PODCAST: United Health Group Acquisition of “Change Healthcare”

A DATA GOLDMINE

By Eric Bricker MD

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HIT: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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What Is Integrative Medicine?

By Staff Reporters

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The term integrative medicine was born from combining the practice of so-called “conventional” medicine and “complementary medicine.” Conventional medicine is what most doctors practice. This is also called “traditional Western medicine.”

Adding “outside-the-box” treatments such as chiropractic care, acupuncture, and other lifestyle recommendations like improving diet, supplements, herbs, exercise, stress management, and functional specialty labs results in the actual integration of the two disciplines. And we need both.

READ: https://www.msn.com/en-us/health/medical/the-one-doctor-you-dont-have-but-likely-need/ar-AAXagMw?li=BBnb7Kz\

Complimentary Medicine: https://medicalexecutivepost.com/2007/12/16/complimentary-medicine/

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?s=books&ie=UTF8&qid=1287563112&sr=1-9

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DHIMC: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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The Impact of Private Equity Acquisition on Health Care Spending and Utilization

By NIHCM
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READ HERE: https://nihcm.org/assets/articles/NIHCM-ResearchInsights-Singh01.pdf
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CITE: https://www.r2library.com/Resource/Title/082610254

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PODCAST: Patient Centricity in Value Based Care?

By Eric Bricker MD

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Dr. Sachin MD MBA Jain wrote an outstanding article on Value Based Care in the April 12, 2022 issue of Forbes stating that the Patient Must Come First in Value Based Care.

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RELATED PODCAST: https://medicalexecutivepost.com/2021/12/13/podcasts-the-case-against-value-based-care/

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ADDITIONAL: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

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PODCASTS: Signify Health Stock Market Debut

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By Kyle Armbrester

By Eric Bricker MD

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PODCAST 2: https://www.youtube.com/watch?v=-1_mBZLsKvU

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PODCAST: PBM Money Flow Explained

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PHARMACY BENEFITS MANAGER

By Eric Bricker MD

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HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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PODCAST: Health Insurance Carrier Stock Performance Has Been Amazing!

By Eric Bricker MD

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DJIA: 32,197.59 at close ‎+436.05 (‎+1.37%)

NASDAQ: 12,032.42 at close ‎+469.85 (‎+4.06%)

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CITE: https://www.r2library.com/Resource/Title/082610254

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WHY? Give Up Tele-Medicine!

By Michael Kirsch, M.D

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Why This Doctor Gave Up Telemedicine

During the pandemic, I engaged in telemedicine with my patients out of necessity.  This platform was already destined to become part of the medical landscape even prior to the pandemic.  COVID-19 accelerated the process.  The appeal is obvious.  Patients can have medical visits from their own homes without driving to the office, parking, checking in, finding their way to the office, biding time in the waiting room and then driving out afterwards.  And patients could consult physicians from far distances, even across state lines.  Most of the time invested in traditional office visits occurs before and after the actual visits.  So much time wasted! Indeed, telemedicine has answered the prayers of time management enthusiasts.

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RELATED: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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PODCAST: Peter Thiel on “Zero to One”

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

David Cummings on Startups

After reading Peter Thiel’s book Zero to OneI was interested in hearing him talk and his presentation at UT Austin doesn’t disappoint.

From YouTube: Thiel is hailed as one of the most successful investors in the world. After co-founding PayPal, he went on to co-found Palantir Technologies and invest in Facebook, where he still serves on the board. He’s played major roles in dozens of successful companies and continually strives toward the next big thing. In “Zero to One,” he emphasizes the need for entrepreneurs to grasp for the ideas that nobody else has in order to truly innovate. This new way of thinking about innovation encourages burgeoning business leaders to carve their own lane in a heavily saturated race toward success.

“Zero to One,” based on a course Thiel taught in 2012 at Stanford University, urges readers to see the broad picture and look past traditional boundaries between…

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PODCAST: Start-Ups & Healthcare Venture Capital in the COVID-19 Recession

By Eric Bricker MD

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RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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About “Non-Profits” for Entrepreneurs

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[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd. Edition]

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[Foreword Dr. Hashem MD PhD] *** [Foreword Dr. Silva MD MBA]

David Cummings on Startups

Back in college I’d routinely jump in my old Jeep Wrangler and make the 10 mile drive down the Durham Freeway to RTP for events and programs at the Council for Entrepreneurial Development (CED). CED bills itself as “the network that helps Triangle entrepreneurs build successful companies” and has 700+ member companies with 4,000 members. In Atlanta, we have a number of strong entrepreneurial non-profits:

Only, we don’t have a central entrepreneur organization that encompasses both tech and non-tech startups. As expected, there are a tremendous number of non-tech entrepreneurs in town. EO has a strong Atlanta chapter with over 100 members, but that’s limited to companies with at least $1 million in revenue. Where do non-tech entrepreneurs go?

Last week I had the chance to learn…

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To all UNHAPPY Financial Advisors, JDs, CPAs and Physician-Focused Insurance Agents in 2022

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AVOID COLLATERAL ECONOMIC DAMAGE OF HEALTH CARE REFORM – AS A CERTIFIED MEDICAL PLANNER PROFESSIONAL

By Eugene Schnmuckler PhD MBA MEd CTS

[Academic Provost and Dean]

CMP logo

http://www.CertifiedMedicalPlanner.org

ME-P Doctors, Advisors and Consultants

The healthcare industrial complex represents a large and diverse collateral support industry, and the livelihood of synergistic professionals who advise doctors depend on it. So, if you want to be an outstanding financial advisor in the healthcare space, you better read this book and learn something about physician specific financial planning.

