Dr. David Edward Marcinko MBA MEd CMP™

US Navy Ship Comfort Heads to Haiti

Posted on January 18, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

More on the Hatian Military Sealift Command Operations

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

According to www.USNavySeals.org, the Military Sealift Command hospital ship Comfort just sailed from its pier home-port in Baltimore Maryland and is now on its way to Haiti to assist in relief operations.

On board are 550 doctors, nurses, technicians and support staff who, according to the Bureau of Medicine and Surgery of the United States Navy, will give a variety of medical services, among them primary care, trauma care, pediatric care and orthopedic care.

Assessment

I was privileged to visit the big ship last summer [2009] while on speaking tour. It is a sight to behold:

https://healthcarefinancials.wordpress.com/2009/08/21/off-road-touring-with-dr-marcinko-part-v/

For more info, I encourage all ME-P readers and subscribers to lean more about her:

http://www.med.navy.mil/sites/usnscomfort/Pages/default.aspx

Channel Surfing

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Filed under: Breaking News, Ethics, Military Medicine | Tagged: Haiti, Military Sealift Command, US Comfort, USNavySeals.org | 1 Comment »

Healthcare Reform and the US Constitution

Posted on January 17, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Consider this Proposed 28^th Amendment

Submitted by Cecelia T. Perez; RN

Author Unknown

For too long we have been too complacent about the workings of Congress. Many citizens have no idea that Congress members can retire with the same pay after only one term, that they didn’t pay into Social Security, and that they specifically exempted themselves from many of the laws they have passed (such as being exempt from any fear of prosecution for sexual harassment); while ordinary citizens must live under those laws.

The Healthcare Reform Exemption

The latest is to exempt themselves from the Healthcare Reform that is being considered … in all of its forms. Somehow, that doesn’t seem logical. We do not have an elite class that is above the law. I truly don’t care if they are Democrat, Republican, Independent or whatever. The self-serving must stop. This is a good way to do that. It is an idea whose time has come.

Proposed 28th Amendment to the United States Constitution:

“Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and Representatives; and, Congress shall make no law that applies to the Senators and Representatives that does not apply equally to the citizens of the United States.”

Assessment

Each person contact a minimum of twenty people on their address list, in turn ask each of those to do likewise. Then in three days, all people in The United States of America will have the Message. We ask you to pass this idea to your friends for their consideration.

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Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Op-Editorials | Tagged: congress, healthcare reform, public option, social security, US Constitution | 2 Comments »

Desperately Seeking Medical Professionals in Haiti

Posted on January 16, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Catastrophe in Port-au-Prince

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

The ME-P is attempting to assist those in need in Haiti. So, if you are a healthcare professional interested in volunteering, please send an email to volunteer@pih.org with information on your credentials, language capabilities (Haitian Creole or French desired), availability and contact information; etc.

Acute Medical Needs

Orthopedic and trauma surgeons and related specialists are especially desired. In particular, ER doctors and nurses – and full surgical teams (including anesthesiologists, scrub and post-op nurses, and nurse anesthetists) – are in short supply.

Chronic Medical Needs

Down line, primary care doctors, infectious disease specialists, nurses, dentists and internists will be needed once the acute situation has been controlled.

Assessment

We at the ME-P would be very grateful if you are able to contact them, or the Red Cross, and provide medical assistance. As patients flood from Port-au-Prince, they are also finding themselves in need of both personnel and medical supplies, as well.

In other words, any help is much appreciated [time, talent and money].

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. If confirmed, we will laud your humanitarian efforts in an upcoming edition of the ME-P.

Godspeed!

Filed under: "Doctors Only", Breaking News, Media Mentions and PR, Op-Editorials | Tagged: Haiti | 1 Comment »

Who Admires the EU Healthcare Model?

Posted on January 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Not so Fast – Old Man

By Darrell K. Pruitt; DDS – el Viejo

Here’s something interesting I found on Courthouse News.com about Germany’s mandatory retirement age for dentists.

“EU Court OK’s Age Limits for Firefighters, Dentists” (no byline).

http://www.courthousenews.com/2010/01/14/European_Courts.htm

European Court of Justice

“The European Court of Justice released a ruling reconciling a ban on age discrimination with German age limits for firefighting and dentistry.”

The article continues:

“For dentists, the high court agreed with the national court that an age limit is justified by the need to protect patients from declining performance.”

As we wait for octogenarian Gordon Christensen DDS to discover and describe the lame “declining performance” claim in that statement, let me focus on the rest of the paragraph:

“But it said that such a limit must apply across the board, not only for panel-certified dentists within the public sector, but also for private practitioners.”

Touting the Next Generation of Dentists

It gets worse. The EU openly states that it intends to hand young dentists (and mid-level providers?) an immediate chance at making swell money with a huge demand for dental care that will arise when thousands of thriving dental practices across Europe close.

“The Court of Justice also agreed that such a limit is reasonable to provide work positions for young dentists, but only if it can be proven to fulfill this purpose.”

Assessment

Hell, I’ll probably still have kids in college if US HIT stakeholders fall in love with this plan. Not only that, but since thousands of dental practices like mine will be up for sale at the same time, the business I’ve built over the last 27 years will be worthless on the open market.

So what are my plans? I hope the ADA is adequately protecting Americans from such folly.

And – if not?

Porque hablo español, tengo la intención de mover el culo viejo a una ciudad en la costa en México y sacar dientes a los extranjeros ilegales a su regreso desde el norte. ¡Viva el NAFTA!

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Who agrees with the EU; why or why not? 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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Filed under: Career Development, Health Economics, Pruitt's Platform | Tagged: ADA, Darrell Pruitt, DDS, EU, European Union, Gordon Christensen DDS | 2 Comments »

Understanding Hospital Community Essentiality

Posted on January 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Views Differ on this Important Concept

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

An important component of hospital financial analysis is essentiality. Hospitals are unusual businesses that many times possess some form of essentiality to their communities. Healthcare is important to the economic vitality of every community. Many hospitals have served their communities for many years; it is not uncommon to find hospitals that have been continuously operating for more than 100 years in the same community.

Many Hospital Types

As we have discussed here and elsewhere, most hospitals are not-for-profit. In not-for-profit hospitals, no private party actually “owns” the hospital; control is vested in various boards, but no one explicitly “owns” a not-for-profit hospital. In a broad sense, communities own not-for-profit hospitals. They are considered “charities” with a “charitable purpose.” Though a not-for profit hospital may not have owners, it has many” stakeholders,” parties that have vested interests in the continuing success of the hospital.

Many Diverse Stakeholders

Many hospitals have broad and vast webs of stakeholders. Stakeholders are why hospitals rarely close or are shut down. Too many stakeholders have interests in the continuing successful operation of hospitals.

Hospital stakeholder relationships need to be considered in the analysis of essentiality. How strong are these relations? How many are there? How important is the continuing success of this hospital to these stakeholders?

Health Services Analysis

Another dimension of the essentiality is medical service analysis. For examples, how significant are the hospital’s services? If the hospital shuts down, what population segments would suffer? How significant is the population that would suffer? How much would they suffer?

Assessment

Analysis of hospital’s stakeholders and services should provide a credible view of the degree of essentiality associated with a hospital. Higher degrees of essentiality suggest higher likelihoods that hospitals, one way or another, will meet their commitments, particularly their payment commitments.

Conclusion

So, tell us what you think about your hospital’s essentiality? 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.

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: CMP Program, Health Economics, Healthcare Finance, Research & Development | Tagged: Calvin Wiese, hospitals, www.healthcarefinancials.com | 1 Comment »

Asking Uncle Sam – Why Health IT?

Posted on January 13, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Let ONC and CMS Explain

By Staff Reporters

On December 30, 2009, CMS and ONC issued proposed regulations on the definition of meaningful use and the initial set of standards, implementation specifications, and certification criteria for EHR technology.

According to the DDHS

Health information technology (health IT) allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of HIT has the potential to improve health care quality, prevent medical errors, increase the efficiency of care provision and reduce unnecessary health care costs, increase administrative efficiencies, decrease paperwork, expand access to affordable care, and improve population health.

Improving Patient Care

Furthermore, according to the DHHS, interoperable health IT can improve individual patient care in numerous ways, including:

Complete, accurate, and searchable health information, available at the point of diagnosis and care, allowing for more informed decision making to enhance the quality and reliability of health care delivery.
More efficient and convenient delivery of care, without having to wait for the exchange of records or paperwork and without requiring unnecessary or repetitive tests or procedures.
Earlier diagnosis and characterization of disease, with the potential to thereby improve outcomes and reduce costs.
Reductions in adverse events through an improved understanding of each patient’s particular medical history, potential for drug-drug interactions, or (eventually) enhanced understanding of a patient’s metabolism or even genetic profile and likelihood of a positive or potentially harmful response to a course of treatment.
Increased efficiencies related to administrative tasks, allowing for more interaction with and transfer of information to patients, caregivers, and clinical care coordinators, and monitoring of patient care.

Assessment

Is the above really true in light of these two recently released reports on meaningful use?

ONC IFR (PDF) http://tinyurl.com/ya7bn2k
CMS NPRM (PDF) http://tinyurl.com/yb62fcr

More information is available at http://healthit.hhs.gov

Conclusion

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Filed under: Health Law & Policy, Information Technology, Quality Initiatives | Tagged: CMS, DHHS, EHRs, EMRs, health information technology, HIT, meaningful use, obama, ONC, www.HealthDictionaySeries.com | 3 Comments »

Webinar on Doctors and the Economic Stimulus Package

Posted on January 12, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

An ME-P TV First

By Ann Miller; RN, MHA

[Executive-Director]

Recently, we caught up with Houston Neal – of Software Advice – who thought our ME-P readers would like to see their new podcast on eHR stimulus funds. In-as-much as they are still hearing from doctors who want to know how to take advantage of the stimulus, they’ve teamed up with the Chairman of HIMSS to help answer questions via webinar. The final clip is now live on the blog.

And the Question … Is?

After talking with hundreds of physician practices each month, their biggest question seems to be: “What does the economic stimulus package mean for me?”

Of course, practices understand that up to $45 billion is allocated to provide incentive for physicians to adopt eHRs. However, many questions remain about how and when providers will receive stimulus funds.

