About the Comparative and International Education Society

A Cross-Cultural Collaborative

[By Staff Reporters]

The Comparative and International Education Society (CIES) was founded in 1956 to foster cross-cultural understanding, scholarship, academic achievement and societal development through the international study of educational ideas, systems, and practices. The Society’s members include more than 2,000 academics, practitioners, and students from around the world.

Protean Interests

CIES work is built on cross-disciplinary interests and expertise as historians, sociologists, economists, psychologists, anthropologists, and educators. The Society includes 1,000 institutional members, primarily academic libraries and international organizations.

Comparative Studies and Policy

Over the last four decades, the Society’s members have strengthened the theoretical basis of comparative studies and increasingly applied those understandings to policy and implementation issues in developing countries and cross-cultural settings. The membership has increased global understanding and public awareness of education issues, and has informed both domestic and international education policy debate. The Society works in collaboration with other international and comparative education organizations to advance the field and its objectives.

Assessment

As a registered non-profit [501(c)3] organization in the United States, the Comparative and International Education Society supports the activities of its members to:

  • promote understanding of the many roles that education plays in the shaping and perpetuation of cultures, the development of nations, and in influencing the lives of individuals
  • improve opportunities for the citizens of the world by fostering an understanding of how education policies and programs enhance social and economic development
  • increase cross-cultural and cross-national understanding through educational processes and by the study and critique of educational theories, policies and practices that affect individual and social well being

Newsletter: http://www.cies.us/newsletter/jan10/index_jan10.html

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Sales of Dental Equipment and eDRs Down

Peterson Dental Supply Reveals a Decline

By Darrell K. Pruitt; DDS

Yesterday, Kevin Henry posted “Dental news of the day for Thursday, Feb. 18” on the DentistryiQ Blog.

The source for the day’s dental news was a sales report provided by Patterson Dental Supply.

http://community.pennwelldentalgroup.com/profiles/blogs/dental-news-of-the-day-for

Soft Sales

“Sales of dental equipment and software declined 10% from the year-earlier level, which was consistent with Patterson’s forecast for this period.”

If one remembers the economy at the last of 2008, it is not difficult to understand why Patterson’s analysts forecast that sales of dental equipment would drop. But, how did they know that sales of Patterson EagleSoft, their clinical and practice management software would also fall by 10%? I find it interesting that their accurate prediction was made shortly after Patterson announced the release of EagleSoft Version 15.00 on October 10, 2008. That must have been discouraging to EagleSoft employees.

When is the last time you’ve heard of a company roll-out of a new version of software – expecting it to be even less successful the previous version? That’s interesting.

Health Policy and Politics 

What makes Patterson’s valiant prediction of a decline in software sales even more remarkable is that a year ago, President-elect Barack Obama was giddy enthusiastic for digital health records, which includes Patterson’s EagleSoft. Not to say I told you so [maybe-a-little], but Patterson’s analysts obviously recognized what I did long before: Digital dental records are losing popularity among dentists. What’s more, none of my patients have ever said that they wish I had digital dental records. Dental patients simply do not desire them.

As a matter of fact, some have expressed relief that my paper records are more secure than anyone’s digital records. They also like not having to sign HIPAA forms – a meaningless waste of trees and appointment time.

Insightful or clueless dentist?

Assessment 

A year after Patterson privately admitted doubt about paperless dental practices, the slow-moving ADA House of Delegates met in Hawaii in October ‘09 and officially encouraged ADA members to adopt eDRs. Why doesn’t the American Dental Association know at least as much about dentistry as Patterson Dental?

This is an intriguing time in dental history. I can’t wait until the ADA opens up about their mistakes in dental informatics. One of these days we’ll all have a good laugh about their lame, expensive shenanigans.

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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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Health 2.0 Empowers Patients – Worries Doctors

Patient 2.0 Collaborative Care Worries Doctors

By Staff Reporters

Writing for Time, Bonnie Rochman digs into the ramifications of patients sharing information and tips online, an “empowerment movement” she calls “Patient 2.0.”

Society of Participatory Medicine

In the piece, she profiles the newly created Society for Participatory Medicine, which “encourages patients to learn as much as they can about their health and also helps doctors support patients on this data-intensive quest,” as well as PatientsLikeMe.com, a free service which makes its money by selling anonymized patient information.

Assessment

Link: http://www.healthjournalism.org/blog/2010/02/patient-20-empowers-patients-worries-doctors/

Our New Book

For more information, please visit our new companion blog for the: Business of Medical Practice [Transformational Health 2.0 Profit Maximizing Skills for Savvy Doctors] – third edition.

Link: www.BusinessofMedicalPractice.com

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GE and Muzzled Radiologist End Libel Case

MRI Drug Omniscan Implicated in UK

By Staff Reporters

General Electric Healthcare has settled its libel lawsuit against Dr. Henrik Thomsen, the Danish radiologist who raised questions about the safety of one of the company’s drugs used for magnetic resonance imaging [MRI] scans.

Press Release: statement

According to Jeff Gerth of ProPublica, the two-year-old suit in London involved a 2007 presentation Thomsen made in Oxford and statements in an article published in his name by a European scientific journal in February 2008. Both contained descriptions of his experiences at a Copenhagen hospital in 2006, when 20 kidney patients, all of whom had been injected with the GE Healthcare drug, Omniscan, developed a crippling and sometimes deadly disease. The rare condition is called nephrogenic systemic fibrosis, or NSF.

Assessment

Link: http://www.propublica.org/feature/ge-muzzled-radiologist-end-uk-libel-case

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Dangerous Healthcare Givers

Names Reported Missing from Federal Database

By Staff Reporters

Writing in ProPublica, and the Los Angeles Times, Tracy Weber and Charles Ornstein report that more than two decades ago, Congress set out to stop dangerous or incompetent caregivers from crossing state lines and landing in trouble again.

So, it ordered up a national database allowing hospitals to check for disciplinary actions taken anywhere in the country against licensed health professionals.

But, this database invoked no fear and dread, like the NPDB for physicians.

Ready for Hospital Use

Now On March 1, 2010– 22 years later – the federal government finally plans to let hospitals use it.  

Defective Database?

But, the database is missing serious disciplinary actions against what are probably thousands of health providers.

Link: http://www.propublica.org/feature/federal-health-professional-disciplinary-database-remarkably-incomplete

Division of Practitioner Data Banks (DPDB)

For physicians, the Division of Practitioner Data Banks (DPDB) is responsible for the implementation of the National Practitioner Data Bank (NPDB) and Healthcare Integrity and Protection Data Bank (HIPDB).  The NPDB and HIPDB are alert or flagging systems intended to facilitate a comprehensive review of the professional credentials of health care practitioners, providers, and suppliers.

One Doctor’s Opinion

“For doctors, the NPDB was always the “elephant in the room” regarding professional liability reporting, according to ME-P Publisher-in-Chief Dr. David Edward Marcinko, MBA. And so, I find this whole care-giver affair most disturbing. To think, this is the same government that wants to socialize medicine, or force implement eMRs. They should “clean their own house”,  first.” 

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Dr. Somnath Basu on Investing

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By Ann Miller; RN, MHA

[Executive-Director]

Dr. Somnath Basu is no stranger to the ME-P, or the financial planning community. He is a Professor of Finance at California Lutheran University and the Director of its California Institute of Finance.

Academic Background

Dr Basu earned his BA in Economics, University of Delhi, MBA (Finance), Marquette University and a PhD (Finance), University of Arizona. He is well published and is an award winning teacher. He has significant consulting experience with US Fortune 100 companies, advising institutional money managers and in developing proprietary finance and planning software. He serves on various Boards and committees including the CFP (chaired the Model Curriculum Revision Committee) Board of Standards and the Financial Planning Association.

Basu’s New Book

His new book, co-authored with Professors’ Block and Hirt, Investment Planning for Financial Professionals is available now, published by McGraw Hill, in May 2006.

Link: http://www.amazon.com/Investment-Planning-Geoffrey-Hirt/dp/0071437215/ref=sr_1_1?ie=UTF8&s=books&qid=1265918999&sr=1-1

Additional essays by Dr. Basu can be viewed at: http://blog.fpaforfinancialplanning.org/author/somnathbasufpa/

He also writers a column for the Journal of Financial Services Professionals. He can be reached at:

Contact Dr. Somnath Basu
Director – California Institute of Finance
Cell: 805 405 4448
Work: 805 493 3980
http://www.clunet.edu/cif

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

About Disruptive Women in Healthcare™

Online Since September 2008

By Staff Reporters

According to their website, Disruptive Women in Healthcare™ seeks to serve as a platform for provocative ideas, thoughts, and solutions in the health sphere.

They recognize that to accomplish this, a call on experts outside of the health industry is required

Service Goals

The founding Disruptive Women have audacious hopes for their blog.  Furthermore, they say:

We’re not managing change;

We’re not thriving on chaos;

We’re not waiting for cures;

We’re driving change;

We’re creating chaos;

We’re finding cures;

IOW: They’re disrupting the health care status quo.

Blog Goals

To become the “go to” health care blog that is recognized as a petri dish for fresh ideas and bold solutions.

Assessment

Open to all. Disruptive Women in Health Care™ is not intended to be positioned left, right or center. It will be what the authors — and those who comment — make it. Their goal is to generate as many wide-ranging posts as possible.

Link: http://www.disruptivewomen.net

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HealthyMagination and Direct to Consumer [D2C] eMRs?

About HealthyMagination.com from GE

By Staff Reporters

Just imagine … the broadcast TV or radio commercial fades in, as the announcer says:

“Almost everyone wants to make healthier choices, but they don’t always know how. The amount of information available on wellness, nutrition and exercise is overwhelming, to say the least. Even when we do know how to improve our health, we often try to make sweeping changes or set goals that seem too daunting to reach.”

