Seeking your Medical Practice Management [Horror] Story

Help us Find a Case Report Learning Experience

By Ann Miller; RN, MHA

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

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

Difficult Doctor Clients

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

Assessment

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

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

Call to Action

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

Submissions

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

Related: www.CertifiedMedicalPlanner.com

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

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Understanding the New “Mixed” Economy

Musings of an Informed Thought-Leader

By Somnath Basu PhD, MBA

Brief Excerpt

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

Review of Past Performance

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

Assessment

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

White Paper Link Here:  The New Economy

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Practicing Medicine in the Web 2.0 Era

A Slide-Show Visual Presentation

By Ann Miller; RN, MHA

[Executive-Director]

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

About the Author

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

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

In Dr. Bert’s Opinion  

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

Assessment

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

1. Medicine 2.0 – A Brief Description

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

2. How Web 2.0 is Changing Medicine

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

3. Assessment on the Quality of Medical Wikis

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

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

Please take a minute to opine. And, to prevent that annoying spam, we ask that you register for the ME-P.  

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ADVETISEMENT

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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

Sponsors Welcomed

Credible sponsors and like-minded advertisers are always welcomed.

Hank Paulson’s Book – Reviewed

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

By Staff Reporters

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

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

Assessment – The Ticking Clock

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

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

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

Conclusion

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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

DrBicuspid.com is Biased against Dentists

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More on Delta Dental

By Darrell K. Pruitt; DDS

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

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

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

Of Delta Dental

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

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

Kincade closes her ad with a quote from Chris Pyle:

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

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

Dr. Hamm                     

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

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

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

——————————————————–

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

DDPA Employee 

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

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

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

– Ari Adler, communications administrator at Delta Dental of Indiana

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

Dr. Ron Tankersley

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

————————————————

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

An Invitation

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

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

Assessment 

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

Conclusion

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

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About Medical Clinical IT Groupware

What it is – how it works

By Staff Reporters

According to Bill Crounse MD of Microsoft,

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

Distribution Platforms

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

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

Assessments

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

Conclusion

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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On the Elimination of Medicare Consultation Codes

Is it Budget Neutral?

By Brian J. Knabe MD, CFP, CMP

http://www.CertifiedMedicalPlanner.org

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

Reported Revenue Neutrality

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

Of Averages and Outliers 

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

Private Payers 

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

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Assessment 

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

Conclusion

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

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On the Cash Conversion Cycle for Healthcare Organizations

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Understanding Why Cash Flow is King

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

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

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

The Balancing Act

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

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

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

CCC Averages

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

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

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

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

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

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

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

Assessment

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

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

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Conclusion

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

The Wall Street Journal Health Blog

Staff Reporters

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

“This website is packed with great information”

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Top Hospital Administration and Healthcare Business Blogs

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The Top 50 List for 2009

[By Staff Reporters]

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

Assessment

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

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

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

Conclusion

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

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

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On the New Pot Health Policy in NJ?

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It’s Medicinal – Man!

By Staff Reporters

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

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

Jersey is Toughest State

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

Dispensaries

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

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

Assessment

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

Conclusion

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Access Management in the Hospital Check-In and Admissions Setting

The Role of Operational Activity Based Cost Management

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

www.HealthcareFinancials.com

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

Access Management

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

Increasing HR Complexity

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

Beware Un-Happy Stakeholders

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

Emotional Touch Points

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

Tips from the Manufacturing Sector

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

Assessment

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

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

Conclusion

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Predicting the Economic Recovery

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How Would Life Change – Even if Prescience Possible?

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

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

Of Rumors, Guesses, Optimism and Pessimism

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

The Two Questions

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

Let’s Begin the Evaluation

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

 

 The Comparisons

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

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

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

Departure from the Traditional View

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

War- What is it Good For?