Better yet! Combine financial planning and practice management and become a Certified Medical Planner ™. Then, integrate this knowledge, and CMPmark of distinction, into your current financial advisory or healthcare consulting practice.

Or, as some of the following financial services professionals are learning, you might just become more collateral economic damage in the current managed healthcare debacle, if you don’t.

Certified Public Accountants

The nation’s 330,000 or so CPAs know little about the new healthcare dynamics and financial planning. Many often feel as though they are laboring away in obscurity and that their doctor clients do not appreciate what they do or how hard they work.

If you are a CPA, your workweek is ridiculously long, especially January through April; and you often deliver bad news to your doctor clients. You do not earn a generous salary, but you do receive their ire for your efforts. Even ex-SEC chief Arthur Levitt said, “Accounting is clearly a profession in crisis”, after reviewing Arthur Andersen, LLP’s role in Enron Corporation’s collapse, in 2002; not to mention the Global Crossing Ltd, Vivendi Universal, Warnaco, Martha Stewart and WorldCom fiascos.

So, you begin to scratch your head and ponder, quietly at first, and then out loud. Perhaps advising and managing the medical practice of a physician, or providing consulting services to other medical professionals is an opportunity that won’t require a new client base? You can keep your accounting practice during the first four months of the year, and supplement your income with something that may actually earn more than you are making now.

A light then goes off in your head. Epiphany! Enter iMBA’s Certified Medical Planner(CMP) professional certification program, exhorting accountants to “integrate personal financial planning with medical practice management”, through an additional 500 hours of online managerial and planning experience.

However, terms such as capitated medicine; per member-per month fixed fees; payment withholds’; activity based costing with CPT codes; utilization and acuity rates; and more investment and financial nomenclature is likely quite unfamiliar to you.

Furthermore, you may not have the temperament to be responsible for the financial affairs of others. Then you realize that CMPs along with MBAs and CFPs may actually be the new denizens of the healthcare bean counting and practice management scene. Rather than present numbers of the historic past, they make logical and mathematical inferences about the future.

Slowly, you realize that this has occurred because these professionals are proactive, not reactive, as the accounting profession is loosing its premier advisory position within the medical profession. Since doctors are paid a fixed fee amount, regardless of the number of services performed, these futuristic projections are the most important accounting numbers in healthcare today.

In fact, your research suggests that as a result, nearly every major accounting firm has created a financial advisory unit, or acquired one. Moss-Adams acquired Financial Securities in Seattle. Plante and Moran’s advisory unit is one of the largest and most successful in Michigan. And, 1st Global now offers a turnkey program that allows nearly every accounting firm to create its own advisory unit overnight.Even, the AICPA is providing encouragement to CPAs who wish to provide more professional client services by uniting with Fidelity to serve as a professional vendor. And, the PFS designation is about to be abandoned by the AICPA.

Doctor Advisor Teamwork

Tax Attorneys and Lawyers 

As a tax planning, health-law or estate attorney, you already know that almost every legal magazine around has articles or advertisements proposing that you become a financial planning professional or business consultant to your physician clients. Moreover, lawyers of all stripes are being pushed toward interdisciplinary alliances by encroachment on their turf by the Big Four consulting firms. With audits of publicly held companies now a commodity, the giant law firms are getting more of their revenues from consulting fees; and that puts them into direct competition with you and other legal professionals.

Of all careers, you know how absolutely onerous it is to practice medicine today, and are finally thankful that you did not take that career route many years ago. So, like your neighbor the accountant, you begin to explore that potential of developing a service line extension to your legal practice, in order to assist your medical colleagues who have been hit on hard economic times.

In fact, you soon realize that more than 90,000 trust, probate and estate planning attorneys like yourself are interested in pursuing financial planning in the next decade. Sure, you know its difficult to get a CLU or variable annuity license, or become a Certified Financial Planner (CFP), but earning your law degree was no cinch either. And, you reckon, advising physicians has got to be easier than law, or less stressful than the corporate lifestyle of your CMP trained brother-in-law, right?

So, you set out to stretch your legal horizons with an online Certified Medical Plannercertification program and explore the basic legal nuances of those topics not available in law school when you were a student. Things like medical fraud and abuse; managed care compliance audits and Medicare recoupments; PP-ACA, RACS, OSHA, DEA, HIPAA and EPA standards; anti-trust issues; and managed care contract dilemmas or de-selection appeals.

What a brave new world the legal profession has become! Even the American Bar Association’s commission on multi-disciplinary practice has recommended that lawyers be permitted to share fees and become partners with financial planners, money managers and other similar professionals.

As a real life example, the venerated Baltimore brokerage firm of Legg Mason, Inc, has recently teamed up with the Boston law firm of Bingham Danna, LLC, to create one of the first marriages between a law and securities firm. If you want in on the challenge, and bucks, you’d better acquire at least a working knowledge of health care administration, or perhaps help craft some new case law, or assist your doctor-clients in some other fashion; otherwise, you will remain a legal document producer.

Financial Planners and Investment Advisors

As a CFP, CFA, investment advisor or general securities representative, you realize that the financial service sector is going to become the next great growth opportunity of the 21st Century, despite the fact that the stagnant stock market in 2003-2004 set profits for the securities industry back by seven years.

Even H & R Block, and the Charles Schwab Corporation are trying to build medical professional interest in their respective firms and compete with your independent practice. They are fervently wooing away one group or another to interface with their embryonic financial advisory programs. Meanwhile, more than 260,000 of the nation’s brokers are moving into the investment advisory and financial planning business, as transactions have become commoditized.

A recent survey conducted for the Financial Planning Association clearly demonstrated the dominance of registered investment advisors, over stockbrokers, among clients 35-49 years old. With the average Merrill Lynch private client well over 60, it’s easy to spot the future vulnerability of this business model.

When asked to determine the added value of key industry players, baby boomers in a recent Dalbar study ranked financial planners first, followed by stockbrokers, CPAs, mutual fund companies, insurance agents, and commercial bankers, respectively. Even if you are a CFP, and despite the proliferation of investment advisors, evidence suggests that your individual impact is still narrow.

Furthermore, another Prince & Associates study of 778 affluent individuals including physicians, each with more than 5 million dollars to invest, examined the relationship between clients and their providers of five key financial services; retirement planning, estate planning, investment management, executive benefits and health-disability insurance. Prince found that 59 percent of the clients had been serviced in only one area by a particular advisor. Despite the significant assets of each client, the advisers have been unsuccessful at broadening these relationships– a key indicator that many affluent clients do not have a primary financial adviser.

Among the challenges you face to broaden your influence is to offer your clients value added services, perhaps by establishing your expertise in the medical niche and capitalize on being different (your unique knowledge-based value proposition). You must not remain just another of the more than 250,000, or so individuals who claim to be financial planners, with a collective universe of an additional 700,000, who purport to be financial advisors, in some fashion or another. You must begin to develop the strategic competitive advantage of practice management knowledge to synergize with your existing financial services product line.

Like the physicians you advise, you must consider becoming a specialist. In the highly coveted healthcare space, this specialist to high net worth doctors, is known as a Certified Medical Plannerpractitioner.

Integrated practice management and financial planning will also become much more competitive among physicians because they are aware of the above fusion. No one is suggesting therefore, that you abandon your core financial advisory business for medical practice management. It is merely a fact that healthcare has drastically changed during the past decade, and the knowledge you used yesterday will no longer be enough for you to get by on in the future.

Medical practice management is the natural outgrowth of traditional financial planning services, and investment advice in turn, is central to the implementation of a unified medical office and personal financial plan. The most successful financial planners therefore, may be CMPs and CFPs who incorporate medical management services into their practices.

cmp-program1

Insurance Agents and Counselors

As a traditional life insurance agent, it seems that almost all your colleagues are acquiring a general securities license, or CFP designation in addition to the CLU or ChFC after their name. Currently, there are more than 3 million insurance agents, half of which are independent. They are being pressured to move toward financial planning, as distribution of insurance products over the Internet spreads like wildfire.

Meanwhile, the same insurance and investment companies that are knocking on your door are also courting the medical professionals with their practice enhancement programs. Even if you are not interested in going into the financial planning business, you have seen the status of the American College erode of late, even as your own insurance business has declined because of the World Wide Web and various discounted insurance companies.

And, in the eyes of your former golden goose doctor-clients, you may have become a charlatan and everyone is clamoring for a piece of your insurance business and cloaking it in the guise of the contemporary topic of the day; medical practice management and financial planning. Think this is an exaggerated statement? An October 1997 survey conducted by Deloitte & Touche Consulting Group of New York, found insurance agents ranked last in having the trust of a wide selection of the public! Erosion has continued, ever since.

So, how do you regain this lost trust, and what about this new entity known as managed care? How do you learn about it at this stage in your career? What ever happened to the traditional indemnity health insurance, with its deductible and 80/20payment scheme? It was so easy to sell, provided good coverage, and the agent made a nice profit.

As an insurance agent, all you want to know is, can I still sell insurance and make a living? Like the struggling doctors you seek to advise, and the collateral advisors above, you find yourself asking, how do I talk the talk, and walk the walk, in this new era of medical insurance turmoil?

Slowly, as you read, study and learn about the Certified Medical Plannercertification program, you become empowered with the knowledge and ideas for new insurance product derivatives, that actually provide value to your physician clients. You are no longer just an insurance salesman, but a trusted medical risk management advisor.

Congratulations!

You can avoid the managed care economic ripple effect. Act now!

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Office: Dean of Admissions

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Peachtree Plantation – West

Suite # 5901 Wilbanks Drive

Norcross, Georgia 30092-1141

770.448.0769 (voice)

770.361.8831 (fax)

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MarcinkoAdvisors@msn.com

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Financial Planning MDs 2015

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

PODCAST: The “Common Bridge” Interviews Ken Cooper MD

By Rich Helppie

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PODCAST: “UNIVERSAL PRECAUTIONS” EXISTED LONG BEFORE THE CORONA VIRUS

WHAT’S OLD – IS NEW AGAIN?

Courtesy: www.CertifiedMedicalPlanner.org

cropped-dem

Dr. David E. Marcinko MBA

Universal Precautions refer to the medical practice of avoiding contact with patients’ bodily fluids, by means of the wearing of nonporous articles such as medical gloves, goggles, and face shields.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

The infection control techniques were essentially good hygiene habits, such as hand washing and the use of gloves and other barriers, the correct handling of hypodermic needles, scalpels, and aseptic techniques.

Following the AIDS outbreak in the 1980s the US CDC formally introduced them in 1985–88. Every patient was treated as if infected and therefore precautions were taken to minimize risk.

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PODCAST: https://www.bing.com/videos/search?q=universal+precautions&&view=detail&mid=CF8A605C252259D0DA6FCF8A605C252259D0DA6F&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3Duniversal%2Bprecautions%26FORM%3DHDRSC3

ASSESSMENT: Your thoughts and comments are appreciated.

