Sign the pledge to create the healthiest nation in one generation

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The Healthiest Nation Pledge

  • By Susan L. Polan PhD
  • [Associate Executive Director]
  • Public Affairs and Advocacy

Dear Dr. David E. Marcinko,

Study after study consistently confirms an unpleasant fact: Americans live shorter lives and suffer more health issues than people in other high-income countries.

  • We live up to four years less than our peers.
  • We suffer more chronic disease, such as diabetes, cancer and heart disease.
  • We have higher infant mortality rates.
  • Within the U.S., there is as much as a 15-year difference in life expectancy depending on where you live, your race, your income and how educated you are.

In truth, the U.S. trails other high-income countries in these and most other measures of health.

Hope and Change

How do we change this? We need to make healthy lifestyle choices both as individuals and as a society. Our health is affected by a complex web of social and environmental factors that are often outside of our individual control. The homes we live in, our access to healthy food, the quality of our schools, clean air and water – these and other factors directly affect our health. And for many people, they limit their ability to make healthy choices.

Together We Can

Together we can change this. If we join together, we can demand that our leaders consider health in all their decisions. We can create communities that have a positive influence on our health – communities where it is easy for us all to make healthy choices.

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Assessment

Take the first step. Sign the pledge to create the healthiest nation in one generation. Ask your colleagues, friends and family to sign also. The more people who sign, the more influence we can wield. And the more momentum we can build for change.

Sincerely,

Susan Polan

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

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The Resurgence of Prescription Drug Price Increases‏

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Trends 2006-2014

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Curing By Numbers

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Taking Cloud Computing to a New Level

[By GE Healthcare IT]

American healthcare has by far the most expensive system in the world, but few would argue that it’s also the most efficient. A study published in the Journal of American Medical Association found that almost 40 percent of patients are misdiagnosed in primary care1. Another report by the American College of Physicians discovered that unnecessary testing and medical procedures, and extra days in the hospital caused by wrong diagnosis could add up to $800 billion per year2.

That’s close to a third of all U.S. healthcare costs. “There is a lot of waste in the system,” says Jeanine Banks, general manager of marketing at GE Healthcare IT. “We want to help rein in the costs and make the system far more efficient.”

That’s not just talk. Engineers at GE Healthcare IT are developing a new “cloud imaging” solution that will allow doctors to create a professional profile, store patient images and data together in one place, view 3D images from anywhere, and access intuitive analytics. “It’s like LinkedIn professional networking meets diagnostic imaging,” Banks says. “It’s all about virtually limitless computing, storage and collaboration on tough cases to help healthcare teams make more informed decisions.”

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Banks says that the information physicians need to make diagnoses is often fragmented and sits in siloes. The new platform, GE’s Cloud Imaging solution, allows doctors to exchange images and use social digital tools to share cases with each other over a network instead of distributing CDs, as common practice now. “They can open their browser, click on a link and share quickly,” she says.

Banks says that GE intends to give hospitals the flexibility to host the system on their own servers, as a private cloud, or through GE’s public cloud environment. “We are committed to using industry standards to make it easy to connect medical devices, link with existing PACS (picture archiving and communication systems) and EMR (electronic medical records environments), and enable consistent access to a flourishing ecosystem of apps,” she says. “Providers don’t need more silos of data.” GE’s first Cloud Imaging pilot site is the Kadlec Health System in Washington State. Kadlec is helping evaluate the platform ahead of plans to demonstrate the new solution during the annual meeting of the Radiological Society of North America in December. “It’s an opportunity for them to use it inside their health system and give us feedback,” Banks says.

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For Banks, this is the beginning of a new healthcare revolution. “What if together with industry we could help physicians reduce waste?” she asks. “We could process that information, learn from past diagnostic decisions and store the data all in the cloud to inform future decisions. One day, we could tap into knowledge based on cases from around the world.”

Assessment

That’s just brilliant.

Citations:

1 Journal of American Medical Association 2012

2 Reuter’s, citing study by American College of Physicians  

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Emerging New-Wave Cloud Technology for HIPAA

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Securing Electronic Communication in the Cloud

[By Carol S. Miller BSN MBA PMP]

Carol S. MillerTo help hospitals and health systems comply with burdens of the Health Insurance Portability and Accountability Act [HIPAA] regulations, best practices are emerging for securing all electronic communication – cloud, wireless, and texting –  of protected health information.

These new technologies will continually be evolving with hospitals, providers and patients move to new means of communication.

And so, below is a very brief description of one: cloud solutions.

Cloud Solutions

Cloud solutions are becoming a needed commodity in treating patients today but also present a risk to privacy and security violation.  Despite the advantages of cloud computing, organizations are often hesitant to use it because of concerns about security and compliance.

Specifically, they fear potential unauthorized access to patient data and the accompanying liability and reputation damage resulting from the need to report HIPAA breaches. While these concerns are understandable, a review of data on HIPAA breaches published by the HHS shows that these concerns are misplaced.

In fact, by using a cloud-based service with an appropriate security and compliance infrastructure, a facility can significantly reduce its compliance risk.

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USB drive

[A.I. and the “SINGULARITY”]*

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Because HIPAA compliance involves stringent privacy and security protections for electronic protected health information (PHI), many cloud providers are balking at signing new Business-Associate agreements.

Most cloud-technology providers, such as Box and Dropbox, do not include the built-in privacy protections that guarantee HIPAA compliance. Because many cloud storage companies store plaintext data on their servers, PHI is especially vulnerable to breaches and compliance violations.

Note:

The SINGULARITY is that hypothetical moment in time when Artificial Intelligence [AI] will have progressed to the point of a greater-than-human intelligence.

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ABOUT THE AUTHOR

  • Carol S. Miller; BSN, MBA, PMP
  • ACT IAC Executive Committee Vice Chair at-Large
  • HIMSS NCA Board Member
  • President – Miller Consulting Group
  • 7344 Hooking Road
  • McLean, VA 22101
  • Phone: 703-407-4704
  • Fax: 703-790-3257
  • email: millerconsultgroup@gmail.com

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The Economics of Electronic Healthcare Transactions

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For FY 2013

By http://www.MCOL.com

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The Medical Painting Gallery of HCC, LLC

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A Digital Medical Painting Gallery GOOD FRIDAY Review

Courtesy Robert James Cimasi; MHA ASA FRICs MCBA AVA CM&AA CMP™

[Health Capital Consultants, LLC]

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OK; I was never much of a liberal arts guy in my younger days; despite my Jesuit education at Loyola University. Always more of a modified STEM scientist.

Still, I remember the first time I learned of this famous painting in college, then medical school [a requirement of all anatomy students, worldwide]. So, imagine how blessed I felt when I viewed the original when I visited Amsterdam … chilling!

And, this painting and entire gallery seems an appropriate ME-P for Good Friday 2015.

David Edward Marcinko

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The Anatomy Lesson of Dr. Nicolaes Tulp

Rembrandt (1606–1669)

[1632: commissioned by Chirurgijnsgilde, Amsterdam]

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CLICK FOR MORE:

http://www.healthcapital.com/resources/medical-painting-gallery

Assessment

Paintings are part of the collection of the U.S. National Library of Medicine. 

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Human error causes alarming rise in data breaches

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For the Insurance, Healthcare, Education, and Financial Services Sectors

[By Egress Software Technologies]

http://www.egress.com

Human error causes alarming rise in the number of data breaches and resulting monetary penalties, according to ICO FOI request carried out by Egress Software Technologies.

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PC bug

[Blame Human Error – Not Hardware Bugs]

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Drug Poisoning Deaths Involving Heroin

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US 2000-2013 [Quadrupled]

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Seeking Authors by “Crowd-Sourcing” our Proposed Medical Marketing TextBook

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Seeking Authors by “Crowd-Sourcing” our Proposed Medical Marketing TextBook

SOAR

MEDICAL PRACTICE MARKETING MANAGEMENT, ADVERTISING, SALES, COMMUNICATION AND SOCIAL MEDIA SKILLS

[New-Wave Success Strategies for Savvy Doctors]

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

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NPCs Info-Graphic on Comparative Effectiveness Research

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National Pharmaceutical Council

[By Staff Reporters]

The National Pharmaceutical Council’s fourth annual survey of health care stakeholders sheds some light on the environment for comparative effectiveness research (CER) and health care decision-making.

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CER-Survey

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Questions

  • How important is CER?
  • Which organizations play key roles in the CER effort?
  • How long will it take to see the impact of CER on decision making?

Assessment

Find the answers to these questions and more in this info graphic. (Source: National Pharmaceutical Council, 2014)

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18 Financial Planning Tips For Physicians from a DR-CPA

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For Personal and Medical Practice Management Modernity

Dr. Gary Bode; CPA, MSA, CMP

By Dr. Gary L. Bode CPA MSA CMP [Hon] PA

http://garybodecpa.com/

http://www.CertifiedMedicalPlanner.org

1. Consider establishing an employee stock ownership plan (ESOP).

If you own a clinic or medical practice or business and need to diversify your investment portfolio, consider establishing an ESOP. ESOP’s are the most common form of employee ownership in the U.S. and are used by companies for several purposes, among them motivating and rewarding employees and being able to borrow money to acquire new assets in pretax dollars. In addition, a properly funded ESOP provides you with a mechanism for selling your shares with no current tax liability. Consult a specialist in this area to learn about additional benefits.

2. Make sure there is a succession plan in place.

Have you provided for a succession plan for both management and ownership of your medical practice, clinic or business in the event of your death or incapacity? Many business owners or physician-executives wait too long to recognize the benefits of making a succession plan. These benefits include ensuring an orderly transition at the lowest possible tax cost. Waiting too long can be expensive from a financial perspective (covering gift and income taxes, life insurance premiums, appraiser fees, and legal and accounting fees) and a non-financial perspective (intra-family and intra-company squabbles).

3. Consider the limited liability company (LLC) and limited liability partnership (LLP) forms of ownership.

These entity forms should be considered for both tax and non-tax reasons.

4. Avoid nondeductible compensation.

Compensation can only be deducted if it is reasonable. Recent court-decisions have allowed physician executives or business owners to deduct compensation when (1) the corporation’s success was due to the shareholder-employee, (2) the bonus policy was consistent, and (3) the corporation did not provide unusual corporate prerequisites and fringe benefits.

5. Purchase corporate owned life insurance (COLI).

COLI can be a tax-effective tool for funding deferred executive compensation, funding clinic or company redemption of stock as part of a succession plan, and providing many employees with life insurance in a highly leveraged program. Consult your insurance and tax advisers when considering this technique.

6. Consider establishing a SIMPLE retirement plan.

If you have no more than 100 employees and no other qualified plan, you may set up a Savings Incentive Match Plan for Employees (SIMPLE) into which an employee may contribute up to $12,500 per year if you’re under 50 years old and $15,500 a year if you’re over 50 in 2015. As an employer, you are required to make matching contributions. Talk with a benefits specialist to fully understand the rules and advantages and disadvantages of these accounts.

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7. Establish a Keogh retirement plan before December 31st.

If you are self-employed and want to deduct contributions to a new Keogh retirement plan for this tax year, you must establish the plan by December 31st. You don’t actually have to put the money into your Keogh(s) until the due date of your tax return. Consult with a specialist in this area to ensure that you establish the Keogh or Keoghs that maximize your flexibility and your annual contributions.

8. Section 179 expensing.

Businesses and medical practices may be able to expense up to $25,000 in 2015 for equipment purchases of qualifying property placed in service during the filing year, instead of depreciating the expenditures over a longer time period. The limit is reduced by the amount by which the cost of Section 179 property placed in service during the tax year 2015 exceeds $200,000.

9. Don’t forget deductions for health insurance premiums.

If you are self-employed (or are a partner or a 2-percent S corporation shareholder-employee) you may deduct 100 percent of your medical insurance premiums for yourself and your family as an adjustment to gross income. The adjustment does not reduce net earnings subject to self-employment taxes, and it cannot exceed the earned income from the business under which the plan was established. You may not deduct premiums paid during a calendar month in which you or your spouse is eligible for employer-paid health benefits.

10. Review whether compensation may be subject to self-employment taxes.

If you are a sole proprietor, an active partner in a partnership, or a manager in a limited liability company, the net earned income you receive from the entity may be subject to self-employment taxes.

11. Don’t overlook minimum distributions at age 70½ and rack up a 50 percent penalty.

Minimum distributions from qualified retirement plans and IRAs must begin by April 1 of the year after the year in which you reach age 70½. The amount of the minimum distribution is calculated based on your life expectancy or the joint and last survivor life expectancy of you and your designated beneficiary. If the amount distributed is less than the minimum required amount, an excise tax equal to 50 percent of the amount of the shortfall is imposed.

12. Don’t double up your first minimum distributions and pay unnecessary income and excise taxes.

Minimum distributions are generally required at age seventy and one-half, but you are allowed to delay the first distribution until April 1 of the year following the year you reach age seventy and one-half. In subsequent years, the required distribution must be made by the end of the calendar year. This creates the potential to double up in distributions in the year after you reach age 70½. This double-up may push you into higher tax rates than normal. In many cases, this pitfall can be avoided by simply taking the first distribution in the year in which you reach age 70½.

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13. Don’t forget filing requirements for household employees.

Employers of household employees must withhold and pay social security taxes annually if they paid a domestic employee more than $1,900 a year in 2015 (same as 2014). Federal employment taxes for household employees are reported on your individual income tax return (Form 1040, Schedule H). To avoid underpayment of estimated tax penalties, employers will be required to pay these taxes for domestic employees by increasing their own wage withholding or quarterly estimated tax payments. Although the federal filing is now required annually, many states still have quarterly filing requirements.

14. Consider funding a nondeductible regular or Roth IRA.

Although nondeductible IRAs are not as advantageous as deductible IRAs, you still receive the benefits of tax-deferred income. Note, the income thresholds to qualify for making deductible IRA contributions, even if you or your spouse is an active participant in a employer plan, are increasing.

The $100,000 income test for converting a traditional IRA to a ROTH IRA was permanently eliminated in 2010, allowing anyone to complete the conversion.

You can withdraw all or part of the assets from a traditional IRA and reinvest them (within 60 days) in a Roth IRA. The amount that you withdraw and timely contribute (convert) to the Roth IRA is called a conversion contribution. If properly (and timely) rolled over, the 10 percent additional tax on early distributions will not apply. However, a part or all of the distribution from your traditional IRA may be included in gross income and subjected to ordinary income tax.

Caution: You must roll over into the Roth IRA the same property you received from the traditional IRA. You can roll over part of the withdrawal into a Roth IRA and keep the rest of it. However, the amount you keep will generally be taxable (except for the part that is a return of nondeductible contributions) and may be subject to the 10 percent additional tax on early distributions.

15. Calculate your tax liability as if filing jointly and separately.

In certain situations, filing separately may save money for a married couple. If you or your spouse is in a lower tax bracket or if one of you has large itemized deductions, filing separately may lower your total taxes. Filing separately may also lower the phase out of itemized deductions and personal exemptions, which are based on adjusted gross income. When choosing your filing status, you should also factor in the state tax implications.

16. Avoid the hobby loss rules.

If you choose self-employment over a second job to earn additional income, avoid the hobby loss rules if you incur a loss. The IRS looks at a number of tests, not just the elements of personal pleasure or recreation involved in the activity.

17. Review your will and plan ahead for post-mortem tax strategies.

A number of tax planning strategies can be implemented soon after death. Some of these, such as disclaimers, must be implemented within a certain period of time after death. A number of special elections are also available on a decedent’s final individual income tax return. Also, review your will as the estate tax laws are influx and your will may have been written with differing limits in effect. In 2015, estates of $5,430,000 (up from $5,340,000 in 2014) are exempt from the estate tax with a 40 percent maximum tax rate (made permanent starting in tax year 2013).

18. Check to see if you qualify for the Child Tax Credit.

A $1,000 tax credit is available for each dependent child (including stepchildren and eligible foster children) under the age of 17 at the end of the taxable year. The child credit generally is available only to the extent of a taxpayer’s regular income tax liability. However, for a taxpayer with three or more children, this limitation is increased by the excess of Social Security taxes paid over the sum of other nonrefundable credits and any earned income tax credit allowed to the taxpayer. For 2015 (as in previous years), the income threshold is $3,000.

For more information concerning these financial planning ideas, please call or email us.

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ABOUT  DR. GARY L. BODE MSA CPA CMP [Hon]

Dr. Gary L. Bode was Chief Executive Officer of Comprehensive Practice Accounting, Inc., a firm specializing in providing tax solutions to medical professionals. Originally, he was a board certified podiatrist and managing partner of a multi-office medical practice for a decade before earning his Master of Science degree in Accounting from the University of North Carolina. He then served as Chief Financial Officer [CFO] for a private mental healthcare facility. Today, Dr. Bode is a nationally known Certified Public Accountant, financial author, educator, and speaker. Areas of expertise include producing customized managerial accounting reports, practice appraisals and valuations, restructurings, and innovative financial accounting as well as proactive tax positioning and tax return preparation for healthcare facilities. He has been quoted in Newsweek.

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Take the Geneia “Joy of Medicine” Challenge

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Submit your Ideas – Today!

Bryan Vartabedian, MD's avatar By Bryan Vartabedian MD

It’s a fact, there’s not a lot of joy out there among today’s physicians. 84 % of you report that ‘quality patient time’ may be a thing of the past. And, 67 % of you know a colleague who’s actually thinking about giving it all up.

Timeline

  • about 2 months until voting ends on Wednesday, May 13th, 2015 at 7:00 PM

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hospital

VOTING LINK HERE:

https://medstro.com/groups/joy

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Assessment

At Geneia,we’re working hard to find the answers. And; we need a second opinion — yours. Submit your ideas to the Geneia Joy of Medicine Challenge today!

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ABOUT

Dr. Bryan Vartabedian is considered one of health care’s most influential voices on technology and medicine. His insight and thought leadership has made him a sought after keynote speaker in the area of medicine and new media. Dr. V has developed unique expertise in understanding how new media can be leveraged by organizations and individual stakeholders in health care. He consequently has served on the advisory board of Stanford’s Medicine X conference and currently serves on the External Advisory Board of the Mayo Clinic Center for Social Media. Dr Vartabedian currently serves as a founding advisor to the Health Care Track at the SXSW Interactive Festival. You can find him quoted in outlets such as The Wall Street Journal, The New York Times, US News and World Report and CNN.

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Women Retirement Confidence

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Financial Preparation

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

Rick Kahler MS CFPWhen it comes to being financially prepared for retirement, Chinese women are the most confident women in the world. In fact, they are almost twice as confident as their US counterparts.

The Survery

This conclusion comes from a 2014 global survey, the Aegon Retirement Readiness Index. It found that the percentage of women saying they are very confident or extremely confident about retirement is 42% in China, 35% in India, 29% in Brazil, 22% in the US, and 18% in Canada.

The survey included responses from 16,000 employees and retirees in 15 countries, half of whom were women. About 62% of the women were married, 52% had some higher education, and 80% took an active role in managing the household finances.

The Insights

Several aspects of this survey really caught my attention:

  • I was puzzled that only two developed countries—the US and Canada—made the top five. The first three—China, India, and Brazil—were  emerging markets with little or no social safety nets in place.
  • Even more notable is that, in the US and Canada, the number of women who do not feel prepared to retire (38% in the US and 36% in Canada) is almost twice as high as the number that are confident about retirement.
  • And more notable yet is that the bottom five includes three developed countries with strong social safety nets. In France, Japan, and Spain, less than 6% of women reported retirement confidence, while 60% or higher said they had no confidence.

It seems puzzling that the countries with large social safety nets spawned less retirement confidence than did developed countries with little or no safety net. Why isn’t it the opposite? Why aren’t women in countries where government plays a big part in retirement income more confident?

The Answer?

Therein may lay the answer. Possibly because of the lack of government retirement programs, people in the emerging market countries like China, India, and Brazil realize they cannot count on anyone but themselves in retirement. They know they must begin saving a significant amount of their income, starting early in life, to be able to sustain themselves in retirement. A failure to do so will result in them literally being “thrown out onto the street” or into the “poor house.” As harsh as that may sound to our Western ears, the reality must be a powerful motivator.

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Depression

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The Reality

This reality was brought home to me by two people I met on visits to China and India. One Chinese woman in her 20’s told me she saved a third of her income. She said, “People in America don’t need to save. China doesn’t have the social safety nets you have.” Part of surviving in their society is to learn money skills and how to save early in life for emergencies and retirement. A man I met in India told me much the same story; he had his retirement fully funded by age 45.

In the US and most other developed countries, government programs like Social Security have become the retirement plan of the masses. Yet the majority of women in developed countries don’t seem to find comfort in those programs.

However, neither do they save like their emerging market counterparts. In fact, 56% of Americans live hand to mouth, according to a 2005 survey of retirement savings for baby boomers and others, by Sharon A. Devaney and Sophia T. Chiremba, reported at the US Bureau of Labor Statistics [USBLS].

Assessment

What might motivate women globally to gain confidence in their retirement preparedness? I don’t know. But based on the results of this survey, the answer won’t be found in more government programs.

Conclusion

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Meet Next-Gen Healthcare Powered by the Industrial Internet

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This is Your Body Online

[By GE Healthcare IT]

A couple of years ago, the Kadlec Health System in Washington State started testing a new cloud-based technology that mashes up professional networking and diagnostics. The system allows doctors to create a professional profile, store patient images and data together in one place, view them from anywhere and access intuitive analytics.

“It’s like LinkedIn professional networking meets diagnostic imaging,” said Jeanine Banks, general manager of Commercial Cloud Solutions at GE Healthcare IT, which developed the technology. “There is a lot of waste in the system. We want to help rein in the costs and make the system far more efficient.”

A study published in the Journal of American Medical Association found that almost 40 percent of patients are misdiagnosed in primary care [1]. Another report by the American College of Physicians discovered that unnecessary testing and medical procedures, and extra days in the hospital caused by wrong diagnoses could add up to $800 billion per year, close to one-third of all U.S. healthcare costs [2].

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tumblr_m7tx4hQDeq1qk4ealo1_1280

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At a panel of experts, John Dineen, president and CEO of GE Healthcare, Bill Ruh, who runs GE’s Global Software Center, and Michael Leavitt, the former secretary of U.S. Health and Human Services discussed the state of American healthcare and the ways to improve it with technology. Their panel, which was moderated by technology investor and philanthropist Esther Dyson, was part of GE’s conference focused on IT in healthcare.

Ruh and Dineen reminded everyone that over the last two decades many consumer-facing industries got thoroughly remade and that healthcare won’t be different. “There was an architectural shift of technology,” Ruh said. “We changed how we deliver and interact with music and books.”

Dineen said that the healthcare landscape was also changing “from cost plus to profit and loss. The consumer will start making buying decisions,” Dineen said. “There’s going to be transparency. There is going to be a real focus on productivity and customer satisfaction and that’s going to require tremendous investment …The industry will pivot over the next few years.”

Industrial Internet systems like the GE technology that’s now working at Kadlec will be one driver of change. But, former Sec. Leavitt said collaborative tools that bring together patients, insurers and providers will help distribute the risk associated with healthcare costs.

“Exchanges will allow consumers to make trade-offs,” Leavitt said. “If you stay with me and get your body in a better shape, I’ll give you a better [insurance] price.”

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tumblr_inline_nhs0a2MZUr1qzgziy

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Next-generation healthcare will also focus on outcomes. Dineen said that engineers used to be concerned chiefly with building better machines and “taking the technology to the next level.” But, medical systems in the future will have to combine high quality and lower costs with results.

Dineen and Ruh stressed the need to focus on predictive analytics, which has started empowering other industries. Dineen said that in aviation, Industrial Internet systems can already see “a signature of a problem and get it fixed when [the aircraft] comes to a shop and not on a mountain top.”

“It’s not that you get this magic answer that something is going to break,” Ruh said. “You get early indicators. You still need to have experts in the loop.”

Dineen said that right now, the healthcare industry was going through “this clumsy period when the incentives have not kicked in” yet. He listed three stages of the IT revolution in healthcare that need to take place. They include connecting machines and digitizing data, getting data from siloes like primary care providers, as well as the “rich stage,” which involves analysis and learning from the data.

Assessment

Researchers estimate that the majority of healthcare costs stem from preventable chronic health conditions rather than disease prevention and early detection. Dineen called the status quo “unproductive.” The new system will have the rewards and the incentives to change that, he said.

Citations:

1 Journal of American Medical Association 2012

2 Reuter’s, citing study by American College of Physicians

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Five Most Costly Domestic Surgeries

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USA Aggregate Hospital Stays for 2011

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On Physicians and Automobile Leases

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Advantages, Disadvantages and Types

[By Dr. David Edward Marcinko MBA CMP™]

Dr. Marcinko 1972 VetteThe Rites of Spring!

As a former licensed state insurance agent, and financial advisor, I know that leasing a car may have advantages to a physician – and others – such as convenient maintenance, low down and monthly payments, no resale responsibility, and tax savings since you pay sales tax on the lease portion rather than the purchase price of the car.

It might also be worthwhile if the after tax borrowing cost of a home equity loan is less than the lease financing rate.

***

Spring 2011 - NIH

[First Days of Spring 2017]

May Day Weekend 2011 [Dr. David E. Marcinko MBA]

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Types of Leases

There are two major types of leases: open and closed ended. In the former type, if the car is worth more than the set price upon expiration of the lease, you are responsible for the underage or coverage. In the more advantages later type, the responsibility of the value of the car is shifted to the leasing company. Other tips on care leasing include:

  • Inform the lessor how you want the auto equipped; do not accept unwanted options.
  • Obtain all delivery, and other, charges in advance, including down payment, security.
  • Deposit, registration fees, interest rates, residual value, rebates and all taxes (sales, personal property, use and gross receipt).
  • Know the capitalized cost (selling price) of the car
  • Know annual mileage limits, usually 15-18,000 miles, and all excess use charges.
  • Avoid maintenance and service contracts, and arrange for your own insurance.
  • Understand that terms, such as money factor, or interest factor, may be used instead of the term interest rate. In this case, simply multiple the rate by 24 for an estimate of the true interest rate involved.
  • Read the contract and understand all penalties, especially for premature or late termination, purchase or return terms, and consequences of theft.
  • Check the lease terms through an independent company, such as First National Lease Systems.

Rough Rules of Thumb

A rough rule of thumb to determine whether to buy or lease involves multiplying all the payments required by the number of months you will have to pay, and add the down payment to yield the total amount of the purchase. Then, multiply the lease payment by the number of months, and add required up-front costs, as well as residual value (end of lease buyout cost), to determine the total amount to lease. Compare the two figures to determine the most economical deal.

Typically, a cash deal is less expensive in the long run, providing a higher after tax rate of return is not available, as an alternate investment, for the funds.

***

Jaguar Touring sedan XJ-V8-LWB***

Dis-Advantages

But, there are dis-advantages to auto leasing, too!

Perhaps the worse reason to lease a car is to drive one that you could not otherwise afford to drive. This is because most low monthly payments are only composed of two portions: interest on the note and the prorated cost of auto depreciation. No money is applied to ownership of the vehicle.

Assessment

Finally, beware Spring-Fever and do not likely buy “gap” insurance to cover the difference between what your auto insurer would pay if your car was totaled, and what you would owe the leasing firm. It’s usually too expensive and the risk is minimal.

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***

On the FBI’s Medicare Fraud Strike Forces

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$6.5 Billion in Cash

Edward Bukstel

[By Edward Bukstel]

ME-P SPECIAL REPORT

FBI’s Medicare Fraud Strike Forces Strikes $6.5 Billion in Cash.

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Miami based Home Health Agency owner guilty of Medicare fraud,  The Medicare Fraud Strike Force since its inception in March 2007, is now operating in nine cities across the country, has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion.

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benjamin-bills3

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 In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

***

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***

Money

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More on “Passive Investing” for Physicians

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Basic Financial Concepts

tim

By Timothy J. McIntosh; CFPMBA MPH CMP [hon]

By Jeffery S. Coons; PhD CFA

By Dr. David E. Marcinko; MBA CMP™

Passive investing is a monetary plan in which an investor invests in accordance with a pre-determined strategy that doesn’t necessitate any forecasting of the economy or an individual company’s prospects.

Premise

The primary premise is to minimize investing fees and to avoid the unpleasant consequences of failing to correctly predict the future. The most accepted method to invest passively is to mimic the performance of a particular index. Investors typically do this today by purchasing one or more ‘index funds’. By tracking an index, an investor will achieve solid diversification with low expenses.  Thus, a physician-investor could potentially earn a higher rate of return than an investor paying higher management fees.

Passive management is most widespread in the stock markets.  But; with the explosion of exchange traded funds on the major exchanges, index investing has become more popular in other categories of investing. There are now literally hundreds of different index funds.

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Bull Markets

[Domestic Bull Markets – Historical USA]

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Passive management is based upon the Efficient Market Hypothesis theory.  The Efficient Market Hypothesis (EMH) states that securities are fairly priced based on information regarding their underlying cash flows and that investors should not anticipate to consistently out-perform the market over the long-term.

The Efficient Market Hypothesis evolved in the 1960s from the Ph.D. dissertation of Eugene Fama.  Fama persuasively made the case that in an active market that includes many well-informed and intelligent investors, securities will be appropriately priced and reflect all available information. If a market is efficient [even emerging and/or world markets], no information or analysis can be expected to result in outperformance of an appropriate benchmark.

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World Markets

[USA versus World Index]

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The Author

Timothy J. McIntosh is Chief Investment Officer and founder of SIPCO.  As chairman of the firm’s investment committee, he oversees all aspects of major client accounts and serves as lead portfolio manager for the firm’s equity and bond portfolios. Mr. McIntosh was a Professor of Finance at Eckerd College from 1998 to 2008. He is the author of The Bear Market Survival Guide and the The Sector Strategist.  He is featured in publications like the Wall Street Journal, New York Times, USA Today, Investment Advisor, Fortune, MD News, Tampa Doctor’s Life, and The St. Petersburg Times.  He has been recognized as a Five Star Wealth Manager in Texas Monthly magazine; and continuously named as Medical Economics’ “Best Financial Advisors for Physicians since 2004.  And, he is a contributor to SeekingAlpha.com., a premier website of investment opinion. Mr. McIntosh earned a Bachelor of Science Degree in Economics from Florida State University; Master of Business Administration (M.B.A) degree from the University of Sarasota; Master of Public Health Degree (M.P.H) from the University of South Florida and is a CERTIFIED FINANCIAL PLANNER® practitioner. His previous experience includes employment with Blue Cross/Blue Shield of Florida, Enterprise Leasing Company, and the United States Army Military Intelligence.

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Understanding State Medical Board Structures

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 “The Tale of Two Boards”

[By Eric A. Dover MD]

[By Michael Lawrence Langan MD]

SOAR

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The great majority of States have in reality two Medical Boards. All States have a “Board Proper” and all but a handful have an “Administrative Board”.

First Board

The “Board Proper” is, depending on the State, made up of seven to sixteen individuals. There will be a President (Chairperson) and President Elect. The Board Members are “volunteers”, typically placed by the State Governor. The individuals who constitute the Board may vary greatly and are somewhat determined by the medical disciplines overseen by the Medical Board. Oklahoma presently separates Medical Doctors (M.D.) and (D.O.) into two Boards http://www.okmedicalboard.org/

Other Medical Boards may oversee Physician Assistants (P.A.), Midwives, Respiratory Therapists, Podiatrists, Athletic Trainers, etc., who may or may not have direct Board representation. All States have M.D.s on the Board, and some Boards are all M.D.s. Others members of the Board may include D.O.s, P.A.s, Podiatrists, Midwives, Respiratory Therapists, a representative from the Secretary of State’s office, the Commissioner of State Boards or an Educational Director. Many, but not all Medical Boards, will have anywhere from one to three Public Members.

Some States require Public Member(s) come from a specific profession such as a lawyer or hospital administrator. Other States have no such qualifications; therefore the Public Member can be from any profession.

Second Board

The “Administrative Board” is the other Medical Board. They run the operation throughout the year. Their personnel, structure and operation vary widely from State to State.

Most States will have an Executive Director who supervises the Board.   Some states, such as New Mexico http://www.nmmb.state.nm.us/ or Indiana http://www.in.gov/pla/3638.htm, use a State Board Director for all boards, and don’t have a specific Executive Director.

Pennsylvania uses a State Administrator in lieu of an Executive Director. Individuals filling these positions are either legally or administratively trained.

http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Pages/default.aspx#.VOO-ZfZ0zIU

Many States have a Medical Director. They are physicians whose tasks, for example, may include working with Investigators, lending medical expertise or working on Board Committees. Many other State Medical Boards, such as Delaware don’t have one. http://dpr.delaware.gov/boards/medicalpractice/members.shtml

Medical Boards are divided regarding in-house Legal Staff. Oregon has in-house legal staff, but also relies upon a single Assistant Attorney General from the State Department of Justice   http://www.oregon.gov/OMB/Pages/index.aspx.

In Pennsylvania, all State Boards use the Office of General Council for legally related issues. http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/Medicine/Pages/default.aspx#.VOO-ZfZ0zIU.

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professor

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Assessment

Each State handles their Medical Board investigations differently. Some have in-house investigators. They may be ex-police officers, which are common, but they don’t have to be.

California’s Investigators are called “Peace Officers” and they aren’t typically ex-police http://www.mbc.ca.gov/

In North Dakota, the Board Members act as the investigative staff and will hire outside investigators if necessary https://www.ndbomex.org/

In Delaware, investigations are handled for all Boards by the Division of Professional Regulation http://dpr.delaware.gov/boards/medicalpractice/members.shtml.

About the Authors

Dr. Eric Dover is a board certified family practice and primary care physician in Portland, Oregon. He is a graduate of the University of California at Los Angeles [UCLA] School of Medicine.

Dr. Michael L. Langan graduated from Oregon Health Sciences University School of Medicine, Portland Oregon as a Medical Doctor 21 years ago. He had his residency training of Geriatric Medicine-Internal Medicine at Beth Israel Deaconess Medicine Center and Internal Medicine at St Vincent Hospital Medicine Center.

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Understanding the National Practitioner Data Bank (NPDB)

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What it Is – How it Works?

[By Eric A. Dover MD]

The NPDB, also known as the Data Bank, was written into HCQIA [Health Care Quality Indicators].  It is the national database for all physician reports.

Reporting Entities

Entities that are required to report physicians to this government program are:

  • Medical malpractice payers
  • State health care practitioner licensing and certification authorities
  • Hospitals
  • Other health care entities with formal peer review (HMOs, group practices, managed care organizations)
  • Professional societies with formal peer review
  • Federal and State Government agencies
  • Health insurance companies
  • The information collected by the NPDB includes:
  • Medical malpractice actions against a healthcare provider
  • Any adverse licensure actions by Medical Boards or peer review entities, including revocation, reprimand, censure, suspension, probation or dismissal or closure of any proceedings by reason of the practitioner surrendering the license or leaving the State or jurisdiction.
  • Adverse clinical privileging actions
  • Adverse professional society membership actions
  • Private accreditation organization negative actions or findings against health care practitioners
  • Criminal convictions that are health care-related
  • Exclusions from Federal or State health care programs
  • Entities that can query the NPDB include:
  • Hospitals, health care entities and professional societies with formal peer review
  • State health care practitioner licensing and certification authorities
  • Agencies or contractors administering Federal health care programs
  • State agencies administering State health care programs
  • State Medicaid Fraud Units
  • U.S. Comptroller General, U.S. Attorney General and other law enforcement
  • Self query by health care practitioner
  • Plaintiff’s attorney/pro se plaintiffs, but under limited circumstances
  • “Quality Improvement Organizations”
  • Researchers (statistical data only)
  • Federal and State Government agencies
  • Health plans
  • Researchers (Statistical data only)

Source: http://www.npdb.hrsa.gov/

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npdb

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Physician Reportage

Once a physician is reported to the NPDB, their career, if they still have one, is dramatically changed forever.  There is no expungement process to remove defamatory physician reports, whether true or not.  The stain is there forever.  You have the opportunity to write a rebuttal for what it’s worth.  Actions reported to the National Practitioner Data Bank by one entity will most likely trigger cross investigations and actions by other entities.

Source: http://www.drlaw.com/Articles/White-Paper—The-Targeting-of-Physicians—Insigh.aspx

Assessment

It is easy to extrapolate the simplicity of destroying a physician’s career, psyche and family with the untenable protections afforded by HCQIA to those responsible for the destruction.

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About

Dr. Eric Dover is a board certified family practice and primary care physician in Portland, Oregon. He is a graduate of the University of California at Los Angeles [UCLA] School of Medicine.

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The Impact of Medical Identity Theft on Health Care

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Health Plan Related Breaches Since 2009

By http://www.MCOL.com

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Conclusion

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Is there a Migration of Patients to Paper-Based Dentists?

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Paper Medical Records Become Popular Again?

[By Kellus Pruitt DDS]

1-darrellpruitt

Starting long ago, I warned that as more dental patients are notified of data breaches – some more than once – we are likely to witness an event mandate stakeholders said would never happen: A migration of patients to paper-based dentists.

Now, because of the rapidly escalating costs and liabilities, defiant, slow adopters of electronic dental records [EDRs] can not only expect to provide dental care at a lower cost than “paperless practices,” but patients are on course to learn that some dentists do not put their patients at risk of medical identity theft by putting identities on computers.

Just sit back and watch!

The Ponemon Institute

In February, the Ponemon Institute published  their “Fifth Annual Study on Medical Identity Theft.”

 “Consumers expect healthcare providers to be proactive in preventing and detecting medical identity theft. Although many respondents are not confident in the security practices of their healthcare provider, 79 percent of respondents say it is important for healthcare providers to ensure the privacy of their health records. Forty-eight percent say they would consider changing healthcare providers if their medical records were lost or stolen. If such a breach occurred, 40 percent say prompt notification by the organization responsible for safeguarding this information is important.”

The Paper-Gold Standard? 

So if your patients start asking you not to put their identities – including medical records – on your computers, what will you do, Doc?

Since encryption is a non-starter in dentistry for solid, business reasons, and will make paperless practices even less competitive with paper-based, would you consider employing staff which knows how to use pegboard, ledger cards and lots of carbon paper (The gold standard of security)?

Or, would you prefer not to give up computerization, yet keep your patients safe?

*** paper

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Assessment

De-identification of primary electronic dental records is sounding better all the time. Am I right? If patients’ identities are not available, they cannot be hacked.

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Socio Economic Status, Payment Reform and Medical Records

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Yet Another Component of the Medical Record?

[Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

Dr David E Marcinko MBAHistorically, medical records [paper or electronic] were previously used to aid in the quality of medical care.

Now they are also the basis for payment for services, not as a record or reflection of the care that was actually provided, but as a separate justification for billing. The lack of appropriate documentation now no longer threatens just non-payment for services but risks civil money penalties and criminal charges.

Enter S.E.S.

Today, the idea known as Socio Economic Status [SES] is conceptualized as the social standing, or class of an individual or group. It is often measured as a combination of education, income and occupation. Examinations of socioeconomic status often reveal inequities in access to medical resources, plus issues related to privilege, power and control.

Assessment

SES is increasingly being considered as another payment component [CPT® codes] to medical providers, as reflected in the paper medical record, EMR and elsewhere.

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eMRs

[Electronic Medical Records]

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Conclusion

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On Physicians Texting [SMS]

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Some Technical Considerations

By Carol Miller BSN RN MBA PMP [Miller Consulting]

Carol S. Miller

Text (SMS = Short Message Service) Messaging has become nearly ubiquitous on mobile devices. According to one survey, approximately 72 percent of mobile phone users send text messages (TMs).

Clinical medical care is not immune from the trend, and in fact physicians appear to be embracing texting on par with the general population. Another survey found that 73 percent of physicians text other physicians about work.

(Source:  Journal of AHIMA, “HIPAA Compliance for Clinician Texting”, by Adam Green, April 2012)

Advantages

Texting can offer providers numerous advantages for clinical care. It may be the fastest and most efficient means of sending information in a given situation, especially with factors such as background noise, spotty wireless network coverage, lack of access to a desktop or laptop, and a flood of e-mails clogging inboxes.

Further, texting is device neutral—it will work on personal or provider-supplied devices of all shapes and sizes. Because of these advantages, physicians may utilize texting to communicate clinical information, whether authorized to do so or not.

Risks

All forms of communication involve some level of risk. Text messaging merely represents a different set of risks that, like other communication technologies, needs to be managed appropriately to ensure both privacy and security of the information exchanged.

Text messages, like all digital data,  may reside on a mobile device indefinitely, where the information can be exposed to unauthorized third parties due to theft, loss, or recycling of the device. Text messages often can be accessed without any level of authentication, meaning that anyone who has access to the mobile phone may have access to all text messages on the device without the need to enter a password.

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AA9tsnE

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Texts also are generally not subject to central monitoring by the IT department. Although text messages communicated wirelessly are usually encrypted by the carrier, interception and decryption of such messages can be done with inexpensive equipment and freely available software (although a substantial level of sophistication is needed.

If text messages are used to make decisions about patient care, then they may be subject to the rights of access and amendment. There is a risk of noncompliance with the privacy rule if the covered entity cannot provide patients with access to or amend such text messages.

The Wireless Association

According to 2012 data from CTIA–The Wireless Association, U.S. citizens alone exchange nearly 200 billion text messages every month. So it’s not surprising that an increasing number of clinicians are using text messaging to exchange clinical information, along with a wide range of other modes — smartphones, pagers, computerized physician order entry, emails, etc. Electronic communication is certainly faster, can be more efficient, enhances clinical collaboration and enables clinicians to focus on patient care. But with these benefits comes an increased risk of security breaches.

(Source:  Clarifying the Confusion about HIPAA – Compliant Texting, by Megan Hardiman and Terry Edwards, May 2013)

Unfortunately, vendor hype about the Health Insurance Portability and Accountability Act [HIPAA] is causing many hospitals and health systems to implement stop-gap measures that address part — but not all — of a problem. To identify all vulnerabilities, health care leaders need to consider not only text messaging, but all mechanisms by which protected health information in electronic form is transmitted — as well as the security of those mechanisms.

Mobile device-to-mobile device SMS text messages are generally not secure because they lack encryption.  The sender does not know with certainty that his or her message is indeed received by the intended recipient.  In addition, telecommunications vendor/wireless carrier may store the text messages.

Recent HHS guidance indicates text messaging, as a means of communicating PHI, can be permissible under HIPAA depending in large part on the adequacy of the controls used.  A hospital or provider may be approved for texting after performing a risk analysis or implementing a third-party messaging solution that incorporates measures to establish a secure communication platform that will allow texting on approved mobile devices.

***

AA9tvIj

***

The Ponemon Institute

A study reported in Computer World in May 2013 by the Ponemon Institute with 577 healthcare and It professional in facilities that ranged from fewer than 100 beds to over 500 beds stated that fifty-one percent of the respondents felt HIPAA compliance requirements can be a barrier to providing effective patient care.

Specifically HIPAA reduces time available for patient care (85% of the respondents), makes access to electronic patient information difficult (79% of the respondents) and restricts the use of electronic mobile communications (56% of the respondents).

The study stated “respondents agreed that the deficient communications tools currently in use decrease productivity and limit the time doctors have to spend with patients. “ They also stated “they recognized the value of implementing smartphones, text messaging and other modern forms of communications, but cited overly restrictive security policies as a primary reason why these technologies were not used.”

Clinicians in the survey stated that only 45% of each workday is spent with patients; the remaining 55% is spent communicating and collaborating with other clinicians and using the electronic medical record and other clinical IT systems.

Several other statements made were:

  • Because of the need for security, hospitals and other healthcare organizations continue to use older, outdate technology such as pagers, email and facsimile machines. The use of older technology can also delay patient discharges – now taking an average of 102 minutes.
  • The Ponemon Institute estimated that the lengthy discharge process costs the U.S. hospital industry more than $3.189 billion a year in lost revenue, with another $5 billion lost through decrease doctor productivity and use of outdated technology. Secure text messaging could cut discharge time by 50 minutes.

(Source:  Computer World, “HIPAA rules, outdate tech cost U.S. hospitals $3.38 B a year”, by Lucas Mearian, May, 2013)

***

smart phone mobile ME-P

***

Assessment

Several suggestions offered for these preferred mobile devises are:  1) ensure encryption and access to individuals who need to have access; 2) use secure texting applications; and 3) even consider alerting employees with warnings before they send an email or share files that lets them know they are liable for the information sent

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ABOUT CAROL MILLER; BSN, MBA, PMP millerconsultgroup@gmail.com ACT IAC Executive Committee Vice Chairwoman at-Large HIMSS NCA Board Member [President – Miller Consulting Group] Phone: 703-407-4704 and Fax: 703-790-3257

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.

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PARTICIPATE: An Observational Research Study

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 By Patti Peeples; RPh PhD of HealthEconomics.com

SOAR

The results of this Survey will be distributed in a report to all participants in the HealthEconomics.com Newsletter, and ultimately presented in manuscript form.
Your participation is encouraged and should take no more than 15 minutes to complete.

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The Survey

In collaboration with HealthEconomics.Com, Jeff Trotter of Continuum Clinical is resuming the widely-praised series of Surveys with this all-new edition focused, once again, on the critical subject of Observational Research.

This thought-provoking Survey strives to uncover challenges associated with the design and implementation of Observational Studies, and the important organizational challenges and opportunities.

  • Who should “drive the bus” in running Observational Studies?
  • How conclusive are findings from Observational Studies?
  • What processes are optimal in support of Observational Research?

Your participation will help provide critical insights regarding this important topic, increasing clarity and shared understanding.

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Mobile-Health or Global Economy?

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Boom or Bust?

Edward Bukstel

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mHealth or Global Economy, Boom or Bust?

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mobile EHR health

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UNDERSTANDING SPOUSAL DEBT

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For Doctors and Other Couples

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The general rule is that spouses are not responsible for each other’s debts, but there are exceptions.

Many states will hold both spouses responsible for a debt incurred by one spouse if the debt constituted a family expense (e.g., child care or groceries).

In addition, community property states will hold one spouse responsible for the other’s debts because both spouses have equal rights to each other’s income.

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couple

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Assessment

Also, you are both responsible for any debt that you have in both names (e.g., mortgage, home equity loan, credit card).

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Un-Insured Adults in the USA

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Fall 2014

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un insured

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A Medicare Fraud 2.0 Prediction

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More on Healthcare Fraud and Abuse with Video

Edward Bukstel

 By Edward Bukstel

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Medicare Fraud 2.0 Prediction.

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fraud

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On Digital Health Investments

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258 Digital Health companies raised over $2 million in Venture Capital in 2014

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Edward Bukstel

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$4.1 Billion in Digital Health Investments in 258 Digital Health Investments 2014.

***

business

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Disease Management and Preventative Health Savings?

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Health Data Breaches Multiplying

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YET – Fines Remain Rare

By Charles Ornstein @charlesornstein

[ProPublica]

Federal health watchdogs say they are cracking down on organizations that don’t protect the privacy and security of patient records, but data suggests otherwise.

***

Fines Remain Rare Even As Health Data Breaches Multiply

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data

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SUBSTANCE ABUSE AND IMPAIRED PHYSICIANS

On Physician Health Programs [Help or Hindrance?]

[By Eric A. Dover MD]

Approximately 10-12% of physicians will develop a drug or alcohol problem at some point during their career. If physicians are impaired, they should be able to seek help from a firm but supportive and fair resource—one that demands sobriety and can determine when physicians are safe to practice.

About PHPs

Physicians with substance use disorders often seek the assistance of a state physician health program (PHP). Some physicians engage willingly with PHPs, but most are compelled to do so either by their hospital or their board of medicine.  PHPs meet with, assess, and monitor physicians who have been referred to them for substance use or other mental and behavioral health problems.

In most states, physicians who comply with any and all demands of the PHP often may continue to work, provided their sobriety is ensured through drug testing and other means. Many state boards of medicine rely completely on the PHPs for guidance about how to deal with impaired physicians.  PHPs are therefore extremely powerful.

The Problem

The problem with PHPs, though, is that despite their enormous power, they are generally barely known to most physicians and often operate with little oversight and no real means of appealing their recommendations.

To compound matters, evaluation/treatment centers and PHPs are often financially dependent on one another: Centers depend on referrals from PHPs for their viability and, reciprocally, PHP regional and national meetings are often heavily sponsored by these centers.

***

Stress

***

Largely Unknown Practices

Because PHP practices are largely unknown to physicians until they themselves are referred to one, physicians who do register complaints about standard PHP practice are often dismissed as bellyaching. But, some voices of concern have been heard.

For example, several years ago, a paper was published in the Journal of Addiction Medicine outlining concerns about standard PHP practice, which included the points raised above; along with others.

More recently, a group of North Carolina physicians complained about their state PHP to the state auditor. The auditor conducted an investigation and found poor oversight of the PHP by both the state medical society and the board of medicine, a lack of due process for physicians who disputed the PHP’s evaluations and/or recommendations, and multiple instances of potential conflicts of interest.

And so, some authorities suggest a national federation of PHPs to implement national standards for its members and commence routine audits of its members.

Assessment

Doctors who are unsafe to practice medicine ought to be prevented from doing so, but every doctor who enters any kind of treatment or monitoring program should be treated respectfully, and fairly, monitored appropriately, and have legitimate avenues of appealing decisions about their care.

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ABOUT

Dr. Eric Dover is a board certified family practice and primary care physician in Portland, Oregon. He is a graduate of the University of California at Los Angeles [UCLA] School of Medicine.

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Investing in State Health Innovation Plans [SHIPs]

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SHIPS

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The Financial Value of Maternity Management

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Doctor Suicide and Physician Health Programs

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The Elephant in the Room

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A SPECIAL ME-P REPORT

The Elephant in the Room: Physician Suicide and Physician Health Programs

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Physician

[Courtesy SplitShire]

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Top Ten Most Innovative Healthcare Companies of 2015

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World Class Innovation

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 ***Start-Ups***

THE LIST

  1. APRICOT FOREST: For seeking a cure to what ails Chinese health care
  2. PERFINT HEALTHCARE: For attacking cancer with robotics
  3. OMADA HEALTH: For improving health through coaching
  4. ELMINDA: For changing the way we see our brains
  5. CARDIOMEMS: For reducing heart failure hospitalizations
  6. ORGANOVO: For getting one step closer to human drug trials—without harming actual humans
  7. THERANOS: For introducing a better blood test
  8. GOOGLE: For developing the next generation of health monitors
  9. ZENEFITS: For helping small businesses provide health insurance
  10. COHEALO: For bringing the sharing economy to the surgery room

Source: Fast Company, February 9, 2015 

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Why Healthcare is F@#Ked !

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Edward Bukstel

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What I Learned at The Wharton School of Business and Why Healthcare is F@#Ked !

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Business%20Optimization

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Google Wants to Replace your Brain

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Edward Bukstel

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ME-P SPECIAL REPORT

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Seeking Peer Reviewers for New Medical Risk Management Text Book

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RISK MANAGEMENT, LIABILITY INSURANCE, AND ASSET PROTECTION STRATEGIES FOR DOCTOR AND ADVISORS

[Best Practices from Leading Consultants and Certified Medical Planners™]

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Skills Needed

If you are a physician, nurse, accountant, attorney, medical risk manager or healthcare executive, we need you.

Form below or contact us for details to peer-review, etc. MarcinkoAdvisors@msn.com

Assessment

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The Economic “American Dream”

On Income Earners

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Understanding the Top 50 Percent

[By Anonymous Reader]

QUESTION: How much do you need to make to be in the top 50 percent of earners?

ANSWER: Just $36,055. Fall below that level and you are in the bottom half, along with about 68 million of your fellow taxpayers. All told, that group earned just 11.1 percent of the AGI reported on 2012 Federal returns.

Half of all taxpayers earn less than $35,055

If the top one percent where the decision makers live were to quit squeezing so hard, the rest of the population might be subject to paying more taxes.

The problem with the American Dream sold to the masses is that it is not achievable for them. Yet, they keep on voting for it. The biggest problem with voters is they do not have a solid grounding in economics.

Thus, they cannot judge economic policy in any rational way. If the voting public voted for what was truly in their interest, the top one percent would see their influence wane rapidly. It is the height of insanity that the public keeps on voting for politicians who espouse policies that are designed to benefit the economic elite.

***

Tax

***

Note: A recent finding by Oxfam that the top one percent will control fifty percent of the worlds’ wealth by 2016.

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Hospital Data Does NOT Equal Community Health

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Edward Bukstel[By Edward Bukstel]

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Hospital Data does not Equal Community Health.

***

eHR diagram

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The Social Media Shakeup in Healthcare

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An Info-Graphic

By Matthew Smith [CDW]

Patients are increasingly turning to social media channels to seek health information and become more informed about their care, rate the quality of care they receive from providers, and communicate with their peers regarding health advice.

For their part, physicians are seeing increased value in social media for their own research discussions with colleagues — utilizing it to become more informed on patient care resources and for career development and networking.

Social media is slowly starting to foster meaningful results in the healthcare industry. This infographic from CDW Community IT claims social media enables:

  • Better knowledge of health conditions
  • Increased dialogue
  • Connected support
  • Improved patient engagement

Doctors and hospitals alike are tapping into social media. Consider these stats:

  • 87 percent of physicians ages 26 to 55 use social media.
  • 65 percent of physicians ages 56 to 75 are interacting online.
  • In 2012, four in five (79 percent) of hospitals were using social media. That number increased to 91 percent in 2013.

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[To view a full-size version of the infographic, please click here and then click the image when it opens]

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Understanding MD Employee Accident and Health Benefits

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Tax-free benefits provided to employees

[By Perry D’alessio CPA]

perry-dalessio-cpaMore and more physicians are employees; not employers.

So, here are the most common types of tax-free benefits provided to employees.

They include payments for health care insurance, payment to a fund that provides accident and health benefit directly to the employee, company direct reimbursements for employee medical expenses and contributions to an Archer MSA (medical savings account).

The IRS definition of employee, for health care benefit purposes, is very broad

Health benefits are exempt from income, FICA and FUTA (Federal Unemployment Tax).    This saves the employer 7.65% that would otherwise be the “matching” 6.2% Social Security tax and the 1.45% Medicare Tax components due if these were true wages.  The employer also saves the 0.8% FUTA tax, but since FUTA taxes only the first $7,000 of calendar year wages, per employee, this usually doesn’t factor in.

Calculation:

If you pay the full state unemployment tax, then your FUTA tax = Gross Salary * .08% – The maximum amount is $56 per employee:

  • $50,000 Salary = ($7,000)*(.8%) = $56.00
  • $5,000 Salary = ($5,000)*(.8%) = $40.00

The hospital employee saves federal income taxes on health benefits received, at their marginal tax rate, and, their components of FICA taxes. Depending on the coverage provided, these plans, when fully funded by the employer, can save the employee thousands of dollars in taxes each year.

IRS restrictions include:

  • Certain payments to S Corporation employees who are 2% shareholders are subject to FICA taxes.
  • Certain long term care benefits.
  • Certain payments for highly compensated employees.

Example 1: Let’s say the annual cost of providing medical coverage for an employee, age 50, with a spouse and two minor children is $7,500. An employee in the 30% tax bracket who received this amount in cash each year and then paid for his or her own medical coverage would be liable for as much as $2,250 in income taxes. In addition, FICA taxes save another 7.65% or $574, for a total savings to the employee of $2,824. The employer saves $574 in FICA taxes.

Benefits

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On “Best-in-Class” Independent / Provider Sponsored Health Plans

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February 2015 Edition of Plan Management

DS

[By Douglas B. Sherlock CFA] Sherlock@sherlockco.com

Please find attached, the February 2015 Edition of Plan Management Navigator.

In this issue, we highlight characteristics among Independent/Provider-Sponsored plans in the lowest 25th percentile in costs, which we consider Best-in-Class health plans. We found that Best-in-Class plans operated with administrative costs that were lower by $10.99 PMPM, excluding Sales and Marketing and Medical Management.

A lower Staffing Ratio was mainly responsible for low costs, while low Staffing Costs also contributed. Non-Labor Costs, however, were actually higher in the Best-in-Class plans. Almost every functional area was lower for the Best-in-Class plans with IS, Claims, and Corporate Services most responsible for overall low costs.  Finance and Accounting was the exception in that its costs were higher.

The Analysis

To perform this analysis, we endeavor to quantify and eliminate the effect of factors largely beyond management control. We then isolate and measure the specific contributing factors that are more susceptible to management.

In addition, we are building the universes for the Sherlock Benchmarks. For the Independent/Provider-Sponsored universe we have 23 plans committed to participate in this year’s study. This is up by 44% from last year and collectively, the committed plans serve 10.5 million people with comprehensive products.

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conference

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Participation Solicitation

We are meeting to finalize the survey form in about one month, will distribute the survey forms in late March, collect the completed surveys in May and publish results beginning in July. Participation entails notable efforts on your part since useful outputs require relatively granular inputs. However, the cost is relatively modest.

Link: Navigator – February 2015

Assessment

Please contact me if you are interested in participating. You will be among good company.

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No More 10 and 90 Day Global Periods

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New Changes on the [CMS Payment Reform] Horizon
[By Dreama Sloan-Kelly MD CCS]

thDid you hear about the changes that are coming down the pike in regards to global services when billing for surgical procedures — be they in the office, in an ambulatory surgical center, or in the hospital?

CMS released their final 2015 Medicare Physician Fee Schedule (MPFS) ruling late last year. Embedded in this document was a proposal by CMS to get rid of both the 10 day and 90 day global periods! In fact, they want to do away with global period billing all together and have all procedures paid based on the work required to do the procedure itself — thereby billing for all post-surgical visits separately using E/M codes.

According to the final ruling, CMS proposes to transform all 10 day global services to ZERO global days starting in 2017. They will do the same in regards to 90 day global services starting in 2018. And, according to the U.S. Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) they have “identified a number of surgical procedures that include more visits in the global period than are being furnished”. They go on to say that they are “also concerned that post-surgical visits are valued higher than visits that were furnished and billed separately by other physicians such as general internists or family physicians”. Based on the final ruling, they plan to begin the transition as previously stated in 2017 after they have considered all comments.

The ruling goes on to state, “as the agency begins revaluation of services as 0-day global periods, we will actively assess whether there is a better construction of a bundled payment for surgical services that incentivizes care coordination and care redesign across an episode of care”. So let’s talk reality and my take on this change.

Over the past few weeks I have read a lot of articles on this subject from various pundits in the industry — they are actually arguing that this change will mean increased reimbursement when you combine the separate payment for the procedure itself along with the visit by visit billing for the post-surgical follow up care when compared to the current reimbursement rate.

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Personally, I think they are all wrong for the following reasons:

Procedure Reimbursement Amount: This is the wild card. They are going to use the same RVU system that has always been used to calculate payment — but I guarantee you the payment for the procedure will not be anywhere near the reimbursement for the global package. I think the closest we could get to estimating the reimbursement rate of the procedure is to figure out what the current surgical care only rate would be (ie. as if you appended Modifier 54 to the procedure code). Beware that this rate would still encompass the pre-surgical evaluation — which I am assuming would be carved out since that is a part of the current global package they are trying to phase out.

Post Op Visits: Getting a patient to comply with medical visits is hard enough — now adding in the fact they would have to pay a copay each time — most often a specialty co-pay is going to make it even harder. Patient’s understand their follow up visits are currently covered in the cost for the surgery, and hence they tend to show up to these visits knowing they do not have any out of pocket expenses. If the proposed change comes to fruition many of the post-surgical visits may become cost prohibitive for a lot of patients and actually lead to a decrease in the number of follow up visits the patient actually schedules. Once the patient starts to feel better their motivation to return dwindles.

Lower Reimbursement Rate for Post-Surgical Visits: It is clearly stated in the CMS ruling that it is felt the post-surgical follow up care visits are paid at a higher rate than what a regular E/M visit would be paid for had the patient been seen by a primary care provider or an internist. That simple statement confirms to me that when the new procedure rate is combined with the individual visit payment rate, the overall reimbursement rate will be less than what is currently being paid.

So, how do you prepare?

First, stay on top of all bulletins coming from CMS in regards to this issue. Most of your medical societies and/or specialty societies have taken clear positions in regards to this matter — so be sure to stay in the loop and become a part of the process.

Run a report that allows you to pinpoint the average number of post-surgical follow up visits for your most billed procedures. This will give you an idea of the average number of follow up visits for particular procedures you know you will bill for if this transition does occur. Does this mean this number will be exact — NO — I would factor in a decrease of 15-20% for visits across the board based on the dynamics I previously described.

Lastly, begin creating a policy in regards to post-surgical follow up care that can act as an education tool for the patient, teaching them the important benefits of being compliant with their post-surgical care schedule and also warning them about the possible increase in out of pocket cost. Being transparent can go a long way into easing patient’s fear and encouraging their follow through.

As always I have included documentation for your library of information — you can find the CMS 2015 MPFS final ruling fact sheet HERE! I also created a brief video presentation on this hot topic HERE

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2015 Medicare Part D [What it is = How it works]?

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Update on the Medicare prescription drug benefit program

[By Staff Reporters]

Part D

Medicare Part D, also called the Medicare prescription drug benefit, is a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries. It was enacted as part of the Medicare Modernization Act of 2003 (which also made changes to the public Part C Medicare health plan program) and went into effect on January 1, 2006.

Medicare Part D Premiums

The monthly Medicare Part D base premium is set to pay 25.5 percent of the cost of standard coverage, established by bids submitted annually by Part D plans. CMS releases the Medicare Part D base premium in early August each year. Actual premiums are based on this set premium, but can vary greatly. The premium for 2014 was $32.42.

As of 2011, beneficiaries with higher incomes must pay a premium adjustment based on their income. This premium adjustment is called the Income-Related Monthly Adjustment Amount (IRMAA), and is paid directly to the Federal government (deducted from Social Security, Railroad Retirement Board, or Office of Personnel Management benefits).

Medicare Part D Deductible

The annual deductible for the standard Medicare Part D benefit was $310 in 2014, which is a decrease of $10 from the 2013 deductible. No Medicare drug plan may have a deductible more than $310 in 2014, although some plans may have a lower deductible or no deductible at all.

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CMS Part D 2015 Standard Benefit Model Plan Details

Here are the highlights for the CMS defined Standard Benefit Plan changes from 2014 to 2015. The chart below shows the Standard Benefit design changes for plan years 2011, 2012, 2013, 2014 and 2015. This “Standard Benefit Plan” is the minimum allowable plan to be offered.

  • Initial Deductible: will be increased by $10 to $320 in 2015
  • Initial Coverage Limit: will increase from $2,850 in 2014 to $2,960 in 2015
  • Out-of-Pocket Threshold: will increase from $4,550 in 2014 to $4,700 in 2015
  • Coverage Gap (donut hole): begins once you reach your Medicare Part D plan’s initial coverage limit ($2,960 in 2015) and ends when you spend a total of $4,700 in 2015. In 2015, Part D enrollees will receive a 55% discount on the total cost of their brand-name drugs purchased while in the donut hole. The 50% discount paid by the brand-name drug manufacturer will still apply to getting out of the donut hole, however the additional 5% paid by your Medicare Part D plan will not count toward your TrOOP. Enrollees will pay a maximum of 65% co-pay on generic drugs purchased while in the coverage gap.
  • Minimum Cost-sharing in the Catastrophic Coverage Portion of the Benefit**: will increase to greater of 5% or $2.65 for generic or preferred drug that is a multi-source drug and the greater of 5% or $6.60 for all other drugs in 2015
  • Maximum Co-payments below the Out-of-Pocket Threshold for certain Low Income Full Subsidy Eligible Enrollees: will increase to $2.65 for generic or preferred drug that is a multi-source drug and $6.60 for all other drugs in 2015.

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Medicare Part D Benefit Parameters for Defined Standard Benefit 2011 through 2015 Comparison
Part D Standard Benefit Design Parameters: 2015 2014 2013 2012 2011
Deductible – (after the Deductible is met, Beneficiary pays 25% of covered costs up to total prescription costs meeting the Initial Coverage Limit. $320 $310 $325 $320 $310
Initial Coverage Limit – Coverage Gap (Donut Hole) begins at this point. (The Beneficiary pays 100% of their prescription costs up to the Out-of-Pocket Threshold) $2,960 $2,850 $2,970 $2,930 $2,840
Total Covered Part D Drug Out-of-Pocket Spending including the Coverage Gap – Catastrophic Coverage starts after this point. See note (1) below. $6,680.00 (1) $6,455.00 (1) $6,733.75 (1) $6,657.50 (1) $6,447.50 (1)
Out-of-Pocket Threshold – This is the Total Out-of-Pocket Costs including the Donut Hole. 2015 Example:    $320 (Deductible) +(($2960-$320)*25%) (Initial Coverage) +(($6680.00-$2960)*100%) (Cov. Gap) = $4,700 (Maximum Out-Of-Pocket Cost prior to Catastrophic Coverage – excluding plan premium) $4,700 $320.00 $660.00 $3,720.00 $4,700.00 $4,550 $310.00 $635.00 $3,605.00 $4,550.00 $4,750 $325.00 $661.25 $3,763.75 $4,750.00 $4,700 $320.00 $652.50 $3,727.50 $4,700.00 $4,550 $310.00 $632.50 $3,607.50 $4,550.00
Total Estimated Covered Part D Drug Out-of-Pocket Spending including the Coverage Gap Discount (NON-LIS) See note (2). $7,061.76 plus a 55% brand discount $6,690.77 plus a 52.50% brand discount $6,954.52 plus a 52.50% brand discount $6,730.39 plus a 50% brand discount $6,483.72 plus a 50% brand discount
Catastrophic Coverage Benefit:
   Generic/Preferred    Multi-Source Drug (3) $2.65 (3) $2.55 (3) $2.65 (3) $2.60 (3) $2.50 (3)
    Other Drugs (3) $6.60 (3) $6.35 (3) $6.60 (3) $6.50 (3) $6.30 (3)
Part D Full Benefit Dual Eligible (FBDE) Parameters: 2015 2014 2013 2012 2011
   Deductible $0.00 $0.00 $0.00 $0.00 $0.00
   Copayments for    Institutionalized    Beneficiaries $0.00 $0.00 $0.00 $0.00 $0.00
Maximum Copayments for Non-Institutionalized Beneficiaries
    Up to or at 100% FPL:
        Up to Out-of-Pocket Threshold
      Generic/Preferred       Multi-Source Drug $1.20 $1.20 $1.15 $1.10 $1.10
      Other $3.60 $3.60 $3.50 $3.30 $3.30
     Above Out-of-Pocket      Threshold $0.00 $0.00 $0.00 $0.00 $0.00
    Over 100% FPL:
        Up to Out-of-Pocket Threshold
      Generic/Preferred       Multi-Source Drug $2.65 $2.55 $2.65 $2.60 $2.50
      Other $6.60 $6.35 $6.60 $6.50 $6.30
     Above Out-of-Pocket      Threshold $0.00 $0.00 $0.00 $0.00 $0.00
Part D Full Subsidy – Non Full Benefit Dual Eligible Full Subsidy Parameters: 2015 2014 2013 2012 2011
Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $8,580 (individuals) or < $13,620 (couples) (4)
   Deductible $0.00 $0.00 $0.00 $0.00 $0.00
    Maximum Copayments up to Out-of-Pocket Threshold
      Generic/Preferred       Multi-Source Drug $2.65 $2.55 $2.65 $2.60 $2.50
      Other $6.60 $6.35 $6.60 $6.50 $6.30
   Maximum Copay above    Out-of-Pocket    Threshold $0.00 $0.00 $0.00 $0.00 $0.00
Partial Subsidy Parameters: 2015 2014 2013 2012 2011
Applied and income below 150% FPL and resources between $8,581-$13,300 (individuals) or $13,621-$26,580 (couples) (category code 4) (4)
   Deductible $66.00 $63.00 $66.00 $65.00 $63.00
   Coinsurance up to    Out-of-Pocket    Threshold 15% 15% 15% 15% 15%
    Maximum Copayments above Out-of-Pocket Threshold
      Generic/Preferred       Multi-Source Drug $2.65 $2.55 $2.65 $2.60 $2.50
      Other $6.60 $6.35 $6.60 $6.50 $6.30

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(1) Total Covered Part D Spending at Out-of-Pocket Threshold for Non-Applicable Beneficiaries – Beneficiaries who ARE entitled to an income-related subsidy under section 1860D-14(a) (LIS)

(2) Total Covered Part D Spending at Out-of-Pocket Threshold for Applicable Beneficiaries – Beneficiaries who are NOT entitled to an income-related subsidy under section 1860D-14(a) (NON-LIS) and do receive the coverage gap discount. For 2015, the weighted gap coinsurance factor is 90.693%. This is based on the 2013 PDEs (85.9% Brands & 14.1% Generics)
(3) The Catastrophic Coverage is the greater of 5% or the values shown in the chart above. In 2015, beneficiaries would be charged $2.60 for those generic or preferred multisource drugs with a retail price under $52 and 5% for those with a retail price greater than $52. As to Brand drugs, beneficiaries would pay $6.60 for those drugs with a retail price under $132 and 5% for those with a retail price over $132.
(4) The actual amount of resources allowable may be updated for contract year 2015.

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 Medicare and Medicaid drug capsules

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“Vesalius on the Verge”

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The Book and the Body

[By Dr. David Edward Marcinko MBA]

DEM blue

“Vesalius on the Verge: The Book and the Body” explores the groundbreaking work of 16th century professor and physician Andreas Vesalius, who changed the way that human anatomy was taught forever with “De humani corporis fabrica (On the fabric of the human body)”.

The book did two things not seen before: it corrected errors in the conception of the human body that existed for over a millennia, and it combined text with artistic illustration, which enabled interactive learning.

Where else can you see a first edition of the 1543 published text, a desiccated body juxtaposed with a full skeleton, and a contemporary recreation of Vesalius’ dissection table?

Plan your visit today! #muttermuseum #vesalius #anatomy #medicine #rarebooks” By muttermuseum on Instagram

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anatomy

Source: tumblr_inline_nhs0feL7wW1qzgziy

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Assessment:

I went to medical school in Philadelphia PA, and visited the Mutter Museum many times. If you’ve never been there – I urge you to check it out!

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Dentists for De-Identification

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A Start-Up Idea

[By Darrell K. Pruitt DDS]

1-darrellpruittAn early, shoestring proposal for a non-profit dedicated to common sense security solutions.

Why? if patients’ identities are unavailable, they cannot be hacked.

Recently, I’ve considered starting a non-profit dedicated to keeping patients’ identities off of dentists’ computers where they are far too easily fumbled thousands at a time. I think I might call it “Dentists for De-identification.” What do you think?

My son Ryan and I have discussed putting together an educational YouTube cartoon – comparing the cost, convenience and security of encrypted Protected Health Information (PHI), to storing PHI, including medical information, only on paper in bulky metal filing cabinets – leaving only nameless, unencrypted dental records on the computer. De-identification is the “other” HIPAA Safe Harbor, meaning if patients’ de-identified dental information is stolen or hacked, nobody has to be notified. And, since the patients’ nameless dental records remain unencrypted, de-ID should not slow down work flow like encryption does.

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eHRs

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One could call employing in-house reference numbers to re-connect patients’ digital dental information to paper-based PHI a hybrid solution to an otherwise intractable security problem. The solution is nothing new, and has a long history of success. For decades, police departments have been substituting in-house reference numbers for citizens’ names to protect the owners. I see no reason it cannot work for dental radiographs as well.

Depending on staff’s familiarity with the alphabet, pulling a patient’s thin paper record from a loud filing cabinet might even take less time than correctly typing in an encryption key (on the first try). What’s more, since there is a limit to the number of patients even the fastest dentists can treat in one day, 4000 or so active patients per dentist is a reasonable estimate of the number of records in a  busy dental practice – which is probably one third of the records in the average physician’s practice. Since the dental information remains digital and only a couple of sheets of paper are needed to reveal the patients’ reference number along with a brief medical history, very little filing space should be needed.

The problems with encryption don’t end with correctly entering the key. Once permitted access to encrypted ePHI, it will take much more time to de-crypt one radiograph than it takes to open a manila folder. Depending on the number of radiographs and other digital images – including complex cone-beam radiographs – a patients’ encrypted diagnostic history could require several minutes to view.

I would want to witness the De-ID non-profit professionally investigate whether de-identification indeed offers a cheaper and more secure solution to data breaches from dental offices. I think we all know by now that full disk encryption will never be the answer.

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Medical Charts

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Assessment 

Still too soon? Give it time. The FBI assures us that more massive data breaches are just around the corner.

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Publishing Impact of the ME-P Website

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Who needs it … What for?

[By Ann Miller RN MHA]

microBlog

What’s the point of publishing your essays, thoughts, comments and articles on this ME-P?

Today, many physicians, FAs and health economic experts still don’t have the potential to express themselves to a large audience. By adding articles to their own blogs, with poor attendance, they deprive a wide audience of the opportunity to familiarize themselves with their works.

That’s why material from our ME-P website is available to all English-speaking inhabitants of the world. Some website owners even visit our web portal to pick up or re-post the best articles to place on their own websites.

Why publish with the ME-P?

All this is interesting, but what is the use of the website to an author? So, here is what you get by publishing with us:

• A unique method of promoting your website, self, financial advisory or medical practice; or ideas. If your essay is really interesting – many others will want to read our related books, white-papers and texts; so you will become well-known among our readers.

• The content of our website is automatically placed on other main web sources via RSS feeds. By this you can attract a wide range of readers – and with little effort. The readers will get acquainted with your thoughts, articles and the personal data you share in your included profile.

• Our website is a great launching pad for new doctors, starting academics, medical practitioners, FAs, CPAs, health economists and fledgling writers. By publishing your articles here, you will be able to raise your prestige among colleagues and ME-P readers.

• You may use any free articles from our website to fulfill your own web project (you must add a link to our original material) via RSS feeds. The probability that someone will be interested in you is increased many times.

• Everyday our website is visited by many people, and their numbers are growing constantly. By adding articles the number of your readers will grow in geometric sequence.

• Once placed on the ME-P, your essay will stay on our website [almost] forever. All published materials [probably] will not be deleted with the lapse of time. This means that many years later – your articles will be still available to everyone.

Assessment

The number of ME-P subscribers and regular visitors is growing rapidly. And, the traffic to our authors’ web sources are growing too. Join us – we welcome all authors who are willing to cooperate with our vision and mission!

Channel Surfing the ME-P

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. It is fast, free and secure.

Conclusion

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

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

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