BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on November 19, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
Hospitals Must Treat All Patients
BY ERIC BRICKER MD
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The Emergency Medical Treatment and Active Labor Act is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act
Posted on November 18, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
Harm from Physicians and Health caRE
By Eric Bricker MD
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Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence.
Posted on November 15, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
By THCB
Today on Health in 2 Point 00, Jess DaMassa claims to be blameless for the drama between Jonathan Bush and Glen Tullman. On Episode 198, we talk about Microsoft buying Nuance for $16 billion and $3 billion in debt – is Microsoft taking over healthcare, and is this going to slow Nuance down?
IPOs
Cohere Health raises $36 million in a Series B, working on improving prior authorizations between health plans and providers. We wrap up with a lightning round of IPO rumors regarding Privia Health, VillageMD, and Bright Health.
Health Insurance Companies Paid for Hospital Outpatient Services at an Even Higher Average Rate of 293% of Medicare.
A Detailed Look at the RAND Analysis Reveals that the ‘Basket’ of Services at Each Hospital Had Very Little Data.
For Example, the RAND Study’s Data for the Baylor Scott & White Hospital System in Dallas – Fort Worth Represented Only 0.4% of the Hospital’s Total Revenue.
For the Texas Health Hospital System Also in Dallas – Fort Worth, the RAND Study’s Data Only Represented 0.96% of the Hospital’s Total Revenue.
That Sample Size Is Likely Too Small to Make Accurate Comparisons from One Hospital System to Another Regarding their Commercial Insurance Prices Relative to Medicare.
ASSESSMENT: Your thoughts and comments are appreciated.
Posted on November 5, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
MORE ON EDR SECURITY
By Darrell K. Pruitt, DDS
Dental Care Alliance Data Breach Impacts More Than 1 Million Patients
NEWS FLASH!
“Sarasota, FL-based Dental Care Alliance, LLC, a dental support organization with more than 320 affiliated dental practices across 20 states, has been hacked and the protected health information of more than a million individuals has potentially been compromised. The breach occurred on September 18, 2020, was detected on October 11, and was contained on October 13.”
Currently I am in conversation on LinkedIn with a Chief Information Officer for an IT firm. He assures me that the cloud is more secure than paper dental records stored in heavy and loud metal filing cabinets, but cannot say why.
Meanwhile, I have never heard of a million paper dental records being stolen in one heist. Wouldn’t that require a truck or two? What’s more, once the thieves escape to their hideout, someone will have to enter the data onto computers – while struggling to interpret bad handwriting.
ASSESSMENT: Your thoughts are appreciated …. More later.
Posted on November 4, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
NO LONGER EVEN NOTICED?
BY DARRELL PRUITT DDS
Data breaches are now so common that hardly anyone in healthcare notices them – especially in dentistry. I imagine that more than half of the data breaches from dental offices are never reported, and their patients never warned that their identities might be available on the internet.
Whether you ignore this problem or not, this will not end well, folks.
A June 2021 PricewaterhouseCoopers (PwC) report found that healthcare costs have been on a steady decline for the past decade, but trailing effects from the COVID-19 pandemic could cause increases above anticipated rates over the next several years.
In 2007, the annual cost growth for healthcare spending was 11.9% and declined steadily until 2017, where it floated between 5.5% and 6.0% until 2020. However, projected healthcare cost growth for 2022 is expected to reach 6.5% due to factors such as deferred or forgone care, increased mental health issues, preparation for future pandemics, and investment in digital tools. (Read more...)
Posted on October 27, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
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The right to repair electronics refers to proposed legislation that would provide the practical means for equipment owners to repair their devices, and not a new legal right. The implications for medicine are huge.
Advocates observe that while repair is legal under copyright law and patent law, owners are often prohibited from making their own repairs or hiring technicians they trust to help by manufacturer limitations on access to repair materials such as parts, tools, diagnostics, documentation and firmware.
Posted on October 20, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
OVERHEARD IN THE DOCTOR’S LOUNGE
By Jaan E. Sidorov MD
*** DEFINITION: Prospect theory is a theory of behavioral economics and behavioral finance that was developed by Daniel Kahneman and Amos Tversky in 1979. The theory was cited in the decision to award Kahneman the 2002 Nobel Memorial Prize in Economics.
Amanda, an RN client, was just informed by her financial advisor that she needed to re-launch her 403-b retirement plan. Since she was leery about investing, she quietly wondered why she couldn’t DIY. Little does her FA know that she doesn’t intend to follow his advice, anyway! So, what went wrong?
The answer may be that her advisor didn’t deploy a behavioral economics framework to support her decision-making. One such framework is the “prospect theory” model that boils client decision-making into a “three step heuristic.”
Prospect theory makes the unspoken biases that we all have more explicit. By identifying all the background assumptions and preferences that clients [patients] bring to the office, decision-making can be crafted so that everyone [family, doctor and patient] or [FA, client and spouse] is on the same page.
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*** Briefly, the three steps are:
Simplify choices by focusing on the key differences between investment [treatment] options such as stock, bonds, cash, and index funds.
Understanding that clients [patients] prefer greater certainty when it comes to pursuing financial [health] gains and are willing to accept uncertainty when trying to avoid a loss [illness].
Cognitive processes lead clients and patients to overestimate the value of their choices thanks to survivor bias, cognitive dissonance, appeals to authority and hindsight biases.
ASSESSMENT
Much like in healthcare today, the current mass-customized approaches to the financial services industry fall short of recognizing more personalized advisory approaches like prospect theory and assisted client-centered investment decision-making.
Generally speaking, all income is taxable unless it’s specifically excluded, as is the case with certain gifts and inheritances. In most instances, the income you earn will be reported to both you and the government on an information return, such as a Form 1099 or W-2. If the income you report doesn’t match the IRS’s records, you could face problems down the road—so be sure you include the income from all of the following forms that are applicable to your situation:
1099-B: The form on which financial institutions report capital gains.
1099-DIV: The form on which financial institutions report dividends.
1099-MISC: The form used to report various types of income, such as royalties, rents, payments to independent contractors, and numerous other types of income.
1099-R:The form on which financial institutions report withdrawals from tax-advantaged retirement accounts.
Form 1099-INT: The form on which financial institutions report interest income.
Form SSA-1099:The form on which the Social Security Administration reports Social Security benefits (a portion of which may be taxable, depending on your level of income).
Form W-2:The form on which employers report total annual compensation, payroll taxes, contributions to retirement accounts, and other information.
If you receive an inaccurate statement of income, immediately contact the responsible party to request a corrected form and have them resend the documents to both you and the IRS as soon as possible to avoid delaying your tax return. Also, be aware that you must report income for which there is no form, such as renting out your vacation home.
When you sell an investment, you’ll need to know both the cost basis (what you paid for the investment) and the sale price to determine your net gain or loss. The cost basis of your investment may need to be adjusted to account for commissions, fees, stock splits, or other events, which could help reduce your taxable gain or increase your net loss.
Financial institutions are required to adjust your investments’ cost basis and provide that information on a Form 1099. However, brokerages aren’t required to report the cost basis for investments purchased prior to a certain date, which means you’ll be responsible for supplying that information (see the table below). Be sure to keep records of all investment purchases and sales—even those for which your brokerage is responsible.
Your reporting responsibility
Depending on security type and date of purchase, you—rather than your brokerage—could be responsible for reporting the cost basis of your investment to the IRS.
Posted on October 16, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
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By Darrell K. Pruitt DDS
Compared to hospitals, the business of dentistry is as simple as a lemonade stand. Dental practice management software is an option – not a necessity.
Thank goodness.
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“Cyber Daily: Congress Inches Toward Response to Ransomware Attacks – U.S. legislators in the House and Senate have several bills in play that would put new requirements on companies [including dental offices] to report cyber incidents, including details about ransomware payments.”
As transparency makes it increasingly difficult for dentists to hide ransomware breaches from their patients by quietly paying the ransom (one or more times), paper dental records remain the gold standard of security. Practice management software is not only more expensive than paper records, but it vastly increases patients’ risk of identity theft while offering them NO TANGIBLE BENEFITS… Just ask anyone.
The three Nobel Prize winners in economics show that science is happening all around us—if we’re willing to look.
David Card, Joshua Angrist, and Guido Imbens, US-based economists who shared the prize awarded yesterday, helped pioneer the use of “natural experiments” to conduct studies on real-life situations as if they had happened in a tightly controlled lab.
Here’s one example: Card is most famous for his and Alan Krueger’s 1993 study on the effects of minimum wage on employment. They compared fast food jobs in New Jersey, which had just raised its minimum wage from $4.25 to $5.05, to fast food restaurants in neighboring Pennsylvania. The idea was that NJ and PA are generally pretty similar, so any observed differences in the labor market could lead to important conclusions about raising the minimum wage.
What did they find? That NJ’s higher minimum wage did not hurt job growth…and may have even increased employment. This shocked most experts at the time.
Bottom line: Natural experiments are now ubiquitous in economics research, but only because these Nobel Prize recipients showed what was possible. —NF
Posted on October 12, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
By Bernie Portal
The Consolidated Omnibus Budget Reconciliation Act of 1985 is a law passed by the U.S. Congress on a reconciliation basis and signed by President Ronald Reagan that, among other things, mandates an insurance program which gives some employees the ability to continue health insurance coverage after leaving employment.
COBRA compliance can be difficult, especially if you’re handling it yourself. Now, it’s even more complicated thanks to recent stimulus bill changes that implemented a 100% free COBRA subsidy for eligible employees and employers.
In this episode, host Ryan McCostlin talks through the ins and outs of this important component of healthcare law that’s designed to help out employees during the pandemic.
Posted on October 11, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
BYSTEVE WINOKER
Hi David,
I hope this note finds you well. Here at GE, September was an important month for us. We concluded our annual strategy reviews with each business, complementing the quarterly operating reviews with a longer-term focus. I had the opportunity to participate in many of the review processes and came away impressed with our progress, leadership team, and the growth opportunities that lie ahead as we innovate for the future of flight, precision health, and energy transition.
In my last investor update, I shared the exciting news that GE announced an agreement to acquire BK Medical, and in the spirit of growth and innovation, I’d like to share a few more recent business highlights that illustrate how our teams are delivering for our customers:
At Aviation, Bamboo Airways signed a Memorandum of Understanding agreement to purchase GEnx engines for its Boeing 787-9 aircraft. This order of 10 firm and 20 options, valued at a list price of approximately $2 billion, will help the airline expand its transcontinental flight network. Dang Tat Thang, CEO of Bamboo Airways, said, “The selection of the GEnx engines for our Boeing 787-9 aircraft will help increase the operational efficiency and service quality of Bamboo Airways on Vietnam-U.S. nonstop flights as well as many potential international routes.”
Renewable Energyannounced today that it received an order to supply Haliade-X turbines for Massachusetts’s Vineyard Wind 1, the first utility-scale offshore wind installation in the U.S. Additionally, our Haliade-X offshore wind prototype turbine recently became the first in the industry to operate at 14 MW, increasing our customers’ ability to produce more power from a single turbine.
Gas Powerannounced the delivery, installation, and commissioning of four TM2500 aeroderivative gas turbines in only 42 days to supplement renewable power generation for the State of California’s Department of Water Resources during peak demand season. GE’s TM2500s start and ramp up quickly in just minutes and will help enhance the reliability and sustainability of California’s grid.
We’re excited about what the future holds, as our teams are highly focused on executing for our customers, leveraging lean to drive meaningful progress and innovating for a more sustainable world.
We look forward to sharing more on our 3Q’21 earnings call on Tuesday, October 26. As always, I welcome your feedback.
An August 2021 study published in the Journal of the American Medical Association (JAMA) analyzed medical and surgical episodes of care in U.S. hospitals to determine whether outcomes differed in hospitals that participated in Medicare’s Bundled Payments for Care Improvement (BPCI) Initiative depending on whether the patient being treated was attributed to a Medicare Shared Savings Program (MSSP) accountable care organization (ACO).
This Health Capital Topics article will discuss the study’s findings and potential policy implications.(Read more…)
Posted on October 8, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
THE CULTURAL SHIFT
Dr. Bertalan Meskó, MD
The pharma industry has taken a big swung into digital transformation. All participants invest in digital health topics.
But as with all trending issues, and there is a lot of fuss that is hard to see through. As the medical community increasingly acknowledges the importance of digital health, the cultural shift we so often talk about is still a way to go. To change that, the first step is always getting to know what’s coming.
In this article, with podcast, Bert collected the trends changing the pharmaceutical industry.
In Response to a Question Regarding the Ending of Haven Healthcare–the Joint Venture Among Berkshire Hathaway, JP Morgan Chase and Amazon to Improve Healthcare for their Employee Health Plan Members–Warren Buffett Made the Following Statement:
“Healthcare is the Tapeworm of the US Economy and the TAPEWORM WON.”
Additionally, Warren Buffett Goes on to Say that ‘Prestigious‘ People in the Community Run Hospital Boards and These People Are ‘Fairly Happy‘ with the Healthcare System the Way It Currently Is.
It is Likely that Warren Buffett Formed Some of This Opinion in Speaking About Healthcare with the Vice Chairman of Berkshire Hathaway, Charlie Munger, and Berkshire Board Member and Famous CEO, Tom Murphy.
Charlie Munger Has Served on the Board of a Los Angeles Hospital for 31 Years and Tom Murphy Currently Serves on the NYU Langone Hospital System Board of Directors.
The Support of the Status Quo by ‘Prestigious,’ ‘Fairly Happy’ Hospital Board Members Cannot Be Understated… It Blocks Change and Warren Buffett Appears to Think Similarly.
The first World Financial Planning Day was held on October 4, 2017. The Financial Planning Standards Board (FPSB) hosts the day. Every year, the FPSB partners with the International Organization of Securities Commissions (IOSCO).
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Today, it is always held during the first Wednesday of October during IOSCO’s World Investor Week.
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QUERY: But, what about the entire ecosystem of personal and professional financial planning, investing, risk, business and medical practice management for physicians and healthcare professionals? A vital, unique and complicated niche!
ANSWER: According to the Institute of Medical Business Advisors, Inc., WFP Day is every day for CERTIFIED MEDICAL PLANNER® professional certification holders.
So – If you are in this WFPD industry – Become a fiduciary focused board CERTIFIED MEDICAL PLANNER with extreme healthcare industry ecosystem specificity.
Artificial intelligence is all around us. From self-driving cars to shopping suggestions and everything in between.
In this episode of The Entrepreneur MD, we sit down with Sergei and Daniel from Well-Ai who share with us how their platform uses Artificial Intelligence to augment physicians and improve patient outcomes.
Posted on October 5, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
FORPHYSICIAN INVESTORS
By David Belk MD
Health Insurance Company Financial Index
Below is a listing of the Nine largest for-profit health insurance Companies. The Annual financial statements are linked to the year for each Company and a four page summary report is linked to the name of the health insurance company at the top of the listing.
The relevant pages in each financial statement I used to prepare my summaries are listed next to each year’s statement. Aetna and Coventry’s summaries are combined because they merged in 2012. Health Net also Merged with Centene in 2016 leaving only seven major health insurance companies.