Healthcare Organizations – The eJournal on CD

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

Journal of Financial Management Strategies **

Beginning in August 2009, we are pleased to inform you of two new milestones reached by Healthcare Organizations [e-Journal of Financial Management Strategies].

First, we have achieved journal status with our periodical publication. From a nomenclature perspective, we will no longer be known as a guide, but more rightly as the comprehensive journal we envisioned at inception.

Second, we have ceased our print-only existence and migrated to a CD-ROM format, via Adobe Reader, with quarterly email updates. This transition illustrates our collaborative philosophy in the modern health 2.0 participatory era. Of course, all chapter files are still printable at your own discretion.

“Bridging the Intersection of Medical Mission and Profit Margin”

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

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

* Unlimited non-transferabl license; not for redistribution or resale.

** Embossable binder available at slight surcharge

Letter: Publisher’s Letter

Conclusion

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

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

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

Sponsors Welcomed

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

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

Filed under: Alerts Sign-Up, Breaking News, Career Development, iMBA, Inc., Marketing & Advertising, Practice Management | Tagged: ASCs, CD-ROM, clinics, david marcinko, DC, DDS, DMD, DO, DPM, economc journal, financial journal, health 2.0, Healthcare Organizations, hope hetico, hospitlas, MD, medical clinics, medical offices, medical practices, OD, www.healthcarefinancials.com, www.medicalbusinessadvisors.com | Leave a comment »

Health Care Uses for Twitter [Suggestions for Micro-Sharing]

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

Health Care Should be the Leader in MicroSharing – Why isn’t It?

[By Staff Reporters]

According to by Phil Baumann, RN BSN; @ www.PhilBaumann.com

“Twitter may either be the greatest time wasting prank ever played on the internet community – or- it may be the best thing since sliced bread. It’s easy to make the first case if you read the public time-line for a few minutes. It’s a bit harder to make the second, but I’ll do my best to make it. Specifically, I’d like to take a stab at offering 140 health care uses for Twitter. Twitter’s simplicity of design, speed of delivery and ability to connect two or more people around the world provides a powerful means of communication, idea sharing and collaboration. There’s potency in the ability to burst out 140 characters, including a shortened URI. Could this power have any use in healthcare? After all, for example, doctors and nurses.”

Assessment

Read the 23 page white-paper here:

Link: http://blogs.usask.ca/medical_education/archive/2009/02/140_healthcare.html

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:

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

Filed under: "Doctors Only", Career Development, Information Technology, Marketing & Advertising, Media Mentions and PR, Practice Management, Research & Development | Tagged: betwittered, healthcare communications, micro-sharing, microsharing, phil baumann, tweet, tweets, twitter, twittering, URI, www.PhilBaumann.com, www.twitter.com | 19 Comments »

Obama, HIT and Transparency in Government

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

Enhancing Transparency in Government using the Internet

By Darrell K. Pruitt; DDS

I recently came across news that could possibly be the first tangible step in the inevitable demise of traditional lobbyist representation that we have known and endured all our lives. True to what the man promised in the fall of 2007, Barack H. Obama is ready to show the nation that he intends to decentralize power by enhancing transparency in government using the Internet.

Decentralization

Decentralization naturally scares entrenched, oppressive leaders inside and outside government who in the best of all worlds, shouldn’t be entrusted with power in the first place. It is my opinion that we are witnessing a huge Presidential step in the inevitable progress of the Internet-powered social revolution many have predicted for a decade or more. According to the unprecedented lobbying rules, virtually anything anyone says to public officials about the Recovery Act and Stimulus package must be immediately posted on the Internet (if it is not there already). No kidding. For example, I discovered this news in an article on the White House blog, posted by Jesse Lee on Friday, Its title is “Update on Recovery Act Lobbying Rules: New Limits on Special Interest Influence” (copied below).

Here is a line from the article: “Following OMB’s review, the Administration has decided to make a number of changes to the rules that we think make them even tougher on special interests and more focused on merits-based decision making.”

I am hopeful that Obama is sincere in his effort to steer our legislative body to make decisions based on merits rather than undocumented conversations funded by special interests. If he succeeds, one class of losers will be managed care stakeholders like Delta Dental who prefer to spend healthcare dollars to lobby congress rather than work things out with dentists who have to deal with their calculated lies. A perfect example of Delta’s stupidity is documented in “National insurer asks legislators to keep dental benefits in mind in health care reform” featuring Delta’s shy PR rep, Janis Oshensky.

http://ifawebnews.com/2009/04/01/national-insurer-asks-legislators-to-keep-dental-benefits-in-mind-in-health-care-reform

Insurance and Financial Advisor Website

The fact that Delta would pay for such a disingenuous PR piece on the Insurance & Financial Advisor Website shows how out of touch Oshensky is. It was posted appropriately enough on April 1. Two months later, I still cannot figure out the purpose of the ad. Just who was the vice president of dental relations and public policy for DDPA trying to impress? Her insurance buddies? Was this Janis Oshensky’s swell idea, or did a committee come up with the stinker? I don’t think we’ll ever know. Also, among the losers to transparency will be healthcare IT stakeholders with lousy goods to move. Rather than compete with each other, they prefer lobbying for mandated sales of worthless, but nevertheless CCHIT-certified products. Fair sales without the help of billions of stimulus dollars are impossible because doctors don’t want eMRs for unanticipated reasons of intelligence.

Healthcare IT Business Leaders

Recognized leaders of big healthcare IT businesses, such as Glen Tullman, the CEO of Allscripts, won’t like handing over political empowerment one bit. Did you know that Tullman and Obama are long-time Chicago buddies? I think the new rules mean Americans will finally have immediate access to their discussions about HIT. Sweet; I think I could learn to like Obama. I bet Tullman keeps his mouth shut. That’s sweet as well. If this news is as significant as it appears to be, I’m surprised it hasn’t attracted more attention by now. While nobody knows yet how Obama’s plan to post transcripts of oral communications with government officials is going to ultimately affect the way professional organizations are represented in Washington (or if it in the end changes anything at all), I’m pretty sure that what I have been reading carefully has the potential to turn the government over to those who can create content independent of committees, talking points and traditional hierarchy. I interpret Obama’s rules as the manifestation of what Thomas Friedman (“The World is Flat”) long ago called individual empowerment.

Got a beef? How are your writing skills these days? How effective is your social network?

This is good. The new restriction on oral communications with government officials for both registered and non-registered lobbyists (everyone in the nation) is terrible news for organizations which depend on store-bought secretive representation. On the other hand, it’s wonderful news for English majors, speech writers and special bastards with no shame.

ADA Lobbyists

I would never attempt to persuade you to take on my personal issues as your own, but please roll this development over in your mind and decide for yourself if the information I’m sharing might become an advantage for dental patients in the nation if dentists are mobilized for a more democratic form of representation long before the insurance industry can react. And that shouldn’t be too hard. Committees move oh so slowly, including ADA committees. If I am correct, if we work unconventionally, dentistry could be way ahead of the curve by preparing for independent written representation using informal social networks and Internet blogs. No planning or financing is needed. Face it, the money the ADA has paid to lobbyists starting a few years ago was wasted, and there is no way they can help the organization now. Dump them.

PR Assistance

Here is some powerful PR help I offer for free that cannot be purchased at any price, anywhere: If a dentist posts something that parallels my goals, on any blog, I will easily boost the exposure of the article more effectively than any SEO genius in the nation. I’ve proven so many times how I can do this by merely mentioning someone’s name. And I can help again, and again. All I have to do is discover someone who has confidence in good ideas for protecting our patients from harm. Put it out there and sit back. I’ll do the rest.

Assessment

I wonder if Obama knew anything about special bastards and unconventional PR when he chose transparency as a goal for his administration. Maybe I can teach him a thing or two. I have faith that if one’s goals are noble, nothing can hurt you in the land of the free. Come on out. The air is fine.

http://www.whitehouse.gov/blog/Update-on-Recovery-Act-Lobbying-Rules-New-Limits-on-Special-Interest-Influence/

FRIDAY, MAY 29TH, 2009 AT 5:35 PM

Update on Recovery Act Lobbying Rules: New Limits on Special Interest Influence

Posted by Jesse Lee

THE BRIEFING ROOM • THE BLOG

Another update from Norm Eisen, special counsel to the president for ethics and government reform, in the spirit of transparency as always:

I am writing with an update on the President’s March 20, 2009 Memorandum on Ensuring Responsible Spending of Recovery Act Funds. Section 3 of the Memorandum required all oral communications between federally registered lobbyists and government officials concerning Recovery Act policy to be disclosed on the Internet; barred registered lobbyists from having oral communications with government officials about specific Recovery Act projects or applications and instead required those communications to be in writing; and also required those written communications to be posted on the Internet. That Memorandum instructed the Office of Management and Budget (OMB) to review the initial 60 days of implementation of the stimulus lobbying restrictions, to evaluate the data, and to recommend modifications.

Following OMB’s review, the Administration has decided to make a number of changes to the rules that we think make them even tougher on special interests and more focused on merits-based decision making.

First, we will expand the restriction on oral communications to cover all persons, not just federally registered lobbyists. For the first time, we will reach contacts not only by registered lobbyists but also by unregistered ones, as well as anyone else exerting influence on the process. We concluded this was necessary under the unique circumstances of the stimulus program.

Second, we will focus the restriction on oral communications to target the scenario where concerns about merit-based decision-making are greatest –after competitive grant applications are submitted and before awards are made. Once such applications are on file, the competition should be strictly on the merits. To that end, comments (unless initiated by an agency official) must be in writing and will be posted on the Internet for every American to see.

Third, we will continue to require immediate internet disclosure of all other communications with registered lobbyists. If registered lobbyists have conversations or meetings before an application is filed, a form must be completed and posted to each agency’s website documenting the contact.

OMB will be consulting with agencies, outside experts and others about these principles and will publish detailed guidance, but we wanted to update interested parties on the outcome of the initial review. We consulted very broadly both within and outside of government (including as reflected in previous posts on the White House blog) and we are grateful to all those who participated in the process.

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

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

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

Filed under: Alerts Sign-Up, Career Development, Ethics, Health Law & Policy, Information Technology, Op-Editorials, Research & Development | Tagged: ADA, Allscripts, American Dental Association, “Update on Recovery Act Lobbying Rules: New Limits on Special Interest Influence”, CCHIT, DDPA, delta dental, EHRs, EMRs, Glen Tullman, HIMMS, HIT, Insurance & Financial Advisor, IT, Janis Oshensky, Jesse Lee, lobbyists, Norm Eisen, obama, OMB | 11 Comments »

The Power of “ME Inc” for Physicians

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

Embracing a New Competitive Practice Culture

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

There are more than 900,000 physicians in the United States. Yet, the brutal supply/demand/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. And, the government as payer will likely increase with the Obama Administration. So, going forward, it is not difficult to imagine the following four rules for a new-wave competitive medical care culture for all physicians.

[A] Rule No. 1

Forget about large office suites, surgery centers, fancy equipment and the bricks and mortar that comprised traditional medical practices. One doctor with a great idea, good bedside manner or competitive advantage, can outfox a slew of CPAs, while still serving the public and making money. It’s a unit-of-one healthcare economy where “ME Inc.”, is the standard and physicians must maneuver for advantages that boost their standing and credibility among patients and payers. Examples include patient satisfaction surveys, the rise of evidence-based medicine; outcomes research analysis, concierge medicine, direct reimbursement payment plans, and economic credentialing; etc.

[B] Rule No. 2

Challenge conventional wisdom, think outside the traditional payer box, recapture your dreams and ambitions, disregard conventional gurus and work harder – and smarter – than you have ever worked before. Remember the old saying, “if everyone is thinking alike, then nobody is thinking”. Do insurance panel members think rationally or react irrationally?

However, you should realize the power of networking, vertical integration and the establishment of virtual medical practices, which come together to treat a patient, and then disband when a successful outcome achieved. Job security in this structure is achieved with successful outcomes, and perhaps not necessarily a degree in the near future. Medical futurists even presume the establishment of virtual medical schools and hospitals, where students and doctors learn and practice their art on cyber-entities that look and feel like real patients, but are generated electronically through the wonders of virtual reality units.

www.HealthcareFinancials.com

[C] Rule No 3

Differentiate yourself among your medical peers. Do or learn something new and unknown by your competitors. Market your accomplishments and let the world know. Be a non-conformist. The conformity of health insurance plans are an operational standard and a straitjacket on creativity. Doctors should create and innovate, not blindly follow entrenched medical society leaders into oblivion. Seek, and practice, health 2.0 collaboration with all stakeholders.

[D] Rule No 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 the quick change and fast but informed decision making. Do what you love, disregard what you don’t, and let the fates have their way with you. Then, decide for yourself if health plans adhere to any of the above rules?

Assessment

Regardless of the future de facto business model of the learned profession of medicine, current practice models are no longer the structure of choice. Rather, a more laissez-faire and highly competitive business model should be pursued. Physicians have been slow to accept this philosophy. Remember, as a physician, if you merely want a static job with promised security, pledged retirement benefits, limited goals and structured regulations; join a health plan panel and become their laborer.

However, if you desire more, such as the possibility of a dynamic career, the unlimited security of your brainpower, non-defined retirement contributions, infinite potential with rules you can create along the way; incorporate the power of ME, Inc., in everything you do. Remain a competitive professional and be a physician ... Get fly!

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

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

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

Filed under: Career Development, Ethics, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Practice Management | Tagged: Comparative Medical Effectiveness, competition, concierge medicine, CPAs, david marcinko, direct reimbursement, healthcare competition, outcomes research, physician economic credentialing | 3 Comments »

On Incestuous eHR Relationships

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

More on HIMMS and CCHIT

By Darrell Pruitt; DDS

Ann and ME-P Friends

I want to share with you this article from Kaiser that just popped up.

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=58548

The Healthcare Information and Management Systems Society (HIMSS), an organization founded by healthcare IT technology vendors and other stakeholders, is the parent organization of the Certification Commission for Healthcare Information Technology (CCHIT). In fact, CCHIT is presently managed by HIMSS’s former chief medical officer, Mark Leavitt. That’s not all. This Kaiser article points out that until recently, Leavitt was being paid by HIMSS while working for CCHIT. As some of us already openly suspect, the public-private powerhouse called CCHIT certainly sports the architecture of world-class conflict of interest in the Victorian style of the late 19^th century.

The Washington Post Expose’

Just yesterday, Robert O’Harrow Jr., writing for the Washington Post, said documents show HIMSS asked the Obama Administration to require that any electronic health record equipment receiving stimulus funding be certified by CCHIT – the stakeholders’ bastard progeny.

http://www.washingtonpost.com/wp-dyn/content/article/2009/05/20/AR2009052003600.html

Well, O’Harrow actually didn’t use the words, “bastard progeny.”

CCHIT Steering HIMSS

HIMSS naturally thinks keeping CCHIT as the steering organization of healthcare IT is a really swell idea, and maintains that ‘meaningful use” of their goods is very, very important in rewarding stimulus money. Yet, as significant as the buzz-word sounds, it looks to me like “meaningful use” will be better described as “clicking for cash.”

Leavitt Brushes Off Criticism

The Kaiser article says that Leavitt brushes off the critics of CCHIT as would-be vendors who are angry because they failed certification; incredible mind, that man!

