The Americans with Disabilities Act and Deaf Patients

Interpreting … the Interpreter

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QUERY:

I understand that as doctors we need to accommodate the disabled and follow the ADA of 1990. In the case of hearing-impaired patients, it is our cost to have an interpreter present.

But, for example, is the doctor able to dictate what interpreter will be used or does the patient decide who will be interpreting? As far as the charge for the services of the interpreter, how is the appropriate fee set?

It takes about twenty minutes for us to see a hearing-impaired patient. We are told from the interpreting service that it is their policy to charge us for a minimum of two hours.

Any thoughts?

Assessment

Link:  http://www.ada.gov/pubs/ada.htm

Conclusion

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An Integrated Approach to Healthcare Network Alignment and Scalable Innovation‏

More on Healthcare Network Design and Automation

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[Part 5 in a 6 part series]

By Sam Muppalla – Vice President, McKesson Health Solutions Network Performance Management

Previously, on this ME-P, I wrote about the barriers to alignment across product, network, care and reimbursement innovations. And, yes, I teased you with the three-word preview of what was to come this week: Integrated Building Blocks. The idea of building blocks lies at the heart of an approach to achieving alignment and scaling innovation, so let’s dive in.

Unlocking potential administrative, IT and medical savings — while also creating sustainable alignment of the innovation engines — requires various building blocks be in place as a sound foundation for network design and implementation. These building blocks deliver the required functionality in the most efficient manner. When these building blocks are utilized in an integrated fashion, the current barriers are removed and innovation alignment is achieved.

Four Essential Building Blocks

There are four essential network design automation building blocks that comprise the foundation for innovation: networks, contracting, reimbursement and engagement.

Each of these building blocks enables capabilities by delivering necessary functionality within and across the spectrum of network design. Reaching levels of maturity with this capability unlocks additional value and alignment.

Networks

The network building block enables health plans to differentiate and compete. The purpose is to differentiate their value for each customer segment by aligning the product and care model designs with the underlying network designs. It ensures network performance by facilitating the selection of appropriate providers into networks and the alignment of provider reimbursement with network design objectives. It enables networks to be mapped to member-facing and provider-facing products. The provider-facing products can be used for contracting and provider rate differentiation. The member-facing products can be aligned with benefits and serve as steerage targets for benefit designers.

These constructs, in conjunction with each other, enable productization of care model and payment innovation. For example, a health plan could define a “Medical Home Network” that consists of medical homes and supporting providers in a given geography. It could then enable PCMH-specific reimbursement (e.g., PMPM capitation + Fee For Services (FFS) for preventive services + P4P for EBM) by defining a provider-facing product and associating specific reimbursement policies with that provider product. Additionally, it could also define a member-facing product (e.g., PPO Value) which combines the medical home network with the general market PPO network. This in turn will allow the health plan to define a benefit extension which gives a 10 percent premium reduction to members who use Medical Home Network providers for their primary care. In short, a health plan is now able to monetize its care innovation (PCMH), align benefit design to network design for steerage, and align its provider payment with member incentives (around preventive services), while incenting higher quality care (P4P).

The network building block also achieves administrative cost leadership through comprehensive provider data governance and automation of core provider processes.

Contracting

The contracting building block is designed to enable health plans to reduce contract administrative costs while increasing provider payment accuracy. It optimizes the management of the provider contracting lifecycle through the automation of contract authoring, offering negotiating and acceptance while ensuring the standardization of terms and policies. This building block achieves reduced medical expenditure driven by contract standards adherence, reduced claims mis-payments, and increased speed to market for new payment innovations. It also can support rules-based enforcement of network level reimbursement guidelines to ensure consistent network performance.

Reimbursement

The reimbursement building block enables health plans to maximize the effectiveness of their medical expenditures by paying for value versus volume and by incenting team-based performance. It is the single source of truth for all forms of reimbursement including traditional claims pricing, episodes of care, shared savings, capitation and P4P. This building block enables the mixing and matching of reimbursement methodologies to incent optimal provider performance. It supports a modeling engine to analyze the financial impact of reimbursement and contract changes. It incorporates network-aware provider/contract selection for claims pricing intake. This is a rules driven, high performance service that leverages provider relationship information to select the right provider, the right governing contract and the right reimbursement model for each incoming claim. Additionally, it includes provider transparency services that enable health plan provider portals to support online pricing lookups and reimbursement status/detail inquiries for providers. These services can be extended to support provider performance scorecards and benchmarks.

Engagement

The engagement building block is designed to increase collaboration and participation. It enables meaningful engagement among health plans, providers and members in order to improve health outcomes and reduce costs. This building block achieves reduced administrative and service costs, increased member participation and adherence, increased provider satisfaction and adoption of care/payment initiatives, and the enablement of collaborative/integrated care delivery models such as PCMH and ACO.

Utilizing flexible, automated and integrated building block capabilities is the key to sustainable success that not only unlocks the promise of affordable care to customer segments but also delivers on reduced administrative, medical and IT costs. Incorporating information technologies that can facilitate, if not altogether replace, the manual interactions will be an important part of every organization’s evolution.

Assessment

Next week, in our final part 6 of this series, we’ll wrap up this discussion with a look at some of the potential savings health plans could achieve through alignment and an integrated approach to network design. The potential savings are not slight, so stay tuned. As always, if you just don’t want to wait for next week, visit our website and download the entire Unlocking Affordable Care by Aligning Products white paper; it’s available now.

Conclusion

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Financial Planning for Physicians

A Handbook for Doctors and their Financial Advisors

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Financial Planning Handbook for Physicians and Advisors

Book Review and Summary

Financial Planning for Physicians and Advisors describes a personal financial planning program to help doctors avoid the perils of harsh economic sacrifice.

It outlines how to select a knowledgeable financial advisor and develop a comprehensive personal financial plan, and includes important sections on: insurance and risk management, asset diversification and modern portfolio construction, income tax and retirement planning, and medical practice succession and estate planning, etc.

When fully implemented with a professional’s assistance, this book will help physicians and their financial advisors develop an effective long-term financial plan.

Order now: http://www.jblearning.com/catalog/0763745790/

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###

Are Physicians Really Going Broke?

Am I Prescient, Lucky or Just an Observant Trend Reporter?

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

A few years ago I was involved in a Physician’s Money Digest report that showed the average physician reader (ie, 47 years old and $184,000 in annual income) would need about $5.5 million to retire. This was in 2007-08, right before the infamous financial “meltdown”.

Lifestyle Preservation

Now, that’s if they planned to have the same lifestyle after retirement as in the years just prior to retirement. In other words, to live on 80% of pre-retirement income, my doctor colleagues would need about $4.4 million. Although that isn’t exactly loose change, the average PMD reader at the time, had a head start, with a net worth of $1.1 million. By maxing out on retirement plans, we reckoned the average reader could be in shouting distance of the goal by age 65.

Although the figures were daunting, they were a wakeup call to the fact these doctors, now age 52-53, still needed to save more aggressively to be able to finance the retirement they were working toward. But since then, their home worth and practice value, savings, investment and retirement accounts are probably down in 2012; as is their net worth. Down –  and I mean way down!

Link: http://www.physiciansmoneydigest.com/issues/2005/92/3951

Fast Forward to 2012

Today, some pundits posit that doctors in America are harboring an embarrassing secret: Many of them are going broke. This quiet trend and seeming reality, which is spreading nationwide, is claiming a wide range of casualties including family physicians, cardiologists and oncologists. Sadly, it is a trend that I have professionally observed and personally seen.

Link: http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. And, no doubt, these are all true reasons – in part. But, some experts counter that doctors’ lack of business acumen is also to blame.

So, that’s why we started our physician focused financial planning firm www.MedicalBusinessAdvisors.com  –  and – our online educational program for their managerial consultants and financial advisors www.CertifiedMedicalPlanner.com These firms were conceived and launched more than a decade ago; to much derision and haughtiness at the time. Not some much today, however! Why?

Assessment

A decade ago, Forbes magazine ran an article about doctors making six figure salaries and still wanting a medical union to bargain collectively.  This was a bit difficult for the average man or woman in the street to imagine about such learned professionals, formerly considered affluent and a cut above the rest. So, where is medical union clout today? Where is MD salary clout? And, where is physician net worth now – and in the future?  Doctor – what’s in your wallet?

Conclusion           

And so, your thoughts and comments on this ME-P are appreciated. Are doctors really going broke? Are they OWS…ers? Was I prescient, lucky or just an observant reporter of this trend, early on? Please 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.

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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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Healthcare Organizations: www.HealthcareFinancials.com

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The Prescription [Rx] Drugs Most Marketed to Doctors

An Infographic

This ME-P comes to us from Appature, a Seattle based company that provides a cloud based healthcare marketing tool.

Upon submission of this infographic, the folks at Appature had the following to say:

Appature Inc, a Seattle-based software company that makes marketing tools for the healthcare industry, just launched its first infographic about Prescriptions Most Marketed to Doctors in the healthcare industry! Our infographic breaks down the ins and outs of which prescriptions are most marketed to doctors, to which prescriptions have the greatest sales ($5.3 Billion!) and even patient sentiments regarding a doctor’s prescribing habits. By reading this infographic, we hope that readers will get a little peek inside the intricate inner-workings of the infamous pharmaceutical industry! As TIME magazine highlights, “…the pharmaceutical industry is – and has been for years – the most profitable of all businesses in the U .S.”

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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***

On e-Claim Only Dental Plans

About their Hidden Costs – I’m Talking PHI Breaches

By D. Kellus Pruitt DDS

If the rumor is true about Bluebell Ice Cream’s “e-claim-only” dental benefit plan that is to go into effect in March, how many in the east-central Texas town of Brenham (pop. 16,000) will be properly warned about the danger to themselves, their families and Bluebell officials’ reputations because of reckless policy?

Transmissions Risks

Each time their dentists send an electronic dental claim (e-claim) over the internet to insurance employees in Chicago as a favor to a patient – and especially the insurer – the Bluebell employee’s digital medical identity which is worth fifty bucks on the black market, rides along to destinations unknown. It’s my guess that very few Bluebell employees are yet aware of the increasing risk of medical identity theft from dentists’ e-claims – much less given the opportunity to opt out of the risk by simply visiting a dentist who still uses the telephone, fax and US Mail.

Security Risks Growing

It certainly won’t improve my popularity with 9 out of 10 dentists for saying this, but risks of identity theft from HIPAA-covered dental offices are climbing daily. In the introduction to a recent interview with Larry Ponemon, chairman and founder of the Ponemon Institute, GovernmentIT.com editor Tom Sullivan ominously described the ever-increasing risk of a massive “data spill” of perhaps millions of patients’ protected health information (PHI):

 “The street value of health information is 50 times greater than that of other data types. Even worse, the healthcare industry is among the weakest at protecting such information. With organized criminals trying to steal medical IDs, sloppy mistakes becoming more commonplace, mobile devices serving as single sign-on gateways to records and even bioterrorism now a factor, healthcare is ripe for some a wake-up call – one that just might come in the form a damaging ‘data spill.’” (See: “Q&A: How a health ‘data spill’ could be more damaging than what BP did to the Gulf.”

Tom Sullivan – Editor [December 05, 2011]

http://govhealthit.com/news/qa-how-health-data-spill-could-be-worse-what-bp-did-gulf?page=0,0

According to Dr. Ponemon:

“The basic issue, when you think about data theft not data loss – because it’s hard to know whether that lost data ultimately ends up in the hands of the cybercriminal and all of these bad things occur – but in the case of identity theft, the end goal has been historically to steal a person’s identity, and just like getting a financial record, getting a health record probably has your credit card, debit card, and payment information contained in that record.”

Of Credit Cards … and More!

But that’s not all. Credit cards are just chump change. He continues:

“The financial records are actually lucrative for the bad guy, but the health record is actually much, much more valuable item because it not only gives you the financial information but it also contains the health credential, and it’s very hard to detect a medical identity theft. What we’ve found in our studies is that medical identity theft is likely to be on the rise and, of course, there’s an awareness within the healthcare organizations that participate in our study that they’re starting to see this as more of a medical identity theft crime. It’s not just about stealing credit cards and buying goodies, it’s about stealing who you are, possibly getting medical treatment and, therefore, messing up your medical record.”

Dr. Ponemon suggests that the victim may not know about the theft until he or she “stumbles on something that alerts them their medical identity was stolen.” Perhaps something like death following anaphylactic shock from a medication that was once digitally highlighted as “Allergic to.” Understandably, Ponemon adds that respondents recognized altered medical histories as an emerging threat they believed was affecting the patients in their organizations. Such danger for dental patients is almost non-existent if their dentists simply don’t put PHI on office computers.

Should a data breach of Bluebell Ice Cream employees’ identities occur in Brenham or Chicago, which is more likely than not, the fact that electronic dental records do nothing to improve the quality of dental care won’t make Brenham citizens any happier with local Bluebell officials. 

Conclusion       

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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About Pancreas Cancer Survival Rates

 Still Not Improving

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Here is an infographic to highlight the main statistics about pancreatic cancer that are unknown – you know, less than 3% of people who are diagnosed will live to see five years post-diagnosis?

Assessment

The tree maps showing the difference between death rates and funding for the different forms of cancer is also interesting

Source: Pancreatic Cancer UK

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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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Are We Finally Lifting the Secret IRS Veil on Un-Paid Taxes?

The Tax Gap Increases to $450 Billion

By Children’s Home Society of Florida Foundation

By Dr. David Edward Marcinko MBA, CMP

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Each year the IRS conducts a survey to determine the amount of unpaid taxes. The “tax gap” is defined as the amount of taxes that are owed by taxpayers but not paid on time.

2006 Results

For the year 2006, revised figures released this week showed that the tax gap increased.  The previous estimate of the 2006 tax gap was $345 billion but it increased to $450 billion. The “net tax gap” is a smaller number that reflects the ability of the IRS to collect some of the unpaid taxes.  When the additional $65 billion in taxes collected later is subtracted from the $450 billion, the net tax gap is $385 billion.  The net tax gap number increased from $290 billion in 2001 to the larger number by 2006.

Tax Compliance Level

The compliance level for taxpayers remains 83.7%.  This indicates that the majority of Americans are continuing to calculate and pay their taxes correctly.

Sen. Max Baucus (D-MT) is Chairman of the Senate Finance Committee.  He responded to the IRS survey by noting,

“This report shows that closing the tax gap needs to be a major focus of tax reform.  An improved tax code that’s simple and fair to all Americans will help close the tax gap, boost our economy and create jobs.”

Editor’s Note: 

Both Sen. Baucus and House Ways and Means Committee Chair Dave Camp (R-MI) have been conducting hearings that will lead to major tax reform in 2013.  For the vast majority of Americans who pay their fair share of taxes, it is beneficial if Baucus and Camp are able to simplify the tax system and reduce the tax gap.  More effective collection of revenue decreases the need to raise taxes on those who are currently paying their fair share.

Conclusion     

And so, your thoughts and comments on this ME-P are appreciated. What is the tax-gap for medical professsionals? Please 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.

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Healthcare Organizations: www.HealthcareFinancials.com

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Is it Time for a Credit Check-Up [brief doctor visit or extendend consultation]?

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Reviewing your Credit Report for the New Year [A CPT® code analogy]

Source: creditdonkey.com

Conclusion     

And so, your thoughts and comments on this ME-P are appreciated. Please excuse our pun and review the 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.

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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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Automobile Insurance Update for Medical Professionals

Some Need-to-Know [Not Boring] Information for Doctors, Nurses and CXOs

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By Dr. David Edward Marcinko FACFAS, MBA, CPHQ, CMP™

[Publisher-in-Chief]

As regular ME-P readers know, I held a property and casualty insurance license for more than 15 years; this included homeowners and automobile insurance.

BTW:  P&C also includes malpractice insurance [doctors and medical professionals] and E&O insurance [accountants, financial advisors, attorneys, etc]. Yep! Med-mal is classified under the property-casualty moniker. I even edited a handbook on the topic. But, I digress.

On the Importance of Automobiles

With the possible exception of the handgun, the automobile represents the greatest single item of ownership that is capable of inflicting death, injury and damage. I learned this first-hand after covering the ER for many years.

America’s fascination with the automobile has resulted in a marked increase in the power and potential speed of our vehicles.  The aging trend in Sports Utility Vehicles (SUVs) has also witnessed a substantial increase in damage due to their higher ground clearance and heavier frames.  The owners and operators of any vehicle must be financially able to respond to any resulting claims, or they need to transfer the risk through insurance.  All states require some minimal coverage for personal vehicles.

The F.A.P.

The most frequently used policy to insure individual private passenger vehicle risks is the Family Automobile Policy (FAP).   It provides two major types of coverage: liability and physical damage.

Liability coverage includes both bodily injury and property damage. Physical damage, on the other hand, includes comprehensive and collision coverage.

[A] Liability Coverage

The liability section of the FAP is contained within most policies as Part A – Liability and Part B -Personal Injury Protection.

[1] Bodily Injury

Bodily injury liability coverage generally includes sickness, disease and death, and is expressed in dual limits — per person and per occurrence.  Nearly half of the states require minimums of $25,000 per person and $50,000 per occurrence.  Higher limits of $100,000 per person and $300,000 per occurrence are often required for consideration of umbrella coverage.