ME-P TV

The podcast, with Justin Barnes Chairman of the HIMSS Electronic Health Record Association and Vice President of Greenway Medical Technologies, seeks to answer these questions. The original presentation was delivered last week; however you can view the entire webinar here, as well.

In this hour webinar, we hope you’ll learn:

How the stimulus money will be paid out
What it takes to qualify for funding
Which specialties qualify for funding
How “meaningful use” is defined
What constitutes a “qualified EHR”

Assessment

There’s some great content here, so be sure to check it out.

http://www.softwareadvice.com/articles/medical/what-does-it-take-to-qualify-for-ehr-stimulus-funds-1122209/

Further Contact

512.364.0117
www.SoftwareAdvice.com
houston@softwareadvice.com

Conclusion

And so, your thoughts and comments on this video 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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Filed under: Health Economics, Health Law & Policy, Information Technology, Videos | Tagged: EHRs, Electronic Health Record Association, EMRs, Greenway Medical Technologies, HI-TECH, HIMSS, Houston Neal, Justin Barnes, stimulus package, www.SoftwareAdvice.com | 1 Comment »

What is a HIT Security Firewall?

Posted on January 11, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Concepts and Terms

By Dr. Richard J. Mata; MIS

www.HealthcareFinancials.com

Firewalls are devices or systems that control the flow of health information network traffic between networks or between a host and a network. A firewall acts as a protective barrier because it is the single point through which communications pass. Internal information that is being sent can be forced to pass through a firewall as it leaves a network or host. Incoming data can enter only through the firewall.

www.HealthDictionarySeries.com

The Federal publication NIST Special Publication 800-41, Guidelines on Firewalls and Firewall Policy provides details of firewalls and firewall product selection that are beyond the scope of this post.

Implications Beyond Internet Connectivity

While firewalls and firewall environments are often discussed in the context of Internet connectivity, firewalls have applicability in network environments beyond Internet connectivity.

For example, many corporate healthcare enterprise intranets employ firewalls to restrict connectivity to and from internal networks servicing more sensitive functions, such as the accounting or personnel department. By employing firewalls to control connectivity to these areas, an organization can prevent unauthorized access to the respective systems and resources within the more sensitive areas. The inclusion of an internal firewall environment can therefore provide an additional layer of security that would not otherwise be available.

Imperfect Security

Although firewalls afford protection of certain resources within an organization, there are some threats that firewalls cannot protect against: connections that bypass the firewall, new threats that have not yet been identified, and viruses that have been injected into the internal network.

Assessment

It is important to remember these shortcomings because considerations will have to be made in addition to the firewall in order to counter these additional threats and provide a more comprehensive security solution.

Conclusion

So, tell us what you think about this information. 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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Sponsors Welcomed

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Filed under: Health Law & Policy, Information Technology | Tagged: bots, HIT, IT, Richard Mata, security firewalls, trojans, viruses | 1 Comment »

A Quality Story all Doctors and Patients Should Re-Read

Posted on January 10, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

[Mis] Adventures in Cardiology

Reposted by Ann Miller RN MHA

[Executive Director]

According to the author of this re-posted e-journal, Johns Hopkins Medicine has a long tradition of prioritizing patients, and striving for the bottom rung that are the anonymous poor.

And, many agree this is true. In fact, our Publisher-in-Chief grew up in Baltimore Maryland and has written about this venerable institution on the ME-P before.

Outliers

If, for example, you catch a bullet on a Baltimore street corner, or your mother presents you at the ER as a feverish welfare child, then it us open season for the medical students, well meaning as they may be. They can practice on you because if their actions result in an adverse outcome—which is to say that if you are mangled or killed—nobody will question said outcome, precisely because … you are a nobody.

At the other end of the spectrum are wealthy and prominent patients, who get treated by doctors who have already learned what not to do from the mistakes inflicted upon the lower classes.

Of … Quality Medical Care

However, sometimes mistakes happen, and medical errors do occur as we all are human. But, what is reported to have happened to one journalists’ wife – Pam – at Johns Hopkins Hospital in March of 2002 is beyond the pale.

As a middle class citizen, she landed somewhere in the middle of the bell shaped curve. Maybe she got snookered by all the hype from US News into thinking that she was going to be treated by the best doctor at “The Best Hospital in America” … You decide.

Assessment

This is the story of what happened to Pam; as reported by her journalist husband Don.

Link: http://adventuresincardiology.com/

Conclusion

Indignation Index: 96

We trust medical quality guru Bob Wachter MD will opine. And so, your additional thoughts and comments on this ME-Pare also 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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Filed under: Book Reviews, Industry Indignation Index, Quality Initiatives, Risk Management | Tagged: Baltimore, cardiology, ER, IOM report, Johns Hopkins, medical quality, Robert Wachter, US News | 4 Comments »

Introducing our New Name

Posted on January 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Or … What’s in a Formal Name?

By Ann Miller; RN, MHA

[Executive-Director]

Some ME-P readers have already noted our new moniker so it seems appropriate to formally announce our new name … domain name that is.

The Complete Migration

We’ve migrated from the rather unwieldy www.HealthcareFinancials.wordpress.com extension to the more facile and relevant www.MedicalExecutivePost.com

The first domain name refers to our companion institutional journal: Healthcare Organizations [Financial Management Strategies], located at www.HealthcareFinancials.com. Of course, the synergy there is perfect.

But, we were searching for something more expansive for the entire healthcare 2.0 universe for this rapidly growing blog, and had the epiphany to simply rename the site using our existing MEP tagline; and voila www.MedicalExecutivePost.com was born.

Confusing?

Not at all, since either name will get you to the same place via “domain sub-name pointing” technology.

What’s a Reader to Do?

So, what’s a reader to do about this name change; nothing! Just be aware and join us by reading and subscribing as you have always done … and we’ll do the rest. Fast, free and secure. Oh, and be sure to comment, too. Your opinion counts!

Conclusion

So, tell us what you think about our new name. Then, be sure to subscribe to the MEP. A rose by any other name … smells as sweet.

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Physician Advisors: www.CertifiedMedicalPlanner.com

Filed under: Breaking News, MAST-HEAD, Quality Initiatives | Tagged: Medical Exeutive Post, www.healthcarefinancials.com | 1 Comment »

Hospital Materials Management Information Systems [Part 2]

Posted on January 8, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Fundamentals of Software Implementation

By David J. Piasecki; CPIM

By Hope Rachel Hetico; RN, MHA

Dr. David Edward Marcinko; MBA

www.HealthcareFinancials.com

The singular focus of any Hospital Materials Management Information System (HMMIS) is to deliver significant improvements in the ability of hospital facilities, networks, and other healthcare organizations to optimize the processes and work flows associated with materials management systems and reduce the costs related to inventory, durable medical equipment, pharmaceuticals and supply chain management (SCM).

Understanding Strategies

Strategically, hospitals must exploit contemporary technologies and connectivity with suppliers and trading partners to:

improve patient care and safety,
increase efficiency,
drive down costs, and
optimize inventory levels.

Software Implementation

As with the selection process written about previously, ERP software implementation may also require outside assistance. Whether you use consultants from the software vendor, a business partner, or an independent firm, the implementation plan will likely be the same. It’s very important to listen to consultants and be prepared to dedicate the resources outlined in the implementation plan. A common mistake made by healthcare entities going through their first major implementation is to underestimate the complexity of their operations, the extent of system setup and testing, and the impact the implementation will have on their operation.

ERP Implementation

Here is an outline of a common scenario in single-hospital ERP implementations.

The consultants warn of the consequences of not dedicating adequate resources.
Management publicly agrees but privately thinks the consultants are crying wolf.
Implementation fails or goes poorly.
Management claims “how could we have known?”

Don’t let this be you. The only thing to assume about the implementation is that it that it will be much more difficult than expected, it will take longer than you expected, and it will cost more than expected.

Like most other projects, the success of a software implementation will be based upon the skill of the people involved, training, planning, and the effort put forth. Plan to have the most knowledgeable employees heavily involved in the system setup and testing.

Testing Programs

Adequate time should be dedicated to make sure every aspect of every process is thoroughly tested. An example of a detailed testing program is listed below:

Does the purchase order [PO] receipt screen have all the information needed to perform the receipt such as vendor item number, item description, unit of measure?
What happens when we receive more than the PO quantity?
What happens when we receive less than the PO quantity?
What happens when we enter multiple receipts against the same line?
What happens if someone tries to change the PO quantity after we have entered a receipt?
What happens if one changes the PO quantity at the same time we are entering a receipt?
What happens when we reverse a receipt?
What happens when we reverse a receipt after it has been paid?
What happens if the ordered unit of measure is different from the stocking unit of measure?
What happens when we receive an early shipment?
What happens when we try to receive against a cancelled PO?
What happens when we change the receipt location?

After the system has been thoroughly tested, employee training begins. Remember, dealing with unexpected issues is the norm; you don’t also need to be training employees after the system is supposed to be operating.

Hands-On Training

The training should consist of hands-on training and include written procedures for the tasks performed. For most positions, make sure that each employee has entered the equivalent of at least a full day’s transactions during the training. Using an actual day’s transactions is a good way to make sure the variety of transactions an employee is likely to encounter have been experienced. The most common mistake made in training is a lack of adequate repetition. Just because someone was able to perform the task once, during a training session on a Saturday three weeks prior to “going-live” does not mean they will be able to perform the task with system start-up. If they have repeated the task many times over a series of training sessions, they are much more likely to remember how to do it.

Assessment

Watch the data. During and immediately after the implementation it is incredibly important to watch the data and make sure everything is working as planned. Monitor the status of orders, purchase orders, and delivery orders paying specific attention to “stuck orders” or other exceptions. Conduct some aggressive cycle counting of fast-moving items to make sure transactions are working correctly.

Conclusion

So, tell us what you think about your hospital’s SCM software implementation? 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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Health Administration Terms: www.HealthDictionarySeries.com

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Sponsors Welcomed

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

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

Filed under: Information Technology | Tagged: david marcinko, David Piasecki, DME, durable medical equipment, ERP, HIT, HMMIS, hope hetico, IT, SCM, supply chain management, www.healthcarefinancials.com | 1 Comment »

Hospital Materials Management Information Systems [Part 1]

Posted on January 7, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Fundamentals of Inventory Software Selection

By David J. Piasecki; CPIM

By Hope Rachel Hetico; RN, MHA

By Dr. David Edward Marcinko; MBA

Understanding Strategies

Strategically, hospitals must exploit contemporary technologies and connectivity with suppliers and trading partners to:

improve patient care and safety,
increase efficiency,
drive down costs, and
optimize inventory levels.