Assessment

Even before I read this article, and the accompanying “In related news” blurb about National Coordinator for Health IT David Blumenthal, I have seen a few things that make me suspect that Blumenthal and CCHIT leaders, specifically Glen Tullman from Allscripts, are probably already viciously, but secretly butting heads. I interpret this real-time history to show that soon, Blumenthal will either hang Leavitt and CCHIT over “meaningful use’ or he will resign in frustration.

But, what do I know? I’m a dentist, not a plumber.

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Alerts Sign-Up, Breaking News, Career Development, Ethics, Information Technology, Op-Editorials | Tagged: Allscripts, CCHIT, Certification Commission for Healthcare Information Technology, David Blumenthal, EHRs, EMRs, Glen Tullman, Healthcare Information and Management Systems Society, HIMMS, Kaiser, Mark Leavitt, National Coordinator for Health IT, Robert O' Harrow Jr | 5 Comments »

Interview with Jack Levy of Securebill, Inc

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

President – Securebill, Inc

What: An Interview and Special Report Exclusively Prepared for the ME-P
Who: Mr. Jack Levy, CISSP [President – Securebill, Inc]
Topic: Physician Selection of eHRs
Reporter: Amaury Cifuentes; CFP®
Where: Internet Ether

Although skeptics of eHRs abound, President Barack H. Obama’s signing of the American Recovery and Reinvestment Act [ARRA] of 2009 has created a massive push for their implementation. The Act provides $19.2 billion, including $17.2 billion for financial incentives to be administered by Medicare and Medicaid. This assistance of up to $40 to $65 thousand per eligible physician, and up to $11 million per hospital, begins in 2011.

Link: https://medicalexecutivepost.com/wp-content/uploads/2009/05/jack-levy-interview.pdf

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

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

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

Filed under: Breaking News, Career Development, Information Technology, Interviews, Practice Management | Tagged: Amaury Cifuentes, American Recovery and Reinvestment Act, ARRA, CISSP, EHRs, electronic medical records, EMRs, HITECH, Jack Levy, Medicaid, medicare, obama, Securebill | 1 Comment »

Feds Propose Educational Website on ePHRs

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

Site Aimed at Consumers

[By Staff Reporters]

As reported by Mary Mosquera on May 22 2009, the Office of the National Coordinator for Health Information Technology (ONCHIT) just proposed developing a Web site for consumers. The site is to contain facts about electronic-personal health record systems and their privacy policies. It aims to help consumers and patients make informed decisions.

http://govhealthit.com/articles/2009/05/22/feds-propose-phr-website.aspx?s=GHIT_260509

Assessment

The Department of Health and Human Services [DHHS] Agency information collection request, for a 30-days public comment period, is also located here.

http://edocket.access.gpo.gov/2009/E9-12023.htm

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Breaking News, Career Development, Information Technology, Military Medicine, Practice Management | Tagged: CCHIT, DHHS, EHRs, electronic health records, electronic medical records, EMRs, ePHRs, ePRs, medical records, Office of the National Coordinator for Health Information Technology, ONHIT | 5 Comments »

About Timely Medical Alternatives; Inc

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

Understanding Canadian Health System Alternatives

By Staff Reporters

In 2003, Timely Medical Alternatives Inc. was formed to help Canadians, on long medical waiting lists, to take personal responsibility for their own medical care and “Leave the queue” [the national healthcare system waiting-list].

Urgent Need

According to their website, the need for private medical services is thriving in Canada. The mission of Timely Medical Alternatives [TMA] is to accommodate Canadian’s needs for private medical services by providing them with options, referrals to hospitals, clinics and diagnostic imaging facilities.

Link: http://www.timelymedical.ca

Assessment

Timely Medical Alternatives, a PPO, says it is able to expedite most types of private medical services from diagnostics to virtually all types of surgery, including procedures not available within the Canadian healthcare system. Wait times for clients are measured in days rather than in months or years.

Link: www.HealthDictionarySeries.com

Sicko Alternative

The movie documentary Sicko was directed by Michael Moore in 2007. It compared the highly profitable American health care industry to other nations, and HMO horror stories

Link: www.michaelmoore.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Please compare and contrast TMA to “Sicko”, our current domestic health system, and the Obama administration’s vision of national healthcare for the US; and opine .Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

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

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

Filed under: Career Development, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Practice Management, Quality Initiatives | Leave a comment »

About the ASTER Pilot Project

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

Improving the Reporting of Adverse Events

By Staff Reporters

According to its website, ‘ASTER’ stands for “ADE Spontaneous Triggered Event Reporting”. The ASTER study was conceived as a proof-of-concept project for a new model of gathering and reporting spontaneous adverse drug events (ADEs).

A Collaborative Project

ASTER is a collaboration of the following organizations and individuals:

Brigham and Women’s Hospital (Dr. David Bates is sponsor, Dr. Jeffrey Linder is Lead Investigator)
Partners Healthcare – use of the Longitudinal Medical Record
CDISC (an international standards group)
CRIX International (a public/private not-for-profit organization)
Pfizer Incorporated

Assessment

ASTER will implement automated ADE collection in an ambulatory clinic electronic health record (eHR). It employs a flexible standard for data collection known as “Retrieve Form for Data” (RFD) from CDISC and Integrating the Healthcare Enterprise (IHE), and will use CRIX International to host the application. The application allows direct downloading of data from the EHR and will forward the report to the FDA in the proper formats for electronic reporting of individual case safety reports (ICSRs).

http://www.asterstudy.com

www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/05MAY2009/0905HHN_Inbox_Medication&domain=HHNMAG

Conclusion

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

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

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

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

Filed under: Breaking News, Career Development, Drugs and Pharma, Information Technology, Practice Management | Tagged: ADE Spontaneous Triggered Event Reporting, ADEs, adverse drug events, adverse drug reactions, ASTER, CDISC, CRIX, Dr. David Bates, Dr. Jeffrey Linder, EHRs, EMRs, FDA, ICSRs, IHE, longitudinal medical records, Partners Healthcare, Pfizer | 2 Comments »

Global Health CIO Congratulations

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

Medical Technologists That Stand Out in the Crowd

By Staff Reporters

The May 25, 2009 issue of InformationWeek listed the top Fifty Global Chief Information Officers [CIOs] from around the world and profiled them by the strategic contributions made to their respective companies.

Healthcare IT Leaders

Curiously, we noted these health care, medical and pharmaceutical related CIOs on the report:

Chen Jinxiong – Fuzhou General Hospital
Jody Davids – Cardinal Health
Dan Drawbaugh – University of Pittsburgh Medical Center
Feng Taichuan – Xian-Janssen Pharmaceutical
Michael Heim – Eli Lilly
Daniel Lebeau – GlaxoSmithKline Biologicals

Assessment

Full profiles may be accessed at: www.informationweek.com/globalcio50

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to congratulate these folks for a job well done, and review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Sponsors Welcomed

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

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

Filed under: Breaking News, Career Development, Drugs and Pharma, Information Technology | 2 Comments »

Beware the Faux Medical Journals

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

When is a “Journal” … not a Journal?

By Dr. David Edward Marcinko; MBA, CMP™

Publisher-in-Chief

Allow me to begin this post by making the unusual disclosure that I was the Editor-in-Chief of a print guide in healthcare finance and economics [aka periodical or journal].

Formally, the title was: Healthcare Organizations [Financial Management Strategies]. At 2 volumes, and more than 1,200 pages, it was quite a job to update it quarterly. And, with more than two dozen contributing authors, it was a labor of love indeed. Alas … no more!

Varying Levels of Credibility

Now, we doctors know that medical journals are not all alike. There are different levels of “credibility.” Some are peer-reviewed, others not. Some are trade magazines. Frankly, some “real” journals are better, and more respected than others. Some entrenched journals are in decline, while other emerging journals are leading-edge in the health 2.0 space. Still others, like the formerly esteemed Journal of the American Medical Association [JAMA], have been accused of outright censorship.

Link: https://healthcarefinancials.wordpress.com/2009/04/02/is-jama-censoring-physician-dissent/

Adventures

Of course, doctors also know that pharmaceutical companies routinely offer us reprints of articles from medical journals that are favorable to their products. But, news of a Merck-sponsored publication for doctors in Australia has come to light in a personal injury lawsuit over Vioxx. It raised more than a few eyebrows in international medical publishing circles. It may have even crossed the line of journalistic, not to mention medical, ethics.

Read: Merck Paid for Medical ‘Journal’ Without Disclosure; by Natasha Singer, May 13, 2009.

Link: http://www.nytimes.com/2009/05/14/business/14vioxxside.html?_r=1&adxnnl=1&adxnnlx=1242313549-xaAEwW4MCd7pJh9OdgWdUQ

Mis-Adverntures

Tracy Staton wrote more about these mis-adventures in a story, dated May 14, 2009, in FiercePharma.

Analysis and Apology

Analysis in the Pipeline: http://seekingalpha.com/article/136942-merck-and-elsevier-cross-the-line-in-joint-medical-journal?source=yahoo

Libology Mea Culpa: http://www.libology.com/blog/tag/excerpta-medica

Assessment

Perhaps; Merck ought to read our Medical-Executive Post on health journalists?

Link: https://healthcarefinancials.wordpress.com/2009/03/17/battered-health-journalists

Or, our Medical-Executive Post on medical experts, reporters and journalists?

Link: https://healthcarefinancials.wordpress.com/2009/03/09/healthcare-experts-versus-health-journalists

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: "Doctors Only", Breaking News, Career Development, Drugs and Pharma, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Op-Editorials, Recommended Books, Risk Management | Tagged: big-pharma, david marcinko, Drugs, JAMA, medical journals, Merck, Natasha Singer, pharmaceticals, Tracy Staton, Vioxx, www.healthcarefinancials.com | 12 Comments »

Employers and eDocAmerica

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

An Emerging Health 2.0 Benefits Program

By Staff Reporters

eDocAmerica’s mission is to improve health by providing direct, online access to medical services, making it much more convenient to get the information for employees to take better care of themselves.

Services

Services enable employees to provide better self care, to lead to a healthier life, and to visit a physician only when necessary. Medical problems can often be managed with the tools available on eDocAmerica’s website. Services include medical information from board certified physicians, and educational material about the medical conditions of employees and family members. Physician responses are authoritative and are made within 24 hours from the time of the request, with most responses arriving in three to four hours. Problems that require a more rapid response should be managed by a visit to a personal physician or an emergency facility.

MD Online

MD Online LLC [dba eDocAmerica] is a fully funded, private company. eDocAmerica has a ‘no advertising policy’ and therefore does not host or receive funding from advertising from the display of commercial content. It is an HONcode compliant website. (www.hon.ch)

Benefits

eDocAmerica provides an innovative and effective Health 2.0 employee benefit program that purports to:

Increase employee satisfaction and morale
Decrease absenteeism
Save money on health care costs
Improve employees’ health
Provide online access to board certified physicians.

Assessment

eDocAmerica allows employees or members to have access to board certified, experienced physicians to consult with them about health care. eDocAmerica physicians provide personal advice, suggest treatment alternatives, use links to websites, provide patient information from other sources, or refer employees to their specialists – all from the workplace desktop computer or from home. The cost of eDocAmerica for a year for one employee is less than one primary care visit.

More Info
email: info@edocamerica.com and phone: 1-866-525-eDoc (3362)

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Alerts Sign-Up, Career Development, Financial Planning, Health Insurance, Information Technology, Insurance Matters, Quality Initiatives, Research & Development | Tagged: eDocAmerica, employee benefits, health 2.0, health 2.0 employee benefits, MD Online, online healthcare, online medical services | 1 Comment »

Economic Facts your Dentist Doesn’t Want You to Know

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

Some Office Visit Schedules Linked to Insurance Payment

By D. Kellus Pruitt; DDS

http://thebulletin.us/articles/2009/05/21/herb_denenberg/doc4a15404e56e5f308210565.txt

Here is the link to an article written by Herb Denenberg titled: “Some Facts Your Dentist Doesn’t Want You to Know”. In it, he shared with his readers some information about dentistry that is hard to find. I submitted the following comment.

Dear Herb Denenberg,

Yours was a great article, and as a dentist with 27 years in a comfortable practice and 32 years in an expensive marriage, I find your cost-saving points oh so painfully accurate. Nevertheless, I must honestly agree that not only can some patients safely go a year or more between check-ups (ouch!), but many don’t need bitewing x-rays every year either (Good thing neither my patients nor my wife read the stuff I write).

Of BiteWing X-Rays

Readers who are hopefully from places other than the east side of Fort Worth can easily understand that the more treatment and x-rays I recommend, the more money I make. I must honestly add that my devoted and trusting dental patients, like most Fort Worth dentists’ patients, are reliably willing to accept my recommendations for these kinds of procedures without questioning the need. Let me put it this way: Annual bitewings are an easy $56 sale, mostly because fee-for-service insurance pays for them at 100% anyway. (If an angry dentist should ask who told you that, it wasn’t me). That is why it should not be taken lightly my approval of the advice about dentistry published in the book “1,001 Things They Won’t Tell You.” And; they won’t, sometimes.

Ethics and EBD

True to ethics I learned at the University of Texas dental school, in San Antonio (UTHSC), in the last six months, my hygienists and I have been determining which patients are safe to go a year and a half without routine bitewing x-rays. They are commonly taken every year simply because it has always been that way, and that interval was adopted as the minimum time most insurers allow. As readers can see, not a hint of Evidence-Based Dentistry [EBD] was involved in that determination. It was just a 1950’s guess.

Extended Prophylactic Schedules

This week we found four candidates in our practice for extended schedules. Our honesty will save these patients (their insurance companies) money by eliminating unnecessary care. And I really, really hate saving insurance companies money, on principle alone.

In My Defense

In my defense of continuing to maintain a large number of my patients on 6 month prophys and 12 month x-rays – and with the hope of restraining local dentists from throwing rocks through my windows – let me say up front that most people still need the old-school schedule in order to prevent disease. And, a few of the more fragile cases need x-rays and cleanings even more often than insurance allows.

Assessment

My patients and I are fortunate that I can freely charge the prices I deem necessary in order to put my patients’ interests above my wife’s. Let’s face it. Ethics are invisible to dental patients and they are not free. Ethics are a precious courtesy that dentists who accept managed care insurance find themselves forced to eliminate because contracts prevent them from raising fees as the market demands. Managed care dentistry is dentistry by the lowest bidder with no quality control. I only wish that someone would have pointed out that chunk of information in the book. Now, I’d better have my wife go ahead and start my car in the morning when she grabs the paper.

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Doctors Only", Career Development, Ethics, Health Economics, Health Insurance, Managed Care, Practice Management | Tagged: ADA, bite wing X-rays, cavities, Darrell Pruitt, DDS, dental visits, DMD, EBD, evidence based dentistry, Herb Denenberg, UTHSC | 7 Comments »

Sign-Up for the ME-P

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

Direct Delivery to your Private e-mail Box

By Ann Miller; RN, MHA

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

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

Sponsors Welcomed

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

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

With more than 50 topic channels to select, the ME-P is sure to professionally “enlighten” you, and “illuminate” your day; almost each and every day.