[2] Property Damage

Property damage liability is coverage for damage or destruction to the property of others and includes loss of use.  Liability coverage limits usually include property damage limits as the third number, i.e., $100/300/25.  The coverage here would be for $25,000 of property damage.  As automobiles become more expensive, however, coverage to $50,000 is not considered excessive.

[3] Personal Injury

Personal injury coverage is provided for medical expenses, funeral expenses and loss of earnings for anyone sustaining an injury while occupying your vehicle, or from being struck by your vehicle while a pedestrian.

Liability insurance follows the vehicle, not the driver.  Coverage is extended to the vehicle owner and any resident in the same household.  It also covers anyone using the insured vehicle with the permission of the owner and within the scope of that permission.

Newly acquired vehicles are usually covered automatically for liability for 15-30 [getting shorter] days after acquisition, but physical damage must have been on all currently covered vehicles to be included.  Coverage is also typically extended to a temporary substitute automobile, but only if this vehicle is used in place of the covered automobile, because of its breakdown, repair, servicing, loss or destruction.

[B] Physical Damage Coverage

[1] Comprehensive

Comprehensive physical damage includes coverage for theft, vandalism, broken windshields, falling objects, riot or civil commotion, and even damage from foreign substances, such as paint.  Comprehensive is often described as coverage for all those hazards other than collision.

[2] Collision

Collision involves the upset of the covered vehicle and collision with an object, usually another vehicle, and not enumerated in the discussion of comprehensive.  Colliding with a bird or animal is considered under the comprehensive coverage.

The distinction between comprehensive coverage and collision coverage is more than technical.  The deductible provisions of the FAP often show a considerable difference in these areas, with the collision deductible typically being much greater.

Damage to tires can be covered by provisions in either comprehensive or collision.  Exclusions typically include normal wear and tear, rough roads, hard driving or hitting or scraping curbs.

[C] Repairs after the Accident

Following a collision, the insurance company will assign a claims adjuster to determine the extent of damage and the cost of repairs.  If these repairs exceed the estimated value of the vehicle, it may be “totaled.”  Experience tells me that the value of the vehicle to the owner nearly always exceeds that estimated by the insurance company.

[D] Uninsured / Underinsured Motorists Coverage

Uninsured motorist coverage provides protection from the other driver who is operating his/her vehicle without any insurance coverage.  It covers expenses resulting from injury or death as well as property damage.  There are currently a dozen states where it is estimated that over 20 percent of the vehicles on the highway are being operated without any insurance.  This is not coverage that should be rejected when buying automobile insurance.

Underinsured motorist coverage provides protection from the other driver who purchased only the state-mandated minimum liability insurance coverage.  Again, this is not coverage that the medical professional or healthcare practitioner should thoughtlessly reject when buying automobile insurance.

Assessment

The medical professional is strongly urged to consider purchasing replacement cost coverage rather than accepting actual cash value car insurance, which is the depreciated value of the vehicle. The cost may be higher for this coverage, but accepting a larger deductible will often make up the difference. Paying a little more towards the deductible could easily be worth it, if the damage is extensive.

Or, if you have a classic pristine Eurpean touring sedan [2000 pearl-white Jaguar, XJ-V8-L], built for the Queen in Coventry England, like I do. Jay Leno is my hero!

Conclusion                

And so, 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Send Us Your Medical, Financial and Management Consulting Jokes

A New ME-P Feature

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By Ann Miller RN MHA

[Executive-Director]

The Set-Up

A motorcycle patrolman was rushed to the hospital with an inflamed appendix. The doctors operated and advised him that all was well; however, the patrolman kept feeling something pulling at the hairs in his crotch. Worried that there might be a second surgery that the doctors hadn’t told him about it, he finally got enough energy to pull his hospital gown up so he could look at what was making him so uncomfortable.

The Punch-Line

Taped firmly across his pubic hair and private parts were three wide strips of adhesive tape, the kind that doesn’t come off easily, if at all. Written on the tape in large black letters was the sentence, ‘Get well soon, from the nurse in the Jeep you pulled over last week.’

Assessment

Kinda brings tears to your eyes doesn’t it!

Conclusion         

And so, your thoughts and comments on this new ME-P feature are appreciated. Send in your jokes, puns and funny anectdotes. Keep them relevant to the financial services, healthcare and consulting management space. Or – at least germane to an existing post.

And, please 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.

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Anatomy of a Doctor

Risks versus Rewards [A Changing Calculus]

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Some laymen enjoy helping others, but don’t seriously consider medical school. Hard work does pay off, but only if you’re good at biology in this case. One problem has always been the crazy amount of names to learn.

The thought of SAT exams, medical school and MCAT tests already raise stress levels. It’s no surprise that a large percent of doctors feel stressed. Today, only half of them recommend their career to others. It seemed like a fun career once all the classes and training was done. And, many doctors seemed to be happy by the way they carried themselves.

Not so today! The higher than average salaries probably helped to boost their attitude before the ACA. But, perhaps not so much, today!

So; not everyone is cut out to be a doctor. Although it sounds really cool and we can dream about it as a child, becoming a doctor is not always practical. It is a high-intensity job but with decreasing stature and pay, likely going forward.

Assessment

But, the joys of helping others and saving lives are always worth it; aren’t they?

Conclusion 

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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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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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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How Much Money to Retire [The Number]?

Men and Women at Work

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Conclusion           

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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About Hospitals and Healthcare Organizations

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

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Book Review and Summary

Drawing on the expertise of decision-making professionals, leaders, and managers in hospitals and healthcare organizations, this book addresses their ubiquitous struggles with decreasing revenues, increasing costs, and high consumer expectations in a competitive market.

Offering practical experience and applied operating vision, the authors integrate 5-S and six-sigma managerial applications and regulatory perspectives, with real-world case studies, models, and reports, as well as charts, tables, diagrams, and sample contracts.

The result is an integration of lean management and operational strategies vital to hospitals, clinics and healthcare administrators; CXOs, COOs and CEOs; comptrollers, nurse-leaders and physician-executives.

Pre-Order here: http://www.crcpress.com/product/isbn/9781439879900

Conclusion      

As always, 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Barriers to Performance Based Healthcare Networks and Medical Cost Savings

 Understanding the need to align care models, payment, products and networks

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[Number 4 in a series of 6]

By Sam Mupalla – Vice President, McKesson Health Solutions, Network Performance Management (NPM)

I wanted to follow up on last month’s ME-P discussion about Performance-based Networks and Medical Cost Savings. I wrote about the need to align care models, payment, products and networks, and then promised to address some of the barriers standing in the way of achieving alignment. Well, that’s what I’m writing about today.

Strategic Difficulties

Health plan operations responsible for supporting the intent of the provider network designs will find it increasingly difficult to maintain strategies that provide affordable care by applying existing methods and systems.

Currently, the systems and processes that enable these operations are frequently based on systems that are neither integrated nor automated, rather relying on various manual interventions to achieve some scale of efficiency. Creating and maintaining innovative value-based offerings in this environment requires process excellence coupled with tight coordination executed across multiple departments. As the complexity and frequency of demand for these offerings increase, this approach becomes more challenging to sustain, thus risking long term success of the affordable care promise.

Figure 1: Today’s operational engine interactions are not optimized for enabling innovation.

The traditional systems and processes that health plans have used to respond to specific client demands appear in Figure 1.

For example, product demands from consumers may come in through the sales team, which manually interacts with the product management, care management, network development, and health economic teams to design a product to meet the market need. This first set of interactions, in effect, becomes the innovation engine for value-based product designs. Additionally, it becomes the starting point for a myriad of manual and highly paper-based interactions that ripple throughout the enterprise.

The interactions within this innovation engine then set forth a series of parallel and independent sequences with three different operational engines: the provider contracting department, the provider management department and the claims operations department. Each of these areas relies heavily upon their own set of manual and paper-based processes and interactions. The inefficiency of this current approach suggests the potential for an annual administrative cost savings opportunity of $5-25 million, depending on the health plan’s size and current system architecture.

In addition to administrative costs, this approach creates inefficiency and waste in IT costs and medical costs that could be between $40-100 million.

Assessment

So, how can you unlock these savings and eliminate this waste? We’ll discuss that next week. I’ll say only three words here: Integrated Building Blocks. I’m not going to say a word more — but if you can’t wait for next week you can read the entire Unlocking Affordable Care by Aligning Products white paper; it’s available on our website now.

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.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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What is a Stock?

About Fractional Company Ownership

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This inforgraphic explains what stock ownership is.

To make investment choices that ultimately pay off, you need to start by knowing the fundamentals. It’s a step many medical investor wannabes skip, since … well, studying the basic terms and trends are not exactly entertaining. See elsewhere on this ME.P.

