Encrypt or De-identify PHI

Posted on September 28, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Which One Just Might Work?

[By Darrell K. Pruitt; DDS]

The United States’ advancement in Healthcare Information Technology, which has the potential to lead to wonderful money-saving cures through research using trustworthy interoperable health records, is currently stopped cold by patient security problems that are only getting worse. Our lawmakers cannot get around the security obstacle without resorting to authoritarian means using CMS’s power to withhold providers’ discounted payments and threats of obscene fines from the HHS and the FTC. History shows that tyranny is not tolerated well in this part of the world. Lawmakers can get their butts voted smooth out of office in my neighborhood.

HITECH

Here is something nobody mentions: Despite the current hope in a thick, political fantasy called HITECH, encryption of patients’ Protected Health Information [PHI] is a non-starter in the land of the free. Everyone knows that resourceful, cynical Americans will simply never trust encryption to protect their secrets, and will reliably withhold important information from their eMRs – one way or another. Doctors as well as patients can be expected to go out of their way to sabotage technology they fear. We all intuitively know this is true, don’t we? We aren’t so naïve to think all the players will happily play by the rules, are we? And I think we can all agree that an untrustworthy digital health record in an emergency room is worse than no patient information at all. Security is a grand problem with eMRs that started with HIPAA changes in 2003 that made eHRs so slippery. And the problem is clearly not being resolved. Not yet.

Public Lacks Trust

Regardless of the campaign donations which follow him, there is nothing Newt Gingrich and his entrepreneurial friends in high places can do about the public’s lack of trust in encryption. It gets worse: Encryption hasn’t a chance of isolating PHI from dishonest employees in doctors’ offices, and slippery digital patient data can be moved soo easily. Everyone knows that as well, don’t they? It is estimated that two-thirds of the identities stolen in the nation are lifted from doctors’ offices. That’s us, Doc. HIPAA is not only irrelevant, it is an expensive distraction – it gives future ID theft victims a false sense of security.

HIPAA Approved

De-identifying digital records is not mentioned in HITECH as a HIPAA-approved method of security. Yet it is the ONLY solution that promises to be even more secure than paper records. Because of heavy stakeholder stakes in hospital care, it will take longer for CEO-types to embrace patient-friendly de-identification. Other than identifiers such as names, social security numbers, birthdates, addresses and other items that have street value, NOBODY cares what is in a dental record. I actually think this opens a tremendous opportunity for someone courageous in the Texas Dental Association to discuss the feasibility of de-identification of dental records. Otherwise, instead of leading the nation in solving security problems, the TDA will look just as stupid as the ADA.

Encryption would also provide a dangerous false sense of security in eMRs – that is if it had a chance in the marketplace. But encryption will never go far because consumers simply won’t buy it. That is a marketplace fact that stoically optimistic HIT stakeholders are trying hard to avoid. They also know they are running out of time. Deadlines are quickly approaching for both HIPAA and the Red Flags Rule that providers are far from prepared for.

Former Attorney Speaks

Bill Lappen, a former attorney and author of the ad I copied below, as well as a partner with his brother David in the de-identified health record venture says: “Since no identifying information is ever entered, a hacker can’t determine whose information is shown.”

So in addition to protecting one’s practice against dishonest or vindictive employees, de-identification of dental records would make hacking a dentist’s computer a complete waste of time, and hackers wouldn’t endanger dental patients and bankrupt dentists.

My Confidence

I confidently tell you that soon, someone smart will come upon the unprecedented idea that the ultimate answer to our security problem in healthcare will be de-identification of medical records, not encryption. De-identification allows a compromise of privacy for only a miniscule percentage of physicians’ patients. We cannot allow that to stand in the way of better health for everyone else. Those special cases are so few that I am confident that they can be dealt with individually. We simply must move forward. I’ll have to retire some day. I may need help from Medicare.

Encryption gives us only danger and protects nobody but a thief with a key.

Assessment

We’ve wasted enough time on HITECH and HIPAA, as well as CCHIT. It’s time to say no to stakeholders and pay attention to patients’ needs instead of those who would needlessly increase the cost of their care. Stimulus money attracts cockroaches.

In the name of Hippocrates, disregard the tainted HIPAA mandate. It is dangerous, and especially absurd in dentistry.

Link: http://www.theopenpress.com/index.php?a=press&id=58568

Life-Saving Patient Information can be Online, Anonymous and Usable

Published on: September 26th, 2009 12:19am

By: blappen

Los Angeles, CA (OPENPRESS) September 26, 2009 — Hospital Emergency Rooms need instant access to patient medical information. Allergic reactions and dangerous drug interactions can be deadly. Time is critical. Until now, privacy was a large concern. Two brothers, who have developed medical software over the past 15 years, think they have a simple first step towards moving patient information on to the internet.

“The ER doesn’t need to look up the information by patient name” said Bill Lappen, a former attorney. “We have implemented secure systems in the past, but no matter how secure we make the site, we have to assume that it will be hacked” added David Lappen, a computer design engineer from Stanford. “But providing instant access to life-saving information is too important to ignore”, he added. To protect patient privacy, their system does not know to whom the medical information belongs. Since the person’s identifying information is never on the system, it can’t be stolen. “By enabling anonymous entry, we have protected people’s privacy while allowing them to put their life-saving information in a place where it can be instantly accessed when needed”, added Bill Lappen.

www.AMCC.me is the public service website they created. It allows anyone to enter medical information anonymously. The site provides a random ID which the user carries in his/her wallet. For someone to see that user’s medical information, they merely enter the ID into the site. Unless the user has given them their ID, the information shown is meaningless. That same information, when associated with a patient, can save their life.

Since no identifying information is ever entered, a hacker can’t determine whose information is shown. “Secure patient-controlled Electronic Medical Records are now available on the internet” said David Lappen. A sample ID has been set up on the site to allow users to evaluate the concept before setting up their own free ID.

Contact:

Bill Lappen

Bill@AMCC.me

(818) 789-6531

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Filed under: Ethics, Health Law & Policy, Information Technology, Op-Editorials, Pruitt's Platform | Tagged: ADA, ARRA, Bill Lappen, CCHIT, CMS, Darrell Pruitt, David Lappen, EHRs, electronic medical records, EMRs, encryption, FTC, healthcare information technology, HHS, HIPAA, HIT, HITECH, ID theft, Newt Gingrich, PHI, protected health information, red flag rules, www.AMCC.me | 3 Comments »

Whither Health Information Technology – Seriously?

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

Is it Really About Quality Improvement?

By Staff Reporters

Health information technology (HIT) 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

Interoperable HIT 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

Link: http://healthit.hhs.gov/portal/server.pt?open=512&objID=1327&parentname=CommunityPage&parentid=112&mode=2&in_hi_userid=11113&cached=true A Letter from David Blumenthal, MD.

Conclusion

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Filed under: Information Technology, Quality Initiatives | Tagged: ARRA, CCHIT, David Blumenthal, EHRs, EMRs, ePRs, health information technology, HIT, HITECH | 3 Comments »

Using our Medical Executive-Posts

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

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[Executive Director]

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Stockholder Suit Targets Troubled Mental Health Chain

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

Psychiatric Solutions, Inc

By Robin Fields, ProPublica – September 22, 2009 5:01 pm EDT

Psychiatric Solutions Inc. the nation’s leading provider of inpatient mental health care is being sued by stockholders who claim the company issued “false and misleading statements” about troubles at one of its hospitals.

The Lawsuit

The lawsuit, filed Monday in U.S. District Court in Tennessee, alleges that PSI violated securities laws by downplaying problems at Riveredge Hospital near Chicago and waiting too long to tell shareholders how they had affected the company’s bottom line.

The Investigations

Investigations last year by the Chicago Tribune and ProPublica detailed violence, sexual abuse and neglect at PSI facilities from coast to coast, including Riveredge. In several instances, PSI facilities were cited for not reporting patient deaths and injuries as required, federal and state records showed. In response to the reports, the Justice Department opened an investigation and the Illinois Department of Children and Family Services froze admissions of foster children to Riveredge.

The Allegations

The lawsuit alleges that PSI’s statements – particularly those indicating the admissions hold would end soon and that other regulatory deficiencies had been fixed – inflated the company’s stock price, helping company leaders reap millions from insider sales. In early 2009, PSI announced that its 2008 results had fallen short of estimates. Its share price dropped about 35 percent on the news.

Assessment

Through a spokesman, PSI called the lawsuit “wholly without merit.” “We have at all times operated, and will continue to operate in full compliance with the rules and regulations of the Securities and Exchange Commission,” John Van Mol said in a written statement.

Note: Robin Fields is a reporter for the ProPublica news service, which first published this article.

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Filed under: Ethics, Health Law & Policy, Healthcare Finance, Op-Editorials | Tagged: John Van Mol, lawsuit, mental health, ProPublica, PSI, Psychiatric Solutions Inc, Riveredge Hospital, Robin Fields | Leave a comment »

Understanding Expenses and Investment Portfolio Performance

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

A Direct Relationship

By Clifton N. McIntire, Jr.; CIMA, CFP®

By Lisa Ellen McIntire; CIMA, CFP®

Expenses can play an important role in portfolio performance. You don’t hear much about expense ratios in an up market, like early 2007. If your account was up +28 percent, whether the expense was 3 percent or 1 percent doesn’t seem to make much difference. But, let the market decline, like it did later on in October 2007 and we change our perspective. A 10 percent portfolio decline plus charges of 3 percent equals a 13 percent decline. Now we need a 15 percent increase net of fees just to get even.

The Four Cost Horsemen

Basically you have four cost areas:

Custody—someone must hold the stocks and bonds, collect dividends and interest, prepare tax information for the government, issue monthly statements, and send checks.
Commissions—orders must be executed, transfer securities into and out of your account, trades settled.
Investment Decisions—the money manager must be paid.
Monitoring Performance and Advice—usually an investment management analyst is engaged to provide this service; as well as write the investment policy statement and prepare the asset allocation study.

Portfolio Size

Naturally, size makes a difference. For a doctor’s stock account with a $200,000 total value, all of the above can be accomplished for annual fees between 2.00 and 3.00 percent. An account with $1,500,000 in total assets part bonds and part stocks would pay annual fees between 1.25 and 1.75 percent depending on the ratio of stocks and bonds. These are annual fees and are all-inclusive. Commissions, portfolio management fees, and statements check charges are all included. One quarter of the annual fee is charged every three months. Family related accounts are generally grouped for a quantity fee discount.

Assessment

Some financial consultants prefer to use mutual funds with smaller accounts. A charge of 1 percent per year for their service with a stated minimal fee is common practice. This does not include fees deducted from the account by the mutual fund (anywhere from .50 to 2.50 percent) or commissions paid by the fund managers for trade executions.

Morningstar Report: Morningstar Expense Ratio Results

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Filed under: Financial Planning, Investing, Portfolio Management | Tagged: CFP, CIMA, Clifton N. McIntire, CMP, david marcinko, Financial Planning, Lisa Ellen McIntire, portfolio expenses, Portfolio Management, www.certifiedmedicalplanner.com | 1 Comment »

Sponsorship Opportunities

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

Advertise on the Medical Executive-Post

Let’s get right to the point!

Reach out and impress more than 100,000 physician and nurse-executives, financial advisors, CEOs and medical management consultants in the Health 2.0 space.

