Seeking Director of Clinical Informatics [RN]

Nursing Informatics or Administration

By Lindsay Good
National Healthcare Recruiter
LGood@csihealthinc.com

Dear ME-P Readers and Subscribers,

I am contacting the ME-P to see if you might know someone that would be qualified and interested in a Director of Clinical Informatics position approximately 10 miles outside of Washington DC area, in Maryland. We are looking for someone with a RN-nursing background that has a master’s degree in Nursing Informatics or Administration. This person MUST have management experience in the clinical information systems arena. This is a full time, permanent position with great benefits and relocation assistance for the right candidate. The pay range is negotiable depending upon years of relevant experience, education and credentials. We do offer a $1,000 referral bonus to you if you refer someone to this position and they get the job.

Responsibilities

The Director of Clinical Informatics applies expert knowledge of clinical information systems to the management and communications of data, information and knowledge in clinical practice and administrations. He/she serves as a member of the HealthCare Excellence in Informatics leadership team, driving the transformation of care delivery at the bedside. Over sees process changes utilizing technology as a tool; facilitates the coordination of system changes; provides onsite leadership and is the hospital liaison to the Care Excellence team. As a member of the Clinical Standards Board, the CI Director will represent one of our hospitals to standardize the clinical care processes and lead the change management strategy at the hospital. She/he is responsible for representing all users of the clinical system to ensure adoption of the new process as well as technology to achieve organizational and health system strategic goals.

In addition, the CI Director will work closely with the Hospital educational resources to ensure the highest standard of education associated with care transformation is provided to the clinical users. The director collaborates with the vorporate informatics team in order to achieve the strategic goals of Care Excellence.

This position reports to the AVP-Quality @ the hospital level with matrix reporting to Corporate for Cerner.

Qualifications

*Master’s Degree in Nursing Informatics or Administration with certification and extensive experience in Informatics.
*Current Maryland RN License
*Minimum of 5 years clinical nursing experience, and 3 years of progressive responsibility in information system administration, including leadership participation in implementation of a major information system.
*Knowledge of research, methodology, healthcare delivery systems and financial/reimbursement issues.
*Ability to work with multidisciplinary teams to facilitate change.
*Experience in group facilitation.
*Strong customer service skills,
*Excellent written and verbal skills.
*Strong problem solving and analytical skills.
*Demonstrated ability to be self-directed

Additional

*Project management skills.
*Computer proficiency in HIS, Windows and Internet environments and Microsoft Suite Applications.

Contact

Lindsay Good
National Healthcare Recruiter
CSI Health
http://www.csihealthinc.com
LGood@csihealthinc.com

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Advertise with the Medical Executive-Post

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Government Launches Population Health Improvement Initiative

Called “Million Hearts”

[By Staff Reporters]

The Department of Health and Human Services (HHS) has launched a “Million Hearts” campaign that is designed to prevent a million heart attacks and strokes in the next 5 years.

Assessment

You can read about it in the New England Journal here or in Circulation here.  There is also more detail here at the HHS gov web site.

Conclusion

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Women’s Health in the USA

Pro-activity and Self-Care Still Needed

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These days women are more inundated than ever with information about how to live better. Yet a snapshot of women’s health in theU.S.shows many women still need to be more proactive about self-care.

A surprising number have risk factors for serious health threats such as heart disease, cancer, and strokes due to lifestyle habits that, according to the American Heart Association, may be controllable in many instances.

Assessment

A collaboration between GOOD and Deeplocal, in partnership with GE.

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Health-Care Reform Rules Would Restrict Public Reporting

 Information Restricted to “qualified entities” Only

By Marshall Allen

ProPublica, Sept 15th, 2011, 10:46 am

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It’s estimated that hundreds of thousands of patients die annually from preventable harm suffered while undergoing medical care. The infections, injuries and errors could rank as a leading cause of death in the United States.

The PP-ACA of 2010

Last year’s sweeping health-care reform law — the Patient Protection and Affordable Care Act — promised to improve the problem by allowing outside groups to use Medicare billing records to analyze and publicly report on the quality of care. But proposed rules that would guide the release of the data are being criticized by consumer groups that say the rules would make independent accountability impossible.

CMS  

Agencies typically adopt rules to administer laws like the health-care act. The rules being developed [1] by the Centers for Medicare & Medicaid Services (CMS) propose restricting the release of Medicare billing data to “qualified entities.” To qualify, a group would have to:

  • Pay up to $200,000 for the data.
  • Have its methods pre-approved before obtaining the data.
  • Already possess billing information from other sources to combine with the Medicare data — an advantage to insurance companies.
  • Limit public reporting to quality measures approved by the health-care industry.
  • Present its reports and findings to every doctor and facility being measured before they are released to the public — a requirement that would make large-scale reports difficult.

Medicare officials declined to discuss the proposed rules because they are being finalized after a public comment period ended Aug. 8th. But interviews and a review of comments show that the rules have sharply divided consumer-oriented groups and health-care providers.

Safe Patient Project

Lisa McGiffert, director of the Safe Patient Project run by Consumers Union, the nonprofit publisher of Consumer Reports magazine, said the new law was seen as “a real opportunity” because, for the first time, Medicare data could be used to tell the public about the performance of doctors. But the proposed rules would make it impossible for Consumers Union to use the data, she said.

“The best-kept secret inAmericais what doctors are doing,” McGiffert said. “People should be able to find out information about outcomes of care, whether their docs are using appropriate practices and whether they’re providing too much of something that people don’t need.”

Bruce Boissonnault, president and CEO of the Niagara Health Quality Coalition, a nonprofit that’s been independently measuring the quality of health care since 1995, said the rules are needlessly complex and designed to suppress freedom of information. He said the rules would make it impossible for all but industry insiders to access the new data, giving them control over what’s released.

“We will only see the scraps of information that the industry wants us to discuss,” Boissonnault said. “It’s advertising wrapped in a lab coat.”

Boissonnault [2] and Consumers Union [3] submitted public comments, urging Medicare to reconsider the restrictions.

Enter the AMA

The American Medical Association submitted comments [4] mostly supporting the access limitations and in some cases urging more restrictive rules. For instance, the proposed rules say doctors would need 30 days to review any analysis before it’s publicly reported, but the AMA wants that review period increased to 90 days. The AMA also wants Medicare to consider complaints by physicians against an organization before allowing the organization access to the data.

Assessment

The Federation of American Hospitals, which represents investor-owned health-care facilities, said in its comment [5] that it is “very troubled” by the proposed rules, despite the increased restrictions, because billing data have a limited ability to measure quality. The federation wants a limit on the number of qualified entities that have access to the data.

Link: http://www.propublica.org/article/health-care-reform-rules-would-restrict-public-reporting

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A Word About ME-P Links and Commentary

We Are More Than Just … Posts

By Ann Miller RN MHA

[Executive-Director]

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OK, we know our ME-P posts are popular with readers and subscribers. We have more than 2,500 of them, after all.

Comments versus Posts

But, if you are not reading comments, you are not getting all you can from each post. And, if you are not reading the links in each post, you are not getting all you can from the Medical Executive-Post.

So, please don’t fail to check out the comments, and learn from them, too! Along with our contributors and “thought-leaders”, we have some of the smartest readership around the blog-o-sphere.

Assessment

And, rest assured; we almost never block them.

Intelligence – Candor – Goodwill to all!

Conclusion

Your thoughts and comments on this ME-P are appreciated. This is the very essence of social media. 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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Does Financial Regulation Kill Jobs?

Perhaps Not!

By Marian Wang
ProPublica, Sept. 12, 2011, 1:20 pm

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With the presidential campaign in motion, and President Obama urging immediate passage of his new jobs bill, the attention in Washington has shifted almost exclusively to the economy and job creation. And, that means a shift away from regulation, right? Not necessarily.

Growth Spurts?

Some regulators and financial industry experts are predicting the opposite—that new financial regulations will spur some growth.

For example, The New York Times’ DealBook blog cited derivatives regulation [1] as one example. Dodd-Frank requires a substantial chunk of the $600-trillion derivatives market to trade on exchanges or on new electronic trading platforms.

“I have no doubt that these new regulations, instituting new types of clearing, trading and reporting platforms, will foster a landslide of hiring in the financial sector,”

Bart Chilton of the Commodity Futures Trading Commission said in a recent speech cited by the Times. As another New York Times piece noted, previous financial regulation laws have resulted in additional jobs for accountants and lawyers [2], at least.

