859,557 Colleagues-to-Date [Sponsored by a generous R&D grant from iMBA, Inc.]
David E. Marcinko [Editor-in-Chief]
As a former Dean and appointed University Professor and Endowed Department Chair, Dr. David Edward Marcinko MBA was a NYSE broker and investment banker for a decade who was respected for his unique perspectives, balanced contrarian thinking and measured judgment to influence key decision makers in strategic education, health economics, finance, investing and public policy management.
Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.
Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].
Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.
Later, Dr. Marcinko was a vital and recruited BOD member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.
As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.
Dr. David E. Marcinko’s professional memberships included: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA, FPA and HIMSS. He was a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.
Marcinko is “ex-officio” and R&D Scholar-on-Sabbatical for iMBA, Inc. who was recently appointed to the MedBlob® [military encrypted medical data warehouse and health information exchange] Advisory Board.
BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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FINANCIAL OPINIONS OF MEDICAL PRACTICE FAIR MARKET VALUE [FMV]
Courtesy: https://lnkd.in/eBf-4vY Plastic Surgery-Medical Practice Worth, Valuation, Sales & Succession Planning
For doctor-colleagues, buying or selling a practice may be the biggest financial transaction of their lives. Reasons for appraising practice worth include: sales, merger, succession, retirement and estate planning; partnership disputes and divorce; or as an important tool for organic growth and strategic planning.
However, the transaction is fraught with many pitfalls to avoid and no medical specialty seems immune; especially when it comes to contentious fair market value [FMV] appraisals.
ON “PRUDENCE” IN FINANCE AND INVESTMENT MANAGEMENT
Courtesy: https://lnkd.in/eBf-4vY TERMS & DEFINITIONS FOR PHYSICIANS
PRUDENT BUYER: The efficient purchaser of market balance between value and cost.
PRUDENT MAN RULE: An 1830 court case stating that a person in a fiduciary capacity (a trustee, executor, custodian, etc) must conduct him/herself faithfully and exercise sound judgment when investing monies under care. “He is to observe how men of prudence, discretion and intelligence manage their own affairs, not in regard to speculation, but in regard to the permanent distribution of their funds, considering the probable income as well as the probable safety of the capital to be invested.” Allows for mutual funds and variable annuities.
PRUDENT INVESTOR RULE: A fiduciary is required to conduct him/herself faithfully and exercise sound judgment when investing monies and take measured and reasonable investment risks in return for potential future rewards. Allows for mutual funds, stocks, bonds, variable annuities asset allocation & Modern Portfolio Theory.
On this day in 1863, Henry Dunant founded the Red Cross, which would go onto receive the Nobel Peace Prize three times.
During the Battle of Solferino in the Franco-Austrian war, Swiss businessman Dunant was shocked to witness tens of thousands dead or wounded left on the field after just one day of fighting.
After this experience, on 17 February 1863, he decided to form the International Committee of the Red Cross in Geneva Switzerland with four other Swiss businessmen to take care of casualties and prisoners of war. In the following year, the first Geneva Convention was adopted, “for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field.”
The First World War was an enormous challenge for the organisation. At the outbreak of the war in 1914 medical staff from all over the world gathered to take care of the many wounded. One of them was the young Ernest Hemingway (awarded the Nobel Prize in Literature 1954), employed as an ambulance driver on the Austrian-Italian front. The experience later inspired him to write the novel ‘Farewell to Arms’.
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Henry Dunant was awarded the first ever Nobel Peace Prize in 1901 for his humanitarian work.
The organization he founded received the prize three times.
WHAT IS DISEASE MANAGEMENT?
Courtesy: https://lnkd.in/eBf-4vY A Holistic Philosophy of Medical Care
DISEASE MANAGEMENT is a philosophy toward the treatment of the patient with an illness (usually chronic in nature) that seeks to prevent recurrence of symptoms, maintain high quality of life, and prevent future need for medical resources by using an integrated, comprehensive approach to healthcare. Pharmaceutical care, continuous quality improvement, practice guidelines, and case management all play key roles in this effort that (in theory) will result in decreased healthcare costs. HEALTH ECONOMICS DICTIONARY:https://lnkd.in/dqdbWM9
DEFINITION: What the insurance company will pay on a doctor’s behalf in the event of a claim. If your limits of liability are “$1,000,000 / $3,000,000” it would mean that the insurance company would pay a maximum of $1 million per occurrence and $3 million per year for claims.
For further clarification, refer to the examples below and assume limits of liability of 1,000,000 / $3,000,000:
· In one year you have 4 lawsuits each for $800,000:
The insurance company pays $3,000,000 and you are responsible for $200,000.
· In one year you have 2 lawsuits each for $2,000,000:
The insurance company pays $2,000,000 ($1 million each) and you are responsible for $2,000,000 ($1 million each).
· In one year you have 9 lawsuits each for $20,000:
The insurance company would pay everything.
However, most states have minimum requirements for limits of liability should you have hospital privileges. And so your thoughts are appreciated.
(a) In this section, “hospital” means a hospital: (1) licensed under Chapter 241; or (2) owned or operated by this state or an agency of this state. (b) A hospital shall disclose the hospital’s cash price for each health care service regularly provided by the hospital. The required disclosure must be made: (1) by posting the prices on the Internet website of the hospital; or (2) if the hospital does not have an Internet website, by providing the prices in writing on request to any person.
SECTION 2. This Act takes effect September 1, 2021.
WHAT IS A “KINKED DEMAND CURVE” IN HEALTH CARE ECONOMICS?
Courtesy: https://lnkd.in/eBf-4vY A Medical Oligopoly?
DEFINITION: A kinked demand curve occurs when the demand curve is not a straight line but has a different elasticity for higher and lower prices. DHEF: https://lnkd.in/dqdbWM9
One example of a kinked demand curve is the model for an oligopoly. This model of oligopoly suggests that prices are rigid and that firms will face different effects for both increasing price or decreasing price. But, what about medical economics?
“A paradox of prosperity is revealed and shown to be stable in the cycles of economic advancement between generations. I would put the matter this way: If one accepts, for example, that Mr. Brokaw’s ‘Greatest Generation’ were characterized by prudence, diligence, and patriotism in deed rather than word, that very generation produced its opposite in the generation that followed it. That is to say, I have found it repeated across the ages and across cultures, that the more diligent a previous generation, as a natural propensity, the more licentious the generation that follows. Invariably therefore, the generation that exhibits the more cogent properties of character for the best sort of citizenship fails to produce a generation of the same or similar characteristics.”
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“Paradox of Prosperity” was applied as a term of analysis in the recent New York Times, Wall Street Journal bestseller Rescue America: Our best America is only one generation away (published October 2011), which Professor Morris co-authored with Chris Salamone. There the inter-generational breakdown is given a fuller exposition. Morris, who has been a careful reader of Thorstein Veblen, particularly Veblen’s masterpiece The Theory of the Leisure Class, says his own advancement of this inter-generational thesis was influenced by Veblen. “I think”, says Morris, “Veblen gave some insight as to what is produced in the generation which follows one such as Tom Brokaw described. The Greatest Generations – if by that we mean a generation characterized by prudence and sacrifice – nearly always produces a generation which can be characterized as a leisure class. They consume without manufacturing. They project feelings over principles. In general terms, they lack a spirit of sacrifice because they abhor the notion of “Objective Values” and so lack the will to re-create or advance the social ethos created by their parent’s generation.” In cultural terms, the generation that followed the “Greatest Generation” were the baby boomers (essentially, the children of the Greatest Generation between 1945–1965). The “Boomers” fit the classic definition of a “leisure class”, which Veblen described as being characterized by Conspicuous Consumption. To quote their description of their leisure class “they move values toward behavior, rather than behavior toward values”.
Book Speaker Dr. David E. Marcinko CMP® MBA for your Next Medical, Pharma, Hospital, University or Financial Services Seminar or Personal and Corporate Coaching Sessions
Dr. David Edward Marcinko, editor-in-chief, is a next-generation apostle of Nobel Laureate Kenneth Joseph Arrow PhD, as a health-care economist, insurance advisor, financial advisor, risk manager, and board-certified surgeon from Temple University in Philadelphia.
In the past, he edited eight practice-management books, three medical textbooks and manuals in four languages, five financial planning yearbooks, dozens of interactive CD-ROMs, and three comprehensive health-care administration dictionaries.
Internationally recognized for his clinical work, he is a past endowed chair; professor of health economics, finance and public health policy management; and distinguished visiting professor of surgery as a Bachelor of Medicine–Bachelor of Surgery (MBBS) degree recipient from Marien Hospital in Aachen, Germany.
He provides litigation support and expert witness testimony in state and federal court, with medical publications archived in the Library of Congress and the Library of Medicine at the National Institutes of Health.
A Medical Practice business valuation is a set of procedures to estimate the economic value of a physician owner’s interests. Valuation is used to determine the price they are willing to pay or receive to affect a sale of the practice.
The same valuation tools are often used to resolve disputes related to estate and gift taxation, divorce litigation, allocated purchase price among business assets, establish a formula for estimating the value of partners’ ownership interest for buy-sell agreements, and other business and legal purposes.
QUERY: But, what are the most common medical practice valuation blunders to avoid? Written over a decade ago, this white paper highlights the most common mistake still seen today.
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.
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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.
One of the most important concepts in behavioral economics is that people react differently to gains and losses. An example from Hodja Nasreddin:
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Hodja Nasreddin
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“One day Nasreddin went to his neighbour and asked to borrow a large cooking pot. The neighbour obliged and Nasreddin promised to bring it back shortly. Weeks passed when the neighbour came by to remind Nasreddin about his pot.
Embarrassed, the hodja went inside and after a short time re-emerged with the pot. On handing it over there was a clanging sound inside upon which the neighbour lifted the lid to reveal a smaller pot inside. “Hodja, what is this?” He exclaimed. “Neighbour, it seems the pot you gave me was expecting and this is her young!” The neighbour gave the hodja a silent look and left with both pots.
Some time later Nasreddin again asked to borrow the pot and the neighbour happily obliged. Again weeks passed and the neighbour came again inquiring about his pot.
“Alas!” Nasreddin said, your dear pot passed on to the afterlife, please accept my condolences.”
“But hodja, how can a metal pot die?” said his neighbour whereupon Nasreddin hodja flew into a rage and yelled:”You had no trouble believing it gave birth but her death strikes you as incredible? Now begone, you rascal!
Anscombe’s Quartet comprises four data sets that have nearly identical simple descriptive statistics, yet have very different distributions and appear very different when graphed. Each dataset consists of eleven (x,y) points.
They were constructed in 1973 by the statistician Francis Anscombe to demonstrate both the importance of graphing data before analyzing it and the effect of outliers and other influential observations on statistical properties. He described the article as being intended to counter the impression among statisticians that “numerical calculations are exact, but graphs are rough.”
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…)
Good Rx makes money by perpetuating the, artificially set, high sticker prices of medications and receiving a portion of Pharmacy Benefits Manager [PBM] fee.
How it Works
GoodRx taps into PBM network for their “discounts” off of sticker price (e.g. Express Scripts, Optum Rx, Navitus … etc)
Consumer pays the newly “discounted” drug price.
Pharmacy pays PBM fee.
PBM pays GoodRx portion of the fee.
Good Rx adjusted EBITDA in 2019: $160 Million
Good Rx 2020 revenue is up 48% first half of 2020 – $257M
The thousands of “Trumpcare” ads Facebook and Google have published show that the shadowy “lead generation” economy has a happy home on the platforms — and even big names like UnitedHealthcare take part.
Yesterday, The President @POTUS outlined his plans for “America First Healthcare Plan”.
In 45 min. in front of Medical Professionals he brilliantly outlined a free market, competitive and PATIENTS centered philosophy for Medical Care in America. For those who care please view the video. you can find it here:https://lnkd.in/e9pxR-U
Medicare Advantage Plans (Private Medicare) are sold on a county-by-county basis. Attached is the market penetration of MA (compared to traditional FFS Medicare) for every county in the USA.
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Wonder why Medicare Advantage Premiums are going down (on average)? Because premiums are one of the measures by which the elderly decide what to purchase. Even though premiums are declining, not all MA plans are ‘cheaper’ than traditional FFS Medicare. Caveat Emptor.
It is also interesting to note that 3 carriers – Humana, UHC and BCBS Affiliates — cover 60% of all MA plan subscribers and use national networks of providers to offer broad service availability (compared to smaller plans, PSP’s and other narrow network options).
Medicare premiums per beneficiary typically exceed $10,000 per year. With effective ingenious use of benefit design, prior authorization, incentives, PBM contract rebates, etc., — there is a lot of money to be made in Medicare Advantage plans — accounting for the rapid growth in these plans over the last decade.
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