Sign-Up Here:

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

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Alerts Sign-Up, Career Development, Marketing & Advertising, Sponsors | Tagged: david marcinko, hope hetico, medical executive post, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.healthdictionaryseries.com, www.medicalbusinessadvisors.com | Leave a comment »

Join our Corporate Reporting Staff

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

Free-Labor Experts and ME-P Contributing Authors Wanted

By Ann Miller; RN, MHA

[Executive Director]

Please contact us if you are interested in becoming an ad-hoc, free-lance, independent-contractor or regular contributing author for the Medical Executive Post.

Deep industry-related experience is required. All writing samples will be considered. CV submission is required.

Outstanding experts may also request consideration for print book, journal-guide and/or other peer-reviewed publications and assignments for additiona high-end exposure.

Assessment

“Nurturing Expertise – Promoting Talent with Insights Unavailable Elsewhere”

Conclusion

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

Get our Widget: Get this widget!

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

Filed under: Alerts Sign-Up, Breaking News, Career Development, iMBA, Inc., Nominations Sought, Research & Development, Sponsors | Leave a comment »

Understanding Periodic or New Employee Practice Compliance Audits

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

Perform and Improve as Needed

By Patricia Trites MPA, CHBC; with Staff Reporters

www.HealthcareFinancials.com

There are several types of compliance audits that a medical practice, clinic or healthcare organization might need to perform. The starting point, discussed elsewhere on this ME-P, is to obtain a baseline audit. The next step is periodic audits or reviews that are performed after information is obtained from the baseline audit.

Periodic Audits

Periodic audits are performed on an on-going basis. Depending on the volume of billing, these may occur weekly for a large multi-specialty ambulatory clinic to quarterly for a small medical practice. These periodic audits can be random or scheduled. Sometimes in the process of seeing how things run, a surprise review can be informative to staff and practitioners.

New Employee Audits

New employees require regular training and reviews until there is confidence in their capabilities. Background checks are often helpful to find out whether there are any potential conflicts. In hospitals, health plan offices, surgery centers, and other regulated facilities, background checks are a normal part of the credentialing process. This process typically includes Medicare violations, which would show up on the National Practitioner Data Bank report. However, independent medical practices do not have access to this type of information and may have to rely on other organizations to obtain the information. The OIG and the General Services Administration both maintain a database of excluded persons and entities that can be accessed through the Internet. As part of the organization’s initial and periodic audits, queries of these two databases should be performed for all employees and independent contractors (like locum tenens physicians). Failure to do so can put the practice at risk of large civil money penalties ($10,000 for each occurrence) and liability for refunds of all claims the excluded individual had part in providing or billing.

Assessment

Additional audits can be performed whenever new employees are added, or if there are complaints or issues that arise in the course of business; prn.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? What interesting, informative or strange tidbits have you uncovered in your auditing processes?

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Doctors Only", Career Development, Ethics, Managed Care, Practice Management, Risk Management | Tagged: audits, baseline audit, compliance, david marcinko, GSA, HMO, hope hetico, locum tenens, medicare, Medicare Advantage, Medicare audits, medicare billing, Medicare compliance audit, medicare compliance audits, Medicare HMOs, Medicare plans, National Practitioner Data Bank, new employee audit, OIG, Patricia Trites, www.healthcarefinancials.com, www.healthdictionaryseries.com | Leave a comment »

Military Electronic Dental Records [eDRs]

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

US Defense Department Leads the Way

By Staff Reporters

According to Peter Bauxbaum on May 13, 2009, the Defense Health Information Management System [DHIMS] is in the process of deploying AHLTA [Armed Forces Health Longitudinal Technology Application] Dental; a module eDR included with the new AHLTA 3.3 release.

It is the U.S. military’s first integrated dental and medical electronic health record.

Link: http://govhealthit.com/articles/2009/05/13/dod-electronic-dental-record.aspx?s=GHIT_190509

Assessment

And so, when will eHRs for osteopaths [eOsteoRs], podiatrists [ePodRs] and optometrists [eOptRs] become available? Is this an occasion when the military is an early HIT adopter?

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: "Doctors Only", Breaking News, Career Development, Military Medicine, Quality Initiatives, Research & Development | Tagged: AHLTA, AHLTA 3.3, Armed Forces Health Longitudinal Technology Application, DHIMS, EHRs, EMRs, HIT, IT, Military Medicine, Peter Bauxbaum, US Defense Department | 12 Comments »

Doctor’s and Tax Deductions

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

Physicians Can Take More Tax Deductions

By Staff Reporters

Now that tax season is over, it’s time for physician practices to start saving receipts and filing tax records again.

The Report

According to the May 04, 2009 report of Chelsey Ledue, Associate Editor of Healthcare Finance News; there are more than 400 possible deductions that medical practices can take, although most physicians only know of a few common ones.

Link: www.CertifiedMedicalPlanner.org

Assessment

In reality, “most docs are taking somewhere in the neighborhood of 40 deductions”, according to one industry expert.

Link: http://www.healthcarefinancenews.com/news/physicians-can-take-more-tax-deductions

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: Accounting, Book Reviews, Career Development, Financial Planning, iMBA, Inc., Practice Management, Recommended Books, Taxation | 5 Comments »

American Recovery and Reinvestment Act Primer for Physicians

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

Free ARRA Webinar Series

By Staff Reporters

Are you ready to maximize American Recovery and Reinvestment Act (ARRA) opportunities in your medical practice?

The Webinar Series

This webinar series is designed to support physician practices as they prepare for a new health care environment. As new information becomes available, experts and health care leaders representing diverse sectors will review key components of ARRA and offer insights on the impact to the physician community.

Topic: Stimulus 101: Basics of the Health Information Technology Provisions

When: Thursday, May 21, 12:00 PM CST

Presenters:

Glen Tullman, Chief Executive Officer – Allscripts
Margaret Garikes, Director of Federal Affairs – AMA

Assessment

Plus, hear from practices using eHR systems and how they made the transition.

Registration: https://cc.readytalk.com/cc/schedule/display.do?udc=1ip8sqjax7frw

Conclusion

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

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

Filed under: "Doctors Only", Breaking News, Career Development, Information Technology, Op-Editorials, Practice Management, Research & Development, Videos | Tagged: Allscripts, AMA, ARRA, EHRs, EMRs, Glen Tullman, HIT, HITECH, IT, Margaret Gariks, webinar, www.healthcarefinancials.com, www.healthdictionaryseries.com | 6 Comments »

Health Information Technology Security and Encryption

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

Understanding the Risks of eMRs and Internet Connectivity

[By Carol S. Miller; RN, MBA]

E-mails, PDA data, and Internet connectivity, unless encrypted, can be read by anyone. Therefore, if these items are not encrypted, physicians should be careful of what they say and how they say it, especially when discussing any patient information with other providers, vendors, or managed care organizations. In addition, just because you deleted e-mail from the system does not mean that you have deleted it from the server or from the computers that maintain copies of your server’s data. HIPAA regulations set forth the criteria in electronically transferring patient related data via the Internet.

Secure and Encrypt Messages and Health Information

If you want secure messages, an encryption program should be used. If the message is intercepted the text will be scrambled to anyone other than your intended recipient. Most physicians feel encryption is too time consuming; however, programs such as Pretty Good Privacy at www.pgp.com provides an easy and nearly seamless integration into e-mail and operating systems, encrypting the sensitive files but still allowing ease of communication. PCP software developed by MIT and endorsed by HIPAA, uses privacy and strong authentication. Only the intended recipient can read the data. If files were intercepted, they would be completely unreadable. Other software programs are available in the marketplace that will work using a private key – similar to a password. Tell the program the name of the file you want to encrypt and the private key, and the program uses a mathematical algorithm to encrypt the file. For reference material on various encryption and security software programs, search the web under “encryption” or go to one of the following sites: www.zixit.com, www.cisco.com, www.aspencrypt.com, or www.verisgn.com.

Assessment

In addition to encryption, the office needs a good anti-virus program that is designed to detect and prevent viruses, such as Norton Anti Virus at www.symantec.com and McAfee VirusScan at www.mcafee.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Book Reviews, Career Development, iMBA, Information Technology, Practice Management, Recommended Books, Sponsors | Tagged: carol s. miller, david marcinko, EHRs, EMRs, health 2.0, health data encryption, health information security, healthcare IT, HIPAA, hope hetico, internet connectivity, PDAs, www.healthdictionaryseries.com, www.medicalbusinessadvisors.com | 6 Comments »

On Medical and Other Patient-Centric Specialty Homes

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

New Guidelines Released

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

According to Chris Silva, AMA News on May, 12 2009, new medical home guidelines have just been released.

Physician Input

Four physician organizations have developed new guidelines for medical home projects to ensure consistency and help define how a patient-centered home model should look. The 16 guidelines include recommendations on who should collaborate on the projects, how they should choose practices to participate, what type of support should be provided to practices, how practices should be reimbursed, and what each project should do to analyze and report results.

Link: http://www.ama-assn.org/amednews/2009/05/11/gvse0512.htm

Assessment

Physician groups hope clarity and consistency will lead to broader acceptance of the programs. But, what about mental health homes or dental homes; how about podiatry or optometric homes, etc? What about patient mobility?

Is this concept even viable given our increasingly mobile society? Or, is this philosophy fixed in the last century; especially in light of the Obama Administration’s HIT, and eHR initiatives? Was the fluid health 2.0 culture even considered? What are we missing?

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: "Doctors Only", Breaking News, Career Development, iMBA, Inc., Information Technology, Op-Editorials, Practice Management, Quality Initiatives, Research & Development, Sponsors | Tagged: Chris Silva, david marcinko, dental homes, EHRs, HIT, medical homes, obama, patient centric medical homes | 15 Comments »

Physician [Fee] Schedule Augmentation

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

Organizing and Analyzing Financial Data

[By Christy Clodwick; MHA]

After all medical practice management data has been gathered, organize it onto a spreadsheet or chart. This analysis report will help to determine the codes and/or health plans that should be targeted for process improvement.

Focus … Focus … Focus

The focus should be on the highest volume and dollar value codes. Does this mean patients with unusual conditions or low dollar value codes are not treated? Hopefully it will not; but it will push this process forward and the practice will see the greatest benefit from these categories. When you review the report and find that a fee is being paid at a much lower rate, this would be indicative of a necessary negotiation with the payer for an increase for that procedure. Most health plans are committed to preventing disease. Maybe, but they are still actually aimed at treating diseases; not preventing them. If this is true of many payers then they should be willing to provide the incentives for those services to be carried out. You will find that some payers’ fee schedules are very much out of line with a percentage of Medicare payments, therefore the practice administrator should focus on those payers and bring evidence of the inadequacies to their attention.

The Specialists

Specialists are, for the most part, paid at a higher rate than primary care physicians not usually for the same service! And, with GPs as gatekeepers, the specialty doc incomes may have actually decreased in some instances, while the GPs may have increased. There was a time when Medicare had two conversion factors, and this was the result. This inequity could also be used as a tool for better reimbursement rates.

Finalizing the Fee and Revenue Analysis

When the final preparations of the fee analysis have been completed, it is time to react to the results of the findings. There are several options to choose from when it has been determined that a health plans fee schedule is not in tune with the practice’s financial growth. The practice should act on these results as soon as they are discovered, to avoid the loss of any more revenue.

No longer Accepting Health Plans

During the analysis phase, you may determine that a health plan’s payment levels are extremely low. You will have to determine whether the plan is worth negotiating or the practice administrator should consider dropping out of the plan altogether at the end of the contract period. It will have to be carefully determined by the local market. If the practice is in a highly competitive market, this process should not be considered as first choice. However, if the market is very slim, the health care purchaser will be responsible for complaining to the health insurance plan provider that there is simply not enough physician coverage for their employees for the area. This could be a very effective way to force a negotiation with the health care company. If this were the case, the area would have less managed care and more MC/MD.

Not Accepting New Patients from Low Paying Health Plans

One option would be to not accept any more patients from the health plan that is reimbursing the practice with low rates. Although this may initially lower your patient count, over time the practice will benefit from new patients with health plans that have a better reimbursement policy. Include snapshot of what the final analysis or report should look like and the details of what it should include. This can be used in any specialty to assist in putting together the individual practice analysis to achieve the same results. But is it noble or ethical? What about any willing provider laws?

The Future for Health Care Reimbursement

The health care purchasers who pay most of the bills, such as employers and the government, will soon be challenging the annual increase and the overall cost of health care. The cost increases of the hospital and pharmacy sectors of healthcare are far higher than that of the physician. However, the pressure for cost containment is being felt across the board. This will eventually depress future reimbursement for all healthcare providers. In the future it will be hard for practices to keep up with the demands of labor, malpractice and supply cost increase. All medical providers need to plan for this future paradigm. To offset this trend, physicians will need to get the most out of the work that they are doing today as well as look to new revenue generating procedures for their practice that will be cheaper and more convenient to the patient.

Process Improvement

The biggest benefits will come from continually improving the process of the daily operations of the practice, as well as ensuring accurate diagnostic coding. This will enable a practice to keep up with charge capturing through the explanation of benefits (EOB) when the charge has been processed and paid by the health insurance provider. When this process identifies that there is room for negotiation, the provider should proceed for a better reimbursement rate. If the provider is in a dominant market, the payers will be more likely to issue sweeping fee increases and so can you give me an example of this ever happening? By completing a Practice Fee Analysis, any practice should be able to use this tool to demonstrate the inequities and negotiate a better reimbursement rate for the practice.

Assessment

The first step in the negotiation process would be to contact a representative of the health insurance company that is in question. If you can produce compelling evidence to the representative, the negotiation process should be the next meeting. These folks may be fired if they do what you suggest, too frequently. Continually updating the practice fee schedule will help the practice stay on top of the contracts that it practices under. Practices that present a well-documented argument may (almost never) be rewarded with positive payer response. Again, proper planning will make for great future performance in any health care practice.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Accounting, Book Reviews, Career Development, Glossary Terms, Health Economics, Health Insurance, Managed Care, Practice Management, Recommended Books, Sponsors | Tagged: CPT, david marcinko, fee analysis, fee schedules, healthcare plans, hope hetico, Medicaid, medical practice management, medical reimbursement, medicare, revenue analysis, RVU, www.healthcarefinancials.com, www.healthdictionaryseries.com | 2 Comments »

On HIT Cost Savings

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

Real or Imagined Solutions

According to David M. Cutler, of the Center for American Progress Fund [CAPF] on May 11, 2009, health care will be the major challenge to the federal budget in coming decades. Rising health costs will account for nearly all of the expected increase in government spending relative to gross domestic product [GDP].

Healthcare Costs and GDP

Health care currently accounts for 16 percent of domestic GDP, and that share is forecast to nearly double in the next quarter century. Spending money on health care is not bad, but wasting money is very bad.

Link: http://www.americanprogressaction.org/issues/2009/05/health_modernization.htmlHIT

HIT to the Rescue

But, $600 billion might be saved over the next ten years, and $9 trillion saved over the next 25 years, if HIT initiatives are used; says the CAPF.

Assessment

Estimates suggest that a third or more of medical spending—perhaps $700 billion per year—is not known to be worth the cost. Wasting hundreds of billions of dollars on inefficient health care is a luxury the country cannot afford.