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

Global Climate Change

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

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

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

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

Other Issues

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

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

SAARS

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

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

Non-Economic Issues

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

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Educated ME-P Readers

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

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

Assessment

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

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

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VIDEO: Cool New HIT Gadget for Physicians?

3D Head-Tracking Interface

By Ann Miller; RN, MHA

[Executive-Director]

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

Head Tracking Technology

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

Video Presentation

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

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

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Shopping for Health Software

Some Doctors Get Buyer’s Remorse

By D. Kellus Pruitt; DDS

Dear Huffington Post Investigative Fund

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

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

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

Duped Physicians 

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

A Volatile Industry 

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

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

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

A Canadian Illustration 

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

A Dentist’s Question 

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

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

The ADA 

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

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

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

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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

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Seeking Real Results; not Empty Rhetoric

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

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

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

In My Opinion

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

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

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

1. Medicare Integrity Program

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

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

2. Beneficiary Incentive Program

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

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

Assessment

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

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

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

Assessment

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

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Words of a Healthcare Reform Philosopher

The Lady Speaks

By Staff Reporters

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

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

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Events Planner: February 2010

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Events-Planner: FEBRUARY 2010

Staff Writers

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

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

First, a little about us! The Medical Executive-Post is still a relative newcomer. But today, we have almost 150,000 visitors and readers from all over the country, in addition to our growing subscriber base. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily.  And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention. And so, enjoy the Medical Executive-Post and our monthly Events-Planner with our compliments. 

A Look Ahead this Month

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

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

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

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

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

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

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

MarcinkoAdvisors@msn.com

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

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Healthcare Organizations [A Journal on CD-ROM]

Journal of Financial Management Strategies

By Ann Miller; RN, MHA

[Executive-Director]

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

Our Beliefs 

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

Our Vision

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

Our Mission

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

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Assessment

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

Conclusion                                               

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Do Prices Drive Regional Medicare Spending Variations?

A New Study Says – Apparently Not

By ME-P Staff Reporters

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

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

The Study

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

The Answer

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

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

Assessment

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

Conclusion

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Submitting a Guest Post to the ME-P

Make your Voice Heard

By Hope Rachel Hetico; RN, MHA

[Managing Editor]

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

Out Reach Efforts

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

Format, Length and Style

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

Become a Thought-Leader

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

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Assessment

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

Conclusion

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

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Healthcare Organizations: www.HealthcareFinancials.com

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

Broad Consensus Seems Impossible for Medical Professionals – and Everyman

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

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

Incorrect Unanimity

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

THINK: The US Senate and Congress

Rules for Upward Mobility

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

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

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

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

The Paradigm Shift

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

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

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

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

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

The Physician Net-Worth Numbers

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

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

Link: www.CertifiedMedicalPlanner.com

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

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

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

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Assessment

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

IOW: Is President Barack H. Obama correct?

Conclusion

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About the Cisco HealthPresence Medical Delivery Model

What it is – How it works

By Staff Reporters

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

A Multi-Media Platform

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

Healthcare services include:

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

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

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

    Conclusion

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

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    Health Administration Terms: www.HealthDictionarySeries.com

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    Apple Tablet PC Poll for Medical Professionals

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    About Ambulatory Gadgets in Medicine

    By Chris Thorman
    Chris@softwareadvice.com


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

    The Big-Breaking News from Apple

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

    A Short Survey

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

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

    Assessment

    Thank you in advance for your survey participation.

    Medical Software Advice [512.364.0118]

    Conclusion

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

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

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    Capital Formation for Hospitals

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    Understanding Strategic Expenditures

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

    [By Dr. David E. Marcinko MBA CMP]

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

    Strategic Importance of Capital Investing

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

    Profit Driven

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

    Capital Opportunity Selection

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

    Stewardship

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

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

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

    Product DetailsProduct Details

    MORE: Capital Formation Hospitals SAMPLE DEM

    Assessment

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

    CASE MODEL: CASE MODEL

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    Conclusion

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

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    Is the HITECH Act Unconstitutional?

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    Parts 1 and 2

    [By Alberto Borges; MD]

    Is the HITECH Act Unconstitutional? – PART 2

    Is the HITECH Act Unconstitutional? – PART 1

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

    Assessment

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

    Conclusion

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

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

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    I Want Obama Transparency for the ADA

    No More Hiding Places

    By D. Kellus Pruitt; DDS

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

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

    O’Keefe writes:

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

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

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

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

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

    Obama promises that his administration:

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

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

    Assessment 

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

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    Conclusion

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

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

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    Healthcare Organizations: www.HealthcareFinancials.com

    Health Administration Terms: www.HealthDictionarySeries.com

    Physician Advisors: www.CertifiedMedicalPlanner.com

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    OSHA Financial Cost Analysis Software

    About the “Safety Pays” Program

    By Staff Reporters

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

    A Free Software Program  

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

    Assessment

    Conclusion

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

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

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

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    Our Other Print Books and Related Information Sources:

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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

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    Sponsors Welcomed

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    The Scott Brown versus Healthcare Reform Poll

    The Sott Brown Opinion Poll

    By Staff Writers

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

    Our ME-P Audience

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

    The Question Is?

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

    Please VOTE:

    US Navy Ship Comfort Heads to Haiti

    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:

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

    Channel Surfing

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

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

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

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

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

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    Healthcare Reform and the US Constitution

    Consider this Proposed 28th 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.

    Channel Surfing

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

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

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

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    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

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

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    Sponsors Welcomed

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    Desperately Seeking Medical Professionals in Haiti

    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.

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    Godspeed!  

    Who Admires the EU Healthcare Model?

    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!

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    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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    Understanding Hospital Community Essentiality

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    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

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    Asking Uncle Sam – Why Health IT?

    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?

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

    Conclusion

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

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    Webinar on Doctors and the Economic Stimulus Package

    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/

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    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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    Health Administration Terms: www.HealthDictionarySeries.com

    Physician Advisors: www.CertifiedMedicalPlanner.com

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    What is a HIT Security Firewall?

    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

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    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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    Healthcare Organizations: www.HealthcareFinancials.com

    Health Administration Terms: www.HealthDictionarySeries.com

    Physician Advisors: www.CertifiedMedicalPlanner.com

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    Sponsors Welcomed

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    A Quality Story all Doctors and Patients Should Re-Read

    [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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    Introducing our New Name

    Or … What’s in a Formal Name?

    By Ann Miller; RN, MHA

    [Executive-Director]

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    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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    Hospital Materials Management Information Systems [Part 2]

    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

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    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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    Healthcare Organizations: www.HealthcareFinancials.com

    Health Administration Terms: www.HealthDictionarySeries.com

    Physician Advisors: www.CertifiedMedicalPlanner.com

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    Hospital Materials Management Information Systems [Part 1]

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    Fundamentals of Inventory Software Selection

    By David J. Piasecki; CPIM

    By Hope Rachel Hetico; RN, MHA

    By Dr. David Edward Marcinko; MBA

    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 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

    documents

    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.

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

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

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    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

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

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

    Conclusion

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

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

    OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

    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?

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    Conclusion

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

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

    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

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

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    Sponsors Welcomed

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

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

    Understanding the Healthcare Integrity and Protection Data Bank

    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.

    Join Our Mailing List

    Conclusion

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

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

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

    OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

    Secure e-mail Delivery with a Widget for your Website

    By Ann Miller; RN, MHA

    [Executive-Director]

    Join Our Mailing List

    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!

    Get our Widget: Get this widget!

    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

    Announcing ME-P TV

    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

    Join Our Mailing List

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

    Get our Widget: Get this widget!

    Channel Surfing

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

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

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

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

    Events Planner: January 2010

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    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

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

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

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

    Off Road Touring in Boston with Dr. Marcinko

    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

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

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

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

    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

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

    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

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