Software Selection

Software selection and implementation services have become big business for consulting firms as well as the software vendors themselves. Even with outside assistance, selecting the right software for hospital operations and having a successful implementation can be an extremely difficult undertaking. Horror stories of failed enterprise resource planning (ERP) system implementations are unfortunately very common. Anyone who frequently reads business publications have read stories where large healthcare corporations, posting smaller than forecasted profits, cite problems associated with the implementation of a new software system as one of the causes. Whether these claims are legitimate or not is up to debate. What is true is that hospitals are highly dependent on information systems and failures in the selection and implementations of systems can result in anything from a minor nuisance to a complete operational shutdown.

Those unfamiliar with business inventory management software should be prepared to be bombarded with acronyms and buzz words. E-business, web-enabled, E-procurement, E-fulfillment, E-manufacturing, collaborative, modular, and scaleable are just a sampling of the terms used to describe (sell) hospital software inventory products.

Inventory Tracking Software

Healthcare enterprise inventory tracking software with implementation ranges in price from a few thousand dollars to millions. In fact, up until recently, if you were a medical clinic with annual revenues of less than $200 million, many of the top enterprise software vendors didn’t even consider you a potential customer. Fortunately, this arrogance has been tempered recently due to economic conditions (primarily the software vendors’ cash flow). Unlike five years ago, when the software vendors felt they held all the cards, today it is truly a buyer’s market. No matter how big or small an entity, many vendors will be vying for software dollars. That’s the good news. The bad news is that you must sift through all these products to find the one that best meets your business needs.

Process Definition

The most important part of the software selection process is defining the processes within your health organization and determining functionality that is critical to your medical operation. Many times clients get distracted by the bells and whistles and forget about their core healthcare business functions. As a healthcare entity in the DME distribution fulfillment business – focus on functionality related to order processing, as well as warehouse and transportation management. Be wary of the software vendor that claims packages that work equally well in all environments. Most software packages are initially designed with specific situations in mind; asking the vendor about their biggest customers will often give you an idea as to the type of operation the software was designed to work in.

Product Functionality

When you look at the detailed functionality of a product it will be important to have listed detailed functionality requirements of your healthcare operation. This is where hospitals often make mistakes by emphasizing functionality that they currently don’t have, but would like, and overlooking core healthcare processes that their current system handles well.

Example:

For example, if you are awestruck with functionality that allows remote access to a medical charting system from an Internet browser on an ambulatory device – and as a result – overlook critical functionality related to order entry or demand planning, you may end up with a system that provides great visibility to the fact that patient revenues are failing. Never assume a software package “must” be capable of handling something considered a standard function. Some examples of detailed functional requirements are as follows:

E-commerce capabilities
Multi-facility demand planning
Postponement and configure-to-order functionality
Forecasting and demand planning
Back-order processing
Lot or serial number tracking
Forward pick location replenishment
Batch or wave order picking
Returns processing
Back flushing DME inventory
Co-product processing
Outsourcing specific operations
Multiple stocking units of measure
Product substitutions
Blanket orders
Shipment consolidation
Multi-carrier rate shopping and manifesting
First-in first-out processing

Assessment

Don’t settle for “yes, we can do that” responses from the software vendor. It’s your responsibility to verify that not only can they do it, but also that they can do it to the level required. Ask detailed questions as to exactly how it works in their system. Look at the specific programs used to achieve the task and verify that the data elements required to achieve the task are present. Don’t allow the software vendor to sidestep your questions by retreating into obfuscating technical jargon

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.

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Information Technology | Tagged: CCHIT, david marcinko, David Piasecki, DME, ERP, HIT, HMMIS, hope hetico, Inventory Software, SCM, supply chain management, www.healthcarefinancials.com | 1 Comment »

Meet Shahid N. Shah MS [Our Newest IT Thought-Leader]

Posted on January 6, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

And Textbook Contributor, Too!

By Ann Miller; RN, MHA

[Executive Director]

Shahid N. Shah is an internationally recognized healthcare thought-leader across the Internet. He is a consultant to various federal agencies on technology matters and winner of Federal Computer Week’s coveted “Fed 100” Award, in 2009.

Professional Career

Over a twenty year career, Shahid built multiple clinical solutions and helped design-deploy an electronic health record solution for the American Red Cross and two web-based eMRs used by hundreds of physicians with many large groupware and collaboration sites. As ex-CTO for a billion dollar division of CardinalHealth, he helped design advanced clinical interfaces for medical devices and hospitals. Mr. Shah is senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize healthcare applications.

He runs four successful blogs: At http://shahid.shah.org he writes about architecture issues; at http://www.healthcareguy.com he provides valuable insights on applying technology in health care; at http://www.federalarchitect.com he advises senior federal technologists; and at http://www.hitsphere.com he gives a glimpse of HIT as an aggregator.

Industry Awards

Mr. Shah is a Microsoft MVP (Solutions Architect) Award Winner for 2007, and a Microsoft MVP (Solutions Architect) Award Winner for 2006. He also served as a HIMSS Enterprise IT Committee Member. Mr. Shah received a BS in computer science from the Pennsylvania State University and MS in Technology Management from the University of Maryland.

Assessment

Shahid is also contributing the chapter on HIT in the third edition of our book “Business of Medical Practice” [Transformational Health 2.0 Profit Maximization for Savvy Doctors], now in-progress www.BusinessofMedicalPractice.com

Channel Surfing

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Book Reviews, Experts Invited, Information Technology | Tagged: Business of Medical Practice, Cardinal Health, Computer Week, health information technology, HIMSS, HIT, Microsoft MVP, NIH, Red Cross, Shahid Shah | 1 Comment »

Stuff that Still Floats to the Top on the ME-P

Posted on January 6, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Interesting Articles of Yore

By Darrell K. Pruitt: DDS

I’ve posted hundreds of articles on the Medical Executive-Post over the last year, and it always surprises me when something I long ago forgot rises to the top of their popularity scale.

The Run-Down

Earlier today, a comment I posted on March 30 titled “Usual and Customary UnitedHealthcare” was the most popular article out of thousands (?).

https://healthcarefinancials.wordpress.com/2009/03/30/usual-and-customary-unitedhealthcare/

Why the sudden interest in UnitedHealth? Where is it coming from?

At the same time, an article I posted on June 17 titled, “GM Bankruptcy Hits Delta Dental Hard,” had just showed up at 11th of the top dozen most popular articles. Why?

https://healthcarefinancials.wordpress.com/2009/06/17/gm-bankruptcy-hits-delta-dental-hard/

Now, the UnitedHealthcare has dropped off the top dozen, and GM Bankruptcy has moved up to number 6.

Assessment

Do you find that interesting? What do you think happened in the dental insurance market that has ME-P juggling my articles?

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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Sponsors Welcomed

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

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Filed under: Contest Entrance, Op-Editorials, Pruitt's Platform | Tagged: Darrell Pruit, DDS, delta dental, GM, medical executive post, United Healthcare | 4 Comments »

Understanding the Healthcare Integrity and Protection Data Bank

Posted on January 4, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Healthcare Fraud and Abuse Data Collection Program

By Patricia Trites; MPA, CHBC, CPC

The Healthcare Integrity and Protection Data Bank (HIPDB) were created to coordinate information with the National Practitioner Data Bank (NPDB). Currently, health plans, health maintenance organizations, and federal and state agencies are required to report final adverse actions taken against healthcare providers on a monthly basis.

The NP Database

The database operates under the auspices of DHHS, the Health Resources and Services Administration, and the Bureau of Health Professions. The Secretary of DHHS is responsible for operating this data bank in the same fashion as the NPDB.

Adverse Actions

Five types of final adverse actions against a healthcare provider, supplier, or practitioner are reported into this data bank:

1. civil judgments in federal or state court related to the delivery of a healthcare item or service;

2. federal or state criminal convictions related to the delivery of a healthcare item or service;

3. actions by federal or state agencies responsible for licensing and certification;

4. exclusions from participation in a federal or state healthcare program; and

5. any other adjudicated actions or decisions that the secretary of DHHS establishes by regulations.

Assessment

These actions must be reported, regardless of whether the subject of the report is appealing the action. Federal and state agencies, hospitals, and health plans are permitted to query the HIPDB. This will also lead to increased activities by other federal agencies, including the Internal Revenue Service and the Federal Trade Commission, which can lead to civil and criminal penalties.

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Ethics, Quality Initiatives, Research & Development | Tagged: david marcinko, DHHS, FTC, healthcare abuse, healthcare fraud, Healthcare Fraud and Abuse Data Collection Program, NPDB National Practitioner Data Bank, Patricia Trites, www.healthcarefinancials.com | 3 Comments »

Sign-Up for the ME-P and Get our Free Widget

Posted on January 3, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Secure e-mail Delivery with a Widget for your Website

By Ann Miller; RN, MHA

[Executive-Director]

If you haven’t had a chance to sign up for the Medical Executive-Post yet, you really should. You’ll get a helpful daily email reminder when breaking news occurs, or when important posts go up on the site. Plus; recently added new features like classified ads, job posts, “ask-the-advisor”, videos, voting polls, surveys and much more!

Many Related Topic Channels

With more than 50 topic channels to select, the ME-P is sure to professionally inform and illuminate your day; almost each and every day. So, also feel free to review our top-left column, and top-right sidebar materials, links, URLs and related sites.

And, get a free ME-P widget for your website, too!

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Sponsors Welcomed

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

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

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

Filed under: iMBA, Inc., Marketing & Advertising, Sponsors | Tagged: david marcinko, Health Economics, Healthcare Finance, healthcare reform, medical executive post, obama | Leave a comment »

Announcing ME-P TV

Posted on January 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

What it is – How it works [beta]

By Ann Miller; RN, MHA

[Executive Director]

What is ME-P TV?

The emergence of Internet video is creating new opportunities to provide richer, more effective information on our core subject areas and more than 50 related topical channels. Internet video gives anyone the ability to create a personal TV channel to distribute information on demand. We are creating the opportunity for you to participate in the Internet video revolution. ME-P TV opens the door to real financial advisors, medical management consultants and health care providers to share their views and opinions with us; each and every day.