Conclusion

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

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

Filed under: Career Development, Health Economics, iMBA, Inc., Information Technology, Practice Management | Tagged: CAPF, Center American Progress Fund, David Cutler, federal budget, GDP, health costs, health technology, healthcare economics, HIT, medical spending | 3 Comments »

Business Property and Liability Insurance Coverage for MDs

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

General Commercial Property Insurance for Physicians

By Gary A Cook; MSFS, CLU, ChFC, RHU, CFP® CMP™ (Hon)

One category of property and casualty coverage is commercial or business coverage. Commercial Insurance protects against those perils and losses that a medical practitioner routinely faces in their practice of healthcare. These exposures are both wide and varied and include aspects that may never affect most practitioners, such as the explosion of boilers, or aviation mishaps, or ship’s hulls failing. However, many risk exposures should be considered. This post will outline the covered property, covered perils, and a little known area titled Loss Settlement.

Covered Property

Buildings
Business personal property of the policyowner (which, remember, may be the practice)
Property and equipment used in the business
Personal property of others in the care and custody of the policyowner.

Covered Perils

This topic defies clear summarization because it usually defines the exposures unique to the healthcare practice. The risks of loss for a radiology practice are different from those of an obstetrician / gynecology office. Within numerous policy forms, “named perils” are identified in addition to the “all-risks” form that generally cover common perils such as crime or fire. In addition, just like with the individual Homeowners policies, endorsements can be obtained to cover unique and specific risks, such as earthquakes in California and hurricanes in Florida.

Loss Settlement

This special provision of commercial policies provides for the settle of losses on a cash value basis. Most policies are subject to a deductible amount, although “Full loss replacement value” coverage is usually available. Typically, the deductible is 20 percent of the covered value, with the insurance company only covering the balance. As with personal lines of coverage, the amount of the deductible effects the premium charged.

www.HealthDictionarySeries.com

Commercial General Liability Insurance

Commercial general liability (CGL) provides coverage for a wide variety of risks that a medical/healthcare facility may face. In brief, these exposures will include (there are others in a general liability policy that may be “endorsed out” for the particular practice):

Premises liability – injuries on the property owned or occupied by the policy-owner
Business operations liability – losses caused by business activities of employees
Contractual liability – litigation arising from oral or written contracts assumed by the organization.

Unfortunately, for the medical practitioner, as with many property and liability contracts, liabilities that occur “from the rendering or failure to render professional services” are standard exclusions from this section of liability coverage.

BOP

Often, insurance companies offer “packaged” programs or, Businessowners Policy (BOP) especially for small to medium medical practices. These policies include “all–risks” coverages for the property and limited liability. Most BOP programs include such coverages as:

Debris removal
Fire department service charges
Pollutant cleanup and removal
Water damage.

Most importantly, BOP contracts will cover:

Loss of Business Income (it is difficult to run the practice if half of it was destroyed by water damage from the fire in the office upstairs);
Extra Expense Coverage (the cost of renting substitute property while the covered property is being repaired); and
Payroll Expense (the need to retain specialists or key employees while the property is being rehabilitated).

Although the latter is limited in amounts and period of coverage, it is valuable coverage, especially for professional practices.

Assessment

Finally, the Businessowners Policy will cover losses due to crime (such as, forgery and alteration). As with Commercial Liability coverage, professional liability is excluded from Businessowner policies.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

Filed under: Book Reviews, Career Development, Financial Planning, iMBA, Inc., Insurance Matters, Recommended Books, Risk Management, Sponsors | Tagged: BOP, business insurance, business owner's policy, CGL, commercial general liability, commercial insurance, covered perils, david marcinko, gary cook, hope hetico, property insurance | 1 Comment »

About HealthCareTownHall.com

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

The Great eHR Debates

By Staff Writers

Milliman hosts this blog to encourage an informed dialogue about healthcare reform. Healthcare is complicated, and there is no single, silver-bullet answer to the question of “How do we best improve the current system?” But thoughtful discussions will help move reform in the right direction and mend the fractured system.

Assessment

A shout-out of thanks, for this link, goes to Jeremy Engdahl Johnson of Healthcare Town Hall.

Link: http://www.healthcaretownhall.com/

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Breaking News, Career Development, Health Law & Policy, Information Technology, Practice Management | Tagged: EHRs, EMRs, Health I.T., Healthcare Town Hall, HIT, Jeremy Engdahl Johnson, Milliman, www.HealthcareTownHall.com | Leave a comment »

Securing Medical Professional Liability Insurance Coverage

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

Tips for Doctors Looking for Malpractice Insurance

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

The following are buying tips for healthcare professionals who are shopping for medical professional liability insurance coverage:

** Shop well in advance of your renewal or expiration date. Your agent should have all of the necessary information to the insurer at least six to eight weeks before your coverage expires. See below for more tips and the type of information your agent will need.

** If you do not know an agent who can place your coverage, the Bureau of Insurance has a list of agencies that are licensed and appointed with at least one of the insurers on the Bureau’s list of “Insurers Writing New Business for Physicians and Surgeons.”

Contact one or two agents and be sure to ask each agent which insurer will be contacted for a quote. Ask the agent if an application will also be submitted to a surplus lines broker. If so, ask for the name of the surplus lines broker and ask which surplus lines insurers will be contacted. Provide this information to the other agent to avoid multiple applications being submitted to one insurer from different agents. If the application is being submitted to a surplus lines broker, be sure to ask the agent for information on the coverage provided and specifically request information on exclusions.
If the agent recommends coverage through an unlicensed company (such as a surplus lines insurer or a risk retention group), be aware that, in the case of insolvency, the insured will not have coverage through the [State] Property and Casualty Insurance Guaranty Association. However, if the healthcare professional has had several claims or an open claim, they may only be able to obtain coverage through a company not licensed in their state.
Ask the agent for information on the financial rating of the company and if the surplus lines insurer has its own guaranty fund. Also, if shopping, the medical professional should feel free to check with the Insurance Bureau of their respective state to see if the company and agent are licensed or authorized to do business.
The agent should fully understand the healthcare professional’s business. If incorporated, ask the agent what coverage is needed to protect the corporation as well as any individual doctors.
Ask the agent about the availability of “tail coverage” or if the new insurer will provide coverage for “prior acts.” If coverage is offered with two insurers, ask the agent what each insurer charges for “tail coverage.” This information may help in deciding which insurer has the most competitive price.
Complete the application for coverage in its entirety. Don’t omit any information and be sure to provide as much detail as possible, especially about prior claims. Many insurance companies want 10 years of information. They may also request information about any risk management practices and procedures.
Discuss deductible options with your agent. These may help lower your premium.
Find out if the insurance company offers any risk management or loss prevention programs. Such programs may lower the premium and help reduce exposure to losses.

Assessment

The author has been an expert medical witness in both state and federal court. He is a former licensed insurance agent and certified financial planner, advisor and consultant.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Have you ever considered a more modern liability coverage method, such as an RRG, etc?

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.org

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

Filed under: "Advisors Only", "Doctors Only", Career Development, Professional Liability, Recommended Books, Risk Management, Sponsors | Tagged: Bureau of Insurance, david marcinko, hope hetico, insurance agent, malpractice, malpractice insurance, medical liability, professional medical liability coverage, property casualty insurance, risk retention group, surplus line broker, tail coverage | 7 Comments »

Negotiating Physician Fee Schedules

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

Better Data for Improved Fixed Compensation

[By Christy Clodwick; MHA]

[By Dr. David E. Marcinko MBA]

It is known that most health plans operate with fixed fee schedules. While these fee schedules have little or nothing to do with RBRVS, and most are based on a percentage of what Medicare pays, the question is: “are they tied to levels that are more than 3 or 4 years old?” Physicians who have no negotiating tools or a plan in place, and who question the methodology that the payers are using, are (too casual-left) with a ‘take it or leave it’ response from the health insurance provider.

Gathering the Data

A good solid foundation of data is necessary to negotiate better reimbursement rates successfully. The practice administrator or accountant (not 1 in 100 accountants can actually do this) should have this information readily available, especially if the office has an automated billing system.

Steps to Preparing a Fee Analysis

First and foremost, the medical management team in charge of this project will need to determine the most commonly used CPT® codes for the practice. The bulk of primary care or family practice physician fees should be derived from the revenue of the office visit, hospital and preventive medicine codes. This in turn may limit the number of codes for the study. The frequency of each CPT code should be listed over a 12 month period. If applicable, laboratory fees should also be included to see if there are fluctuating reimbursement schemes for these services. The codes on the list should account for at least 75% of the total practice charges.

Determining Top Payers and Reimbursement by Payer

It is known that Medicare and Medicaid use established fee schedules and do not negotiate, therefore the focus should be on the other major payers that make up the bulk of the reimbursement. In this process, make sure that the payers in the report are the practice’s top payers. The practice administrator will also need to determine the reimbursement for each code that is sent to the various payers’ list in the report. The administrator or team leader (the average GP has 3-4 employees, so I don’t think there would be a team leader, here). For this project we can use the Explanation of Benefits EOB that is received from each payer that has been selected for the report. When including this data, make sure the allowed amount, not the paid amount, is referenced. After this information has been gathered, each payer’s reimbursement rate will need to be calculated as a percentage of Medicare’s reimbursement rate. Medicare’s current rates for any geographical area can be found through the “Medicare Physician Fee Schedule Look-up” tool at:

Link: https://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php?p_sid=1reSKuxj

This site also provides a reference to Relative Value Unit, (RVU) that Medicare assigns to each code.

RVU Conversion Factors

It is important for the practice administrator or manager to understand the RVU conversion factors and how they work, simply because most payers are in the beginning stages of using this method. To calculate a payment for service you multiply a particular CPT Code by the Medicare conversion factor for that code. For an example we will use the code 99214 – office visit. The Relative Value Unit for that Code is 2.2. The Medicare conversion factor for the same code is $37.34. The calculation would result in a rate of $82.15. Geographical adjustments must be taken into account when performing these calculations. The next step in this process would be to review the fees for each code listed in the report. Calculate each fee as a percentage of Medicare’s rates. You will find different statistics for each payer.

Apply the Rules and Process

Follow these basic rules when applying this new process:

First, if the charges are being reimbursed at 100%, the fee may be too low. At this point, raising the fee for that code would be acceptable (Usually not the case). Next, If several fees are in this category, the practice should just set all its fees to a percentage of Medicare reimbursement across the board, such as 125 percent (many managed care plans pay at less than MC, i.e., 80% MC). Finally, a tiered fee schedule would be applicable if the payers seem to pay more for certain procedures or diagnostic studies. That would set evaluation and management codes at 125 percent of Medicare reimbursement while charging 150 of Medicare reimbursement for other procedures and diagnostic tests.

Assessment

The medical practice administrator should make sure that, no matter which fee schedule is best suited for the practice, it is updated annually to prevent loss of any increases that may occur per payer.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Career Development, Glossary Terms, iMBA, Inc., Managed Care, Practice Management, Recommended Books | Tagged: CPT codes, david marcinko, EOB, hope hetico, Medicaid, medical fee schedules, medicare, physician fee schedules, RBRVS, RVU | 2 Comments »

Improving Financial Viability of Medical Practices

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

Medical Practice Financial Management

By Christy Clodwick; MHA

To combat the climate of barriers and frustrations in medical practice today, physician executives and administrators need to create innovative ways to change and improve medical providers’ outlook in the health care marketplace.

Many Barriers

The barriers—federal anti-trust laws, lack of state or federal regulatory action, marketplace resistance and tremendous cost pressures—are being confronted throughout the healthcare sector and are being felt by medical practices of all sizes, including hospital organizations, medical organizations as well as independent solo practitioners. Although there are tremendous financial pressures in operating a healthcare practice, the demand for healthcare is on the rise. To remain viable in today’s healthcare market place, strategic planning is needed at all levels of every practice’s processes.

Disenchanted Doctors

It is increasingly acknowledged that physicians in today’s health care market are becoming disenchanted with the reimbursement compensation from managed care. This also affects the outlook that they have on the medical profession as a whole. It is important to point out that there are ways to put processes in place to combat or, at the very least, survive all the changes taking place. Strategies can be put in place to offset the high demand for quality care and the discouragement and outrage that physicians are feeling about reimbursement. Physicians did not learn the business side of medicine in medical school, although many physicians today are choosing to diversify their careers by going back to school to get an MBA, or even just further business knowledge, to stay abreast of the changes. Selecting an outside source to assist a practice with the needs of business growth planning can be difficult, if the physician or practice administrator does not know what the needs really are. The best option would be to ask for a recommendation from a colleague who has hired consultants to assist in his or her practice, or to call on the local hospital administrator for assistance in locating an appropriate consultancy firm or management company.

The Planning Process and Process Improvements

The planning process of any business operation should always include management systems that clarify the business strategy and the metrics that most reflect success with that strategy. They should provide the framework to prioritize resources for projects that will improve the metrics, and leverage leaders who will manage the efforts for rapid, sustainable, and improved business results. This plan should also include improvement of processes that are already in place. In essence, this should be a corporate wide approach to process improvements and management of the processes to control the outcome of the progress of these changes.

Driving Success for Plan Development and Implementation

During the plan development stage, all aspects of operations have to be included in the plan in order to ensure a successful outcome. The plan for a healthcare practice should include time management, cost containment, third party reimbursement (to include annual contract(s) review as many practices have 100-200 contracts), insurance coding and compliance, accounting, business management, capitation economics, marketing and business development, medical advertising, and especially important is the health information management system. Plan development, in short, should focus on:

Understanding and managing patient demands and requirements (this is clinical material).
Aligning key business processes to achieve those requirements.
Using rigorous data analysis to minimize variations in those processes, i.e. fee analysis, revenue analysis, and time management.
Driving rapid and sustainable improvement of business processes.

Future Health Economic Policy

With all the changes that have occurred in healthcare, it is safe to assume it will be a struggle to come up with a perfect plan that will sustain all future changes in such a volatile healthcare market. Practice reimbursement would be a good place to start since this is the lifeblood of any healthcare provider. Income from fees has not nominally increased for more than a decade. The introduction of the Resource Based Relative Value Scale (RBRVS), as well as the adoption of a national fee schedule by Medicare, has virtually eliminated a practice’s ability to generate more income from insurance plans by increasing what the practice charges for its services.

www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Who can update the above post for modernity? What have we missed? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Career Development, Glossary Terms, Managed Care, Practice Management, Recommended Books | 1 Comment »

Physician Use of the Internet

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

The Slow Evolution of a Healthcare Tool

[By Carol S. Miller; RN, MBA]

The Internet is a constantly evolving service that continues to grow at an exponential rate, especially in physician practices. Primarily, the Internet is used as a means to electronically and expeditiously transfer data via e-mail as well as obtain information from a variety of sites. Initially, in the physician’s office, the primary use was e-mail communications with peers, hospitals and others. Next providers linked to hospitals and managed care organizations to obtain more direct connectivity for clinical information and benefit coverage. Today physicians are finding other beneficial avenues to expand their utilization of the Internet. Several examples include:

Direct e-mail inquiries from the patient to the physician.
Patient educational newsletters and links to other healthcare educational web sites.
Continuing medical education (CME).
Chat room consultations, conferences or presentations with other providers.
Nurse to patient e-mail connectivity.
Immediate data on lab results with alerts for abnormal high or low values.
CPOEs (Computerized Purchase Order Entry Systems).
Radiology images.
EMR (Electronic Medical Records).
Monitoring of patients blood sugars or EKGs via the Internet.
Appointment scheduling on-line by patients.
Patient appointment reminders via the Internet.
Secure physician portals such as Medicity, located at www.medicity.com, which allows access to pertinent and prioritized data from a wide range of sources and vendors to include, labs, imaging centers, hospitals, payers and others.
HIPAA compliant Application Service Providers (ASP) for dictation, recording, routing and speech recognition and transcription services, such as Speech Machines at http://www.speechmachines.com.