Our premium institutional e-journal: www.HealthcareFinancials.com and complimentary companion www.MedicalExecutivePost.com has limited sponsorship and advertising opportunities available; So, be sure to act now!

Advertise with us!

Reserve your space today.

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Sponsors Welcomed

Credible sponsors and like-minded advertisers are always welcomed.

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Introducing Somnath Basu; PhD MBA

Posted on September 25, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Our Newest ME-P Thought-Leader in Finance and Economics

By Ann Miller; RN, MHA

[Executive Director]

Dr. Somnath Basu is a Professor of Finance at California Lutheran University and the Director of its California Institute of Finance. Dr. Basu is also a Professor of the Helsinki School of Economics Executive MBA Program. He earned his BA in Economics, University of Delhi, MBA (Finance), Marquette University and a PhD (Finance), University of Arizona.

Publications and Experience

Dr. Basu is extensively published in the field of investments and financial planning and is an award winning teacher. He has significant consulting experience with US Fortune 100 companies, advising institutional money managers and in developing proprietary personal investment software. Dr. Basu is actively involved with financial planning organizations including the National Endowment for Financial Education (NEFE), the CFP Board of Standards, International CFP Board and the Financial Planning Association. He coauthored the book (with Block and Hirt), “Investment Planning for Financial Professionals” McGraw Hill, May 2006 which is widely used by financial planning programs nationwide.

Assessment

To regular our ME-P readers, Dr. Basu’s opinions are well known and not without controversy. But, whether you agree with him or not, his commitment to the industry and his economics and financial planning students is solid. And, always adhering to the Socratic dialog tradition of candor intelligence and goodwill.

Link: https://healthcarefinancials.wordpress.com/2009/04/09/i-jealously-shake-my-fist-at-somnath-basu/

Link: https://healthcarefinancials.wordpress.com/2009/04/16/dr-somnath-basu-replies-to-the-cfp%c2%ae-mis-trust-controversy/

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Filed under: Experts Invited, Financial Planning, Investing, Portfolio Management | Tagged: “Investment Planning for Financial Professionals”, Basu, Block, California Institute of Finance, california lutheran university, CFP, CFP Board of Standards, CMP, economics, finance, Financial Planning, financial planning association, FPA, Helsinki School of Economics, Hirt, International CFP Board, McGraw Hill, National Endowment for Financial Education, NEFE, Somnath Basu, www.certifiedmedicalplanner.com | 4 Comments »

Essay on Individual Health Insurance Mandates

Posted on September 25, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A White Paper by Jonathan Gruber; PhD

Submitted by Nancy Chockley; PhD

NIHCM: President and CEO

Dear Colleagues,

As health reform proposals become more concrete, there is renewed attention to the role of an individual mandate and issues of affordability. With this in mind, I am sending you NIHCM Foundation’s Expert Voices essay, “The Role of Individual Mandates in Health Reform” by Jonathan Gruber, PhD, Professor of Economics, at the Massachusetts Institute of Technology.

Assessment

In this essay Gruber explores the primary arguments for and against individual mandates and the challenges faced in their design and implementation. Then, pulling strongly from the Massachusetts experience, he examines evidence on the effectiveness of individual mandates in practice.

Conclusion

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Filed under: Alerts Sign-Up, Breaking News, Health Insurance, Healthcare Finance, Op-Editorials, Research & Development | 2 Comments »

Take the MD / MBA Survey

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

Seeking Collegial Input

[By Joshua T. Goldman]
MD/MBA Candidate, 2010
President & Founder, The Franklin Society
President, Associated Students of the Keck School of Medicine
University of Southern California | Marshall School of Business|Keck School of Medicine [760.409.4531]

Dr. Marcinko and ME-P Readers,

My name is Joshua Goldman and I am a 5th year MD/MBA student at the University of Southern California. The MD/MBA department at USC is conducting a study investigating the utility of the MD/MBA combined degree. People always ask, “What can you do with an MD/MBA?” We hope to better answer that question through a comprehensive look at MD/MBA graduates now working in industry. And, we would love to include and the experiences of your ME-P readership in our research.

Online Survey

We have designed a simple online survey that takes about 5-10 minutes to complete. The link to the survey is included below. If you have any colleagues or ME-P readers who have completed an MD and an MBA, it would be wonderful if you could forward them this e-mail, as well. We hope to publish our findings in a number of journals this spring and have been asked to present our results at this year’s Annual MD/MBA Conference. If you would like to receive a copy of our final manuscript, let us know and we will ensure you receive a copy in the spring jtgoldman@gmail.com

Take the Survey

Thank you for your help and support and we look forward to hearing from you!

Survey Here: MD/MBA Survey

Conclusion

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Critical Expense Issues in Healthcare Reform

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

American Academy of Actuaries Report

By John Park

Health Care Analyst

Sherlock Company

jpark@sherlockco.com

ME-P Subscribers

Late last week, the American Academy of Actuaries released the attached paper discussing administrative functions and expenses. It is designed to provide an actuarial perspective relating to various components of comprehensive health care reform proposals.

Assessment

Sherlock Company benchmarks, as excerpted in the Plan Management Navigator, are cited in the paper and we thought you might find it of interest.

Link: American Academy Actuaries

Conclusion

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ReThinking Medical Professional Autonomy in the Era of Obama Care

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

Eying Contemporary Medical Ethics in Healthcare Reform

By Render S. Davis; MSA, CHE

And, Staff Reporters

Not so long ago, a physician’s clinical judgment was virtually unquestioned. Now with the advent of clinical pathways and case management protocols, many aspects of treatment are outlined in algorithm-based plans that allied health professionals may follow with only minimal direct input from a physician. Much about this change has been good. Physicians have been freed from much tedious routine and are better able to watch more closely for unexpected responses to treatments or unusual outcomes and then utilize their knowledge to chart an appropriate response.

Restrictive Protocols

What is of special concern, though, is the restrictive nature of protocols in some managed care plans that may unduly limit a physician’s clinical prerogatives to address a patient’s specific needs. Such managed care plans may prove to be the ultimate bad examples of “cook book” medicine. While some may find health care and the practice of medicine an increasingly stressful and unrewarding field, others are continuing to search for ways to assure that caring, compassionate, and ethically rewarding medicine remain at the heart of our health care system.

Assessment

Link: For another opinion: http://healthcareorganizationalethics.blogspot.com/2009/09/obamas-speech-good-ethics-and-good.html

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. How does the specter of HR 3200-3400 in the healthcare reform debate impact the concept of medical autonomy and professional ethics? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Book Reviews, Career Development, CMP Program, Ethics, iMBA, Inc., Managed Care | Tagged: bioethics, Business of Medical Practice, cook book medicine, david marcinko, healthcare reform, HR 3200, HR 3400, managed care treatment algorithms, medical ethics, medical judgment, medical protocols, obama, ObamaCare, physician autonomy, Render Davis, www.medicalbusinessadvisors.com | 1 Comment »

On Increasing Price Transparency in Medicine

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

About NewChoiceHealth.com

By Staff Reporters

NewChoiceHealth, Inc. is an online comparison shopping marketplace built to provide healthcare consumers a way to save money. With NewChoiceHealth.com, consumers can easily locate medical facilities and compare medical procedure costs for services like MRIs, CT scans, mammograms, and more. Patients may shop nationwide, or right in their own local market from over 20,000 medical facilities for over 400 of the most commonly performed medical procedures.

Employer Portal

The site also features an employer portal to combat the rapidly escalating costs of healthcare. A Medical Cost Action Plan (mCAP) is reported to deliver an independent, unbiased, measurable plan which segments employer’s medical cost consumption categories into measurable Consumer Healthcare Efficiency Indices (CHEI) to deliver an actionable plan that reduces healthcare costs.

The Founder

CEO and Founder Brad Myers is a medical cost expert with 24 years of broad experience and extensive knowledge in medical cost informatics, healthcare insurance, managed care, clinical laboratory, and health and life insurance. His website message to ME-P readers, and others, is “shop & save!”

Assessment

Employee passion drives price transparency to healthcare consumers through the web site www.NewChoiceHealth.com Give it a click, for more information, and tell us what you think!

Conclusion

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Filed under: Accounting, Ethics, Health Economics, Health Insurance, Healthcare Finance, Information Technology, Managed Care | Tagged: Brad Myers, Consumer Healthcare Efficiency Indices, CT scans, healthcare price transparency, Medical Cost Action Plan, medical price transparency, MRIs, www.NewChoiceHealth.com | 4 Comments »

Ask an Advisor – Must an Insurance Claim CramDown be Accepted?

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

Calling on Insurance Professionals to Expose the “Wizard” Behind the Curtain

By ME-P Staff Reporters

We received the following request recently. Apparently, this ME-P reader-nurse sustained a covered loss with valid home insurance property-casuality claim. It resulted in disagreement with her insurance adjuster [a common occurrence]. The adjuster cited his/her supervisor’s insistence on claim settlement and closure. The nurse’s general contractor thinks the monetary amount is significant [$50,000 range after three independent estimates]. The insurance company wants to settle for about half that amount.

What say you about this scenario?

INSURED

Dear Big Insurance Company Adjuster

”Many thanks for reaching out to us by phone yesterday. Please be aware that we did not agree to partial payment or supplements and are sorry for any confusion.

We would however, be pleased to assist by informing your management of our declination of same. Thus, there is no need to issue any payments at this time.

It seems to make far more sense to get all the numbers together with our general contractor and then arrive at a consensus before moving forward. As you know, this was our original plan. We appreciate your deeper understanding of these very complex issues.”

Your Small Client

INSURANCE ADJUSTER

Dear Client

“This email will serve as a follow up to our telephone call yesterday. I am sorry we were disconnected but I attempted to call you several times and I was unable to leave a message. I am attaching a copy of the updated Big Insurance Company estimate which reflects those changes made due to additional information gathered during my second inspection of your property on September 8^th. Also you will find an updated Replacement Cost Letter.

As discussed, due to the fact we know we owe you the value of the attached estimate, I am processing the actual cash value payment in the amount of $ XYZ. Any additional payments will be handled as supplements. Please feel free to contact me with any questions.

Your Big Insurance Company Adjuster

MANAGEMENT

Dear Client

Also, my management told me I need to proceed with issuing payment based on the amount I know I owe you [insured] as of now, and that I should handle any further negotiations as supplements. I have already discussed this with your husband.

Your Big Insurance Company Adjuster

Assessment

After some internet research, our RN reader discovered that abut 85% of all folks accept inadequate PC insurance payments after being strong-armed by their insurance company in various ways. She is determined to be made whole and indemnified. She also understands that future negotiations and “supplements” after acceptance are typically not favorable to her, and she wishes to maintain her leverage by not accepting them. Can she refuse to cash the check, if sent to her, until satisfied? She is not feeling in good hands, at the moment!

Industry Indignation Index: 85%

Audio Razz: Click to play :

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Must our reader “accept assignment” in the form of this under payment cram-down? How can she expose the Wizard of Oz manager behind the curtain? Will she be the “squeaky wheel” of informed insureds who “get the economic grease” they deserve. Should our Industry Indignation Index percentage be higher, or lower? Is the audio razz deserved, or not. What can she do? Insurance agent and attorney input is appreciated.