Conclusion 

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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About our Money

Interesting Facts on the USD

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Conclusion      

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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Death and Grave Stone Symbolism

Common Signs and Symbols

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This infographic takes an in-depth look at the most common signs and symbols used on gravestones around the world.

Assessment

Death is life’s ending. Because everyone who is born eventually dies, it is the center of many traditions and organizations. Customs relating to death are a feature of every culture around the world. And, a part of those customs are symbols, which signify or try to make sense of the phenomena.

Source: LifeInsuranceFinder.au

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.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors


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About Herbal Medicines

More Popular than Ever

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Herbal medicines have seen an increase in popularity since many people have become more health conscious. Others are mistrustful of the health industry, so they are taking their health into their own hands. If you’re smart about your herbal medicines and how you use them, some believe you can be a much healthier person.

This infographic sets out to help you learn about herbal remedies.

A Pantheon of Herbs

St. John’s Wort is reported to help sooth low mood and mild anxiety, while Valerian root may help alleviate anxiety-related sleep problems, as long as they are mild. Passion Flower may help with mild anxiety and stress for a person with a nervous disposition, while Rhodiola may relieve anxiety, exhaustion, fatigue and stress in someone who is really stressed out from work or burned out.

Feverfew may help with migraine headaches, and Echinacea is reported to be good for colds and flu. Pelargonium may help with the coughs, runny nose, blocked nose, and sore throat associated with upper respiratory infections and the common cold.

Agnus Castus may relieve PMS symptoms like irritability, breast tenderness, cramps, bloating, and mood swings. Milk thistle may help with indigestion, an over-full stomach, nausea, and other digestive complaints. Black cohosh may help with menopausal symptoms like hot flashes, mood swings, and night sweats. Saw palmetto may help control the frequent urination, weak stream, and incomplete sensation associated with an enlarged prostate.

Finally, Devil’s claw, despite its foreboding name, may soothe joint aches and pains, backache, muscle aches, and even rheumatic pain.

Some Statistics

An herbal remedy must be documented for use with a specific symptom for 30 years, while it only must be used for 15 years in the European Union.

Price Differences

Scientific trials cost a lot of money, which means that the herbs are more expensive than they used to be. It is worth it, however, because it means the product has been tested and contains helpful consumer information.

Note: Any herbal product that is not classified as “culinary” and does not hold a THR logo is not on the up and up. It is either illegal or “end of the line” stock.

Culinary Herbs

Garlic, sage, turmeric, and artichoke all have amazing health benefits, but are classified as culinary, and therefore are subject to different legal regulations.

Source: Milk Thistle and St. John’s Wort from Healthspan

Related articles

Conclusion    

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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Doctors May Save Some Money with These 2011 IRS Tax Changes

A Brief IRS Tax Code Update

By Children’s Home Society of Florida Foundation

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In an information letter, the IRS outlined seven specific changes in the 2011 law that will be useful to doctors and all taxpayers filing their tax returns this year. And, some of these 2011 tax law changes may reduce your taxes:

1. Energy Credits – The energy credit was reduced from the $1,500 limit for 2010 to a maximum of $500 for 2011. Up to 10% of qualified expenditures for high-efficiency heating and air conditioning systems, water heaters, biomass stoves, energy-efficient windows and doors and other energy improvements will qualify. The 2011 limit is $500. This credit is reduced by previously-taken energy credits and will generally be available for taxpayers who made their first energy improvements in 2011.

2. 2008 Homebuyer Credits – Some purchasers of new homes in 2008 qualified for a first-time homebuyer credit. The credit was essentially an interest-free loan to be paid back over 15 years. For these taxpayers, the second repayment of the credit amount will apply for 2011.

3. Capital Gains and Losses – Previously, capital gains and losses were recorded on Schedule D. There is a new Form 8949 to report gains and losses. Schedule D will still be used for a summary of capital gains and losses.

4. Roth Conversions – Those individuals who converted a traditional IRA to a Roth IRA in 2011 must report their taxable income. In previous years, only half of the income was reported each year for two years. However, for 2011 conversions the full amount is reportable.

5. Standard Mileage Rates – The standard mileage rates changed on July 1 for business use, medical travel, moving or charitable services. For the first half of 2011, the rates are business travel at 51 cents, medical and moving travel at 19 cents, and charitable travel at 14 cents per mile. For July 1 through the end of the year, business travel is 55.5 cents, medical and moving travel at 23.5 cents and charitable travel remains 14 cents per mile.

6. Alternative Minimum Tax Exemption – The AMT exemption for 2011 will be $74,450 for a married couple, $37,225 for married persons filing separately and $48,450 for single person or heads of household.

7. Health Insurance – Generally, self employed persons who operate a small business will qualify for deduction of health insurance premiums.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

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How Technology Changed Medicine

A Historic Timeline Review of Advances

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Today we address how technology has changed the medical industry.

Definition

This infographic starts off by stating “medical technology is the application of devices, procedures, and knowledge for diagnosing and treating disease for the purpose of maintaining, promoting, and restoring wellness while improving the quality of life.” On the left of the infographic is a timeline of technological advances in the medical industry, starting with the invention of the stethoscope in 1816 and ending with the production of the first commercial hybrid PET/MRI scanner in 2008.

US Medical Technology Companies by Segment

A pie chart shows us that a great many medical technology companies are focused on therapeutic devices, while the next biggest segment belongs to non-imaging diagnostics. The next largest segment is dedicated to research and other equipment, and the next segment (second to the smallest) is dedicated to imaging. The smallest segment is designated as “other.”

In the therapeutic devices category, the largest piece of that piece of the pie goes to cardiovascular and vascular developments, and the smallest to urology/pelvic with many other therapeutic devices in between.

Three Ways Medical Technology Has Improved Treatment Processes

1. Faster Diagnosis

2. Less Invasive Treatments

3. Shorter Hospital Stays

Survival Rate

It is noted that the survival curve has flattened because of lower mortality and has become increasingly vertical with older people because of the technological advances. A graph shows the percentage of people who lived until a certain age between 1900 and 1902, when only about 10% of people lived past the age of 85, and 2002, when almost 30% of people lived past the age of 85. Based on this graph, most people live to age 55 or older; and around 50% of people live to at least age 80.

Advances in Medical Technology

Some of the advances mentioned are wireless heart monitors, skin cell guns, the STEM microscope, Nexagon healing gel, Berkeley Bionics’ eLEGS, and the iPhone Blood Pressure Monitor. A description of each of these advances is included on the infographic.

Advancements in Health Record Technology and More

Sprint has something called M2M healthcare initiative that provides GPS tracking for patients with Alzheimer’s and dementia, and offers faster access to more unified personal data like heath records and test results.

Now, there is also a “know before you go” option for hospital emergency rooms. Some hospitals place their wait times on billboards, make them available on their website, and even offer the wait time via text. Other hospitals participate in a service called InQuick ER where a patient can pay a $9.99 fee and hold a place in the ER online [noted elsewhere on this ME-P].

Helpful Healthcare Apps

Some of the apps listed are My Medical, which allows one to store medical histories, BP Buddy that helps track blood pressure levels, Glucose Buddy, which helps manage diabetes, and iTriage, that is a diagnostic tool.

Also listed is the Ovulation Calendar – guess what that does? While – the Mediquations Medical Calculator brings 231 medical calculations and scoring tools right to your mobile device.

Source: SmallCellLungCancer.net

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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About Hospitals & Healthcare Organizations

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

Healthcare Organizations: Management Strategies, Operational Techniques, Tools, Templates and Case Studies

Conclusion           

And so, your thoughts and comments on this textbook are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Controlling Health Care Spending [An NIHCM Foundation Webinar]

The Imperative to Act and Diverse Views of the Road Forward

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The U.S.now spends $2.5 trillion annually on health care, accounting for well over 17 percent of GDP and growing rapidly with challenging fiscal consequences. Despite the imperative to control spending, we face much uncertainty about how to move to a more sustainable path.

Political opposition threatens implementation of the Affordable Care Act, and many of its cost-control measures are still unproven. A long-term fix for Medicare physician payment remains elusive. The trigger mechanism activated by the failure of the Super Committee is poised to affect myriad health programs, but decisions on the specific cuts await sure-to-be intense congressional negotiations.

And, the many ideas for entitlement reform that were advanced during deficit reduction talks continue to generate much debate but little consensus.

Topics

To shed light on these complex issues, this webinar will feature leading health policy experts discussing topics including:

  • health spending growth and the implications for government budgets, employers and individuals
  • the societal trade-offs we face as health spending grows and as we think about ways to control spending
  • alternative viewpoints on the viability of cost control approaches now being tried and the most promising options for the future.

Assessment

Visit NIHCM Foundation’s website to view an agenda and additional resources on health care spending. And, please register by noon (EST) on February 1st.