Access Management

Besides the value to the patient and the physician, the physician can utilize his or her Internet connection with software firms such as NextGen to automate the registration, scheduling, eligibility verification, billing and “clean” claims processing via innovative Web-base solutions in real-time scenarios. All the physician’s office needs is a PC, a standard Internet browser, and a connection to the Internet to take advantage of this service.

Assessment

These resources and more, via the Internet super highway, enable physicians to have quicker and easier access to clinical information and improve productivity. Furthermore, these tools will quickly assist providers with accurate and timely medical decision making, thus improving patient care and outcomes.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

http://www.BusinessofMedicalPractice.com

***

Filed under: Book Reviews, Career Development, iMBA, Inc., Information Technology, Practice Management, Recommended Books, Sponsors | Tagged: ASP, carol s. miller, CPOEs, david marcinko, EHRs, EMRs, health 2.0, hope hetico, internet physicians, medical internet, physician computing, physician connectivity, superhighway, www.healthcarefinancials.com, www.HelthDictionarySeries.com. www.MedicalBusinessAdvisors.com | 2 Comments »

Understanding Automobile Insurance

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

A Review for Physicians

By Gary A Cook; MSFS, CLU, ChFC, RHU, CFP® CMP™ (Hon)

Like the Home Owners policy, automobile insurance comes in a package (commonly called a Personal Auto Policy, or PAP) containing declarations, forms and endorsements.

These are: Liability Coverage, Medical Payments coverage, Uninsured Motorist coverage, and Coverage for Damage to your auto.

Important Elements

The important elements of automobile coverage are:

The vehicle or vehicles is covered, whether owned or leased
The insured – the covered driver
What is covered?
What are the limits of coverage – for both property and liability?

Exclusions

What are the exclusions – for example, the business use of a vehicle may not be covered under the personal policy? Other coverage for example includes a friend driving your car, or, coverage driving a rental vehicle. The medical payments coverage outlines the limits of liability for medical services needed as the result of an accident.

PULP

The final area of common personal coverages is the Personal Umbrella Liability Policy. To say that our society has become very litigious may be a gross understatement. The umbrella liability policy transfers the risk of losing substantial assets or future personal income to pay legal obligations resulting from an adverse judgment. The umbrella policy originated to provide risk protection against catastrophic legal claims or judgments. Typically, coverage limits begin at $1 million with upper limits of $10 million, and some unique situations, more. The term “umbrella” arises from the contract language that reflects that the individual carries the appropriate underlying basic coverages (homeowners or automobile) and that this coverage is triggered after the limits of the base contracts are exhausted.

Provided Coverage

An important element of this policy is that coverage provides for protection for the named insured, spouse, and family members living in the household. This coverage should be very important to those households with teenage drivers. Organizations may also obtain the protection of an umbrella policy, with certain limitations and exclusions. Unfortunately, “failure to render proper professional services” is very frequently a common exclusion, though some insurance companies will cover this loss exposure with an increased premium.

Other Policies

Other common policies available include: Watercraft and Airplane coverage, Title Insurance, Flood Insurance (offered by very few private insurance companies), Renters Insurance (which covers the contents), and Condominium protection (like homeowners, but has language for common wall risks).

Personal Legal Expense Protection

Finally, there is the issue of the taxation of premiums and claim payments. Premiums for personal property and casualty coverage are not deductible. Therefore, only under unusual circumstances will any benefits received from the coverage be considered taxable income.

Assessment

However, the benefit payments may be considered capital gain if they happen to exceed the insured’s basis in the property. Uninsured losses are generally deductible under the current Internal Revenue Code.

As usual, specific questions concerning the taxation of premiums or benefits should be directed to your professional advisors.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Book Reviews, Career Development, Financial Planning, iMBA, Inc., Insurance Matters, Practice Management, Professional Liability, Recommended Books | Tagged: airplane insurance, auto insurance, condo insurance, david marcinko, flood insurance renter's insurance, gary cook, home owner's insurance, hope hetico, IRC, PAP, personal auto policy, personal umbrella liability policy, PULP, title insurance, uninsured motorist, vehicle insurance, watercraft insurance | 5 Comments »

Physician Property, Casualty and Liability Protection

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

Essentials of Risk Management

By Gary A Cook; MSFS, CLU, ChFC, RHU, CFP® CMP™ (Hon)

Medical professionals may not be familiar with the unique differences between the terms – property, casualty and liability. Property insurance is coverage for the loss of, or damage to, real and personal property caused by fire, theft, explosion, riot, vandalism and a host of other risks. Casualty and liability are generally interchangeable terms for the coverage of legal liability due to injury to others or damage to their property.

Personal Liability Coverage

One of the most common of all personal liability coverages is the Homeowner’s policy. This is not one policy, but several policy declarations (what is insured – the location), forms, endorsements, and “floaters,” which protect the structure of the home against loss, as well as the personal property (contents) to various degrees. Risks for homeowners need not be consistent across the country and the rates generally reflect the differences. For example, homes in the Midwest need protection from tornados, while homes along the East, West and Southern coasts need coverage for hurricanes and flood risks.

Policy Form

The Home Owners Policy Form contains five categories of coverage for property:

The dwelling
Other structures
Personal property
Loss of use
Additional coverages, such as debris removal, trees, shrubs, and plants, or now, electronic theft (credit card, checking account theft).

The Contract

The contract contains three areas of Liability Coverage:

Personal liability
Medical payments to others
Miscellaneous liability benefits.

The Endorsements

Endorsements are an important aspect of the Homeowners coverage because they permit the customization of the coverage to the unique requirements of the individual. Two examples:

We noted that the West coast does not have tornados, however, they do have earthquakes and therefore, an endorsement can be added which will transfer the risk for earthquakes – or even volcanic eruptions. If the individual doctor has a home business, the business property can be protected against such perils as loss of business records due to fire or water damage. There is, however, no coverage for liability for providing poor professional services.

The Floaters

Finally, the Homeowners policy may contain “floaters” (named because the articles covered are moveable, thus “float around.”). The use of floaters can be very beneficial for coverage of unique or expensive electronic equipment and most commonly, jewelry. The other common personal coverage is Automobile Insurance. Forty-two states have compulsory insurance laws that require insurance on automobiles before it is registered. Various states have unique laws pertaining to:

Financial Responsibility, or proof of responsibility, by carrying insurance, a cash deposit, bond or security for future liability effective after an accident, which is the major criticism of these laws.
Unsatisfied Judgment Funds that compensate individuals who are unable to collect from a judgment resulting from an automobile accident.
Uninsured Motorist Coverage is required in most states as mandated by state insurance regulators. In essence, the insured’s own insurance company acts as the insurance company for the uninsured motorist.
No-fault Automobile Insurance stems from the problems associated with today’s tort law. These policy forms, however, vary dramatically by state and a full discussion is not possible here. Information and advice from a professional insurance agent is always recommended.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Career Development, Glossary Terms, iMBA, Inc., Insurance Matters, Practice Management, Recommended Books, Risk Management, Sponsors | Tagged: casualty insurance, david marcinko, floaters, gary cook, hope hetico, insurance, no fault auto insurance, property casualty insurance, property insurance, www.healthdictionaryseries.com, www.medicalbusinessadvisors.com | 2 Comments »

Long-Term Care Insurance

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

A Review for Doctors and Advisors

By Gary A. Cook; MSFS, CLU, ChFC, LUTC, RHU, CFP®, CMP™ (Hon)

Long-term care (LTC) insurance is considered one of the newest forms of personal coverage insurance. LTC insurance is designed to transfer the financial risk associated with the inability to care for oneself because of a prolonged illness, disability, or the effects of old age. In particular, it is designed to insure against the financial cost of an extended stay in a nursing home, assisted living facility, Adult Day Care Center, hospice or home health care. It has been estimated that two out of every five Americans now over the age of 65 will spend time in a nursing home. As life expectancy increases, so does the potential need for LTC. One unfortunate consequence of being the “new kid on the block” is the lack of actuarial data specifically collected for this style of policy. This results in policy premiums being underpriced to sustain the claims currently being experienced. During the first half of 2003, at least three insurance companies stopped writing these policies because of their losses. Those insurers remaining in this market are expected to increase premiums quickly. Unless these policies can be profitable for the company, their future will be an uncertain one.

Medicare

Any discussion of LTC must begin with an understanding of what Medicare is designed to cover. Currently, the only nursing home care that Medicare covers is skilled nursing care and it must be provided in a Medicare-certified skilled nursing facility. Custodial care is not covered. Most LTC policies have been designed with these types of coverage, or the lack thereof, in mind. To qualify for Medicare Skilled Nursing Care, an individual must meet the following conditions:

Be hospitalized for at least three days within the 30 days preceding the nursing home admission;
Be admitted for the same medical condition which required the hospitalization; and
The skilled nursing home care must be deemed rehabilitative.

Once these requirements are met, Medicare will pay 100 percent of the costs for the first 20 days. Medicare covers days 21 to 100 along with a daily co-payment, which is indexed annually. After the initial 100 days, there is no additional Medicare coverage. Medicare Home Health Services cover part-time or intermittent skilled nursing care, physical therapy, medical supplies and some rehabilitative equipment. These are generally paid for in full and do not require a hospital stay prior to home health service coverage.

Critical LTC Policy Features

According to the U.S. Department of Health and Human Services and the Health Insurance Association of America, there are seven features that should always be included in a good long LTC policy:

Guaranteed renewable (as long as premiums are paid, the policy cannot be canceled).
Covers all levels of nursing care (skilled, intermediate and custodial care).
Premiums remain level (individual premiums cannot be raised due to health or age, but can be raised only if all other LTC policies as a group are increased).
Benefits never reduced.
Offers inflation protection.
Full coverage for Alzheimer’s Disease (earlier contracts tried to eliminate this coverage).
Waiver of premium (during a claim period, further premium payments will not be required).

In addition, there are another seven features considered to be worthwhile and are included in the better LTC policies:

Home health care benefits
Adult day care and hospice care
Assisted living facility care
No prior hospital stay required
Optional elimination periods
Premium discounts when both spouses are covered
Medicare approval not a prerequisite for coverage.

ADLs

Most LTC policies provide benefits for covered insured’s with a cognitive impairment or the inability to perform a specified number of Activities of Daily Living (ADLs). These ADLs generally include those listed below and the inability to perform two of six is generally sufficient to file a claim:

1. Bathing: Washing oneself in either a tub or shower, or by sponge bath, and includes the task the getting into and out of the tub or shower without hands-on assistance of another person.

2. Dressing: Putting on or taking off all necessary and appropriate items of clothing and/or any necessary braces or artificial limbs without hands-on assistance of another person.

3. Toileting: Getting to and from the toilet, getting on and off the toilet, and performing associated personal hygiene without hands-on assistance of another person.

4. Transferring: Moving in and out of a bed, chair or wheelchair without hands-on assistance of another person.

5. Eating: The ability to get nourishment into the body without hands-on assistance of another person once it has been prepared and made available.

6. Continence: The ability to voluntarily maintain control of bowel and/or bladder function, or in the event of incontinence, the ability to maintain a reasonable level of personal hygiene without hands-on assistance of another person.

Other Issues

Another issue concerning ADLs is whether the covered insured requires “hands-on” assistance or merely needs someone to “stand-by” in the event of difficulty. Obviously, LTC policies that read the latter are considered more liberal.

Long-Term Care Taxation

Some LTC policies have been designed to meet the required provisions of the Kassenbaum-Kennedy health reform bill, passed in 1996, and subsequently are “Tax Qualified Policies”. Insured’s who own policies meeting the requirements are permitted to tax deduct some of the policy’s premium, based on age, income and the amount of total itemized medical expenses. The major benefit of the tax-qualified LTC policy is that the benefit, when received, is not considered taxable income. There are several initiatives in Congress, however, which would expand and simplify these deductibility rules.

Assessment

Regardless, the medical professional or financial advisor [FA] should investigate the opportunity afforded them through their current form of business, or client use, for any purchase of a LTC policy. And, small businesses may be permitted to deduct LTC premiums on a discriminatory basis.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What have we missed, and who might wish to update this post?

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Advisors Only", "Doctors Only", Book Reviews, Career Development, Glossary Terms, iMBA, Inc., Insurance Matters, Practice Management, Recommended Books, Retirement and Benefits, Sponsors | Tagged: ADLs, Alzheimer's disease, david marcinko, elder care, elder law, gary cook, HIPAA, home health care, hope hetico, insurance, Kennedy-Kassenbaum, long term care insurance, LTC, LTCI, Medicaid, medicare, nursing home care | 9 Comments »

ISP Primer for Physicians

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

Understanding Basic Access and Connectivity

By Carol S. Miller; RN, MBA

To connect with an Internet service, the medical office will need a computer, modem, telephone line and software. The modem, either external via a connection or internal via a built-in or slot card, takes the digital signals from your computer and converts them to analog signals that your phone line uses. As a rule of thumb, the faster the better; therefore, the office should have at least a 56 bps or use a DSL line.

Accessing the Internet

To access the Internet, the office must obtain an Internet Service Provider (ISP) such as America Online (AOL), Earthlink, ATT Worldnet, Microsoft Network Premiere (MSN), Hot Link, or others. The cost varies on the plan selected but usually averages in the range of $10 to $25 per month. In selecting an ISP, several guidelines need to be considered:

The major online services often make it very easy to connect to the Internet, but may be more expensive;
Many low-priced ISPs may have customer service that matches their prices;
In selecting the ISP, make sure the provider has a toll-free or local support telephone line;
For a nationwide directory list of ISP providers, go to the Internet site of www.isp.com.

Besides the POTS (plain old telephone service), the physician may wish to have a faster connection to the Internet. Several options are available.

Cable Modems

Cable connection is very fast, providing a lot of bandwidth (the amount of information that can be sent through a particular communication channel). As an example, in the time it takes to transfer a half page across a 56K connection, the cable connection can transfer over 25 pages. As is suggested by the name, the local cable TV provider or community antennae TV (CATV) deliver this service.

www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Who can update the above for modernity?

Link: https://healthcarefinancials.wordpress.com/2009/03/13/rip-retail-financial-services-industry/

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

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Book Reviews, Career Development, Glossary Terms, Information Technology, Practice Management, Sponsors | Tagged: AOL, bandwidth, cable modems, carol s. miller, CATV, david marcinko, DSL, EHRs, EMRs, hope hetico, internet connectivity, ISPs, MSN, POTS | 1 Comment »

Essential Insights on Successful Physician Budgeting

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

Avoiding Common Cash Flow Budget Mistakes

[By Dr. David Edward Marcinko; MBA, CMP™]

[By Hope Rachel Hetico; RN, MHA, CMP™]

[Publisher-in-Chief and Managing Editor]

Although some doctors might view a budget as unnecessarily restrictive, sticking to a spending plan can be a useful tool in enhancing the wealth of a practice. We emphasize the keys to smart budgeting and how to track spending and savings in these tough economic times.