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Filed under: "Advisors Only", "Ask-an-Advisor", Ethics, Industry Indignation Index, Insurance Matters, Op-Editorials | Tagged: Allstate, insurance adjuster, insurance claim settlements, insurance supplements, John Bell, Justin Owens, property casualty insurance, Tom Wilson, www.allstatesucks.com | 39 Comments »

On Healthcare Inventory Management

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

Understanding Fundamental Principles

By Staff Reporters

www.HealthcareFinancials.com

According to industry inventory management expert Mr. David Piasecki, healthcare inventory is a term that describes medical items used in the delivery of healthcare services or for patient use and resale. Much like Durable Medical Equipment, a certain safety margin of stock should always be available. Inventory ranges from normal administrative office supplies to highly specialized chemicals and reagents used in the clinical laboratory. It should be distinguished from capital supplies, such as major equipment, instruments, and other items that are not used up faster than inventory or related inventory wastes.

Historical Review

Historically, asset utilization ratios provided information on how effectively the enterprise used its inventory assets to produce revenues, or deplete its cash. For example, the inventory turnover ratio (ITR) determines the total volume of inventory turnover (change) during a pre-determined accounting period (month or quarter). It is defined as cost of inventory purchased for the period, divided by average inventory (AI) at cost.

Consulting Firms

Dunn and Bradstreet, the supply chain management – consulting firm and others, do not provide exact comparatives for private healthcare ITR. Nonetheless, ITR is useful as an internal performance indicator of inventory turnover speed and cash flow enhancement. Currently however, for public hospitals, 60 – 75 days is estimated to be the average time for inventory turnover.

www.HealthcareFinancials.com

The main problem with traditional ITR, similar analyses such as AI and ICP, and the usual inventory costing methods (e.g., last-in first-out, first-in first-out, specific identification, average costs), and even just-in-time inventory costing, is that they do not embrace Supply Chain Inventory Management. This occurs because sources of profit or loss are not recognized in the traditional inventory cost accounting equation:

Assessment

Cost of goods sold = beginning inventory + net purchases – ending inventory

Conclusion

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Filed under: "Doctors Only", Glossary Terms, Practice Management | Tagged: beginning inventory, cost of goods sold, david marcinko, David Piasecki, DME, Dunn and Bradstreet, ending inventory, inventory turnover ratio, ITR, medical inventory management, www.healthcarefinancials.com, www.healthdictionaryseries.com | 3 Comments »

The VistA Client Server System

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

What it is – How it works

By ME-P Staff Reporters

According to Dr. Richard Mata MS, a client-server system configuration occurs when one or more “repository” computers [ known as “servers”] store large amounts of data but perform limited processing. Communicating with the server(s) are client workstations that perform much of the data processing and often have graphical user interfaces (GUIs) for ease of use.

High Functionality

Both customizability and resource use is high, depending on the desired sophistication. Many clinical medical information systems that process data directly related to patient care use this configuration.

VA Example

For instance, the Veterans Health Administration, which has implemented what is likely the largest integrated healthcare information system in the United States, uses client-server architecture. Known as the Veterans Health Information Systems and Technology Architecture (VistA), this system provides technology infrastructure to about 1,300 care facilities, including hospitals and medical centers, outpatient facilities, and long-term care centers. VistA utilizes a client-server architecture that links together workstations and personal computers using software that is accessed via a graphical user interface.

Assessment

Overall, for hospitals that have the financial and manpower resources for a significant investment in IT, client-server architectures are the fastest-growing and typically the most preferred of the system architectures, due in large part to their local adaptability and flexibility to meet changing hospital and medical center needs.

Conclusion

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Filed under: Information Technology, Military Medicine | Tagged: ARRA, client servers, EHRs, EMRs, GUIs, health information technology, HITECH, IT, rack servers, Richard Mata MD, VA, Veterans Health Information Systems and Technology Architecture, VistA, www.healthcarefinancials.com | 24 Comments »

Introducing Dr. Leila M. Hover

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

Our Newest ME-P Thought-Leader

By Ann Miller; RN, MHA

[Executive-Director]

Leila M. Hover, D. Med. Hum, has a varied background having worked in OB/GYN and as a Clinic Supervisor in a Planned Parenthood Center. She served as Director of a hospital medical library, and then as Director of Scientific Information in several medical communications/advertising organizations.

Interest in Concierge Medicine

Her doctoral dissertation topic was concierge medicine, in which she has a continuing interest.

Assessment

Dr. Hover is a member of the Institutional Review Board of the Atlantic Health System in New Jersey and the Bioethics Committee of Overlook Hospital in Summit, New Jersey. She is also a principal at Information Developers, a medical literature research and document retrieval organization.

ME-P Shout-Out

And so, please give a warn ME-P “shout-out” to Dr. Lee Hover, our newest thought-leader.

Conclusion

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INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Breaking News, Ethics, Experts Invited | Tagged: Atlantic Health System, bioethics, concierge medicine, Dr. Lee Hover, Information Developers, Leila M. Hover, Overlook Hospital | Leave a comment »

Happy New Year 5770 and 5771

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

We wish all our Jewish Subscribers a Happy and Healthy

New Year 5770

The Shofar is a ram’s horn blown as a wind instrument, sounded in Biblical times chiefly to communicate signals in battle and announce certain religious occasions and in modern times chiefly at synagogue services on Rosh Hashanah and Yom Kippur.

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Filed under: Breaking News, Sponsors | Tagged: 5770, Happy New Year 5770, Jewish New Year, Rosh Hashanah, synagogue services, Yom Kippur | 1 Comment »

Branch Davidian David Koresh is Dead

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

Take it … from a Forensic Dentist

By Darrell K. Pruitt; DDS

For those who might be interested, these two plaster models are proof David Koresh died in the Mt. Carmel disaster.

Please allow me to offer I have been a forensic dentist since shortly after graduating from dental school in 1982. I have helped ID victims of two plane wrecks at DFW – Delta 191 in 1985 and Delta 1141 in ’88. I also helped identify the victims of Mount Carmel in 1993.

Some may choose to stop reading now, because I see no need to refrain from describing forensics to this crowd. After all, one sees it on TV these days. For those who stay, it is my wish that you find this adventure interesting.

The Branch Davidian Disaster

At the time of the Branch Davidian disaster, Tarrant County (Fort Worth) had a contract with McLendon County (Waco) for autopsy services. Along with 49 other dentists, I volunteered to help with the ID chores. I spent 8 days at the county morgue sorting through badly burnt and rapidly decaying cadavers of men, women and far too many children. There were so many fragments of ammunition that exploded from the heat, that one could hardly see the skeletons in x-rays of the body bags.

There was a lot of .223 (AR-15) and 7.62 mm (AK – 47) ammunition, both unfired bullets and their exploded casings. I also saw 9 mm and .45 cal. (handgun) ammunition. In addition, I saw the empty casing of a spent 50 mm (not caliber) round. That could also be called a 2 inch artillery shell. It was not fired during the skirmish. It was probably a military souvenir. I witnessed it because it was “melted” into a mass of comingled, badly burnt bodies. Those on site near Waco simply loaded the mass of ammunition and flesh into the body bag in one piece.

Even though the Davidians were not armed with a 50 mm gun, I read a report that there were two .50 cal. semi-automatic sniper guns side-by-side and pointed at the front doors, with ammunition. One thing I immediately found curious about the body-bag x-rays were the numerous “Y” shaped metal pieces, about 3/16″ long. In some bags they were everywhere, while they weren’t present in others. Any guesses? I’ll tell you later.

Plaster Models

The plaster model on the left is from an impression of Koresh’s teeth post mortem, 33 years of age. The model on the right was from when he was 15 years old. Is it the same person? Notice the inclinations of the front teeth. His lateral incisors are positioned a little more palatally than the centrals in both models. It may be difficult for the layperson to recognize, but there is a stainless steel crown on Koresh’s left second molar that was there when he was 15. Note the consistency of missing teeth. Notice the consistent shapes of teeth. Once a team member opened the right bag, it was an immediate positive ID.

The fresh extraction socket of the bicuspid on Koresh’s right was because the tooth was extracted post mortem for DNA analysis – not to ID Koresh, but to ID the 60 or so kids who were in the compound that burned to the ground. By the way. We could smell the accelerant. It was Coleman fuel, and it was spread from the inside of the compound. From what I saw and sensed, it is my opinion that government forces did not start the fires.

What else can we tell from the models? The gums and soft tissue had been burnt away, leaving only the bone around the teeth. If one looks closely, one can see a fracture line on his right central incisor. It was where the top of the front tooth was fractured off when Koresh fell forward and struck his mouth on a hard object, possibly the floor. The piece of the tooth was found among the fragments scooped up in the body bag. It was super-glued back in place before the impression was taken.

So How Did Koresh Die?

The back half of Koresh’s skull was missing when the bag was opened, but in the bag were found some skull fragments which were burned and others barely scorched. This tells us it wasn’t the fire that killed him. There was a hole in the middle of the forehead almost 1/4 inch in diameter, with a “starburst” – like scoring of the bone radiating from the edges of the wound. This was later determined to be caused by a .223 bullet. The radiating “starburst” means that the barrel of the gun was contacting Koresh’s head when the bullet was fired. Any ideas yet? Was it a self-inflicted wound?

More clues: The body of Steve Schneider, Koresh’s second in command, was found not far from Koresh’s. Schneider had a hole in the roof of his mouth caused by a 9 mm bullet. For those who don’t know, the .223 round is a rifle bullet, while the 9 mm is likely a handgun. So here is the theory: Schneider did Koresh in the hallway with an AR – 15 that was found close by, and then did himself with his pistol. Anybody have any guesses about the thousands of pieces of metal shaped like “Y”s that littered the body bags?

Zipper Teeth

It is my understanding that this spring a dental forensics course will be offered at the Southwest Dental Conference in Dallas, and it is open to everyone. If forensics interests you, there could come a time when your community might desperately need your help, especially if you are trained in the techniques of identifying victims in a mass disaster. I attended the course two years ago. It was fascinating.

Assessment

In closing, let me leave you with this: I remember late in the evening following a long, hard day at the morgue, I witnessed something that struck me as so ironic that I impulsively giggled out loud. In one of the body bags was a military-style vest designed for carrying ammunition and tools of warfare The label on the inside of the collar read “David Koresh Survival Gear.” David Koresh marketed his own signature line of survival Gear. Get it?

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Reviewing the Baucus Health Care Reform Bill

Posted on September 18, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

America’s Healthy Future Act of 2009

By ME-P Staff Reporters

Senate Finance chair Max Baucus finally unveiled his health-care bill. Baucus is the last committee chairman to weigh in on reform, largely because he has spent months wrangling with Republicans for their support.

Senate Republican leader Mitch McConnell immediately denounced the bill, calling it a “partisan proposal” and claiming it will create “massive new tax burdens on families and small businesses.”

And, no GOPers have had a kind word to say about it; yet. Baucus is keeping his fingers crossed that Olympia Snowe will ultimately come on board, but does one GOP vote really make for a bipartisan bill?

Assessment

We ask our ME-P subscribers to read all 223 pages and decide for your self.

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Filed under: Alerts Sign-Up, Breaking News, Ethics, Experts Invited, Health Law & Policy, Quality Initiatives, Videos | Tagged: America's Healthy Future Act of 2009, Baucus Bill, healthcare reform, Max Baucus, Mitch McConnell, obama | 2 Comments »

Create Your Very Own Private ME-P Channel

Posted on September 18, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Potential New ME-P Feature [Beta]

By Ann Miller; RN, MHA

[Executive-Director]

A private online ME-P blog channel allows you to express yourself in a completely safe, protected, and secure environment. Enjoy the public benefits of the ME-P, as well as the private journaling benefits and experience of writing your daily thoughts and ideas on your own channel; just like Pruitt’s Platform.

Link: https://healthcarefinancials.wordpress.com/category/pruitts-platform/

ME-P Innovation

With this innovative and interactive ME-P web-based experience, you can also invite selected colleagues using our password protected ecosystem. Designed to facilitate positive personal or private group information change, this easy-to-use tool gives you control over your posting, commentary and journaling.

Features and Benefits:

Create your own topic channel with our real-life assistance.
Select a private password as an alternative to the public ME-P platform.
Write, import text, or copy-paste material to a central location.
Automate and contribute at your own pace in a comfortable style.
Upload photos with every private ME-P entry; or not.
Save your entries for future reference.
Search past journal entries.
E-mail your journal entries to anyone you wish.
Express yourself in a secure online space with password encryption.
Access your private ME-P anytime and anywhere.
Get unlimited access 24/7 — anywhere and anytime.
Foster a private and/or anonymous ME-P community subset of like minded professionals.

Assessment

The initiation process is not fully automatic; yet. So, we will help create your initial open channel. Then, password protection and privatization is up to you; post privately or publicly; as you wish. Just like a hybrid e-grid or public/private internet cloud.

Conclusion

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Filed under: Alerts Sign-Up, Breaking News, iMBA, Inc., Research & Development | Tagged: david marcinko, ME-P, personal blog, private blog, private channel | 1 Comment »

The ME-Pr [Photo Sharing Feature]

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

With Apologies to Flickr

By ME-P Staff Reporters

A New Feature Launch [Beta]

We are proud to introduce an exciting new Medical Executive-Post feature called the ME-Pr. Our goal is to aggregate and help subscribers make their blog related photographs available to those in our ecosystem who appreciate them; comical or sad, interesting or ironic, shocking or banal; or just plain iconoclastic. We hope ME-Pr will make these things possible … and more! To do this, we want you to send us your photos and videos so we can post, redact and make them searchable.

ME-Pr Rules of Engagement

1. You must own your photos or videos.

2. We reserve the right to post them, or not.

3. These terms and conditions may change without notice.

4. You must be a ME-P subscriber.

Assessment

So, check us out daily to stay apprised of the latest developments. The fact that you’ve read this post with nothing but text to keep your interested is our proof-of-concept. What are you waiting for?

Ann at: MarcinkoAdvisors@msn.com

SAMPLE

The irony of this Prudential insurance logo on an ambulance in Waltham, a city in Middlesex, MA, is obvious and very cheesy!

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Filed under: Breaking News | Tagged: ME-Pr, photo sharing | 1 Comment »

Understanding the Medicare Prospective Payment System

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

Origins of Diagnostic Related Groups

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

The Medicare Prospective Payment System (PPS) was introduced by the federal government in October, 1 1983, as a way to change hospital behavior through financial incentives that encourage more cost-efficient management of medical care. Under PPS, hospitals are paid a pre-determined rate for each Medicare admission. Each patient was classified into a diagnosis-related group (DRG) on the basis of clinical information. Except for certain patients with exceptionally high costs (“outliers”), the hospital is paid a flat rate for the DRG, regardless of the actual services provided.

Enter the DRGs

Each Medicare patient is classified into a DRG according to information from the medical record that appears on the bill:

principal diagnosis (why the patient was admitted);
complications and co-morbidities (other secondary diagnoses);
surgical procedures;
age and patient gender; and
discharge disposition (routine, transferred, or expired).

Medical Records Documentation

Diagnoses and procedures must be documented by the attending physician in the patient’s medical record. They are then coded by hospital personnel using ICD-9-CM nomenclature. This is a numerical coding scheme of over 13,000 diagnoses and more than 5,000 procedures. The coding process is extremely important since it essentially determines what DRG will be assigned for a patient. Coding an incorrect principal diagnosis or failing to code a significant secondary diagnosis can dramatically affect reimbursement.

DRG Categories

Originally, there were more than 490 DRG categories defined by the Centers for Medicare and Medicaid Services (CMS, formerly known as the Health Care Financing Administration [HCFA]). Each category was designed to be “clinically coherent.” In other words, all patients assigned to a DRG are deemed to have a similar clinical condition. The PPS is based on paying the average cost for treating patients in the same DRG. Each year CMS makes technical adjustments to the DRG classification system that incorporates new technologies (e.g., laparoscopic procedures) and refines its use as a payment methodology. CMS also initiates changes to the ICD-9-CM coding scheme. The DRG assignment process is computerized in a program called the “grouper” that is used by hospitals and fiscal intermediaries. It was last significantly updated by CMS in 2006.

Assessment

Each year CMS also assigns a relative weight to each DRG. These weights indicate the relative costs for treating patients during the prior year. The national average charge for each DRG is compared to the overall average. This ratio is published annually in the Federal Register for each DRG. A DRG with a weight of 2.0000, for example, means that charges were historically twice the average; a DRG with a weight of 0.5000 was half the average; and so on.

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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
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BLOG: www.MedicalExecutivePost.com

Filed under: Health Economics, Health Insurance, Healthcare Finance, Practice Management | Tagged: Centers for Medicare and Medicaid Services, CMS, david marcinko, diagnosis-related group, DRG, HCFA, ICD-10-CM, ICD-9-CM, medicare, Medicare Prospective Payment System, PPS | 7 Comments »

ME-P Thought-Leader [MD] in the News

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

Brian J. Knabe MD of Savant Capital Management

By Max Alexander

Dow Jones Newswires; 212-416-2245

Lots of doctors get burnt out dealing with the business end of medicine. But Brian Knabe, a family practice physician in Rockford, Ill., had such a passion for crunching numbers that he became a financial planner.

Knabe, 42 years old, still sees patient’s two half-days a week. He also teaches residents for another half-day at the University of Illinois – College of Medicine.

Most of the week, he’s a certified financial planner with Savant Capital Management.

“I hear all the jokes,” says Knabe, “the most popular being some version of, ‘Hey I guess my portfolio’s doing so badly, they had to bring in the doctor.'”

When the laughter dies down – it doesn’t take long – people often ask what motivated him to transition from medicine into finance.

His short answer is what you’d expect from a wealth adviser: “I wanted to diversify my career.”

The long answer includes a lifelong passion for math that runs in the family. Knabe’s father and brother are both engineers, and the doctor himself majored in bioengineering at Marquette University. “In college, I loved calculus, statistics and differential equations,” he says.

Growing up in Rockford, his best friend was Brent Brodeski, a partner at Savant, and Knabe had been a client of the firm since 1995. “For years, I joked with Brian, ‘If you ever get bored with medicine, you can join us,'” says Brodeski. “Three years ago he called and said, ‘I’ll take you up on that.’ I was floored.”

Knabe wasn’t bored with medicine. “I love taking care of patients, and the intellectual stimulation of the field,” he says. “So I told the partners at Savant that I would only do this if they allowed me to continue practicing medicine part-time.” Meanwhile, he went back to Marquette and got his CFP credentials.

About half of Knabe’s financial clients are doctors, who appreciate his insider’s knowledge of their work and financial issues. Both fields involve privacy and trust, he notes, and both involve planning for the future. They also involve an element of uncertainty.

Sometimes his advice is specifically health-related.

“One client I was working with was a couple where the husband had a terminal illness,” recalls Knabe. “I worked closely with the family in planning living will issues and durable power of attorney for health care. I’ve helped other clients wade through health insurance and disability issues.”

Yes, financial clients do sometimes ask him for medical advice, but he stops them before they can unbutton their shirt.

“If they have a problem and need a diagnosis, I’ll tell them where to go to get a second opinion,” he says.

Link: http://online.wsj.com/article_email/BT-CO-20090914-711325-kIyVDAtMEM5TzEtNDIxMDQwWj.html

Managing Editor’s Note:

Dr. Knabe is also enrolled in the www.CertifiedMedicalPlanner.com program in health economics and medical practice management for financial advisors and healthcare consultants.

Conclusion

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Filed under: "Advisors Only", "Doctors Only", Breaking News, Career Development, CMP Program, Health Insurance, iMBA, Inc., Media Mentions and PR | Tagged: Brent Brodeski, Brian Knabe MD, certified financial planner, certified medical planner, CFP, CMP, CMP www.CertifiedMedicalPlanner.com, financial advisor, savant capital management | Leave a comment »

About Docs4PatientCare

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

Politically Involved Physicians

By Staff Reporters

Docs4PatientCare is a grassroots organization of concerned physicians committed to the establishment of a health care system that preserves the sanctity of the doctor-patient relationship, promotes quality of care, supports affordable access to all Americans, and protects patients’ freedom of choice.

Mission

According to their website, Docs4PatientCare urges patients and physicians to get involved in the current healthcare debates in order to preserve the good qualities of our healthcare system, address the problems, while preventing their bureaucratic destruction.

Board Members

President: Hal Scherz, MD
Vice President: Fred Shessel, MD
Secretary: Tod Rubin, MD
Treasurer: Joanne Thurston CPA

Board of Directors

Scott Barbour, MD
Carl Capelouto, MD
Ron Anglade, MD
Terry Murphy, MD
Mike Koriwchak, MD
Barry Zisholtz, MD

Assessment

D4PC is a group of practicing physicians uniting to represent the interests and concerns of both patients and doctors in the healthcare reform debate. D4PC endorses the concept of needed healthcare reform, but recognizes it can only be accomplished by proceeding in a cautious and responsible manner. Their recommendations seek to enable them to reach this goal without requiring the nationalization of the entire American healthcare system.

But, should medical professionals be involved in such political organizations?

Link: http://docs4patientcare.org

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Are these sorts of organizations a form of self-aggrandizement; or not? Can you cite any others? 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

Filed under: Career Development, Ethics, Health Insurance, Health Law & Policy, Quality Initiatives | Tagged: Barry Zisholtz MD, Carl Capelouto, D4PC, Docs4PatientCare, Fred Shessel MD, Hal Scherz MD, healthcare reform, HR 3200, HR 3400, Joanne Thurston CPA, MD, Mike Koriwchak MD, ObamaCare, Ron Anglade MD, Scott Barbour MD, Terry Murphy MD, Tod Rubin MD | 1 Comment »

Take the Lost Managed Care Contract Challenge!

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

Illustrative Case Model – Are You CMP™ Worthy?

By Staff Reporters

The Hope Outreach Medical Clinic (HOMC) is a private, for-profit, single specialty medical clinic in a south-eastern state. It submitted its bi-annual Request for Proposal (RFP) to continue its current managed care fixed-rate contract. Upon review of the RFP, however, Sunshine Indemnity Insurance Company, the managed care organization (MCO), denied the contract request for the upcoming year.

Seeing Economic Estimates

In shock, the clinic’s CEO asked the clinic’s administrator to work with its legal team to develop a defensible estimate of economic damages that would occur as a result of the lost contract. The clinic intended to bring suit against the MCO for breach-of-contract. However, the administrator is not an attorney and is loathe to-enter the fray. After consideration however, he decided to assist in filing the Statement of Claim (SOC) because he realized that changes in patient services (unit) volume would be a valid economic surrogate. He then requested the following information from his controller, in order to develop a change in economic profit [damages] estimate.