Why would I want to be on ME-P TV?

By participating in ME-P TV, you help us create a useful resource for readers and subscribers, and thereby enhance our product. At the same time, we share these video materials with you to market your ideas, products or services. You are free to use these video materials in any way that you want, including on your own website, mobile device, wiki or blog; or on a DVD to distribute to your referring clients, advertisers and patients, or on your local news station. It’s your choice.

Multiple Formats Available

One format is the simple one-on-one interview between a host [Dr. David Edward Marcinko or Hope Rachel Hetico; RN, MHA] and the guest. We use a format similar to the “Charlie Rose” style – two participants sitting across from one another at a table. Generally, each interview focuses on a single topic area. Each informal interview lasts about 15 to 20 minutes. The structure of each interview is not necessarily consistent to keep interest high and energetic.

You may also send in video material that you have previously recorded for your own purpose. Whatever you would like to get on file, send it in and we will post for free. We do reserve the right of refusal, of course. Once published, the video is available to incorporate into your own website and/or for syndication to any other websites.

Syndication

The dynamic of syndication makes the Internet and the World Wide Web the most powerful media distribution engine the world has ever known. This dynamic is fueling the transition of broadcast television into a new entity that combines the richness of video media with the convenience of “download on demand” to create a new way of accessing and distributing information. The Internet video revolution is creating the mechanism for anyone to create and distribute video information to as wide – or as narrow – an audience as necessary to accomplish your professional goals.

The concept is simple:

Create your message
Make it accessible on the Internet
Enable others to find it

ME-P TV Helps you accomplish these Tasks

You provide the message.
We produce the channel of Internet distribution.
We provide a portal on the Internet to initialize distribution of your message to the target audience.

ME-P TV is the “contextual” portion of solving the distribution equation. Successful Internet distribution requires both content and context. Content is a critical “necessary but not sufficient” element. Providing an appropriate context to serve as a “container” to aggregate and increase the value of the content is also necessary. A growing collection, or library, of similar content is more valuable than isolated, individual offerings. ME-P TV is the container for your content with a “home” on the Internet from which to begin the syndication process. We represent a niche portal that gives us the ability to aggregate an audience to generate the attention necessary to be able to offer this service to you.

A Partnership

ME-P TV is a partnership between you and us. Once your message is produced and available on the Internet for distribution, this message is your asset to use as you like. Embed that message on your financial advisory website, your hospital or medical practice website, burn it on a DVD for physical distribution, send it to your friends, colleagues, clients, prospects and patients via email, or make it available on your local news. We will be hard at work making the message available to other health economics and medical management portals, as well. In addition, we will continue to build a portal devoted to integrating financial planning with medical practice management for all physicians and advisors.

Assessment

Send in your video files or video links here: MarcinkoAdvisors@msn.com

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Channel Surfing

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

Filed under: Career Development, Sponsors, Videos | Tagged: file sharing, syndication, video, video sharing | 2 Comments »

Events Planner: January 2010

Posted on January 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

ADVERTISEMENT

Events-Planner: JANUARY 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 25,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions. As a result, we are adding new resources daily. And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention. And so, enjoy the Medical Executive-Post and our monthly Events-Planner with our compliments.

A Look Ahead this Month

January 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:

Jan 10-14: Arizona Financial Services Society, Phoenix, AZ

Jan 11-12: Kinder Institute of Life Planning, Houston, TX

Jan 11-12: Investment Management Consultants Association, New York, NY

Jan 17-20: AICPA Advanced Personal Financial Planning Conference, Orlando, FLA

Jan 21-23: Symposium on Healthcare Payers and Providers, Las Vegas, NV.

Jan 25-27: EBM Leadership Conference, National Harbor, MD

Jan 25-28: Healthcare Leadership Summit, Dallas, TX

Jan 28-29: Money Management Institute, Bonita Springs, FLA

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

MarcinkoAdvisors@msn.com

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Filed under: Events-Planner | Tagged: david marcinko, Events-Planner | 1 Comment »

Off Road Touring in Boston with Dr. Marcinko

Posted on December 31, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

How Doctors Get Paid

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Just before the Christmas Holidays, I flew up to Boston at the invitation of a pharmaceutical company to lead a managerial workshop entitled: “How Doctors Get Paid” [Treatment is only the beginning in the Changing Billing and Medical Reimbursement Climate].

Our goal was to inform drug representatives, and their regional managers, what value added information physician offices might expect from the pharmaceutical industry of the future.

Topics of Discussion

The two hour interactive workshop included team projects, flip chart exercises, a mock role-playing session and the customary [hopefully energetic] ppt presentation. Other topics of discussion included:

Health insurance payment evolution
Collapse of Medicare
Rise of managed care
Medical records documentation
ICD-9 and 10, HCPCS, DRGs and CPT® coding
ABNs, super-bills and HCFA 150 forms
Billing methodologies
Healthcare fraud, abuse and related policies
Capitation, HSAs, concierge medicine and RACs
Futuristic health 2.0 payment mechanisms, and more.

Assessment

Rest assured; these folks were a very knowledgeable and aggressive group; not like your father’s “detail men” of yore! They seek to … talk the talk, and walk the walk, of the Health 2.0 era.

Many thanks again to Helen, and Jon D, for the invite.

Channel Surfing

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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

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

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

Sponsors Welcomed

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

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

Filed under: "Doctors Only", Drugs and Pharma, Health Economics, Managed Care, Media Mentions and PR, Practice Management, Sponsors, Touring with Marcinko | Tagged: ABNs, concierge medicine, CPT codes, HCFA 1500, health abuse, health fraud, HSA, ICD-10, ICD-9, Managed Care, medicare, super bill | 3 Comments »

Around the Healthcare Financial Blog-O-Sphere

Posted on December 30, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

News and Economics Updates in Thirty Minutes or Less

By Staff Reporters

1. Unions pressure Democrats on health insurance tax
Associated Press via Google, December 10, 2009

2. Is there a doctor in the corporation? Maybe soon
Reuters, December 9, 2009

3. Sebelius Statement on Benefits of Health Insurance Reform for Businesses
HHS Press Release, December 3, 2009

4. Majority of employers would reduce health benefits to avoid proposed excise tax
Mercer Press Release, December 3, 2009

5. U.S. unemployed face higher healthcare premiums
Reuters, December 2, 2009

6. Public support for health-care reform is high, but some CFOs take a different view
CFO.com, December 1, 2009

7. Survey: Growing worker stress seen in benefits use
Associated Press via Google, November 30, 2009

8. Employers Play Dr. Mom to Limit Swine Flu Impact
Associated Press via Google, November 30, 2009

9. Health Care Savings Could Start in the Cafeteria
The New York Times, November 28, 2009

10. Ford, GM Face $2.5 Billion First VEBA Bill
Workforce Management, November 24, 2009

11. Plan credits healthy habits – Employer cuts costs by allowing workers to ‘earn’ lower rates
Business Insurance, November 23, 2009

12. Health Care: GE Gets Radical
Business Week, November 19, 2009

Conclusion

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.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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

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

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

Sponsors Welcomed

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

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

Filed under: Breaking News, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Monthly Reports | Tagged: Health Insurance, healthcare business, healthcare economics, Healthcare Finance | 4 Comments »

Defining “Provider” for Medicare Incentive Payments?

Posted on December 29, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Ask a Medical Practice Management Advisor

Staff Reporters

HR 1 of ARRA states:

“The term ‘health care provider’ includes a hospital, skilled nursing facility, nursing facility, home health entity or other long term care facility, health care clinic, community mental health center (as defined in section 1913(b)(1)), renal dialysis facility, blood center, ambulatory surgical center described in section 1833(i) of the Social Security Act, emergency medical services provider, Federally qualified health center, group practice, a pharmacist, a pharmacy, a laboratory, a physician (as defined in section 1861(r) of the Social Security Act), a practitioner (as described in section 1842(b)(18)(C) of the Social Security Act).”

For Ambulatory Surgery Center’s

HR 1 of ARRA includes ASCs in the definition of “provider” (see above), but the CMS seems to indicate otherwise CMS’s site.

For Pharmacists

HR 1 of ARRA includes pharmacists and pharmacies as “providers.” New information on phamacists’ eligibility for IT loans was recently announced – see the Healthcare IT News coverage on this.

Assessment

What was missed; please advise?

Conclusion

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.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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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

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

Sponsors Welcomed

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

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

Filed under: "Ask-an-Advisor", Health Law & Policy, Information Technology, Practice Management | Tagged: ARRA, HITECH, MC, medicare, Social security act | 1 Comment »

Survey Poll on Who Reads the ME-P?

Posted on December 27, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Getting to Know You in 2010

By Ann Miller; RN, MHA
[Executive-Director]

The ME-P is growing in stature and influence, and we’ve been asked this question quite a lot recently. Truth be told – we have no idea – really.

The Silent Majority

Of course, we know the posters, and some commentators, but there are quite a number of readers who don’t interact at all.

Assessment

So, who are you? Scouts’ Honor, now, and you’re only allowed to vote once. We’re not looking for any particular answer here; it’s just an unscientific survey that will help us select feature topics, and thought-leaders, for 2010.

Choose one. Help us – to help you

Please VOTE:

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

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

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

Filed under: Surveys and Voting, Voting Polls | Leave a comment »

What’s So Special About War Doctors?

Posted on December 26, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Special ME-P Christmas Holiday Tribute

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

Back in the day, I did some trauma training at Martin Army Hospital in Columbus, GA. This 250-bed facility is the center for medical services at Fort Benning. Opened in 1958, it is one of the largest and most comprehensive community hospitals in the Army. The hospital is recognized as one of the best in the nation for quality of care as certified by the Joint Commission on Accreditation of Healthcare Organizations, and service to the community by the Army and TRADOC Communities of Excellence Evaluations.

MEDDAC

Fort Benning’s MEDDAC, a major subordinate command of the U.S. Army Medical Command, furnishes medical care to an eligible patient population in excess of 72,000 beneficiaries. Since the establishment of Fort Benning in 1918, medical services have always been available. In the early days, medical care was dispensed from tents, temporary wooden buildings, and leased space in the Columbus Hospital. In 1924, services were moved into what is now the National Infantry Museum, and in 1958 Martin Army Community Hospital was opened.

Martin Army Hospital

Martin Army Community Hospital is named in honor of the late Major General Joseph I. Martin, Medical Corps. The hospital was opened in 1958 at a cost of slightly over $6 million. As the demand for outpatient health care grew, a 59,000 square foot ambulatory care wing was added in 1975 at a cost of $3.8 million.

To support the purchase of modern medical equipment and to ensure the compliance with the JCAHO standards, an extensive electromechanical upgrade project was completed in 1980. This was my era. The latest major construction occurred in 1990 when the Emergency Room underwent renovation at a cost of $835,000. The ER now contains the latest technology available to preserve life, and can provide these services more efficiently than in the past.

Professional Training Programs

In addition to its medical mission, the MEDDAC has an extensive professional teaching and training mission, and in 1972 established the Army’s first Family Practice Residency Program. This 3-year program maintains approximately 30 residents who provide medical services throughout the hospital.

Other specialty training programs include the clinical portion of the Army’s Physician Assistant Program, a residency in Health Care Administration, Podiatric Surgery internship, training in several enlisted specialties, and numerous clinical rotations or externships conducted in cooperation with local colleges and universities. Located near the Infantry Museum is the Army Substance Abuse Program, Exceptional Family Member Program, and the Early Intervention Program. In addition to these facilities, the MEDDAC operates four Family Practice Clinics, five on-post Troop Medical Clinics (TMCs), a Reception Station, and two satellite TMCs in support of Ranger School training in Georgia and Florida.

A New York Times Re-Post

As so, it is with some degree of pride that we reprint this story from the NYTs.

###

DOCTOR AND PATIENT

By Paulinwe W. Chen; MD

One morning as a medical student on the surgery service, I learned about a patient who had been hemorrhaging on the operating table the night before. The intern who had assisted during the operation took great pains to describe every detail of the failed efforts of several senior surgeons and the final, ultimately lifesaving, maneuvers of the department chairman. “He came in and just got control of the bleeding,” the intern concluded, waving his hands as if the chairman’s work had involved magic.

Assessment

“How did he manage that?” one of my classmates asked. “He’s one of the best,” the intern answered matter-of-factly. “He was a surgeon in Vietnam.”

More Lesson from the War Zone: http://www.nytimes.com/2009/12/11/health/11chen.html?ref=health

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Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Ethics, Military Medicine | Tagged: cecelia perez, Fort Benning, JCAHO, Martin Army Hospital, MEDDAC, Military Medicine, National Infantry Museum, Pauline Chen, TMC, Vietnam | 6 Comments »

Healthcare Quality Improvement Leader Survey

Posted on December 24, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Top 20 “Movers and Shakers” of 2009

By Staff Reporters

The very essence of healthcare is to make a difference for good. At its core, this is an industry focused on making life better for people. That simplicity of mission establishes a shared grounding for the millions who work daily to deliver the best healthcare they can.

Assessment

So, here is the annual Media HealthLeaders survey which offers profiles of some of those who are doing just that. Who did they miss, please advise us?

Link: http://www.healthleadersmedia.com/20people/

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Will eMRs Raise the Legal Standard of Care and Increase Malpractice Risk?

Posted on December 23, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Focus on Malpractice and Professional Liability

By Ann Miller; RN, MHA

By Dr. David E. Marcinko; MBA

[Executive Director]

We first postulated on this topic in our print book “Insurance Planning and Risk Management for Physicians and their Advisors.” Additional posts and comments are contained within this ME-P.

And now, Robert J. Mintz, JD wonders if medical provider liability increases with eHRs, even if the quality of care is vastly improved?

Invite Dr. Marcinko

***

Filed under: "Doctors Only", Career Development, Professional Liability, Recommended Books, Risk Management | Tagged: EHRs, EMRs, healthcare reform, malpractice, medical liability, medical negligence | 15 Comments »

The DB[k] Pension Plan

Posted on December 22, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A New Combination Plan

By Staff Reporters

Did you know that The Pension Protection Act of 2006 will provide for a new kind of hybrid pension plan for employers with 500 or fewer employees?

What it is – How it works

According to PensionRights.org, until now, employee contributions to traditional pension plans have not been tax deferred. For that reason, few pension plans require or permit employee contributions. Instead, many employers supplement their pension plans with separate 401(k) plans which permit employees to defer taxes on their contributions.

The DB/K Plan

The new “DB/K plan” will combine a traditional defined benefit pension plan with a 401(k) savings plan. The plan will provide a low employer-paid guaranteed lifetime monthly retirement benefit that could be supplemented by voluntary tax deferred contributions by employees. The minimum pension benefit, payable to employees who work 3 or more years for the employer, will be equal to the lesser of 1 percent of average pay during the last five years of work multiplied by the number of years of service with the employer, or 20 percent of the average pay in the employee’s consecutive highest 5 years of earnings.

Assessment

The 401(k) component of the plan requires the employer to match at least 50% of an employee’s contributions up to 4% of the employee’s salary. The provision will take effect in 2010.

Read Section 903 of The Pension Protection Act of 2006 Public Law 109-280

Visit: www.PensionRights.org

Conclusion

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How a Few Private Health Insurers Are on the Way to Controlling Health Care

Posted on December 21, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Re-Post from Robert Reich; PhD

Staff Reporters

The healthcare public option is dead, killed by a handful of senators from small states who are mostly bought off by Big Insurance and Big Pharma -or- intimidated by these industries’ deep pockets and power to run political ads against them.

Assessment

Some might say it’s no great loss at this point because the Senate bill Harry Reid came up with contained a public option available only to 4 million people, which would have been far too small to exert any competitive pressure on private insurers anyway.

Link: http://robertreich.blogspot.com/2009/12/how-few-private-health-insurers-are-on.html

Conclusion

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***

Filed under: Breaking News, Health Economics, Health Law & Policy, Op-Editorials | Tagged: big-pharma, Harry Reid, health reform, public option, Robert Reich | 3 Comments »

Prominent Politician Views on Health Information Technology

Posted on December 20, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Guest Thought-Leader Op-Ed Piece

Ann Miller; RN, MHA [Executive-Director]

By Alberto Borges; MD

In this review, ME-P thought-leader and colleague, Al Borges MD dissects and presents the political views of HIT by several prominent politicians. WHY?

He believes that only a handful of politicians are questioning whether the cost of HIT will actually improve healthcare as promised, which can end up in wasted taxpayer money, and worse, become a slow-moving HIT blunder which puts patient lives at risk. Even President Obama’s staff quietly admits that these statements are unproven.

Assessment

For example, Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel and the current health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research stated last year that:

“Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost control, more for show and public relations than for true change.”

Link: Politician Views of HIT [updated November 2009]

Conclusion

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Filed under: Health Law & Policy, Information Technology, Op-Editorials | Tagged: Al Borges MD, ARRA, Bobby Jindal, CPOE, EHRs, EMRs, health information technology, Hillary Clinton, HIMSS, HIT, HITECH, Joe Biden, Mike Huckabee, Mitt Romney, Newt Gingrish, obama, OMB, Ron Paul, Sanford Cobun, Sarah Palin | 3 Comments »

Important Financial Documents for Physicians

Posted on December 19, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Simple Pro-Active List

By Staff Reporters

www.HealthcareFinancials.com

Document	Status	Location

Will, original

Will, copy

Living Will

Power of Attorney

Birth Certificate

Marriage Certificate

Antenuptial Agreements

Postnuptial Agreements

Divorce Decrees

Separation Agreement

Social Security Card

Income Tax Records

Life Insurance Policies

Other Insurance Policies

Stocks and Bonds

Notes Receivable

Mortgages Receivable

Deeds

Leases

Bank and Financial
Records

Business Agreements

Trust Instruments

Assessment

What did we miss, please advise?

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Vote on Healthcare Reform

Posted on December 17, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A ME-P Healthcare Reform Opinion Poll

By Ann Miller; RN, MHA

[Executive-Director]

According to a new NBC News/Wall Street Journal poll, the public has soured on President Barack H. Obama’s health care reform plan.

In fact, former Governor and Democratic National Committee Chairman Howard Dean MD told Vermont National Public Radio:

“This is essentially the collapse of health care reform in the United States Senate. And, honestly, the best thing to do right now is kill the Senate bill and go back to the House … You have the vast majority of Americans want the choices, they want real choices. They don’t have them in this bill. This is not health care reform and it’s not close to health care reform.”

Now, as an informed ME-P reader, do you think healthcare reform overhaul is a good idea?

Please VOTE:

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Filed under: Breaking News, Health Law & Policy, Surveys and Voting, Voting Polls | Tagged: healthcare reform, NBC, obama, public option, Wall Street Journal | 4 Comments »

Ten Questions on Section 127 Plans for College Funding

Posted on December 16, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Physician-Parents and the Cost of Education

[By Staff Reporters]

IRS Section 127 plans are used to pay and deduct college costs. These plans allow your practice to pay up to $5,250 of college expenses per year, but do not require your child to recognize the tuition payment as income. The following questions and answers relate to the IRS Section 127 Educational Assistance Plan which became effective on July 1, 2002

1. What benefits are provided under the Section 127 Plan?

The Section 127 Plan is intended to provide favorable tax benefits only. The Plan will exclude from taxation graduate-level courses provided to eligibles up to a maximum of $5,250 per calendar year. Section 127 plans provide relief from taxation for those eligibles whose graduate-level educational benefits are not covered under other Code provisions.

2. Who will benefit under the Plan?

Employees enrolled in graduate-level courses under the Reduced Fee Enrollment Policy that are not job-related will benefit from the Plan. The value of such courses will not be taxed, up to the $5,250 annual limit. Employees enrolled in non-job-related graduate courses taken for professional development at another educational institution are also covered by the Plan and will not be taxed on the value of those courses, subject to the annual limit.

3. What kinds of graduate courses are covered under the Plan?

The Plan covers graduate-level courses of a kind normally taken by an individual leading to a law, business, medical, or other advanced academic or professional degree. Covered courses do not include courses or other education involving sports, games, or hobbies. Courses covered by the Plan may be taken at another educational institution.

4. Are any undergraduate courses covered under the Plan?

No. Undergraduate courses are excluded from taxation under IRC section 117.

5. Why are job-related courses not covered under the Plan?

Job-related courses are already exempt from taxation under IRC section 162. Thus, only courses taken for professional development that are not directly related to an employee’s current position are covered by the Plan.

6. What is the definition of a job-related course?

A job-related course is a course taken by an employee either to maintain or improve skills required in the employee’s current job; or to meet the express requirements of the employer; or the requirements of law or regulations, imposed as a condition to retaining the employee’s salary, status, or employment.

7. Are Section 127 educational benefits reportable on the Form W-2?

No. The instructions for Form W-2 provide that payments qualifying under a Section 127 educational assistance program are not reportable in box 1 as wages. Only waivers or reimbursements (for non-job-related graduate courses) in excess of the $5,250 annual exclusion limit would be reported on the Form W-2 as taxable compensation, subject to withholding. Accordingly, such excess amounts should be paid through a payroll system.

8. What are the requirements for a Section 127 Plan?

Section 127 requires that an employer prepare a separate written plan for the exclusive benefit of its employees to provide such employees with educational assistance. In addition, eligible employees must be provided reasonable notification of the availability and terms of the plan; and the plan must not discriminate in favor of highly compensated employees. Section 127 does not require the educational assistance program to be funded.

9. May benefits be provided on a retroactive basis?

No. Section 127 requires that employees be provided with reasonable notice about the benefits available under the plan. If benefits are provided before the plan is in effect, employees have not been provided with the requisite notice.

10. Are there any IRS information reporting requirements related to 127 Plans?

No. The IRS has indefinitely suspended the reporting of data related to the administration of a Section 127 Plan (IRS Notice 2002-24).

Assessment

To properly use a Section 127 plan, physicians must adhere to several rules: the student must be 21 years old; the student cannot be a tax dependent of the physician; the student must be an employee of the medical practice; and the plan cannot discriminate against employees not related to the physician.

Conclusion

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Filed under: Financial Planning, Funding Basics | Tagged: college funding, IRS, Section 127 plans | 5 Comments »

To Par or Not to Par? [The Critical Question for 2010]

Posted on December 15, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

About the Medicare HIT 1115 Project

By Ann Miller; RN, MHA

[Executive-Director]

At least one iconoclastic physician, ME-P thought-leader Al Borges MD, has asked that all doctors unite and participate in this year’s Medicare “HIT 1115 Project”; now in-process.

The November 15, 2009 Project

November 15, 2009 began the 6-week time period during which all medical providers can switch Medicare participation. If all physicians become “non-participating” or simply “opt-out,” then lawmakers and their lobbyists may take notice that doctors are fed-up with government intrusion into physician affairs!

Assessment

More: http://www.hcplive.com/technology/blogs/The_HIT_Realist/1269/HIT_1115_project

Cast Your Ballot – Send a Messsage

After reading the above op-ed piece, and a month into the project, please cast your VOTE:

About Dr. Borges

Alberto Borges, MD, is in private practice and is an assistant clinical professor of medicine at The George Washington University School of Medicine and Health Sciences in Washington, DC.

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Filed under: Breaking News, Career Development, Information Technology, Practice Management, Surveys and Voting, Voting Polls | Tagged: Alberto Borges MD, medicare, Non-Par, Par | 2 Comments »

Should Specialists Staff Medical Homes, etc?

Posted on December 14, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Are they Even Needed?

[By Staff Reporters]

In an op-ed piece originally published in HCPLive.com, by Alan Berkenwald MD, the approaching fire storm over the “patient-centered medical home” model reminds us of the destructive powers seen with some early restrictive HMO models.

Enter – Exit – ReEnter the Gatekeepers

Once seemingly destined to revolutionize organized medicine, and empower patients and primary care physicians, the HMO model of “gatekeepers” nearly destroyed it.

Assessment

And so, can we learn from past failures with this new medical home model? Or, are they even needed?

Related posts from Kevin Pho MD:

Conclusion

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Barriers to Free Market Competition in Healthcare Delivery

Posted on December 13, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Why Supply and Demand Doesn’t Work in Medicine

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

Much has been written here, and elsewhere, about free market competition in healthcare; especially in light of the current national political debates. Yet, these markets are not free.

Like Evolution – Healthcare Competition is Only a Theory

Perfectly competitive healthcare markets are not free; they exist only in economic theory as a useful comparative artifice. In reality, industries and markets have varying constraints on competition. The healthcare industry has often been characterized as unique with its many significant barriers to free market competition, such as market controls on price and quality.

According to colleague Robert James Cimasi, of Health Capital Consultants LLC, in St. Louis MO; there are three main reasons for these barriers in healthcare:

Competitive Healthcare Barriers

The nature of healthcare creates an unpredictable, urgent, and “infinite” level of demand.
The ubiquitous involvement of insurance companies, private and governmental, as intermediary organizations in the purchase of healthcare interferes with consumer motivations and consequently their choice of providers and services.
The difficulties in measuring healthcare quality and beneficial outcomes (both of quantifying and qualifying them) and the lack of information on the relative costs of healthcare providers and services also inhibit consumer selection, further removing incentives to providers to increase quality and lower costs.

Barriers to Healthcare Competition

Included among the many other barriers to competition in healthcare delivery are the following:

Patients don’t purchase services directly from providers;
Patients don’t compare prices between providers;
The government is the largest purchaser of healthcare;
Private purchasers often lack market power;
Patients, purchasers and providers lack information;
Occupational licensing;
Many providers have monopoly or near-monopoly power (yet antitrust laws prevent some potentially beneficial integration);
Providers are rewarded for increasing costs;
Capital investments are overly subsidized (It should be noted that Stigler argues that an industry will not use its power to collect money from the government unless the list of beneficiaries can be limited, due to the fact the amount of subsidies will be divided among a growing number of rivals.*
Certificate of Need (CON), regulation, and licensing laws are an entry barrier to competing and substitute providers and services; and
Exit barriers protect low-quality providers.

Assessment

Of course, the supply side is also flagrantly encouraged by excessive medical testing, procedural interventions and surgery; mostly excused by malpractice phobia as a well as the personal financial interests of involved stakeholders.

References

Stigler, George J. “The Theory of Economic Regulation.” The Bell Journal of Economics and Management Science. Vol. 2, No. 1 (Spring 1971): 5.

Conclusion

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Filed under: Health Economics, Managed Care, Op-Editorials | Tagged: david marcinko, Health Capital Consultants LLC, healthcare competition, healthcare economics, Robert Cimasi | 9 Comments »

Get an iMBA Inc Second Opinion

Posted on December 12, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Integrating Medical Practice Management with Personal Financial Planning

By Ann Miller; RN, MHA

[Executive-Director]

Second opinions are sometimes necessary in medicine because a misdiagnosis can have significant consequences.

Thru-put and Follow-up

The same is true for your medical practice and personal financial planning goals. Another perspective may help determine if your portfolio is properly aligned, or your practice efficiently designed to achieve your goals with complete thru-put and follow-up.

Assessment

Link: https://healthcarefinancials.wordpress.com/schedule-a-consultation/

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Appreciating Home Owner’s Title Insurance

Posted on December 11, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Matters Covered and Not Covered by Title Insurance

By Staff Reporters

During the current housing market implosion it is prudent to understand that home owner’s title insurance enables the buyer of real property to take clear title of the purchased property. That means there are no outstanding liens in existence and no one has a prior claim to said property.

Covered Items

In general, items that are covered by title insurance can be determined solely from review of the property records and court records:

Judgments
Liens (Except to the extent that they have superiority, i.e., once recorded, they gain a priority ahead of things recorded prior to the lien, for example, mechanic’s liens.)
Deeds of trust, mortgages, and real estate contracts
Easements
Restrictive covenants
Rights granted in real property by divorce degree (right to half proceeds of sale of property)
Mineral rights reserved by prior owner or granted to a third party
Recorded leases
Latecomer’s agreements
Recorded no-contest agreements (agreement not to contest future imposition of taxes or assessments, usually for things like traffic, water, and sewer mitigation)
Deeds transferring ownership of any interests in the property
Whether the property has access to a public road
Taxes and recorded assessments
Condemnation actions filed with the court or property records.

Not-Covered Items

Generally, items that are not covered by title insurance cannot be determined by reviewing the property records and court records:

Zoning laws, restrictions on the use of property
Building codes, setbacks, lot coverage, construction standards
Wetlands regulations
Storm water drainage permits
Flood plain, location of property in relation to flood plain
Unrecorded leases
Use permits
Hazardous materials, environmental contaminants
Subdivision regulations
Shoreline Management Act
State Environmental Policy Act (SEPA)
Persons claiming an interest in the property, through adverse possession (both ownership of the property and easement rights)
Compliance of the property with recorded restrictive covenants.

Additional Extended Coverage Policy Items

Coverage extends beyond basic coverage. This covers items that show up during an inspection of the property:

Additional matters include those that the title company can determine from either an inspection of the property or a review of a survey showing all improvements to the property and the location of all easements.
Mechanic’s liens filed after the date of the policy, but that take priority prior to the date of the policy
Encroachments (the buildings on the property that overlap the property lines or buildings on adjacent property that overlap onto the client’s property)
Persons claiming an interest in the property through adverse possession (both ownership of the property and easement rights).

Additional Matters Covered by Endorsement

Compliance with subdivision laws (Guarantees that the property constitutes one or more legal lots)
Zoning laws.

Assessment

Conclusion

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

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Filed under: Insurance Matters | Tagged: home owner's insurance, title insurance | 2 Comments »

Take the ICD-10 Survey Poll

Posted on December 10, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

ICD-10 Survey Poll

By Ann Miller; RN, MHA

[Executive Director]

The Department of Health and Human Services [DHHS] recently released the final rule for implementing the ICD-10 [International Classification of Diseases] CM [Clinical Modification] and ICD10-PCS [Procedure Coding System] insurance coding initiatives.

Shifting Deadlnes

The compliance deadline was shifted from October 1, 2011; as proposed in the original rule; to October 1, 2013. And so, how prepared are you for the transition to ICD-10?