Conclusion        

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Drug Companies Reduce Payments to Doctors as Scrutiny Mounts

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Dollars for Doctors [How Industry Money Reaches Physicians]

Part of a year-end series on major investigations

By Tracy Weber and Charles Ornstein
ProPublica, January 3rd, 2012, 2:55 p.m.

Some of the nation’s top medical schools cracked down on professors who give paid promotional talks for drugmakers last year, and the firms themselves cut back on such spending in the wake of mounting scrutiny.

Examples

Last year began with the University of Colorado Denver and its affiliated teaching hospitals launching an overhaul of conflict-of-interest policies [1] after ProPublica found that more than a dozen of its faculty members had given paid promotional talks.

“We’re going to just have to say we’re not going to be involved with these speakers bureaus because they’re primarily marketing,” Dr. Richard Krugman, vice chancellor for health affairs, said in an interview in January 2011.

A few months later, Stanford University took disciplinary action against five faculty members [2] identified by ProPublica who had taken money to deliver drug company speeches, a violation of university policy.

And by last fall, there were indications that pharmaceutical companies were also reducing the money [3] they spent on doctor speakers.

Enter ProPublica

ProPublica first published its Dollars for Docs database [4] in October 2010 listing payments to doctors from seven drug companies. When we updated it this September [3] — with data from five additional companies — spending by some of the firms was down.

Cephalon, a relatively small Pennsylvaniacompany that specializes in pain, cancer and central nervous system drugs, paid physicians nearly $9.3 million in 2009 for speaking and consulting. That figure dropped to $5 million in 2010.

AstraZeneca cut its spending on speakers from roughly $22.8 million in the first half of 2010 to about $9.2 million in the second half. Both companies cited business reasons for the decline.

The Year 2011

Throughout 2011, ProPublica also examined the hefty financial support drug and medical-device makers give to medical societies and health advocacy groups and the impact it has on the groups’ positions.

At the national conference of the Heart Rhythm Society [5] in San Francisco, companies sponsored much of what doctors saw — hotel key cards, bus banners, ads on staircases, even motorcyclists driving mini-billboards in a continuous loop around the Moscone convention center. Nearly 50 percent of the society’s funding in 2010 came from the drug and medical device industry. (We even created a neat interactive graphic [6] that allows you to virtually tour the hotel and exhibit hall.)

The society, which represents doctors who treat abnormal heart rhythms, said its funders don’t influence its positions, but it unveiled a new policy requiring more detailed disclosure of board members’ industry ties.

Then, last month, ProPublica reported about the extensive ties between makers of narcotic painkillers and the American Pain Foundation [7], which bills itself as the nation’s largest organization representing patients afflicted by pain. The foundation received nearly 90 percent of its income in 2010 from drug and device makers and takes positions that closely align with the companies.

Despite a steep rise in overdose deaths tied to the drugs, the foundation has said the risk of addiction to the drugs has been over-hyped and that, if anything, they are underused.

Like the heart society, the pain foundation said its’ funders have no influence on its positions.

Assessment

ProPublica also investigated why physicians were not disciplined or prosecuted [8] after they were accused in federal lawsuits of taking kickbacks from drug or device companies or pushing drugs for unapproved uses. We reviewed lawsuits against 15 drug and device companies that were settled since 2006. None of the more than 75 doctors named as participants in alleged schemes were sanctioned by state medical boards or pursued by prosecutors, ProPublica found.

Last year, dozens of news outlets around the country used our data [9] to localize stories about conflicts of interest in medicine — bringing the discussion to communities large and small.

Link: http://www.propublica.org/article/drug-companies-reduce-payments-to-doctors-as-scrutiny-mounts

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.

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Apply AcademyHealth / NCHS Health Policy Fellowships

How to Apply – January 9th Deadline Looming!

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Vision

AcademyHealth seeks to improve health and health care by generating new knowledge and moving knowledge into action.

Mission

As the pre-eminent professional society for health services researchers and health policy analysts, AcademyHealth collaborates with the health services research community and other key stakeholders to support the development of health services research by:

  • Expanding and improving the scientific basis of the field;
  • Increasing the capabilities and skills of researchers;  
  • Promoting the development of the necessary financial, human, infrastructure, and data resources;
  • Facilitate the use of the best available research and information;
  • Translating research findings and the lessons of experience into useful information for clinical, management, and policy decisions;  
  • Enhancing communication and interaction between health services researchers and health policymakers;
  • Assist health policy and practice leaders in addressing major health challenges;
  • Providing high quality policy and technical assistance;
  • Offering educational programs that advance the use of policy analysis and research; and
  • Identifying areas where additional research and information are needed.

Assessment

Link: http://www.academyhealth.org/Training/content.cfm?ItemNumber=1435&navItemNumber=2332

Conclusion      

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Change in Distribution of Income Among Tax Filers 1996-2006

A Congressional Research Services White Paper

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As tax season draws near, here is an important essay from CRS, by:

Thomas L. Hungerford

[Specialist in Public Finance]

Assessment

Link: http://taxprof.typepad.com/files/crs-1.pdf

Conclusion       

And so, your thoughts and comments on this ME-P are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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The ME-P is Approved for Syndication with Newstex

Because All Content is NOT Created Equal

By Neccia Celli
Content Acquisitions – Newstex LLC

Hi Ann,

Thank you for filling out our web query form and for your interest in content syndication!  

We’ve approved  the Medical Executive Post for syndication with Newstex.

Voice: (212) 380-1855 x 7011
Fax: (203) 889-3000
Skype: ncelli
www.newstex.com / www.newstexblog.com
“Blogs on Demand”

About Newstex

Newstex was founded in 2004 with the goal of providing real-time news and commentary collected from the world’s best online and offline sources to customers who need information but don’t have time to gather it from a myriad of places.

Today, Newstex offers aggregated news and full-text feeds from thousands of premium blogs as well as Twitter, audio and video content from editorially-selected, authoritative news, corporate, and independent publishers. This is Authoritative Content.

Assessment

The Newstex network of distributors covers a wide range of channels. Companies like LexisNexis and Amazon Kindle deliver Newstex Authoritative Content news and commentary in various customized formats to meet end-user needs.

Business people, academics, financial analysts, journalists and more use the content delivered to them through Newstex products everyday to make their jobs easier and enhance their lives.

Conclusion       

And so, your thoughts and comments on this new ME-P syndication are appreciated. Please 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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An Essay on Tax Fairness for Doctors to Consider?

Some Thoughts While Touring Southeast Asia

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[By Rick Kahler CFP® MS ChFC CCIM]

On my recent tour of Southeast Asia, I was taken by the vibrancy of the economies in Hong Kong and Singapore. I knew the 2011 Index of Economic Freedom rated those two countries the first and second most free economies in the world, but experiencing it made a big impact on me.

The Index of Economic Freedom

The index ranks each country on 10 different components including government spending, corruption, labor, and business. While the U.S. is behind Hong Kong and Singapore in most of the categories, our ninth place ranking in the world is largely due to our being far behind in two categories: fiscal freedom (the tax burden) and government spending.

On Tax Brackets

The top tax bracket is 15% in Hong Kong and 20% in Singapore. Since these are city-states, that is equivalent to our local, state, and federal taxes. Local people I talked with—none of whom were in the top 1%—seemed rather proud of that. The top brackets in the U.S. are two to three times higher. Our rates will be significantly above 50% (state and local) on top wage earners a year from now when the tax code reverts to 2001 levels and the Obamacare surtaxes kick in.

That raised the eyebrows of most Asians I spoke with. Their jaws dropped when I explained that growing numbers of Americans view upper income earners with disdain and demand we raise their taxes because they are not paying their “fair share.” One person wondered if America has lost her way.

A Fair-Share!

What is “one’s fair share?” I’ve asked a number of people advocating “the rich need to pay their fair share” exactly how much the top income bracket should be. I usually can’t get them to name a specific number. When they do, the median is usually 50%. When I point out that in most states the top income earners are already paying 50%, they usually harrumph in disbelief.

The bottom line is that if I suggest others need to pay “their fair share” I am simply saying they need to pay more in taxes. Fairness is really not part of the equation. If it was, we would raise taxes on the bottom 50% who contribute just 3% of their income to the national revenue. Would asking them to pay more, too, say 6% or 9%, be asking too much? The answer is obvious. Raising my taxes is bad public and economic policy, but raising your taxes is “fair.”

Speaking of fairness, I will note that the top income earners are paying a lower percentage of their income in taxes than they used to. The wealthiest 0.01% saw their overall federal income taxes fall from 42.9% in 1979 to 31.5% in 2005. (The New York Times, September 21, 2011). That doesn’t change the fact that top income earners pay an exponentially higher amount of their income than those in the lower brackets. Even at today’s lower brackets, they pay two to three times more than their peers in the most economically free countries.