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PODCAST: Avoiding Medical Nightmare Tyranny with John Bush

By Pete Quinones

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John joins Pete to talk about ways to use entrepreneurship, cryptocurrency and alliances to prevent the medical tyranny that is being thrust upon the world.

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PODCAST: The Pete Quinones Show: Episode 613: Avoiding This Medical Nightmare w/ John Bush (libsyn.com)

HEALTH INSURANCE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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PODCAST: Machine Learning For Population Health

BY ERIC BRICKER MD

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ORDER: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

POPULATION HEALTH: https://medicalexecutivepost.com/2016/06/28/what-is-population-health/

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FOREWORD: https://medicalexecutivepost.com/wp-content/uploads/2007/10/foreword-mata.pdf

BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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PODCAST: How Extensive is Healthcare Prior Authorization?

A New Study

BY ERIC BRICKER MD

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RELATED: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

MORE: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

MORE: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

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AMAZON’S New Move in Health Care

By Health Capital Consultants, LLC

Amazon, the largest e-commerce company in the world, has made large, strategic moves over the past several years to make a place for themselves in healthcare.

This article will review Amazon’s most recent advancements in the industry, including those related to Amazon’s voice-controlled personal assistant, Alexa, and Amazon’s employee healthcare system, Amazon Care, and how this non-healthcare company is changing the industry.

LINK: https://www.healthcapital.com/hcc/newsletter/03_21/HTML/AMAZON/convert_amazon_moves_healthcare_3.25.21.php

RELATED: https://medicalexecutivepost.com/2018/09/07/investors-have-misdiagnosed-amazons-push-into-the-pharmacy-business/

MORE: https://medicalexecutivepost.com/2018/03/07/how-amazon-could-lose-its-health-care-bid/

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PODCAST: Ray Dalio on How the Economy Works in Healthcare

Ray Dalio’s ‘How the Economy Works’ Applied to Healthcare … Credit Cycles and Healthcare Policy

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource/Title/0826102549

RELATED: https://www.msn.com/en-us/money/savingandinvesting/ray-dalio-warns-stagflation-will-send-america-back-to-the-1970s/ar-AAVSYgF

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PODCAST: Social Determinants of Health [Impact on Medical Training and Healthcare Costs]

By Eric Bricker MD

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As a result of SDOH problems, Johns Hopkins Hospital Trains Doctors That Have a Ton of Exposure to Diseases That Result from These Social Determinants of Health: 1) Endocarditis, 2) Hepatitis C, 3) HIV, 4) Pancreatitis, 5) Liver Cirrhosis, 6) Diabetes, 7) Heart Attack, 8) Stroke, 9) Infections, 10) Cancer, 11) Spinal Injuries, 12) Dialysis, 13) Diabetic Ketoacidosis and 14) Hypertensive Emergencies.

Johns Hopkins Hospital Also Loses Money When Treating These Diseases Caused by Social Determinants of Health.

CITE: https://www.r2library.com/Resource/Title/0826102549

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MORE: PODCAST: Social Determinants of Health

Mental: Social Determinants of Mental Health

Related: “Social Determinants of Health”

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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HEALTH INSURANCE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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PODCAST: Primary Care Innovation at Scale [ChenMed]

By Eric Bricker MD

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DICTIONARY: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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PODCAST: Excessive Out of Pocket Healthcare Costs

By Eric Bricker MD

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RELATED: https://medicalexecutivepost.com/2022/08/22/dictionary-health-economics-and-finance-2/

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PODCAST: Healthcare Service and Sacrifice [Economics 101]

Understand Diminishing Returns and Opportunity Costs

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource/Title/082610254

Diminishing Returns: https://medicalexecutivepost.com/2010/10/26/higher-spending-on-healthcare-doesnt-always-deliver-quality/

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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PODCAST: Law Firm Fairmark Partners Suing Large Hospital Systems for Antitrust Violations

Using Court System to Change Healthcare

By Eric Bricker MD

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HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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The “Deeper Dive” Costs of College Debt

Unintended Consequences?

[By Rick Kahler MSFS CFP]  [Dr. David Marcinko MBA]

Not only is a college education a door to higher wages, but providing that education is an important segment of our economy and a huge source of good paying jobs.

In 2017 the average salary for the country’s 624,822 full-time college instructors was $82,240, according to an annual study from the Department of Education’s National Center of Education Statistics.

The old days

In the days before college loans were as easy to get as the common cold, college costs were due in cash. Students and parents had to save money or pay tuition out of their earnings. Many students worked their way through college. Those without savings, the ability or desire for college jobs, or high enough grades for scholarships didn’t go to college.

Since colleges competed for students, market forces controlled the tuition rates. Raising tuition too much resulted in fewer students and smaller revenues. The two forces of supply (college capacity) and demand (the ability to pay tuition) kept college costs in check.

Understandably, borrowing to pay for college tuition was difficult. What sane bank or investor would loan money to an unemployed teenager with no collateral to speak of? If you could find someone willing to make such a risky loan, the interest rate was high.

Politics

Well-intended politicians decided it wasn’t fair that those without the means to pay tuition were denied college educations. Their solution was to require taxpayers to underwrite college loans, sometimes at interest rates lower than those available to the most creditworthy.

With tuition money easy to obtain through low-cost, government backed loans, demand for a college education increased. With the increased demand came higher tuition costs. This easy money is the primary reason that college tuition costs have far outpaced inflation and have gone up twice as fast as medical costs since 1985.

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Consequences

Unfortunately, one consequence of loaning money to those deemed poor risks is that a high percentage of those borrowers are unable to repay the debt.  It should come as no surprise that 10.7% of all student loans are currently 90 days or more in default. Conversely, the composite default rate on mortgages, credit cards, and auto loans is 0.82% as of October 2018.

Today, taxpayers are on the hook for over 92% of the $1.5 trillion in outstanding student loans made to over 44 million borrowers, according to a June 13, 2018, Forbes article by Zack Friedman, “Student Loan Debt Statistics in 2018.” Only home mortgages exceed student loan debt.

And the appetite for loans continues to rise. The average student from the Class of 2016 graduated with over $37,000 of college debt. It isn’t uncommon for a medical student to amass over $200,000 of student loan debt. This year we will add another $120 billion in college debt to the books.

The more college debt that graduates take into the workplace, the less they have to spend for vehicles, rent, and consumer goods. The damage to the credit ratings of the 10.7% who are in default will also hinder their purchasing power for years to come.

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Assessment

If taxpayers ever decide to quit footing the bill, my hunch is that many colleges’ tuition rates will fall as hard as housing prices did in Florida, Arizona, and California in 2009. Lower tuition costs would create a financial hardship for most colleges and the some 4,000,000 people employed in higher education.

Politically, I don’t expect that to happen. Colleges are big business with a lot of money and influence in Congress. Further, a college education is becoming viewed as a right that should be free. In the meantime, savvy students will do whatever they can to minimize their college tuition and graduate debt-free.

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COACH

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Conclusion

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New Medical Practice Entrepreneurial Business Rules for Young Physicians [circa 2022]

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Go “Out-of-Box” – OR – Go Employee

By Dr. David Edward Marcinko MBA CMP™ www.CertifiedMedicalPlanner.org

There are more than 950,000 physicians in the United States. Yet, the brutal supply and demand, and demographic calculus of the matter is that there are just too many aging patients chasing too few doctors. Compensation and reimbursement is plummeting as Uncle Sam becomes the payer-of-choice for more than 52% of us. More so, going forward with the PP-ACA OR, perhaps not so much after the Trump election.

Furthermore, many large health care corporations, hospitals, and clinical and medical practices have not been market responsive to this change. Some physicians with top-down business models did not recognize the changing health care ecosystem or participatory medicine climate. Change is not inherent in the DNA of traditionalists. These entities and practitioners represented a rigid or “used-to-be” mentality, not a flexible or “want-to-be” mindset.

Yet today’s physicians and emerging Health 2.0 initiatives must possess a market nimbleness that cannot be recreated in a command-controlled or collectivist environment. Going forward, it is not difficult to imagine the following rules for the new virtual medical culture, and young physicians of the modern era.

A. Rule 1

Forget about large office suites, surgery centers, fancy equipment, larger hospitals, and the bricks and mortar that comprised traditional medical practices. One doctor with a great idea, good bedside manners, or competitive advantage can outfox a slew of insurance companies, Certified Public Accountants, or the Associate Management Accountant, while still serving patients and making money. It is now a unit-of-one economy where “ME Inc.,” is the standard. Physicians must maneuver for advantages that boost their standing and credibility among patients, peers, and payers.

Examples include patient satisfaction surveys, outcomes research analysis, evidence-based-medicine, direct reimbursement compensation, physician economic credentialing, and true patient-centric medicine. Physicians should realize the power of networking, vertical integration, and the establishment of virtual offices that come together to treat a patient and then disband when a successful outcome is achieved. Job security is earned with more successful outcomes; not a magnificent office suite or onsite presence.

B. Rule 2

Challenge conventional wisdom, think outside the traditional box, recapture your dreams and ambitions, disregard conventional gurus, and work harder than you have ever worked before. Remember the old saying, “if everyone is thinking alike, then nobody is thinking.” Do traditionalists or collective health care reform advocates react rationally or irrationally?

For example, some health care competition and career thought-leaders, such as Shirley Svorny, PhD, a professor of economics and chair of the Department of Economics at California State University, Northridge, wonder if a medical degree is a barrier—rather than enabler—of affordable health care. An expert on the regulation of health care professionals, including medical professional licensing, she has participated in health policy summits organized by Cato and the Texas Public Policy Foundation. She argues that licensure not only fails to protect consumers from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible.

Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today.

C. Rule 3

Differentiate yourself among your health care peers. Do or learn something new and unknown by your competitors. Market your accomplishments and let the world know. Be a non-conformist. Conformity is an operational standard and a straitjacket on creativity. Doctors must create and innovate, not blindly follow entrenched medical societies into oblivion.

For example, the establishment of virtual medical schools and hospitals, where students, nurses, and doctors learn and practice their art on cyber entities that look and feel like real patients, can be generated electronically through the wonders of virtual reality units.

D. Rule 4

Realize that the present situation is not necessarily the future. Attempt to see the future and discern your place in it. Master the art of quick change with fast, but informed decision making. Do what you love, disregard what you do not, and let the fates have their way with you.

Assessment

I receive a couple of phone calls each month from young doctors on this topic. I ask them to decide if they are of the philosophical ilk to adhere to the above rules; or become another conformist and go along … to get along? In other words, get fly!

Or, become an employed, or government doctor.  Just remember … the entity that gives you a job, can also take it away.

Sample fly: http://crossoverhealth.com/

MORE: Marriage Business

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What President Biden’s Student Loan Forgiveness Means for Doctors

By Joe Hannan

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Key Takeaways

President Biden’s student loan forgiveness plan may offer some relief to residents, but many attending physicians will not be eligible.

  • Residents may see $10,000 to $20,000 in debt cancellation, plus a reduction in their monthly payments if they are on an income-driven repayment plan.
  • Clinicians should review the requirements to see if they are eligible. They should also keep tabs on developments with the Public Service Loan Forgiveness (PSLF) program, which could also help eliminate their debt.

Source: Joe Hannan, MD Linx [8/26/22] 

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CITE: https://www.r2library.com/Resource/Title/082610254

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PODCAST: Hospitals Block Guiding Patients

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PODCAST: Orthopedic Surgery Payment Changes in Total Knee and Hip Replacements

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TWO SKILLS: Physician Programmers Need to Know

By Joel Comm

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Machine Learning

The global machine learning market was valued at $15.44 billion in 2021, and it is expected to grow to $209 billion by 2029. Machine Learning is a technology that has grown in popularity over the past years, especially driven by the success of companies like Google in the field of AI.

This success is also in big part due to the technology becoming more accessible to the masses. Take OpenAI’s AI image generator, DALL-E, as an example: Since DALL-E Mini went public, it has been given uses ranging from making memes to artwork worth the attention of The New Yorker.

Gone are the days in which machine learning was only accessible to researchers in top-notch institutions. Today, machine learning can be mastered all around the globe in official institutions, online education platforms, and even via comics.

Web3 / Blockchain Development

Whether you are invested in crypto and NFTs or not, the Metaverse is being built, and it promises to turn centralized, corporate-controlled Web2 on its head. The world of computer users–that’s pretty much all of us–has, for years, grown increasingly frustrated by having to operate under the oversight of a few monoliths.

The promise of Web3 is community–not corporation–first.

Innovators in the space like Proof of Learn are developing easily accessible educational platforms where Web2 pros and the tech-interested can learn to code in Web3, in a learn and earn model. The company’s first project is a lore-rich online academy called Metacrafters.io, drawing in gamers and developers, and attracting some serious backing from leading VCs and crypto investors. Fellow industry leaders, such as Solana, Flow, Avalanche, and Polygon Foundations, recently gave $4.5 million in grant funding to support Metacrafters’ mission of upskilling Web2 developers. This grant helps fund their learn and earn protocol, so you get to take courses in a game world and get paid for it.

Metacrafters.io might be one with this learn and earn model teaching coding skills, but it is in line to inspire more of its kind. Look around at the landscape of Web3 education and get cracking, because the Metaverse will be here sooner than expected, and developers will be the major players in it.

HIT: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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DICTIONARY: Health Insurance and Managed Care

Designated a Doody’s CORE TITLE

To keep up with the ever-changing field of health care, we must learn new and re-learn old terminology in order to correctly apply it to practice. By bringing together the most up-to-date abbreviations, acronyms, definitions, and terms in the health care industry, the Dictionary offers a wealth of essential information that will help you understand the ever-changing policies and practices in health insurance and managed care today. For Further Information.

Review

The Dictionary of Health Insurance and Managed Care lifts the fog of confusion surrounding the most contentious topic in the health care industrial complex today. My suggestion therefore is to ‘read it, refer to it, recommend it, and reap’.”
Michael J. Stahl,PhD, Physician Executive MBA Program, William B. Stokely Distinguished Professor of Business, The University of Tennessee, College of Business Administration

DHIMC: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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PODCAST: Hospital CFOs Found Doctors Drive $1.56 Million / Doctor / Year by Ordering Tests and Performing Procedures!

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By Eric Bricker MD

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AMA ECONOMICS: https://medicalexecutivepost.com/2022/08/01/ama-to-teach-medical-students-about-health-economics/

Health Economics: https://medicalexecutivepost.com/2022/07/31/podcast-history-applied-to-health-economics/

DHEF: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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A Fiduciary Comes with Responsibilities to the Client

By Stephen Kelley, CSA

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As a Registered Investment Adviser (RIA) with a Series #65 securities license, we hold a fiduciary duty to you. This means that we are legally bound to put your interests above those of anyone else, including ourselves.

Now you might reasonably think that anyone offering financial advice or services to clients is required to be a fiduciary. Sadly, if you thought that, you’d be wrong. Some estimates claim that only 15 percent of advisors have a fiduciary duty to their clients. The Paladin Registry puts the number even lower, estimating that just one in 12 (8.3 percent) advisors have a fiduciary responsibility.

For the most part, stockbrokers (also called “Registered Representatives,” “Account Executives,” “Financial Advisors,” or “Wealth Managers”) are not fiduciaries, even though they are allowed to portray themselves as full-service investment advisors. If your stockbroker/registered representative/account executive/financial advisor/wealth manager holds a series seven [#7] securities license, then it’s probable that they aren’t a fiduciary.

This was made amply clear in the movie, “The Wolf of Wall Street,” a biopic about Jordan Belfort, a stockbroker who made his fortune selling junk stocks and bonds to middle-class investors: in other words, by cheating them. Much of it was perfectly legal. The SEC went after Belfort’s company, Stratton Oakmont, for nearly a decade before it was able to shut it down. The point being that even in the face of egregious wrongdoing, theft, fraud and a virtual sea of drugs and blatant hedonism, the securities laws in this country are so loose that it took billions in theft and a decade of suspected and known fraud to step in and stop the abuse. And this movie was based on a true story.

That’s why a fiduciary duty is so important to a client. Being a fiduciary is a legal distinction. A Registered Investment Advisor (RIA) or Investment Advisor Representative (IAR) who holds a Series #65 securities license, subject to the Investment Advisers Act of 1940, is a fiduciary. The legal investment advising standards that govern a non-fiduciary stockbroker and a fiduciary Registered Investment Advisor are very different.

A Registered Investment Advisor is legally required to follow the “trust” standard — the highest known in law — which requires it to place the interests of its clients ahead of its own and fulfill critical fiduciary duties of trust and confidence. Under the fiduciary trust standard, a Registered Investment Advisor must provide its “best advice” to a client. A non-fiduciary stockbroker (like the coveted Series #7 of “The Wolf of Wall Street”) follows only the “suitability” standard, which doesn’t require a stockbroker to place the interests of his clients ahead of its own. Under the non-fiduciary suitability standard, a stockbroker need provide only “suitable advice” to his clients — even if the stockbroker knows that the advice is not the best advice for the client.

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The table below helps summarize which professionals are fiduciaries.

Type of ProfessionalAre They A Fiduciary?
PhysicianYes
LawyerYES/Maybe
CPANo
Trust OfficerYes
Stock BrokerNo
Insurance AgentNo
Registered RepresentativeNo
CFP PractitionerMaybe
Financial PlannerMaybe
Registered Investment AdviserYes
NAFPA-Registered Financial AdvisorYes

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MORE: https://medicalexecutivepost.com/2022/05/21/an-interview-with-bennett-aikin-aif/

RELATED: https://www.kitces.com/blog/the-4-different-types-of-financial-advisor-fiduciaries/

CFPs: https://medicalexecutivepost.com/2016/11/18/why-we-cannot-assume-cfp-equals-fiduciary/

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Geographic Variation in Private Equity Penetration Across Physician Specialties

By NIHCM

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READ HERE: https://nihcm.org/publications/geographic-variation-in-private-equity-penetration-across-physician-specialties

CITE: https://www.r2library.com/Resource/Title/082610254

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Crafting a Medical Practice Business Plan for Entrepreneurial Physicians

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By Dr. David Edward Marcinko MBA

An Essential Document for Start-Up Practices

The analog to a personal financial plan is the medical practice business plan. While mature practitioners may casually be familiar with some elements of the former by default, most new physicians are totally unfamiliar with requirements of the later.  

The Need 

Unfortunately, without an initial business plan, the need for a personal financial plan may become moot. This is because absent financial backing from family, friends or a cushy nest egg, the business plan is a key tool for raising start-up capital for a new medical practice. It may also be demanded by a commercial bank, or the Small Business Administration (SBA), for a loan to finance growth of an existing practice; despite the use of new asset based lending and accounts receivable factoring techniques.  

On the other hand, a comprehensive business plan may be required by investment bankers for funding purposes; in exchange for a healthy percentage of your future large group practice. 

Standard Plan Format 

The following format for medical business plan writing can be used for every new practice, established practice or simply an existing practice that wishes to expand or establish a new service or product line to its existing offers.  

The format for any written business plan is somewhat standard. It usually contains at least the following topics and sub-topics, and perhaps many more depending on your specialty with a varying emphasis on some sections or a de-emphasis of others; also depending on the practice and covering no more than 25-40 numbered pages:

· Cover Sheet

· Table of Contents

· Physician Executive Summary (Statement of Purpose)

· Physician Credentials

· Mission Statement

· Goals and Objectives (Risks and Rewards)

· Business Office Form

· Operational and Facilities Management

· Marketing Plan

· Business Competition

· Patient Targeting

· Advertising Methodology

· SWOT Analysis

· Practice Philosophy

· Human Resources and Personnel

· Financial Management

· Financial and Operating Budget

· Proforma Financial Statements

· Exit Strategy

Assessment

In the past, perhaps the two most important components of a medical business plan were [1] physician credentials and [2] the business model. Today; it is the exit strategy! 

Have you ever written a medical office business plan and what was the outcome? 

Link: MBA Capstone Business Planning

Conclusion

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

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Future Trends Help Choose The Most Fitting Medical Specialty

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By Bertalan Meskó, MD PhD

I hope you will find the newsletter useful!
Best regards,
Berci Meskó, MD
The Medical Futurist

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READ HERE: https://medicalfuturist.com/future-trends-help-you-choose-the-most-fitting-medical-specialty/?mc_cid=becfbe85ae&mc_eid=40fee31c25

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MEDICARE FEE CUTS: The Altruism of Physicians is Used Against Them

By Nisha Mehta MD

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CMS Issues 2023 Physician Fee Schedule Proposed Rule

PHYSICIAN REIMBURSEMENT

CMS Issues 2023 Physician Fee Schedule Proposed Rule

On July 7, 2022, the Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2023. Arguably the most noteworthy provision in the proposed rule is the agency’s suggested cut to physician payments. However, the rule also includes a number of other policy proposals, including changes to Medicare accountable care organizations (ACOs), behavioral health care, cancer screening, and dental care. (Read more…)

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BUSINESS: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko
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Physician Mistreatment by Patients, Visitors and Doctors

By UPI News and Staff Reporters

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Nearly 1 in 4 hospital doctors are mistreated at work by patients, visitors and other doctors, and female doctors are nearly two times more likely than male doctors to face this abuse, a new study reveals.

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“All members of the healthcare team share the responsibility to mitigate mistreatment,” said senior study author Dr. Mickey Trockel, a clinical professor of psychiatry and behavioral sciences at the Stanford University School of Medicine and director of Evidence Based Innovation for the Stanford WellMD/WellPhD Center.