But, separate from the jobs created to actually handle new regulation, others have pointed out that regulations can have a long-term, positive effect on overall economic growth by preventing the types of crises that put an industry on life-support.

The Studies

Last year, two studies by central bankers and regulators found that the short-term impacts of stricter capital requirements were “significantly smaller” than the estimates published by banking groups, the Times reported.

Rather, the studies said that stricter regulation would lead to more long-term growth [3] by preventing future crises.

Banks see higher capital requirements

  • Which require them to have more financial cushion to balance out risk-taking as a damper on profits.
  • And, they have repeatedly warned that tougher rules will hamper lending, reduce investment and slow economic growth.

Assessment

But, not everyone sees it that way. Swiss regulators, for instance, indicated last year that they would impose even tougher capital standards on their country’s banks on the premise that investors would rather put their trust [4]—and their dollars—in safer banks.

Conclusion

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White House Proclaims National Health Information Technology Week

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Sixth Annual Event

President Barack Obama has declared the week of Sept. 11-16th, 2011, to be National Health Information Technology Week.

NHIT

National Health Information Technology Week is a time to highlight the importance of efficient information systems that protect the privacy and security of personal health information while improving the delivery of health care in the United States.

Assessment

This White House proclamation underscores the importance of using technology to transform the nation’s health care system and improve the privacy and security of personal health information.

Link: http://www.healthcare-informatics.com/ME2/dirmod.asp?type=news&mod=News&mid=9A02E3B96F2A415ABC72CB5F516B4C10&tier=3&nid=290E96EE4239456DA265E59A1ABAF939

Link: http://www.healthitweek.org/activities.asp

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A Review of Current Personal Finance and Investment Literature

Current Synopsis [Around the Literary World of Economics]

By Dr. Peter Benedek CFA

http://retirementaction.com/

Investors will grapple with more turbulence surrounding Europe’s deepening debt problems this week and the prospect of another round of dismal data on the faltering U.S. economy. So, let us listen while Doctor Benedek speaks.

Dr. David E. Marcinko; FACFAS, MBA, CMP[Publisher-in-Chief]

In the Globe and Mail’s “In an emergency, is your info safe?” Dianne Nice suggests a teachable moment associated with the recent US andOntario tornadoes, north-eastern earthquake and hurricane threat. Specifically, she suggests that we consider taking steps to safeguard our important papers, should our home be destroyed. The ICBA recommends keeping important documents in a bank safe: marriage certificate, tax returns, property deeds, birth certificates insurance policies, credit card number, and list of household valuables for insurance claims, paper or electronic copies of important computer records. Additionally consider keeping copies in the home in sealed plastic bags (Probably not a bad idea.)

Scott Willenbrock in the Financial Analysts Journal’s “Diversification return, portfolio rebalancing, and the commodity return puzzle” argues that “the underlying source of the diversification return is the rebalancing, which forces the investor to sell assets that have appreciated in relative value and buy assets that have declined in relative value, as measured by their weights in the portfolio. Although a buy-and-hold portfolio generally has a lower variance than the weighted average variance of its assets, it does not earn a diversification return. Diversification is often described as the only “free lunch’’ in finance because it allows for the reduction of risk for a given expected return. Diversification return might be described as the only “free dessert” in finance because it is an incremental return earned while maintaining a constant risk profile. The contrarian activity of rebalancing, however, must be performed to earn the diversification return; diversification is a necessary but not sufficient condition. Although an un-rebalanced portfolio generally has reduced risk, it does not earn a diversification return and suffers from a varying risk profile. The control of risk, together with the diversification return, is a powerful argument for rebalanced portfolios.”

In the CFA Institute’s Financial Analysts Journal’s “The winners’ game” Charles Ellis looks at the investment profession’s challenges and opportunities. He writes that the investment profession has made three errors:  two of commission and one of omission. He writes that “In addition to the two errors of commission—accepting the increasingly improbable prospect of beat-the-market performance as the best measure of our profession and focusing more and more attention on business achievements rather than on professional success— we have somehow lost sight of our best professional opportunity to serve our clients well and shifted our focus away from effective investment counseling. Some of the help clients need is in understanding that selecting managers who will actually beat the market over the long term is no longer a realistic assumption or a “given” … most investors need help in developing a balanced, objective understanding of themselves and their situation: their investment knowledge and skills; their tolerance for risk in assets, incomes, and liquidity; their financial and psychological needs; their financial resources; their financial aspirations and obligations in the short and long run … Our profession’s clients and practitioners would all benefit if we devoted less energy to attempting to “win” the loser’s game of beating the market and more skill, knowledge, and time to helping clients recognize market realities, understand themselves as investors, and clarify their realistic objectives and then stay the course that is best for each of them.” (Charles Ellis is the author of the must read book entitled“Winning the Loser’s Game- Timeless Strategies for Successful Investing”.)

Glenn Ruffenach in the WSJ SmartMoney’s “5 best online retirement guides” provides a list from  “One of the most comprehensive and valuable sites online is also among the least known: the Employee Benefits Security Administration.”

In WSJ SmartMoney’s “Why Wall Street’s forecast can’t be trusted” Alex Tarquinio writes that “Over the years, some market forecasters have been about as accurate as, well, weather forecasters… But some financial planners ignore the Wall Street prognostications altogether. George Papadopoulos, the owner of the eponymous financial planning firm in Novi, Mich., says most stock strategists tend to be too bullish, save a few who are “perma-bears.” Ignore the headline number, he says, and “focus on what you can control,” like finding a good balance of stocks and bonds for your portfolio.” (Now there is some sensible advice; ignore talking-heads, ‘strategists’, ‘prognosticators’ and soothsayers. Remember there are very few things that you can actually control: your spend-rate, saving-rate, investment fees and costs, asset allocation and rebalancing.)

In the Globe and Mail’s “Hunting high and low for safe yields” John Heinzl enumerates some of the available options for ‘safe yields’ and concludes that none come even close to paying off your 4% mortgage which at 40% tax rate gives you 6.67% guaranteed.

In Bloomberg’s “Homeowners on East Coast may have to pay for earthquake damage” Leondis and Ody report that “Earthquake protection is generally excluded from standard homeowners’ insurance policies, and consumers have to purchase coverage either as a separate policy…“For most of us, having earthquake insurance doesn’t make sense,” said Sheryl Garrett, founder of Shawnee Mission, Kansas-based Garrett Planning Network Inc., a network of fee-only financial planners. That’s because residents of areas where earthquakes rarely occur generally don’t need the coverage, and policies in parts of the country with frequent earthquakes are more expensive to compensate for the increased risk, she said.”

In the Globe and Mail’s “Vanguard to launch six ETFs in Canada” Shirley Won reports that Vanguard is launching “six exchange-traded funds (ETFs) inCanada. The stock ETFs include Vanguard MSCI Canada and the Vanguard MSCI Emerging Markets, as well as the Vanguard MSCI U.S. Broad Market and Vanguard MSCI EAFE, which will both be hedged to Canadian dollars. The bond category includes Vanguard Canadian Aggregate Bond and Vanguard Canadian Short-Term Bond ETFs.”

Real Estate

On the Canadian front, in the Globe and Mail’s “Most housing ‘reasonably affordable’: RBC” Steve Ladurantaye reports that Vancouver house prices are in “uncharted territory” and “it would take 92 per cent of the median household’s pretax income to own a bungalow in the city at current prices – the highest reading yet in its quarterly national survey on affordability. However according to RBC most (other) Canadian cities offered reasonably affordable” housing options in the second quarter compared to the first. Nationally, a condo required 29.2 per cent of pretax household income (a 0.8 per cent increase), a bungalow 43.3 per cent (1.7 per cent) and a detached home 49.3 per cent (1.8 per cent)… The bank’s affordability index looks at the proportion of pre-tax household income needed to service the costs of owning different categories of homes at current market values. Its standard measure is a 1,200-square-foot bungalow, and the carrying costs include mortgage payments (principal and interest), property taxes and utilities.”

However in the WSJ’s “Toronto wary of condo correction” (note this is in WSJ, not the Globe and Mail or the National Post) Monica Gutschi reports that “A condominium-building boom is lifting Canada’s largest city into the same stratosphere as London, Sydney, Vancouver and Miami, but deepening the worries about a potential tumble…Toronto is a long way from Miami, but the condominium boom north of the border has begun to evoke ominous comparisons, even among real-estate agents. TheToronto area is home to 1,198 condo projects with 210,000 units, according to research firm Urbanation. About 40,000 additional condominium units are under construction, including 16,000 set to hit the market next year. “There’s more supply coming than the market really needs, unless we have a stronger economy than we have today,” says independent housing economist Will Dunning…As many as 60% of recent condominium buyers in Toronto are investors who bought their units from developers before construction began—and then sold their condos…But buyers whose condominiums are investments are getting squeezed. Stagnant rents make it harder to cover mortgage payments.”

On the US front, in Bloomberg’s “Home prices decline 5.9% in second quarter” Kathleen Howley reports that “Home prices in the U.S. fell 5.9 percent in the second quarter from a year earlier, the biggest decline since 2009, as foreclosures added to the inventory of properties for sale…Purchases decreased 3.5 percent to a 4.67 million annual rate, the weakest since November.” Furthermore Nick Timiraos in WSJ’s  “Home-loan delinquencies rise again” reports that “The Mortgage Bankers Association said 12.87% of mortgage loans on one-to-four-unit homes were 30 days or longer past due or in the foreclosure process at the end of the second quarter, representing more than 6.3 million households. The second-quarter figure was down from 14.4% one year earlier but up from 12.84% at the end of March…While mortgage delinquencies remain highest in states hard hit by the housing bubble—such as Nevada, California and Florida—the inventory of loans in foreclosure is highest in states that require banks to obtain court approval when they foreclose on homeowners. Nationally, about 4.4% of all loans were in foreclosure at the end of June. Of the nine states that exceeded the national average, all but one—Nevada—have a judicial foreclosure process. Foreclosure rates were highest inFlorida (14.4%),Nevada (8.2%),New Jersey (8%),Illinois (7%),Maine andNew York (5.5%).”

In Florida context, in Palm Beach Post’s “Palm Beach County home sales slump in July from previous month” Kimberly Miller reports that “A Florida Realtors report released Thursday found 972 single-family Palm Beach County homes traded hands in July, a 21 percent increase from the same time in 2010, but an 18 percent drop from the previous month. The median sales price in Palm Beach County fell 17 percent from last year to $187,900 – a price not seen consistently since 2002. Statewide, sales of existing homes fell 12 percent in July from the previous month, but were up 12 percent compared to July 2010. The median sales price of $136,500 remained mostly stable…The inventory of homes for sale in Palm Beach County was down to an eight month supply in June, a 46.5 percent decrease from 2010 and down 62 percent from 2009, according to the Realtors Association of the Palm Beaches. That may change soon. Forbes, as well as Realtor Dean Hooker, owner of Pompano Beach-based Southeast REO, said banks are preparing to release more foreclosures for re-sale. Also in the PBP is Jeff Ostrowski’s article “Foreclosure-related sales’ prices fall, and the discount widens” in which ne reports that “The average price of a foreclosure sold inPalm BeachCounty in the second quarter was $116,642, down from $142,997 a year ago. And the discount for foreclosure sales compared to non-foreclosure sales widened to 38 percent this year from 23 percent a year ago. There were 3,253 distressed sales – including foreclosure sales, pre-foreclosure sales and sales after a lender has taken ownership – inPalm BeachCounty in April, May and June, according to RealtyTrac. Those sales made up 37 percent of all transactions in the county. In St. Lucie County, 701 foreclosure deals in the quarter accounted for 44 percent of all sales. Statewide, there were 34,558 foreclosure sales in the second quarter, accounting for 35 percent of all sales in the state.”

In the Globe and Mail’s “Foreign buyers see value in U.S. real estate” Simon Avery writes that with Florida prices off typically 50% since the peak, low mortgage rates, the strong Canadian dollar: ” As an alternative investment, U.S. real estate may never look so attractive to Canadians again…At the moment, the best deals in the Miami area are in South Beach, an area where the properties on average are older. There are currently 172 properties listed under $150,000 and 50 per cent of them are within walking distance to the beach. Generally, these are small, art deco-style, low rises. Their monthly maintenance fees run $320 or less and the sizes range from 240 square feet to 440 square feet.” (That doesn’t sound that cheap for an average of 340 SF units comes to about $441/SF…bargain??? You be the judge.)

Things to Ponder

In the Globe and Mail’s “Amid slowdown, Fed has few tools left” Kevin Carmichael discusses the limited remaining options available for the Fed to provide stimulus to rekindleUS growth and employment. The real problem, however, might be related to that “these aren’t normal times. When businesses and consumers would rather save than spend, as currently is the case in theUnited States, the power of monetary policy is muted. Corporations are sitting on some $2-trillion (U.S.) in profits and the household savings rate has climbed to more than 5 per cent from zero before the financial crisis, even though the cost of borrowing already is at record-low levels… What theU.S. economy needs is a massive jolt to demand that would encourage companies to hire and invest. The best way to do that, many economists argue, is through fiscal policy.”

Jack Hough in WSJ SmartMoney’s “Treasurys versus stocks: spot the safe one” provides some support to Jeremy Siegel’s arguments that “bonds are in a bubble and stocks are good deal”. Arnott says that the 10-year Treasurys yield about zero, given nominal yields of 2.1% and past year’s inflation of 3.6%; whereas the S&P 500 dividend yield is 2.3%. “Bond yields are usually larger because stock dividends tend to grow over time and bond coupons don’t, so bond buyers typically want to be compensated for this…The choice is between stocks’ higher and rising yield and bonds’ lower and flat one…The third reason is that stocks have a better chance of keeping up with inflation…Dividends have rarely looked safer…Today’s payments are 29% of S&P 500 profits. That’s the lowest level since 1900, and perhaps in history…(but) Economists have slashed growth forecasts for most rich economies, and many put the chances of renewed U.S. recession at a coin flip.” So it depends on your horizon/risk tolerance, but “savers with a decade to wait” will find the arguments for stocks persuasive. But not everyone agrees that the metrics are valid. For example, in the Financial Times Lex column’s “Equities: metrics of the trade” discusses pundits indicating that based on P/E ratios and dividend yields compared to bond yields, it is time to buy stocks. Lex suggests that “the big flaw with this approach is that current or near-future earnings are very unlikely to represent an equilibrium return from stocks… It is a fact that company returns normalise, so a much longer earnings period against which to compare stock prices is needed. Inflation also needs be taken into account, as do accounting changes over time. Robert Shiller’s cyclically adjusted p/e ratio is a step in the right direction. Such an approach holds the S&P 500 to be anywhere up to 40 per cent overvalued… Likewise, history shows there to be no predictive power comparing equity and bond yields. Why should there be? Dividends are risky and rise with inflation; coupons are risk free and do not. It is like buying apples because pears are cheap. There are good reasons why stocks might rally – flaky valuation metrics are not among them.”

In the Guardian’s “Rating agencies suffer ‘conflict of interest’, says former Moody’s boss” Rupert Neate reports that “ratings agencies suffer from a conflict of interest because they are paid by the banks and companies they are supposed to rate objectively.”This salient conflict of interest permeates all levels of employment, from entry-level analyst to the chairman and chief executive officer of Moody’s corporation,” Harrington said in a filing to theUS financial regulator the Securities and Exchange Commission (SEC), which is considering new rules to reform the agencies. Harrington claims that Moody’s uses a long-standing culture of “intimidation and harassment” to persuade its analysts to ensure ratings match those wanted by the company’s clients.” (Recommended by the CFA Institute Financial Newsbrief)

In Bloomberg’s “Baby Boomers selling shares may depress stocks for decades, Fed paper says” Vivien Lou Chen writes that “Aging baby boomers may hold down U.S. stock values for the next two decades as they sell their investments to finance retirement, according to researchers from the Federal Reserve Bank of San Francisco … Jeremy Siegel, 65, a finance professor at the University of Pennsylvania’s Wharton School in Philadelphia, has also researched the link between demographics and U.S. stocks. He said that growth in developing countries should generate enough demand to absorb a baby-boomer selloff and “keep stock prices high.””

In the Financial Times’ “Inflation a danger for safe havens” Steve Johnson argues that the US/UK/German 10-year government bonds yielding in the 2-2.2% range is due to their perceived “safe haven” status from the wild swings of the markets. “But these miserly yields must also reflect investors’ confidence that inflation will be muted over the next decade. How logical is this assumption?…this insouciance about the prospects for inflation misses the international dimension, that stemming from rising import prices … (but) For the seven US recessions between 1957 and 1991, commodity prices on average fell 1.6 per cent during the period between the start of the recession and two years after its end. The equivalent figure for the two recessions so far this century is a rise of 27.3 per cent… Rather than enjoying a tailwind from falling commodity prices and low inflation rates, it may become the norm for recession-ravaged developed nations to face a commodity headwind and stubbornly high inflation.”

Assessment

And finally, in the NYT’s “In Korea, the game of trading has rules” Floyd Norris writes that “Finance ought to provide an economy with an efficient means of allocating capital. It should provide a means of price discovery of assets, whether real or financial. It should provide a safe and reliable payments system. Financial innovations are worthwhile if, and only if, they help in those areas.  All too often, players see financial innovations as providing ways to manipulate the system and make money off less savvy traders.” In South Korea things are changing. Four traders were indicted for intentionally manipulating stock prices for profit, specifically for causing a market drop. “Countries around the world felt called upon to bail out banks during the financial crisis. That made sense because a functioning financial system is necessary. But these kind of games are not necessary, whether or not they are criminal. These charges provide an endorsement of the Volcker Rule, named for Paul A. Volcker, the former Federal Reserve chairman, and included in the Dodd-Frank law in theUnited States, which sought to restrict proprietary trading by banks whose deposits are insured. If such games are to be played, let them be played by others.“ The article concludes with the need for prison terms for these traders to insure a deterrent effect  (Thanks to DB for recommending.)

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AHIMA Appoints Lynne Thomas Gordon as New CEO

 AHIMA Communities of Practice

Press Release: http://www.ahima.org/

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Lynne Thomas Gordon MBA FACHE RHIA  joins the Chicago-based AHIMA after serving as associate vice president for hospital operations and director of the Children’s Hospital at Rush University Medical Center. She also is a member of the Rush University faculty in the graduate program in health systems management.

Thomas Gordon holds active membership in AHIMA and the American College of Healthcare Executives.  She has served on the information management task force of  the Joint Commission and as a governor on the ACHE board. She held additional offices for ACHE and was awarded their Early Career Healthcare Executive Regent’s Award.

Link: http://www.healthcare-informatics.com/ME2/dirmod.asp?type=news&mod=News&mid=9A02E3B96F2A415ABC72CB5F516B4C10&tier=3&nid=427F747927AF47E986C74F30A7E2A40B

Assessment

And so, the ME-P congratulates Lynne on her new appointment and wishes her well.

Conclusion

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World Trade Center Reborn

National 9/11 Memorial Plaza and Museum

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The new World Trade Center site will include the National 9/11 Memorial Plaza and Museum, and 1 WTC, soon to be the tallest building in the United States.

Brought to you by History.com in collaboration with Column Five Media

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On [H]IT Security

Reviewing the Tools of Prevention

By www.SEO.com

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There are a number of tools to fight negligence, including education, executing best practices and vigilance. More challenging is increasing [health] data protection [PHI] amid the surge in malicious attacks coming from inside and outside the organization.

Assessment

What’s encouraging? The Ponemon Institute says more companies are being proactive about data protection.

The infographic above, produced by SEO.com for Dell, gives a bit more context for the threat environment.

Conclusion

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Introducing Child Stats.Gov

Including a Forum

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The website, Child Stats, offers easy access to statistics and reports on children and families, including: family and social environment, economic circumstances, health care, physical environment and safety, behavior, education and health.

The Forum

Their “Forum” fosters coordination, collaboration, and integration of Federal efforts to collect and report data on conditions and trends for children and families.

Assessment

And so, give em’ a click and tell us what you think?

http://www.childstats.gov/index.asp

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The Federal Strategic Plan to Reduce Health IT Disparities

Request for Comments

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[By Staff Reporters]

Working to ensure all Americans benefit from health IT is one of the principles guiding the development and execution of the federal health IT strategy. The Federal Health IT Strategic Plan that was released for public comment on March 25, 2011, states that we will strive to: Support health information technology (heath IT) benefits for all.

All Americans should have equal access to quality health care. This includes the benefits conferred by health IT.: The government will endeavor to assure that underserved and at-risk individuals enjoy these benefits to the same extent as all other citizens.

Health IT Disparities Workgroup

For the past few months, the Health IT Disparities Workgroup — comprised of staff from agencies of the U.S. Department of Health and Human Services (HHS): with strategic and operational programs in health IT and co-chaired by the Office of the National Coordinator for Health Information Technology (ONC) and the Office of Minority Health (OMH) — has led a focused effort to further define the federal government’s strategies and tactics to reduce health IT disparities within underserved communities. The result of this process will reflect our commitment to do more to reduce health IT disparities.

The Health IT Disparities Workgroup is developing a federal plan to reduce health IT disparities.: A draft set of strategies/tactics — aligned with the five goals of the Federal Health IT Strategic Plan — is included below: We hope you will assist us by providing comments on the following questions:

  • What do you think of the draft strategies / tactics listed below?
  • What specific activities would you like to see the federal government take on to reduce health IT disparities?

HIT

Health information technologies — such as electronic health records (EHRs), telemedicine, mobile health, and electronic disease registries — have been identified as effective means of helping to deliver safe, effective, affordable health care services; coordinate care across providers and clinical settings; and provide critical population data that may catalyze further policy and delivery system innovations.

Meaningful Use

The growing adoption and meaningful use of health IT is even more critical within the context of underserved communities. Within both rural and urban underserved communities, access to primary and specialty health care resources can be limited. This scarcity in many instances contributes to reduced quality of health care and of health outcomes for people residing in these communities. Within underserved communities, the use of health IT has demonstrated it can improve health outcomes, both from an individual and community-/system-wide perspective.

Federal Planning

Federal planning efforts focused at reducing health disparities, including The National Stakeholder’s Strategy and the HHS Action Plan to Reduce Racial and Ethnic Health Disparities, highlight the proliferation of meaningful use of health IT within underserved communities as a critical objective. This draft set of strategies/tactics (see below) for the federal plan to reduce health IT disparities aims to ensure that underserved communities realize the full benefits of health IT.

Assessment

Read more: http://www.healthit.gov/buzz-blog/from-the-onc-desk/federal-strategic-plan-disparities/#ixzz1X7U1WnCQ

Conclusion

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About Costs of Care.Org

What it is – AND – How it Works?

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Costs of Care, a nonprofit 501(c)(3), is a social venture that helps doctors understand how the decisions they make impact what patients pay for care.

By harnessing social media, mobile applications, and other information technologies, they give doctors and patients the information needed to deflate medical bills.

Health Economics Factoid

“The cost of health care now causes a bankruptcy in America every thirty seconds.”

(President Obama to the 2009 Joint Session of Congress)

Essay Contest

Costs of Care will be launching an essay contest for 2011 after Labor Day, with $4,000 in prizes for the best anecdotes illustrating the importance of cost awareness in health care! www.costsofcare.org/essay

 

 

Assessment

And so, give em’ a click and tell us what you think http://www.costsofcare.org/  Better yet! Enter the essay contest and/or give a donation. It’s tax deductible.

Conclusion

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Labor Day US Budget Deficit Estimated at $1.32 Trillion Dollars

Office of Management and Budget Report for 2011

By Children’s Home Society of Florida Foundation

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On September 1st, 2011, the White House Office of Management and Budget (OMB) released an updated estimate of the budget deficit. OMB Director Jacob Lew indicated that the deficit projections are now reduced.

OMB Projections

The February projection by OMB had been a deficit of $1.65 trillion for the current fiscal year. The new deficit number for fiscal year 2011 is $1.32 trillion. The larger number would be 10.9% of the economy. The reduced deficit number is still approximately 8.8% of the gross domestic product.

Lew gives credit to the Budget Control Act of 2011, signed by President Obama on August 2nd. Under the provisions of that act, there are substantial spending reductions.

Budget Committee Pleased

Senate Budget Committee Chair Kent Conrad (D-ND) was pleased with the lower budget numbers, but indicated there still is a long road to recovery. Referring to the Joint Select Committee on Deficit Reduction, he stated, “It is my hope the committee exceeds its $1.5 trillion target. It is also critical that the special committee considers measures to address the near-turn struggling economy.”

Assessment

In his address on September 8th 2011, President Obama is expected to discuss both the Joint Select Committee and long-term budget goals.

