HOSPITAL PARTNERSHIPS: CBOs and SDOH

COMMUNITY BASED ORGANIZATIONS

SOCIAL DETERMINANTS OF HEALTH

NIHCM GRANTS

By Yunyu Xiao Weil of Cornell Medicine

By Timothy Brown of UC Berkley Medicine

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This study will determine the causal effects of hospital-CBO partnerships on hospital re-admissions and mortality for the leading mental health and injury-related causes of death (suicidal ideation or suicide) and the leading physical cause of death (heart attack).

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

Findings may inform how, where, and for whom targeted hospital partnerships with CBOs can reduce hospital readmission and mortality.

Do Hospital Partnerships with Community-Based Organizations (CBOs) that Address Social Determinants of Health Reduce Hospital Readmission and Mortality?

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PRIVATE EQUITY: In Cancer Oncology Care

NIHCM GRANTS

By Ola Abdelhadi

By Richard Scheffler

University California at Berkley

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Despite increases in private equity acquisition of oncology practices, little is known about the effect on market competition, prices, and quality.

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

This research team will examine the changes in health care quality and prices following private equity acquisition of oncology practices and explore whether these acquisitions exacerbate health disparities among racial groups. This work may be relevant to policymakers and antitrust regulators assessing private equity deals.

Increasing Private Equity Investment in Cancer Care: What is the Effect on Prices and Quality of Care?

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USA HEALTHCARE QUALITY: Confidence Down

Confidence in the caliber of the American health system has never been lower

A GALLUP POLL

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ANNUAL GALLUP HEALTHCARE QUALITY REPORT

More than one in five adults (21%) living in the US now rate the country’s healthcare as “poor” quality—a record high, according to Gallup’s annual health and healthcare poll.

Less than half of all respondents (48%) surveyed in 2022 said they’d rank the quality of healthcare in the US as “excellent/good”—a new low since Gallup began tracking the issue in 2001. (That’s down from 50% in 2021 and a record high of 62% in 2010 and 2012.) About a third (31%), meanwhile, said they’d rate the quality of US healthcare as “only fair,” a slight drop from 35% in 2021.

Gallup partially attributed the drop in perceived quality to politics, noting that “Republicans’ positive ratings have been subdued since President Donald Trump left office.” Other likely factors, the organization offered, could be “changes to healthcare that have taken place amid the Covid-19 pandemic or curtailed access to abortion since the Supreme Court’s Dobbs decision.”

Survey Reports:

  • Respondents reported a rosier take on the care they personally receive. Over 70% rated it as “excellent/good” compared to 6% who rated it as “poor.” But that high “excellent/good” mark is still down from 76% in 2021 and 82% in 2020.
  • Costs remained a point of contention in 2022. Less than a quarter (24%) of respondents said they were “satisfied” with the total cost of healthcare in the US, and this proportion is on par with rates from the past two decades. But only 56% of those surveyed reported being satisfied with the total cost they pay for care—the lowest level since 2016.
  • One in five respondents think the US healthcare system is in a “state of crisis” (20%) or has “major problems” (48%).

EDITOR’S NOTE: As a former CPHQ [Certified Physician in Healthcare Quality], I find this report alarming and confusing – David EdwardMarcinko MBA CMP

CMP Program: http://www.CertifiedMedicalPlanner.org

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Product Details

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PODCAST: Medical Utilization Management and Review Explained

By Eric Bricker MD

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SECOND OPINIONS: Physician Financial Planning, Investing, Medical Practice Management and Business Valuations; etc!

BY DR. DAVID EDWARD MARCINKO MBA CMP

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Financial Planning for Medical Professionals

HERE: https://medicalexecutivepost.com/schedule-a-consultation/

CONTACT: Ann Miller RN MHA

770-448-0769

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THANK YOU

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FTC: Proposes Banning [Healthcare] Non-Compete Employment Contract Clauses

By Health Capital Consultants, LLC

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FTC Proposes Banning Non-Compete Clauses

On January 5, 2023, the Federal Trade Commission (FTC) published a proposed rule that would ban employers from imposing non-competes on their employees. The FTC asserted that this practice is widespread and often exploitative, and such actions can suppress wages, hamper innovation, and block entrepreneurs from starting their own businesses. Notably, while the proposed rule will affect all industries, not just healthcare, this proposal comes at a time when healthcare employers across the U.S. are struggling with staffing shortages.

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

This Health Capital Topics article will discuss the proposed rule, reactions from healthcare industry stakeholders, and potential implications. (Read more…)

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***

PODCAST: Nuance DAX: Conversational Healthcare A.I.

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In the patient-physician relationship, time is precious. Nuance DAX helps physicians to focus on patient care during appointments—instead of paperwork and documentation. Nuance DAX uses sophisticated conversational AI and ambient technology to capture and contextualize the patient encounter, reducing documentation time by 50%.