Money and Happiness

There is an aphorism that suggests, “Money cannot buy happiness.” Well, this may be true enough but there is also a corollary that states, “Having a little sure reduces the unhappiness.” Unfortunately, today there is more than a little financial unhappiness in all medical specialties; not just the specialty of podiatry – where this article first appeared as a free-lance writing project. The challenges range from the commoditization of medicine, aging demographics, Medicare reimbursement cutbacks and increased competition to floundering equity markets, the home mortgage crisis, the squeeze on credit and declines in the value of a practice. Few doctors seem immune to this “perfect storm” of economic woes.

Most Doctors Financially Hurting Today

Far too many physicians, dentists and other medical providers are hurting and it is not limited to these above-average earning professionals. However, one can strive to reduce the pain by following some basic budgeting principles. By adhering to these principles, most physicians can eliminate the “too many days at the end of the month” syndrome and instead develop a foundation for building real wealth and security, even in difficult economic climates like we face today.

Three Budget Types

There are at least three major budget types. [1] A flexible budget is an expenditure cap that adjusts for changes in the volume of expense items. [2] A fixed budget does not. [3] Advancing to the next level of rigor, a zero-based budget starts with essential expenses and adds items until the money is gone. Regardless of type, budgets can be extremely effective if one uses them at home or the office in order to spot money troubles before they develop.

Assessment

For the purpose of wealth building, medical professionals may think of a budget as a quantitative expression of an action plan. It is an integral part of the overall cost-control process for the individual, his or her family unit or one’s medical practice.

Read the entire article: http://www.podiatrytoday.com/essential-insights-on-successful-budgeting

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: "Doctors Only", Accounting, Career Development, Financial Planning, iMBA, Inc., Practice Management, Research & Development | Tagged: budgeting, cash flow, cash flow crunch, david marcinko, fixed budget, flexible budget, hope hetico, podiatry today | 2 Comments »

Advisor’s Checklist for Physicians Seeking Insurance

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

Background, Education, and Certifications

By Dr. David Edward Marcinko; MBA, CMP™

Publisher-in-Chief

The following are sample questions and information gathered for Professional Liability Coverage

The Checklist

**Medical specialty information by percentage of practice.

**Information on medical education, including information on medical school, internship information, residency information, and fellowship information, if any.

**Information on medical experience, including information on military discharge (DD214), public health service, moonlighting, ‘locum tenens’, and private practice information. Have dates and locations available. Other information includes:

Information on completed continuing education hours in the past two years.
Publications, speeches, instruction, etc.
Information on medical licenses, including state, license number, expiration dates, and current status.
Information on board certifications.
The above information may be contained in a Curriculum Vita, if you have one.
On an “as applicable” basis:
Complete details including dates and outcomes of any board certification revocations or suspensions, license revocations or suspensions, alcohol or drug addictions and treatments, criminal or sexual misconduct charges, or Medicare or Medicaid charges.
Previous Insurance Information
Insurance history, including the name, policy number, whether the coverage form was occurrence or claims made, policy period, limits of liability, deductible amount, and prior acts date, for your current carrier, and your first, second, third, and fourth prior carrier, if applicable.
Information on any insurance company cancellations or non-renewals.
If your current policy is a claims-made policy, whether you are obtaining tail coverage from your current insurance company.
Copies of prior policies, if available.

Current Medical Practice Information

Information on supervision and employment of residents, physician assistants, nurse practitioners, CRNAs, nurse midwives and other physicians;
Information on networks or managed care organizations associated with (IPA, PHO, MSO, etc.), including group name, type of organization, and relationship;
Information on other contractual relationships other than PPOs, HMOs, IPA, etc;
Full information on all hospital privileges, including hospital name, location, and type of privilege.
Information on any suspension, denial, revocation, restriction, or other sanctioning of hospital privileges.

Classification and Specialty Identification

Full information on procedures performed, including details of surgeries, average number of patients seen weekly, specialty practice areas, etc.

Prior Claims History (if any)

For each claim, patient’s name; date of occurrence; insurance carrier; location of occurrence; date claim was reported; date claim was closed (if applicable); copies of subpoenas, pleadings, or judgments; amount reserved on your behalf; and amount paid on your behalf. Provide as complete a description of the allegations as possible.

Important Note

This checklist is provided as a guide to assist the Healthcare Professional in gathering the information that insurance companies typically request. Discuss this checklist with your agent to identify additional information as needed.

Assessment

The author has been an expert medical witness in both state and federal court. He is also a former licensed insurance agent and certified financial planner.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Advisors Only", "Doctors Only", Career Development, Health Law & Policy, iMBA, Inc., Insurance Matters, Practice Management, Professional Liability, Recommended Books, Sponsors | Tagged: CRNA, david marcinko, DD214, HMO, hope hetico, IPA, liability insurance, malpractice, MCO, Medicaid, medical malpractice insurance, medicare, PPO | Leave a comment »

Reviewing Medical PDAs

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

Physician Use Growing Slowly

By Carol S. Miller; RN, MBA

Handheld personal digital assistants (PDAs), such as Palm Pilot M130, 500 or 515, Sony Clie, Visor Prism or Pro, Psion, RIM Blackberry, Zaurus, iPhone, Zune and other comparable PDA OS platforms, have revolutionized the communication world this past decade. PDAs and their future counterparts are becoming the catalyst for physicians to use information technology, are becoming the intro for physicians into the world of the electronic medical record software, and becoming the virtual office tool, enabling providers to communicate away from the desktop as well as away from his office practice. The reasons for increased utilization with physicians are portability, pocket-size, provides easy access to information at point of care and regardless of location, improves practice efficiency and workflow, improves drug related decisions and decreases adverse drug events.

PDA Components

The common uses of PDAs by physician practices are:

Personal applications such as scheduling, telephone directories, dictionary, “to-do lists” and others
Drug databases
Clinic suite that ties into the hospital information system
Charge and procedure capture
Communications, from provider to provider, provider to hospital, provider to office, and vice versa

Palm Operating System

Palm OS still represents the standard in handheld computing, assisting individuals to manage and access information at any time, at any location. Handhelds are easy to use. Physicians are using the Palm OS and/or compatible PDAs to access their office schedules, receive downloads of clinical information on their patients, and enter clinical services and charges when performing services at remote locations.

PDA Selection

In selecting not only the PDA but also the software, the physician needs to answer the following questions:

What would you like to use the PDA for – clinical reference data, patient information, non-clinical applications, personal data, etc.?
What information do you need to know about the patient that the PDA can simplify?
What is the connection route between the hospital, managed care, or lab and your practice? In other words, how do you get access to the data?
What are your price considerations?
Do you need a color or black and white screen?
What is the system support and warranty?
How do you plan to connect to the office or hospital?
Do you want to go wireless or obtain information via a telephone connection?
Do you plan to render care outside of your office practice, such as in the home, a clinic, hospital setting, etc? If so, what would you like included on the PDA that would improve communication with the office and save time at point-of-service in documentation?

HIPAA

HIPAA regulations do not specifically address the specific term PDA, but the regulations do include guidelines for protecting patient information and transmission of this data that can impact the use of PDAs. Physicians are utilizing handheld digital assistants whether they contain clinical information; or just resource data, may be or not are password protected, and may or may not be officially supported by hospitals or clinics. Providers as they prepare for future applications and usage of PDAs involving patient information must understand the scope of the new HIPAA regulations as it impacts on patient data collected, stored or transmitted. Any application involving patient identifiable data must be HIPAA compliant. The key issues are how to protect the patient information stored on the device, i.e., if lost or stolen, and second how to protect patient information transmitted during a synchronization or wireless transaction. Probably the most vulnerable aspect is the loss rate with recent studies indicating at least 30%.

Security

Most providers using PDAs for patient data utilize a user ID or password level of security. To maintain security, the provider should be required to re-enter their user ID or password every time they enter the application. Likewise, each PDA should have a “time out” feature, requiring a provider to re-enter his ID or password again. This feature will not prevent individuals with technical skills from accessing this information – the only mechanism is encryption.

Synchronization versus Wireless Applications

1. Synchronization transfers information from the enterprise database to the PDA, i.e., hospital lab or x-ray results, patient demographics, consultative notes, and others. It is important that the hospital or hospital system authorize and approve the physician for using and transmitting this information and in turn, the provider authenticates and validates his agreement with the hospital before data is transmitted. In addition for protection, an audit trail of who synchronized and what data was transmitted should be maintained by the hospital system.

2. Wireless providers have immediate real time access to patient data; however this process of transmission is more vulnerable than synchronization. Wireless solutions can utilize a public or private network. HIPAA require encryption for the transmission of data over the public networks – Encryption is optional for others. Sharing data from a wireless over the Internet represents potential security issues; however, more and more technical firms and providers are using a wireless VPN that allows PDA users to connect securely from remote locations just as laptop users do today.

Other Issues

The other issues are who owns the PDA. If the provider does, he or she should be responsible for the security; however if the hospital does, the hospital should be responsible. More current applications of Palm OS will include built-in modems for easier wireless communication, improved secure transactions, and ability of greater resolution for graphics, and other Web-based services. In addition, current and future applications will include refined voice dictation. As an example, MDEverywhere’s package called Everynote allows the provider to digitally record notes and in turn links with MDEverywhere’s coded patient encounter.

The Blackberry

A very versatile product is the Blackberry. It has web browsing capabilities, embedded wireless modem and can (1) write, send receive and respond to messages right from the unit, (2) access web information, (3) has nationwide coverage with no roaming fees, (4) has voice mail message capabilities, and (5) can be the size of a pager or PDA. The next feature with Blackberry will be its text messages to cell telephones. New units start around $150-$300 with monthly service charges of $20-$50 depending on the plan. The wireless Internet connection can be accomplished through Go.Web.

Assessment

The typical cost for a PDA averages between $300 and $600 – depending on color or black and white – plus the cost of additional software and accessories. For wireless connectivity, the physician will need to connect with a communication partner. Reference sites for PDAs are: www.handheldmed.com (for clinical, reviews, and news), www.pdamd.com (PDA resources), www.freewarepalm.com (free software programs), www.palmpilot.com, www.handspring.com. The active shopper can refer to www.zdnet.com or www.palmblvd.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Who can update the above for modernity?

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Book Reviews, Career Development, Health Law & Policy, iMBA, Inc., Information Technology, Practice Management, Sponsors | Tagged: apple iphone, blackberry, carol s. miller, david marcinko, EHRs, EMRs, handheldmed.com, handspring.com, Health I.T., HIPAA, hope hetico, iPhone, MDE, OS, Palm, Palm OS, PDA, personal digital assistants, telemedicine, Zune | Leave a comment »

Red Flag Rules in Dentistry

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

Mayday for Identity Theft Provisions 2009

By Darrell K. Pruitt; DDS

On October 22, 2008, the FTC announced that it would delay the enforcement of the Red Flags Rule for healthcare providers for six months – until May 1, 2009. A handful of attentive dentists, as well as ADA Chief Legal Counsel, Tamara Kempf, released a sigh of relief. Ms. Kempf immediately went to work to persuade the FTC to delay enforcement “indefinitely.”

The FTC Delay

Four days later, Kempf caught the mood of the few who were paying attention in her quote for an article on DentalCompare.com:

“We are very pleased that the Federal Trade Commission has postponed for six months its implementation of the ‘Red Flags Rules.’”

http://www.dentalcompare.com/news.asp?newsid=250078

The DentalCompare article continues:

“If the FTC persists in its position that dentists are covered by the rule as creditors, the ADA will make available a sample compliance plan or program well in advance of the new enforcement date. Dentists will have sufficient time to consult with their personal attorneys and to put an appropriate identity theft prevention program into place, according to the ADA’s Legal Division.”

The ADA Legal Division

Did the ADA’s Legal Division follow through with its promise? If information about the Red Flags Rule is posted on the ADA News Online Website early tomorrow morning, is a 24 day warning considered by the ADA to be “well in advance”? (Emphasis mine) As reassuring as Kempf’s words sounded five months ago, it can be argued that the ADA’s intentions were misrepresented to DentalCompare. I checked the ADA Online Website and found nothing at all about preparation for the Red Flags Rule – at least not yet.

http://www.ada.org/prof/resources/pubs/adanews/index.asp

ADA Archives

When I searched the ADA archives for “Red Flags Rule,” I was provided seven links to the topic, but none included “a sample compliance plan or a program.” Three of the links are irrelevant, three are to articles about the delay of the FTC enforcement, and one is a link to a hopeful letter dated November 24, 2008 and addressed to William E. Kovacic, Chairman of the Federal Trade Commission. In other words, I found nothing that will help dentists become FTC compliant well ahead of time.

HIPAA

If the ADA’s help in preparing members for the 1996 HIPAA Rule is any indication of the help members can expect with Red Flags Rule, it will take the ADA at least 13 years to start on the Red Flags. The leaders of the otherwise conservative ADA seem to have bet a huge chunk of membership trust that Kempf and the Legal Affairs department would succeed in delaying Red Flags enforcement indefinitely, and that the Department of Dental Informatics would not have to admit that contrary to what they led members to believe, computers in dental offices are rapidly becoming too dangerous and too expensive for the profession. For many dentists, pegboards, carbon paper and ledger cards are looking better and better. You can forget about paperless practices. What happened, ADA?

The groveling November 24 letter to the FTC chairman that was signed by Kempf and cc’d to ADA President Dr. Johns S. Findley and President-elect Dr. Ronald L. Tankersley, officially begs for forgiveness and appeals for bureaucratic mercy to allow dentists to be excluded from becoming Red Flags-covered entities.

http://www.ada.org/prof/advocacy/let_081124_redflags.pdf

Since the fines for non-compliance of both HIPAA and the Red Flags Rule are obscene, and since the leaders of the ADA continue to fail to inform members what they should do to prepare for unannounced inspections from either HHS or the FTC, I will once again do the Department of Dental Informatics job for them, and let readers in on the secret.

An Economic Threat

If you wish to continue to accept assignment from insurance companies, and/or otherwise extend credit to your patients, the FTC recently posted a helpful pdf document titled “Fighting Fraud with the Red Flags Rule – A How to Guide for Business.”

http://www.ftc.gov/bcp/edu/pubs/business/idtheft/bus23.pdf

Dentists have become the nation’s unpaid fraud inspectors. And if a dentist’s practice is computerized, the more will be expected, or rather, demanded of the dentist, by law.

Here is a brief description of dentists’ Red Flags obligations lifted from the FTC document:

An Overview

The Red Flags Rule sets out how certain businesses and organizations must develop, implement, and administer their Identity Theft Prevention Programs. Your Program must include four basic elements, which together create a framework to address the threat of identity theft:

First: Your Program must include reasonable policies and procedures to identify the “red flags” of identity theft you may run across in the day-to-day operation of your business. Red flags are suspicious patterns or practices, or specific activities that indicate the possibility of identity theft. For example, if a customer has to provide some form of identification to open an account with your company, an ID that looks like it might be fake would be a “red flag” for your business.

