milliman projected 6.3 percent growth in the costs of health care for a typical family of four on an employer-based plan in 2015. That compares to a low-water mark growth rate of 5.4 percent last year. Milliman’s report is the latest indication that health-care costs, which saw a historic slowdown in their rate of inflation in the years after the Great Recession of 2008, are headed back up toward the trends seen before the financial meltdown. Before the recession, double-digit inflation in health-care costs was common. “There’s a correlation between the CPI medical index and the MMI, but they’re very different measures,” said Chris Girod, a principal and consulting actuary at Milliman, who added that the MMI looks at a broader range of prices. “The annual increases [in the MMI] tend to be a lot higher than CPI.” Milliman’s report blamed resurgent inflation on price increases for prescription drugs, particularly specialty drugs. “The rest of the category, the increases were pretty ho-hum this year,” he said. Prescription drug prices overall are expected to increase by 13.6 percent in 2015, according to Milliman’s index. In the category of specialty drug prices alone, “the annual increases are around 20 percent right now,” Girod said. Those specialty drugs include Sovaldi, made by Gilead, which in a 12-week course of treatment can cost $84,000. “The drug trends have actually been coming down in the last four or five years until now,” Girod said.

***

See more at:

http://www.healthcaretownhall.com/#sthash.xgDF7hpd.dpuf

***

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Economics, Healthcare Finance | Tagged: Chris Girod, Consumer Price Index, Javier Sanabria, Milliman Medical Index | 1 Comment »

Information Overload & Healthcare’s Direction

Posted on June 23, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

hcldr

Blog post by Joe Babaian

The difficulty lies not so much in developing new ideas as in escaping from old ones.
– John Maynard Keynes
Innovation distinguishes between a leader and a follower.
– Steve Jobs

We’ve all been embracing the shift in healthcare from information being contained to just the clinic visit, the surgery waiting room, the nurses’ office, and printed newspaper article. The good old days when the information we received was the information we believed. Well, we all know the good old days weren’t all that good and it’s the journey of developing new ideas and new innovations that takes hard work and matters the most.

We have reached a point where the quantity of information in healthcare is so massive that it actually has become opaque to many – the very people who stand to benefit from new options, current research, and new ways of communicating…

View original post 728 more words

Filed under: Information Technology | Tagged: Healthcare’s Direction, Information Overload, Joe Babaian | 1 Comment »

PERSONAL FINANCIAL ACCOUNTING AND INCOME TAXATION FOR DOCTORs

Posted on June 23, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A SPECIAL ME-P REPORT

[The Ethical Pursuit of Tax Reduction and Avoidance]

[By Perry D’Alessio CPA]

The objective of tax planning is to arrive at the lowest overall tax cost on the activities performed. In as much as physicians constitute 14% of the so-called and maligned “one-percenters” [$388,905 earned-not passive income/year]; this essay will address some methods and strategies to reduce federal and state income taxes. It is applicable to all physicians and medical professionals; as independent practitioners or employees.

So, how much in income taxes do the wealthy pay? The top 10 percent of taxpayers paid over 70 percent of the total amount collected in federal income taxes in 2010, the latest year figures are available, according to the Tax Foundation, a think tank that advocates for lower taxes. That’s up from 55 percent in 1986. The remaining 90 percent bore just under 30 percent of the tax burden. And, 47 percent of all Americans pay hardly anything at all.

Realize, that’s just federal income tax and doesn’t include payroll tax for Social Security and Medicare (which the vast majority of people pay), plus state taxes and all of the other taxes we face. When you add them all together; using figures from the Tax Policy Center and the Institute on Taxation and Economic Policy. Earners in the top 1 percent pay about 43 percent of their incomes in tax. People in the middle quintile pay 25 percent while the poorest fifth pays 13 percent.

Finally, before you assume these one- and 10-percenters are living on luxury yachts and in million-dollar mansions, consider how little money it takes to be a top wage earner.

According to 2011 IRS data, the top 1 percent have adjusted gross incomes of $388,905 per year or more. To be in the top 10 percent, you need an adjusted gross income of just $120,136 or more. These are good incomes to be sure, but definitely not enough to be out work, or the medical office, for more than a few weeks each year.

***

Now consider the following more specifically:

42 percent of all federal tax revenue came from individual income taxes in 2010 and it has been the largest single source of revenue since 1950.
Individuals paid more than $2.2 trillion in 2010.
Bush-era tax cuts have finally expired, giving us the 20th century tax rates with the top income tax rate of 39.6%, we have not seen rates this high in almost 15 years.
39.6% tax rate kicks in at $400,000 for individual taxpayers and $450,000 for married couples filing jointly.
Taxpayers who make over $200,000 ($250,000 for married taxpayers) will be subject to the Medicare surtax. If that’s you, Medicare surtax will be tacked on to your wages, compensation, or self-employment income over that amount. The amount of the surcharge is .9%.
Net Investment Income Tax (NIIT) new as of 2013; if you have both net investment income and modified adjusted gross income (MAGI) of at least $200,000 for an individual taxpayer and $250,000 for taxpayers filing as married an additional 3.8 percent of the net investment income is an added tax.

ASSESMENT

So, where do you fall on this schematic, doctor?

Channel Surfing

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

ABOUT

Perry D’Alessio has twenty years’ experience in public accounting. He specializes in the taxation of closely held businesses and their owners, as well as high wealth individuals. He has a broad range of experience that includes individual, corporate, partnership, fiduciary, estate, and gift taxation. Business development has also been a focus. Particularly in the Healthcare and Fitness Industry, he worked with successful entities whose emphasis was on growth through development of strategic relationships and unit building. Mr. D’Alessio received his Bachelor of Business Administration degree in Accounting from Baruch College. He is a Certified Public Accountant in New York. He is a member of the American Institute of Certified Public Accountants (AICPA), the New York State Society of Certified Public Accountants (NYSSCPA). He served on several New York State Society tax committees including: PCAOB and HealthCare. Mr. D’Alessio presents at financial and medical associations throughout the region, and authored a book chapter in the “Financial Management Strategies for Hospitals and Healthcare Organizations” for the Institute of Medical Business Advisors, Inc.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Accounting, Ethics, Taxation | Tagged: Accounting, Institute on Taxation and Economic Policy, Perry D'Alessio CPA, Tax Foundation, Taxation | Leave a comment »

On Health Plan Member Portals

Posted on June 22, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By http://www.MCOL.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology | Tagged: ACA, Health Plan Member Portals, HIE's, www.MCOL.com | Leave a comment »

Drug Companies and Doctors [A Story of Corruption]

Posted on June 22, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

8

Disrupted Physician

Drug Companies and Doctors: A Story of Corruption.

What we need is a Marcia Angell to take on the multi-billion dollar drug and alcohol testing, assessment and treatment industry.

While all eyes were focused on the drug companies these multi-billion dollar industries erected a scaffold of immunity and profit by removing (and blocking) themselves from essentially all aspects of accountability; answerability, justification for actions and the ability to be punished by outside actors. The 2009 quote in reference to “big pharma” is just as applicable to the drug and alcohol testing industry,” the inpatient assessment and treatment centers and the “authorities” pushing public policy and swaying public opinion to accept irrational and illegitimate authoritative opinion as truth.

And unlike the pharmaceutical industries carefully constructed “bent science” which requires a keen eye and critical analysis , the evidence-base supporting the testing, assessment and treatment industry rests on a foundation that can…

View original post 541 more words

Filed under: Drugs and Pharma, Ethics, Risk Management | Tagged: drug companies, Michael Lawrence Langan MD | Leave a comment »

Claude Monet‏

Posted on June 20, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Master Pieces of Impressionist

Monet’s ambition of documenting the French countryside led him to adopt a method of painting the same scene many times in order to capture the changing of light and the passing of the seasons.

***

From 1883 Monet lived in Giverny, where he purchased a house and property, and began a vast landscaping project which included lily ponds that would become the subjects of his best-known works. In 1899 he began painting the water lilies, first in vertical views with a Japanese bridge as a central feature, and later in the series of large-scale paintings that was to occupy him continuously for the next 20 years of his life.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: LifeStyle | Tagged: Claude Monet‏ | Leave a comment »

Editors of World’s Most Prestigious Medical Journals…Speak?

Posted on June 20, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

“Much of the Scientific Literature, Perhaps HALF, May Simply Be Untrue”

Filed under: Book Reviews | Tagged: JAMA, JAPMA, JBBS, Lancet, medical journals, New England Journal of Medicine | Leave a comment »

ME-P TECH SUPPORT AND HELP DESK

Posted on June 19, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

About ME-P Subscription Registration

***

A reminder from the helpful people at the ME-P Support Desk!

You can now sign-up to join the ME-P as a full member

(Use the login above and below)

***

ME-P membership is free and signing up only takes a few minutes. Registration is required to comment and will qualify you for free stuff, invites to ME-P networking events and more.

If you have trouble signing up, use the contact form below, and above at the left, or email us and somebody will walk you through the signup and subscription process.

If nothing shows up, before contacting us, it’s a good idea to check your spam filter.

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Alerts Sign-Up, Career Development, iMBA | Tagged: ME-P, ME-P Support Desk, Medical Exective-Post | Leave a comment »

About Inventionland‏

Posted on June 19, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Bring Your Idea to Life with Inventionland

[By staff reporters]‏

Inventionland, the world’ s largest invention factory, through their exclusive relationship with Davison, can help take your ideas for the new inventions and develop them into working prototypes!

Find out how Inventionland can help you!

Medical: http://inventionland.com/?s=medical

Assessment

Have an invention or a product idea? Inventionland can help take your Idea to the next level!

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Research & Development | Tagged: Davison, Inventionland‏, inventions, medical reinvention, product ideas | 1 Comment »

Your Organs May Soon Report Their Status Over a New Generation of Wireless Medical Sensors

Posted on June 18, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Facebook for the Body?

[By staff reporters]

Mike Harsh, chief technology officer for GE Healthcare, tells the story of a doctor who had trouble placing a stethoscope to the chest of a cardiac patient and listen his heart because of a tangle of cables coming from monitoring devices attached to his torso.

“You sort of understand what the problem is,” Harsh says. “People wear so many wires. It just tethers them right to their beds.”

***

http://www.gereports.com/post/74545052915/facebook-for-the-body-your-organs-may-soon-report

***

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Research & Development | Tagged: GE Healthcare, Mike Harsh, Wireless Medical Sensors | 1 Comment »

UNDERSTANDING MEDICAL PRACTICE CYBER SECURITY RISKS

Posted on June 17, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A SPECIAL ME-P REPORT

Mitigations for the Digital Health Era

[By Shahid N. Shah MS]

There has been a tremendous explosion of information technology (IT) in healthcare caused by billions of dollars of government incentives for usage of digital healthcare tools.

But, IT systems face threats with significant adverse impacts on institutional assets, patients, and partners if sensitive data is ever compromised. Every health enterprise is required to confidentiality, integrity and availability of its information assets (this is called “information assurance” or IA). Confidentiality means private or confidential information must not be disclosed to unauthorized persons. Integrity means that the information can be changed only in an authorized manner so as to maintain the correctness of the information. Availability defines the characteristic that information systems work as intended and all services are available to its users whenever necessary.

It is well known that healthcare organizations face and have been mitigating many risks such as investment risk, budgetary risk, program management risk, safety risk, and inventory risk for many years. What’s new in the last decade or so is that organizations must now manage information assurance risks related to operating its information systems because information systems. IT is now just as a critical an asset as most other infrastructure managed by health systems. It is important that information security risks are given the same or more importance and priority as given to other organizational risks.

As health records move from paper native to digital native, it’s vital that organizations have information risk management programs and security procedures that woven into the culture of the organization. For this to happen, basic requirements of information security must be defined and implemented as part of both the operational and management processes. A framework that provides guidance on how to perform these activities, and the co-ordination required between these activities is needed.

***

[Black Hat Medical Hacker]

***

INTRODUCTION

The Risk Management Framework (RMF), supported by the National Institute of Standards and Technology (NIST) provides this framework. The NIST 800 series publications provide a structured approach to achieve risk management. It provides broad guidance and not necessarily all the prescriptions, which means it can be tailored to meet the organization’s specific needs and providing the flexibility needed for the different organizations. Using the NIST RMF helps organizations with risk management not only in a repeatable manner, but also with greater efficiency and effectiveness. Healthcare information assurance is complex and without a framework that takes into account a broad risk management approach, it is difficult to consider all the intricacies involved.

The NIST Risk Management Framework consists of a six step process designed to guide organizations in managing the risks in their information systems.

The various steps as defined in the NIST specifications are the following:

Categorize the information system and the information processed, stored, and transmitted by that system based on an impact analysis.
Select an initial set of baseline security controls for the information system based on the security categorization; tailoring and supplementing the security control baseline as needed based on an organizational assessment of risk and local conditions
Implement the security controls and describe how the controls are employed within the information system and its environment of operation.
Assess the security controls using appropriate assessment procedures to determine the extent to which the controls are implemented correctly, operating as intended, and producing the desired outcome with respect to meeting the security requirements for the system.
Authorize information system operation based on a determination of the risk to organizational operations and assets, individuals, other organizations, and the Nation resulting from the operation of the information system and the decision that this risk is acceptable.
Monitor the security controls in the information system on an ongoing basis including assessing control effectiveness, documenting changes to the system or its environment of operation, conducting security impact analyses of the associated changes, and reporting the security state of the system to designated organizational officials.

All information systems process, store and transmit information. What is the possible impact if a worst case scenario occurs that causes endangers this information? A structured way to find out the potential impact on the confidentiality, integrity and availability of information can be done through the first step of NIST RMP, the categorization of information systems.

***

[Triple Redundant Passwords and Encryption]

***

The NIST SP 800-60 ^{[1, 2, 3 4]}provides such guidance. The potential impact is assigned qualitative values – low, moderate, or high. Based on these impact levels for each of the information type contained in the system, the high water mark level is calculated, that helps in selecting the appropriate controls in the subsequent steps.

Organizations need to mitigate risks adequately by selecting an appropriate set of controls that would work effectively. In the selection of security controls step, the set of controls are chosen based on the categorization of the information system, the high water mark and the goals of the organizations.

These baseline controls are selected from NIST SP 800-53 ^[5] specification, one of three sets of baseline controls, corresponding to low, moderate, high impact rating of the information system. These baseline controls can be modified to meet specific business needs and organization goals. These tailored controls can be supplemented with additional controls, if needed, to meet unique organizational policies and environment factors and its security requirements and its risk appetite. The minimum assurance requirements need to be specified here.

All the activities necessary for having the selected controls in place, is done in the implementation of security controls step. The implementation of the selected security controls will have an impact on the organization risks and its effects. NIST SP 800-70 ^{[6, 7]} can be used as guidance for the implementation. An implementation strategy has to be planned and the actions have to be defined and the implementation plan needs to be reviewed and approved, before the implementation is done.

Once the controls are implemented, then the assessment of security controls is done to find out whether the controls have been correctly implemented, working as intended, and giving the desired output with respect to the security requirements. In short, whether the applied security controls are indeed the right ones, done in the right way, giving the right outcome. NIST SP 800-53 ^[5], NIST 800-53A ^[6], NIST 800-115 ^[8-11] can provide the necessary guidance, here.

***

[Frustrated Physician]

***

The authorization of information systems is an official management decision, authorizing that the information system can be made operational, with the identified risks mitigated and the residual risks accepted, and is accountable for any adverse impacts on the confidentiality, integrity and availability of information systems. If the authorizing personnel find that the risks are not mitigated and hence can compromise the sensitive information, they can deny authorizing the information system. NIST SP 800-37 ^[2] provides guidance on authorization. The authorizing personnel are to be involved actively throughout the risk management process.

Risk management is not one-time process, that once it is done, it is forgotten. It is a continuous process, to be integrated with day-to-day activities. One of the key aspects of any risk management is the monitoring of security controls to check whether the controls are performing as intended. The main focus of monitoring security controls is to know whether the controls are still effective over a period time, given the changes that occur in the information systems — the changes in hardware, software and firmware, the changes in environment factors, operating conditions etc. NIST SP 800-37 ^[2] provides guidance about this. And, if the security controls are found to be ineffective, the cycle starts again, with either re-categorization or selecting another set of baseline controls, or assessing the effectiveness of the controls once more etc.

Regardless, in all the steps in risk management framework, one of the important aspects is communication. Appropriate documents needed to be generated in all the steps, reviewed and kept up-to-date.

Organizational risk management provides great benefits to the organization because it helps to prioritize the resources, increase interoperability, and reduce costs incurred due to the adverse effects. It helps to prevent unauthorized access to personally identifiable information which will lead to security breaches.

Channel Surfing

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

ABOUT

Mr. Shahid N. Shah is an internationally recognized healthcare thought-leader across the Internet. He is a consultant to various federal agencies on technology matters and winner of Federal Computer Week’s coveted “Fed 100″ Award, in 2009. Over a twenty year career, he built multiple clinical solutions and helped design-deploy an electronic health record solution for the American Red Cross and two web-based eMRs used by hundreds of physicians with many large groupware and collaboration sites. As ex-CTO for a billion dollar division of CardinalHealth, he helped design advanced clinical interfaces for medical devices and hospitals. Mr. Shah is senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize healthcare applications. He runs four successful blogs: At http://shahid.shah.org he writes about architecture issues; at http://www.healthcareguy.com he provides valuable insights on applying technology in health care; at http://www.federalarchitect.com he advises senior federal technologists; and at http://www.hitsphere.com he gives a glimpse of HIT as an aggregator. Mr. Shah is a Microsoft MVP (Solutions Architect) Award Winner for 2007, and a Microsoft MVP (Solutions Architect) Award Winner for 2006. He also served as a HIMSS Enterprise IT Committee Member. Mr. Shah received a BS in computer science from the Pennsylvania State University and MS in Technology Management from the University of Maryland.

Conclusion

***

READINGS

[1] National Institute of Standards and Technology Special Publication 800-30 Revision 1, Guide for Conducting Risk Assessments, http://csrc.nist.gov/publications/nistpubs/800-30-rev1/sp800_30_r1.pdf

[2] National Institute of Standards and Technology Special Publication 800-37 Revision 1, Guide for Applying the Risk Management Framework to Federal Information Systems, http://csrc.nist.gov/publications/nistpubs/800-37-rev1/sp800-37-rev1-final.pdf

[3] National Institute of Standards and Technology Special Publication 800-60 Volume I Revision 1, Guide for Mapping Types of Information and Information Systems to Security Categories, http://csrc.nist.gov/publications/nistpubs/800-60-rev1/SP800-60_Vol1-Rev1.pdf

[4] National Institute of Standards and Technology Special Publication 800-60 Volume II Revision 1, Appendices to Guide for Mapping Types of Information and Information Systems to Security Categories, http://csrc.nist.gov/publications/nistpubs/800-60-rev1/SP800-60_Vol2-Rev1.pdf

[5] National Institute of Standards and Technology Special Publication 800-53 Revision 4, Security and Privacy Controls for Federal Information Systems and Organizations, http://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-53r4.pdf

[6] National Institute of Standards and Technology Special Publication 800-53A Revision 4, Assessing Security and Privacy Controls in Federal Information Systems and Organizations, http://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-53Ar4.pdf

[7] National Institute of Standards and Technology Special Publication 800-70 Revision 2, National Checklist Program – Guidelines for Checklist Users and Developers Recommendations of the National Institute of Standards and Technology for IT Products, http://csrc.nist.gov/publications/nistpubs/800-70-rev2/SP800-70-rev2.pdf

[8] National Institute of Standards and Technology Special Publication 800-115, Technical Guide to Information Security Testing and Assessment, http://csrc.nist.gov/publications/nistpubs/800-115/SP800-115.pdf

[9] National Institute of Standards and Technology Special Publication 800-137, Information Security, http://csrc.nist.gov/publications/nistpubs/800-137/SP800-137-Final.pdf

[10] U.S. Department of Health and Human Services, HIPAA Security Series, Security Standards: Technical Safeguards, http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf

[11] U.S. Department of Health and Human Services, HIPAA Security Series, Security Standards: Physical Safeguards, http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/physsafeguards.pdf

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Retirement and Benefits, Risk Management | Tagged: Digital Health, EHRs, MEDICAL CYBER SECURITY RISKS, National Institute of Standards and Technology, NIST 800, Risk Management Framework, Shahid N. Shah | 7 Comments »

About Moritz Moszkowski

Posted on June 16, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

And …. the Black Swans

[By Vitaliy Katsenelson CFA] write-us@imausa.com

Today I wanted to share with you undeservedly underrated and under-recorded composer that in my not so humble opinion deserve to be over-rated and over-recorded.

He lived in the golden age of the late romantic, early modern period of classical music, that is, the late 19th to early 20th century.

Lifestyle

I want to share with you the Piano Concerto in E minor by Moritz Moszkowski (part 1, part 2 and part 3), German-Jewish composer born in Breslau, Prussia (now Poland).

***

According to that most trusted source, Wikipedia, he was very popular in his day but died in poverty, “sold all his copyrights and invested the whole lot in German, Polish and Russian bonds and securities, which were rendered worthless on the outbreak of the war.”

Assessment

Now, I am not trying to draw parallels between the early 20th century and today, but when he poured his life savings into German government bonds, he probably could not imagine that they would be wiped out – there is a black swan for you!

***

***

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Investing, LifeStyle, Risk Management | Tagged: black swan, Moritz Moszkowski, Vitaliy Katsenelson CFA | Leave a comment »

BENEFITS OF A HEALTHCARE COMPLIANCE PROGRAM

Posted on June 16, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Reality versus Perception

By Carol Miller RN MHA

There are many associated benefits of a healthcare or medical practice compliance program, some of which are only perceived whereas others are very definitive. Most providers try to comply with the rules and regulations and what is or is not covered by different insurance programs.

Risk Management and Quality Initiatives

Regardless of their ethical and quality processes in their office practice, the decision to develop and implement a compliance program still is an important and needed business decision. The processes involved in a compliance program can help improve the organization’s performance by providing basic principles in quality improvement which can help improve the provider’s bottom line.

The Benefits

Several benefits of a compliance program are:

Improving the quality of patient care
Servicing as a resource for information about compliance-related issues
Saving time, money, and associated apprehensions during audits or reviews
Preventing or identifying improper conduct with systems for evaluation and correction
Providing training for employees and contracted services to recognize fraud and abuse
Providing a way for employees to report potential problems
Demonstrating to staff and community that the practice is committed to honesty and appropriate conduct
Minimizing loss associated with false claims through early recognition and reporting, and decreasing the provider’s exposure to civil penalties, sanctions and other administrative actions, such as exclusion

The OIG

The OIG has developed a series of voluntary compliance program guidance documents directed at various segments of the healthcare industry, such as hospitals, nursing homes, third-party billers, durable medical equipment suppliers, clinical laboratories, home health agencies, hospices, nursing facilities, ambulance suppliers, pharmaceutical manufacturers, physician practices, and others, to encourage the development and use of internal controls to monitor adherence to statutes, regulations and program requirements.

***

Fraud and Abuse, Too!

The OIG documents also identify fraud and abuse risks to watch out for when creating a programs

ABOUT

Ms. Carol S. Miller has an extensive healthcare background in operations, business development and capture in both the public and private sector. Over the last 10 years she has provided management support to projects in the Department of Health and Human Services, Veterans Affairs, and Department of Defense medical programs. In most recent years, Carol has served as Vice President and Senior Account Executive for NCI Information Systems, Inc., Assistant Vice President at SAIC, and Program Manager at MITRE. She has led the successful capture of large IDIQ/GWAC programs, managed the operations of multiple government contracts, interacted with many government key executives, and increased the new account portfolios for each firm she supported. She earned her MBA from Marymount University; BS in Business from Saint Joseph’s College, and BS in Nursing from the University of Pittsburgh. She is a Certified PMI Project Management Professional (PMP) (PMI PMP) and a Certified HIPAA Professional (CHP), with Top Secret Security clearance issued by the DoD in 2006. Ms. Miller is also a HIMSS Fellow.

CASE MODEL: Compliance

Assessment

The documents provide principles to follow when developing a compliance program that best suits the organization’s needs.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Ethics, Quality Initiatives, Risk Management | Tagged: Carol Miller RN MHA, health fraud, healthcare abuse, HEALTHCARE COMPLIANCE, OIG | Leave a comment »

On Hiring Home Contractors

Posted on June 15, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By Rick Kahler MS CFP http://www.KahlerFinancial.com

Doctors Beware!

This time of year, half the homeowners in town are trying to hire landscapers. All of us check our phones even in the middle of meetings or medical appointments, because we desperately hope it might be the yard guy calling back.

As my wife and I work on our yard, however, I’m proceeding with caution. Several years ago I hired a landscaper and paid him $2,000 up-front as a down payment on the work. We never saw a single bush, tree, or shrub. We never saw him or the money again, either.

In response to my recent column about filing consumer complaints, I heard from a reader who is struggling to get recourse from an unethical building contractor. It’s a horror story about bullying, failed inspections, outrageous costs to fix shoddy work, and an expensive lawsuit.

Both this homeowner and I made the same mistake: we trusted someone who turned out not to be trustworthy, and we paid in advance.

Whether you’re hiring someone to redesign your yard, build or remodel a house, create a website for your business, or provide any other kind of service, you can’t afford to just assume that person is trustworthy. It’s your responsibility as the customer to protect your interests in the transaction.

The Hiring List

Here are some ways to increase your chances of finding ethical and competent contractors before you hire anyone:

Be wary of anyone who seems to lack experience or qualifications. Even someone just starting a business should be able to show you related experience or training.
Look for someone who is professional and businesslike. That includes putting estimates and quotes in writing, providing references, and focusing on helping you create what you want rather than telling you what you should want.
Say “no, thanks,” immediately to any contractor who shows a cavalier attitude about requirements like licensing, permits, and inspections.
Use caution with contractors who don’t apply in their own businesses the skills they are trying to sell to you. If you need a website, for example, don’t hire a developer whose own site is a mess.
Get references, and contact them. Ask specific questions about the kind of work the contractor did for them and what the experience was like.
Don’t hire out of desperation, as I did with my so-called landscaper. If you have trouble finding someone to do the work you want done, it’s all too easy to skip essentials like checking references when a candidate does show up. That oversight could cost you dearly.

***

The Project List

Once you do hire a contractor, continue to protect yourself as the project proceeds:

Never pay in advance. Reputable building contractors, for example, should have the resources to buy materials up front. For any services, don’t pay in full until the work is done to your satisfaction. If there is a problem, withholding payment is often your best leverage for getting it resolved.
Pay attention throughout the work. Make sure you get copies of all permits and inspection reports. Insist on fixes for small problems, and follow up to make sure they’re taken care of. As the customer, you should never feel like a trespasser on your own project.
Address serious problems promptly, in a serious way. If issues are not being resolved, don’t hesitate to file complaints with consumer protection agencies, contact professional associations, or involve an attorney.

Finally, when you do receive quality work or service, acknowledge it. Express your satisfaction, write references or positive reviews, and recommend the business to others.

Assessment

One way to discourage predatory or incompetent contractors is to support ethical, trustworthy professionals.

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: LifeStyle | Tagged: Home Contractors, rick kahler | Leave a comment »

Do you Know these ICD 10 Codes?

Posted on June 15, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Funny … if NOT so Serious!

[By Staff Reporters]

Greater Coverage with ICD 10 Codes

***

Injury, Venue, Situation

Assessment:

You’ve got yourself covered.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Insurance, Information Technology, Jokes and Puns | Tagged: ICD 10 Codes | 4 Comments »

Malignant Melanoma Trends

Posted on June 14, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

USA Trends – It is Summer-time

By http://www.MCOL.com

***

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Research & Development, Risk Management | Tagged: Malignant Melanoma Trends | Leave a comment »

Heart Disease Prevention for Caregivers

Posted on June 14, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

[By Samantha Wanner]

Heart disease is the number one killer of women, killing more than all forms of cancer combined. That’s why VITAS Healthcare has partnered with the American Heart Association to raise awareness of heart disease so caregivers can live healthier, longer lives.

As a physician or caregiver, you spend much of your time caring for those around you, and it’s easy to ignore your heart health. When you compromise your health, you compromise the care that you provide to those around you.

***

Start by Taking Control

Knowledge is power and understanding your family history of heart disease is the first step in understanding your risk.

Lifestyle choices play a major role in heart disease prevention. Make sure you manage your stress levels, develop better eating habits and exercise 20 minutes per day.

You are not alone in your journey to heart health. The American Heart Association is your resource for heart health.

***

Learn More About Caregiving:

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: iMBA, LifeStyle, Quality Initiatives, Risk Management | Tagged: American Heart Association, Caregiving, Heart Disease Prevention for Caregivers, VITAS Healthcare, wear red day | 3 Comments »

Holistic Prevention for Alzheimer’s Disease?

Posted on June 13, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

The Time is Now!

By Mark MD MPH

A newly released study demonstrates that approximately one third of Alzheimer’s cases worldwide are attributable to seven modifiable risk factors: depression, physical inactivity, diabetes, midlife hypertension, midlife obesity, smoking, and low educational attainment.

The largest proportion of cases was attributed to physical inactivity, which affects more than half of all Americans. Depression, which affects approximately 14.8 million Americans, accounted for approximately one in ten cases of Alzheimer’s disease globally.

***

Holistic Prevention for Alzheimer’s: The Time is Now

***

ABOUT

Mark J. Harris received his MD/MPH from Columbia University in May 2015. He will be starting Anesthesiology residency in June at Brigham and Women’s Hospital in Boston, MA. Mark is interested in the intersection between medicine and public policy, especially as it relates to chronic disease prevention (such as for diabetes, heart disease, and obesity), and he wishes to merge medicine, outcomes research, and public policy to address issues of perioperative risk factors, pain management, and end-of-life care.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Research & Development, Retirement and Benefits | Tagged: Alzheimer's disease, CDC, depression | Leave a comment »

The Opportunity Cost of Healthy Behavior

Posted on June 12, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

On Health Economics

By Mark MD MPH

Living a “healthy” lifestyle – however defined – takes work and energy. It means extra time to make it to the grocery store (instead of ordering in), saying no to that extra drink, and being conscientious when eating out. It can have the added social side effect of making you seem uptight, judgmental, or boring.

So, what exactly is the Opportunity Cost of Healthy Behavior?

***

The Opportunity Cost of Healthy Behavior

ABOUT

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Economics | Tagged: Cost of Healthy Behavior, Opportunity Cost of Health | 1 Comment »

Ten Steps for Starting a [Medical] Software Business

Posted on June 12, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A ten-point plan for aspiring software entrepreneurs

By Lynne Strang – lbstrang@gmail.com

Author of “Late-Blooming Entrepreneurs:

Eight Principles for Starting a Business After Age 40″

***

Ten Steps for Starting a Software Business

***

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Experts Invited, Research & Development | Tagged: medical startups, Starting a Software Business | Leave a comment »

About IBM Watson “Doctor Evidence”

Posted on June 11, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

What it is … How it works

Doctor Evidence is a leader in technological solutions for Evidence-Based Medicine (EBM) with a mission to support efforts of healthcare providers and patients to gain access to important evidence-based knowledge, based on the most timely and relevant medical evidence and related analytics, to inform clinical decisions and improve the health and wellbeing of patients worldwide.

This specialty software and services company’s methodology uses a Digital Outcome Conversion (DOC™) approach for transforming data from published clinical studies, epidemiological databases, and other sources, into reusable and updatable databases.

***

Doctor Evidence brings valuable health data to IBM Watson Ecosystem

***

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Research & Development, Risk Management | Tagged: Digital Outcome Conversion, Doctor Evidence, evidence based medicine | 2 Comments »

Investing and Economics is an Imprecise Science

Posted on June 11, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

BUT … It’s still all about CONSUMERISM!

[By Dr. David Edward Marcinko MBA MBBS [Hon] CMP™]

http://www.CertifiedMedicalPlanner.org

There is a major variable, dominant in any marketplace that pushes an economy in a forward direction. It is called consumerism.

This became apparent while I was waiting in a doctor colleague’s office one recent afternoon.

Scenario:

The front office receptionist, who appeared to be about 21 years old, was breaking for lunch and her replacement, and appeared not much older, came over to assist.

Realizing the propensity for a long wait, one was taken by the size of waiting room and the number of patients coming in and out of the office. [Americans consume healthcare and a lot of it].

There was another notable peculiarity. The sample prescription bags being carried out the door were no match for the bags under everyone’s eyes, including the doctor’s. The office staff was probably working overtime, if not two jobs, and the doctor was working harder and faster in a managed care / ACA system.

***

[Consumerism driving the Stock Market]

***

Why?

So they all could afford to buy and voraciously consume for their children and themselves. Americans indeed work longer hours than any other industrialized nation.

Assessment

Additionally, as women female medical professionals entered the workforce in unprecedented numbers, the stock markets reached an all time high in 2015, even as money was spent at a feverish pace as the Federal Reserve pumped out money in inflammatory fashion.

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: CMP Program, Financial Planning, Investing | Tagged: certified medical planner, CMP, CONSUMERISM, David Edward Marcinko, economics, financial planing | 3 Comments »

Laugh Loudly!

Posted on June 10, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A discussion on the medical benefits of laughter

By Jeffrey Niezgoda MD

Laugh Loud, Live Long

Publisher’s Note:

Here is what I think about this ME-P.

-Dr. David Edward Marcinko MBA

Click to play :

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Jokes and Puns, LifeStyle | Tagged: Jeffrey Niezgoda MD, medical benefits of laughter | Leave a comment »

The Pill Mill Epidemic

Posted on June 9, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

What it is – How it works?

[By Michelle Peterman]

miche.peterman@gmail.com

People who are getting access to prescription medication illegally are on the rise, thanks to what the government and drug addiction specialists call “Pill Mills.”

The United States has a significant enough problem with people addicted to illegal substances, such as heroin, cocaine, and methamphetamines.

What Is A Pill Mill?

You may be asking yourself, “What’s A Pill Mill?” All over the US there are legitimate doctors and pain management centers that are in place to assist patients with managing pain. These centers take great care to make sure patients do not become addicted to their medications and will provide assistance if they do.

Unfortunately, there are pain management centers that operate as these “Pill Mills” and are glorified drug dealers. These people are as bad as the drug suppliers and traffickers who sell Heroin or Ice on the streets. Pill Mills will often have a walk in appointment policy, minimum record keeping methods, and armed guards. Other signs include accepting cash-only, no physical exams, and supplying patients with doses of narcotics that are over the authorized limits.

Many people who are legally prescribed medication may start self-medicating and become addicted, needing more and more drugs. These same individuals often turn to pill mills to gain access to prescriptions that more ethical doctors would not give them.

***

Pill Mill Issues in Florida

It has been said that Florida is the epicenter of the pill mill industry. In 2010, as many as seven people were dying every day as a result of a prescription medication overdose in the State of Florida, and countless other deaths were occurring throughout The States. Authorities believed that Florida had become a haven for drug abusers and distributors to make huge profits in dispensing narcotics illegally.

In 2011, government took action and many pain management centers, medical practices, and clinics were raided. This happened in South Florida with the intention to crack down on the many “pill mills” that the authorities strongly suspected were prescribing Oxycodone in extremely high doses outside of controlled substance authority guidelines.

The authorities also found during their investigation that patients were recruited via the Internet. Six clinic owners and various other staff were indicted on charges that they conspired together to illegally supply patients with over 660,000 high and illegal doses of Oxycodone and collected over $22 million in profits.

***

The DEA Wages War Against Pill Mills in the South

In 2010, Florida had over nine hundred registered pain management centers. As of January 2014, that number dropped to around three hundred and fifty clinics.

However, it seems that Georgia is now dealing with many of those businesses that fled Florida after stricter measures were implemented. Huffington Post reports that “The DEA is prosecuting pain clinic operators who used to do business in Florida and picked up and moved to Georgia immediately after Florida passed tougher restrictions in 2011.”

Moreover, just recently, Drug Enforcement Administration Raids ‘Pill Mills’ in Four Southern States, including Arkansas, Alabama, Louisiana, and Mississippi.

Assessment

Prescription drug abuse has been declared a massive epidemic in the United States and yet another fight the authorities are trying to win. Tougher regulations and crackdowns from the DEA seem to be making a dent in this major issue.

More:

Sources:

Channel Surfing

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

ABOUT

Michelle is a former communications associate who transitioned into building her own freelance business. She enjoys health and staying on top of the latest news. Sitting by the beach is one of her favorite activities in her free time.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Drugs and Pharma | Tagged: DEA, Drug Enforcement Administration, Michelle Peterman, Oxycodone, pill mills | 3 Comments »

On National Obesity Rates?

Posted on June 8, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

By State for 2014

By http://www.MCOL.com

***

Channel Surfing

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

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Ethics, Risk Management | Tagged: National Obesity Rates | 2 Comments »

On Depressing Investments?

Posted on June 8, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

OR … Boring is Good!

By Rick Kahler MS CFP® http://www.KahlerFinancial.com

“We are in both a depressing and boring investment environment.”

That not-so-cheery statement came from Cliff Asness, Ph.D., managing and founding principal of AQR Capital Management, LLC, in a recent address to investment advisors gathered at the University of Chicago’s Gleacher Center.

Personally, I can handle “boring” investment environments just fine. Actually, when it comes to my investments I much prefer boring to exciting. I had all the investing excitement I need for a lifetime in 2008-2009. It’s the “depressing” portion of Asness’s remarks that caught my attention.

He maintains that both bonds and stocks are expensive when judged by their historical means—bonds in the 97th and stocks in the 92nd percentile.

Does that mean stock and bond markets are in a bubble? Asness says not.
Is a stock or bond market crash likely?

According to Asness, it’s anybody’s guess, because, “We really don’t know what causes crashes. It’s folly to try and predict a crash.”

While Asness doesn’t believe markets are in a bubble or that a crash is impending, what he had to say about expectations for future portfolio returns was certainly depressing.

Historical Review

Over the past 115 years, according to Asness’s data, the real return on a 60/40 portfolio (one holding 60% stocks and 40% bonds) has ranged from as high as 11% to as low as 2.2%. A real return is net of inflation. So, for example, if the total return is 8% and inflation is 3%, the real return is 5%. If inflation is only 1% and the total return is 6%, then the real return is 5%.

Now; for the depressing part. The real return of bonds is currently 0% while that of stocks is 3.7%. Do the math and that’s a 2.2% real return for a 60/40 portfolio. That puts the current real returns from stocks in a historical 8th percentile and bonds in the 3rd percentile.

The bottom line is that if you want high odds that in retirement you will never run out of money, you will need to limit your withdrawals to the real return of 2.2%. This leaves the return that equals the inflation rate in the portfolio to preserve the purchasing power of the portfolio. That means for every $1 million you have in investments you can withdraw $22,000 a year in income on which to live.

That is depressing, especially when you consider the professional norm for withdrawal rates is around 4%. For many years I’ve conservatively advocated for 3% withdrawal rates, which if Asness is right could turn out to be aggressive.

So What’s a Physician or other Investor to Do?

Asness’s advice is a bit self-serving, as his company, AQR, is one of the leading mutual fund managers of alternative investment strategies. That said, what he recommends agrees largely with what I’ve written for 24 years: that investors diversify their portfolios among more asset classes than just stocks and bonds.

Additional asset classes that can bolster portfolio returns and lower volatility are commodities, real estate, TIPS bonds, and alternative investment strategies such as long/short, arbitrage, and managed futures mutual funds.

Another option is to increase what you are saving for retirement and reduce your withdrawal rate expectations to something less than the traditional 4%.

***

Stock Market

***

Marketing Timing?

Whatever you do, there is one thing Asness and I agree you should not consider. Don’t try to time the market. Selling out stocks and bonds, going to cash, and buying back into the market when the time is “right” almost guarantees a depressing future.

Assessment

Instead, rely on the boring strategy of investing for the long term with asset class diversification. It’s an effective investing anti-depressant.

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

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Filed under: Investing | Tagged: AQR Capital Management, Cliff Asness, Depressing Investments, rick kahler, withdrawal rates | 1 Comment »

About the Institute of Medical Business Advisors, Inc

Posted on June 7, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Who we are – What we do!

[By Ann Miller RN MHA]

www.MedicalBusinessAdvisors.com

The Institute of Medical Business Advisors, Inc provides a team of experienced, senior level consultants led by iMBA Chief Executive Officer Dr. David Edward Marcinko MBA CMP™ MBBS [Hon] and President Hope Rachel Hetico RN MHA CMP™ to provide going contact with our clients throughout all phases of each project, with most of the communications between iMBA and the key client participants flowing through this Senior Team.

iMBA Inc., and its skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research and support staff of CPAs, MBAs, MPHs, PhDs, CMPs™, CFPs® and JDs to maintain a thorough and extensive knowledge of the healthcare environment.

The iMBA team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.

***

Risk Management and Insurance Foreword for Doctors by Lloyd Krieger MD MBA

Financial Planning for Physicians Foreword by Jason Dyken MD MBA

***

Our Team

The iMBA Inc project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients. Over the years, our industry specialization has allowed iMBA to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available.

iMBA Inc’s specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the public health, health economics, management, administration, and financial planning and consulting fields.

iMBA Inc’s information resources and network of healthcare industry textbook resources enhanced by our professional consultants and research staff, ensure that the iMBA project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.

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Filed under: Career Development, Financial Planning, iMBA, Investing, Practice Management, Recommended Books, Research & Development | Tagged: Financial Planning, institute of medical business advisors, Investing, medical executive post, Practice Management | 1 Comment »

What’s New at the ME-P… SUBSCRIPTIONs?

Posted on June 6, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Urging ME-P Registration … and our Subscription Mailing List

About the Institute of Medical Business Advisors, Inc

[By Ann Miller RN MHA]

If you’re an observant reader of this Medical Executive-Post, you may have noticed that things are looking a little different around here. That’s because we’ve “upgraded” the site to a new version of WordPress, a new theme, a responsive new layout and made a lots of other changes that will be appearing in your browser in the near future.

The Next Big Thing

The next big thing starting soon: from now on you’ll need to subscribe and be a registered user to comment. The good news is that registering is easy. Just, click on the register link at the top of the page and give us a user name and a working e-mail address.

You’ll also be able to join in the online discussion on the site, submit blog posts to the editors for consideration, send our editors press releases and announcements (if that’s your thing) and do other really fun and productive things that we haven’t even thought of yet.

***

The Internet of Things

On the other hand, this is the Internet and stuff breaks for mysterious reasons nobody really understands. If you have trouble registering, just email us and we’ll set you up.

MarcinkoAdvisors@msn.com

Assessment

And needless to say: if nothing shows up, check your spam filter.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Alerts Sign-Up, Breaking News | Tagged: medical executive post | 2 Comments »

Electronic Medical Data Exchange in Denmark

Posted on June 5, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Used by 91% of doctors according to research2guidance

By Ralf Jahns

Denmark emerges as the number one country to start an mHealth business according to a survey conducted by research2guidance in partnership with HIMSS Europe. Over 5000 app developers, healthcare professionals and mHealth practitioners took part in the “European mHealth App Market Ranking” survey, where participants were asked to rank the mHealth App market readiness of the 28 EU member states. The results were recently revealed by Ralf Jahns, Managing Director at research2guidance, during the HIMSS Europe event in Riga, the mHealth Summit, on 12th May 2015.

The results, which establish Denmark as having the best market pre-requisites needed for an mHealth business, are based on the average of the scores in five categories: eHealth adoption, level of digitalisation, market potential, ease of starting an mHealth business and mHealth regulatory framework. Hans Erik Henriksen, CEO of Healthcare Denmark commented on the survey findings: “Denmark has a very digitalised society and is familiar with using technology in healthcare, supported by a regulatory framework. The research2gudiance and HIMSS Europe survey confirms the progress we are making. I sincerely hope that this will inspire the European countries and mHealth community in their efforts to progress mobile solutions, which will make a big difference for our citizens”. Denmark ranked top country for eHealth adoption being the only country where exchanging patients’ medical data electronically is used amongst 91% of doctors, whereas the average of other covered countries is only 34%

In terms of market attractiveness and healthcare investments, Denmark is at the top in the mHealth market potential category, together with Austria which also has one of the highest expenditures for health. The ease of starting mHealth business category describes how easy it is to start and maintain a new business based on the number of days needed to start business, the number of necessary start-up procedures to register a business and the level of tax and, in this case, Denmark also ranked extremely high, as the smaller countries – Ireland was also top in this category – tend to support new businesses better compared to larger countries. Rainer Herzog, General Manager at HIMSS Europe, added: “This year’s survey has revealed that the market conditions for mHealth which Denmark offers are truly remarkable. This has been the largest global mHealth research study to date and there are different learnings that could be drawn from the EU countries’ mHealth App Market Ranking. Ultimately though, although mHealth is still it is an emerging market, and a number of countries in Europe are currently in the process of defining their mHealth roadmaps, Denmark leads the way in all aspects”.

Download the full mHealth study report here.

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Practice Management, Research & Development | Tagged: eHealth, EHRs, Electronic medical data exchange in Denmark, EMRs, HIMSS Europe, Ralf Jahns | Leave a comment »

On the Wisdom of the Crowd

Posted on June 4, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A Belated Edison’s Birthday Marks National Inventors’ Day

[By Staff Reporters]

Steve Wozniak, who built the first Apple computer, has this advice for inventors: “You are going to be best able to design revolutionary products if you are working on your own,” he writes in his memoir iWoz. “Not on a committee. Not on a team.”

GE engineer Peter de Bock begs to differ. “Innovation is about talking to people, connecting with people,” de Bock says. “It’s about knowing what’s out there, what’s needed.”

Recently, De Bock applied his method to build an ingenious cooling device that could launch a new generation of thinner, quieter, and more powerful laptops and tablets like Apple’s iPad.

***

LINK

http://www.gereports.com/post/74545117561/the-wisdom-of-the-crowd-edisons-birthday-marks

***

More:

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Research & Development | Tagged: Apple computer, GE, Peter de Bock, Steve Wozniak, Thomas Edison, Wisdom of Crowds | 1 Comment »

The Stock Market Has Been Flat For Six Months

Posted on June 4, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

This is Great News!

By Lon Jefferies MBA CFP® http://www.NetWorthAdvice.com

Investors have experienced a very uneventful 2015.

In fact, for seven months the Dow Jones Industrial Average was at essentially the same value.* This lack of fluctuation has been even more pronounced over the last two months. As of the market close on May 14th, 2015, the S&P 500 has closed between 2,040 and 2,120 for 71 days in a row.

Further, for nearly a full month, the DOW hasn’t experienced a 1-month high OR low and traded within a 2% range the entire time (always between -1% and 1%).** This was the longest streak in over 100 years!

***

Believe it or not, this may be the best pattern possible for the U.S. stock market.

***

Trendline Image

***

History tells us that the market is likely to increase in value over time. If we were to plot the market’s value from the time the market first opened to the current day, a chart of those two points would illustrate a return as such:

Trendline Image

However, we all know that the market doesn’t provide a consistent return. On individual trading days, the market can either increase or decrease in value, and the range of potential gains or losses is wide. Over extended periods of time, the market’s actual value may be above or below the expected trend line. In fact, the market’s actual historical return may look more like:

Historical vs Trendline

***

Historical vs Trendline

***

Anyone who is familiar with Net Worth Advisory Group is likely aware that we are not the type to make market predictions. We have no idea whether the market is near a temporary top or is still experiencing the upward trend after hitting the bottom of an S curve in 2008. However, let’s assume the market has reached the top of an S curve and is currently above the trend line that would represent consistent growth (similar to the illustration above).

If that is the case, there are two ways the market could get back in line with the trend line representing consistent long-term growth. The first and most obvious way this could happen is for actual market performance to curve downwards towards the trend line. This would represent a market correction or even crash.

***

crash

***

The second, and perhaps less obvious way that actual returns could become aligned with the long-term trend line is for time to allow the trend line to catch up to the actual returns we have experienced since 2008.

In this scenario, the market doesn’t slump but remains stable while time enables price-to-earnings ratios, valuations, and the economy a chance to catch up.

Time Catch Up

***

Time Catch Up

***

Very few investors enjoy or take advantage of a market correction. In fact, most investors lose control of their emotions when the market experiences a drastic downturn, and do exactly the opposite of what they should do: they sell at market lows – hardly a profitable investment strategy.

Consequently, if we are to avoid an over-heated market, it is likely better for most investors if the market realigns itself with the long-term growth rate by remaining flat for awhile and allowing the trend line time to catch up.

Allow me to reemphasize that I am not predicting that the market is in fact at a temporary high and above where it should be. I have no idea what the market will do tomorrow, over the next month, or over the next year. That is why I’m a believer in having a well diversified portfolio that represents your risk tolerance and you stick to it through thick and thin.

However, let’s look at the other side of the coin and assume the market is still at the bottom of an S curve, below the long-term trend line, and needs to experience further growth in order to catch up. Even in this scenario, an extended period of flat market performance is hardly a bad thing – it would simply make the potential upside needed to get back to market norms all the larger.

Market Under Valued

***

Market Under Valued

***

Assessment

It turns out that an extended period of flat market performance may very well be a positive for investors in any environment, regardless of whether the market is currently over or under-valued.

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

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Filed under: Investing, Practice Management | Tagged: DJIA, Investing, Lon Jefferies, Net Worth Advisory Group, stock market | Leave a comment »

On Medicare Advantage Plan[s] Enrollment

Posted on June 3, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Medicare Pre-Paid Enrollee Composition

By http://www.MCOL.com

***

NOTE: CMS Releases 2013 Hospital, Physician Data

***

The opening of this week’s Health Datapalooza conference in Washington was the setting for a new Medicare data dump on physician and hospital inpatient/outpatient payment and utilization rates. This is the third annual release of data as part of the Obama administration’s information transparency initiative to promote increased quality of care and more informed healthcare spending by consumers. A link to the inpatient dataset is here, the outpatient dataset is here, and the physician / supplier dataset is here.

Source: Joseph Goedert, Health Data Management [6/2/15]

***

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Insurance | Tagged: medicare, Medicare Advantage, Medicare Advantage Plan, Medicare HMOs | 10 Comments »

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