Please VOTE:

Filed under: "Doctors Only", Health Insurance, Research & Development, Voting Polls | Tagged: CM, CMS, DHSS, ICD-10, ICD-9 | 7 Comments »

Understanding Medical Billing Methodologies

Posted on December 10, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Cash Conversion Cycle

[By Staff Reporters]

Most patients and financial advisors don’t have a clue about how doctor’s get paid in our current system; but it’s not by magic. Yet, a number of different steps occur during the processing of a medical claim that can be seen in a flow chart. Each step in the process can be mapped out and each is subject to claim payment-or-claim rejection. A payment time line for a typical FFS or PPO can also be subjected to a number of variables, depending on different factors including staff competency, time, outside vendors, information management, management decisions in general, or regulatory requirements. The total transit times may take weeks for electronic claims or up to two-years for some paper based claims.

First Make the Diagnosis

• ICD-9 alpha numeric code for disease classes, not billing.

• HHS offers ICD-9 [CM] for MDs and facilities.

• WHO-1900, updated every 3-10 years, e-ICD-10 [2013].

• Diagnostic Statistical Manual Mental Disorders, 4th Edition [DSM-IV].

Then Select the Current Procedure Terminology® Code

Medical, surgical and diagnostic task & service billing code numbers [5-digit] of AMA used by payers:

• Thousands updated annually

• Secretive with registered mark ®

• Office Visits: [brief, inter, extended, etc]

• # 99214 physical exam

• # 90658 H1N1 flu shot

• # 12002 one-inch laceration suture

• CDT® and HCPCS codes, too!

Document the Visit in Patient Progress Notes

Subjective:

“I was gardening and noticed my wrist was swollen and itched like crazy”

Objective:

A 4 inch linear red rash with circular oozing papules and swollen skin is present. Patient is wearing a small tennis bracelet which was tight.

Assessment:

Rule out rues dermatitidis versus nickel allergy.

Plan:

Soap soaks, with OTC calamine lotion with Rx oral diphenhydramine or [benadryl].

Submit the “Super Bill”

Not a “big bill” or expensive medical invoice; just an invoice

• Official standard billing form used by doctors submitting MC/MD claims.

• Also used by some private insurers and managed care plans.

• Contains patient demographics, diagnostic codes, CPT®, HCPC codes, etc.

• Generic billing form, like the generic HCFA 1500 claim form.

Conclusion

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HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
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ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Accounting, Health Economics, Practice Management | Tagged: AMA, CDT, CMS, CPT, HCFA 1500, HCPCS, HHS, ICD-9, medical billing, medical coding, WHO | 4 Comments »

Physicians Seeking Financial Support from Hospitals

Posted on December 9, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Results of a New Survey

[By Staff Reporters]

Since domestic economic conditions began to deteriorate in September 2008, the number of doctors seeking financial support from hospitals has increased, according to a new report from the American Hospital Association.

Study Results

Overall: 70%
Physicians Seeking Increased Pay for On-Call or other Services Provided to Hospital: 79%
Physicians Seeking Hospital Employment: 74%
Physicians Seeking to Sell Their Practice: 36%
Physicians Seeking to Partner on Equipment Purchases: 26%
Other: 13%

Source: American Hospital Association. The Economic Crisis: Ongoing Monitoring of Impact on Hospitals: Results from an AHA Rapid Response Survey, August/September 2009. www.aha.org

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Health Economics, Monthly Reports, Practice Management | Tagged: AHA, American Hospital Association | 2 Comments »

Kathleen Sebelius Please Pay Attention to Dr. Darrell Pruitt

Posted on December 7, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Deferred Investment [An Incentive to Access]

By D. Kellus Pruitt; DDS

On Friday, the editor of the Chicago Dental Society’s [CDS] blog “Open Wide” posted a progressive, brief article titled, “State of Illinois offers incentive for dentists to treat Medicaid patients” (no byline).

http://chicagodentalsociety.blogspot.com/2009/12/state-of-illinois-offers-incentive-for.html

CDS says that last week, Governor Pat Quinn signed a law which allows Illinois dentists who treat Medicaid patients to accept payment deposited into a tax deferred investment portfolio instead of the traditional delayed, unpredictable payments that offer no tax advantages – only headaches.

Illinois Governor Quinn is a vast improvement over his predecessor. What was his name? He’s gone on to become a TV personality …. Oh yeah. Blagojevich!

I don’t know about you, but for me, Quinn’s incentive to access could offer not only more relief for those who cannot afford dental care in Texas, but it could also be a more or less painless way for dentists to fund IRAs – rather than having to do it at the last minute like I’ll do in a few months – just like every year. Instead of having an IRA hanging over my head, all I would have to do is donate my skills to help a few more people every now and then. That’s noble, charitable duty, friends – even with the Quinn incentive.

I especially respect current Medicaid dentists who work for nothing at all on the more profitable days.

To HHS Secretary Kathleen Sebelius

Pay attention. You only think you run the show.

The nations’ dentists you need aren’t being paid what they deserve, yet they put up with expensive and threatening CMS bureaucracy and struggle on – simply because they wish to ease suffering everyone else chooses to ignore.

Medicare dentists are American heroes to be sure. But let me warn you, Ms. Sebelius, they will turn on you hard and cold if you try to push them around. It’s time that you welcome real dentists to the bargaining table instead of ambitious ADA-approved stakeholders. You need us more than we need you, Ms. Sebelius. Forget the ADA. That is a foundation on which we can build … or not.

And this is for my stunned dentist colleagues in Texas who cross the street to ignore grandiose special bastards like me. Most of you detest the messy stuff I drag around, but nevertheless can’t stop watching from a safe distance. Rather than get your own hands messy, most of you simply pay the TDA to quietly and ineffectively hide or delay huge approaching problems. So what’s the trade-off? To remain “In the Loop,” you must obediently take up your differences with leadership in the approved, professional manner through designated ADA representatives. And. that’s so cute.

Now that you read about Quinn’s incentive, don’t you also hope that a TDA committee has already approved a draft of a deferred investment proposal to be offered to state lawmakers as soon as possible? After all, similar plans are already being tried in not only Illinois, but in four other states as well: Louisiana, Florida, Mississippi and Arkansas.

Hope as we may, nimrods, I fear those in Austin who should be paying attention to legislative opportunities such as this only heard about Quinn’s incentive to access law a minute or so ago at best.

Of Face Book Accounts

Both the TDA and the ADA desperately need functional Facebook accounts like Chicago Dental Society’s. By the way, it is the CDS which will be hosting their annual mid-winter dental conference in Chicago – reliably a tremendous meeting. This year it is Thursday-Saturday, Feb. 25-27, 2010 in the McCormick Place West Building.

http://www.cds.org/mwm_2010/

The TDA’s Facebook Wall is pristine white and graffiti-ready, and the spray paint is free to any artist who walks by. Not unexpectedly, it’s a mess. Nobody is joining, and whoever is in charge of managing the site is busy deleting unacceptable comments from a jerk who has no respect for anyone. (It’s not me). The TDA Facebook is in trouble, and it has been suggested that it should be shut down. It is indeed an embarrassment.

Assessment

Here’s something we’ll all laugh about later: The one dentist in Texas who could have sent the rogue artist on down the road (me), was kicked off for badmouthing BCBSTX and the NPI number as well as 13 other listed allegations, including posting pornography. I’ll let the TDA Director of Membership explain that and the other allegations if you are curious. I was not provided access to the evidence on which the sudden and uncontestable revocation of my TDA benefit was based. But there’s still hope because a friend of mine resented the way I was treated and complained to the TDA using the approved channels. That was 2 months ago. I wonder how well that one is progressing from the Austin City dump.

The ADA Facebook is no better. Over 1600 fans have piled up at the door waiting for the ADA’s grand opening, yet nothing is happening. What do you think is going on there?

If you’ve missed hearing from me for the last 2 weeks and have an inquisitive mind, I’ve been pursuing answers for such questions about ADA and TDA transparency on Twitter. They call me Proots.

Conclusion

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Filed under: Breaking News, Funding Basics, Health Insurance, Health Law & Policy, Pruitt's Platform | Tagged: ADA, BCBSTX, Blagojevich, Chicago Dental Society, CMS, Darrell Pruitt, DDS, dentists, IRAs, Kathleen Sebelius, Medicaid, NPI, Pat Quinn, Proots, TDA, Texas Dental Association, twitter | 10 Comments »

Investors File Resolutions with Health Companies

Posted on December 7, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Seeking Compensation Transparency

By Staff Reporters

Thirty investors just filed shareholder resolutions involving 21 health companies asking them to publicly disclose the total compensation packages of their top executives.

Assessment

The investors are faith-based institutional shareholders who belong to the Interfaith Center on Corporate Responsibility.

http://www.fa-mag.com/green/news/4805-investors-file-resolutions-with-health-companies.html

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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Filed under: Ethics, Health Insurance, Risk Management | 1 Comment »

BEWARE: Top Ten Mistakes Financial Advisors Make

Posted on December 6, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the “Cobbler’s Children are Barefoot” – Syndrome

Staff Reporters

Here is an article by Philip Palaveev recently published in a financial services trade industry magazine.

“Before helping others, put your own oxygen mask first.”

That’s what they say on airplanes when instructing passengers on what to do in an emergency. It makes a lot of sense: If you can’t breathe, you can’t help others.

Personal Issues

Unfortunately, an alarming number of financial advisors suffer from personal financial “issues” that can interfere with their ability to help their clients. Personal financial problems can indeed cloud advisors’ judgment and can prevent FAs from making much needed investments in the practice.

http://registeredrep.com/advisorland/marketing_selling/top_ten_financial_mistakes_financial_advisors_1124/index.html

Assessment

According to ME-P Publisher-in-Chief Dr. David E. Marcinko, MBA, a former certified financial planner and financial advisor himself;

“Far too many so-called “Financial Advisors” have no formal business management education and precious little real financial training from sources other than their Broker-Dealers or wire-houses; so this report comes as no surprise. The vast majority of stock-brokers are product sales men and women, period. So – always beware – dear medical colleagues and all readers.”

Conclusion

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Health Administration Terms: www.HealthDictionarySeries.com

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Sponsors Welcomed

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Filed under: Career Development, Financial Planning, Op-Editorials | Tagged: BDs, broker-dealers, david marcinko, financial advisors, Philip Palaveev, stock-brokers, wirehouses | 2 Comments »

The ME-P is Now “On-Call”

Posted on December 5, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Leveraging Us for Mutual Advantage

Staff Reporters

Now, for the first time, you can leverage the ME-P social network to engage our members and subscribers. Because over 150,000 readers already use the ME-P, you can reach the right experts faster and more cost-effectively than ever before.