Second: Your Program must be designed to detect the red flags you’ve identified. For example, if you’ve identified fake IDs as a red flag, you must have procedures in place to detect possible fake, forged, or altered identification.

Third: Your Program must spell out appropriate actions you’ll take when you detect red flags.

Fourth: Because identity theft is an ever-changing threat, you must address how you will re-evaluate your Program periodically to reflect new risks from this crime.

Note: More “red-flag” information may be obtained from the 2 volume, 1,200 pages, premium print guide: Healthcare Organizations [Financial Management Strategies].

www.HealthcareFinancials.com

Assessment

Since my business office still uses the pegboard, and no patients’ identifiers are on any computer, my official Red Flags policy is simple:

“Staff; if you notice anything unusual in relation to our patients’ accounts; or if you are handed an unusual-looking drivers license, notify me immediately”.

-The Management

My official notice will be fastened with thumb tacks to my wall of safety posters by May 1, 2008, and I will be in full compliance with not only HIPAA, but the Red Flags Rule as well. If the government continues its reckless, heavy-handed, one-size-fits-all laws, it won’t be long before I’ll be able to further undercut the fees charged by all computerized dental offices, and still make more profit. I say bring out the Department of Agriculture.

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Alerts Sign-Up, Book Reviews, Breaking News, Career Development, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, Managed Care, Practice Management, Professional Liability, Risk Management | Tagged: accounting ledger cards, ADA, AMA, American Dental Association, carbon paper, DDI, DentalCompare.com, Department of Dental Informatics, Dr. Ronald L. Tankersley, fake IDs, FTC, HIPAA, HSS, ID, identity theft prevention, Johns S. Findley, pegboards, red flag rules, Tamara Kempf, William E. Kovacic | 32 Comments »

Networks Basics for Medical Professionals

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

Defining WANs and LANs

By Carol S. Miller; RN, MBA

Depending on whether the practice is housed in one or multiple-office locations and there is a need to connect multiple computers, either a local area network (LAN) or wide are network (WAN) should be part of the package consideration.

The LAN

The LAN is a computer network that covers only a small area (often a single office or building). The advantage of a LAN (besides connecting several computers to a network system) is the ability to configure one printer for multiple stations. The same may be said for sharing administrative, clinical, financial and operational data in real-time manner to support smooth office function.

The WAN

The WAN provides the ability to link data on one network for multiple office site locations.

www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Who can update this post for modernity?

Link: https://healthcarefinancials.wordpress.com/2009/03/13/rip-retail-financial-services-industry/

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

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Book Reviews, Career Development, Glossary Terms, iMBA, Inc., Information Technology, Practice Management, Recommended Books, Sponsors | Tagged: carol s. miller, david marcinko, hope hetico, LANs, medical computer networks, WANs, www.healthdictionaryseries.com | Leave a comment »

MSFT Amalga Video for Hospitals and Health Systems

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

It Was One Year Ago Today … Updated for 2009

By Staff Reporters

Release of a new unified intelligence system allows enterprise health providers to unlock the power of all data from their existing IT systems.

REDMOND, Wash. — April 9, 2008

Microsoft Corp. today announced the availability of Microsoft Amalga, the new unified intelligence system that allows hospital enterprises to unlock the power of all their data sitting in isolated clinical, financial and administrative solutions.

What it is – How it works

Amalga is part of the Microsoft Amalga Family of Health Enterprise Systems, a portfolio of enterprise-class health solutions that provides rich integration, giving clinicians and executive’s quick access to valuable, up-to-the-minute information across their health enterprise. Microsoft also announced the availability of the Amalga family of health enterprise products across Europe at conhIT 2008, a healthcare IT conference being held in Berlin this week (http://www.microsoft.com/emea/presscentre).

Health Vault

The patient compliment to Amalga is MSFT’s Health Vault initiative which helps consumers collect, store, and share critical patient health information, for free.

www.HealthVault.com

Assessment 2009

Video interview, by Matthew Holt, originally appeared on The Health Care Blog [THCB] on April 16th, 2009.

Link: http://www.thehealthcareblog.com/the_health_care_blog/2009/04/interview-microsoft-health-solutions-.html#comments

Conclusion

And so, your innovative thoughts and constructive comments on this Medical Executive-Post are appreciated?

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

Filed under: Career Development, Information Technology, Managed Care, Practice Management, Research & Development, Videos | Tagged: amalga, Chris Sullivan, conhIT, EHRs, EMRs, ePHs, health information technology, healthvault, Heath Enterprise Systems, IT, microsoft, MS-HUG, Randy Fusco, SUNSHINE, unified intelligence system | 2 Comments »

Defining and Understanding “Boutique Medicine”

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

What it is – How it Works

By Dr. David Edward Marcinko MBA

http://www.CertifiedMedicalPlanner.org

According to colleague Robert James Cimasi of Health Capital Consultants LLC in St. Louis MO, concierge or boutique medical practices began in the mid-1970s, and are now in many major metropolitan areas. Concierge medicine is described as a “return to old-fashioned medicine,” where physicians limit their client base and devote more time to each patient. Patients can usually get in to see their physician within a day, and most have 24-hour access to their physician by beeper or cell phone.

The Doctor’s Perspective

Physicians who turn to concierge medicine are typically tired of not having enough time with their patients and dealing with overbooked caseloads, and are looking for a way of balancing their lives while still providing quality care for their patients. Patients who have physicians in this type of practice appreciate the “perks” they get for paying a yearly fee — similar to “annual membership dues.” These fees can range anywhere from $1,000 per year to $10,000 per year depending on the patient’s age, benefits received, area of the country, and practice.

Patient Amenities

Amenities vary by practice, but some include longer physician office visits, increased access to physicians, e-mailed “newsletters” or condition-specific information, physicians accompanying patients on visits to specialists, and house calls. In order to provide more attentive care and amenities to patients, physicians often decrease their patient load to approximately 10-25% of their managed care load. Thus, most of their patients must find other physicians, leading to potential increases in the patient load of managed care physicians.

Elitist Patients

Although concierge medicine may provide many benefits for patients (including more, and in some cases, nearly unlimited access to their physicians), it has been met with some scrutiny. Some say that this type of medicine is elitist, that it is available only to wealthy patients who can pay the annual fees. Medicare beneficiaries who are members of a concierge practice have received political attention, because many politicians have said that the annual fees patients pay is a lot more than the Medicare rate and thus is illegal billing.

Critics

Critics also emphasize that healthcare needs to be first-rate for everyone, something that the current managed care system prevents. The implication that managed care means second-class medicine has also been a fear cited by critics.

Assessment

However, concierge physicians portray their clients as mostly middle-income people who are willing to pay more for this kind of care. Concierge medicine is not a substitute for health insurance. Patients typically keep their traditional insurance to pay for any tests or scans ordered by the physician.

MORE: https://medicalexecutivepost.com/2009/10/26/customer-relationship-management-and-the-nascent-concierge-medical-practice/

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

LEXICONS: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

Invite Dr. Marcinko

***

Filed under: Career Development, Glossary Terms, Health Insurance, Managed Care, Quality Initiatives, Research & Development | Tagged: boutique medicine, concierge medicine, david marcinko, hope hetico, retainer medicine, robert james cimasi, www.healthcarefinancials.com, www.HealthDictionaySeries.com | 7 Comments »

Defining the Central Registration Depository

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

Understanding Financial Terms and Economic Definitions

Staff Reporters

www.HealthDictionarySeries.com

FINRA operates Web CRD^®, the central licensing and registration system for the U.S. securities industry and its regulators. It contains the registration records of more than 7,500 registered broker-dealers and the qualifications, employment, and disclosure histories of more than 690,000 active registered individuals, making it the worlds’ largest and most sophisticated online registration and reporting system.

More Information

For questions or comments, medical professionals and all others may contact the FINRA Gateway Call Center at (301) 590-6500. Or, see the Dictionary of Health Economics and Finance.

Assessment

Now, to the extent that many believe that FINRA, the FPA, CFP BoS, and the SEC dropped the ball when it comes to financial advisor oversight and compliance, how important is the CRD anyway? Link: http://www.finra.org/Industry/Compliance/Registration/CRD/index.htm

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Is the CRD still needed, or is it a plutocratic dinosaur?

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Alerts Sign-Up, Career Development, Ethics, Financial Planning, Glossary Terms, iMBA, Inc., Investing | Tagged: broker-dealers, CFP BoS, CFPs, CRD, david marcinko, dictionary health economics and finance, financia advisors, FINRA, hope hetico, iMBA, Inc., RIAs, SEC, securities industry, Series 63, Series 65, Series 7, stock-brokers, www.healthdictionaryseries.com | Leave a comment »

Understanding the Emergency Medical Treatment and Active Labor Act

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

An Important and Contemporary Issue – Once Again

[By Patricia Trites; MPA, CHBC, CMP™ (Hon) with Staff Reporters]

The Emergency Medical Treatment and Active Labor Act (EMTALA) is receiving increasing scrutiny from prosecutors during these times of financials stress and credit tightening. The statute is intended to ensure that all patients who come to the emergency department of a hospital receive care, regardless of their insurance or ability to pay. Both hospitals and physicians need to work together to ensure compliance with the provisions of this law.

Triad of Requirements

EMTALA imposes three fundamental requirements upon hospitals that participate in the Medicare program with regard to patients requesting emergency care.

First, the hospital must conduct an appropriate medical screening examination to determine if an emergency medical condition exists.

Second, if the hospital determines that an emergency medical condition exists, it must either provide the treatment necessary to stabilize the emergency medical condition or comply with the statute’s requirements to affect a proper transfer of a patient whose condition has not been stabilized. A hospital is considered to have met this second requirement if an individual refuses the hospital’s offer of additional examination or treatment, or refuses to consent to a transfer, after having been informed of the risks and benefits of treatment.

Third, EMTALA’s requirement is activated if an individual’s emergency medical condition has not been stabilized.

Hospital Transfers

A hospital may not transfer an individual with an unstable emergency medical condition unless:

(1) the individual or his or her representative makes a written request for transfer to another medical facility after being informed of the risk of transfer and the transferring hospital’s obligation under the statute to provide additional examination or treatment;

(2) a physician has signed a certification summarizing the medical risks and benefits of a transfer and certifying that, based upon the information available at the time of transfer, the medical benefits reasonably expected from the transfer outweigh the increased risks; or

(3) a qualified medical person signs the certification after the physician, in consultation with the qualified medical person, has made the determination that the benefits of transfer outweigh the increased risks, if a physician is not physically present when the transfer decision is made. The physician must later countersign the certification.

On-Call Responsibilities

One area of particular concern is physician on-call responsibilities. Physician practices whose members serve as on-call hospital emergency room physicians are advised to familiarize themselves with the hospital’s policies regarding on-call physicians. This can be done by reviewing the medical staff bylaws or policies and procedures of the hospital that must define the responsibility of on-call physicians to respond to, examine, and treat patients with emergency medical conditions. Physicians should also be aware of the requirement that, when medically indicated, on-call physicians must generally come to the hospital to examine the patient. Patients may be sent to see the on-call physician at a hospital-owned contiguous or on-campus facility to conduct or complete the medical screening examination due to the following reasons:

all persons with the same medical condition are moved to this location;
there is a bona fide medical reason to move the patient;
qualified medical personnel accompany the patient; and
teaching physicians may participate.

Channel Surfing the ME-P

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: "Doctors Only", Career Development, Ethics, Glossary Terms, Health Insurance, Health Law & Policy, iMBA, Inc., Managed Care, Practice Management, Recommended Books | Tagged: CMP, david marcinko, emergency care, emergency department, Emergency Medical Treatment and Active Labor Act, emergency room, EMTALA, ER, healthcare, hope hetico, hospital, medicare, Pati Trites, www.healthcarefinancials.com, www.healthdictionaryseries.com | 9 Comments »

Healthcare Projections and the US Budget 2007-09

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

Issues and Challenges for Obama Administration Reform

By Staff Reporters

Read the complete testimony and statement of Peter R. Orzag, OMB Director, to the US Senate, dated June 21, 2007.

For more information:

Congressional Budget Office

Second and D Streets; SW

Washington, DC 20515

Link: 06-21-healthcarereform

Assessment

Now, almost two years later, and with the new Obama Administration, has your opinion changed on the potential of healthcare reform; why or why not?

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated?

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: Career Development, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care | Tagged: COngressional Budget Office, healthcare reform, Obama Administration, OMB, OMB Director, Orzag testimony on health reform, Peter Orzag, US Senate | Leave a comment »

Understanding Modern Health Plan Delivery Models

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

By Defining Terms and Concepts

Staff Writers

www.HealthcareFinancials.com

Here are four important health care delivery models that should be understood by all financial advisors, their clients, patients and the public:

1. PHYSICIAN ORGANIZATION (PO)

A PO is a group of physicians banding together, usually for the purpose of contracting with managed care entities, or to represent the physician component in a Physician Hospital Organization. The PO is a managed care contracting entity owned by and composed exclusively of physicians. The PO tends to be more tightly controlled in terms of members and adherence to treatment protocols than an Independent Physician Association. POs typically share information systems, claims-processing procedures, financial data, medical records, and other technical support functions.

2. PHYSICIAN PRACTICE MANAGEMENT CORPORATION (PPMC)

A firm that purchases physicians’ practices in exchange for a percentage of the gross receivables. The PPMC leases the office back to the doctor or employs the doctor on a salaried basis. The PPMC then contracts with the areas MCOs.

3. POINT OF SERVICE PLAN (POSP)

A type of managed care plan that allows members to choose whether to seek medical care within the plan’s network or seek medical care out of network at the point of service (i.e., at the time services are rendered). It allows members to pay little or nothing, if they stay within the established HMO delivery system. But, it also permits members to choose and receive services from an outside doctor, any time, if they are willing to pay higher co-payments, deductibles and possibly monthly premiums. It is also called an “open-ended” plan.

4. PREFERRED PROVIDER ORGANIZATION (PPO)

A PPO is a select, approved panel of physicians, hospitals, and other providers who agree to accept a discounted fee schedule for patients and to follow utilization review and pre-authorization protocols for certain treatments. It is a system in which a payer negotiates lower prices with certain doctors and hospitals. Patients who go to a preferred provider get a higher benefit — for example, 90% or 100% coverage of their costs — than patients who go outside the network.

Assessment

Link: www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated?

Link: https://healthcarefinancials.wordpress.com/2009/03/13/rip-retail-financial-services-industry/

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

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Advisors Only", Book Reviews, Career Development, Glossary Terms, Health Insurance, iMBA, Inc., Managed Care, Practice Management | Tagged: david marcinko, dictionary of health insurance and managed care, financial advisors, health maintenance organization, HMO, hope hetico, managed care organization, MCO, physician organization, physician practice management corporation, PO, point of service health plan, POS, PPMC, PPO, preferred provider organization, www.healthdictionaryseries.com | 2 Comments »

Sherlock Expense Evaluation Report [SEER]

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

ADVERTISEMENT

Plan Management Navigator

By Marco Georeno

Ph: 215-628-2289

Please find attached the April 2009 edition of Plan Management Navigator. In it we provide an update on the timing of the Blue Cross Blue Shield universe and the Independent / Provider-Sponsored editions of the Sherlock Expense Evaluation Report (SEER). In addition, we expect to circulate the benchmarking surveys for the Medicaid and Medicare universes on or about June 1st, for completion by July 20^th, 2009.