What it is

Healthymagination, from General Electric, is a consumer directed internet site, with new D2C TV commercial about becoming healthier, through the sharing of imaginative ideas and proven solutions. It goes beyond innovations in the fields of technology and medicine, celebrating the people behind these advancements.

Seeking to build stronger relationships between patients and doctors, GE created healthymagination to gather, share and discuss healthy ideas and illustrative stories.

Story link: http://www.healthymagination.com/stories/

Participatory Projects for Patients

Because healthymagination is about becoming healthier together, it takes the form of multiple projects that patients can participate in, whether they are looking to change a lifestyle or fine-tune an approach to health.

According to GE, making healthy decisions should be easy … and fun.

Link: http://www.healthymagination.com/projects/

Info and Video for Doctors

There is also a portal for medical professionals, promoting GE eMRs, of course.

Link: http://www.ge.com/innovation/emr/index.html

Due Diligence RFP

And, good preliminary questions for all physicians to ask any eMR vendor are:

  • What is the cost per physician license?
  • Do you have any existing clients in our specialty?
  • Does your system come pre-loaded with templates for my specialty?
  • Is your company the developers of the software or is it re-branded from another vendor?
  • Is your system client/server based or ASP based?
  • Does your system include practice management software?
  • How many clients does your company have?
  • Is your system HL7 compliant?
  • How long has your company been in business?
  • Is your development done overseas?
  • Is support done overseas?
  • Is your software CCHIT certified? If not, why?
  • How often is the software updated?

Assessment

Let us hope that the health 2.0 participatory patient of the future doesn’t select a physician based on the proprietary eMRs s/he uses, as seen on a television commercial, much like the D2C [direct-to-consumer] pharmaceutical industry of today.

IOW: Will that be Allscripts, Cerner or GE, etc? Or, listen to narrator and actor Morgan Freeman intone on a TV spot: “Ask your doctor if XYZ electronic medical records are right for you.” 

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Hospital Capital Formation, Harry Markowitz and Modern Portfolio Theory

Strategic Risk Considerations for Physician-Executives and Healthcare CXOs

[By Calvin W. Wiese; MBA, CPA, CMA]

To most all financial advisors, wealth managers and stock-brokers, the work of Harry Markowitz and Modern Portfolio Theory [MPT] is not usually discussed in terms of hospital capital formation. But, perhaps it should!

Capital Investments Create Risk

Capital investments create risk. Risk is the uncertainty of future events. When hospitals make capital investments, they commit to costs that affect future periods. Those costs are known and relatively fixed. What are unknown are the benefits to be realized by those capital investments.

Defining Risk

For capital investments, risk is the certainty of future costs coupled with the uncertainty of future benefits. In some cases, while the future benefits are uncertain, there is a high degree of certainty that the benefits will exceed the costs. In these cases, risk can be very low. Risk may be better defined as the degree to which the uncertainty of unknown benefits will exceed the known and committed costs.

Asset Burdens and Benefits

When capital assets are purchased, both the burdens and the benefits of ownership are transferred to the owner. The burdens are primarily the costs associated with acquisition and installation. The benefits are primarily the revenues generated by operating the capital assets. Risk of ownership is created to the degree that the benefits are uncertain.

Understanding Risk

Hospital managers need to be skilled at putting hospital assets at risk. Without clear knowledge and understanding of the benefits and the burdens, hospitals can quickly find themselves at unacceptably high levels of risk. Risk must be continually assessed and evaluated in order to successfully put hospital assets at risk. Hospitals require many varied capital investments; their capital investments represent a risk portfolio. An effective combination of risky assets can often create risk that is less than the sum of the risk of each asset.

Modern Portfolio Theory

Of course, financial managers have know this for years as a basic principle of Modern Portfolio Theory (MPT), first introduced by Harry Markowitz, PhD, with the paper “Portfolio Selection,” which appeared in the 1952 Journal of Finance. Thirty-eight years later, he shared a Nobel Prize with Merton Miller, PhD, and William Sharpe, PhD, for what has become a broad theory for securities asset selection; and hospital assets may be viewed as little different.

Prior to Markowitz’s work, investors focused on assessing the rewards and risks of individual securities in constructing a portfolio. Standard advice was to identify those that offered the best opportunities for gain with the least risk and then construct a portfolio from them. Following this advice, a hospital administrator might conclude that a positron emission tomography (PET) scanning machine offered good risk-reward characteristics, and pursue a strategy to compile a network of them in a given geographic area. Intuitively, this would be foolish. Markowitz formalized this intuition.

Detailing the mathematics of diversity, he proposed that investors focus on selecting portfolios based on their overall risk-reward characteristics instead of merely compiling portfolios of securities, or capital assets that each individually has attractive risk-reward characteristics. In a nutshell, just as investors should select portfolios not individual securities, so hospital administrators should select a wide spectrum of radiology services, not merely machines.

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Assessment

Savvy hospital managers will mitigate ownership risk by constructing their portfolio of risky assets in a manner that lowers overall risk

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Video on the Intel Digital Hospital

About the Integrated Digital Hospital

By Staff Reporters

Improving Medical Care Delivery

How does the integrated digital hospital streamline workflows and improve care? View this video for one opinion.

Link: Launch video (WMV 6MB)

Healthcare IT’s Business Value

Now, see how Intel and Cerner helped Banner Health, one of the largest U.S. nonprofit healthcare systems evaluate the bottom-line impact of a holistic-care transformation initiative.

Link: Banner Intel Case Study

Conclusion

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Save Fewer Lives or Save Lives More Efficiently?

An Economics Argument

By Austin Frakt PhD

The Incidental Economist

Originally Posted: 14 Feb 2010 03:58 AM PST

Let’s say the cost per saved life due to providing an additional individual with health insurance is X dollars (Tyler Cowen says X = $9 million; I say that’s an overestimate). If one thinks X is too high, what’s the right policy response? One answer is to extend insurance to fewer people. The other is to try to reduce the cost of care so that X is lower.

The Differential

There is a huge difference between these two responses. I won’t go into all of them now. One important difference I want to highlight is that if we simply reduce the number who will become insured then the rest of us are still left paying exorbitant health care costs. Thus, two problems remain, many are left uninsured and health care costs are still too high.

Cost Reductions

On the other hand, if the policy response is to reduce the cost of care then we all win. More of the uninsured can be insured for some level of funding and the rest of us can benefit from lower health care costs. That’s a double victory.

Assessment

That health reform is too expensive is not a good argument for doing less of it*. It is an argument to do more. The provision of health care will not become more efficient under the status quo. And, the status quo (with perhaps minor tweaks to it) is what we will get if health reform does not pass this year. But, if reform does pass it sets the stage for more reforms, and ones that focus on costs.

*Note: I’m not saying I think it is too expensive. But if you do think it is I do not find that a convincing argument not to do it.

Link: http://theincidentaleconomist.com/save-fewer-lives-or-save-lives-more-efficiently/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+TheIncidentalEconomist+%28The+Incidental+Economist+%28Posts%29%29

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The MediBid Marketplace for Physician Services

The Competition Heats Up for Medical Dollars

By Staff Reporters

www.MediBid.com opened to patients around the world on January 1, 2010 after several years of research and development. The firm was developed to provide access to greater choice and privacy, regardless of insurability, in a completely open market environment, without anyone or anything getting in the way of the decision making process between doctors and patients.

An Interactive Marketplace

MediBid is an interactive marketplace that allows cash-paying patients to seek medical care from doctors, hospitals, and facilities both locally and around the world. More than a physician directory, it is a resource where medical consumers can find a doctor, then actively seek bids for the care they need. It gives physicians a direct connection to their patients.

Founded by Change Agents

MediBid’s founders are change agents who share an unrelenting drive to change the status quo in the field of healthcare financing. Focused on building strong patient-physician relationships, while supporting patients’ privacy rights and choice in the medical market place, MediBid’s goal is to provide the best opportunity for consumers to self-direct their medical care.

Assessment

Patients who use MediBid are promised uncompromisingly unique, highly secure, needs-matching technology to acquire the best cost-to-value services anywhere. And, MediBid protects the identities of all Seekers and Bidders using state-of-the-art internet protocols. MediBid plays no part in the financial transaction or delivery of care.

Conclusion

And so, your comments on this ME-P are appreciated. Give www.MediBid.com a click, and tell us whet you think?

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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INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Seeking Patient 2.0 and Health 2.0 Definitional Stability

What is it – How does it work?

By Hope Rachel Hetico; RN, MHA

[Managing Editor]

The Internet is a constantly evolving service that continues to grow at an exponential rate, despite late adoption by some physician practices. 

History

Since 1995, the primary use of the internet was e-mail communications with peers, hospitals and others. 

Next providers linked to hospitals and managed care organizations to obtain more direct connectivity for clinical information and insurance benefits coverage.

More recently, physicians are finding other beneficial avenues to expand their utilization of the Internet:     

  • Direct e-mail inquiries from patients.
  • Patient educational newsletters and links to other educational sites.
  • Continuing medical education (CME).
  • Chat room, consultations, conferences or professional presentations.
  • Nurse to patient e-mail connectivity.
  • Immediate data on lab results with alerts for abnormal high or low values.
  • CPOEs (Computerized Purchase Order Entry Systems).
  • Radiology images.
  • Appointment scheduling patient reminders.
  • HIPAA compliant Application Service Providers (ASP) for dictation, recording, routing and speech recognition and transcription services.
  • eMR (Electronic Medical Records) and clinical medical group ware, etc.

Health 2.0, Web 2.0 and Patient 2.0

But, ever since the term “web 2.0″ was first used in 2004, there has been an inordinate amount of chatter about what web 2.0 really is and its true impact in medicine. No one’s defined it clearly, but we think the web evolution relative to healthcare essentially falls into 3 generations, as outlined in the new re-source: Dictionary of Health Information Technology www.HealthDictionarySeries.com and our related websites, wikis and professional blogs www.BusinessofMedicalPractice.com

Health 2.0 Journalists

According to healthcare visionary and uber-blogger Matthew Holt, http://www.health2advisors.com and similar other sources, Healthcare 2.0 may be defined as:

“A rapidly developing and powerful new business approach in the health care industry that uses the Web to collect, refine and share information. It is transforming how patients, professionals, and organizations interact with each other and the larger health system. The foundation of healthcare 2.0 is information exchange plus technology. It employs user-generated content, social networks and decision support tools to address the problems of inaccessible, fragmentary or unusable health care information. Healthcare 2.0 connects users to new kinds of information, fundamentally changing the consumer experience (e.g., buying insurance or deciding on/managing treatment), clinical decision-making (e.g., risk identification or use of best practices) and business processes (e.g., supply-chain management or business analytics)”.

And so, if Health 1.0 was a book, Health 2.0 is a live discussion.

Furthermore, Scott Shreeve, MD – http://blog.crossoverhealth.com [personal communication] of Cross-Over Health defines health 2.0 as:

 “A New concept of healthcare wherein all the constituents (patients, physicians, providers, and payers) focus on healthcare value (outcomes/price) and use competition at the medical condition level over the full cycle of care as the catalyst for improving the safety, efficiency, and quality of health care.”

Assessment

By now, you probably realize that Health 2.0 empowers patients and worries doctors.

Writing for Time magazine recently, journalist Bonnie Rochman explored the ramifications of patients sharing information and tips online, an “empowerment movement” that she calls “Patient 2.0.”

In her piece, she profiled the newly created Society for Participatory Medicine, which “encourages patients to learn as much as they can about their health and also helps doctors support patients on this data-intensive quest,” as well as  www.PatientsLikeMe.com, a free service which makes its money by selling anonymized patient information.

Source: http://www.healthjournalism.org/blog/2010/02/patient-20-empowers-patients-worries-doctors

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Conclusion

And so, your comments on this ME-P are appreciated. Do doctors really fear Health 2.0? What do Health 2.0 and Patient 2.0 mean to you? How would you define the terms formally, and how do you use Web 2.0 in your medical practice? Or, are you a late-adopter still waiting for governmental or CCHIT definitional clarity?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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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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Understanding Hazard Communication Labeling

An OSHA Requirement

By Staff Reporters

www.HealthcareFinancials.com

 

 

The Hazard Communication Standard

The OSHA Hazard Communication Standard requires proper labeling of all chemicals present in the workplace. Labels are usually provided on chemicals that are found in a healthcare practice, but when a substance is transferred from its original container to a different container, a label must be affixed to the secondary container to inform any employee who uses it of the contents and their potential risks.

Assessment

The Standard also requires education for employees regarding any chemical present in the workplace to which they may be exposed under normal conditions of use or in a foreseeable emergency.

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, be sure to subscribe to the ME-P. It is fast, free and secure.

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 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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Healthcare Organizations: www.HealthcareFinancials.com

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Physician Advisors: www.CertifiedMedicalPlanner.com

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Become a Paparazzi for the ME-P

Photo-Journalism from the Man / Woman in the Street

By Staff Reporters

Have you ever accidentally run into a “mover and shaker” of the healthcare industrial complex – a “big shot” in the financial services space – or maybe even an expert in the medical management or health information technology ecosystem?

How about the rarest academic celebrity of them all … a federal politician!

If so, the ME-Post has a Mission for You

As a Medical Executive-Post advocate, your position as “everyman-everywhere” is just what we’re looking for. Why? We’ve begun gathering intelligence on those high-profile thought-leaders attending national conferences, regional meetings, or guest seminars, etc.

Be our “Eyes and Ears”

We need your eyes and ears. So we’re asking for your help. If you spot public domain Big Game – anywhere in the world – snap their picture and send it to us. Be polite, be respectful and tell em’ you’re from the ME-P. We will post if appropriate, with complimentary name, title and byline recognition.

Assessment

Maybe that familiar-looking man behind you in line for the men’s room will turn out to be Barack H. Obama or Howard Dean, MD. 

Think: Gawker Stalker meets C-SPAN.

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, be sure to 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 Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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On Health Marketing and Communications

About “Path of the Blue Eye”

[By Staff Reporters]

If you are involved in any area of health marketing communications (e.g., social marketing, digital marketing, social media, public relations, advertising, patient relations management, etc.) and think you have something valuable to contribute to the overall conversation in this field, consider visiting:

http://blog.pathoftheblueeye.com/

The Project Manager

The site and project is run by Fard Johnmar, founder of Envision Solutions, LLC. The firm is a healthcare marketing communications consultancy specializing in analysis, strategy, content development and training. Envision Solutions helps not-for-profit and for-profit organizations to be more efficient and successful.

Assessment

In addition to moderating Walking the Path, Fard is author of Envisioning 2.0 and Healthcare Vox. Both blogs focus on healthcare marketing communications and related topics: www.envisionsolutionsnow.com

Channel Surfing the ME-P

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

Conclusion

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

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

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Seeking your Medical Practice Management [Horror] Story

Help us Find a Case Report Learning Experience

By Ann Miller; RN, MHA

We at the ME-P have been reporting for the past four years on the troubles in which medical professionals often find themselves while running a private medical practice. It’s difficult for doctors to stay abreast of the healthcare industrial complex, or always select the right consultants. And, it’s often more difficult – once consultants are retained – to have expectations met or exceeded.

Often, it is a matter of not knowing, what you don’t know.

Difficult Doctor Clients

And, it is true that doctors make difficult clients in some instances. This occurs because some are desperate for practice enhancement solutions, but don’t know where to turn for help? Others, may have had a prior negative experienced with a business consultant, or management guru, more interested in their bottom line than the doctor’s success?

Assessment

Read this Federal Government report to learn what can happen when your consultant is not an informed medical management practitioner. Although almost a decade old, its’ premise is still fresh today [ie., buyer beware]!

Full Article: http://oig.hhs.gov/fraud/docs/alertsandbulletins/consultants.pdf

Call to Action

To illustrate the problem, we’re looking to shine a light on the [un] lucky doctor who has dealt with poor managerial advice from a consultant, or had a bad experience with one. Give us the gory details and journalistic 5Ws of your ordeal so that others may learn. You may be named, or remain anonymous, as you wish.

Submissions

Please submit your best [worst] case study exprience to me at: MarcinkoAdvisors@msn.com If appropriate, we will publish in an upcoming edition of the ME-P, so that we might all humbly learn from you.

Related: www.CertifiedMedicalPlanner.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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Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Understanding the New “Mixed” Economy

Musings of an Informed Thought-Leader

By Somnath Basu PhD, MBA

Brief Excerpt

The recent debacle in the financial markets has opened up a plethora of issues that require serious attention from all market participants. Perhaps the most serious concern is the emergence of a “mixed” economy where both “public” and government-owned enterprises will coexist with “private” enterprises.

Review of Past Performance

Unfortunately, the historical performances of such economies have been fairly dismal. The debacle is also bound to usher in additional regulation of financial markets. The new regulations are likely to focus on ways to control the possibilities of similar failures in the future.

Assessment

However, the structure of regulation should not be constructed on the basis of how the markets failed the people but instead on how people failed the market. The ramifications of the debacle require our attention and understanding, especially the possibilities of the existence of a regime of both high inflation and high market volatility. 

White Paper Link Here:  The New Economy

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, be sure to subscribe to the ME-P. It is fast, free and secure.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Practicing Medicine in the Web 2.0 Era

A Slide-Show Visual Presentation

By Ann Miller; RN, MHA

[Executive-Director]

Here at the ME-P, we are always searching the relevant universe for interesting people, innovative ideas and novel approaches for unique and competitive healthcare delivery models. And so, we think we’ve found a winner in this presentation by Dr. Bertalan Mesko.  

About the Author

The author of Practicing Medicine in the Web 2.0 Era is Bertalan Mesko of Debrecen, Hungary.

He was a medical student at University of Debrecen, is a medical blogger, and the founder of www.Webicina.com

In Dr. Bert’s Opinion  

Link: http://www.slideshare.net/NCurse/practicing-medicine-in-the-web-20-era-1207689

Assessment

If you’ve enjoyed the show, you will also appreciate these related slideshow presentations by various other authors:

1. Medicine 2.0 – A Brief Description

http://www.slideshare.net/maxedmond/medicine-20-brief-description

2. How Web 2.0 is Changing Medicine

http://www.slideshare.net/kuchmuch/how-web-20-is-changing-medicine-42583

3. Assessment on the Quality of Medical Wikis

http://www.slideshare.net/Pudliszek/assessment-of-the-quality-of-medical-wikis

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Concluding HIT Definitions: http://www.springerpub.com/results.aspx?srch=marcinko

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ADVETISEMENT

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Hank Paulson’s Book – Reviewed

Behind the Scenes, GE’s Top Executive Confided Credit Woes

By Staff Reporters

As the “ticking” financial crisis worsened toward the end of 2008, CEO Jeffrey Immelt and other leaders at General Electric repeatedly assured the public that there was no need to worry about the company’s ability to access credit markets and refinance its massive debts as they came due.

Time line: http://www.propublica.org/special/paulson-ge-timeline

Assessment – The Ticking Clock

But, in private conversations that alarmed Treasury Secretary Henry Paulson, Immelt laid out a different picture of GE’s credit situation, according to Paulson’s new book about the crisis.

Link: http://www.propublica.org/feature/paulson-general-electric-immelt-financial-crisis-022010

Source: First co-published with The Washington Post and ProPublica [February 5, 2010 9:50 pm EST].

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

DrBicuspid.com is Biased against Dentists

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More on Delta Dental

By Darrell K. Pruitt; DDS

Kathy Kincade, Editor-in-Chief of DrBicuspid posted the article, “Studies urge adding adult dental benefits to Medicare” on January 29, 2010.

http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=303755

Ms. Kincade has always been generous to Delta Dental, making me suspect that she is less than unbiased.

Of Delta Dental

For example, at the end of the article, she devotes the last words about dental coverage for the elderly to an advertisement for Delta:

“Through a relationship with Delta Dental, the AARP offers the AARP Dental Insurance Plan, a dental PPO for AARP members that includes more than 100,000 dentist locations across the U.S. Delta also offers individual plans that are ‘particularly popular among retirees,’ according to Chris Pyle, director of public relations and community benefits at Delta Dental.”

Kincade closes her ad with a quote from Chris Pyle:

“Delta Dental has been a pioneer in developing affordable dental insurance options for those who do not have coverage through an employer. Retirees who take the time to do the math are finding individual and family dental insurance plans to be a wise option.”

How much does advertisement space on DrBicuspid go for these days?

Dr. Hamm                     

That is when Dr. Hamm got involved. He first requested that Chris Pyle document his claim:

”Prove it, Mr. Pyle. Let’s see your figures. Be sure to include comparison of the quality of care between PPO dentistry and fee-for-service dentistry. Do you think discounting fees – even for non-covered expenses – improves the quality of intricate care?”

When Dr. Hamm failed to get an immediate response, he went to the source. Here is what he had to say to the Editor in Chief of DrBicuspid:

——————————————————–

Kathy Kincade, pardon me for being straightforward, but at the risk of making it difficult for DrBicuspid reporters to obtain future interviews with Delta Dental PR professionals and ADA presidents, I proclaim that it is DrBicuspid readers’ rights – indeed Americans’ obligation – to challenge unsupported, self-serving statements that strategically discount facts in healthcare to protect stakeholders from principals (that would be dentists and patients).

DDPA Employee 

Chris Pyle, the on again – off again DDPA employee, isn’t the first Delta PR specialist who has told DrBicuspid outrageous statements before failing to answer the bell when challenged. A year ago, in an article by DrBicuspid Associate Editor Rabia Mughal, another shy and unaccountable Delta Dental PR professional poked his head up before diving for cover. Delta employee Ari Adler is reported to have said that “direct reimbursement to out-of-network dentists is a problem because it allows them to enjoy the benefits provided by the network without following cost guidelines and quality control measures of the network.”

http://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=301436

“We put our dentists thorough a credentialing process and provide quality assurance. That means if a dentist does a filling that should last a certain amount of time and it doesn’t, they have to fix it without charging the network or the patients.” 

– Ari Adler, communications administrator at Delta Dental of Indiana

Even after repeated requests for an explanation of Delta’s unprecedented guarantee of dental work done by Delta’s preferred providers, Ari Adler, a very popular master of Twitter who also teaches PR as a part-time job, declined to answer (So much for popularity on Twitter). I assume the PR and social network expert thinks that since he’s the Communications Administrator for such a powerful company, he’s protected from accountability. Besides, American dentists love and respect Delta Dental, don’t they?

Dr. Ron Tankersley

And; what about Dr. Ron Tankersley who is President of the American Dental Association. Is he also simply too good to talk with us?

————————————————

I may or not know Dr. John Hamm. I know Editor in Chief Kathy Kincade, though. She kicked me off of DrBicuspid over a year ago – the day before DrBicuspid consummated a contractual relationship with the ADABEI to receive the ADA seal of approval.

An Invitation

I should warn readers that I could be wrong about what may have been just an odd coincidence, so I invite you, Kathy Kincade, to discuss journalism ethics with me on Pruitt’s Platform. I trust someone will warn you, Kathy, of this invitation before it comes up on your first page in a Google search. My article “DrBicuspid, the ADA and split allegiances” from 2/15/09 is the 8th hit already. Now do you remember me?

http://community.pennwelldentalgroup.com/forum/topics/drbicuspid-the-ada-and-split

Assessment 

Come on out, Kathy. I’ve been waiting for this a long time. Come on out where everyone can see you defend Delta Dental. Please invite Brian Casey as well. He was the Editorial Director of IMV Publishing a year ago. Is he still around – policing the Internet?

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 Medical Clinical IT Groupware

What it is – how it works

By Staff Reporters

According to Bill Crounse MD of Microsoft,

clinical medical groupware is a new and evolving model for the development and deployment of health IT platforms and applications, the characteristics of which include use of the Internet and the Web as a platform, explicit design for health data exchange and online communication among providers and patients/consumers, a modular or component architecture upon which applications can be aggregated to meet specific clinical and workflow tasks; while allowing interface standards and protocols for data exchange to emerge in a market-driven manner.  

Distribution Platforms

Clinical medical groupware applications can be distributed as software-as-as-service, and are intended to support today’s mobile health care environment by supplying the right information, at the right time and the right place.

Link: http://blogs.msdn.com/healthblog/archive/2009/09/14/learn-more-about-clinical-groupware.aspx

Assessments

Advocates of the clinical medical groupware approach are not limited to software developers and technologists, but also include practicing physicians, executives and managers from health care provider organizations and care management companies, patient advocates, and leaders in life sciences, home monitoring, and medical device manufacturing firms.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What is your experience with CMG? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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On the Elimination of Medicare Consultation Codes

Is it Budget Neutral?

By Brian J. Knabe MD, CFP, CMP

http://www.CertifiedMedicalPlanner.org

The New Year 2010 has brought some changes in the Medicare Physicians Fee Schedule.  For many specialists, the most significant change is the elimination of consultation codes, 99241-99245 in the outpatient setting and 99251-99255 for inpatient care.  Physicians can still provide consultations and bill for these services – using codes for routine new or established patient visits (99201-99205 and 99211-99215).

Reported Revenue Neutrality

It has been reported that this change has been made in a revenue neutral manner.  Reimbursement for all E/M codes has been increased in order to make up for the removal of consultation codes.  The increase is approximately 6% in the outpatient setting and about 2% for inpatient codes.

Of Averages and Outliers 

The result of these changes might be revenue neutral overall, but the outlier effect on many specialties and individual physicians can be significant.  Specialists who obtain most of their income from procedures will see less of an effect on their income.  This includes dermatologists, surgeons, and gastroenterologists.  Less procedurally-oriented specialists, particularly those who rely upon Medicare as a primary payor, are seeing the most significant effect.  For example, neurologists and hematologists will likely see double-digit declines in revenue.

Private Payers 

While private payers have not yet adopted these changes, billing codes must be adjusted when filing a claim with a commercial insurer when Medicare is the secondary insurer.  If a consultation code is used in these instances, the primary payer will pay their portion of the bill, but Medicare will deny secondary coverage.  There is no indication yet that commercial insurers are dropping the consultation codes altogether, but if history is any indication, they will likely eventually follow the lead of Medicare.

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Assessment 

Physicians can take certain measures to decrease the impact of these changes on their revenue stream.  It is increasingly important to understand how the complexity of a patient visit affects the appropriate level to be billed.  Prolonged service codes are also available (99356 and 99357) to enable physicians to bill appropriately for more complex and time-consuming evaluations.

Conclusion

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On the Cash Conversion Cycle for Healthcare Organizations

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Understanding Why Cash Flow is King

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

The manager, administrator or COO of a hospital’s working capital, or physician executive of a private medical practice, strives to optimize the amount of cash on hand to ensure daily operations. Too much cash generates little return, while too little may jeopardize the healthcare enterprise, incur borrowing costs or cause missed investment opportunities.

Also, the extent to which current assets cover current liabilities, determines whether the entity is considered liquid and thus able to meet its payment obligations on time.

The Balancing Act

When faced with the management balancing act of current assets and current liabilities, the alternative with the highest net present value (NPV) and internal rate of return (IRR) is typically selected. This is often a difficult balancing act since providing healthcare services generates little immediate cash, and then cash receipts are variable depending upon payers or other third parties.

Yet, each hospital or practice distribution transaction requires immediate liquid cash for employees, vendors, debt holders, and investors in the form of dividend payouts or retained earning disbursements. The cash conversion cycle (CCC) length measured in days is composed of two ratios:

  1. The first is the average inventory holding period (ending inventory divided by revenues per day),
  2. The second is the collection period (ending ARs divided by revenue per day). For both ratios, faster is better.

CCC Averages

Sample CCCs for an industry-average hospital (45 days average-non-electronic) are:

1. hospital admission to patient discharge (5 days);

2. patient discharge to hospital bill completion (5 days);

3. hospital bill completion to insurance (third-party administrator or TPA) payor receipt (5 days);

4. receipt by TPA to mailing of hospital payment (25 days);

5. payment mailed to receipt by hospital (3 days); and

6. payment receipt by hospital to bank deposit (2 days).

Assessment

Naturally, healthcare managers, administrators, physicians and hospital executives should be interested in motivating changes in the behavior of staff such that processes within the control of the enterprise can be streamlined and completed in less time.

For example, a day or two reduction in the amount of time it takes from patient discharge to hospital bill completion, as achieved with the use of electronic charts and medical records systems, can significantly increase cash flow. Likewise, the use of electronic funds transfers and/or lock box collection mechanisms can reduce the amount of time it takes for an account receivable to make it into the bank.

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Conclusion

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See What They are Saying About Us on the WSJ.com

The Wall Street Journal Health Blog

Staff Reporters

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When opining about the Medical Executive-Post on the WSJ’s blog on health and the business of health, JC wrote on January 20, 2010, at 5:46 PM ET:

“This website is packed with great information”

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Top Hospital Administration and Healthcare Business Blogs

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The Top 50 List for 2009

[By Staff Reporters]

According to some experts, one of the best things you can do for your career in health care is to read a variety of blogs to help you get some insight into how things work from an administrative standpoint. This can be very helpful as you learn about different aspects of hospital administration and the business of health care.

Assessment

From IT, economics and finance, to healthcare policy and law, to management leadership and being a hospital CEO or private medical practice physician, there is a great deal of information out there.

So, here are some of the top 50 hospital administration and health business blogs available:

List: http://mastersinhealthcareonline.com/2009/top-50-hospital-administration-business-blogs/

Conclusion

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On the New Pot Health Policy in NJ?

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It’s Medicinal – Man!

By Staff Reporters

Did you know that in January 2010, New Jersey became the 14th state in the nation to legalize marijuana use for certain chronic illnesses?

Other states where the use of medical marijuana is permitted include Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont, and Washington; around a dozen more states are weighing pending bills.

Jersey is Toughest State

The New Jersey law is the most restrictive in the nation and authorizes prescribed marijuana for only a handful of chronic illnesses, such as multiple sclerosis, cancer, glaucoma, epilepsy, Crohn’s disease, AIDS, muscular dystrophy and Lou Gehrig’s disease. Unlike other states, physicians in New Jersey will not be able to prescribe medical marijuana for anxiety, headaches, or chronic pain.

Dispensaries

According to reports, the state of New Jersey plans to authorize six dispensaries, and patients will receive identification cards authorizing them to purchase the drug. They will not be able to grow their own marijuana or use it in public, however. And, individuals without a prescription will still be subject to criminal prosecution if caught in possession of marijuana.

http://www.hcplive.com/oncology/articles/Marijuana?utm_source=Listrak&utm_medium=Email&utm_term=%2foncology%2farticles%2fMarijuana&utm_campaign=Legalizing+Medical+Marijuana

Assessment

Do you support the use of medical marijuana? If you are a doctor that lives in a state where medical marijuana is legalized, have you prescribed it to any patients? If you live in a state where medical marijuana is not legalized, do you want it to be? What about you patients, out there?

Conclusion

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Access Management in the Hospital Check-In and Admissions Setting

The Role of Operational Activity Based Cost Management

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

www.HealthcareFinancials.com

In order to be paid and maintain cash flow, hospitals and clinics set up levels of specialization. The result is usually more handoffs, delays, eroding financial positions, and a frustrated set of patients and physicians. Much seems out of control. When you factor in the maze of Health Insurance Portability and Accountability Act (HIPAA) technologies, it becomes overwhelming. Now, consider these operational inefficiencies in light of Obama Care?

Access Management

At the hub of the patient hospital or clinic experience is admitting or registration. This department collects information for clinicians treating the patient, meets Joint Commission standards and other requirements, facilitates medical record documentation, patient flow, revenue capture, billing and collections, and ultimately begins to settle accounts. The access management area has numerous customers in addition to the doctor, patient, or family member sitting across from them.

Increasing HR Complexity

Without the benefit of relevant information, managers attempt to staff access management departments based on past history — namely, if patient and physician complaints are not too high, there is probably enough staff. However, staffing in access management has not kept up with the increased demands and complexity of the process, and other hospital areas often suffer. Clinicians and medical records personnel must often deal with incomplete or incorrect information, and take up the slack.

Beware Un-Happy Stakeholders

All of these deficits make for an unhappy set of customers (physicians and patients) as they continually live with the repercussions of inaccurate and incomplete information. This does not go unnoticed by patients and physicians, as these situations erode confidence in the hospital’s ability to get things done correctly.

Emotional Touch Points

Access Management is the clinic or hospital’s first chance to create an “emotional contract” with the customer. It is here that the tone is set for the patient on the issues with respect to his or her hospitalization. And it is here that the provider has the chance to begin working on the patient’s behalf so that clinical outcomes are appropriate. All of this must happen in an environment that minimizes the likelihood of an unfavorable occurrence, and outside the realm of the complex legal requirements established by state and federal officials.

Tips from the Manufacturing Sector

So why are there unresolved issues in the access management area? In a manufacturing environment, if there are problems on the front-end design, huge problems ripple downstream in terms of recalls, warranty-related expenses, lawsuits, and customers that abandon the company’s products. world -class manufacturers dealt with these issues with their ISO-9000, Total Quality Management (TQM), and Six Sigma programs during the ’80s and ’90s. Hospitals, however, have allowed issues in their access management process to fester and create huge and costly problems in the downstream process. 

Assessment

In an effort to help solve access management issues, every provider must take a proactive role in dealing with the trend. The first step in this journey is healthcare administrator and physician-executive assessment.

This assessment is not a management engineering set of time studies aimed at micro-costing every second of work. The critical path information needed for this plan is reasonable and collected in a few days by talking to the people performing the work. Estimates are gathered based on workers’ views about how they spend their time. This information is combined with available workload measures and general ledger cost information, and activity-based reports are produced.

Conclusion

Going forward, ABCM it is an exercise in operational planning. Activity-based information is used to look at areas where work can be restructured so errors and rework can be eliminated. New technologies that target problematic activities are selected and implemented. Outside companies that can perform complex activities more economically can be used (e.g., www.ICMS.net).

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Predicting the Economic Recovery

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How Would Life Change – Even if Prescience Possible?

By Somnath Basu PhD, MBA [www.clunet.edu/cif]

All medical professionals and ME-P readers should know that there’s about a 50% chance that someone will predict correctly when and how the domestic economy will recover. The chances of that person failing are the same, at 50%. There is very little chance (probability approaching zero) that nothing will change. Under these circumstances, it’s quite easy for the pundits to take a shot at being right. It is easy to be wrong because it’ll never be held against them, given the circumstances around the global financial crisis. There’s always a way out of being wrong.

Of Rumors, Guesses, Optimism and Pessimism

Of course being right has its rewards of reaping benefits without any downside. In the meantime, a whole nation is being held hostage as to what happens next. Rumors, guesses, optimism, pessimism abound as stock markets rise and fall, employment goes down by less or more than expected, price of oil suddenly becomes a leading economic indicator, China starts showing the way out, interest rates remain low, home (new, used, new construction, commercial vs. residential) sales increase and decrease in tandem, inflation is a problem but not deflation or vice versa and the economy grows as expected or not. The bewilderment at this state of things is taking a toll but the pundits keep going on. Politicians scream and bureaucrats moan. Obviously, this too is a crisis of sorts.

The Two Questions

There are two questions that fall out of this scenario. First, how does one predict the economy and how sound are the methodologies. Second, and more importantly, do we really need a prediction? I will explore these questions in the order presented above but the first one in more detail.

Let’s Begin the Evaluation

To begin with, it’s useful to evaluate the techniques used by our economic gurus who preach lofty sermons from their altars. These folks have a battalion of charts and graphs depicting why something is happening, ably backed up by rigorous mathematical models that have passed the test of their enlightened peers. These people consider economic indicators using complex models of GDP growth, change in unemployment, trade imbalances, flow of goods and services etc. etc. At the end of the day, they still have a 50% chance of being right. Of course they have a theory already explain this possibility (efficient market hypothesis, or EMH) which they use to explain why the market cannot be predicted with any certainty and the odds of predicting correctly are as good as repeatedly calling a coin toss right. However, it seems that this does not dampen their need in any way to keep on predicting.

 

 The Comparisons

Compared to previous recessions, there is a marked difference with the one we just experienced. This difference is that the great recession of 2008-09 can be considered as the first true global recession where even remote countries in Africa experienced mild recessionary conditions.

Hence, one of the first requirements for the predicting community is to truly incorporate global economic conditions in predicting the future. The current emphasis on domestic economic conditions precludes to an extent our ability to comprehend the changes underlying this “one world” which is necessary to get closer to a more realistic prediction. Further, we should include not only the developed economies along with some of the major emerging markets, but literally all economies, in extending our analysis. As we will ponder later, our model for prediction should be much more inclusive of all countries, no matter how small or economically less developed the countries are.  The understanding here is that given the fragile nature of the global economy at present, even a small non-economic ripple in a distant land can turn into something that encompasses the globe in some kind of economic turmoil.

Thus, hopefully, a globally inclusive model of understanding should definitely help us in the business of prediction.

Departure from the Traditional View

At this point I am going to depart from the traditional view that predicting the future of any economy should necessarily be an exclusive economic model. I shall argue that in this world we live in, such a model is inadequate if we realistically expect to beat the odds of a coin toss game. The point I seek to make is that in a world where we are so dependent of each other, how can we exclude factors like political or social conditions, geographic dispositions and historical interrelations, religion, world health, poverty or global climate change. I am going to elaborate upon some of these above contentions with some simple examples to support my view of an all inclusive understanding model before we go about the business of predicting the economy.

War- What is it Good For?

Consider the politics of wars in the world. Does it have an impact on our economy? It sure does. If we are directly involved, it has a huge cost in human suffering besides the direct dollar cost of war. The countries we are engaged in are similarly impacted by their casualties in human lives (and the subsequent economic effect of that) and the real time dollar costs of the real and financial economy being in shambles. If our country is not directly involved in some war overseas, then the whole defense and allied industries stands to gain – we are by far the largest suppliers of weapons in the world. Hence any war has economic consequences from tangible dollar costs to the associated costs of low morale, drops in consumer confidence, etc. An even simpler example would be to look at the wars we are engaged in (in Iraq and Afghanistan) and ask ourselves whether the economic consequences are not sufficient enough to be included in a predictive model.

Global Climate Change

What about global climate change? It is far too late to say it is not real. The main question is whether the economic consequences of global climate change are large enough to be included in any predictive model. What is the impact of climate change on our economy from the increased ravages of floods,   and famines? Costs in crop loss, insurance claims, higher food prices etc. etc. are surely not trivial. Are we willing to say that in the future these extremes of weather will dissipate and not increase so that we do not need to consider their economic impacts? If the climate changes problem is real then we do need to do something about carbon emissions and fossil fuels even as we find larger and larger oil deposits.

However, it is not enough for us to move strongly in this direction. China and India are already crying foul as the world tries to persuade these two countries to slow down carbon emissions. It is a difficult pitch to sell since the retort is that the economic development in the western world is what caused this condition and it is unfair to ask these two countries to slow down their growth ambitions especially since they have waited so long to wait their turn.

Moreover, less consumption of commodities (e.g. of oil, steel, building material) by China and India will trigger economic events of their own since lower production levels in these countries would mean higher costs to us since we are the main consumers of their economic production. The irony of this argument is that if these countries are not halted from their frenetic economic activity and stepped up consumption of commodities, then there is a good chance of inflation creeping through the commodity sector.

However, the point to make is that the effects of global climate change certainly do have serious economic consequences and excluding it would surely denigrate the prediction.

Other Issues

There are other associate issues. What is the impact of global poverty on future economic activities? Should this be an issue at all? What we don’t observe is the staggering scope of this problem. Let me clarify with a simple example. There are roughly 1.2 billion people in India. Another rough estimate would be to state that about 5% of this population are millionaires (in dollar terms), especially when you factor in that for each Indian Rupee that is accounted for (in the economic system) there is at least two Indian Rupees that are unaccounted (money on which tax has not been paid and has not been laundered either (black money) for but that which circulates in the economy.

Another way of expressing the 5% is to say that there are more millionaires (60 million) in India than there are people in France!! Another 400 million can be considered the middle class. No wonder India is an attractive market to developed nations whose internal markets have become tepid.  However, this also means that the rest of the Indians (about 750 million) live in abject poverty, on a dollar a day. Given that this is an average consumption value, there ought to be about 350 million Indians who live on a lot less than $1 a day. And, this entire population is growing.  In China as in Indonesia; in Bangladesh and in Nigeria. In Brazil and Russia. A growing number of people who are hungry and clamoring for food. People who are adding to the others in claiming land to live on, away from agricultural production. Is there a limit of how many people the world can support before it breaks apart. Does this have any significant (other than the usual Malthusian one) economic impact? It does for sure; much more surely than climate change and swine flu. Yet our models and predictions are oblivious to these possibilities.

SAARS

Physicians and ME-P readers may recalls that about 5-6 years ago, we saw the advent of SAARS, a lethal infection in China and Taiwan, beginning to spread in other parts of the world. There was an immediate and sharp economic impact on many of the industrialized nations. Fortunately for us, the spread of the infection was arrested and the global economy quickly got back in track. Surely, we were lucky. A few years ago, the world witnessed bird flu, an even more lethal viral infection. This too was quickly contained. At some point during the financial meltdown of 2008-09 we witnessed the advent of swine flu, a close relative of the bird flu. This time too we were lucky.

Of course, it is important to note that these infections are one step away from being an epidemic of immense proportions where 100s of millions may perish. If the swine flu was not contained when it appeared in late 2008 – early 2009, the financial meltdown we experienced would seem like a tame event. What happens if the next time and next viral mutation around) we are not that lucky? Should we consider the economic consequence of such an event, albeit within a probability framework?

Non-Economic Issues

As we can see, there are many other noteworthy non-economic issues that can have serious economic impacts.  As a matter of fact, we can all conjure up other examples of non-economic issues at will and make a case for their inclusion because we can so easily rationalize their economic impact. But I have made the point to wrap up the answer to my first question – how good are the economic models? Not much, really.

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Educated ME-P Readers

Since my readers possess financial knowledge and acumen, it is worthwhile for me to allude to the various predictions that are flying about in the economy without having to explain them in great detail. This time around, predictions of economic recovery are in the form of shapes. So now the big question is whether the recovery will look like the shape of a V (a sharp recovery) as compared to a U (a prolonged recession followed by a fairly sharp recovery) or a W (a second round of recession followed by another sharp recovery or like a pair of conjoint Vs (V V). The latest one I had the misfortune to hear about was a square root (√, a V-shaped recovery till a point after which the economy changes very little for a considerable period of time). What is also quite obvious that we can make up many other shapes like the above, using economic (and non-economic) arguments as mentioned earlier but at the end of the day, any one of them has a 50% chance of being right. Because our theories say (yes, the very ones we constructed) that markets are efficient and predictions are futile.

Which brings us to the second question: knowing all this, how important are predictions in the way we live. How much better would our lives be, knowing that one or two of these predictions are right and all others are not? Can we identify the ones that are right?  Most likely not, and definitely much harder than finding good or bad stocks.

Assessment

How would our lives change if we could find that handful of people who predicted correctly and consistently more often than not, if there were such people? Surely, armed with this knowledge, we would be able to exploit the predictions for gain. But, given the odds, it is also quite plain and obvious that finding such people is as difficult as winning the lottery. We know the odds. We continue to admonish our clients who stray in these extreme speculative peripheries. Yet, when it comes to reading about predictions, we continue to play the lottery, in hopes of a windfall. The windfall wills make us richer, but will it make us better or happier?

Note: Dr. Somnath Basu is a professor of Finance at California Lutheran University and the President of Financial Health Technology (www.financialhealthtechnology.com), a personal financial software company.

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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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VIDEO: Cool New HIT Gadget for Physicians?

3D Head-Tracking Interface

By Ann Miller; RN, MHA

[Executive-Director]

According to SoftwareAdvice.com, Apple is the hottest topic in the tech blogosphere these days. Even if you ignore all news of the “iSlate,” and the new tablet PC, dozens of rumors abound.

Head Tracking Technology

One interesting idea is a patent for 3-Dimensional head-tracking. Instead of using a mouse and keyboard, Mac users simply move their head or body to control an image on screen. Some think this technology would perfect for healthcare.

Video Presentation

Here’s a short video from Houston Neal to help you visualize the device:

http://www.softwareadvice.com/articles/medical/apple-3d-head-tracking-for-doctors-1011410/

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Healthcare Organizations: www.HealthcareFinancials.com

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Shopping for Health Software

Some Doctors Get Buyer’s Remorse

By D. Kellus Pruitt; DDS

Dear Huffington Post Investigative Fund

As a dentist, I read Emma Schwartz’s “Shopping for Health Software, Some Doctors Get Buyer’s Remorse” with interest.

It was like watching a slow, grinding train wreck from a still safe, but shrinking distance.

http://www.huffingtonpost.com/2010/01/29/shopping-for-health-softw_n_442651.html

Duped Physicians 

The numerous stories about physicians who lost hundreds of thousands of dollars because of bad software purchases – including the case where some doctors alleged they were locked out of their patients’ medical records – is awe inspiring if one isn’t mandated to live the misery. I hope it’s a long, long time before paper dental practices are outlawed. If as Ms. Schwartz describes, broad-band interoperability fails to save money for physicians where it makes sense, I promise that dentists will never invest in interoperability beyond occasionally purchasing a new fax machine, telephone, or postage stamps. Dentistry simply isn’t emergency room medicine, and non-productive technology is especially costly if it fails to function properly.

A Volatile Industry 

Steven Lazarus, president of consulting company Boundary Information Group, was quoted:

 “This is a very volatile industry. Any product doctors buy could be bought or changed within two years.”

You want to see volatile? Try explaining that to thousands of disappointed dentists in solo practices – one disagreeable SOB at a time.

A Canadian Illustration 

Believe it or not, there’s still more kinetic energy behind the train wreck – even without mentioning data breach bankruptcies. As illustrated by Schwartz’s example of Canada-based MedcomSoft, even if a company’s EHR system is CCHIT-certified, bankruptcy can occur unexpectedly – again leaving doctors holding the bag. To stay in business, providers who lose money on EHRs either must cut corners or increase fees to cover the loss … volatile!

A Dentist’s Question 

Why, oh why, would a dentist want to spend $40,000 on software including thousands of man-hours in transition, just to risk pulling this tangled, expensive mess down on top of one’s practice? And – for what? There is no return on investment beyond the stakeholders in the EHR industry – which is ultimately paid by unrepresented patients through their healthcare in higher medical fees. As one can imagine, dentists are staying away from EHRs in droves.

For example, what does it mean that there are few if any advertisements for electronic dental records in industry journals, junk mail ads or Internet venues? I think it means that the Father of Economics Adam Smith is quietly warning ambitious, would-be dental software salespeople that their dangerous and expensive products will get them thrown out of dental offices.

The ADA 

But then again, I could be wrong. Here is what Dr. John Findley, the immediate past president of the American Dental Association, told ADA Reporter Judy Jakush in a September 2008 interview a month before taking office:

“The electronic health record may not be the result of changes of our choice. They are going to be mandated. No one is going to ask, ‘Do you want to do this?’ No, it’s going to be, ‘You have to do this.’ That’s why we absolutely need the profession to be represented in the discussions about EHR to make sure our ideas are enacted to the greatest extent possible.”

To me, that’s scary. It smells a lot like tyranny.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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A Skeptical View of the ‘National Summit on Health Care Fraud’

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Seeking Real Results; not Empty Rhetoric

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

All our ME-P readers and subscribers are aware of the ‘National Summit on Health Care Fraud’, at the National Institutes of Health (NIH), held on January 28, 2010 in Bethesda, Maryland. The much publicized summit discussed ways to eliminate fraud, waste and abuse in the US health care system.

A major speaker, of course, was US Secretary of Health and Human Services [DHSS] Kathleen Sebelius.

In My Opinion

IMHO, the summit was more political posturing and “nibbling at the margins”, than innovative thought leadership. Much like a hawkish politician with a platform against crime; who can argue with the proposition?

But, how do we actually reduce fraud and abuse? In other words, how can we achieve real results, and not just more anti-fraud rhetoric?

Here are two considerations, currently on the books, that need hard enforcement:

1. Medicare Integrity Program

The MP-P allows the DHHS to contract with non-governmental organizations, known as Medicare Program Safeguard Contractors, to carry out fraud and abuse detection, cost report audits, utilization review, provider payment determinations, and provider education, and to create a list of durable medical equipment subject to prior authorization for reimbursement.

Under this program, the Centers for Medicare and Medicaid Services (CMS) must implement regulations for contracting procedures.

2. Beneficiary Incentive Program

Under the BIP, Medicare beneficiaries are encouraged to report any suspicious billing activities. When a claim results in collection of funds of at least $100, the beneficiary may be paid a portion of the collections, up to $1,000 for each occurrence. Since this process does not require the same amount of time and resources associated with whistleblowing actions, there has been activity generated by senior groups leading to various enforcement actions.

This program has allowed the Medicare carriers to send notices to patients, which encourages them to call, report, and possibly be rewarded if the report results in action.

Assessment

The first step in fighting healthcare fraud and abuse is to know which laws apply in specific cases.

The next step is formulating policies and procedures to ensure that all workforce members understand how to comply and what their individual responsibilities are in maintaining a sound healthcare business organization.

The third step is enforcement and punishment; less talk and more action!

Assessment

The most effective way to accomplish all of this is through the implementation of a medical practice compliance program, and more specifically, the augmentation of the above two programs currently in existence.

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Words of a Healthcare Reform Philosopher

The Lady Speaks

By Staff Reporters

Healthcare reform insights from America’s leading contemporary philosopher, Stefani Germanotta (a.k.a. Lady Gaga).

I want your ugly. I want your disease.
I want your everything, as long as it’s free!

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Events Planner: February 2010

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Events-Planner: FEBRUARY 2010

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 150,000 visitors and readers 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. And so, enjoy the Medical Executive-Post and our monthly Events-Planner with our compliments. 

A Look Ahead this Month

February 1: Print Edition Healthcare Journalism: If you would like to “step-up-your-game” and be considered as a peer-reviewed contributor to the third print edition of: The Business of Medical Practice [Health 2.0 Profit Maximizing Techniques for Savvy Doctors]; contact Ann at: MarcinkoAdvisors@msn.com. There are several chapter topics still available. Now, the important dates:

Feb 01-02: Investment Advisor Compliance Conference, FRA, New York, NY

Feb 07-10: Rural Health Leadership Conference, Phoenix, AZ

Feb 21-23: Insured Retirement Institute Marketing Conference, NYC

Feb 22-23: Active-Passive Investor Summit, NYC

Feb 28-29: National Medical Home Summit, Philadelphia, PA

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

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Healthcare Organizations [A Journal on CD-ROM]

Journal of Financial Management Strategies

By Ann Miller; RN, MHA

[Executive-Director]

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All hospitals, healthcare systems and organizations use a variety of teaching, educational and didactic techniques to bring value to patients, payers, providers, governments and third-party intermediaries. This Intellectual Capital is the sum total of all knowledge and expertise used to serve society and stakeholders. Leaders, CXOs and employees provide almost all of this Intellectual Capital.

Our Beliefs 

We believe that Healthcare Organizations: [Journal of Financial Management Strategies] adds to this Intellectual Capital by guiding you, empowering your organization, and creating value for your patients, employees, investors and clients by bridging the intersection of medical mission and profit margin.

Our Vision

To be the pre-eminent interpretive guide for financial management strategies, and the enduring business analytics guide for all healthcare organizations; and to promote related enterprise-wide health economics initiatives.

Our Mission

Healthcare Organizations: [Journal of Financial Management Strategies] promotes and integrates academic and applied research, and serves as a multi-disciplined forum for the dissemination of economic, financial, business, management, IT and administration information to all healthcare organizations; both emerging and mature.

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Assessment

Our goal is: “Bridging the Intersection of Medical Mission and Profit Margin”

Conclusion                                               

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Health Administration Terms: www.HealthDictionarySeries.com

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Do Prices Drive Regional Medicare Spending Variations?

A New Study Says – Apparently Not

By ME-P Staff Reporters

Per capita Medicare spending is more than twice as high in New York City and Miami than in places like Salem, Oregon.

How much of these differences can be explained by Medicare’s paying more to compensate for the higher cost of goods and services in such areas?

The Study

According to Daniel J. Gottlieb, Weiping Zhou, Yunjie Song, Kathryn Gilman Andrews, Jonathan S. Skinner and Jason M. Sutherland – not much!

The Answer

The authors analyzed Medicare spending after adjusting for local price differences in 306 Hospital Referral Regions. The price-adjustment analysis resulted in less variation in what Medicare pays regionally, but not much.

The findings suggest that utilization—not local price differences—drives Medicare regional payment variations, along with special payments for medical education and care for the poor.

Assessment

http://content.healthaffairs.org/cgi/content/full/hlthaff.2009.0609v1

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Submitting a Guest Post to the ME-P

Make your Voice Heard

By Hope Rachel Hetico; RN, MHA

[Managing Editor]

The Medical Executive-Post is a growing and influential media voice with over 150,000 readers, and followers.

Out Reach Efforts

You can reach this influential audience by submitting a guest opinion piece on anything related to non-clinical health care. Newspaper reporters and editors read the ME-P regularly, so this is always an opportunity to expose your writing to major media outlets.

Format, Length and Style

Articles of about 500-1,000 words in length and free of grammatical and spelling errors are preferred. Accepted pieces will not only be published on the blog, but may be syndicated elsewhere. Several professional medical management and financial services organizations already contribute to us, as well as individual physicians, advisors, and consultant readers. Photographs and .jpeg images are encouraged.

Become a Thought-Leader

There is also an opportunity to become a regular contributor to the ME-P, or thought-leader, after several high-quality guest posts have been accepted and published.

Our Philosophy

Remember the words and philosophy of Dr. David Edward Marcinko, our Publisher-in-Chief:

“You allow others to frame the discussion for you – positively or negatively – if you do not contribute your own ideas, thoughts and opinions.”

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Assessment

Articles for consideration can be emailed directly to us at any time: MarcinkoAdvisors@msn.com

Conclusion

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Questioning [Physician’s] Upward Social Mobility and the State of the Union Address

Broad Consensus Seems Impossible for Medical Professionals – and Everyman

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

While an undergraduate student at Loyola University in Maryland, I learned from my Jesuit teachers and philosophers that a couple of centuries ago, the decider of all matters of importance in Jerusalem was the Great Sanhedrin, or a council of 71 judges. The council met most every day except on festivals and the Sabbath. It functioned as sort of a combination of the Supreme Court, Congress and a political debate boiler room.

Incorrect Unanimity

As one might imagine, the Sanhedrin’s members normally disagreed as they hammered out their daily opinions; much like today’s political debates over healthcare reform. But occasionally they came to a unanimous decision, and they had an amazing and very wise rule when that occurred: The decision was immediately overturned because the sages believed that a unanimous conclusion among so many individuals just had to be wrong.

THINK: The US Senate and Congress

Rules for Upward Mobility

Anyway, I was thinking about the Sanhedrin’s rule after last night’s 2010 State of the Union address by President Barrack H. Obama while I was considering the current state of the economic union for doctors – specifically. The translation is easy for non-physicians [everyman] as well; so bear with me.

Anyway, I was struck by the fact that if there was one grand unified theory which gets at least 90-100% agreement from current generations of America’s medical and lay punditocracy – it is the rules for upward [medical professional] mobility.

These rules, especially for second generation Americans like me, were:

  • A medical degree [college education] leads to a lucrative profession [job] and a satisfying lifestyle.
  • [Working hard], or practicing long hours, means your income will grow.
  • Devotion to medicine, or your job, will produce a comfortable retirement.
  • Your children will follow your career path [job] and create a lasting legacy

The Paradigm Shift

Today, with a national unemployment rate hovering around 10%, doctors and everyman may need to reconsider the above unwritten rules that have governed our upward mobility since the end of World War II. As the son of a GM auto worker – I did decades ago – and still do.

For example, from 1945 to 2000, various private and public health insurance mechanisms were developed, along with the idea that health insurance was a fringe benefit in lieu of the wage and price controls instituted after the war. Today it is even considered a “right” by some.

Nevertheless, the doctor-class was a surrogate for the affluent American upper middle class lifestyle, and a type of perpetual prosperity machine that created wealth.

There were periodic general economic dislocations of course, like the recessions of the mid-1970s and early 1980s, and the rise of managed care in the early 1990s. But, wealth seemed to compound for physicians, and progress always resumed its upward trajectory. This was especially true for all medical professional during the “golden age of medicine” [circa 1965-1990, approx].

After all, wasn’t [isn’t] healthcare considered a recession proof business? Perhaps no more!

The Physician Net-Worth Numbers

Then: I was involved in study a few years ago [September 16, 2008] which determined that the average 47 year-old physician, earning $180,000 annually, needed to amass a net-worth of about $5.5-M in order to maintain the same lifestyle throughout retirement at age 65.

Link: http://www.hcplive.com/finance/publications/pmd/2005/92/3951

Link: www.CertifiedMedicalPlanner.com

Now: Today, with the DJIA down about 30% from its’ October 2008 high, is this retirement / employment scenario still possible? Are our opinions Sanhedrin-like?

And remember, the estate tax laws sunset back to their original rates in 2011. Moreover, many financial advisors, like me, believe income tax rates and brackets will increase going forward; along with increasingly onerous regulations for small businessmen and women like physicians and private medical practitioners. New business innovations of all stripes will also be adversely affected.

Full Disclosure: I am founder of the Certified Medical Planner™ online education program for financial advisors and medical management consultants.

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Assessment

And so, I ask, do the rules of upward mobility for physicians or everyman still apply; or have they changed?  Why or why not? If so, is the change permanent or temporary, and is it for the positive or negative. Please consider financial, societal and/or generational implications.

IOW: Is President Barack H. Obama correct?

Conclusion

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About the Cisco HealthPresence Medical Delivery Model

What it is – How it works

By Staff Reporters

Cisco HealthPresence is a new concept developed by the Cisco Internet Business Solutions Group (IBSG) and prototyped at the Cisco Technology Centre. Cisco HealthPresence is based on market-ready Advanced Technologies. It is led by Dr. T. Warner Hudson.

A Multi-Media Platform

Using the network as a platform, Cisco HealthPresence combines state-of-the-art video, audio, and medical information to create an environment similar to what most people experience when they visit their doctor or health specialist.

Healthcare services include:

  • Primary medical care (family medicine, internal medicine, women’s health)
  • Pediatric care
  • Digital x-ray
  • Laboratory services
  • Pharmacy services
  • Physical therapy
  • Condition management and health coaching
  • Travel immunizations and prescriptions
  • Chiropractic medicine
  • Acupuncture
  • Executive physicals
  • EAP/Behavioral health
  • Assessment

    http://www.cisco.com/web/about/ac79/health/hp/index.html

    Currently for employees only, each has a personal account at: www.ciscolifeconnections.com where they can view their eMRs and message physicians.   

    Conclusion

    And so, your thoughts and comments on this ME-P are appreciated. Give em’ a click, and tell us what you think; any users out there? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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    Healthcare Organizations: www.HealthcareFinancials.com

    Health Administration Terms: www.HealthDictionarySeries.com

    Physician Advisors: www.CertifiedMedicalPlanner.com

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    Apple Tablet PC Poll for Medical Professionals

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    About Ambulatory Gadgets in Medicine

    By Chris Thorman
    Chris@softwareadvice.com


    Hello Dr. Marcinko and all Medical Executive-Post readers. I hope you’re doing well.

    The Big-Breaking News from Apple

    You’ve probably heard the news that Apple is set to release a new tablet PC today. That got us thinking here at Medical Software Advice about whether or not this new device will be the first tablet PC to break through in the healthcare industry.

    A Short Survey

    So, we’ve created a short survey (8 multiple choice questions) about what tablet PC features are important to healthcare professionals. I’ll use the results from the survey to determine which tablet PC is best positioned to rule the halls of healthcare. Even if you’ve never used a tablet PC, we’d love to get your opinion on what features are important.

    Link:
    http://www.softwareadvice.com/articles/uncategorized/which-tablet-pc-will-rule-the-halls-of-healthcare-1012610/

    Assessment

    Thank you in advance for your survey participation.

    Medical Software Advice [512.364.0118]

    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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    Capital Formation for Hospitals

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    Understanding Strategic Expenditures

    [By Calvin W. Wiese; MBA, CMA, CPA]

    [By Dr. David E. Marcinko MBA CMP]

    Some of the most important strategic decisions hospital executives make are related to capital expenditures. Almost every hospital has capital investment opportunities that are far in excess of their capital capacity. Capital investments are bets on the future. How these capital bets are placed has long-lasting implications. It is of utmost importance that hospitals bet right.

    Strategic Importance of Capital Investing

    Hospitals are capital intensive businesses. Hospital buildings are unique structures that require large amounts of capital to construct and maintain. Inside these buildings are pieces of expensive equipment that have fairly short lives. Technological innovations continually drive demand for new and more expensive equipment and facilities. The ability to continually generate capital is the lifeblood of hospitals. In order to compete and succeed, it’s imperative for hospitals to continually invest in large amounts of capital equipment and expensive facilities.

    Profit Driven

    Capital investment is fueled by profit. In order to continually make the necessary capital investments, hospitals must be profitable. Hospitals unable to generate sufficient profit will fail to make important capital investments, weakening their ability to compete and survive.

    Capital Opportunity Selection

    Hospital managers bear important responsibility in choosing which capital investments to make. There are always more capital opportunities than capital capacity. In many cases, capital opportunities not taken by hospitals create openings for others with capital capacity to fill the vacuum. By not taking such opportunities, hospitals are weakened, and their operating risk increases.

    Stewardship

    Stewardship is a term that aptly describes the responsibility borne by hospital managers in making capital investments. The New Testament parable of the talents describes this kind of stewardship. In this story, a merchant entrusted three managers with money to invest. One manager was given five units, another two, and a third one. At the end of the investment period, the two managers given five units and two units reported a 100% return. The manager given one unit reported zero return — he was fired and his unit was given to the first manager.

    This is stewardship — and hospital managers are stewards of their organizations’ assets. Too often, not-for-profit hospital managers hold an erroneous view of the returns expected of them. Like the third manager in the parable, they think zero return on equity is acceptable. They understand capital investment funded by debt needs to cover the interest on the debt, but they view capital investments funded by equity as having no cost associated with the equity. From an accounting perspective, they are right. From a stewardship perspective they are dead wrong — just like the third manager in the parable.

    Here’s why: as stewards, they are responsible for managing the entrusted assets. They can either put these assets at risk themselves, or they can put those assets in the market and let other managers put them at risk. If they choose to put them at risk themselves, and then they have the mandate of creating as much value from putting them at risk as they would realize if they put them in the market for other managers to put at risk. They have the duty to realize returns that are equivalent to the returns they could realize in the market; otherwise, they should just put them in the market. They can either invest in hospital assets or work the assets themselves, or they can invest in financial market assets so others can work the assets. When they choose to invest in hospital assets, the required return is not zero. That’s the return they get fired for. The required return is equivalent to market returns.

    Product DetailsProduct Details

    MORE: Capital Formation Hospitals SAMPLE DEM

    Assessment

    Thus, when evaluating performance of hospital management teams, the minimum acceptable performance level is return on equity that is equivalent to the return that could be realized by investing the hospital assets in the market. And when evaluating a capital investment opportunity, it is important to apply a capital charge equivalent to the hospital’s weighted cost of capital — a measure that imputes an appropriate cost to the equity portion of the capital along with the stated interest rate for the debt portion of the capital structure.

    CASE MODEL: CASE MODEL

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    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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    Is the HITECH Act Unconstitutional?

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    Parts 1 and 2

    [By Alberto Borges; MD]

    Is the HITECH Act Unconstitutional? – PART 2

    Is the HITECH Act Unconstitutional? – PART 1

    Dr. Borges is a ME-P thought-leader in private practice. He is an associate clinical professor of medicine at the George Washington University in Washington, DC.

    Assessment

    Check out his website at http://msofficeemrproject.com

    Conclusion

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    I Want Obama Transparency for the ADA

    No More Hiding Places

    By D. Kellus Pruitt; DDS

    Today, Ed O’Keefe of the Washington Post posted “New Obama Orders on Transparency, FOIA Requests.”

    http://voices.washingtonpost.com/federal-eye/2009/01/_in_a_move_that.html

    O’Keefe writes:

    “In a move that pleased good government groups and some journalists, President Obama issued new orders today designed to improve the federal government’s openness and transparency. The first memo instructs all agencies and departments to ‘adopt a presumption in favor’ of Freedom of Information Act requests, while the second memo orders the director of the Office of Management and Budget to issue recommendations on making the federal government more transparent.”

    Soon, other ADA members are going to bluntly ask Pres Dr. Ron Tankersley:

    “If the President of the United States has the courage to face those whom his actions affect, why oh why doesn’t the President of the American Dental Association support transparency in the non-profit organization that belongs to dues-paying members?” After all, ADA members pay more than $1000 per year for ADA services.”

    “If you are an ADA leader, pay close attention. This is the future I warned you about that far too many of you avoided out of convenience. As you can read below in his memos, Obama promises, “The Government should not keep information confidential merely because public officials might be embarrassed by disclosure, because errors and failures might be revealed, or because of speculative or abstract fears.”

    Who will be held accountable for the ADA/IDM blunder… among other bone-head ideas?

    Obama promises that his administration:

    “Will work together to ensure the public trust and establish a system of transparency, public participation, and collaboration. Openness will strengthen our democracy and promote efficiency and effectiveness in Government.”

    I think openness will do the same in healthcare if we can move a handful of entrenched ADA leaders on down the road. They are weighing us down with their selfish special interests.

    Assessment 

    Did you hear that, Dr. Ron Tankersley, President of the American Dental Association? There are simply no more hiding places for the anonymous ADA hobbyists who elected you. I’m sure the long run of irrelevant ADA Presidents was fun before electricity and social networks, though.

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    Conclusion

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    OSHA Financial Cost Analysis Software

    About the “Safety Pays” Program

    By Staff Reporters

    A financial cost analysis can be performed by anyone using the OSHA software program, Safety Pays. This software can be found and downloaded at no cost by accessing the website: http://www.osha.gov/pls/oshaweb/searchresults.category?p_text=safety%20pays&p_title=&p_status=CURRENT

    A Free Software Program  

    The program was developed to assist employers in assessing the impact of occupational illness and injuries on their profitability. Utilizing this software program and profit/loss data from the www.bizstats.com website on physician practices – reveals a number of startling statistics that illustrate how cost effective implementing an OSHA safety program can be for a medical practice, clinic, hospital or emerging healthcare organization (EHO).

    Assessment

    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, be sure to 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 Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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    The Scott Brown versus Healthcare Reform Poll

    The Sott Brown Opinion Poll

    By Staff Writers

    In what some pundits are calling the “Boston Massacre” in liberal Massachusetts, Republican Scott Brown rode a wave of voter anger to win the US Senate seat held by the late Edward M. Kennedy for nearly half a century, leaving President Barack Obama’s health care overhaul in doubt and marring the end of his first year in office.

    Our ME-P Audience

    As a financial advisor, we know you are aware of the rise in healthcare stocks yesterday. And, as a medical executive or healthcare professional, we know you have been against the public option, and healthcare reform, in its current version.  The AMA is not your friend – nor does it represent you.

    The Question Is?

    And so, do you believe that last Tuesday’s Republican victory in Massachusetts means the current Democratic health care bill will not be on the President’s desk in 2010?

    Please VOTE: