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DIRECT CONTRACTING
By Eric Bricker MD
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Filed under: "Doctors Only", Accounting, Career Development, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Interviews, Op-Editorials, Videos | Tagged: alternate networks, direct contracting, direct insurance contracting, direct medical contracting, Eric Bricker MD, Health Insurance | Leave a comment »
By Staff Reporters
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According to Morning Brew, the US banking system is about to speed up, potentially eliminating those frustrating waiting days it can take for money to hit your account. The Fed is launching its FedNow instant payment service later this month. The new system will enable banks to send each other cash instantly, 24/7, as an alternative to the existing system that runs only during regular business hours and often takes days to move money.
FedNow could put America’s banking system on track to catch up to countries like India and Nigeria, where high-speed payments are as common. The US does already have an instant payments system, but it’s private rather than government-backed, and it hasn’t been widely adopted. It’s mostly only used by big banks, and only 1.4% of US transactions happen in real time, according to payment systems company ACI Worldwide.
FedNow enabled services will soon likely appear at the 41 banks that have been certified to participate so far.
Some experts worry that allowing people to drain their bank accounts instantaneously could make SVB-style bank runs more likely. Smaller banks struggling with liquidity would have even less time to react to customer panic and get collateral for emergency government loans to cover fleeing cash.
But there are safeguards built in. FedNow has a transaction limit of $500,000, and banks can set their own ceilings to ensure that customers don’t pull their deposits.
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Filed under: "Ask-an-Advisor", Accounting, Breaking News, Experts Invited, Financial Planning, Insurance Matters, Investing, LifeStyle | Tagged: ACI worldwide, bank, bank run, fast bank payments, FDIC, fed, Federal Reserve, FedNow, FOMC, Morning Brew, SVB | Leave a comment »
By Staff Reporters
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Cash is king, especially in this tough interest rate environment. That’s proving true in the mergers and acquisitions market this year, according to PwC’s US Deals 2023 midyear outlook, which says companies and private equity with cash in hand are making deals happen. There are “opportunities for corporates with strong balance sheets. Private equity sponsors with large amounts of dry powder also have been getting deals done,” according to PwC.
CITE: https://www.r2library.com/Resource
Deal makers need cash because lending has become tougher and more expensive to obtain. Additionally, “the IPO market has remained quiet for over a year.”
Even the private equity market, which often leans heavily on debt financing, is reaching for other ways to get deals done: “Some PE sponsors have turned to more creative financing solutions, including higher equity contribution, seller’s notes, paid in-kind financing and the private credit markets.”
The challenging market is also impacting deal size. PwC found that deal makers are eschewing big deals in favor of smaller opportunities. However, although the deals appear to be smaller, the volume of M&A activity is “relatively strong compared to” COVID pre-pandemic levels.
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Filed under: "Ask-an-Advisor", Accounting, Experts Invited, Financial Planning, Funding Basics, Glossary Terms, Investing | Tagged: CASH, cash is king, debt financing, interest rates, IPO markets, IRS, king cash, M&A, mergers acquisitions, money, PE sponsors, PwC | Leave a comment »
Supplemental Security Income
By Staff Reporters
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Stocks popped 2% this week, as investors expect the Fed to soon pause or dial back interest rates after the release of the June inflation report. Central bankers have raised rates from zero to over 5% since March of last year, a move that led the S&P 500 to shed 20% in 2022.
And yet, No SSI for you!
DEFINITION: Supplemental Security Income (SSI) is a means-tested program that provides cash payments to disabled children, disabled adults, and individuals aged 65 or older who are citizens or nationals of the USA. SSI was created by the Social Security Amendments of 1972 and is incorporated in Title 16 of the Social Security Act The program is administered by the Social Security Administration (SSA) and began operations in 1974.
Individuals or their helpers may start the application for SSI benefits by completing a short form on SSA’s website. SSA staff will schedule an appointment for the individual or helper within 1–2 weeks and complete the process.
SSI was created to replace federal-state adult assistance programs that served the same purpose, but were administered by the state agencies and received criticism for lacking consistent eligibility criteria. The restructuring of these programs was intended to standardize the eligibility requirements and level of benefits. Although administered by SSA, SSI is funded from the U.S. Treasury general funds, not the SS Trust Fund. As of July 2022, the program provides benefits to approximately five million Americans.
CITE: https://www.r2library.com/Resource
The Social Security Administration gives, and the Social Security Administration takes away — at least when it comes to beneficiaries who qualify for Supplemental Security Income (SSI) payments.
July is one of the months when the agency doesn’t issue an SSI check. Because of a quirk in the payment schedule, SSI beneficiaries get two payments in March, June, September and December, while no payments are deposited in January, April, July and October.
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Filed under: "Ask-an-Advisor", Accounting, Ethics, Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc., Marketing & Advertising | Tagged: No July SSI checks, social security, SSA, ssi, SSI checks, Supplemental Security Income, US Treasury | Leave a comment »
By Ann Miller RN MHA CMP™
INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARY FROM iMBA, Inc.
An e-book is an electronic or digital book that can be read on a computer or a handheld device.
Our new e-books consists of text, images, and are fixed to a specific spot on the page.
And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.
You can then access the e-book and read it, or highlight pages and even take side notes.
With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!
Payable thru PayPal [3% courtesy surcharge applies].
MORE HERE: https://medicalexecutivepost.com/me-pr-a-new-feature/
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By Health Capital Consultants, LLC
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Projected National Health Expenditures to Surpass $7 Trillion
On June 14th, 2023, CMS released health insurance enrollment and national health expenditure (NHE) projections for 2022 through 2031.
CITE: https://www.r2library.com/Resource
The NHE, which is published annually, is the official U.S. estimate of insurance enrollment and health spending. CMS projects that from 2022 to 2031, the NHE’s annual growth rate of 5.4% will surpass the U.S. gross domestic product (GDP) annual growth rate of 4.6%. As a result, health spending as a share of the U.S. GDP is set to jump from 18.3% in 2021 to 19.6% in 2031.
This Health Capital Topics article will review the notable findings from CMS’s projection report. (Read more…)
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Filed under: "Advisors Only", Accounting, Drugs and Pharma, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Taxation | Tagged: CMS, GDP, Health Capital Consultants LLC, health expenditures, national health expenditures, NHE | Leave a comment »
By Staff Reporters
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Here is where the major benchmarks ended on Monday:
Financial companies had a good day Monday, with the KBW Regional Banking Index (KRX) rising more than 2%.
The consumer discretionary sector was also strong, while energy companies got a bump as crude oil futures reached their highest level in more than a week.
Health Care stocks lagged.
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Wall Street is hoping for a strong start to the second half of 2023 taking cues from the recent tech rally that has boosted the overall investor sentiment. Turning toward the U.S.-China trade war, on Monday, the mainland posed restrictions on the export of gallium and germanium to the U.S. citing national security concerns. These metals are used in semiconductor manufacturing and the curb is being used as a means of retaliation to the U.S. chip ban on China.
Remarkably, Tesla (NASDAQ:TSLA) stock has been on an uphill climb lately, thanks to the growing adoption of its North American Charging Standard (NACS) charging connectors by major automakers including General Motors (NYSE:GM), Ford (NYSE:F), and Rivian (NASDAQ:RIVN). Moreover, the EV maker posted better-than-expected auto delivery and production numbers for the month and quarter ending June 30, pushing shares up 6.9% on July 3.
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Median incomes are projected to drop over the next few decades, falling by 0.43 percentage points per year between now and 2020, 0.52 points per year between 2020 and 2030, and 0.2 points per year between 2030 and 2040.
Although the figures on their own are not staggering, the percentage drops over time will add up significantly. By 2050, an employee who earned $50,000 in 2013 will only make $44,000. The number is even more noticeable after accounting for inflation.
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Filed under: "Ask-an-Advisor", Accounting, Alerts Sign-Up, Events-Planner, Financial Planning, Funding Basics, Investing, LifeStyle | Tagged: Accounting, CBOE, DJIA, DOW, future salaries, futures, inflation, KBW, NASDAQ, oil, S&P 500, salaries, Tesla, Treasury yields, Volatility Index | Leave a comment »
By Staff Reporters
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Wall Street’s major averages yesterday, on Wednesday, ended lower for a third straight session, weighed down by losses in growth stocks. And, sentiment was dampened by Federal Reserve Chair Jerome Powell’s largely hawkish reiteration that more rate hikes were likely.
Powell in his published opening remarks to his two-day testimony to Congress said that nearly all policymakers expect that interest rates would have to be raised further by the end of the year. The Fed chief then, in responses to questions from lawmakers, said that it may “make sense” for the central bank to raise rates at a “more moderate pace” going forward.
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So, here is where the major benchmarks ended:
Technology shares were among the weakest performers Wednesday, with the Philadelphia Semiconductor Index (SOX) dropping nearly 2% to near a two-week low. Regional banks were also lower.
Energy stocks led sector gainers as crude oil futures jumped nearly 2% to a two-week high on hopes for stronger demand from China. Volatility based on the VIX sank to its lowest level since January 2020.
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Filed under: "Ask-an-Advisor", Accounting, Breaking News, Experts Invited, Financial Planning, Investing, Op-Editorials | Tagged: CBOE, CBOE Volatility Index, central bank, DJIA, DOW, energy, fed, Federal Reserve, FOMC, Jerome Powell, NASDAQ, SOX, Treasury Yield, VIX | Leave a comment »
By Health Capital Consultants, LLC
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Valuation of MA Plans: Regulatory Environment
Healthcare provider organizations, including Medicare Advantage organizations (MAOs), face a range of federal and state legal and regulatory constraints, which affect their formation, operation, procedural coding and billing, and transactions.
CITE: https://www.r2library.com/Resource
This final installment of the three-part series on the valuation of Medicare Advantage (MA) plans will review the regulatory environment in which these plans operate. (Read more…)
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Filed under: "Doctors Only", Accounting, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Investing, Practice Management, Professional Liability | Tagged: Health Capital Consultants LLC, medicare, Medicare Advantage, Medicare C, Medicare Part C, Part C, Valuation Medicare Advantage Plans, Valuation Part C | Leave a comment »
By Health Capital Consultants, LLC
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On April 26, 2023, the California-based healthcare giant Kaiser Permanente announced a $5 billion “mega deal” to acquire Pennsylvania health system Geisinger Health. Kaiser also announced the formation of a new nonprofit health system, to be called Risant Health. Geisinger Health will be the first health system under the umbrella of Risant Health, although Kaiser aims to add approximately five more systems to the entity.
CITE: https://www.r2library.com/Resource
This Health Capital Topics article will review this mega deal and discuss what this transaction may mean for hospitals and health systems. (Read more…)
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Filed under: "Doctors Only", Accounting, Breaking News, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Investing, Managed Care, Op-Editorials | Tagged: Geisinger, Geisinger Health, Health Capital Consultants LLC, Kaiser, KaiserPermanente, Kaises Acquires Geisinger, KP | Leave a comment »
By Health Capital Consultants, LLC
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Congress Mulling Medicare Site-Neutral Payment Policy
Congress is actively considering several bills related to site-neutral payment that has hospitals across the U.S. significantly concerned. The proposed legislation would lower the price that Medicare pays hospitals for common outpatient services, such as x-rays and general checkups, and match what it pays outpatient facilities such as physician offices. Facilities that are owned by hospitals (known as hospital outpatient departments, or HOPDs) earn more than twice what an independent outpatient facility earns for providing the same services.
CITE: https://www.r2library.com/Resource
This Health Capital Topics article will review the changes that are being considered by Congress, as well as the responses from stakeholders. (Read more…)
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By Staff Reporters and MGMA Survey
Physician Compensation is Rising but Not Keeping Pace with Inflation
Despite physician and advanced practice provider productivity continuing its post-pandemic recovery, compensation gains are being outstripped by the most severe inflationary growth in decades, according to a new report. Provider compensation increased across the board, with primary care physicians (PCPs) receiving the biggest increase last year. Growth in median total compensation for primary care doctors doubled from 2021 to 2022—from pay growth of 2.13% to 4.41%. But these gains were eclipsed by the rate of inflation at 7% and 6.5%, respectively.
CITE: https://www.r2library.com/Resource
Surgical and non-surgical specialists saw their change in median total compensation cool slightly in 2022, dropping from 3.89% for surgical specialists in 2021 to 2.54% in 2022, and from 3.12% for non-surgical physicians in 2021 to 2.36% in 2022, according to the Medical Group Management Association’s 2023 provider compensation and production report.
Source: Heather Landi, Fierce Healthcare [6/6/23]
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Filed under: "Doctors Only", Accounting, Career Development, Health Economics, LifeStyle | Tagged: doctor compensation, doctor salary, inflation, MGMA, PCP, PCP salary, physician salary, salary inflation | Leave a comment »
By Staff Reporters
Meta, the Facebook tech giant sold the GIF platform it had recently bought at a steep loss after the UK’s competition regulator demanded it unwind its acquisition over antitrust concerns.
Meta had acquired Giphy in 2020 for $400 million, and just sold the company to Shutterstock for nearly $350 million less than that—$53 million. This was the first instance of British authorities dismantling a Big Tech deal that had already closed
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Filed under: "Ask-an-Advisor", Accounting, Breaking News, Information Technology | Tagged: Facebook, FB, GIF, giphy, Meta, Meta Sells Giphy | Leave a comment »
Personal Physician Budgeting Rules
BY DR. DAVID E. MARCINKO MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
NOTE: The US debt-ceiling bill just passed, June 1, 2023. So, here are some budgeting rules for doctors and medical professionals.
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Budgeting is probably one of the greatest tools in building wealth. However, it is also one of the greatest weaknesses among physicians who tend to live a certain lifestyle. This includes living in an exclusive neighborhood, driving an expensive car, wearing imported suits and a fine watch, all of which do not lend themselves to expense budgeting. Only one in ten medical professionals has a personal budget. Fear, or a lack of knowledge, is a major cause of procrastination.
The following guidelines will assist in this microeconomic endeavor:
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Verify Your Budget and Follow a Financial Plan
The process of establishing a budget relies heavily on guesswork, and the use of software or “apps”, that seamlessly track expenditures and help your budget and your financial plan become more of reality. Most doctors underestimate their true expenses, so lumping and best guesses on expense usually prove very inaccurate. Personal financial software and mobile phone applications make the verification of budgets easier. Once your personal accounts are setup, free apps like MINT.com will let give you a detailed report on where your money is going and the adjustments you must make. Few professions make larger contributions to the Internal Revenue Service than physicians and the medical profession. It is very important to categorize different budget categories not only to be proactive about your expenses, but also to accurately reflect the effect your different expenditures have on your real savings capability. All expense dollars are not equal.
For example, a mortgage payment, which is mostly interest expense in the early years, is likewise mostly tax deductible. Spending money on your family vacation is typically not tax deductible. Itemized deductions, which are deductions that a US taxpayer can claim on their tax return in order to reduce their Adjustable Gross Income (AGI), may include such costs as property taxes, vehicle registration fees, income taxes, mortgage expense, investment interest, charitable contributions, medical expenses (to the extent the expenses exceed 10% of the taxpayers AGI) and more.
Employing a qualified certified medical planneR® that utilizes a cash-flow based financial planning software program may help the physician identify their actual after-tax projected cash flow and more accurately plan their future.
ASSESSMENT: Your thoughts are appreciated.
ORDER TEXTBOOK: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-
THANK YOU
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Filed under: Accounting, Financial Planning, iMBA, Inc., Taxation, Touring with Marcinko | Tagged: budget, budget rules, budgeting, David Marcinko MBA, Personal Budgetings Guidelines | 1 Comment »
By Staff Reporters
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Student loan payments could restart soon. Tucked into the debt ceiling deal agreed to by President Biden and House Speaker Kevin McCarthy is a measure that requires student loan borrowers to start paying their monthly bills again 60 days after June 30th.
A freeze on repayments has been in place since March 2020 due to COVID-19, and it’s been extended several times as the pandemic dragged on. This deadline for the resumption of payments is similar to the timeline previously laid out by President Joe Biden, but it prevents him from issuing another pause.
COLLEGE COSTS: https://medicalexecutivepost.com/2016/07/18/is-the-cost-of-a-college-education-really-worth-it/
GOV PSLF: https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service
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Filed under: "Ask-an-Advisor", Accounting, Breaking News, Career Development, Ethics, Financial Planning, LifeStyle | Tagged: Covid-19, Joe Biden, Kevin McCarthy, loan forgiveness, PSLF, public student loans, Student, student loan forgiveness, Student loan repayments, student loans, students | Leave a comment »
By Eric Bricker MD
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Filed under: "Doctors Only", Accounting, Career Development, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: Eric Bricker MD, hospital, hospital out patient pricing, hospital pricing, Out patient, out patient pricing, out patient pricing explained | Leave a comment »
A”Surprise Billing” Maven
By Staff Reporters
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Envision, a $10 billion physician and ambulatory surgery firm owned by private equity giant Kohlberg Kravis Roberts, filed for Chapter 11 bankruptcy on May 15th 2023. It was the largest healthcare bankruptcy in US history.
CITE: https://www.r2library.com/Resource
Envision claimed to employ 25 thousand clinicians- emergency physicians, anesthesiologists, hospitalists, intensivists, and advanced practice nurses and contracted with 780 hospitals. Envision’s ER physicians delivered 12 million visits in 2021, not quite 10% of the US total hospital ED visits.
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Filed under: "Doctors Only", Accounting, Career Development, Health Economics, Healthcare Finance, Investing, Risk Management | Tagged: Envision, Envision Bankrupt, Envision Healthcare, KKR, Kohlberg Kravis Roberts, out network, Surprise billing | Leave a comment »
By Staff Reporters
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The AI hype train that left the station last November with ChatGPT’s release made its grand arrival on Wall Street last week. According to Bloomberg, the top seven tech stocks (Microsoft, Alphabet, etc.) gained a combined $454 billion in market cap over five days, fueled by Nvidia’s earnings report that many considered a watershed moment for the technology. AI’s disruptive potential is why the tech-heavy Nasdaq is leaving the other indexes in the dust this year.
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By Eric Bricker MD
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CITE: https://www.r2library.com/Resource
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By Eric Bricker MD
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By Staff Reporters
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Thousands of clients of Maxim Healthcare Services are about to receive a payment of up to $5,000 in compensation for a data breach. According to information obtained by The Sun, the private medical personnel company based in Columbia, Maryland; agreed to pay 2020 data breach claims filed in a class action lawsuit by residents of the state of California.
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Gold futures tallied a third consecutive session decline settling at their lowest in nearly a week as further strength in the U.S. dollar pressured prices for the precious metal. Gold gave up early gains that had been driven by uncertainty surrounding a U.S. debt-ceiling deal in Congress.
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And, here is where the major benchmarks ended yesterday:
Technology and regional bank stocks were among the weakest sectors, with the Philadelphia Semiconductor Index down more than 2%. Energy was one of the few gainers among S&P 500 sectors as crude oil futures climbed to a three-week high of near $74 a barrel. The U.S. dollar index rose a third straight day to a two-month high.
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Filed under: "Ask-an-Advisor", Accounting, Financial Planning, iMBA, Inc., Investing, Risk Management | Tagged: debt ceiling, DJIA, DOW, gold, gold futures, markets, Maxim, Maxim Data Breach, Maxim Healthcare Services, NSDAQ, oil, S&P 500, Treasury yields | Leave a comment »
By Staff Reporters
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Happy 203rd birthday to Florence Nightingale, the founder of modern nursing. She rose to fame during the Crimean War, when her hygiene standards substantially reduced the mortality rate at army hospitals. The healthcare industry still relies on some of her ideas, such as using data as a tool to improve hospital care. The “lady with the lamp” is still lighting the path forward.
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Other Health Care Stories
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Filed under: "Doctors Only", Accounting, Breaking News, Drugs and Pharma, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Risk Management | Tagged: AI, covid, Crimean war, Florence Nightingale, pharma | Leave a comment »
By Eric Bricker MD
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Filed under: "Doctors Only", Accounting, Career Development, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Industry Indignation Index | Tagged: CEO, CEO compensation, Eric Bricker MD, hospital CEO, hospital CEO compensation | Leave a comment »
HOW TO SURVIVE?
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By Staff Reporters
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Treasury Secretary Janet Yellen warned this week that the government could run out of cash to cover its expenses as early as June 1st. Congress can avert the looming economic catastrophe by authorizing more government borrowing so the US can keep paying its bills and avoid an unprecedented default on its financial obligations.
CITE: https://www.r2library.com/Resource/Title/082610254
But with the deadline just weeks away, lawmakers are locked in a game of chicken.
If the US does run out of money…look out. The Treasury would have a range of extremely bad to absolutely terrible belt-tightening options, including delaying payments to federal contractors and Social Security recipients, all to avoid falling behind on interest payments for Treasury bonds.
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Filed under: "Ask-an-Advisor", Accounting, Alerts Sign-Up, Investing | Tagged: bonds, debt, debt ceiling, Janet Yellen, treasury bonds, Treasury Secretary, US Debt, US Debt ceiling, Yellen | Leave a comment »
By Ann Miller RN MHA CMP™
INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARY FROM iMBA, Inc.
An e-book is an electronic or digital book that can be read on a computer or a handheld device.
Our new e-books consists of text, images, and are fixed to a specific spot on the page.
And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.
You can then access the e-book and read it, or highlight pages and even take side notes.
With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!
Payable thru PayPal [3% courtesy surcharge applies].
MORE HERE: https://medicalexecutivepost.com/me-pr-a-new-feature/
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FOR MEDICAL AND HEALTHCARE ENTREPRENEURS AND INNOVATORS
By Dr. David Edward Marcinko MBA MEd CMP®
I was asked by business schools and medical colleagues – and their bankers, CPAs and advisors – to speak about this topic several times last year before the pandemic.
Now, with the specter of M-4-A etc; it certainly is a vital concern to all young entrepreneurs, doctors & medical professionals whether live, audio recorded or in podcast form. And so, here is a written transcript of a recent presentation for your review.
Now, with the specter of tele-health, tele-medicine, M-4-A etc; it certainly is a vital concern to all young doctors & medical professionals whether live, audio recorded or in podcast form. And so, here is a written transcript of a recent presentation for your review.
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![New Product Business Plan Sample [2021 Updated] | OGScapital](https://www.ogscapital.com/wp-content/uploads/2013/09/newproductbusinesspan-736x440.png)
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READ: https://medicalexecutivepost.com/wp-content/uploads/2017/08/mba-business-plan-capstone-outline.pdf
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Filed under: Accounting, Career Development, CMP Program, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Interviews, Investing, Research & Development, Touring with Marcinko | Tagged: business plan, Certified Medical Planner™, CMP, MBA capstone, Tele-Health, tele-medicine | 1 Comment »
By Health Capital Consultants, LLC
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On April 18th, 2023, the U.S. Supreme Court heard oral arguments in two False Claims Act (FCA) cases, which cases center on the necessary state of mind needed to violate the FCA.
This Health Capital Topics article will review the oral arguments in the combined cases and how the justices seem posed to rule based on their questions and comments during the session. (Read more…)
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JUST IN: CA Doctor Settles FCA Allegations for $23.9 Million
A plastic surgeon in Beverly Hills, along with his son, and medical practices and billing company, have agreed to pay $23.9 million to resolve allegations that they violated the False Claims Act by submitting or causing the submission of false claims to both Medicare and Medicaid.
The civil settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Act by parties who worked for the plastic surgeon (Dr. Aronowitz) and his associated medical practices and businesses. Whistleblowers include TDP, a billing company; Dr. Jason Morris, a podiatrist; and Harold Bautista, a billing department employee. Under the qui tam provisions, a private party can file an action on behalf of the government and receive a portion of any recovery.
Source: Sierra Sun Times [4/29/23]
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CHIEF FINANCIAL OFFICER
By Eric Bricker MD
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: "Ask-an-Advisor", "Doctors Only", Accounting, Career Development, CMP Program, Ethics, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Investing, Videos | Tagged: CFO, confessions CFO, Confessions Hospital CFO, Eric Bricker MD, Hospital CFO, hospital economics, hospital finance | Leave a comment »
By Staff Reporters
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Venture capital funding in the digital health space cooled significantly in 2022 following a red-hot 2021; according to Healthcare Brew. Overall, digital health companies raised $15.3 billion last year, down substantially from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to research from Rock Health, a seed fund that supports digital health startups.
Analysts predict investors will still put a good amount of money into digital health in 2023, particularly in alternative care, drug development technology, and software that reduces physician workload. But investors will likely pull dollars away from a few specific sectors this year.
“There is definitely more diligence, a little bit more skepticism in the investments that are made. So you tend to see investments go slower because diligence is taking longer or investors are being a little bit more conservative,” Adriana Krasniansky, head of research at Rock Health, told Healthcare Brew.
Direct-to-consumer products. The first sector in which Krasniansky expects to see funding slow this year is direct-to-consumer (DTC) products. One reason is that with recession fears, “Consumer spend is not as readily available,” Krasniansky said.
But Apple’s new data privacy rules are also partially to blame. As of April 2021, apps sold through Apple’s App Store must ask users for permission to track activity, and users can opt out. That tracking data is crucial for advertisers to create personalized ads.
“Apple’s privacy measures have impacted customer acquisition costs, making the DTC channel more challenging for a lot of startups—and not just digital health startups,” said Krasniansky.
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Filed under: "Advisors Only", "Doctors Only", Accounting, Career Development, Ethics, Experts Invited, Information Technology, Investing, Taxation | Tagged: Adriana Krasniansky, Healthcare Brew, rock health, VC, VC Healthcare, Venture Capital | Leave a comment »
By Staff Reporters
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DEFINITION: Financial technology (abbreviated fintech or FinTech) is the technology and innovation that aims to compete with traditional financial methods in the delivery of financial services. Artificial intelligence, Blockchain, Cloud computing, and big Data are regarded as the “ABCD” (four key areas) of FinTech. The Fintech industry is an emerging industry that uses technology to improve activities in finance. The use of smartphones for mobile banking, investing, borrowing services, and cryptocurrency are examples of technologies aiming to make financial services more accessible to the general public.
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Financial technology companies consist of both startups and established financial institutions and technology companies trying to replace or enhance the usage of financial services provided by existing financial companies.
CITE: https://www.r2library.com/Resource/Title/082610254
A subset of fintech companies that focus on the insurance industry are collectively known as insurtech or insuretech
READ: https://tinyurl.com/yrx2kxy4
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Filed under: Accounting, Glossary Terms, Health Economics, Investing | Tagged: AI, block chain, ChatGPT, Entrepreneurial Start-Ups, fin-tech, financial technology., Financial-Tech [Entrepreneurial Start-Ups] Falling, start-up, Venture Capital | Leave a comment »
THE EIGHT [8] GIFTS
By Staff Reporters
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Much like the False Claims Act, the Anti-Kickback Statute (AKS) remains a frequent tool used by the Department of Justice to investigate the healthcare industry. Unlike the False Claims Act, the AKS imposes criminal penalties on violators.
CITE: https://www.r2library.com/Resource
The leaders of a physicians’ practice may be held liable for what others in the practice do, even if the leader did not know precisely what was going on. It has been called the “crime of doing nothing.”
1. Providing free dinners or lunches to physicians
2. Travel expenses paid to physicians
3. Entering into consulting or research agreements with physicians under which payments are made but minimal (or zero) work is done in return
4. Other gifts, such as electronics or tickets to sporting events
5. Laboratory pays a specimen processing fee to physicians above the fair value for those fees
6. Physician retention or recruitment agreements, when those agreements provide for payments above fair market value or are made with the intent to induce Medicare referrals
7. Agreements for speaking or teaching where the payments are above fair market value or made with the intent to induce referrals
8. Discount schemes that do not meet the safe harbor requirements
Source: Sara Kropf and Logan Lutton, Physicans Practice
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Filed under: "Doctors Only", Accounting, Ethics, Health Economics, Health Insurance, iMBA, Inc., Risk Management | Tagged: AKS, anti-kickback, false claims act, FCA, Stark laws | Leave a comment »
By Staff Reporters
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Physicians Who Accept Medicare, Medicaid at All-time Low of 65%
Reduced Medicare and Medicaid payments are having more physicians considering reducing those patient bases, according to Medscape’s “Physician Compensation Report” for 2023. Sixty-five percent of physicians surveyed said they would continue treating current Medicare or Medicaid patients and take on new ones, according to the report. Medscape said it is the lowest percentage it has seen in its annual compensation reports. Five years ago, 71 percent of physicians said they would continue treating current Medicare or Medicaid patients and take on new ones.
CITE: https://www.r2library.com/Resource
For the report, Medscape collected responses from 10,011 physicians across more than 29 specialties. The data was collected between Oct. 7, 2022, and Jan. 17, 2023. Eight percent of physicians surveyed said they would not take on new Medicare patients, and 5 percent said they would not take new Medicaid patients. Four percent said they will stop treating some or all of their current Medicare patients and will not take on new ones, and 3 percent said the same about Medicaid patients. Twenty-two percent said they have not yet decided how they will move forward regarding Medicare and Medicaid patients, according to the report.
Source: Andrew Cass, Becker’s Payer Issues [4/18/23]
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Filed under: "Doctors Only", Accounting, Career Development, Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Managed Care, Risk Management, Taxation | Tagged: doctor compensation, doctor pay, doctor salary, medacape, Medicaid, medicare, Medscape.physician compensation, physician compensation | Leave a comment »
By Staff Reporters
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Moody’s research released on Friday suggests that the industry is experiencing greater instability from several bank failures and high inflation, calling “into question whether some banks’ assumed high stability of deposits and their operational nature, should be reevaluated,”
The Wall Street Journal reported. Six U.S. banks were placed on Moody’s review list in March, per Reuters. All six banks put for review failed and were downgraded with the new study, including Comerica Inc., First Republic Bank, Intrust Financial Corporation, UMB Financial Corp, Western Alliance Bancorp and Zions Bancorporation.
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Apple’s latest product launch, in partnership with Goldman Sachs, is a savings account that will yield a meaty 4.15% in annual interest just for parking your money in it. The details:
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Filed under: "Ask-an-Advisor", Accounting, Alerts Sign-Up, Alternative Investments, Experts Invited, Insurance Matters, Investing | Tagged: Apple, Apple savings account, bank failures, banks, banks dive, Comerica, First Republic Bank, Intrust Financial, Moody's, Reuters, UMB Financial, Wall Street, Wall Street Journal | Leave a comment »
Examples of Exploitation and Deception?
BY ERIC BRICKER MD
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Triple Entry Accounting: https://medicalexecutivepost.com/2020/12/28/triple-entry-accounting/
HEALTH ECONOMICS CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: "Doctors Only", Accounting, Career Development, Experts Invited, Taxation, Videos | Tagged: ASCs, Eric Bricker MD, healthcare accounting, healthcare taxation, hospital accounting, hospital cost accounting, managerial health accounting, medical cost accounting, value based care, VBC | Leave a comment »
By Eric Bricker MD
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: "Doctors Only", Accounting, Experts Invited, Practice Management, Risk Management, Taxation, Videos | Tagged: CPA, Dr. Bode, Eric Bricker, Gary Bode, maedical practice managers, medical office abuse, medical office fraud, office medical theft, stealing from doctors | Leave a comment »
Physician Salary Pay Gap Comparisons
By Staff Reporters
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Physician Salary Pay Gap Follow-Up: https://medicalexecutivepost.com/2023/04/14/physician-salary-pay-gap/
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Women earn as much as or more than their husbands in just under half of US opposite-sex marriages, a significant advancement for economic equality from past decades, according to a new Pew Research study.
But, according to MorningBrew, in marriages where both partners have the same income, women spend about four-and-a-half more hours per week on chores and care giving than men.
And when women become the house’s primary income earner, little really changes about how much time either partner spends on chores, Pew found. But in this scenario, men report almost five more hours of leisure time per week than men in egalitarian households
CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Accounting, Career Development, Ethics, Experts Invited, Health Economics, Investing, LifeStyle, Taxation | Tagged: MorningBrew, pay gap, Pew Research, physician salary, wives economic influence, women, women earnings | Leave a comment »
By Staff Reporters
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CITE: https://www.r2library.com/Resource
MORE FUN TRIVIA: https://blog.cheapism.com/fun-tax-facts/
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A LAST MINUTE REMINDER
By Staff Reporters
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Tax Day arrives Tuesday, April 18, 2023 as America’s small businesses are worried their own government will treat them like suspected criminals, even as they hire workers, raise wages and strengthen their communities. And, do not forget that Monday the 17th is the last day deadline for 2022 IRA and HSA contributions.
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G-7 holds its annual summit in Japan. Ministers from the Group of Seven countries have arrived at a Japanese hot spring resort town for a rejuvenating soak and to discuss the world’s most pressing geopolitical challenges, such as China’s aggression toward Taiwan, the war in Ukraine, and climate change. Japan has ramped up security after an apparent smoke bomb was thrown at the prime minister on Saturday.
More companies report earnings. Investors will be poring over reports from Tesla, Netflix, Bank of America, Goldman Sachs, American Express, and dozens of other firms this week for clues on how corporate America is faring in these confusing economic times.
CITE: https://www.r2library.com/Resource
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Filed under: "Advisors Only", "Doctors Only", Accounting, Investing, Taxation | Tagged: American Express, Bank America, G-7, HSA, IRA, IRS, Netflix, Tax Day, Tesla | Leave a comment »
By Staff Reporters
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America’s biggest banks just kicked off the corporate earnings season by revealing that they raked in massive profits last quarter.
CITE: https://www.r2library.com/Resource/Title/0826102549
The Fed rate hikes that spelled doom for smaller fries like Silicon Valley Bank and Signature Bank were a boon to the big potatoes since they could charge more for loans. With the money they made from lending shooting up, JPMorgan, Citigroup, and Wells Fargo all zoomed past expectations for Q1.
The banking behemoths have made it through the chaos caused by the biggest bank failures since 2008 not just unscathed but stronger—though there’s some debate over whether they’ll be able to hang on to the many new deposits that came their way as customers fled from regional lenders.
But smaller banks are still struggling. And there were signs the three megabanks weren’t ready to declare total victory: They cautioned that credit is likely about to get more expensive and put aside a combined $2 billion in case a recession hits.
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Filed under: "Ask-an-Advisor", Accounting, Alerts Sign-Up, CMP Program, Experts Invited, Glossary Terms, Investing, Risk Management | Tagged: Bank America, banks, big banks, CitiGroup, inflation, JPMorgan Chase, Signature Bank, Silicon Valley Bank, Wells Fargo | Leave a comment »
By Staff Reporters
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A 2020 analysis of Doximity’s physician compensation data found that men physicians make an estimated $2 million more than women over the course of their careers.
Other findings:
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RELATED: https://medicalexecutivepost.com/2022/01/21/personal-budgeting-for-physician-executives/
CAREERS: https://medicalexecutivepost.com/2022/10/01/careers-and-net-worth/
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Filed under: "Ask-an-Advisor", "Doctors Only", Accounting, Career Development, Financial Planning, Health Economics, iMBA, Inc., Investing | Tagged: Doximetry, Marcinko, physician budgeting, physician financial planning, physician salary, physician salary gap, surgery | 2 Comments »
By Health Capital Consultants, LLC
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| GROWING SCRUTINY OF TELE-MEDICINE |
On July 20, 2022, the Office of Inspector General (OIG) of the U.S. Department of Health & Human Services (HHS) released a Special Fraud Alert on telemedicine. On the same day, the U.S. Department of Justice (DOJ) announced a “nationwide coordinated law enforcement action” against 36 defendants, and the Centers for Medicare & Medicaid Services (CMS) Center for Program Integrity announced administrative actions against 52 providers, related to alleged telemedicine arrangements. These coordinated actions indicate a growing scrutiny of telemedicine arrangements by federal government regulators. (Read more...)
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Filed under: "Ask-an-Advisor", Accounting, Career Development, Ethics, Experts Invited, Health Insurance, Health Law & Policy, Taxation | Tagged: Growing Scrutiny of Tele-Medicine, Health Capital Consultants LLC, Jessica Bailey-Wheaton, Tele-Health, tele-medicine, TODD A. ZIGRANG | Leave a comment »
NOW AVAILABLE
By Staff Reporters via CMS
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Open Payments is a national disclosure program that promotes a transparent and accountable healthcare system. Open Payments houses a publicly accessible database of payments that reporting entities, including drug and medical device companies, make to certain healthcare providers, which are referred to as covered recipients.
Pre-publication review and dispute for the Program Year 2022 Open Payments data opened on April 1st and is available through May 15th, 2023. Disputes must be initiated by May 15th, 2023 in order to be reflected in the June 2023 data publication.
CITE: https://www.r2library.com
For more information on review and dispute timing and publication, refer to the Review and Dispute Timing and Data Publication Quick Reference Guide.
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Filed under: "Doctors Only", Accounting, Career Development, Ethics, Events-Planner, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Insurance Matters, LifeStyle, Quality Initiatives | Tagged: CDC, Centers for Disease Control and Prevention, CMS, CMS payments, Health Insurance, Open Payments | Leave a comment »
The R.O.A.D. to Happiness?
By Eric Bricker MD
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CITE: https://www.r2library.com/Resource/Title/082610254
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Filed under: "Doctors Only", Accounting, Career Development, Ethics, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Investing, Op-Editorials, Taxation | Tagged: anesthesiology, dermatology, doctor specialties, Eric Bricker MD, orthopedics, physician specialities, physician specialty, radiology, ROAD, speciality rankings | Leave a comment »
By Staff Reporters
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Mass firings at tech companies continue as Accenture (NYSE:ACN) just announced plans to lay off around 19,000 people, or 2.5% of its current workforce, in the next 18 months. Over half of the departures will consist of people in non-billable corporate functions, the professional services firm said.
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Despite strong gains early this week, antifungal drug developers lost steam even after Cidara Therapeutics (NASDAQ:CDTX) won FDA approval for its candidemia treatment Rezzayo. Shares of Cidara (CDTX) and its rival in antifungal space Scynexis (NASDAQ:SCYX) jumped amid concerns of a fast-spreading fungal infection caused by yeast species Candida auris in the U.S. New approval of Rezzayo for fungal disease candidemia and invasive candidiasis has failed to reignite the interest, with Cidara (CDTX) and Scynexis (SCYX) trading at least 20% lower. Meanwhile, Cidara (CDTX) has not replicated its regulatory success on the financial front, reporting lower-than-expected financials for Q4 2022 on Thursday.
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The following is a round-up of today’s market activity:
The energy sector led declines Thursday as crude oil futures fell back under $70 a barrel, with financials and consumer staples also losing ground. Technology and communications stocks managed to hold onto gains.
Finally, gold futures surged over 2% to a one-year high near $2,000 an ounce.
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THE EVOLUTION OF VBC
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Filed under: "Ask-an-Advisor", Accounting, Career Development, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: David Kopans, Debra Finnel, Digital Health New York, Evolution of VBC, Michael Meng, Richard Park MD, value based care, VBC, VBC Evolution | Leave a comment »
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By Staff Reporters
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Marking to Market (MTM) means valuing the security at the current trading price. Therefore, it results in the traders’ daily settlement of profits and losses due to the changes in its market value.
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An exchange marks traders’ accounts to their market values daily by settling the gains and losses that result due to changes in the value of the security. There are two counterparties on either side of a futures contract—a long trader and a short trader. The trader who holds the long position in the futures contract is usually bullish, while the trader shorting the contract is considered bearish.
If at the end of the day, the futures contract entered into goes down in value, the long margin account will be decreased and the short margin account increased to reflect the change in the value of the derivative.
An increase in value results in an increase in the margin account holding the long position and a decrease in the short futures account.
According to investopedia, for example, to hedge against falling commodity prices, a wheat farmer takes a short position in 10 wheat futures contracts on November 21st. Since each contract represents 5,000 bushels, the farmer is hedging against a price decline on 50,000 bushels of wheat. If the price of one contract is $4.50 on Nov. 21st. the wheat farmer’s account will be recorded as $4.50 x 50,000 bushels = $225,000.
| Day | Futures Price | Change in Value | Gain/Loss | Cumulative Gain/Loss | Account Balance |
| 1 | $4.50 | 225,000 | |||
| 2 | $4.55 | +0.05 | -2,500 | -2,500 | 222,500 |
| 3 | $4.53 | -0.02 | +1,000 | -1,500 | 223,500 |
| 4 | $4.46 | -0.07 | +3,500 | +2,000 | 227,000 |
| 5 | $4.39 | -0.07 | +3,500 | +5,500 | 230,500 |
Because the farmer has a short position in wheat futures, a fall in the value of the contract will result in an increase in their account. Likewise, an increase in value will result in a decrease in account value. For example, on Day 2, wheat futures increased by $4.55 – $4.50 = $0.05, resulting in a loss for the day of $0.05 x 50,000 bushels = $2,500. While this amount is subtracted from the farmer’s account balance, the exact amount will be added to the account of the trader on the other end of the transaction holding a long position on wheat futures.
The daily mark to market settlements will continue until the expiration date of the futures contract or until the farmer closes out his position by going long on a contract with the same maturity.
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CITE: https://www.r2library.com/Resource/Title/082610254
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By Staff Reporters
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Editor’s Note: FHA manual underwriting guidelines were updated in 2020 and require that, for those applicants with credit scores below 620 or a debt-to-income (DTI) ratio that exceeds 43%, mortgage applications must be manually underwritten. For a fiercely frugal doctor, or debt adverse medical professional with “poor” credit because of little to no debt, this may actually be good for them. But, it may also make it difficult for a modern automated mortgage lender to issue a loan. Our debt ridden and consumer driven society is largely causative.
CITE: https://www.r2library.com/Resource/Title/082610254
Consumption: https://medicalexecutivepost.com/2018/09/18/are-doctors-practitioners-of-conspicuous-consumption/
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With many Lenders now making automated lending decisions, much like emerging healthcare A.I. initiatives, it can seem confusing why others are still sticking to a manual process. But, a few physicians with little to no credit/debt history, and hence a low FICO score, may actually find it a bonus.
Banking A.I.: https://www.msn.com/en-us/money/companies/this-american-bank-is-closing-the-most-branches/ar-AAT3PvQ?li=BBnbfcL
Automated Decision Making
Many mortgage lenders currently use computer-based systems to assist with their lending decisions. These systems will look at your client’s credit score, borrowing history, etc. to decide whether or not to approve a mortgage application. It can then be argued that the value of an Underwriter is decreasing; much like physicians are slowly being devalued for many emerging reasons.
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So, Why Manual Underwriting?
Now, understand that not all [minority of clients] applicants will fit into the box that automated decision making systems like. Due to this, there is a need for manual decisions to be made, that will benefit both the Lender and the Borrower (client)!
Manual underwriting allows our Underwriters to look at the bigger picture and get a balanced view on the potential physician and/or client’s ability to repay the mortgage they are applying for. This means they can have a look at the overall risk to the Society and consider what conditions can be used to meet our lending policies. By using manual underwriting in every case, this embeds sensible and responsible decision making within the Society.
A hands-on approach means a look deeper into your financial position, and consider cases where physician clients may have:
Manual Underwriters
It is clear to see the benefits for the Society, and physicians, retrospectively. Some benefits of manual underwriting, according to experts David Cox and Richard Groom, include;
“I like that we can look at cases that many other high street lenders wouldn’t consider. This doesn’t mean we are risk takers; we just apply common sense”.
“I enjoy the hands-on approach we apply. Every applicant is different, so why should they all be pushed through an automated system?”
“Just because something doesn’t quite fit, it shouldn’t result in a computer says no decision. It’s great to be able to look at an individual’s situation and see what changes we can make to turn the negative to a positive”.
“The great thing about manual underwriting is that while our lending policy is the core of what we do, applying a manual approach means we can consider applications outside of this, where it benefits the borrower and the Society”.
MORE: https://www.bankrate.com/mortgages/manual-underwriting/
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By Staff Reporters
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Often, common stock issued to founders will be made subject to specific restrictions. This is normally carried out by placing limiting provisions in the stock grant agreement or by requiring founders to enter into shareholders’ agreements. The purpose of these agreements is to make the common stock similar in nature to preferred stock, which is generally issued to later investors in the company.
CITE: https://www.r2library.com/Resource/Title/0826102549
Commonly, founder’s stock will be subject to various conditions, as follows:
Restricted Shares – Restriction refers to a shareholder’s ability to sell or otherwise transfer the equity for a specific period. The restrictive provisions generally require that the shareholder offer the company the right to repurchase the shares before they can be transferred to any third parties. This is known as a “right of first refusal”. Also, if the company issues additional shares, the shareholder generally has the right to sell her shares along with the issuance. This is known as “co-sale rights”.
Vesting Schedule – A vesting schedule states that time period or period in the future when shareholders become full owners of the stock granted to them. The vesting term is generally 4 years, with no stock vesting until 12 months after the grant. Granting stock to shareholders subject to vesting makes certain that the shareholder remains loyal to (or perhaps remains an employee of) the company. If the shareholder leaves the company prior to shares vesting, she forfeits her ownership interest. To protect the shareholder, the stock grant generally provides for accelerated vesting if the company is sold, goes through a later equity financing, or the shareholder is an employee and fired without cause.
Super-voting Rights – This is where the class of stock grants the shareholder more than one vote per share. This is extremely important for early founders who wish to retain control of the company.
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Valuation of Internal Medicine Services: Reimbursement
BY HEALTH CAPITAL CONSULTANTS, LLC
As noted in the first installment of this five-part series, internal medicine is the largest specialty among physicians and an understanding of the various environments in which these physicians operate is crucial in determining their numerous value drivers.
In particular, healthcare reimbursement, the process by which private health insurers and government agencies pay for the services of healthcare providers (including internists), is perhaps one of the most important environments to understand, as it comprises a provider’s expectation of future return on investment.
CITE: https://www.r2library.com/Resource/Title/0826102549
This installment will discuss the reimbursement of internal medicine services. (Read more…)
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