Change in patient visits (unit) volume

Fees (price) per patient (unit)
Marginal (incremental) cost per patient (unit)
Change in current fees (prices)
Patient volume (units) affected

Key Issues:

Fee (price) per patient (units) may be obtained from the fee schedule used by the MCO to pay HOMC.
Marginal (incremental) costs per patient (unit) are approximated using variable costs.
Higher cost payors exist because lower patient volumes raise the average cost per patient (unit) due to existing fixed costs.

Assessment

Medical management consultants, are you up to answering this challenge? We dare you to respond!

Visit: www.CertifiedMedicalPlanner.com

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Filed under: "Advisors Only", "Ask-an-Advisor", "Doctors Only", CMP Program, Healthcare Finance, Managed Care, Practice Management | Tagged: capitation, economic profiling, fixed rate medical reimbursement contracts, HMO, Managed Care, marginal cost, marginal profit, marginal revenue, MCO, SOC | 2 Comments »

The Largest Purchaser of Domestic Healthcare?

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

It’s the Government – Silly

By Ann Miller; RN, MHA

[Executive Director]

By far, our federal government is the largest purchaser of healthcare services, according to Robert James Cimasi MHA, AVA, CMP™ of Health Capital Consultants, in St. Louis, MO; and many others.

Obama Care

Although the government faces immense pressure to control healthcare costs, especially during the current HR 3200-3400 debates, it also faces pressure to expend additional funds in order to achieve its ostensible primary mission in its involvement in healthcare, i.e., to expand and improve public health.

Federal Payment Schemes

In many ways the government has led the way for cost control through its development of resource-based reimbursement, prospective payment systems, budget limitations and other payment schemes. However, its conflicting goals have led it to approach these controls in a hesitant and piecemeal manner rather than effecting bold, comprehensive reforms.

Consider, for example, the lack of government intervention in the face of mounting pressure to remove some of the barriers preventing a reduction in US pharmaceutical costs.

Assessment

Today, most experts agree that Uncle Sam pays for at least 51% of domestic healthcare when Medicare, Medicaid, SHIPS, the VA, Indian and Prison Healthcare Systems are considered. In fact, according to our Publisher-in-Chief, Dr. David Edward Marcinko; MBA:

‘We already have a single payer health system in this country, but most folks just don’t realize it.”

Conclusion

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Filed under: Drugs and Pharma, Health Economics, Managed Care, Military Medicine, Op-Editorials | Tagged: david marcinko, healthcare reform, HR 3200, HR 3400, Indian Health Services, Managed Care, Medicaid, medicare, Obama care, Prison Healthcare, prospective payment systems, resource-based reimbursement, robert james cimasi, SHIPs, VA System | 7 Comments »

Do Financial Advisors Add Value to Retail Portfolios?

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

Some Consultants Emphatically Say … No!

By Staff Reporters

Nope! So says Andre’ Cappon, Guy Manual, Stephan Mignot and Seth Varnhagen of the CBM Group, Inc; a consulting firm in Manhattan, New York. In fact, while writing in Registered Rep – a trade magazine for FAs in September 2009 – they estimate that long-term real (adjusted for inflation), actual (after taxes, fees and market timing) returns for the average retail investor, to be around 0 percent. That’s right; not the 8-12 percent usually attributed to long term investing trends.

Or; do you simply have the wrong type of Financial Advisor [FA]?

Visit: www.CertifiedMedicalPlanner.com Do you need a fiduciary advisor? Who really knows for sure?

About the CBM Group

Founded in 1992, the CBM Group is a general management consulting firm specialized in the financial services industry. Their goal is to help leading financial institutions, and their financial advisors, create and sustain the competitive advantages necessary to thrive in the global marketplace.

Link: www.theCBMGroup.com

Assessment

Despite the math, and numerics like Ibbotson charts showing impressive long-term gains, on average retail investors — like doctors, medical professionals and ME-P readers — have made very little actual return on their savings; according to CMB.

Link: http://registeredrep.com/advisorland/marketing_selling/0901-small-investment-return/index.html

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Does your FA add value to his/her fees of 1-3%; or are they a drag on your portfolio’s performance. Ever consider “doing it yourself” like some medical institutions www.HealthcareFinancials.com

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Filed under: CMP Program, Financial Planning, Investing, Portfolio Management, Recommended Books | Tagged: Andre’ Cappon, CBM Group Inc, CFP, CMP, fiduciary advisory, financial advisors, Guy Manual, Ibbotson, registered representative, Seth Varnhagen, Stephan Mignot, www.certifiedmedicalplanner.com | 6 Comments »

Soliciting Textbook Peer-Reviewers and Experts

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

Business of Medical Practice

Ann Miller; RN, MHA

[Executive Director]

Please contact me if you would like to serve as a peer-reviewer for the third edition of our popular textbook, “Business of Medical Practice”.

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

If interested, please email me and send in a bio. A non-disclosure agreement is required.

Email: MarcinkoAdvisors@msn.com

In return for conscientious industry and expertise, if accepted, we may offer you a possible mention, blog promotion and/or book acknowledgement … such a deal!

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

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

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Filed under: "Ask-an-Advisor", Book Reviews, Experts Invited, iMBA, Inc., Media Mentions and PR, Research & Development | Leave a comment »

Dr. Pruitt Invites Dr. Cohen to Discuss eDRs

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

Where is the ADA’s Representative?

By Darrell K. Pruitt; DDS

He or she should have been talking with me long ago. I have the audience and I’m giving you that opportunity I promised you, Dr. Donald Cohen.

Rest Easy

I’m aware that I possibly make you uncomfortable, considering how “unprofessionally” I’ve publicly treated lesser devoted HIPAA consultants. Rest easy! As soon as I read your article, I could tell that you’re different from your colleagues I’ve met. First of all, like me, you’re a dentist. That’s very important. Secondly, your credentials are impressive and reveal that compliancy is not a hobby for you like it is for others. Nobody can accumulate a history as impressive as yours without professional dedication. The last point, and the most important of the three, you seem honest about HIPAA compliance.

A Professional

It wasn’t lost on me that in your article you were professionally non-judgmental of the Rule. Instead of trying to justify a defenseless law, your job is to help dentists comply with the mandate as it is written or risk significant fines. Like tax-collecting, someone’s got to do the job of delivering bad news. You have a legitimate purpose to be involved in the dental industry, even if what you teach makes little difference at all if a dentist’s records are breached. I argue that following the inevitable bankruptcy from a breach, HHS fines are hardly a deterrent. And that is the issue: eDRs containing patient identifiers are too risky for the marketplace.

Electronic Dental Records

I think you would have to agree that eDRs are going nowhere until records are safe, and encryption is not going to be sufficient to protect dentists against dishonest employees. Ambitious bureaucrats in waiting, such as HIPAA consultants Travis Criswell, Sharalyn Fichtl, Kelly Mclendon and Olivia Wann – not a dentist among them – hooked their careers to the HIPAA mandate to avoid the tough sales jobs competition otherwise demands in the free market. All four share an authoritarian misconception that since it is the law, dentists will be forced to purchase their products – even if they are utterly senseless. I think we both know that they are oh so wrong. I promised earlier to give you an opportunity to publicly support truth in eDRs if you so choose. Perhaps we could rationally discuss in front of everyone how dentists can wriggle free of the approaching mess. There is no pressure here, other than this is public invitation. Since you haven’t made unrealistic claims about eDRs like others have, I am not interested in hounding you further. I simply ask you to consider responding to the article I posted in your name on PennWell titled “Dr. Donald Cohen’s opportunity.”

http://community.pennwelldentalgroup.com/forum/topics/dr-donald-cohens-opportunity

Assessment

I sincerely appreciate the respect you have shown me, and I pledge to afford you the same. Of all the consultants I have approached with my concerns about HIPAA and eDRs, you are the first to even acknowledge a problem simply by posting my concerns. I think you have the courage to face the realities of the marketplace, while others foolishly think dentists are a captive market.

Note: I submitted this to be posted following an August 28^th press release posted by HIPAA consultant Dr. Donald Cohen titled, “Dentists Should Know about New HIPAA Rules.”

http://www.dentalblogs.com/archives/administrator/dentists-should-know-about-new-hipaa-rules/comment-page-1/#comment-35672

If you are interested in discussing the topics of interoperability with fax machines, de-identified eDRs and security that surpasses paper records, in front of you is the opportunity to address your largest audience yet, Dr. Cohen. I’m self-syndicated.

Note: Do you realize that if Dr. Cohen takes me up on the offer, this will be the first time two dentists have openly discussed eDRs on the Internet? Do you think it’s about time?

Conclusion

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Filed under: Information Technology, Practice Management, Pruitt's Platform, Quality Initiatives | Tagged: ADA, American Dental Association, Darrell Pruitt, DDS, dental records, DMD, doctoroogle.com, Dr. Donald Cohen, eDRs, EHRs, ePRs, health information technology, HHS, HIPAA, HIT, IT, kelly McLendon, medical records, Olivia Wann, PennWell, Sharalyn Fichtl, Travis Criswell | 11 Comments »

Take the DME Inventory Switching Challenge!

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

Calling all Administrators and Management Consultants – Are You CMP™ Worthy?

[By Staff Reporters]

The new administrator for the ABC Medical Clinic understood that all inventory costing methods were acceptable to use in his Durable Medical Equipment [DME] department. LIFO, FIFO, specific identification, and the average cost method are all attractive methods under different circumstances in the business cycle, and companies may use the method that best fits their circumstances.

www.CertifiedMedicalPlanner.org

Reducing Taxes

For example, if ABC wished to reduce corporate income taxes in a period of inflation and rising prices, it would use LIFO. If matching DME sales revenue with the current cost of DME goods sold was desired, LIFO would also be used. Unfortunately, LIFO may charge against DME revenue the cost of DME not actually sold, and LIFO may allow the ABC Medical Clinic to manipulate net income by varying the time-periods it makes additional DME purchases. On the other hand, FIFO and specific identification method allows a more precise matching of ABC revenue with historic DME costs. However, FIFO too, can promote “paperless-phantom profits,” while specific identification can promote possible income manipulation. It is only under FIFO that net income manipulation is not possible.

CEO – 2 – CFO [Case Model]

“Let’s go with FIFO,” the new administrator said to his Chief Financial Officer, Bert. “The profits will make us look good to the home office and we can always switch back to LIFO if inflation starts back-up again, right Bert?” He mused, but he was not amused because freedom of choice does not include changing DME inventory methods every few years, especially if only to report higher income. “The switching of methods violates the basic tenet of consistency, which requires the use of the same inventory cost and accounting methods in preparing financial reports and statements,” Bert emphatically stated.

Key Issues

1) Is this sort of inventory costing and maneuvering permissible?

2) What is its justification?

3) How is it notated in financial reports?

4) Is this sort of thing ethical?

Assessment

“The switching of methods violates the basic tenet of consistency, which requires the use of the same inventory cost and accounting methods in preparing financial reports and statements,” Bert emphatically stated.

Conclusion

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Filed under: "Advisors Only", "Ask-an-Advisor", Accounting, CMP Program, Ethics, Practice Management, Taxation | Tagged: cost accounting, costing methods, DME, durable medical equipment, FIFO, inventory costing methods, inventory management, LIFO, specific identification | 7 Comments »

Improving Patient Control of eHRs

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

Traditional Command-Control Option Dying Out … Slowly!

[By Staff Reporters]

NewYork-Presbyterian Hospital recently introduced a new personal electronic health record [eHR] enabling patients to access medical information wherever and whenever they need it. Called myNYP.org, the system uses Microsoft’s HealthVault and Amalga technologies to offer patients the ability to select and store personal medical information generated during visits to NewYork-Presbyterian.

About NewYork-Presbyterian

NewYork-Presbyterian Hospital is one of the most comprehensive university hospitals in the world, with leading specialists in every field of medicine. The hospital is composed of two renowned medical centers, NewYork-Presbyterian Hospital/Columbia University Medical Center and NewYork-Presbyterian Hospital/Weill Cornell Medical Center, It is affiliated with two Ivy League medical institutions, Columbia University College of Physicians and Surgeons and Weill Cornell Medical College.

Assessment

MyNYP.org uses a “pull model” in which patients proactively opt to copy their medical data into their own personal health record and access that information using a secure username and password with any Web-enabled device. And yes, online bill pay features are available.

Conclusion

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

Filed under: Breaking News, Information Technology, Research & Development | Tagged: amalga, Columbia University Medical Center, eHR, electronic health record, electronic medical records, eMR, ePHR, healthvault, microsoft, myNYP.org, NewYork-Presbyterian Hospital, Weill Cornell Medical Center | 4 Comments »

Off-Road Touring with Dr. Marcinko [Part VIII]

Posted on September 8, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Interview with David B. Lumsden; MD

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Dateline: Baltimore Maryland, August 10, 2009.

About David B. Lumsden MD

Dr. David Lumsden; MS, MA practices general orthopedic surgery and trauma as a board certified surgeon and partner with Orthopedic and Hand Surgery Associates in Baltimore, Maryland. He completed his training in community health at Towson State University, earned Master’s Degree in Anatomy / Neuroanatomy at University of Maryland/Baltimore and Exercise Physiology at University of Maryland, College Park. He is a graduate of Penn State University School of Medicine. Dr. Lumsden completed his internship and residency at Union Memorial Hospital with associative residency training at Johns Hopkins and the world renowned Shock Trauma Center at the University of Maryland, Baltimore City.

Our Brief Interview

When I caught up with David during a recent house-call visit, we discussed many things; especially the American Affordable Health Choices Act [HR-3200]. Unfortunately; I did not have my audio-recorder with me. So, here are a few points of interest about him that I jotted down, from memory, in my ever-present reporter’s notebook. No doubt, I missed many more:

He became a physician as a career change in mid-life.
He has read HR 3200 in its’ entirety.
He hired an attorney for HR 3200 interpretation and review.
He is for healthcare reform, but against HR 3200.
He is against a public health care plan.
He is against individual insurance mandates.
He does 10-12 house-calls every month.
He does not charge MC, MD or VA house-call patients; rarely bills them and/or accepts assignment without balance billing.
He regularly operates on same, under similar terms.
He does other pro-bono work.
He practices defensive medicine.
He is for tort reform.
He is not a member of the AMA with no plans to join.

Assessment

Review and vote for -or- against HR 3200 here: http://www.opencongress.org/bill/111-h3200/text

About Off Road with Dr. Marcinko

These sporadic off-road segments will continue through-out my 2009 summer promotional tour. Formal attendance increased toward the later part of the summer as the Obama Administration’s healthcare debates heated up. Our many local book stores and sponsors noted a spike in our CD and book sales, as well as interest in our online www.CertifiedMedicalPlanner.com program and premier quarterly guide: Healthcare Organizations [Journal of Financial Management Strategies] www.HealthcareFinancials.com

Part VII: https://healthcarefinancials.wordpress.com/2009/09/01/off-road-touring-with-dr-marcinko-part-vii/

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Sponsors Welcomed

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Filed under: Ethics, Health Insurance, Health Law & Policy, Sponsors, Touring with Marcinko | Tagged: American Affordable Health Choices Act, David Lumsden, david marcinko, healthcare reform, HR 3200, Obama care | 2 Comments »

How Proprietary HIT Vendors May Demolish Health Reform

Posted on September 8, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Top Five Issues from the Longman Report

By Staff Reporters

Here are the top five quotes from the Longman Report. The author, Phillip Longman, is a senior fellow at the New America Foundation and the author of: “Best Care Anywhere: Why VA Health Care Is Better than Yours as well as The Next Progressive Era: A Blueprint for Broad Prosperity.

http://www.newamerica.net/people/phillip_longman

The List

1. Twenty years after the digital revolution, only an astonishing 1.5 percent of hospitals have integrated information technology systems. Almost all experts agree that in order to begin to deal with the problems of the health care system, this has to change.

2. Done right, digitized health care could help save the nation from insolvency while improving and extending millions of lives at the same time. Done wrong, it could reconfirm Americans’ deepest suspicions of government and set back the cause of health care reform for yet another generation.

3. Thanks to the stimulus bill, $20 billion is about to be poured into buggy, expensive, proprietary software that will not bring the benefits the Obama administration hopes for. Rather, it will amount to a giant bailout of a health IT industry whose business model has never really worked.

4. The VA’s open-source software allowed a nurse in Topeka, Kansas, to adapt for her own work a bar-code scanner she saw used at a rental-car agency. Her innovation cut the number of medication-dispensing errors in half at some facilities, and saved thousands of lives.

5. While a few large institutions have managed to make meaningful use of proprietary health IT, these systems have just as often been expensive failures. In 2003, Cedars-Sinai Medical Center in Los Angeles tore out a “state-of-the-art” $34 million proprietary system after doctors rebelled and refused to use it.

Assessment

http://www.newamerica.net/publications/articles/2004/the_best_care_anywhere

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Filed under: Breaking News, Information Technology, Military Medicine, Practice Management, Research & Development | Tagged: digital medical records, EHRs, EMRs, health information technology, HIT, New America Foundation, Obama Administration, Philip Longman, VA, www.healthdictionaryseries.com | Leave a comment »

Take the Hospital eHR Implementation Challenge!

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

Illustrative Case Model – Are You CMP™ Worthy?

By Staff Reporters

The fictitional Washington Hospital is embroiled in the healthcare reform debate and interested in implementing an electronic health record (EHR) for its major clinic areas. The flagship hospital currently utilizes a legacy-based system and several of the clinics have independently purchased software programs to provide a more inclusive electronic data base particular to that clinic.

Scenario

In addition, each of the software programs purchased in specific clinics has been modified to serve their own needs. The other satellite hospitals and clinics are not linked to the flagship hospital and have independent systems, applications and software in place. The hospital is interested in obtaining one EHR system that can be used in a standardized and uniform methodology and process throughout all of its hospitals and clinics.

Key Issues

Should the Washington Hospital?

1) Abandon the clinic’s software programs in lieu of a more centralized EHR?

2) Assess various EHR systems for healthcare providers available in the marketplace, comparing a series of hospital and clinic developed requirements against vendor capabilities?

3) Obtain an EHR product that provides interface to the existing clinic software products?

4) Assess whether the EHR vendors totally comply with HIPAA and privacy regulations as well as update their systems automatically with HIPAA changes?

5) Have the vendors assess the existing system/applications/software programs currently in use at each of the hospitals and clinics and determine the best application configuration?

6) Utilize the internal Information Technology staff to develop an interface solution?

Assessment

Medical management consultants, are you up to answering this challenge? We dare you to respond! Visit: www.CertifiedMedicalPlanner.com

Conclusion

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Filed under: "Ask-an-Advisor", CMP Program, Information Technology, Practice Management | Tagged: EHRs, EMRs, health information technology, healthcare reform, HIPAA, HIT, Obama Administration | 1 Comment »

On Regional Extension Centers [RECs]

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

Another New Governmental Machination?

[By Staff Reporters]

A Regional (health information) Extension Center [REC] is similar to a Health Information Organization [HIO] that brings together healthcare stakeholders within a defined geographic area and governs Health Information Exchange [HIE] among them for the purpose of improving health and care in that community.

Fundamental to this definition is the meaning of Health Information Exchange and Health Information Organization. A Health Information Organization (HIO) is an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards.

Thus, the goal of an REC is to act as a local support organization to help doctors install electronic health records and use them to achieve improved quality, efficiency, and continuity of care.

Past and Present

The RECs are based on the example of agricultural extension offices, established over 100 years ago by Congress, which offered rural outreach and educational services across the country.

Today, the HITECH Act amends Title XXX of the Public Health Service Act by adding Section 3012, Health Information Technology Implementation Assistance. This section provides supportive services for the rest of the HITECH Act. Section 3012 (a) establishes the Health Information Technology Extension Program (Extension Program). The Extension Program provides grants for the establishment of Health Information Technology

Assessment

Link: Regional Extension Center

Link: http://www.chhs.ca.gov/initiatives/HealthInfoEx/Documents/SUMMIT%20DOCUMENTS/RECSummitSlides_FinalDraft-7-15.pdf

Link: HIT Extension Program – Regional Centers Cooperative Agreement Program

Conclusion

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

Filed under: Breaking News, Career Development, Health Economics, Information Technology | Tagged: health information exchange, Health Information Organization, health information technology, Health Information Technology Extension Program, HIE, HIO, HIT, HITECH Act, HR 3200, Information Technology, Public Health Service Act, REC, Regional Extension Center, RHIO, Title XXX | 2 Comments »

VOTE: Poll on Rule 206(4) of the IAA of 1940?

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

Please Vote

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Sponsors Welcomed

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Filed under: "Advisors Only", "Ask-an-Advisor", Career Development, Ethics, Financial Planning, Investing, Professional Liability, Surveys and Voting | Tagged: 206(4) Investment Advisers Act 1940?, CFP, financial advisors, financial planners, IA, investment advisors, RIA, SEC, stock-brokers | Leave a comment »

E. A. Poe and Touring with Dr. Marcinko [Part VII]

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

Edgar Allan Poe, Church Hospital, Johns Hopkins and Me

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Dateline: Baltimore Maryland, August 7, 2009

To the entire world, Church Home and Hospital, formerly known as the Washington Medical College, was where Edgar Allan Poe died on October 7, 1849. Located in Upper Fell’s Point, it was also where many doctors were trained who served in the Union and Confederate armies during the Civil War. But for me, its emergency room seemed like home, as a local inner city youth, back-in-the-day.

Link: http://www.eapoe.org/balt/poechh.htm

About Fells Point

Fell’s Point is an historic waterfront community just east of Baltimore’s Inner Harbor. The Fells Point Historic District occupies the area from Gough Street south to the water’s edge, roughly between Caroline and Chester Streets. Established in 1763, Fells Point is a city, state and National Historic District and boasts over 161 buildings on the National Register, along with the oldest standing residence in Baltimore City, the Robert Long House at 812 S. Ann Street. The neighborhood is home to dozens of unique retail shops, restaurants and pubs; along with our community Church Home and Hospital; and its more famous behemoth neighbor up the street, Johns Hopkins University Hospital and Medical School.

Link: http://www.fellspoint.us/

It was as a freshman medical student, visiting “the Johns”, where I first met J. Alex Haller Jr. MD – the world famous Children’s-Surgeon-in-Charge of Johns Hopkins Hospital, and pectus excavatum surgical pioneer, from 1964 until 1997. As well as pediatric heart surgeon Helen Brooke Taussig MD (1898 – 1986), developer of a famous operation to alleviate “blue baby” syndrome, and who first warned the public on the dangers of thalidomide. JHU is also where I played stick-ball as a kid, in the hospital parking lot. But, I digress.

Link: http://www.msa.md.gov/msa/educ/exhibits/womenshall/html/taussig.html

Church Home and Hospital and Me

My first visit to the Church Home Hospital ER was to repair a forehead laceration which was sustained after a fall onto one of Baltimore’s famous brick steps.

The second was to re-attach my right hallux [big toe] after almost completely severing it on a piece of glass [broken beer bottle].

My final visit was to repair a thigh laceration. Of course, my younger brother made two subsequent visits, over the years, as well. On all occasions we were sutured and repaired by Raymond Atkins MD; following his career as a junior and senior attending resident, fellow and well into private practice. In a time before eMRs; Dr. Ray would later tell us that just hearing the name “Marcinko” was enough medical history for him to commence his trip to the ER. God bless you Dr. Atkins and Church Home and Hospital.

Assessment

As a student of the city, I knew of Church Home Hospital and Edgar Allan Poe before ever learning of Haller, Taussig or Atkins. But, they all made impressions on me, in one way or another. I just had to revisit the sites and them, if only in memory

About Off Road with Dr. Marcinko

These sporadic off-road segments will continue through-out my 2009 summer promotional tour. On the one hand, formal attendance at several engagements was a bit sparse because of the death of several recent celebrities and entertainer types.

On the other hand, local book stores and sponsors noted a spike in our book sales, as well as interest in our online www.CertifiedMedicalPlanner.org program.

Part VI: https://healthcarefinancials.wordpress.com/2009/08/27/off-road-touring-with-dr-marcinko-part-vi/

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think about this trip down memory lane? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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***

Filed under: Touring with Marcinko | Tagged: "blue baby" syndrome, Church Home Hospital, Edgar Allan Poe, Fell's Point, hallux, Helen Brooke Taussig MD, J. Alex Haller Jr, Johns Hopkins, pectus excavatum, Robert Long House, thalidomide. | 6 Comments »

Events Planner: September 2009

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

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Events-Planner: SEPTEMBER 2009

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 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

Sept 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:

Sept 11: New England Healthcare Association Conference, Boston, MA.

Sept 13: Medicare and Medicaid AHIP Conference, Washington, DC.

Sept 13: Schwab Impact, Convention Center, San Diego, CA

Sept 14: Medicare RAC Summit, Washington, DC.

Sept 15: DOL Employees Benefits Conference, Washington, DC

Sept 18: Healthcare Compliance Association Conference, Minneapolis, MN.

Sept 21: Healthcare Financial Management Conference, Chicago, Ill

Sept 21: GIPPS Interactive Workshop, CFA Institute, Boston, MA

Sept 22: Health Plan Innovation Conference, Chicago, Ill.

Sept 24: Executive Forum Public-Private Employer Partnerships, Atlanta.

Sept 25: Family Office Symposium, FINRA, Aventura, FL

Sept 30: Consumer Health Management Conference, Alexandria, VA.

Conclusion

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Guest ME-P Bloggers Welcome

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

Join Us!

By Ann Miller; RN, MHA

[Executive Director]

Perhaps you have a great idea for a short article to promote the integration of personal financial planning and medical practice management, including expert posts, humorous stories or interesting news; but don’t want to maintain a blog? We have more than 50 topic channels to consider.

Contact me at MarcinkoAdvisors@msn.com and be a guest blogger!

Conclusion

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

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Filed under: "Advisors Only", "Doctors Only", Career Development, Op-Editorials | Tagged: bloggers, CFA, CFP, CMA, CMP, DDS, experts, financial blogers, MBA, MD, medical bloggers, PhD | Leave a comment »

Tightening Payment Rules for Non-Physicians

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

Understanding the Medicare “Incident To” Rules

By Staff Reporters

Under the “incident to” rules, Medicare Part B pays for some services that are billed by physicians, but performed by non-physicians. And, the Department of Health and Human Services [DHHS] and Office of Inspector General [OIG] says that some of these services might be used improperly.

Suggestions to CMS

The agency recommends the Centers for Medicare & Medicaid Services [CMS] perform the following:

Revise the “incident to” rule to require that physicians who bill Medicare, but don’t perform the services themselves, ensure that the services are provided by a licensed physician, or a non-physician with the necessary training, certification or licensure.
Require that physicians who use non-physician services identify this with a service code modifier on bills.
Take appropriate action to detect when physicians bill for “incident to” services that are not covered under the rule.

Assessment

In the current healthcare reform environment, Medicare services by non-physicians are coming under increased scrutiny. And, the OIG is finding that the “incident to” rule is allowing medical care to be provided by non-physicians who may lack the necessary qualifications. This may be a healthcare financial, insurance and quality breach. So, don’t let this trap “bite” you.

Source: HHS Office of Inspector General (www.oig.hhs.gov/oei/reports/oei-09-06-00430.pdf)

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Has anyone been bitten by the ‘incident to” rules? Tell us what you think. 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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Sponsors Welcomed

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

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

Filed under: Health Insurance, Health Law & Policy, Healthcare Finance, Research & Development | Tagged: "incident to" rules, Centers for Medicare & Medicaid Services, CMS, Department of Health and Human Services, DHHS, HHS, medicare, Medicare Part B, non-physician providers, Office of Inspector General, OIG | Leave a comment »

Tell Us about Yourself – Reader Survey

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

Understanding our Readers and Subscribers

By Ann Miller; RN, MHA

[Executive Director]

Greetings!

www.HealthcareFinancials.com

Healthcare Financials [Journal of Financial Management Strategies], our 1,250 page premium institutional subscription publication, and this complimentary companion personal blog, work hard to make our content relevant for you.

Two Minute Autobiography

And so, can you give us just 2 minutes of your time to tell us a little about yourself in prose form? Your responses can be named or anonymous. And, your participation will help us tailor future issues of this growing blog and communications forum.

Assessment

Your feedback is valuable and much appreciated! Write me and tell us what you think. Thank you!

MarcinkoAdvisors@msn.com

Conclusion

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

Subscribe Now: 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

Filed under: Alerts Sign-Up, Quality Initiatives, Surveys and Voting | Tagged: ann miller, david marcinko, Financial Planning, Health Economics, Healthcare Finance, healthcare financials, hope hetico, medical executive post, www.healthcarefinancials.com | Leave a comment »

Your Chance to be Heard on the ME-P

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

What Gripes You?

By Ann Miller; RN, MHA

[Executive Director]

The Medical Executive-Post is among the web’s most influential and well-read health economics and financial blogs, with more than 100,000 subscribers. But, we refrain from Twitter triteness on our more than 50 topic channels with deep experienced gravitas.

Reach our Audience and be Heard

You can have the opportunity to reach this target audience by submitting a guest opinion piece or post on anything related to health care economics, medical practice management and physician focused financial planning. Articles of about 500 words in length, free of grammatical and spelling errors are preferred. Accepted pieces will not only be published on the blog, but may be syndicated on affiliated networks, as well as an e-newsletter distributed to thousands.

Professional Organization Members

Members of professional organizations, such as the American Medical and Dental Association, and the Financial Planning Association, already contribute as individual readers and subscribers. Other writers refuse to join these organizations for various reasons. They too are welcomed. There is also an opportunity to become a regular contributor to the blog if several, quality, guest posts have been accepted and published.

Assessment

Articles for consideration can be e-mailed directly to me.

MarcinkoAdvisors@msn.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. 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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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

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

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

Filed under: Alerts Sign-Up, CMP Program, Experts Invited, iMBA, Inc., Op-Editorials | Tagged: ADA, AMA, APMA, CFP, CMP www.CertifiedMedicalPlanner.com, CPA, DDS, DO, DPM, financial advisors, financial planners, health care economcis, Health Insurance, Healthcare Finance, iMBA, Inc., MD, medical pratice management, twitter, wealth managers | Leave a comment »

On PHI Security Breaches

Posted on August 28, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

New HHS Regulations

[By Staff Reporters]

Effective September 23, 2009, new regulations issued by the U.S. Department of Health and Human Services (“HHS”) will require covered entities to notify affected individuals and HHS following the discovery of a breach of patient information. These regulations are more expansive than other notification laws that may already exist. Under these new regulations, covered entities must analyze every privacy and/or security incident to determine whether a notification requirement exists and then satisfy detailed notice requirements.

Breach Defined

According to Garfunkel, Wild and Travis PC, a “breach” may be defined as the unauthorized acquisition, access, use or disclosure of unsecured Protected Health Information (“PHI”) which compromises the security or privacy of the PHI. It is important to note that this definition of breach is broader than most state notification laws under which most covered entities have already been operating for a number of years. While state notification laws may only require notification when there is an unauthorized disclosure of social security numbers or other specific kinds of personal information, under these new Federal regulations, unauthorized access, acquisition, use or disclosure of any PHI, not just social security number, is a potential breach. Furthermore; unauthorized uses of PHI, not just access or disclosure, requires notification.

Assessment

For more info: http://www.gwtlaw.com

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: Glossary Terms, Health Law & Policy, Information Technology | Tagged: Department of Health and Human Services, EHRs, EMRs, Garfunkel, HHS, HIPAA, PHI, security breach, Wild and Travis, www.healthdictionaryseries.com | 3 Comments »

Let’s Think about Vitality GlowCaps for a Moment

Posted on August 28, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Lights, Ring Tones and E-mails – Oh My!

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

Vitality Inc, is a new firm that reports to address the billion-dollar adherence problem for pharmaceutical brands, retail pharmacies, and healthcare providers with a simple device — an Internet-connected pill cap.

What it Is

Vitality GlowCaps illuminate, play a melody, and even ring a home phone so patients don’t forget to take their pills. They can send weekly emails to remote caregivers, create accountability with doctors through an adherence report, and automatically refill prescriptions. Vitality reports to improve medication adherence, health, and peace of mind.

Video: http://rxvitality.com/glowcaps.html

Name Droppers

According to its website, Vitality is currently working with researchers at Harvard Medical School and the Center for Connected Health on a study to measure the impact of the GlowCaps CONNECT system.

Vitality is the only company with a product designed to tackle the combination of factors that conspire to cause non-adherent behavior.

Overkill

Our society is now at the point of paying obese patients to diet and exercise [they don’t seem to recognize the benefit], paying public school children to study [they don’t seem to recognize the benefit], and now using internet enabled technology to help patients remember to take their own medication [they don’t seem to … yada, yada, yada].

A Reasonable Query?

But, may one reasonably ask; is this admittedly “very cool” technology overkill? THINK: RFID tags for wrong extremity surgery; when common sense and a magic marker might do just as well? Sure, there may be some modicum of benefit here for elderly patients and select other reasons. But, does the marginal cost outweigh the marginal benefit? Or, is this technology really a solution in search of an exaggerated “problem” that just may involve slack personal responsibility? And, most importantly, who will pay for it?

Assessment

Vitality Inc, leverages deep expertise in customer research, wireless consumer electronics, web services and behavioral psychology. Vitality’s patent pending solution is said offer each patient the optimal mix of intervention, feedback, reminders, accountability, education and incentives to improve their ongoing medication adherence. But, does it really improve health, and at what cost? Can’t we solve the “problem” of pill non-compliance cheaper and easier?