ME-P Empowerment

The ME-P enables you to start private discussions with any group of medical professionals, or financial advisors, you wish. You can then:

• Test messaging and strategies in real-time.
• Quantify product adoption and service utilization.
• Confirm effectiveness of message dissemination.
• Identify new key influencers, and more.

Assessment

Only the ME-P gives you instant access to an active community of practicing financial advisors, consultants and medical professionals already discussing your products and services. The ME-P panels allow you to use new social media tools to gain real-world insights into the diagnostics, devices, financial products or drugs that matter most to you.

Now, let the ME-P be on call – for you – 24/7/365. Contact us today!

Sponsors Welcomed

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

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

Filed under: Career Development, Drugs and Pharma, iMBA, Inc., Marketing & Advertising, Sponsors | Tagged: david marcinko, medical executive post, Sponsors, www.HealthcareFinancials.wordpress.com | Leave a comment »

Understanding the Healthcare Fraud and Abuse Control Program

Posted on December 4, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Joint Project Between the OIG and DOJ

By Patricia Trites; MPA, CHBC, CPC

The Healthcare Fraud and Abuse Control (HCFAC) program is a joint project between the Office of Inspector General [OIG] and the Department of Justice (DOJ).

Functions

The primary functions are to coordinate federal, state, and local enforcement in controlling healthcare fraud, and to conduct investigations relating to delivery and payment of healthcare services, and oversee Medicare and Medicaid exclusions, civil money penalties, and the anti-kickback law. The program is also designed to provide opinions, alerts, and a means for reporting and disclosing final adverse actions against healthcare providers.

HIPAA Policies

HIPAA established the Health Care Fraud and Abuse Control Account within the Medicare Part A Trust Fund and funds DOJ and DHHS activities for operation of the HCFAC. In addition to federal appropriations, the fund receives a portion of funds collected from healthcare fraud and abuse penalties and fines. HIPAA also authorizes funds from general revenues for the Federal Bureau of Investigation (FBI) to combat healthcare fraud and abuse.

Assessment

Anti-fraud and abuse provisions were also included in the Balanced Budget Act of 1997 and the Deficit Reduction Act [DRA] of 2005, and annotated and

Conclusion

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Filed under: Career Development, Health Law & Policy, Healthcare Finance, Professional Liability | Tagged: anti-kickback, BBA, david marcinko, DOJ, DRA, FBi, HCFAC, healthcare abuse, healthcare fraud, HIPAA, Medicaid, medicare, OIG, Patricia Trites, Stark, www.healthcarefinancials.com | 17 Comments »

The “Real Facts” about eMRs with .ppt Presentation

Posted on December 3, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Guest Thought-Leader Presentation

Ann Miller; RN, MHA [Executive Director]

By Alberto Borges; MD

In this colorful MSFT PowerPoint presentation, ME-P thought-leader and colleague, Al Borges MD dispels a plethora of eMR myths. He discusses the true cost of eMR implementation, and presents his views on the dark side of the eMR certification process.

Assessment

He concludes with an opinion on insider C-eMR politics in the USA.

Link: The Real Facts about eMRs [last updated April 2009].

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.

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Filed under: Information Technology, Op-Editorials, Videos | Tagged: Al Borges MD, ARRA, Blumenthal, CCHIT, Dashle, EHRs, EMRs, Frieden, Glaser, HIMSS, HITECH, Kissinger, Kundra, Leavitt, obama, Park, RICO Act, Tullman | 7 Comments »

A Healthcare Reform Budget Deficit Opinion Poll

Posted on December 2, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Deficit Neutral, or Not [You Decide]

By Ann Miller; RN, MHA

[Executive Director]

President Barack H. Obama just promised not to sign any health reform legislation that increases the federal deficit. This promise recognizes the rising public concern about a fiscal trend that, if left unchecked, could leave us with $19 Trillion Dollars in federal debt within a decade.

Of course, without the pledge, given the current dismal economic climate, health reform would be dead-in-the-water.

QUESTION: And so, is healthcare reform really deficit neutral?

Please VOTE:

Filed under: Breaking News, Health Economics, Health Law & Policy, Healthcare Finance, Voting Polls | Tagged: federal debt, federal deficit, health care reform deficity neutrality, health reform, obama, public plan | Leave a comment »

About the Scribbos Secure Communication Platform

Posted on December 1, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

What it is – How it works

By Staff Reporters

Scribbos is a secure business communications solution that enables clients to easily and quickly send confidential messages or large files to colleagues, business partners or outsourced service providers.

Scribbos uses an intuitive email-like interface that provides secure communications whether sending a confidential message, or a file with sensitive or proprietary information. Additionally, as most financial and covered healthcare entities must comply with federal and industry regulations, Scribbos helps maintain compliance with all mandates whether corporate, federal or industry-specific [Sarbanes-Oxley and HIPAA, etc].

Several Industry Verticals

Scribbos offers four industry specific and scaleable verticals for healthcare, insurance, finance and professional services; all centers of focus for the ME-P subscriber. For example:

1. The financial vertical enables providers to securely send company financials, accounting reports, internal systems transfers, payments and remittances, etc.

2. The healthcare vertical enables providers to confidentially send personal healthcare information, claims adjudication, eligibility, billing information, insurance claims, X-rays, medical necessity documentation, PHR (Personal Health Records) and eMRs (Electronic Medical Records), etc

3. The insurance vertical enables providers to encrypt policy information, payments, enrollments and claims information, etc.

4. The professional vertical is ideal for healthcare attorneys.

Assessment

So give www.scribbos.com a click today, and tell us what you think?

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

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Filed under: Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Insurance Matters | Tagged: EHRs, EMRs, HIPAA, Sar-Box, Sarbanes-Oxley, scribbos | Leave a comment »

Events Planner: December 2009

Posted on December 1, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

ADVERTISEMENT

Events-Planner: DECEMBER 2009

Staff Writers

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

A Look Ahead this Month

December 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:

Dec 1: Investment Advisors Association Workshop, Los Angeles, CA

Dec 3: Equity research and Valuation, CFA Institute NY, NY

Dec 6: IMCA Practice Management Conference, INCA, Park City, UT

Dec 7: HFMA Fall Seminar, Chicago, ILL.

Dec 8: CBI Pharmaceutical Conference, Philadelphia, PA

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

MarcinkoAdvisors@msn.com

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Filed under: Career Development, Events-Planner, Monthly Reports | Tagged: Events-Planner | Leave a comment »

Promoting the “Minimum Necessary” Rule

Posted on November 30, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding HIPAA Security Standards

By Richard J. Mata; MD, MS

www.HealthcareFinancials.com

One concept that is stressed by HIPAA is the “minimum necessary” rule, which states the minimum use of personal health information [PHI] that can be used to identify a person, such as a social security number, home address, or phone number. Only the essential elements are to be used in transferring information from the patient record to anyone else that needs this information. This is especially important when financial information is being addressed. Only the minimum codes necessary to determine the cost should be provided to the financial department. No other information should be accessed by that department. Many institutions have systems where a registration or accounting clerk can pull up as much information as a doctor or nurse, but this is now against HIPAA policy and subject to penalties. The “minimum necessary” rule is also changing the way software is set up and vendor access is provided.

Chain of Custody

Another challenging task is keeping up with the number of people who access PHI, because the privacy regulations allow a patient to receive an accounting of anyone who has accessed their information, both internally [within your hospital, Emerging Health Organization, or medical practice) and externally [such as through your business associates]. The patient has the right to know who in the lengthy data chain has seen their PHI. This sets up an audit challenge for the medical organization, especially if the accountability is programmed internally. When other business associates use this PHI without documenting access to a specific patient’s PHI, no one would be accountable for a breach in privacy.

Enter the Designated Record Set

One way to track access is through a designated record set, which contains medical or mixed billing records, and any other information that a physician and/or medical practice utilizes for making decisions about a patient. It is up to the hospital, EHO, medical practice, or healthcare organization to define which set of information comprises “protected health information” and which does not, though logically this should not differ from locale to locale.

Assessment

Overlaps from the privacy regulations that are also addressed in the security regulations are access controls, audit trails, policies on e-mail and fax transmissions, contingency planning, configuration management, entity and personal authentication, and network controls. For more information about the Security Standards final rule, reference the Federal Register.

Conclusion

In the age of Twitter, IMing, blogging and texting, some young doctors are forgetting the basic fundamentals of patient privacy. 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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Filed under: Health Insurance, Health Law & Policy, Information Technology | Tagged: david marcinko, designated record set, EMRs, HIPAA, minimum necessary rule, PHI, Richard Mata | 1 Comment »

Diagnostic and Statistical Manual of Mental Disorders

Posted on November 29, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Coding Classification

By Staff Reporters

The classification and coding systems used by mental health insurers both diagnosis-related groups (DRGs) and current procedural terminology (CPT®) are still being defined through historical methodologies and are vague compared to the medical classification coding structure.

As an example, mental health insurers classify Tourette Syndrome (TS) as a “mental disorder.” In fact, TS is an inherited, neurobiological disorder, and both neurologists and psychiatrists treat TS with the same medications. If TS were reclassified under the medical coding structure, TS would not only receive potentially a better reimbursement but public perception of TS as a “mental disorder” would be changed.

The DSM-IV

The Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision), also known as the DSM-IV-TR, is a manual published by the American Psychiatric Association (APA) that includes all currently recognized mental health disorders. The coding system utilized by the DSM-IV is designed to correspond with codes from the International Classification of Diseases, commonly referred to as the ICD. Since early versions of the DSM did not correspond with ICD codes and updates of the publications for the ICD and the DSM are not simultaneous, some distinctions in the coding systems may still be present.

Assessment

For this reason, it is recommended that users of these manuals consult the appropriate reference when accessing diagnostic codes. For more information, contact the APA at (800) 368-5777.

Link: www.HealthcareFinancials.com

Conclusion

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Filed under: Career Development, Health Insurance, Healthcare Finance, Information Technology, Practice Management | Tagged: American Psychiatric Association, APA, billing codes, CPT, Diagnostic and Statistical Manual of Mental Disorders, DRG, DSM, DSM-IV, ICD, mental disorders, mental health | 1 Comment »

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