If we wanted to follow the model of Singapore and Hong Kong to more economic prosperity, we would do well to have an informed discussion about fairness; much like informed patient consent for surgery.

The Purpose of Taxation 

Maybe it should start with defining the purpose of taxation. If we believe taxes are meant to provide public services like roads and defense that are used by all, we might view “fairness” differently than if we believe taxes are intended to provide services like medical care or even basic income to those who don’t or can’t take care of themselves.

Assessment

In fairness to those at all income levels, this is a discussion all Americans ought to have – even her doctors.

The Author

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

Conclusion      

As always, 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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Current Approaches to Patient Self Management – Do They Improve Quality or Lower Costs? [An Encore Video Debate]

A Symposium Debate  

Moderator: Cynthia Bouthot: MA, President, Collaborative Innovation Group.

Dis-Agree: Shahid Shah MS: CEO Netspective; blogger www.HealthCareITGuy.com, and HIT “Thought-Leader” for the ME-P.

Agree: Joseph Kvedar MD: Director, PartnersCenter for Connected Health.

Get Ready to Rumble!

http://healthcare.partners.org/streaming/CCH/symposium2011/Plaza/PlazaThursday01.html

Assessment

Mr. Shah is the author of Ch 13 [Interoperable eMRs for the Small to Medium-Sized Medical Office] in the book: Business of Medical Practice [3rd edition], edited by Dr. David Edward Marcinko MBA CMP™  www.BusinessofMedicalPractice.com

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.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Events Planner: January 2012

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Events-Planner: JANUARY 2012

By Staff Writers

“Keeping track of important health economics and financial industry meetings, conferences and summits”

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 175,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily. And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention.

So, enjoy the Medical Executive-Post and this monthly Events-Planner with our compliments. 

A Look Ahead this Month – And now, the important dates:

  • January 22-24: The Inside ETFs Conference. Hollywood, FLA.
  • January 30-31: The IMCA Conference. New York, NY.

Please send in your meetings and dates for listing in the next issue of our Events-Planner.

MarcinkoAdvisors@msn.com

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

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. It’s free. You can unsubscribe at any time. Security is assured.

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Snarky Example of a Medical Practice RAC Audit

Ask a Consultant

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RAC Repayment Demand – Query

I just received a demand for payment from the RAC program for $32.46. I treated a patient with a non-displaced fibula fracture with a BK CAM boot and crutches. I coded 99212-25 and 27786,73610 on 1-29-09.  The audit claims the evaluation and management is part of the fracture care.

Should I appeal for $32.46?

Back then (3 years ago), my records were hand-written and not as comprehensive as they are now with EHR. Am I exposing myself to further inquiry by sending my admitedly inadequate records?

Doctor Name Withheld

Conclusion      

As always, 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.

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

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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Medical Identity Theft on the Rise

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Open Up Dentists – and Physicians, Too!

[By D. Kellus Pruitt DDS]

If I tell you that your patients’ insurance identities can be sold for $50 each, how much will you trust your employees on Monday, Doc?

The Experts Speak

According to a panel of cyber-security experts at a recent Digital Health Conference, medical identity theft has become one of the most lucrative forms of identity theft. “DHC: EHR Data Target for Identity Thieves” by MedPage Today Associate Staff Writer Cole Petrochko, was posted last week

http://www.medpagetoday.com/PracticeManagement/InformationTechnology/30074

“Presentations at the Digital Health Conference here indicated that a single patient’s electronic health records can fetch $50 on the black market — a much fatter target than more familiar forms of identity theft, such as Social Security numbers ($3), credit card information ($1.50), date of birth ($3), or mother’s maiden name ($6).”

eMRs Not Like Credit-Cards

“And, unlike a credit card number, patients’ healthcare records cannot be cancelled or changed to prevent stolen data from being used by criminals”, said John DeLuca, of EMC Corp., an information technology company.

The Street Value of eDRs 

What do you want to bet that medical identities downloaded from dentists’ computers bring $50; as well. I’d like to share a special, visceral sentiment with my shy, HIPAA covered colleagues:

I warned you, damn it! And, I assume, just like virtually all other silent dentists in the nation, you’ve done NOTHING to safeguard your patients’ identities. Even if you don’t like truth served bluntly, this dentist has your reputation in mind when I warn that if your practice experiences a reportable data breach of over 500 records, and your patients’ identities aren’t encrypted, those who choose to remain with your practice will never trust you as much as they do today – even if you properly report the breach. Of the estimated 20% who will never return, many will probably look for a gentle dentist who doesn’t store patients’ Protected Health Information (PHI) on computers …. Like me. (Yea, that was a sales pitch. As one might expect, I certainly welcome discussion of it with anyone).

ADA Laggards 

After 5 years of awaiting responses from unaccountable leaders inside and outside the American Dental Association concerning HIPAA and EDRs, It feels really good to aggravate 9 out of 10 dentists still reading this – challenging those who normally take offense with professional stoicism to loosen up and share their feelings with everyone for once … God help me, I do love this so.

More About the Black Market 

The black market price for EHRs has increased ten-fold in the last 5 years. In 2006, I warned in a guest column on WTN that it only takes one dishonest employee needing a couple of thousand quick dollars to potentially bankrupt a practice almost without risk of being caught. Back then, the black market price for a stolen medical identity was estimated at only $5 (See: “Careful with that electronic health record, Mr. Leavitt,” WTN News, October 18, 2006).

http://wtnnews.com/articles/3407/

It’s no secret that reticent ADA officials like President-elect Dr. Robert Faiella have suspiciously failed in their duty to be transparent with dues-paying members about the liabilities of the EHRs – even as they continue to recklessly promote paperless practices. The result: Almost all dentists in theUSstill maintain patients’ unencrypted medical identities on their office computers – often guarded by a flimsy password that is still cute a decade later. (Did I hear a gasp?).

Consider This!

Consider this, Doc! If a practice has 3000 active patients with identities worth $150,000, all one dishonest employee needs for dreams to come true is a flash drive and private time with your computer.

Assessment

Show me a dentist who thinks the benefits of EHRs to dental patients still outweigh the liabilities and I’ll show you a dangerously naive healthcare provider who probably doesn’t know about KPMG Auditors. Let’s face the facts bravely, Doc. Now would be a terrible time to invest in an EDR system – even cloud based. The proven, avoidable danger EDRs bring to American dental patients is unacceptable and only getting worse. Give it a year or so.

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Do Doctors have an Obligation to Bill their Patients for Co-Payments?

Ask an Advisor – Query

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I have read about pro-bono care on the ME-P. But, as doctors, are we required to bill our patients their co-pay amount by law, or can it be written off at our discretion? In other words, if we decide not to bill them, will we be penalized by Medicare.

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

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End of Year Tax Giving Tips for Charitable Giving

On IRS published IR-2011-18

By Children’s Home Society of Florida Foundation

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On December 14, 2011, the IRS published IR-2011-18 and suggested a number of tax tips for end-of-year charitable giving. These included several specific recommendations.

1. IRA Rollover – For individuals age 70½ and older who are IRA owners, they may have their IRA custodian make a direct transfer to qualified charities of up to $100,000. These direct transfers may fulfill part or all of the required minimum distribution for this year.

2. Clothing and Household Goods – Deductions for gifts of clothing and household goods are permitted if they are in “good used condition or better.” A gift item that has a value over $500 may be of a different quality, provided that there is an appraisal.

3. Gifts of Money – All gifts of money must be documented through a bank record or receipt. The gift should show the date, amount of the gift and the name of the charitable organization. Bank records may include a cancelled check, a bank statement or a credit card statement. Gifts may also be made through payroll deductions. In this case, the taxpayer should retain a pay stub, Form W-2 or a pledge card that shows the amount, the date of the gift and the name of the charity. If the gift is $250 or more, a contemporaneous written acknowledgement from the charity is required. This receipt must be in the taxpayer’s possession on the date of filing his or her tax return.

4. Timing – A contribution is deductible in the year when it is given. Credit card contributions may be made through December 31st, 2011. Similarly, checks that are sent through U.S. mail by December 31 are deductible if they clear in the normal course.

5. Charities – Deductions are only permitted for gifts to qualified charities. IRS Publication 78 is available on http://www.irs.gov and lists the qualified charitable organizations.

6. Itemized Deductions – Individuals who wish to claim their charitable gifts will need to itemize deductions on Schedule A of Form 1040. Normally, a taxpayer will itemize only if his or her charitable gifts, state and local taxes, mortgage interest and other deductions are larger than the standard deduction.

7. Clothing and Household Item Receipts – The taxpayer should obtain a receipt from the charity. It must list the name of the charity, the date of the gift and a reasonably-detailed description of the gift items.