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Tell us what you think. Any early adopters out there, and ready to opine? Or, give em’ a click and tell us what you think! http://rxvitality.com 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

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Filed under: Drugs and Pharma, Ethics, Information Technology, Op-Editorials, Videos | 3 Comments »

HALLOWEEN: Nathaniel Potter MD & Touring with Dr. Marcinko [Part VI]

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

About Nathaniel Potter, MD

By Dr. David Edward Marcinko; MBA, CMP™
[Publisher-in-Chief]
Dateline: Baltimore Maryland

While in Washington DC on the second portion of our recent ME-P book “signing and opining” tour, I had the good fortune to visit the gravesite of the noted physician Nathaniel Potter, MD. Dr. Potter was born in Carolina county Maryland in 1770 and died in Baltimore on 2 January, 1843. He graduated from the University of Pennsylvania in 1796, and settled in Baltimore, where he practiced medicine until his death. In 1807, he associated with Dr. John B. Davidge in founding the University of Maryland, School of Medicine where he ultimately served as professor and dean. He died penniless.

THINK Potter’s field!

About Green Mount Cemetery

Green Mount Cemetery is located in Baltimore, MD. Established in 1839, it is noted for the large number of historical figures that have been interred in its grounds as well as a large number of prominent Baltimore-area families. It retained the name Green Mount when the land was purchased from the heirs of Baltimore merchant Robert Oliver. Green Mount is also a treasury of precious works of art, including striking works by major sculptors like William Rinehart and Hans Schuler. The cemetery was listed in the National Register of Historic Places in 1980.

Assessment

In as much as Dr. Potter was a well know figure to me, I was most pleased at the impromptu visit to his grave. You see, although I attended Temple University because of my future specialty, my first medical school choice would have been at University of Maryland if post-graduate education opportunities had been different at the time. And, I passed the medical school, and the imposing Greek themed Davidge Hall Dome, daily for four years as I rode the number 8 public transportation bus to my undergraduate studies at nearby Loyola University, in Townson Maryland. Of course, the fact that Potter was educated at the University of Pennsylvania School of Medicine, the first in the nation, did not elude me when I worked in its ER as a young medical student in Philadelphia, back in-the-day. University of Maryland was the fifth such medical school in the country.

About Off Road with Dr. Marcinko

These sporadic off-road segments will continue through-out my summer promotional tour. Attendance at several formal and informal engagements increased since the early summer. The previously noted sales spike for our texts, handbooks and dictionaries; as well as interest in our online www.CertifiedMedicalPlanner.org program.

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

***

Filed under: CMP Program, Glossary Terms, iMBA, Inc., Media Mentions and PR, Op-Editorials, Sponsors, Touring with Marcinko | Tagged: david marcinko, Dr. John B. Davidge, ER, Green Mount Cemetery, Hans Schuler, Loyola University, medical school, Nathaniel Potter MD, Robert Oliver, University of Maryland Medical school, University of Pennsylvania Medical School, William Rinehart | Leave a comment »

About HealthDataRights.org

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

Mitigating the Unintended Consequences of HIPAA

By Staff Reporters

Many patients and pundits opine how today’s HIPAA regulations [written in the relative paper based stone age] say that while doctors must provide a copy of your records, they can take a month to do so. And, if they want, they can say that’s not enough and take another month. However, when a patient needs medical care; that time-line is not acceptable.

Enter a Website and Start a Movement

According to the website www.HealthDataRights.org, in an era when technology allows personal health information to be more easily stored, updated, accessed and exchanged, the following rights should be self-evident and inalienable. We the people:

Have the right to our own health data.
Have the right to know the source of each health data element.
Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; if data exist in computable form, they must be made available in that form.
Have the right to share our health data with others as we see fit.

Assessment

These principles express basic human rights as well as essential elements of health care that is participatory, Health 2.0 appropriate and in the interests of each patient. No law or policy should abridge these rights.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Visit the site, join the movement by signing their petition, and tell us what you think. 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

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

Sponsors Welcomed

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

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

Filed under: Ethics, Health Law & Policy, Information Technology | Tagged: EHRs, electronic medical records, EMRs, health data, health information technology, HIPAA, HIT, IT, www.HealthDataRights.org | Leave a comment »

Henry Louis Gehrig, eMRs and Healthcare Reform

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

What’s the “Iron Horse” Got to Do with Health IT?

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

According to UPI reports from Charlestown, WVa on August 24 2009, at least 1,200 veterans across the country were mistakenly told by the Veterans Administration [VA] that they suffered from a fatal neurological disorder.

Link: http://www.msnbc.msn.com/id/32541579/ns/health-health_care/

Panicked Veterans

One of the leaders of a Gulf War veterans group is reported to have said that panicked veterans from the states of Alabama, Florida, Kansas, North Carolina, West Virginia and Wyoming contacted the group about the error. Denise Nichols, the vice president of the National Gulf War Resource Center, reportedly blamed a “coding error” for the mistake. In medicine, we call this a “false positive.”

About Henry Louis “Lou” Gehrig

Henry Louis “Lou” Gehrig (June 19, 1903 – June 2, 1941), born Ludwig Heinrich Gehrig, was an American baseball player in the 1920s and 1930s; chiefly remembered for his prowess as a hitter, the longevity of his consecutive games played record and the pathos of his tearful farewell from baseball at age 36, when he was stricken with a fatal disease. Of course, Gehrig was known as the “The Iron Horse” for his durability. Yet, the irony is that Amyotrophic Lateral Sclerosis [ALS], or Lou Gehrig’s disease [sometimes also called Maladie de Charcot] is progressive and fatal. Lou died in 1941 after developing the illness. Will the same death-spiral happen to eHRs and Obama care?

Link: http://www.lougehrig.com

Assessment

Having rotated through the VA system as a young medical student back-in-the-day, I have never been a fan. It smacked of socialized medicine and government plutocracy, and was never a leading-edge example of domestic healthcare, in my informed opinion. Recent HIPAA administrative, security, IT and clinical medical errors are well known. So, to blame the mix-up on an insurance billing and “coding error” seems somewhat disingenuous. Especially now, at a time when eMRs and the Obama Administration’s healthcare reform itself is being vigorously debated by the citizenry. I mean, are there no human checks and balances? Would there be any human intervention if a public healthcare policy was adopted?

Of course, we have written about military medicine previously on this Medical Executive-Post, and devoted an entire channel to it. And, I do realize that more than fifty percent of us receive similar governmental care in some form, or another [Medicare, Medicaid, CHIPS, the Indian and Prison Healthcare Systems, etc].

Link: https://healthcarefinancials.wordpress.com/category/military-medicine/

Nevertheless, shall we give a new moniker to this mistake? How about “Lou Gehrig’s coding error”, and document it in our www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Is it even fair to relate this “isolated incident” to the current healthcare reform debate, the eMR conundrum and/or similar discussions on health Information Technology [IT]? Tell us what you think. 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

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

Sponsors Welcomed

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

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

Filed under: Breaking News, Ethics, Health Law & Policy, Information Technology, Military Medicine, Op-Editorials, Touring with Marcinko | Tagged: ALS, amyotrophic lateral sclerosis, CHIPS, CMS, david marcinko, Denise Nichols, EHRs, EMRs, health information technology, healthcare reform, HIPAA, Indian Health Service, Iron Horse, IT, Lou Gehrig, Medicaid, medicare, National Gulf War Resource Center, nationalized medicine, obama, Obama Health, Prison Health Service, public health plan, socialized medicine, VA, Veterans Administration | 1 Comment »

How to Reprint an ME-P Entry

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

Spreading ME-P Content and Expertise

By Ann Miller; RN, MHA

[Executive Director]

Our Offer

All ME-P material is owned and copyrighted © by the Institute of Medical Business Advisors, Inc www.MedicalBusinessAdvisors.com

But, ME-P professional content and educational online new-wave or traditional print-media are welcomed to reprint our posted articles and comments in their entirety [digitally or hard-copy]; without any edits or changes.

Correct Style

Please include the following credit style and format in your reprint: Reprinted with permission of the Medical Executive-Post at: www.HealthcareFinancials.wordpress.com © iMBA Inc, all rights reserved.

Courtesy Copy

A courtesy copy of the reprinted post, article, ezine or website URL is appreciated; along with a reciprocal blog role listing link, if possible. Contact me for additional details on rights and permissions: MarcinkoAdvisors@msn.com

Channel Surfing

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

Filed under: "Advisors Only", "Doctors Only", Alerts Sign-Up, Career Development, CMP Program, Ethics, Media Mentions and PR | Tagged: david marcinko, medical executive post, reprint, reprint requests, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.HealthcareFinancials.wordpress.com, www.medicalbusinessadvisors.com | Leave a comment »

Superannuation Demographics for Financial Advisors

Posted on August 25, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

www.CertifiedMedicalPlanner.org

“Live Long and Prosper”

By Dr. David Edward Marcinko; MBA, CMP™

By Thomas A. Muldowney; MSFS, CLU, CFP®, CMP™

By Hope Rachel Hetico; RN, MHA, CMP™

The words of Mr. Spock!

Recently, during my promotional speaking tour for the summer of 2009, I had the occasion to visit a few nursing and related homes for the elderly, sick, infirmed and aged. This harkened warm thoughts back to my time at Temple University in Philadelphia, PA as a young medical student. So, as a health economist and former certified financial planner, I recruited some folks and did some research on the domestic aging population to refresh my understanding of the facts and figures; especially in light of the current healthcare reform political debates [DEM].

Just the Facts

According to the U.S. Bureau of the Census, there were almost 49 million people in the United States who were over age 60 in 2001. There are approximately 4 million people over the age of 85 living in the US and there are over 60,000 people older than age 100 estimated as of July 1st 2004. For every100 middle aged persons in the United States there are at present about 114 persons over the age of 65. This statistic will change as we move forward through time. In the year 2025, there will be about 253 people over age 65 for every 100 middle-aged people.

Enter the Baby Boomers

Beginning on January 1, 2006 at midnight and every 12 seconds thereafter for fifteen years, a baby boomer will have a birthday and cross over the age threshold of age 60. In the next 30 years, the 60+ age group will more than double, becoming 25% of the total population, and will have to be supported by a proportionately smaller workforce. Research published in June 2005 by AARP (based on data from 2002) estimates that: ‘‘In 2002, roughly $140 billion was spent on nursing home and home health care, with 24% of these costs being paid out of pocket” (O’Brien and Elias, 2004).

Aging Boomers

As the baby boom generation ages, the care needs will expand precipitously. Add to this, scientific and technological improvements in healthcare. These very same people will need more expensive healthcare and more expensive custodial care, and they will need it for an even longer period of time. Who will pay for this expanded need is not so clear. What is clear is that it will take money and lots of it to make these payments.

Money Preservation Variables

There are only three variables associated with the accumulation or preservation of money: ‘‘time, money and rate of return.’’ Time is reduced to the following two questions ‘‘How long until I will need my money?’’ and ‘‘How long will I live?’’ an uncertainty to be sure. Rate of return is either a function of the financial markets or the successful maintenance of a Long Term Care Insurance [LTCI] plan. Because of the volatility in the financial markets, the ‘‘money’’ question is equally as uncertain. In order to accumulate sufficient assets; an aging physician must ’tradeoff’ many other alternatives such as ’lifestyle.’

Assessment

What is certain is this—financial planning is important. More important is the implementation.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Ethics, Financial Planning, Health Economics, Insurance Matters, Research & Development, Retirement and Benefits, Touring with Marcinko | Tagged: AARP, baby boomers, Bureau of the Census, CLU, custodial care, david marcinko, hope hetico, insurance, long term care insurance, LTCI, nursing homes, Thomas A. Muldowney | 2 Comments »

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