Learn more.

***

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PODCAST: JP Morgan Healthcare Conference 2023

EXPLAINED

By Eric Bricker MD

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It is a healthcare investor conference where investors meet with digital health companies, not-for-profit hospital systems, insurance carriers, biotech and med device companies.

The J.P. Morgan Healthcare Conference is invite-only. There is no large exhibition hall. The agenda is not published.

Most of the ‘action’ happens outside the conference with private meetings across the city.

Most people who attend are not invited and they just go for the private meeting opportunities.

Hear a summary of the 2023 J.P. Morgan Healthcare Conference from This Week Health‘s Bill Russell and his guest Rob, DeMichiei–the former CFO of UPMC.

Hospital systems actually have a plan to cut costs for the first time in AGES.

Insurance carriers are going to become healthcare providers themselves.

Will insurance carriers eat hospitals’ lunch? etc.

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

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***

PODCAST: Financial Planning and Medical Business Management Mistakes of Independent Doctors

By Entrepreneurial MD

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In this episode, host Christopher Hughey talks to Steven Huskey about the financial, management and planning mistakes many independent doctors make when setting up their own medical practice.

PODCAST: https://www.theentrepreneurmd.com/search?query=mistakes

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***:

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PODIATRY PREP: Pass All Your Board Certification Examinations

Celebrating 30 Years of Your Success!

***

pod_prep_text

Pass ALL the Certification Boards!

By: http://www.PodiatryPrep.org

The Foot and Ankle Research Consortium, Inc. (FARC) is the leading publisher of Podiatric educational software. Since 1992, we have been producing the most effective and innovative method of preparing for ALL the Podiatry Board Examinations.

CURIOUS STUDY: Hallux Valgus Met I

SCARF: scarf osteotomy

This includes: The American Board of Podiatric Surgery, The American Board Of Podiatric Orthopedics and Primary Podiatric Medicine, the American Podiatric Medical Specialties Board, ABLES and the PMLexis. (Now includes the latest information for all Board Re-Certifications).

CONTENTS: https://podiatryprep.org/compatibility-test/

Customization and private  tutoring services also available.

FAN CLUB: https://podiatryprep.org/podiatryprep-fan-club/

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PURCHASE – PREPARE – PASS®

ORDER HERE: https://podiatryprep.org/order-form/

GOOD LUCK!

Thank You

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

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ADVISORY OPINION: Allows Nurse Practitioner Support in Hospitals

NURSE PRACTITIONERS [NPs]

By Health Capital Consultants, LLC

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Advisory Opinion Allows Nurse Practitioner Support in Hospitals

On December 19, 2022, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published Advisory Opinion (AO) No. 22-20, analyzing the utilization of nurse practitioners (NPs) in lieu of attending physicians within medical units. The OIG concluded that the arrangement utilizing NPs in certain medical units, subject to several safeguards, presented a low risk for fraud or abuse.

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

As noted by legal experts, this AO deviates from OIG’s typical approach to limiting arrangements involving potential remuneration from a hospital to its referring physicians. (Read more…)

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***

RECESSION: Healthcare Industry Layoffs

Not even the healthcare industry is recession-proof

By Staff Reporters

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According to Kristine White of Healthcare Brew, New York City-based Memorial Sloan Kettering Cancer Center (MSK), one of the country’s top cancer treatment facilities, laid off 337 employees on Jan. 17 in response to ongoing financial challenges, according to a New York State Department of Labor filing.

The 337 employees, who worked across 14 sites and in multiple departments, represent about 1.5% of MSK’s 22,500 employees. This is a slight decrease from the expected 3% of layoffs announced in November 2022.

“This reduction was necessary to ensure that MSK can continue to invest in the future of cancer care, research, and education for the benefit of generations to come, and every effort has been made to ensure that patient care is not impacted,” spokesperson John Connolly said in a statement shared with Healthcare Brew.

The institution’s operating losses totaled $116.1 million for Q3 of 2022, compared to a loss of $8.7 million during the same period in 2021, according to a quarterly financial report released in November last year.

Factors such as increased patient activity, wages, and supply costs from inflation pushed the system’s operating expenses up by 7.5% from Q3 of 2021 to Q3 of 2022. The cancer center hired more staff in 2022 with the expectation that patient volume would increase, according to the financial report.

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

Health systems like MSK often reevaluate their biggest expense (workers) when business is down, Lori Kalic, a healthcare senior analyst at consulting firm RSM, told Healthcare Brew.

Just this year, multiple hospitals and health systems have also announced layoffs, including Tufts Medicine in Boston and Integris Health in Oklahoma, according to White.

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Medical CBD: No FDA Advocacy

By Staff Reporters

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The Food and Drug Administration said it can’t vouch for the safety of cannabidiol (CBD)—a nonpsychoactive compound found in marijuana and hemp plants—and because of that, it can’t regulate it. Instead, it’s calling on lawmakers to help supervise $12 CBD lavender sodas.The FDA said that CBD doesn’t fit the mold of the dietary supplements and food additives it typically monitors, such as ginseng and caffeine.

POT: https://contrarianedge.com/should-you-invest-in-marijuana-stocks/?uid=5f78aa3cd815b&utm_source=IMA++-+Main+Articles&utm_campaign=b43e790647-MARIJUANA_STOCKS_RESEND&utm_medium=email&utm_term=0_f1c90406d1-b43e790647-55139025

The agency claims the science is lacking on the safety of long-term CBD use, let alone on any potential perks—like preventing diabetes or aiding sleep.

No-2-Drugs: https://medicalexecutivepost.com/2022/04/20/just-say-no-to-drugs/

Derived from Hemp

Congress legalized hemp four years ago, and most CBD is derived from hemp, not marijuana. As a result, CBD got kicked off the controlled substances list and got lobbed from the Drug Enforcement Administration’s desk to the FDA’s.

Mental Health Drugs: https://medicalexecutivepost.com/2022/10/07/drugs-and-county-mental-health-programs/

Since then, the FDA’s been less active in regulating CBD than a teen in a ’90s anti-marijuana ad. That’s resulted in a chaotic and confusing marketplace, and CBD industry players were hoping the FDA would soon start reining it in.

Drug Middlemen: https://medicalexecutivepost.com/2022/03/14/drugs-money-and-the-middleman/

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INDUSTRY STATURE: Certified Medical Planner®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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OUR OEUVRE’ OF TEXT BOOKS IS GROWING WITH OUR INDUSTRY STATURE

We believe that by writing and sharing our experiences in standard textbook, white-paper and new media electronic format, our experts are able to address most areas of physician-focused financial planning, business or medical practice management needs in an understandable and unbiased manner.

But, we recognize that some consultants and financial advisors may appreciate reading current medical business management theory, healthcare economics, technology or financial planning information privately, prior to becoming a Certified Medical Planner® professional.

However, there is a virtual information overload out there, little of which addresses the pragmatic concerns of the modern medical provider or healthcare industry. None imparts the wisdom to become a better financial advisor or medical management consultant. All motivate the purchase of products.

Therefore, as part of the iMBA Research Library for the Certified Medical Planner® program, we highly recommend the following in-house produced books. You may even recognize some of our nationally known contributing authors and CMPs®.

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

TEXT BOOKS AND HAND BOOKS

iMBA Inc offers links to these publications, to members, and non-members, alike:

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ENJOY THEM ALL

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PODCAST: Personal Branding for Doctors

By Entrepreneurial MD

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In this episode, we talk about the importance of building a personal brand, regardless of whether you own your own practice or are employed. We touch on why this is important, what are the most common mistakes doctors make when doing it and how to get started.

PODCAST: https://www.theentrepreneurmd.com/4

Related: https://medicalexecutivepost.com/2021/06/03/physician-branding-post-pandemic/

More: https://medicalexecutivepost.com/2011/03/15/self-branding-for-physicians/

Related More: https://medicalexecutivepost.com/2011/11/10/content-life-cycle-and-branding-management-for-physicians/

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Comments Appreciated

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***

COVID PANDEMIC: Official National Emergency Ending

By Staff Reporters

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President Biden plans to end both the public health and national emergencies originally declared to address the Covid pandemic in 2020 (and extended several times since) on May 11th 2023.

The White House just disclosed the plan while opposing efforts by Republican lawmakers to end the emergency declarations immediately with a bill called the Pandemic Is Over Act. The end of the emergencies will mean that many Americans will have to start paying for COVID tests, treatments, and vaccines.

It also signals a shift in how serious the government considers the pandemic to be. But, is this wise?

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HEALTHCARE: Top A.I. Companies to Watch!

By Bertalan Mesko MD PhD

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TOP ARTIFICIAL INTELLIGENCE COMPANIES IN HEALTHCARE TO KEEP AN EYE ON 

More and more companies set the purpose to disrupt healthcare with the help of artificial intelligence. Given how fast these companies come and go, it can prove to be hard to stay up-to-date with the most promising ones.

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

So, I collected the most prominent names currently on the market ranging from start-ups to tech giants to keep an eye on in the future.

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FAs & CPAs Wanted -BUT- Certified Medical Planners® Needed?

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Career Development, Products and Services for Medical Specificity

“The informed voice of a new generation of fiduciary advisors for healthcare”

SPONSOR: http://www.CertifiedMedicalPlanner.org 

CMP

FINANCIAL ADVISER WANTED: New York’s Belfer family, which gained riches from oil, is racking up quite an investing losing streak. They lost billions in Enron’s collapse and were clients of Bernie Madoff, and now it’s come to light that they were shareholders in FTX.

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CPAs WANTED: Just as tax season kicks off, US firms are facing a national shortage of accountants, forcing them to look overseas for workers to look over your W-2. More than 300k accountants and auditors have quit in the last two years, per the WSJ.

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CMPs NEEDED: The Certified Medical Planner® program was created in response to the frustration felt by doctors in small and mid-sized practices that dealt with top financial, brokerage and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized to few, despite ever changing needs.

Enter the CMPs

Learn why brokerage sales-pitches and/or internet resources will never replace the knowledge and deep advice of a collegial Certified Medical Planner® professional.

Letterhead CMP

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Artificial Intelligence Passes U.S. Medical Licensing Exam

ChatGPT

By Staff Reporters

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Two papers show that large language models, including ChatGPT, can pass the USMLE. The papers highlighted different approaches to using large language models to take the USMLE, which is comprised of three exams: Step 1, Step 2 CK, and Step 3. ChatGPT is an artificial intelligence (AI) search tool that mimics long-form writing based on prompts from human users. It was developed by OpenAI, and became popular after several social media posts showed potential uses for the tool in clinical practice, often with mixed results.

According to Victor Tseng, MD, of Ansible Health in Mountain View, California, and colleagues, the results showed “new and surprising evidence” that this AI tool was up to the challenge. Tseng and team noted that ChatGPT was able to perform at >50% accuracy across all of the exams, and even achieved 60% in most of their analyses. While the USMLE passing threshold does vary between years, the authors said that passing is approximately 60% most years.

Source: Michael DePeau-Wilson, Medpage Today [1/19/23]

RELATED: https://medicalexecutivepost.com/2013/06/21/will-future-doctors-need-a-medical-license/

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PODCAST: Medicare Advantage Plan Over Payments

A SYNOPSIS

By Eric Bricker

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PODCAST: Government Overpayments to Medicare Advantage Plans are a major problem.

CMS pays Medicare Advantage Plans per member based on a risk score. The more chronic conditions the person has, the larger the payments CMS makes to the Medicare Advantage Plan.

Medicare Advantage Plans may be overexaggerating how sick their members are in order to increase their payments from CMS.

The Department of Justice is currently suing Cigna and Elevance (Anthem) for such over exaggerations.

However there is a deeper problem… CMS itself had performed its own audits, but has not done so in 10 years. CMS identified $650M in overpayments and did nothing about them.

When the Kaiser Family Foundation (KFF) requested information on the audits, CMS refused. KFF had to sue CMS to obtain the audit information and it took 3 years for KFF to win the case.

Perhaps it is incompetence on the part of CMS or perhaps CMS does not want to reveal the audits or do anything about them due to political pressure.

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PODCAST: Hospital Money Problems 2023

INFLATION AND COMPETITION

By Eric Bricker MD

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PODCAST: Medicare Traditional [A and B] v. Advantage [C] v. Part [D] v. Supplements

By Eric Bricker MD

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

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HOSPITALS: Financial Management Update

By Staff Reporters

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Hospitals saw a slight financial boost in November 2022, despite continued negative operating margins throughout the year, according to a new Kaufman Hall National Hospital Flash Report, as reported in Healthcare Brew.

Lower expenses and increased outpatient revenue help buoy their performance and increase margins by 12% month over month from October 2022. But Kaufman Hall, a management consulting firm, reported that its year-to-date operating margin index reflected an actual negative figure of -0.2% in November 2022.

The findings underscore the financial challenges hospitals continue to face as they recover from the Covid-19 pandemic.

And, Erik Swanson, senior vice president of data and analytics at Kaufman Hall, wrote that the “November data, while mildly improved compared to October, solidifies what has been a difficult year for hospitals amidst labor shortages, supply chain issues, and rising interest rates.”

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

The monthly report, which is based on data from more than 900 hospitals, partially attributed November’s lowered expenses to a decline in patient volume and slightly shorter lengths of stay. Decreased labor costs, likely due to a drop in a reliance on contract labor, also helped lower expenses, the Kaufman analysis found.

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

Hospitals further saw a 10% increase year over year in outpatient revenue in November 2022, despite inpatient revenue remaining flat, according to the report. Swanson said “[h]ospital leaders should continue to develop their outpatient care capabilities amid ongoing industry uncertainty and transformation.”

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PODCAST: “Sage Transparency” on Hospital Prices

EMPLOYER SPONSORED HEALTH INSURANCE PLANS

By Eric Bricker MD

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

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

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PODCAST: Employee Engagement and Health Plans

By Eric Bricker MD

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

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

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AFFORDABILITY: Healthcare on Notice for Patients

By Staff Reporters

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People living in the US are finding it increasingly difficult to afford needed health services—even with employer-sponsored health insurance, a new analysis suggests.

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

Researchers at the NYU School of Global Public Health (GPH) examined data from the National Health Interview Survey—an annual CDC survey—that was collected from 2000 to 2020 for 230,000+ adults who received health insurance through an employer or union. Both men and women found most healthcare services to be less affordable now compared to the early 2000s, according to the finding of the NYU analysis reported in a December 2022 JAMA abstract. Women, in particular, found all types of health services to be less affordable than men.

From a nationally representative survey which is conducted annually, researchers included data from 5,545 women and 5,353 men sampled in 2020, and found that about 6% of women reported they couldn’t afford needed medical care. This compares to just 3% of slightly larger sample groups from 2000, per the analysis. By contrast, about 3% of men gave that response in 2020, compared to 2% in 2000.

Avni Gupta, a doctoral student in the public health policy and management department at NYU GPH and the lead author of the analysis, offered that “lower incomes and higher healthcare needs among women could be driving these differences in reported affordability.”

And, José Pagán, the department chair and co-author of the JAMA analysis, said people with employer-sponsored coverage—the largest source of health insurance for people living in the US—“generally think they are protected.”

“[B]ut our findings show that health-related benefits have been eroding over time,” he said; according to Healthcare Brew

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

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PODCASTS: Digital Health + Health I.T.

By Becker’s Hospital Review

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LISTEN: https://www.beckerspodcasts.com/health-it-digital-health-podcast

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

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VIDEO TELECONFERENCE: How to Prepare?

By Coach: Dr. David Edward Marcinko MBA

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PHYSICIANS AND ADVISORS

TIPS TO PREPARE FOR A VIDEO INTERVIEW

Practice with someone to become comfortable with the process.

Background/Staging:


• Pay attention to the background, what will be seen around and behind you. Get rid of
clutter – it affects “your presentation.” Make sure there is nothing in the background you
don’t want anyone to see including personal pictures, etc.


• Conduct the test in the same location you plan to conduct the video interview.
• Adjust lighting to highlight your face. Do not let light wash out your facial features.


• Have back-up equipment nearby (extra laptop, phones, cables).
Clothing


• Dress in professional, conservative, non-fussy clothing as though you were going to be
with the committee in person. Wear a jacket.


• Wear a solid/bold color. Stay away from dark colors.


• Stay away from prints (e.g. herringbone) which, depending upon the design, lighting and
camera pixels, can make your outfit “vibrate” on screen.


• Dress knowing that the committee will see you “closer up” than you will see them.
Eye Contact/Body Language/Clear Communications


• Be sure to look at the camera not at the image of the committee on the screen;
otherwise you do not appear to be “looking them in the eye” or will appear nervous.


• It is hard to read committee body language without typical in-person conversation cues,
so watch the time and limit each answer to 3-4 minutes. Be attuned to a timer.


• Be attentive to your body language — leaning back in your chair is a no-no; lean forward
to convey interest in the position and the committee. Don’t rock back and forth.


• Place support things out of camera range (glass of water, a timer, notes, notepad, pen,
list of committee members) so your eyes go to the side and not up/down to these items.


• Don’t be afraid to ask to have questions repeated, either because the question was long
and complex or because of audio problems. Jot notes on complex questions.

COACH: https://medicalexecutivepost.com/2023/01/08/personal-coaching-dr-marcinko-at-your-service/


Sound Amplification and Noise Control:


• Microphones magnify noises and can be distracting to the committee. Avoid ruffling
papers and jangling jewelry. In the same vein, speak up clearly and enunciate your
words.


• Place a “do not disturb/do not enter” sign on the door of your space. Turn off running
programs (like your email) to eliminate beeps when new emails arrive.

• Silence all other technology EXCEPT if there should be technical issues, turn your
phone back on to receive a call from your Greenwood/Asher consultant for
troubleshooting.


• Ask family and colleagues to be quiet during the interview. If a family member or
colleague is your resident IT expert, have that person close-at-hand but out-of-sight
during the call.


• Be prepared to switch to a landline or cell speaker phone for the audio portion since
audio with Skype/Zoom is not always great. If you do use this option, mute your
computer microphone to eliminate conflicting noise.

SECOND OPINIONS: https://medicalexecutivepost.com/2023/01/10/physician-coaching-second-opinions

PODCAST: https://www.youtube.com/watch?v=n7bYGhEVjd8

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More Orthopedic Physicians Sell Out to Private Equity Firms, Raising Alarms About Costs and Quality

STAFF REPORTERS

Private Equity Partnerships in Orthopedic Groups: Current State and Key Considerations

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

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READ HERE: https://journaloei.scholasticahq.com/article/17721-private-equity-partnerships-in-orthopedic-groups-current-state-and-key-considerations

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PODCAST: Hospital Financial Cross – Subsidization

By Eric Bricker MD

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Hospital Profit Margin from Employers = 57%

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

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PODCAST: Podiatric Medicine in the Metaverse!

Closer than You Think?

By Staff Reporters

An interactive look at how the health space — from education to therapeutic support — is evolving with virtual reality.

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When Dr. Linda Ciavarelli tried out her 13-year-old son’s new Quest headset for the first time, she saw the future.

Specifically, the podiatry specialist in Wilmington, Delaware saw a new way to make health information accessible — an idea that is now a functioning Horizon Worlds space called HouseCall VR.

READ HERE: https://technical.ly/software-development/healthcare-virtual-reality-metaverse/

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

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METAVERSE: Expert Consensus in Medicine?

By Staff Reporters

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A multi-disciplinary panel of doctors and IT experts from Asia, the United States, and Europe analyzed published articles regarding expert consensus on the Medical Internet of Things, with reference to study results in the field of metaverse technology.

READ HERE: https://reader.elsevier.com/reader/sd/pii/S2588914122000016?token=4509ACBB9748F76769BCB6562B7413EAFAA5D83509412E53E17AC36F08A581B66B0F4E7B2D31A444F80A603E8FF22792&originRegion=us-east-1&originCreation=20221015174759

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

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

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

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NEW FDA DRUGS and Money

By Staff Reporters

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New medicines launched by US drug makers reached a median price of $222,003 last year, according to Reuters. These astronomical prices were fueled by three very-expensive gene therapies approved by the FDA. In fact, one of them, from Hemgenix, costs $3.5 million, making it the most expensive drug ever.

Congress did cap annual drug price increases via the Inflation Reduction Act, but that doesn’t cover the cost of new medications. Drug-makers, meanwhile, say the cost of their drugs doesn’t reflect what patients pay out-of-pocket for them.

MORE: https://www.msn.com/en-us/health/other/fda-approves-new-drug-lecanemab-that-appears-to-slow-early-mild-alzheimer-s/ar-AA163pDq?cvid=ee09eaf5a43f49bca0eb3a775051002e

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Pass Your Foot and Ankle Surgery Board Exams

A REVIEW OF HALLUX LIMITUS AND RIGIDUS SURGERY

Courtesy: www.PodiatryPrep.org


ESSAY: http://www.PodiatryPrep.org

Thank You
***

MEDICAL PROVIDERS: Hobson’s Choice in Medicine

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

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TUCSON, Ariz., Dec. 06, 2022 (GLOBE NEWSWIRE) — Sheila Page, D.O., a family physician in Aledo, Texas, and president of the Association of American Physicians and Surgeons (AAPS), is featured in the winter issue of the of the Journal of American Physicians and Surgeons. She writes:  “Today physicians often feel constrained to pick from among options that are not in the best interest of patients but are ‘covered’ by insurance or approved by officials.”

“An apparently free choice when there is no real alternative is a Hobson’s Choice, and physicians must understand the political structure in which this type of ‘choice’ is embedded,” Dr. Page explains.

“During the COVID pandemic, people often faced a Hobson’s Choice of taking a shot that they believed put their life, health, or fertility at risk, or be barred from their education or career,” she noted.

“Voters generally believe that they have two choices, Republican or Democrat, and that they represent extremes of political ideology. However, when they are in office, politicians behave as if they belong to the same club,” she writes.

“Physicians have accepted the Hobson’s Choice of either abiding by ridiculous regulatory burdens or refusing to treat the senior population,” she explains. They “accept the Hobson’s Choice of either standing against the oppression or keeping their ‘place at the table.'” 

“The phrase ‘we need to keep our place at the table to avoid being on the menu’ entirely misses the point,” she states. “The profession is on the table already being carved up. How many times have we been told we must choose the lesser of two evils? Either choice is still evil!”

“We must identify the enemy within,” Dr. Page writes. “The medical profession must grasp the extent to which it has been manipulated by pharmaceutical, insurance, and other systems tied to medicine. We have been burdened with regulations and threats to our licenses by the same people who are selling us the solutions.”

“There is tremendous profit in the existing system, but we must nevertheless offer healing and hope, learn how to fight back effectively, and reject the Hobson’s Choice,” she concludes.

CITE: The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.

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

Contact Information:
Jane Orient
Executive Director
janeorientmd@gmail.com
(520)323-3110

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What Are the 7 Types of Mental Illnesses? Neuro-Psychiatric Hospitals

There are several types of mental illnesses, but the list below will provide an overview. These categories are also helpful in understanding a person with a particular ailment. Knowing more about these conditions will help you develop more profound empathy for those with the same condition and hope that treatment will be available. The following […]

What Are the 7 Types of Mental Illnesses? — NeuroPsychiatric Hospitals

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PODCAST: Value Based Healthcare Delivery by Dr. Michael Porter PhD

HARVARD BUSINESS SCHOOL

By Staff Reporters

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

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

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CENTENE CORPORATION: Medicaid Over-Billing?

By Staff Reporters

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Centene Corporation showers politicians with millions as it courts contracts and settles over-billing allegations by Samantha Young, Andy Miller, and Rebecca Grapevine (Kaiser Health News)

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Somehow KHN made Medicaid over-billing sound sexy.

This deep dive into Centene, “the nation’s largest private managed-care provider for Medicaid,” shows how the company has maintained good relationships with politicians as it looked to keep its market share and settle over-billing allegations.

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

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PODCAST: https://medicalexecutivepost.com/2021/11/12/podcast-centene-giant-medicaid-hmo/

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

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MEDICAL PRIOR AUTHORIZATION: Proposed Modernization from CMS

By Health Capital Consultants, LLC

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CMS Proposes Modernizing Prior Authorizations

On December 6, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed a modernization of the prior authorization process for health insurance. The proposed rule seeks to require certain insurers to implement electronic prior authorization, shorten decision timeframes, and make the process more transparent and efficient.

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

The rule includes “five key provisions and five Requests for Information,” aiming to “improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.” This Health Capital Topics article will review those provisions and requests for information, as well as stakeholder responses to the proposals. (Read more…)

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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MEDICARE: Physician Payments Cuts?

By Health Capital Consultants, LLC

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Congress Overrides Some – But Not All – Medicare Physician Payment Cuts

On December 20, 2022, the U.S. Congress announced its deal to fund the federal government through 2023, averting an imminent government shutdown. The 4,155-page, $1.7 trillion spending bill spans a vast array of funding initiatives and other bipartisan measures, including a number of noteworthy healthcare provisions.

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

Perhaps most significantly, Congress intervened in the impending cuts to the Medicare Physician Fee Schedule (MPFS), overriding some, but not all, of the payment reductions. This Health Capital Topics article will discuss the congressional measures to ameliorate the payment cuts to physicians in 2023, as well as the other healthcare provisions included in the omnibus spending bill. (Read more…)

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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DIGITAL SECURITY and the American Dental Association [ADA]

By Darrell K. Pruitt DDS

Digital security and the ADA

I wrote the following letter four years ago today. Neither The Digital Dental Record nor its sponsor, The American Dental Association, responded. In fact, a few years later, The Digital Dental Record was predictably hacked and more than 500 dentists, including many ADA members, were victims of a breach of the ADA’s favored digital record system. The ADA is still silent, but they did however, terminate their business relationship with The Digital Dental Record.

Dear The Digital Dental Record,

Thanks for your response on Linkedin to my concerns about the security of EHRs compared to paper. To be honest with you, I’m pleasantly surprised. Contrary to the norm of what I consider an open and free market, very few vendors in the dental IT industry seem willing to openly discuss the dangers or cost of software they hope to sell to dentists – who obviously don’t ask the right questions. That is why I respectfully decline your offer of a private telephone conversation.

You know my name is Darrell Pruitt because it heads my post. I never hide it. Whoever you are, you should probably show potential customers the respect of accountability through transparency. After all, The Digital Dental Record is the only EHR system endorsed by the ADA. I hope that still stands for something of value.    

If you have any non-anecdotal evidence on which you base your bold claim that DDS Safe R2 is more secure than paper dental records, please share it. I’ll be transparent:  Nobody believes you. Then again, maybe “Luddites” who question the security of digital records are simply wrong. Here’s your chance to show the nation why the ADA chose to endorse The Digital Dental Record above all other electronic dental record systems.

D. Kellus Pruitt DDS

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

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PHARMACISTS: Retail Burnout Shortage?

By Staff Reporters

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DEFINITION: Retail pharmacist work in a retail setting rather than in a hospital. They are responsible for dispensing and controlling both prescription and non-prescription medicine, advising customers on general healthcare and must work to high legal and ethical guidelines.

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

Today, retail pharmacies across the board are struggling to hire and retain enough pharmacists and pharmacy technicians to keep up with the increased pandemic-related demand for vaccinations and prescriptions. On top of that, pharmacist burnout has prompted companies like Walgreens to reduce the workloads of their employees.

The stakes are high. A decline in pharmacy school enrollees and a seemingly tight job market for those graduates makes it hard to replace departing staff.

“One of the challenges in healthcare in general is that it has been a difficult couple of years for those working in this industry. And pharmacy isn’t immune to that,” said Nate Shenck, a managing director and senior partner at Boston Consulting Group.

To tackle the worker shortage, Walgreens announced it would invest $265 million in its pharmacy staff in FY 2023. Those funds are earmarked for raises, additional training and career development opportunities, and larger scholarships for pharmacy students, Erin Loverher, a spokesperson at Walgreens, said via email.

MORE: https://www.msn.com/en-us/money/companies/pharmacies-are-cutting-hours-and-closing-stores-what-it-means-for-customers/ar-AA15iBOC?cvid=bfc3491382f64937b71476a89016ae5b

PS: Some retailers, such as CVS and Kroger, are limiting the sale of children’s pain relievers. Demand for pediatric pain meds has spiked due to the “tripledemic” of respiratory illnesses spreading right now.

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

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Performance Coaching for Doctors? [A Voting and Opinion Poll]

On the Need  for Coaching Medical Professionals

Join Our Mailing List

Like some other folks, doctors may benefit from having an objective, outside consultant or coach advise them on how to maximize their medical practice and/or personal performance.

In fact, it’s becoming a popular service, particularly as the ACA, market volatility, heightened insurer and patient demands, and profit pressures are challenging physicians in ways that may not be familiar to them.

But, not all coaches are created equal. What is a coach? What are the risks and benefits? Is this a real need or perceived marketing ploy in a time of tumult?

Q: And so, should doctors hire a performance coach?

Conclusion            

And so, your thoughts and comments on this ME-P are appreciated. Please 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

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

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

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HEALTH GORILLA: A New Health Data Interoperability Start-Up

By Staff Reporters

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Health Gorilla is in the business of health data interoperability and the double-backflip this startup is doing to both make clinical data an easily accessible commodity – while also making sure that access to that data adheres to the privacy rules established by the US government – takes a minute to understand, but is critically important for the future of many health tech businesses.

LINK http://www.HealthGorilla.com

And, it’s not often that 10,000-plus like-minded individuals come together for a common cause. Luckily in the healthcare space, we have HLTH – bringing together the entire health ecosystem to focus on innovation and transformation.

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

So for Health Gorilla, last month’s four-day event in Las Vegas was a most successful conference.

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

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TURQUOISE HEALTH? Compare Prices Before Receiving Medical Care

By Staff Reporters

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Last year, all hospitals were required to list their prices for elective services on an annual basis. Whether you have insurance or plan to pay cash – find and compare prices.

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

So, just like you wouldn’t buy a car, rent an apartment or even order food without knowing the cost, you shouldn’t pay blindly for healthcare.

Now you can compare prices before showing up for treatment.

READ MORE: https://turquoise.health/

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

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PODCAST: Financial Deception in Healthcare

THIRTY EXAMPLES

By Eric Bricker MD

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

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

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ELIXIR: Rite Aid’s New PBM [mail order pharmacy]

By Staff Reporters

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When Rite Aid dropped roughly $2 billion in 2015 to buy its pharmacy benefit management (PBM) subsidiary now known as Elixir, the company had framed the investment as a strategic move to compete in the healthcare marketplace among rivals like CVS and Walgreens.

The deal quickly helped make Rite Aid $4.1 billion in its newly formed pharmacy services segment—including Elixir and other pharmacy services, according to the company—bolstering its financial standing the next fiscal year. Maybe it would no longer be the ugly duckling next to the cooler, sleeker swans.

It seemed to be working—for a while at least. But by 2018, analysts were recommending Rite Aid sell off Elixir to reduce the parent company’s debt. Still, Rite Aid stuck with Elixir in hopes of boosting its competitiveness in the retail pharmacy scene.

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

This year, Rite Aid President and CEO Heyward Donigan was still painting a rosy picture of Elixir, saying in earnings calls that the PBM was gaining more members and Elixir’s operating margins were improving.

But a month after its latest earnings call in September, Rite Aid was hit with a class-action lawsuit accusing the company of making “false and/or misleading statements” to investors about Elixir’s status between April and September of this year.

READ: https://www.healthcare-brew.com/stories/2022/12/09/rite-aid-faces-a-class-action-lawsuit-over-its-pharmacy-benefits-subsidiary

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

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PODCAST: Medical Utilization Management [UM]

By Eric Bricker MD

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

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

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NUCLEAR FUSION: New Energy Source?

By Staff Reporters

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Researchers have reportedly made a breakthrough in the quest to unlock a “near-limitless, safe, clean” source of energy: they have got more energy out of a nuclear fusion reaction than they put in. Nuclear fusion involves smashing together light elements such as hydrogen to form heavier elements, releasing a huge burst of energy in the process.

Unlike nuclear fission, the energy reaction we currently use, fusion does not create radioactive waste, and the U.S. Department of Energy estimates that it produces three to four times more energy.

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Scientists had a nuclear breakthrough

The Department of Energy is expected to announce today that scientists at California’s Lawrence Livermore National Laboratory successfully produced a nuclear fusion reaction with a net energy gain (meaning it produced more energy than it used).

Scientists and governments have been trying to make that happen for decades because nuclear fusion, as opposed to the nuclear fission that current nuclear plants use, has the potential to create energy to power the world without producing carbon or radioactive waste. Still, it will be a long time before nuclear fusion becomes commercially viable as a source for energy.

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