8. Boat, RV or Car – The gift is usually limited to the gross proceeds from sale if the vehicle is valued at over $500. The charity will send IRS Form 1098-C to the taxpayer and this should be attached to Form 1040.

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
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The Ten Best Apps for [MD] Car Phones

Physician Necessity or Luxury?

By Dr. David Edward Marcinko MBA

[Editor-in-Chief]

The ME-P has published many insightful essays and comments on health information technology and related issues. It’s a hot topic, no doubt. Robust and controversial, too!

Regular readers of the ME-P also know that I’m a Jaguar fanatic; not the animal –  the British automobile. In fact, I’ve got a classic 2000 pearl white, XJ-V8-LWB from Coventry England, sitting in my garage right now. She’s never seen snow or rain; and when I’m not out jogging, on speaking tour or consulting with clients; or involved with this publication – you can usually find me ministering to her needs [and there are many]. Do I spend too much time with her; just ask my wife? She’s another high maintenance babe, but we both love her.

So, how do smart phones and tablet PCs relate to HIT and Jaguars?

Of Smart Phonese and Tablet PCs

Smartphones and tablets have revolutionized the way many of us live, and practice medicine. This change was undoubtedly what prompted one manufacturer to coin the marketing phrase, “There’s an app for that.”

Apps can help with shopping, exercising, learning, health information–and even driving.  So, here we look at the 10 best apps for car owners [courtesy Nalley Lexus-Jaguar] that help with everything from maximizing fuel efficiency and organizing a carpool to locating roadside assistance while using your hands-free via voice commands [checking patient status or relaying hospital orders]. Doctors, Jaguar owners and laymen alike, often love em’.

More http://www.nalleylexusroswellnews.com/Articles/10BestAppsforCarOwners/

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Doctor – Is Your Mac Vulnerable to Viruses?

Not Just a PC Problem Anymore!

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We all know that PCs are more vulnerable to viruses, worms, trojans, malware, adware and other electronic miscreants, than are Macs. And, that some medical professionals absolutely love their iPads and Macs.

But doctor, are you leaving your Mac vulnerable to unwanted intrusions?

 

Source: MacKeeper

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Finding [In]-Equality in [Medical and Financial Services] Executive Leadership

On Women Rising in the Professional Workforce

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Over the course of thousands of years, men have continued success in their dominant roles. However, it’s no surprise that 21st century data seems to be leaning toward the women; especially female physicians and female executives in the financial services industry.

Of course, we have written on leadership and gender differences before, on this ME-P, and in our textbooks, journal, handbooks and CDs, etc. All hve been medically focused or aimed at the financial services industry sector.

But, this infographic illustrates the overall success and independence that women have now experienced. Not only in relationships and family – but in business, medicine, finance and education – women have seen increasing gains of power.

Source: educationalleadership.com

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The Texas Dental Association Board Must Face the Truth

More on NPI Numbers

[By D. Kellus Pruitt DDS]

Dear Past TDA Board Members

I have some questions similar to the ones that got me suspended from the TDA a year ago: Who among you can defend your decision to persuade trusting TDA members to volunteer for National Provider Identifier (NPI) numbers?

And, why did you give up on the effort while BCBSTX continues to unfairly force dentists who aren’t even HIPAA covered entities to adopt the identifiers?

If you’re still unaware that everyone can see TDA leaders allowed themselves to be manipulated by stakeholders like BCBSTX, prepare yourself. It won’t be long before at least a few TDA members blame you personally for the bad things I warned would come to dentists with NPI numbers. Since the identifier does nothing to improve the quality of care, its promotion cannot be reconciled with the mission statement of the TDA, leaders. I hope angry dentists throughout the state seek the names of those of you who misled them.

A Non-Profit 

BCBSTX is a non-profit whose handsome profits are paid by taxpayers. The healthcare parasite sells dental insurance to theUSgovernment for federal employees. In their letter to me that I’ve attached, you can see for yourself that along with BCBSTX’s stated refusal to process any of their clients’ dental claims that come from my office, it says in capital letters, “DO NOT FORWARD THIS NOTIFICATION TO THE MEMBER!” How proud does it make you feel to know BCBSTX defines your level of ethics, TDA Board? Two years ago, your Director of Membership censored from the TDA Facebook this dentist’s criticism of BCBSTX’s NPI demands. Sometimes, you bozos are idiots.

I have no contractual relationship with BCBSTX, so as soon as could, I defied BCBSTX’s order and sent their client the letter – making sure to point out that BCBSTX ordered me to keep it secret from her. As you might expect, she’s pissed at BCBSTX! I hope she looks into a class action lawsuit. I bet BCBSTX has been secretly extorting their customers’ dentists by the thousands … but then, do you even care, TDA? What did BCBSTX offer the TDA that caused you to betray dentists and patients who used to have faith in your honesty?

BCBSTX is a Tyrant, and the TDA is an Enabler

There’s more: As a favor to our patients, my office has traditionally called their insurers for coverage information so that those who purchased the dental benefits will know how much of the bill they are responsible for before we start treatment. It’s called transparency.

Today, my office manager informed me that according to alerts she has received from insurers, if I don’t “volunteer” for a National Provider Identifier (NPI) number by 2012, my office will be deprived of the right to product information about BCBSTX’s plans. How does that help anyone, TDA?

Assessment 

Were you aware that this was the purpose of the NPI number when you pushed TDA members to sign up? Do you even care? Because of your silence inTexas’ dental community, it’s really hard to tell.

Conclusion

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A Message to all ME-P Readers about Physician Nexus TV for Doctors

Launching a New Video News TV Channel for Physicians

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By Omar Baig

Dear ME-P Community,

Drum roll please!

We have just launched a 24/7 video news channel.

Now every hour every day we will be adding valuable video content to Nexus. Our community is composed of physicians from 81 countries in time zones that span the world.  So regardless of where the member is or what time of the day it is there will be new and valuable content added within the hour.

You can search by specialty, latest videos, most popular, keyword, etc.

http://physiciannexus.com/video/

We are going through great lengths to ensure you get the highest value content possible.   If there is anything you would like us to add, just let us know.  We are here to serve you.

Instead of having to go to multiple sites to get the content you need, just come to Nexus.  Every minute that is saved is time that you can use to see patients or spend with your family.

We have also included a poll on the homepage which asks the type of information you seek (alternative/additional revenue opportunities, free CME, jobs, or other).  This feedback will be used to better serve our global physician community.

http://physiciannexus.com/main

Finally, I want to thank our entire team, including your ME-P publisher Dr. David Edward Marcinko, and all the members of our Medical Advisory Board for helping to make this vision a reality! 

About the Author

Omar Baig – Physician Nexus Team

2530 Berryessa Road – San Jose, CA 95132

www.PhysicianNexus.com 

Assessment

Visit Physician Nexus at: http://physiciannexus.com/?xg_source=msg_mes_network

Conclusion            

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Update on Tablet Usage in the Health Care Industry

A Growing Trend?

By Cyndi Laurenti

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The rapidly evolving technological era has ushered a host of industries into the digital world, including the medical field. Health care professionals in private and public institutions and even masters and PhD programs are quickly learning the immense benefits of utilizing technology in their practices and this has specifically included the use of the tablet computer.

Convenience and Mobility

In addition to the convenience tablets offer in size and mobility, more and more production companies are creating interfaces and programs specifically geared towards the healthcare industry and the tablet computer makes them more accessible and dynamic than the traditional clipboard. This is crucial in an industry where time is of the essence and life-changing decisions are made from moment to moment. Having a tablet computer puts the latest resources and tools in doctors and other health care professionals’ hands so they can make decisions efficiently.

Brand Neutral?

Although Tablet computers tend to be associated with the most popular brands like the iPad by Apple, a recent survey of 178 doctors indicated that even though the healthcare industry wants a tablet, it may not necessarily want the iPad in particular which does not have all the applications they require.

A whole industry of tablets has been specifically designed to meet the medical field’s particular needs, one example being the motion computing tablet PC. The West Clinic in Memphis which was founded by Supportive Oncology Services (SOS) and which caters for over 10,000 patients found that the motion computing tablet computer enabled them not only to streamline information between patients and physicians, but that it also lead to an improved quality of care and life for their patients and increased efficiency for their caregivers.

Other Healthcare Early Adopters

Another facility that adapted the use of tablet computers is the Lancaster General Hospital in Lancaster, PA, which has been rated as one of the top 100 hospitals for its efficiency and quality of care. The doctors and nurses are currently using 170 tablet computers in 21 units for a variety of tasks. Jon White, M.D. called it a ‘productivity tool’ and it is utilized around the hospital for patient safety through an application that assigns drugs through a unique bar code which ensures the right patient is getting the right medication and dose. It is also used to access patient records from anywhere in the hospital, review patient orders or test results, and access a library of medical reference information.

A third facility that utilizes the tablet computer is St. Mary’s Medical Center, an acute care facility in Evanville, Indiana, that provides inpatient and outpatient care. The tablet computer has currently replaced their paper-based patient charts, and cut down nurses’ charting times significantly.

Assessment

There is little doubt that the tablet computer has and will continue to revolutionize the healthcare industry. Tremendous positive changes have been made like the streamlining of once time-consuming and arduous processes. This increased efficiency ultimately translates into quality care for patients and the continued advancement of the medical field.

Conclusion      

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Healthcare Organizations: www.HealthcareFinancials.com

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The One-Woman Physician Investors Should Not Trust

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Why We Should “Run” from the SEC’s Mary Schapiro

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

OK, I’ve opined about fiduciary accountability for stock brokers, FAs and FPs – as well as Mary Schapiro [Chairman of the SEC] before – on this ME-P. And usually, in not so glowing terms!

But now, Mary really chaps my ethical and linguistic sensibilities.

Why I’m So P…… Off!

According to Bloomberg, and Advisor One [a financial services industry trade magazine], the chairwoman is considering something called the “business model neutral” rule that retains proprietary financial products, and brokerage sales commissions.

This concept of ‘business neutral’ is the one sought by many in the brokerage and insurance industry in order to redefine the term ‘fiduciary’ as an enhanced form of ‘suitability’ with opt-out provisions.

But, it is not sought by me, and should not be accepted by physicians.

Definitions

Suitability Rule – According to the Free Dictionary:

A stated or implied requirement by a regulatory body that a broker or investment adviser must reasonably believe that a certain investment decision will benefit a client before making a recommendation to him/her. That is, the broker or investment adviser must act in good faith, and may not knowingly recommend bad investments. Different regulators and self-regulating organizations incorporate suitable rules in different places in their bylaws. Two commonly referenced suitability rules are Rule 2310 for the Financial Industry Regulatory Authority and Rule 405 for the NYSE. See also: Due diligence, Prudent-person rule, Twisting.

Fiduciary Rule – According to the Free Dictionary:

A uniform standard for financial advisors that requires them to put retail customer interests ahead of their own financial interests.

This is clearly a higher duty [level of care] than suitability. Insurance agents, stock brokers, BDs and most “financial advisors” hate it.

Link: http://www.advisorone.com/2011/12/09/reaction-to-schapiro-comments-on-fiduciary-rule-ar?ref=hp

“Suitability on Steroids”

Some pundits suggest we think of this new “business model neutral” rule as “suitability on steroids.”

However, as most of us in medicine know, steroids are not a panacea and are typically used as a quick fix for short term gain, only.

Otherwise, the excessive use of anabolic steroids is bad for our physical health. Just like Mary Schapiro is bad for our fiscal health. But, a Certified Medical Planner™ is a fiduciary at all times http://www.CertifiedMedicalPlanner.org

More: Enter the CMPs

Assessment       

And so, your thoughts and comments on this ME-P are appreciated. I was an insurance agent and certified financial planner for almost 15 years [Series 7, 63 and 65] before I resigned all – in disgust over the fiduciary flap.

Doctors are fiduciaries. I am a fiduciary, a doctor, and a financial advisor. Shouldn’t all physician-investors demand same from their own financial advisors [NASD-FINRA, RIAs, RIA-Reps]?

But hey – I’m just a medical provider.

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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Financial Planning MDs 2015

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

Front Matter with Foreword by Jason Dyken MD MBA

[BY DOCTORS – FOR DOCTORS – PEER REVIEWED – NICHE FOCUSED]

***

Population 7 Billion [A Video]

How Did We Get So Big – So Fast?

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As higher standards of living and better health care are reaching more parts of the world, the rates of fertility — and population growth — have started to slow down, though the population will continue to grow for the foreseeable future.

The Forecasts

U.N. forecasts suggest the world population could hit a peak of 10.1 billion by 2100 before beginning to decline. But, exact numbers are hard to come by — just small variations in fertility rates could mean a population of 15 billion by the end of the century.

So, watch this video as the global population explodes from 300 million to 7 billion.

How we got to a population of 7 billion

Source: npr.org

Conclusion   

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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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Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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On Performance Based Health Networks and Medical Cost Savings‏

Achieving Proper Healthcare Alignment

[Number 3 in a Series of 6]

By Sam Muppalla – Vice President, McKesson Health Solutions, Network Performance Management (NPM)

Last week, on this ME-P, I wrote about Health Plans and the Three Levers of Innovation for Affordable Care. We looked at a number of innovations taking place in the areas of products, care models, reimbursement, and network designs. It’s vitally important to be able to innovate in each of these areas, but even more important to be able to align these network elements properly. The key to affordable care is enabling every member to get the right care, at the right time, from the right provider, and for the right price. But, when you look at what it takes to deliver such care, the interdependencies of design of care models, payment, products and networks become apparent, as you can see in Figure 1 below:

 Figure 1: Affordable care requires alignment of product, network, care model, and payment design.

Steering the member to the right provider at the right setting is influenced by the member incentives built into the product design and the provider choice component of the network design. The right care is dependent on the care model design and the provider reimbursement design. Overall affordability of care is obviously tied to payment design. Not so obvious are the dependencies between product design and payment design. The member behavior targeted by product incentives should be reinforced by the provider engagement influenced by reimbursement design. All these interdependencies necessitate alignment between product, care model, reimbursement and network design. Alignment is fundamental to scaling innovation.

Network Design Drives Alignment

As shown in Figure 2, network design drives alignment between product, care model, and payment approaches. As an illustration, it facilitates the alignment of products and care models by enabling steerage of members to the appropriate care teams or sub-segments of the network. This steerage can only occur if member benefits and incentives (which are embodied in the product design) and the structure of care teams (which are described in the network design) are systematically matched. This systematic matching has to be governed by network-level guidelines for provider performance management.

Figure 2: Network design drives the alignment that delivers affordable, high-quality care.

Focusing on the alignment between products and payment, network design enables this by ensuring that the goals of member incentives are supported by the provider behavior driven by payment design. This enablement is achieved through network-level reimbursement guidelines being automatically enforced during provider contracting.

Finally, network design incorporates network-level reimbursement guidelines to drive alignment between care model and payment design by ensuring that provider behavior envisioned in the care model design is incented by payment design.

As health plans productize new care models and payment innovations, the complexity and the frequency of the abovementioned alignment efforts will mushroom. Customer segmentation and the need for tailored products to serve these customer segments will further amplify the alignment challenge.

The approach of using network design automation to efficiently operationalize alignment is a critical core competency for health plans. By innovating with this approach, it will be possible for health plans to strike the optimal balance between the value to their customers (competitive premiums, high-quality care) and the value to themselves (revenue enablement, reduced medical and administrative cost).

Assessment 

Are there barriers to operationalizing alignment? Of course! But stay tuned: Next week, I’ll be writing about the barriers to alignment — and after that, I’ll go into more detail about why it takes an integrated approach to remove these barriers. As before, if you don’t want to wait to read more, you can read the entire Unlocking Affordable Care by Aligning Products white paper now; it’s available on our website.

Conclusion

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Certified Medical Planner

Out Newest M E-P “Thought-Leader”

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Academic Credentials

Dr. Phillips academic credentials include a B.A. and M.D. from the University of Louisville, a M.B.A. from Jacksonville University, a J.D. from Florida Coastal School of Law and a LL.M. from Thomas Jefferson School of Law in International Taxation with concentrations in 1) International Financial Services and 2) Wealth Management and Private Banking.

Additional course work was completed at Stetson University College of Law LL.M. program in Elder Law and the University of Alabama School of Law LL.M. program in U.S. Taxation. Course work has been completed for a Ph.D. with the thesis pending. Dr. Phillips completed a general surgery residency at University of Florida / Jacksonville, a plastic surgery fellowship at University of Florida / Gainesville and a Hand Fellowship at the University of Miami. Dr. Phillips clinical career includes positions in academic medicine, private practice and as an independent contractor.

Personal Philosophy

Jim believes that modern healthcare professionals receive the best medical education in the world, but receive little or no education in the business of medicine in medical or professional school or during clinical training.

According to Dr. Phillips: Medicine may be a calling – but – the practice of medicine is a business.

Assessment:

Dr. Phillips’s quest for higher education led to the founding of: The OTHER Medical Education, Inc., a place where health care professionals can obtain the business education they need. Clients include a wide variety of health care professionals including physicians, dentists, pharmacists, veterinarians, podiatrists, nurse practitioners, physician assistants, and others. These health care professionals may have their own practices, work within someone’s practice or be employed by a health care facility or company. They may or may not be involved in the decision making process of the practice. However, they recognize sound business practices even if not directly involved in the decision making process, and are involved in their own personal finances.

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Conclusion

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