LINK: https://www.msn.com/en-us/health/medical/1-in-4-hospital-physicians-face-mistreatment-by-patients-visitors/ar-AAXa6Jp?li=BBnb7Kz

MD Burnout: https://medicalexecutivepost.com/2017/12/03/u-s-hospitals-feeling-the-pain-of-physician-burnout/

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PODCAST: Surescripts [Gatekeeper for Electronic Prescribing Explained]

By Eric Bricker MD

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PODCASTS: HEDIS Explained

Healthcare Effectiveness Data & Information Set

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#2 PODCAST: https://www.ahealthcarez.com/how-hedis-quality-scores-work

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Health Economics: https://medicalexecutivepost.com/2022/07/31/podcast-history-applied-to-health-economics/

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Hospital Consolidation: Trends, Impacts & Outlook

By NIHCM

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READ HERE: https://nihcm.org/publications/hospital-consolidation-trends-impacts-outlook

CITE: https://www.r2library.com/Resource/Title/082610254

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PODCAST: Google Launches Health Insurance Stop-Loss Company

By Eric Bricker MD

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Google Starts Stop Loss Company Called Coefficient

Coefficient Will be a Part of the Verily Healthcare Subsidiary Within Google. Coefficient Will Also Be in Partnership and Partly Owned by the Giant, International Reinsurance Company Swiss Re.

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PODCAST: Healthcare Stocks, Investing & IPOs?

By Eric Bricker MD

Healthcare Stock and IPO Investing Can Be Confusing. The Story of Privia Health is a Good Case Study in Understanding the Underlying Economics in Healthcare Investing:

CITE: https://www.r2library.com/Resource/Title/0826102549

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

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MEDICARE ADVANTAGE PLANS: TV Ads are Deceiving?

By Dr. Keith L. Gurnick, DPM

[Los Angeles, CA via PM Online]

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Paid spokespersons consisting exclusively of older celebrities, including William Shatner, George Forman, Joe Namath, and Jimmie “J.J.” Walker read similar, if not exact, scripts in an attempt to induce the elderly to phone and check their “zip code” to see if they are eligible. I can’t figure out what the zip code has to do with anything, but maybe someone can help me to understand this fish hook?

As of November 2021, 42% of all Medicare eligible patients are enrolled in Medicare Advantage plans. Does the viewing public not wonder why there is never any mention at all during these commercials that changing to a Medicare Advantage plan means switching their traditional Medicare over to an HMO, and that most likely they will lose their network of doctors and possibly hospitals as well? 

Why don’t they just tell the truth?

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Health Insurance: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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AMAZON Buys “One Medical”

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By Neal Freyman [Morning Brew]

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Amazon turned and coughed up $3.9 billion to buy One Medical, a primary care provider, in its biggest push yet into health care. It may not be long until your Prime membership comes with a complimentary physical.

What’s One Medical? A company that operates more than 180 medical offices across 25 US markets, offering both in-person and virtual medical services. When it went public as a unicorn in January 2020, it followed a similar trajectory of other high-flying startups: A huge spike when telehealth was in feverish demand, then an equally huge crash to fall well below its IPO price.

The deal for One Medical represents Andy Jassy’s first major acquisition as CEO of Amazon, showing that he’s willing to make bets on growth in certain areas even as he reins in costs in others.

So why is health care a priority?

As you know all too well from every time you pay a medical bill, health care is a massive industry. With a market size of $4 trillion, it accounts for about 20% of the entire US economy. And as Amazon looks to grow outside of its core areas, it sees potential in sending a digital shock wave through a medical industry that’s entangled in a complex web of insurance companies and government regulations.

Not that it’s even clear what a “core” area of Amazon is anymore. Besides its e-commerce marketplace, Amazon has tentacles in cloud services, grocery stores, entertainment, and many other sectors. Basically, we’re about to live in a world where one company owns the James Bond franchise…and also medical clinics.

But Amazon’s infatuation with health care isn’t new. It acquired the online pharmacy PillPack in 2018, and launched its own on-demand health care services one year later. Some projects, like its buzzy joint venture with Berkshire Hathaway and JPMorgan, collapsed, illustrating the challenges for anyone—even Bezos and Buffett—to break into the medical realm.

Those stumbles won’t stop Amazon, or Big Tech in general, from trying. Just this week, Apple released a 60-page report outlining why health care will be a major focus for the company going forward.—NF

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COMMENTS APPRECIATED

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?s=books&ie=UTF8&qid=1287563112&sr=1-9

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My Conversation with an Anonymous Cigna Representative

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Cigna, do you even have a clue that dentists don’t like you?

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By Darrell K. Pruitt DDS

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Hi Dr. Pruitt,

I’m truly sorry for any negative experience you’ve encountered with us. Is there a claim, benefit, or authorization concern I can help with? Please email me at LetUsHelpU@cigna.com. I’d like an opportunity to assist.

At a time when interest rates are surging, and just when I request an increase, CIGNA REDUCED MY REIMBURSEMENTS! Never again will I do business with you, and will discourage other dentists from falling into your trap …. And that is why dentists don’t like #TeamCigna. 

What is your name, anyway. You know mine. Perhaps Linkedin’s transparency makes it a poor choice for marketing Cigna.

As if things could get no worse between Cigna and dentists, you censored my response!

NOTE: Cigna representatives prefer to remain anonymous for reasons of accountability.

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COMMENTS APPRECIATED

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

Health Insurance: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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PODCAST: The “Hospital” – A Book Review

By Eric Bricker MD

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Book Review: ‘The Hospital’ by Brian Alexander –

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HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

HEALTH INSURANCE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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COMMENTS APPRECIATED

Thank You

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