The OMB report also estimated the total debt by the end of 2011. The federal debt is a combination of debt held by the public and various government trust funds. The debt held by the public at the end of 2011 is estimated to be $10.26 trillion or 72% of the economy.

Conclusion

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Multi-Hospital System Executive Summary [2001-2009]

Number of Hospitals In and Out of Multi-Hospital Systems

By Staff Reporters

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This .PDF details key demographics measures, including hospital breakouts by size, ownership type, region and multihospital system (MHS) affiliation.

Link: http://www.managedcaredigest.com/pdf/MCD11HospInstDemoPgs.pdf

Assessment

The data measures outlined come directly from Managed Care Digest Series print digests and related materials. As always, these data are available at the state and local levels by contacting your sanofi-aventis account manager.

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Stock Market Collapse or Earth Quake?

On the Road, Again!

By Dr. David Edward Marcinko MBA

[Editor-in-Chief]

A 5.8-magnitude earthquake rattled the East Coast on August 23rd and continued to produce aftershocks for several days. At least 18 aftershocks ranging in magnitude from 4.5 to as little as 2.0 followed the strongest earthquake to strike the East Coast since World War II, according to the US Geological Survey.

Aftershocks are smaller tremors that take place in the weeks and possibly months following a major earthquake like the one centered in Mineral, Virginia. They are usually felt in a smaller area than the original quake. The largest of the aftershocks so far was a 4.5-magnitude quake, according to the USGS. Tens of millions of people from Georgia to Canada were jolted by the initial tremor.

We felt it here in Atlanta too, as well as my home town of Fell’s Point, in Baltimore, Maryland [just north of Washington, DC], where I was visiting Johns Hopkins Hospital, engaging clients and lecturing at the time.

St. Patrick’ Church

Here is a reference file photograph of St. Patrick’s Roman Catholic Church in Baltimore, Maryland, before the quake and just down the street a bit from Johns Hopkins Hospital, toward the waterfront district.

 

Enter the Tremors

Now, here is the church on August 23rd, 2011, after a finial at the top edge of the spire fell, shattering a manhole cover far below.

The Damage Today

Fortunately, no one was injured.

This remaining damage is now the problem on this historic building.

Assessment

However, some ME-P readers and www.MedicalBusinessAdvisors.com clients are wondering if the finial collapse was due solely to the quake, or might the recent world-wide stock market tremors be involved in some way – you decide?

Conclusion

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The ACA Individual Mandate [Voter Opinion Survey]

Individual Mandate Opinion Survey

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Do you think the individual mandate of PPACA should be overturned?

Conclusion

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Events Planner: September 2011

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Events-Planner: SEPTEMBER 2011

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:

  • September 15-18: FPA Experience 2011, San Diego, CA.
  • September 26-28: First Annual Fiduciary Management Summit, Boston, MA.

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

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RAC Demand Letters Replaced

CMS Transfers Responsibility

By Staff Reporters

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January 2012 marks a significant change for Recovery Auditors as the Centers for Medicare & Medicaid Services (CMS) is transferring the responsibility for demand letters from the auditors to claims processing contracts. The reason for the change is “to avoid any delays in demand letter issuance,” according to MLN Matters article 7436.

The Result

As a result, when a Recovery Auditor finds improper payments, they will submit claim adjustments to your Medicare (claims processing) contractor. The contractors will carry the responsibility of fielding concerns throughout the time frame of the payment recovery and the appeals process.

Assessment

Read the full article here.

Conclusion

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The Cost of Early [HIT] Adopters

An eHR Lesson for Physicians?

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With the rapid change in technology, such as eHRs, knowing when to purchase a truly innovative product is becoming increasingly more difficult. With promises of changing our lives or saving time and money, more often than not, the initial release doesn’t live up to these expectations – at least not right away.

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Assessment

However, many of us – doctors included – wait in long lines to be the first adopters, understanding that we most likely will pay more and have to deal with problems. Even with these known hurdles, being an early adopter does have its benefits.

Conclusion

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Video on Being a ‘Real Doctor’

DVM vs MD, etc.

By Dr. David Edward Marcinko MBA

[Publisher-in-Chief]

While discussing the future of medicine at Drexel University in Philadelphia recently [privately and off-the-record], a medical colleague shared the below video with me that strangely struck a chord.

Turf Battles

MD vs DO vs DPM vs DDS vs NP vs ANP vs PA vs DNP vs OD vs PT vs DC etc.

Can you think of any others; formal degrees and designations, or mere turf battles?

Assessment

Trust me … it’s worth 3.55 minutes out of your life to view and ponder.

Link: http://www.xtranormal.com/watch/6868901/veterinarian-vs-md

Conclusion

Have we created a system that is more careless health than health care?

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Doctor’s Lawsuit Targets Parents of Patient Who Overdosed

By Marshall Allen
ProPublica, Aug. 26, 2011, 10:57 am

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The dramatic rise in prescription narcotics use [1]—and the subsequent increase in overdose deaths—has led to a spate of lawsuits around the country targeting doctors for malpractice or running pill mills [2]. But legal experts say the case of one family physician in Henderson,Nev., stands out.

The case of Kevin Buckwalter

Dr. Kevin Buckwalter has turned the tables, filing a lawsuit against the parents of a young woman who died from an overdose of narcotics that he prescribed.

Buckwalter’s suit accuses John and Maggie DeBaun of abusing the legal process, intentionally inflicting emotional distress and interfering with his ability to do business by filing a medical malpractice case against him for the death of their daughter.

“I’ve never heard of such a lawsuit,” said Stacey Tovino, a professor at the William S. Boyd School of Law at theUniversity of Nevada, Las Vegas. Tovino and otherNevada legal experts said it appears to them that Buckwalter abused the legal process in an attempt to intimidate the DeBauns.

Buckwalter did not respond to a call for comment. His brother Bryce, who serves as his attorney, declined to comment about the lawsuit. In an email, he accused this reporter of harassment for attempting to contact his brother, said he would seek a restraining order and threatened to sue ProPublica.

A Controversial Subject?

Buckwalter has been a subject of controversy for several years. A 2008 Las Vegas Sun investigation [3], also by this reporter, highlighted the opinions of four pain-management specialists who reviewed Buckwalter’s care of patients and said it appeared to be negligent.

Staci Voyda, a teenager addicted to prescription narcotics, wrote in her journal that she went to Buckwalter to get off drugs. But his treatment included ramping up her dosages of narcotics. She killed herself in August 2007, and family members say the drugs pushed her over the edge.

Another Buckwalter patient, 69-year-old Barbara Baile, was prescribed large doses of narcotics, which caused constipation so severe it ruptured her bowels. A subsequent infection killed her.

These are prescriptions for Xanax and morphine written by Dr. Kevin Buckwalter for Andrea and Clint Duncan. (Sam Morris/Las VegasSun) | See Las Vegas Sun’s full investigation on Painful Painkillers [4].

The DeBauns’ daughter, Andrea Duncan, died in 2005 from intoxication with opiates and benzodiazepines [5], a class of drugs that includes Valium and Xanax. Four days earlier, her husband Clint, also a Buckwalter patient, had overdosed on prescription narcotics and died.

In a 2007 videotaped deposition [6] for an unrelated lawsuit, Buckwalter described the treatment he provided Duncan. Under oath, Buckwalter said he did not examine Duncan on her first visit because he “did not have time,” yet prescribed her 300 tablets of Xanax, an anti-anxiety medication, and the painkiller hydrocodone, a synthetic opiate.

The following year, the U.S. Drug Enforcement Administration and Nevada State Board of Medical Examiners stripped Buckwalter of his license to prescribe controlled substances. The DEA attributed at least eight overdose deaths [7] to Buckwalter. The medical board blamed him for four cases of malpractice [8], including one in which the patient died. Buckwalter closed his practice.

Dallaslawyer Kay Van Wey, who specializes in pill mill cases, filed six lawsuits against Buckwalter on behalf of patients who died or were harmed. The DeBaun case was filed in April 2009, past the statute of limitations in Nevada. But Van Wey argued in the complaint that the deadline should be extended because Buckwalter allegedly concealed his negligence and altered medical records.

A judge didn’t buy the argument and dismissed the case. Buckwalter claims in his lawsuit that the DeBauns sued to harass and annoy him.

Buckwalter has denied all of the allegations that he provided substandard care. His lawsuit against the medical board to get his prescribing privileges reinstated was unsuccessful.

Jeffrey Stempel, a professor at the UNLV law school, said that for the DeBauns’ lawsuit to be considered an “abuse” of the legal process, there would have to be some ulterior motive other than seeking damages for their daughter’s death.

Assessment

Ann McGinley, another professor at the UNLV law school, said it takes more than simply filing a lawsuit to support a claim of intentional infliction of emotional distress. And given that Buckwalter lost his ability to prescribe controlled substances in 2008, it’s difficult to see how the DeBauns interfered with Buckwalter’s ability to conduct his business, she said.

McGinley said that if lawsuits like Buckwalter’s became more common, they could have a chilling effect, discouraging patients from pursuing legitimate malpractice claims. “My concern is that other doctors will take this on as something that they will do regularly,” she said.

Link: http://www.propublica.org/article/doctors-lawsuit-targets-parents-of-patient-who-overdosed

Conclusion

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PODCAST: Dr. Somnath Basu on Retirement Happiness

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By Staff Reporters

A PodCast Clip

This brief podcast clip features Dr. Somnath Basu, director of the California Institute for Finance [CIF].

Dr. Basu, a popular ME-P thought-leader, shares his insights on what makes people happy in retirement.

PODCAST: https://www.youtube.com/watch?v=iTrtmW831Xk

Conclusion

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How Lifetime Benefits and Contributions Point the Way Toward Reforming Our Senior Entitlement Programs

By Staff Reporters

From Expert Voices

By C. Eugene Steuerle PhD [Institute Fellow and Richard B. Fisher Chair, The Urban Institute]
By Stephanie Rennane [University of Maryland]

For August 2011

Reforms to Medicare and Social Security will likely be debated over the next few months as the new “super committee” formed by the debt ceiling agreement works to develop its long-term deficit reduction plan.

The Essay

In this essay, Dr. Eugene Steuerle and Stephanie Rennane help to inform this debate by presenting findings from their newly updated analysis showing that seniors retiring today can expect to receive dramatically more in entitlement program benefits during retirement than they contributed to the programs while working.

For example, the average Medicare beneficiary can expect $3 in benefits for every $1 paid in payroll taxes.

Link: http://nihcm.org/images/stories/EV-Steuerle-Rennane-FINAL.pdf

Assessment

The authors posit that the magnitude of the resources involved when viewing these programs in tandem over a lifetime gives policymakers new impetus and flexibility to develop coordinated entitlement reforms that promote a coherent, equitable and sustainable support system for current and future generations of seniors.

Conclusion

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Dr. Somnath Basu on Financial Planning Client Expectations [PodCast]

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By Staff Reporters

On Client Attitudes in the New Economy

In this encore podcast, Somnath Basu PhD examines how the recent economic turmoil has changed financial planning clients’ attitudes and expectations.

Dr. Basu is a popular ME-P contributor and thought-leader.

Assessment: http://www.youtube.com/watch?v=jzAkB8h5v3Q

Conclusion

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A Nutrition Label for Health Insurance Plans?

Appreciating “Search Frictions”

By Dr. David Edward Marcinko MBA CMP™

[Editor-in-Chief]

Because products vary so much across many characteristics, health insurance is not easy to shop for. Comparing plans is an apples-to-oranges problem.

Of Search Frictions and Economic Externalities

As a former insurance agent for more than a decade, this is a situation by design – to obfuscate the patient and consumer.  

The challenges of comparison – health insurance plan – shopping then, creates what economist and colleague Austin Frakt PhD calls “search frictions” or inefficiencies in the ability to wisely choose. This may be likened to economic “externalities” and perhaps even motivated the recent development of (draft) standards for health plan labeling.

Beginning March 2012

So, how much will the new health plan labels, required starting next March, help consumers in their search for plans? How much grease will they add to the otherwise highly frictional process? I sure don’t know.

A good place to start however, is an examination of those frictions. What are they and how much do they matter?

Link: http://www.healthcare.gov/news/factsheets/labels08172011b.pdf

Assessment

Did food nutrition labeling, and the old food pyramid help – or confuse – consumers? What about the old and new cigarette warning label warnings? Or – the prohibition of alcohol for pregnant women – helpful or not! Any labeling for that matter?

Conclusion

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The Debt Agreement Explained in Three Steps

The Bi-Partisan Compromise

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The recent budget compromise created a joint committee of Congress, which you might have seen referred to as the “super committee.”

This committee is responsible for developing a bipartisan plan for reducing our deficit by $1.5 trillion over the next 10 years. (That’s on top of about $1 trillion from the down payment that was included in the first phase of the deal.)

Brought to you by The White House.

 

Conclusion

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Why PACs Won’t Jeopardize a Hospital’s Tax Exempt Status?

According to IRS Private Letter Ruling

By http://www.garfunkelwild.com/

Recently, the Internal Revenue Service (“IRS”) issued a private letter ruling (the “Ruling”) that will allow the requesting tax-exempt hospital to establish and operate a social welfare organization as a means of engaging in political activities and establishing a larger presence in the political arena. The Ruling concluded that these actions will not jeopardize the hospital’s tax-exempt status under the Internal Revenue Code of 1986, as amended, (“IRC”) § 501(c)(3). Pursuant to IRC § 501(c)(3), a corporation organized and operated exclusively for religious, charitable, scientific, literary or educational purposes is exempt from federal income taxes, provided that its net earnings do not inure to the benefit of a private individual and a substantial part of its activities do not involve lobbying or related political conduct.

The Requesting Hospital

The requesting hospital is a comprehensive regional, integrated health care system that has qualified as a tax-exempt, charitable organization (the “Hospital”).  Currently, the Hospital conducts an insubstantial amount of lobbying through its government affairs department (the “Department”), in an effort to improve the cost efficiency of health care services. The Ruling serves to permit the Hospital to take a more active role in the political arena, through the formation of a separate, non-profit social welfare organization (the “Organization”) that will, in turn, establish two independent political action committees (collectively “PACs”).

Social welfare organizations are tax-exempt entities that are designed to promote the general welfare of the community. See IRC § 501(c)(4).  Social welfare organizations may conduct political campaign activities and establish political organizations, as long as political campaigning is not the primary activity. Reg. § 1.501(c)(4)-1(a)(2)(ii).  Accordingly, in order for the Hospital to create the Organization, the IRS requires that the Organization (a) remain independent from the Hospital and (b) apply for tax-exempt status as a social welfare organization.  Notwithstanding the preceding sentence, the Hospital proposed that it would remain the sole voting member of the Organization, and that the majority of the Organization’s Board of Directors would be officers, directors or employees of the Hospital.  The IRS permitted the Hospital to act accordingly, provided the Hospital complied with the IRS requirements set forth in this Legal Alert, and expanded upon in the Ruling.

More on the Private Ruling

The Ruling permitted the Organization to establish two PACs for the purpose of accepting contributions from, or making expenditures to, a political candidate or party.  See IRC § 527(e). As part of its analysis, the IRS concluded that the PACs, Organization and Hospital must operate independently, in order to ensure that the political activities of the Organization and the PACs would not be attributed to the Hospital and would not impact the Hospital’s tax-exempt status.  To comply with the Ruling, the PACs must maintain separate bank accounts and records, as well as separate addresses and phone numbers.  In addition, any leasing or sharing of employees, goods or services among the Hospital, Organization and PACs must be conducted at arms-length.

Assessment

Furthermore, the Ruling concluded that the Hospital may establish and operate a voluntary payroll deduction plan permitting Hospital employees to make political contributions through the PACs.  The Ruling provided that political contributions by employees of the Hospital will not impact the tax-exempt status of the Hospital, as long as the Hospital does not influence the employees’ choices regarding contribution.

Editor’s Note

Please note that this Private Letter Ruling is limited to the facts at issue, and should not be relied upon by anyone other than the Hospital.

Conclusion

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On the Deadliest Disease Outbreaks in History

Black Death to Measles

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From the From the Black Death to the measles, rapidly spreading diseases have taken a toll on humanity for centuries. Here’s a look at the biggest and deadliest pandemics ever.  

A collaboration between GOOD and Column Five Media.

Conclusion

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How to Burglar-Proof Your Cash Stash?

Avoid Burglar-Friendly Spots

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Brought to you by mint.com

If the wobbly financial markets have you hoarding cash at home, beware. Yes, as a doctor, you may be safe from bear markets, but you’re still vulnerable to losses, especially if you leave your money and valuables in burglar-friendly spots.

View the image below to expand the infographic and see where you’re best off hiding your cash, according to tips gathered from a real burglar, and places where you shouldn’t put any money.  

Conclusion

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Recruiting Medical Director

Corvallis Clinic‏

By Judy Kliethermes

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Corvallis Clinic, a large, physician-owned, multi-specialty clinic located in the heart of Willamette Wine Valley, is seeking a Medical Director. Corvallis Clinic is comprised of 82 providers located at five sites. Founded in 1947, Corvallis Clinic boasts more than 25 specialties and employs 600 medical professionals. Corvallis Clinic serves more than a quarter million people in surrounding communities and has been recognized for superior performance by the American Medical Group Association, the National Committee of Quality Assurance, and the Medical Group Management Association.

The Medical Director will be responsible for EHR implementation and enhancement, risk management, peer review and quality improvement. Additionally, the Medical Director must have experience working with LEAN and Six Sigma concepts as they relate to process improvement. The Medical Director will be charged with encouraging physician involvement and will act as a change agent for the organization.

Furthermore, the Medical Director will be the face of Corvallis Clinic and will be expected to represent the clinic in civic and community events and activities. We are seeking collaborative, patient-focused physician leaders who have strong experience leading physician-owned clinics.

Medical Director candidates must be board-certified and possess a minimum of ten years clinical experience. An MBA or MHA is preferred, but not required. The role is 80% administrative; 20% clinical.

I would welcome your interest.

Sincerely,

Cejka Executive Search
4 CityPlace Dr., Ste. 300
St. Louis, MO 63141
314.236.4429 Office
judyk@cejkasearch.com
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OCR Imposes Penalties for Employee’s Unauthorized Viewing of PHI

By Garfunkel Wild, PC

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Early in July, the Department of Health and Human Services Office of Civil Rights (“OCR”) entered into a settlement for $865,500 with UCLA Health System (“UCLAHS”) as a result of complaints alleging that UCLAHS employees repeatedly and without permissible reason looked at the electronic protected health information (“ePHI”) of celebrity patients.

Initial Complaints

Although the complaint was initially made by only two patients, in its investigation OCR determined that from 2005-2008 unauthorized employees of UCLAHS repeatedly looked at the ePHI of numerous other patients as well. In addition to paying the settlement, UCLAHS committed to a correction action plan that includes (1) implementation of policies and procedures; (2) robust training for employees; (3) a commitment to sanction offending employees; and (4) designation of an independent monitor to assess compliance over 3 years.

Assessment

This settlement is the fourth settlement in a year and highlights OCR’s increasing enforcement of violations to HIPAA Privacy and Security Rules. Failure to have an effective HIPAA compliance program can result in significant monetary penalties, and therefore, providers and business associates alike should be evaluating their HIPAA compliance programs to ensure that appropriate safeguards are in place.

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Docs and FAs Stressed Out Over Fee Disclosures?

Financial Services and Healthcare Industry Affected

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

Starting April 1, 2012, financial advisors [FAs] are going to have to disclose fees for their services to retirement plan sponsors, according to changes to the ERISA rules.

But, as you may not know, advisor fees to retirement plan fiduciaries have gone unnoticed for decades because their compensation comes out of the service providers’ compensation.

Link: http://blog.registeredrep.com/yield_of_dreams/2011/08/12/stressed-over-fee-disclosure-look-to-service-providers-for-templates/

Are Medicine and the Financial Services Sector Similar?

Recently, while visiting the Wharton School at the University of Pennsylvania, and discussing same with several colleagues, I realized that this is not unlike medical provider fees which are typically paid for by a private or public third party insurance-like carrier. Historically, relatively covert to patients, but not so much today!

For example, in 2007, federal and state legislatures called for hospitals across the country to make their prices “transparent.” The term was defined as the full, accurate, and timely disclosure of hospital charges to consumers of healthcare, as well as the process employed to arrive at those fees.

Moreover, transparency does not merely involve publishing a list of prices and fees.  Essentially, hospital CXOs must be able to present their prices in a manner that is understandable to the general public and they must be prepared to explain the rationale behind their charges.

And, for the solo or small group medical practitioner, dentist, retail or direct care practice, is this a trend that is growing or declining?  

Assessment

So, where are fees for FAs, under the above scenario, headed. We know the answer for doctors, of course, buy why are the FAs so fretful? Is it because they fear a healthcare-like meltdown disaster?

And, why would any vendor [doc or FA] fear letting the customer / patient  know the price of his products or services? Aren’t there many companies who are a huge success, following just this business model; retail / wholesale anyone? Why fear telling folks what you charge?

Conclusion

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America’s One-Stop Shop for Healthcare [HIEs]

Health Insurance Exchanges [HIEs]

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Brought to you by ACS a Xerox Company

For some Americans, selecting a health insurance plan will soon feel a bit like shopping. As part of healthcare reform, each state is required to have a Health Insurance Exchange (HIE or HIX) in operation by Jan. 1, 2014.

Given the complexity of the topic, we’ve created the attached infographic that visually represents the process Americans will experience when participating. If you’re planning to write about HIXs in the near future – we hope you’ll consider using this graphic to help explain the process to your readers.

Here is additional information on HIXs to support the infographic:

  • Q:  How will states develop a HIX? A: States can either build their own HIX structure or buy a platform from the federal government.
  • Q:  Who can participate in a HIX? A: Only individuals without other coverage, individuals from whom coverage is unaffordable or inadequate, or small employers can participate in the exchange in 2014. Large employers can join the exchange in 2017.
  • Q:  How many people are expected to participate? A: The Exchanges are expected to cover as many as 29 million people by 2019, including five million with employment-based coverage.

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Medicare and the Budget Control Act’s Joint Select Committee

Creating Spending Reductions for the Next Decade?

By Children’s Home Society of Florida Foundation

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Under the compromise between President Obama and leaders of the House and Senate, the Budget Control Act of 2011 created spending reductions of over $900 billion during the next decade. The bill also requires leaders of the House and Senate to appoint members to a Joint Select Committee. The committee has three Republican, three Democratic Senators, three Republican and three Democratic Representatives.

House and Senate leaders have now appointed the committee members. The 12 committee members are tasked with creating a $1.5 trillion budget solution by Thanksgiving. Their bill will be voted on without amendments by December 23, 2011.

If the committee is not able to develop and pass a bill by Dec. 23, there will be $1.2 trillion in budget cuts. Half of the cuts will come from the Department of Defense and one-half will be reductions in payments to Medicare providers.

Majority Leader Harry Reid (D-NV) appointed three Senators. The Co-Chair of the Joint Select Committee will be Sen. Patty Murray (D-WA). His other two appointees are Sen. John Kerry (D-MA) and Sen. Max Baucus (D-MT). Sen. Kerry is Chair of the Senate Foreign Relations Committee and Sen. Baucus is Chair of the Senate Finance Committee.

Republican Leader Mitch McConnell (R-KY) appointed Sen. John Kyl (R-AZ), Sen. Pat Toomey (R-PA) and Sen. Rob Portman (R-OH). Sen. Kyl is the Republican Whip and a senior member of the Finance Committee. Sen. Toomey is a member of the Budget Committee. Sen. Portman was previously Director of the Office of Management and Budget.

Speaker John Boehner (R-OH) appointed Rep. Jeb Hensarling (R-TX) as Co-Chair of the committee. His other appointments are Rep. Dave Camp (R-MI) and Rep. Fred Upton (R-MI). Rep. Camp is Chairman of the Ways and Means Committee and Rep. Upton chairs the Energy and Commerce Committee.

Democratic Leader Nancy Pelosi (D-CA) appointed Rep. James Clyburn (D-SC), House Ways and Means Member Xavier Becerra (D-CA) and Budget Committee Member Chris Van Hollen (D-MD).

The Joint Select Committee is expected to initiate meetings in September after Congress returns from the August recess.

Editor’s Note: There will undoubtedly be a spirited debate. All of the twelve committee members will want to avoid drastic budget cuts for the Department of Defense or Medicare providers. The group will need to discuss potential cuts in discretionary expenditures, defense and entitlements. With the appointments of key taxwriters Baucus and Camp, it is clear that taxes will also be a part of the discussion. Whether or not there are tax increases as part of the budget solution remains to be seen.

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How to Take Care of Your Eyes

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In celebration of National Eye Health Week we at Ultralase have immersed ourselves in the world of vision in order to produce this handy graphic containing facts and tips to help encourage you, and the rest of the world to Love Your Eyes. Brought to you by www.ultralase.com

 

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The Sick Cost of Medical Paperwork – Maybe?

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[By Staff Reporters]

If there’s one thing Americans can agree upon 100%, it’s that the cost of helath care is completely insane. Costs are far higher in theUSthan in any other industialized nation, and even health care reform hasn’t been able to reel them in yet.

But, where is all the money going, exactly? Hundreds of billions are going straight into the paper shredder. Brought to you by Medicaltranscription.net

 

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What Does the S&P Downgrade Mean?

If France Is Rated Higher Than the US!

By Marian Wang
ProPublica, Aug. 8, 2011, 5:38 p.m.

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The decision by credit rating agency Standard & Poor’s to downgrade the United States [1] after markets closed on Friday may have kicked up political [2] consternation [3] and triggered a market plunge [4], but it also raises important questions about the reliability of credit ratings and, for that matter, the firms that bestow them.

Just over a dozen countries currently have an AAA [5]—or lowest-risk—rating from each of the three main rating agencies: Moody’s, Fitch, and Standard & Poor’s. Until this weekend, the United States was among them. (It’s now roughly on par with Australia, which also has two AAAs and one AA+.)

So, which countries are among the lucky few that still have perfect ratings from all three firms? The United Kingdom and France, just to name a couple. S&P apparently thinks that both the U.K. and France are safer investments than the United States.

The United States still has a higher per-capita GDP [6] than most countries, including both the U.K. and France. Last year, the U.S. GDP grew 2.9 percent [6]—almost double the U.K.’s 1.4 percent and France’s 1.5 percent. Between April and June of this year, the U.S. GDP grew 1.3 percent [7] while the U.K. economy grew 0.2 percent [8]. A June forecast from the Bank of France estimated that the country’s economy would grow 0.4 percent [9] in the second quarter. (U.S. growth, granted, is still slower than it used to be [10].)

As a percentage of GDP, both the U.K. and France have a higher percentage of external debt [11], or debt owed to outside bondholders. In 2010—the latest year for which the Organization for Economic Cooperation and Development has numbers—U.S. external debt was 61 percent of GDP, compared to France’s 67 percent and the U.K.’s 86 percent. Austria also maintains a lowest-risk rating from all three firms, and its external debt was 66 percent of GDP last year. 

Let’s not forget unemployment. Our July 2011 unemployment rate figure was 9.1 percent [10]. That’s higher than the U.K.’s, which has hovered around 7.7 percent [6], but it’s lower than France, which had 9.7 percent unemployment in June.

S&P, in explaining the historic downgrade—the first in U.S. history—cited both the U.S. debt burden and the political brinksmanship over the debt ceiling as reasons it lowered the credit rating of the United States to AA+, with a negative outlook.

So, what do the ratings mean, really? It seems to be a question that economists and investors are asking, too.

“France is not, in my view, a AAA country,” a UBS economist told Bloomberg [12]. And yet there are no indications [13] that France will face a downgrade, the Wall Street Journal reports. In fact, all three of the rating agencies recently affirmed France’s triple-As [12].

Credit rating agencies have taken a collective hit to their reputations for issuing flimsy triple-A credit ratings on securities that collapsed and helped trigger the financial meltdown. A Senate investigation earlier this year identified the firms as “a key cause [14]” of the financial crisis. Documents released by congressional investigators also pointed to serious conflicts of interest [15] that caused some ratings firms to bend to the wishes of the banks that paid for their ratings. 

Assessment

As we’ve written, some of the same problems with company culture [16] and inaccurate ratings [17] have persisted. Meanwhile, the Office of Credit Ratings—an office created by Dodd-Frank, the financial reform bill, to oversee these firms—hasn’t even been set up because Congress didn’t allocate funds for it. Other efforts written into the measure to lessen U.S. reliance on ratings and open up the firms to more liability have been slowed or stalled altogether.

Wiping out the references to credit ratings in U.S. law is a “harder task than the legislation assumes,” said Barbara Roper, director of investor protection for the Consumer Federation of America. The downgrade, she thinks, may provide just enough impetus to keep those efforts moving. 

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Hospitals Slowly Affiliating with RBACs

The Rise of Role-Based Access Controls

By Dr. David Edward Marcinko MBA CMP

Last month I visited the University of Pennsylvania in Philadelphia. Of course, I graduated from Temple University myself and worked as an admissions clerk in the ER, back in the day.

There I learned that some local hospitals are affiliating in role-based access control (RBAC) electronic networks by controlling which patients, medical providers or health plans have access based on the needs of patients, payors, physicians, or insurers. User, doctor, and patient rights and services are then grouped by name, and access to medical resources is restricted to only those authorized.

The technology was first pioneered and used in London hospitals several years ago.

Example:

For example, when an RBAC network system is used by a hospital, each individual that is allowed access to the hospital’s network would have a pre-defined role (doctor, nurse, lab technician, administrator, patient, etc.).

If someone is defined as having the role of doctor, for example, then that user can access only resources of the healthcare network that the role of doctor has been allowed access to (electronic medical records, for example).

If another user has access as a diabetic patient, then that user cannot access unapproved health services, like OB-GYN. Each user is assigned one or more roles, and each role is assigned one or more privileges for users in that role.

Assessment

Link: http://www.computerweekly.com/Articles/2007/10/19/227566/How-to-implement-role-based-access-control.htm

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Things You Didn’t Know About Death

Not a Unique Experience

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Death is an experience that we’re all going to have at one point or another. Why not take a few minutes to learn some interesting and some truly bizarre facts about death, dying, and the dead? Brought to you by medicalinsurance.org

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USN&WR – Meet the ADA President

Dr. Raymond Gist

By Kellus Pruitt DDS

I just found a US News Health article by Angela Haupt titled, “The Era of Electronic Medical Records.”

http://health.usnews.com/health-news/most-connected-hospitals/articles/2011/07/18/most-connected-hospitals?PageNr=1 

Even though dentistry wasn’t mentioned even once, I took liberties with the comment I posted. Besides, dentistry is never mentioned anywhere in the healthcare press, and that’s just not healthy. That is the point I hope I got across to Angela Haupt when I suggested she become Dr. Gist’s 7th Facebook friend.

 

Dear US News and World Report:

Last year, President Barack Obama promised that digitizing America’s health records will go beyond just improving care. He said transforming from paper to digital is a “panacea for the economy.” Somehow, illness became a renewable national resource.

I’m pretty sure neither the President nor US News have a clue about the business of dentistry.

Defying your common, misinformed bias for EHRs over paper records, here is a bite of reality from a dentist who actually treats patients: Other than me, the nation’s other 170,000 dentists are stone-silent about adoption of electronic dental records. Don’t you find that odd? What’s more, stakeholders inside and outside the American Dental Association, including even software vendors, avoid public discussions of EDRs. Dr. Oz’s Sharecare.com won’t even touch the topic. Why?…  a reporter might ask.

Do you trust that the widely-respected ADA always represents first and foremost the safety of dental care for both dentists and their patients? Let me fix that for you: ADA President Dr. Raymond Gist recently opened a Facebook, and two days ago, I was fortunate enough to be his second fan and the first to post a comment.

https://www.facebook.com/pages/Raymond-F-Gist/165275266868843

I took advantage of an unprecedented opportunity to speak directly to a vetted ADA official and asked the President, “Are electronic dental records more or less dangerous for dentists and patients than paper records?” I’m disappointed that Dr. Gist still has not responded. Why did he even bother opening a Facebook, one might ask.

Here’s what I think:

Because of the cost and safety issues with digital records that I warned each ADA President about since 2006, EDRs, and especially HIPAA, have become so difficult to defend in a free-market that nobody even tries any more. I think a handful of ADA leaders expected pigs to fly much sooner than this.

Assessment 

Want to do some real reporting, US News? Become Dr. Raymond F. Gist’s 7th Facebook fan and ask him on behalf of your publisher if EDRs are safer than paper dental records. Sure. It’s unconventional, and as far as journalism goes, it’s kind of kinky to post a question on someone’s Facebook. Nevertheless, it could be fun to watch a USN&WR reporter be treated with the same level of respect ADA officials offer dues-paying members.

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Events Planner: August 2011

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Events-Planner: AUGUST 2011

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:

  • August 15-18: National Quality Colloquium at Harvard, Cambridge,  MA

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 

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