Benchmarking Studies

If you are interested in participating in our benchmarking studies please contact us as soon as possible. Additional information about SEER is available at www.sherlockco.com/seer.shtml or by contacting Doug Sherlock (sherlock@sherlockco.com).

Best Practices for the Healthcare Enterprise

We also endeavor to provide an enterprise view of best practice. Best practice is typically considered to be the most efficient way of achieving a desired outcome. We believe that the best way of determining the best practice in its most practical application is to start with an overall objective and weigh all particular practices in light of how they contribute to that overall objective.

In that vein, over the next several months, Sherlock Company will be offering web conferences focused on best practices. The first conference will address activities within Customer Services, as well as activities or effects in other functional areas. This web conference will be held on Wednesday May 20th at 2:30 PM, Eastern Time. The costs will be $225. Participation is free of charge to health plans participating in our 2009 benchmarking studies. If you are interested in participating, please email Erin Sawchuk (erinsawchuk@sherlockco.com) or call at 215-628-2289.

Assessment

This edition of Navigator also discusses the latest private health plan Dashboard results for the trailing three months ended January 31, 2009.

Link: navigator

Sincerely,
Sherlock Company

Marco Georeno – Analyst
mgeoreno@sherlockco.com

Fax: 215-542-0690

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated?

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Advisors Only", "Doctors Only", Breaking News, Career Development, Health Economics, Managed Care, Monthly Reports, Practice Management, Research & Development, Sponsors | Tagged: Blue Cross, Blue Shield, douglas sherlock, Goereno Marco, health econoics, health maintenance plans, healthcare enterprise, Healthcare Finance, HMO, Managed Care, MCO, Medicaid, medicare, Plan Management Navigator, SEER, Sherlock Company, Sherlock Expense Evaluation Report | Leave a comment »

Understanding the Health Maintenance Organization Delivery Model

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

Defining Terms and Concepts

By Staff Writers

www.HealthcareFinancials.com

An HMO is a legal corporation that offers health insurance and medical care. It is a health care delivery system that provides comprehensive services for subscribing members in a particular geographic area. Most HMO care is provided through a managed network made up of MD/DOs, hospitals, and other allopathic/osteopathic professionals selected by the HMO. HMO enrollees are required to obtain care from this network of providers in order for their care to be covered, except in cases of emergency. All the care the members may need is paid for by the single monthly fee, plus nominal co-payments. HMOs typically offer a range of health care services at a fixed price (capitation).

Different Types

The types of HMOs are:

1. STAFF MODEL: Organization owns its clinics and employs its doctors.

2. GROUP MODEL: Contract with medical groups for services.

3. INDEPENDENT PHYSICIAN ASSOCIATION (IPA) MODEL: IPA contract that in turn contracts with individual physicians.

4. DIRECT CONTRACT or NETWORK MODEL: Contracts directly with individual physicians.

5. MIXED MODEL: Members get options ranging from staff to IPA models.

6. OPEN-PANEL MODEL: A managed care plan or HMO where members can see any provider for an extra premium cost.

Assessment

Link: www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated?

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Ask-an-Advisor", Book Reviews, Career Development, Glossary Terms, Health Insurance, iMBA, Inc., Managed Care | Tagged: david marcinko, Dctionary of Health Insurance and Managed Care, DDS, DO, DPM, Group Model HMO, health maintenance organization, HMO, hope hetico, IPA, Managed Care, MD, medical network, mixed model HMO, open panel HMO, staf model HMO, www.healthdictionaryseries.com | 1 Comment »

Understanding Collateralized Mortgage Obligations

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

Defining Terms and Concepts for Medical Professionals

By Staff Reporters

www.HealthcareFinancials.com

A CMO is a debt security backed by mortgages. These mortgage pools are usually separated into different maturity classes called tranches (from the French word for “slice”). The securities were issued by private issuers, as well as the Federal Home Loan Mortgage Corporation (Freddie Mac). As the mortgages were usually government-guaranteed, CMOs usually carried AAA ratings until their current financial meltdown. The early versions of CMOs were known as “plain vanilla,” but recent developments gave us PACs (planned amortization certificates) and TACs (targeted amortization certificates); among too many others. They were all variations on how principal repayments in advance of maturity date were treated.

Assessment

Link: www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated?

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

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

Filed under: "Ask-an-Advisor", Alternative Investments, Book Reviews, Career Development, Glossary Terms, iMBA, Inc., Investing, Recommended Books | Tagged: CMO, CMOs, collateralized mortgage obligations, david marcinko, Dictionary of Health Economics and Finance, Dictionay of Health Insurance and Managed Care, Federal Home Loan Mortgage, Freddie Mac, hope hetico, mortgages, PACS, planned amortization certificates, TACs, targeted amortization certificates, www.healthdictionaryseries.com | 3 Comments »

Will the SEC Protect eMRs [Welcome to my Healthcare Nightmare]

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

A Frightening Progressive Policy Institute [PPI] Report – Redeux

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

It is no surprise to ME-P readers, that I am a big fan of Dr. Regina E. Herzlinger, the Nancy R. McPherson professor of business administration and chair at Harvard Business School. I quote her often, in our books, despite her recent MA fiascos chronicled here. I am also a competitive medical analyst, IT devotee and health economist, who was a CFP® designee for more than a decade; before my fiduciary reformation. In her books, Creating New Healthcare Ventures and Market Term in Healthcare, Regi rightly states that many medical professionals are becoming depressed at the current state of affairs in healthcare, and want to give up their careers, entirely. We all know that many doctors, like me, no longer wish their kids to follow our professional footstep [Busia; please don’t roll-over in your grave – I know what I am doing – RIP].

But, is the same emerging trend true for FAs?

Medical Career Changers

For example, Gigi Hirsch, MD, a former ER physician and instructor at Harvard Medical School grew so disenchanted with clinical medicine, that she ditched her career and started her own business, MD IntelliNet, in Brookline, Mass. The company places doctors in non-traditional jobs by pairing them with venture capitalists and other businesses seeking physicians. Of course, this re-engineering and formal re-education has been the experience of my personal career journey, as well.

“Don’t Give up Practice, Yet”

And, Herzlinger implores in her book, Market Driven Healthcare, “don’t give up practice, yet.”

Patients Concerned Too

On the other hand, patients and healthcare consumers are also worrying about the looming so-called governmental free-for-all regarding healthcare delivery, mandated benefits and taxes, federally mandated electronic medical records, and data collection reportage and security; etc. Can you say “Big Brother” or “Command and Controll?”

Assessment

So, now may be the time to review Regi’s op-ed piece and policy report, penned for the PPI back, in 1999. It concerns patient and consumer healthcare protections. And, in this time of an Obama administration push for national healthcare – perhaps a prescient word to the wise might be sufficient.

Link: herzlinger

Conclusion

Your thoughts and comments on this Medical Executive-Post are appreciated? Should there be a healthcare SEC surrogate, much link the financial SEC? Or, would another governmental agency be as incompetent as Wall Street’s SEC and FINRA? Do we want FA wonks directing our healthcare needs? As an SEC controlled broker-dealer, and/or FA drone, should you even pursue same in your financial planning practice? What about the independent’s, CFPs and RIA’s? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to this ME-P. It is fast, free and secure.

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Filed under: "Advisors Only", "Ask-an-Advisor", "Doctors Only", Alerts Sign-Up, Book Reviews, Breaking News, Career Development, Ethics, Financial Planning, Managed Care, Op-Editorials, Practice Management, Quality Initiatives, Research & Development | Tagged: CFP, CMP, Creating New Healthcare Ventures, david marcinko, fiduciary financial advisors, financial advisors, FINRA, Gigi Hirsch, health economists, MA, Market Term in Healthcare, MD Intellinet, Medicare Advantage, ntional healthcare, obama, progressive policy institute, regina herzlinger harvard business school, SEC, socialized medicine | 5 Comments »

Calling for CFP® Fiduciary Status, Real Education and Higher Duty

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

Marcinko Predates Basu – Joins in on Promoting Same

[By Ann Miller; RN, MHA]

Executive Director

Editor’s Note:

We cut and pasted this verbatim anonymous comment, obtained from the trade magazine – Financial Advisor [FA] online – for its pointed charges important to the currently contentious topic of CFP mark status. Although emotional, and borderline abusive, it may represent more reality; than not.

The Letter

Liars and Frauds
Grossly Incompetent
Conveniently Stupid
Simply Unethical

The bulk of the commentary seems to focus on ethics and fiduciary duty to clients. It does not now, nor has ever existed. Fiduciary:

“As fiduciaries, financial planners must make fair and complete disclosure of all material facts and must employ reasonable care to avoid misleading their clients. The utmost good faith is required in all their dealings. Simply put, fiduciaries must exhibit the highest form of trust, fidelity and confidence, and are expected to act in the best interest of their clients at all times.”

The bulk of planner’s violate this tenet and always have. A fiduciary MUST be legal. The idea that one is practicing ethically while never being legal is an affront to any rational person. Or; shall we simply say a “prudent man” at as minimum.

As a fact, about 35 states require licensing that planners don’t want to hear about, never mind adhere to. California – with 8,000 CFPs – has only ONE that is fully licensed and legal to offer comprehensive fee services. Where is the outrage from CFP®s regarding this – and what the other 35 states demand?

A Conspiracy?

Nothing at all: The Board has actively engaged in a conspiracy of silence regarding such duty. NAPFA is a joke and always has been regarding high standards. Yet not one CFP® apparently even cares. That is being a fiduciary? It goes further. The UC system in California was also made aware of this deception more than a decade ago – yet did nothing. The illegal planners/instructors were left to “instruct and guide” new planners to the same level of illegality and fraud. You simply have a wholesale violation of integrity and honesty permeates the educational system and no one cares. I am not sure California Lutheran knows of the deception either. I doubt it. Does that make the lack of integrity and knowledge any the less worse? No.

You have to know what is required legally to perform a function. Every commentator would immediately notify regulators if a physician or attorney was practicing illegally. Yet; nothing here. Is this a double standard by CFPs etc, all to allow themselves a free pass from licensing? Sure.

Every officer, director and most staff members of the Board since Bob Goss has been aware of the fraud. All on formal written record since 1995, at the very least. Not one CFP® in this commentary venue has even bothered to address illegal and unethical activity- yet while extolling the virtues of the organization and themselves. What about the New Disciplinary Board Members? Are they not aware of the breach? If not, why not. Incompetency? If they do now, then why have they done nothing? Conveniently stupid – worse?

Steven Covey noted:

“Integrity means avoiding any communication that is deceptive, full of guile or beneath the dignity of people. A lie is any communication with intent to deceive. Whether we communicate with words or behavior, if we have integrity, our intent cannot be to deceive.”

FA is also aware of the lies and deception and at least has allowed this discussion. But to have further commentary from Board officers extolling the virtues of their standards and the highest integrity is disingenuous at best and a fraud at its worst.

Shame

Shame on all of you for not forcing the issue – of being a true fiduciary? But then again, worse yet, we have these same organizations and people deceptively going to Congress to instill this level of a breach of duty to the American public. Yet, hardly an outcry because the deception is so good and because members would benefit. So we have a benefit by deception.

“it is a lot easier to talk about your ethics than to live up to them.”

The standards might be fine. But who cares if they do not have to be adhered to. Is that not the real question?

Link http://www.fa-mag.com/online-extras/4064-weighing-the-cfp-mark-the-debate-continues.html

Assessment

Contrary to the above and CFP BoS requirements, the Certified Medical Planner program demands a college degree [with verifiable proof], a written and signed statement of legal fiduciary accountability at all times, and CEs consisting of a published dissertation, not mere annual lucre www.CertifiedMedicalPlanner.org

The CMP™ Experience

Now, in as much as I am the ED for our CMP™ online program, I vet most applications. The prioritized reasons for matriculation rejection are: 1] unwillingness / inability to accept fiduciary status while blaming it on BDs, 2] lack of at least an undergraduate college degree, and 3] absolute “panic” regarding our writing and publication requirements.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: "Advisors Only", Alerts Sign-Up, Breaking News, Career Development, Ethics, Financial Planning, Op-Editorials, Quality Initiatives, Research & Development | Tagged: Bob Goss, california lutheran university, CFA, CMP, CPA, david marcinko, financial advisor magazine, financial fiduciary, financial planner, MBA, NAPFA, PhD, Somnath Basu, Steven Covey | 22 Comments »

About Certified Medical Planner™

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

SPONSOR NOTICE

Top 10 Reasons to Become a

Certified Medical Planner™

1. Expertise: Provide health economics, business and financial advice to physicians.

2. Credibility: Gain health industry recognition and fiduciary clout.

3. Opportunity: Focus on the lucrative and expanding physician advisory niche.

4. Recognition: Join a select group of advisory experts.

5. Distinction: Become quality; rather than product driven.

6. Achievement: 500 hours of financial, health economics and management education.

7. Evidence: Validate deep healthcare industry knowledge.

8. Resource: CMP™ text and hand books, dictionaries, and institutional print journal.

9. Distinction: Set yourself apart with our chartered logo and trade-mark identity.

10. Commitment: Become the “go-to” financial advisor for all medical professionals.

www.CertifiedMedicalPlanner.com

Get our Widget: Get this widget!

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

Filed under: "Advisors Only", Career Development, CMP Program, Ethics, Financial Planning, Health Economics, iMBA, Inc., Managed Care, Marketing & Advertising, Practice Management, Quality Initiatives, Sponsors | Tagged: certified medical planner, CFP, CMP, doctors, fiduciary advisor, financial advisor, financial planner, medical management, nurses, physician advisors, Practice Management, www.certifiedmedicalplanner.com | 2 Comments »

« Previous Page — Next Page »

Subscribe MEDICAL EXECUTIVE-POST?

Member Statistics

ME-P Information & Content Channels

Ann Miller RN MHA [Managing Editor]

CERTIFIED MEDICAL PLANNER® program

Most Recent ME-Ps

PodiatryPrep.org

ME-P Free Advertising Consultation

Medical & Surgical e-Consent Forms

iMBA Inc., OFFICES

ME-P Publishing

SEEKING INDUSTRY INFO PARTNERS?

Reader Comments, Quips, Opinions, News & Updates

Start-Up Advice for Businesses, DRs and Entrepreneurs

Up-Trending ME-Ps

Capitalism and Free Enterprise Advocacy

OIG Fraud Warnings

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Improving the Reporting of Adverse Events

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Free ARRA Webinar Series

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

The Great eHR Debates

Share this:

Share this:

Share this:

Medical Practice Financial Management

By Christy Clodwick; MHA

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Avoiding Common Cash Flow Budget Mistakes

Share this:

Share this:

Share this:

Share this:

Share this:

It Was One Year Ago Today … Updated for 2009

Share this:

What it is – How it Works

Share this:

Understanding Financial Terms and Economic Definitions

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Calendar

Advertising Info:

Book Offerings:

Dictionary Offerings: