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In the last few years, research has shown that deep learning can match expert-level performance in medical imaging tasks like early cancer detection and eye disease diagnosis. But there’s also cause for caution.
Other research has shown that deep learning has a tendency to perpetuate discrimination. With a health-care system already riddled with disparities, sloppy applications of deep learning could make that worse.
According to colleague David K. Luke MIM, MS-PFP, CMP™ the current structure of the life insurance industry regarding cash-value life insurance policies with most major insurance companies is to reward the selling agent with the entire commission upfront on a newly issued policy. The criticism to this practice is that this of course reduces the needed client-agent reviews and interaction and generates more “churning” and “flipping”. Unscrupulous agents are tempted to sell physician-clients another policy for another commission rather than encourage them to maintain and keep their existing policy, which most likely would have lower costs than any new policy considering the client was younger and most likely in better health with the existing contract. A model in which the insurance agent would have a financial incentive for their client’s continued patronage could create a win-win for both parties. We see this “pay as you” model currently operating successfully with wealth advisors and property/casualty agents, why not life insurance agents [personal communication]?
There are some flaws to this argument. The reality is that the captive life insurance industry and their agents prefer this form of lump compensation. The claim is that selling an individual a life insurance policy (the ultimate intangible product) is hard work, and likewise the 70% – 110% of the first year premium is fair compensation for the efforts. For existing agents to reduce their current income to a fraction of this commission upfront, but convert it into a trail over a multiyear period is actually quite distasteful. Therefore, this change will likewise not be initiated from the Insurance agent or insurance industry side unless other forces prevail.
The drive by the consumer to change this up front lump form of compensation has not yet presented itself in full force. After all, why does the consumer care about how the agent is paid if the consumer is satisfied with the end result? One must acknowledge that the drive to reduce commissions and up front loads in the investment advisory business was driven by the consumer that insisted on lower fees and costs.
However, the relevant costs of a life insurance policy are not quite as obvious. Only by comparing a quote from different companies can a consumer compare costs, and even then it is unknown and not understood how the pricing mechanisms used by the insurance company work. The advent of non-agent sold policies however is decreasing the cost of life insurance (there is no big commission check written to the selling agent) and is hitting the radar of consumers. The consumer can notice this difference if the consumer compares the proposed agent sold policy premium with one sold directly by a financial institution such as USAA or AARP. These companies have a work force of sales people that are compensated primarily on salary. Likewise the company can structure more competitive pricing, and in effect offers a levelized cost (in place of commission) insurance product.
For example, Mark Maurer CFP® of Low Load Insurance Services believes that a levelized compensation basis will not occur unless all the insurance companies were to go to such a plan all at once. If an agent can “pick and choose” he/she may use a “levelized compensation” policy when in a competitive situation, as such a policy should in theory make a policy more inexpensive. An agent would then use the higher “front-end” policy when there is a large up-front premium or in a scenario with limited competition. Mark believes the answer to the whole argument is full disclosure. Both agents and home offices would not want the purchaser to know that 100% or more of their premium is going to sales costs and then products would then get better [personal communication].
The insurance industry has a powerful lobby in Washington. Only market pressure will cause a change in this decades old insurance industry practice that has made many life insurance policies expensive and inefficient. Pricing from non-agent sold life insurance companies will be the impetus that drives the old-line Insurance companies to restructure their commissions to agents.
Insurance agents also remember the days of 8% load mutual fund commissions and minimum $60 dollar commissions on stock trades in the late 1980’s! That is an inflation equivalent of more than $130 per trade, minimum commission, today. The current investing world would laugh at these costs [charges] today. When the physician-consumer realizes, through full disclosure and outside competitive market pressures, that life insurance protection can be more affordable from other non-traditional channels, then s/he will insist on a better, more affordable product.
Ultimately, the big agent driven life insurance companies will have to change their commission structure. The transition is currently in process. Only time will tell now [personal communication].
The popularity of special purpose acquisition companies (SPACs) has been soaring in recent years. There are 35 times as many SPACs operating in 2020 as in 2010, and these companies seem poised for greater exponential growth in the future.
While many experts are predicting a continued, rapid increase in SPACs, this article will also examine the factors that could possibly slow SPAC growth and diminish their future prospects. SPACs span several market areas, including biotechnology and healthcare; this article will review SPAC trends generally as well as healthcare SPACs in particular. (Read more…)
A client recently asked me whether there is a difference in our sell discipline between high and low growth companies.
Selling is one of the hardest parts of investing. I wrote a lot on the subject in the past, but let’s zoom in on how our selling practice differs between high-growth companies with long runways for compounding and slow-growth companies.
EDITOR’S NOTE: It has been a few years since I spoke with my colleague Vitaliy. But, I read his newsletters and blog regularly and suggest all ME-P readers do the same.
EDITOR’S NOTE: It has been a few years since I spoke with my colleague Rick. But, I read his newsletters and blog regularly and suggest all ME-P readers do the same.
NOTE: Dr. Grace Torres-Hodges is a board certified podiatrist and has been in her own independent solo practice since 2001. She is on the surgical staff at Baptist, Gulf Breeze and Sacred Heart Hospitals as well as the Andrews Institute of Orthopedics & Sports Medicine. She completed her undergraduate studies at Vanderbilt University and was pursuing graduate studies in sports medicine at the United States Sports Academy prior to medical school. Dr. Torres-Hodges was an FPME scholarship student and received her medical degree from the New York College of Podiatric Medicine. Dr. Torres-Hodges completed her post graduate residency training in both medicine and surgery at St. Vincent’s Medical Center in Jacksonville, Florida.
My Journey From Financial Advisor to Journalist to Fiduciary Ambassador
ByKathleen M. McBride, AIFA® [Founder, Fiduciarypath, LLC]
EDITOR’S NOTE: Kathleen M. McBride, AIFA®, Founder, Fiduciarypath, LLC and CEFEX-certified analyst, talks about her journey from advisor to journalist to fiduciary ambassador.
Reporter Jessica DaMassa, the emerging ‘It girl’ of health tech interviewing, chats it up with a ‘who’s who’ of the health care business scene. Today, it is Scott Shreeve MD of Crossover Health.
Looking past the virtual-first primary care company’s $168M Series D offering, CEO Shreeve gets grilled on the long-game.
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
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Even as a child growing up in Hawaii, Nobel Laureate Jennifer Doudna had a strong urge to know things. One day, her father placed the book ‘The Double Helix’ on her bed. This detective-style story about how the structure of the DNA molecule was solved was like nothing she had read in her school textbooks. She was captivated by the scientific process and realised that science is more than just facts.
However, when she started to solve scientific mysteries, her attention was not on DNA, but on its molecular sibling: RNA. This would eventually lead her to the discovery of CRISPR/Cas9 a tool that can be used to change the DNA of organisms with extremely high precision and, in 2020, to the Nobel Prize in Chemistry.
1. I will continue to verify any statements I make about the healthcare system by talking to physicians and operators with REAL-WORLD EXPERIENCE and not rely solely on statistical comparisons.
2. I will promote that there is a correlation between cost, quality, and access in today’s healthcare system. Those who believe health systems should approach anything close to Medicare breakeven advocate for low quality and significant service reductions.3. I will continue to promote the fact that whoever affiliates with the best doctors will win in the long run.
4. I will encourage my clients to avoid the attempt by payers and many industry desk jockeys (e.g., Rand Corp.) to commoditize healthcare delivery. The best doctors, services, and ultimately the best outcomes are not commodities; they come at a price.
5. I will not stand by and watch the payers, government, and the aforementioned academic knuckleheads destroy the hospital industry using the ‘value con’– they already destroyed the rural hospital sector.
6. I will only consider a health system to be under quality leadership if market share grows and profits meet or exceed the industry benchmark. I won’t accept ‘mission’ as an excuse.
The Biden Administration has put forth their healthcare plan, which seeks to expand access to affordable healthcare with the following:
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(1) upholding and expanding the Patient Protection and Affordable Care Act (ACA), to reduce the amount that consumers pay for health insurance on the individual marketplace; (2) offering a new, public insurance option similar to Medicare; (3) prohibiting the practice of “surprise billing”; (4) leveraging the Department of Justice’s (DOJ’s) and Federal Trade Commission’s (FTC’s) antitrust authority to target market concentration within the healthcare system; and, (5) driving down prescription drug prices by increasing competition for, and regulation, of pharmaceutical companies.
On October 29, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Transparency in Coverage final rule. This long-anticipated final rule stems from President Donald Trump’s June 2019 executive order on “Improving Price and Quality Transparency” and builds upon the hospital Outpatient Prospective Payment System (OPPS) price transparency requirements released in November 2019.
These requirements came under fire in a lawsuit filed by the American Hospital Association (AHA), Association of American Medical Colleges (AAMC), Children’s Hospital Association (CHA), and Federation of American Hospitals (FAH), against the Department of Health and Human Services (HHS); the requirements were upheld by the courts in June 2020 and the lawsuit is being appealed by the plaintiffs. (Read more…)
The second installment in this five-part Health Capital Topics series on the valuation of telemedicine will focus on the reimbursement environment for telemedicine.
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Telemedicine is reimbursed based on the services provided through this medium and includes many restrictions on where, how, and by whom services can be conducted. The first installment in this series introduced telemedicine and its increasing importance to, and popularity among, providers and patients. It also discussed the current and future challenges related to telemedicine, many of which hinge upon reimbursement restrictions and regulations. (Read more…)
On September 14, 2020 the Centers for Medicare & Medicaid Services (CMS) released the financial and quality performance results for the Medicare Shared Savings Program (MSSP) Performance Year (PY) 2019. The results revealed record net savings of $1.19 billion for Medicare, marking the third consecutive year of net savings.
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Most significantly, included in these results are the first six months of performance for accountable care organizations (ACOs) that enrolled in the MSSP under one of the Pathways to Success models that commenced in July 2019. These results provided the first look at ACO performance under the new, controversial model. (Read more…)
Did you know that far more MBAs and bachelor-degree holders were among top managers and board of directors among startups filing for IPOs between 1990 and 2018 than were other degree holders?
About 55% of them had an MBA for their highest degree vs. 20% for bachelors, 7% for PhD, 3% for MD, 12% for MS, and 3% for JD. The high percentage of MBAs and bachelor-degree holders reflects the move away from #science-based #technologies such as semiconductors, and electronic, communications, and medical equipment that once dominated Silicon Valley (hence the name), and towards Internet commerce, content, and services over last 25 years.
In fact, most PhDs among top managers and board of directors at IPO time studied life sciences and were employed in #biotech#startups, a sector that continues to thrive. Creating successful science-based startups in other sectors continues to be a big challenge, one that may be partially overcome by #AI in near future.
As for which #universities train these people, Harvard, Stanford, Berkeley and MIT had the most graduates in many categories, representing almost 20% of PhDs for instance.
As a teacher educating is your job. It’s what you enjoy. There’s a fairly lax time schedule and resources are already built in the equation. Little accountability because the ultimate burden and measure of success is placed on the student to pass a test. If they don’t do well, it’s the student not directly the teacher who pays the price.
Now, I work with first year students who don’t know what a red blood cell looks like (biconcave disc, you thought I forgot, didn’t you) all the way to a chief resident who can probably do some surgeries better than me. It’s my job to take that first year student and turn them into a chief resident.
As an entrepreneur with limited resources, time, and energy, you don’t have the luxury to continuously teach, develop, and convince. You need people who simply get it especially in strategic positions. You don’t have the luxury of time or resources. You also are directly accountable if they don’t understand because you have a burn rate that probably just got worse. So how much “oxygen” do you allocate when trying to build your team?
Different story for Apple, Boeing and others that can create academies and educational tracks to teach and develop internally.
There are perverse incentives in the healthcare system. As a part of my mission to provide affordable and accessible health care in Detroit and beyond, it needs to be said that the middlemen in healthcare inflate the cost of the care that you receive.Anthem Revenue $104 Billion (2019)
Cigna CEO salary $18.9 million (2018)
United CEO salary $21.5 million (2018)
Aetna CEO salary $18.7 million (2017)
The total annual healthcare spending in the US is over $3.6 trillion annually.
Healthcare spending on administration: 34%
Healthcare spending on physician salary: 8.6%
When your doctor can’t get you the tests/imaging/procedures/surgery/medication you NEED, remind yourself that the middle management, the CEOs, the lobbyists for health insurance company did NOT swear an oath to put your health above money.
Your doctor did.
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Doctors are missing sleep, skipping vacation, answering calls on weekend and holidays, missing important family events, and otherwise working tirelessly to keep you healthy.
All of that’s to say that I firmly believe in the power of the doctor-patient relationship and removing the middlemen from this equation.
Welcome FinancialAdvisors: An Invitation to Prospect & Promote Your Self
Healthcare Prospecting with FAs in Mind
Would you like to present your self or firm, your strategic competitive advantage, and your value proposition to the medical community?
Would you like to share some unique financial planning, financial advisory or health economics pearls with your colleagues?
Would you like to see a new financial product or service in action before you start using it in your practice, or recommending it to physician clients?
Would you like to introduce yourself and prospect to the HNW medical community, for free?
If so …
Join your ME-P peers and colleagues. Get free access to on-demand videos and other presentations from leading financial advisors [FAs] and brought to you by www.MedicalExecutivePost.com.
The ME-P is your source for the best online-exclusive content in the financial advisory marketing, and financial planning e-prospecting space, for all healthcare professionals [physicians, podiatrists, osteopaths, dentists, chiropractors, nurses, medical CXOs, etc].
How to Submit a Video
To submit a personal or product presentation video [pod-cast], sponsor a video [pod-cast], or inquire about specific advertising on the ME-P, please contact Ann Miller RN MHA at: 770.448.0769 or MarcinkoAdvisors@msn.com
Video Formats
Acceptable 5-12 minute video formats include: Flash (in either SWF or FLA), MPEG, MP4, QuickTime or AVI. Submission of a podcast/video does not guarantee publishing on the ME-P website. FA submitted videos are subject to review by the Executive Editor. Company submitted videos are subject to review by the Publisher and Executive Editor.
SAMPLE PODCAST
In this encore podcast, Somnath Basu PhD MBA examines how the recent economic turmoil has changed financial planning clients’ attitudes and expectations.
ME-P and iMBA Inc pledges always to respect the privacy and anonymity of its users and participants. The information (the names, email addresses or any other contact information, personal or financial data) provided to us by our visitors in their registrations and communications with us is securely stored and not shared with any third party. We are committed to working with the Internet community in cultivating and maintaining trust between all its members.
Affiliates’ Research in Medical and Other Journals
By staff reporters
Many NBER-affiliated researchers publish some of their findings in medical and other journals that preclude pre-publication distribution. This makes it impossible to include these papers in the NBER Working Paper Series. This is a partial listing of recent papers in this category by NBER affiliates.
How Discrimination and Bias Shape Outcomes Lang K, Kahn-Lang Spitzer A. How Cultural Factors Shape Children’s Economic Outcomes, Kearney MS, Haskins R, editors. The Future of Children 30(1), June 2020, pp. 165–186.
“Medical Management and Health Economics Education for Financial Advisors”
STOCKS: A global stock market crash on March 12 set the worst single-day decline for stocks since 1987. But in Q2, major indexes clawed their way back on the promise of economic reopenings. Filled to the brim with tech companies, the Nasdaq has distanced itself from the Dow and the S&P.
FED: The Fed slashed interest rates in March to stem the economic bleeding, and in early June said it would hold rates near zero through 2022.
OIL: In late April, oil prices crashed below -$37 a barrel as plummeting demand from lockdowns left traders with nowhere to put their oil. Following an agreement by OPEC+ to reduce supply by 9.7 million barrels a day, prices are slowly rebounding back to March’s highs.
On June 19, 2020 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule regarding Medicaid Drug Rebate Program (MDRP) regulations, with the aim of lowering drug prices, increasing patient access, and encouraging innovation in the insurance and pharmaceutical industries.
This proposal is consistent with the Trump Administration’s Blueprint to Lower Drug Prices (Blueprint) released in May 2018, in which the administration highlighted its goal to “avoid excessive pricing by relying more on value-based pricing by expanding outcome-based payments in Medicare and Medicaid” and to “speed access to and lower the cost of new drugs by clarifying policies for sharing information between insurers and drug makers.”
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The proposed rule seeks to accomplish the Blueprint’s goals by reducing regulatory barriers that have previously prevented commercial plans and states from entering into value-based purchasing (VBP) arrangements with drug manufacturers.
Colleagues from Health Capital Consultants, LLC; explain.
As the coronavirus (COVID-19) global pandemic has wreaked havoc on the U.S. economy generally, and the healthcare industry specifically, the previously-active healthcare transactional environment has been largely stunted.
Despite (or perhaps because of) this economic turbulence, stakeholders expect that merger and acquisition (M&A) activity will soon resume with a vengeance. This potential opportunity, however, is not without pitfalls, due in part to the concern from stakeholders and regulators that well-capitalized entities may use this economic and public health crisis to prey on debilitated physician practices. (Read more…)
ASSESSMENT: Your thoughts and comments are appreciated.
BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
On June 3, 2020, Seema Verma, the Administrator of the Centers for Medicare & Medicaid Services (CMS), announced in a Health Affairs article that CMS is providing significantly more flexibility for healthcare entities participating in CMS-sponsored value-based reimbursement (VBR) models for the duration of the COVID-19 pandemic.
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CMS has made a number of changes related to these models to provide added flexibilities to participating entities and to respond to participant concerns that VBR models will incur losses this year due to both the general disruption in operations and the greater expense associated with treating COVID-19 patients. (Read more…)
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ASSESSMENT: Your thoughts and comments are appreciated.
BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
“The financial planner is a like juggler, trying to keep a variety of balls simultaneously in the air. Each aspect of practice becomes critical, just as action is needed.
Some of the activities of operating a successful financial planning practice generally attract more attention than others, such as marketing and advertising, closing engagements, and office administration. Because product review, selection and implementation are often related to advisor compensation, they attract a great deal of the financial juggler’s concentration.
But, the heart of financial planning, niche advice, often receives little attention. Not because it is unimportant, it just doesn’t seem immediately and predictably urgent. Here, that ball does not seem to be dropping so rapidly.
However, retaining clients and receiving referrals from other professionals is very dependent on the quality of the advice delivered. And, the first line of protection from practitioner liability exposure is to not deliver incorrect or incomplete advice.
But, where does the financial advisor turn for ideas and organized research in the healthcare sector?”
Edwin P. Morrow; CFPTM, CLU, ChFC, RFC
[Middletown, Ohio, USA]
Your thoughts are appreciated.
BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
The COVID-19 global pandemic has brought a time of grave uncertainty for U.S. healthcare and the greater economy.
While the focus of healthcare providers is, appropriately, on the access and delivery of care to those impacted by the COVID-19 outbreak, there are many providers who will require financial resources to persevere during a time when all sectors of the U.S economy are being significantly impacted.
The federal government has announced a myriad of programs in the form of grants and loans to reimburse hospitals and physicians for some expenses and loss of revenue. (Read more…)
Spurred by how unprepared the American healthcare system was for a pandemic, the current COVID-19 emergency may present the conditions necessary to commence a healthcare delivery model paradigm shift.
In response to the public health emergency, the federal government, which has a record of reducing regulatory “burdens” under the Trump Administration, has taken aggressive actions to create regulatory flexibilities for healthcare providers and suppliers.
At least some of the various actions taken to reduce provider burden as they treat COVID-19 patients are likely to stay intact following the end of this pandemic, potentially revising the fundamental tenets of U.S. healthcare delivery. (Read more…)
Does the Internet Promote the Same Dynamic as “Road Rage?”
Courtesy: https://lnkd.in/eBf-4vY
The best way to get an answer on the Internet is not to ask a question. It’s to post the wrong answer.
This “law” by Ward Cunningham is known to those with social media accounts. Once you’re arguing with a computer – social norms vanish! People like to fight online more than they like to help.
They’re quicker to point out flaws than to become a friendly resource.
In fact, psychologist Jonathan Haidt wrote that if you constantly express anger in your private conversations, your friends will likely find you tiresome. But, when there’s an audience, the payoffs are different and outrage can boost your status.
A study by William J. Brady at NYU measured half a million tweets and found that each moral or emotional word used in a tweet increased its virality by 20 percent.
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Finally, another 2017 study, by the Pew Research Center, showed that posts exhibiting “indignant disagreement” received nearly twice as much engagement [likes and shares] as other types of content.
The ONLY way to protect dentists, staff, patients and their families from the risk of fatal COVID-19 infections is to keep the virus out of dental offices. (See graph from the New York Times).
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Prediction: If quick and reliable testing is not available soon, within weeks after dental offices re-open for routine dental care – creating aerosols with high speed hand pieces, air/water syringes and ultrasonic scalers – dental offices will justifiably become known as reliable sources of COVID-19 infections, before being closed down again by the state.
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