The Health Economic Costs Moving from Adult EMPLOYER Sponsored Health Insurance to MEDICARE Coverage

Impact of Moving Older Adults from Employer Coverage to Medicare

Peterson-KFF’s recent brief “How Lowering the Medicare Eligibility Age Might Affect Employer-Sponsored Insurance Costs” explores potential percent reduction in employer health plan spending if all enrollees in age group leave large employer-sponsored coverage.

The brief found:

 •  Ages 60-64 would cause a 15% reduction
 •  Ages 55-64 would cause a 30% reduction
 •  Ages 50-64 would cause a 43% reduction

Understanding Medicare options to help make confident ...

Source: Peterson-KFF Health System Tracker, “How Lowering the Medicare Eligibility Age Might Affect Employer-Sponsored Insurance Costs”

Your thoughts are appreciated.

THANK YOU

***

Re-Imagining Global Health Care Business Models?

The State of MEDICAL TOURSIM in the USA

Image preview

By Dr. David Edward Marcinko MBA CMP®

CMP logo

SPONSORED: www.CertifiedMedicalPlanner.org

American businesses are extending their cost-cutting initiatives to include offshore employee medical benefits, and facilities like the Bumrungrad Hospital in Bangkok, Thailand (cosmetic surgery), the Apollo Hospital in New Delhi, India (cardiac and orthopedic surgery) are premier examples for surgical care. Both are internationally recognized institutions that resemble five-star hotels equipped with the latest medical technology.

What Is Medical Tourism? - YouTube

Foreign countries where I studied medicine and surgery, and practiced briefly, such as Finland, England, Canada and Germany are also catering to the English-speaking crowd, while dentistry is especially popular in Mexico and Costa Rica. Although this is still considered “medical tourism,” Mercer Health and Benefits was retained a decade ago by three Fortune 500 companies interested in contracting with offshore hospitals and The Joint Commission [TJC] has accredited 88 foreign hospitals through a joint international commission.

To be sure, when India can discount costs up to 80%, the effects on domestic hospital reimbursement and physician compensation may be assumed to increase downward compensation pressures.

So far, so good; right? Thumbs Up!

But, then came the Corona Virus Pandemic!

Hand With Thumb Down Free Stock Photo - Public Domain Pictures

Johns Hopkins University Covid 19 Tracker: https://coronavirus.jhu.edu/map.html

India Today: https://www.indiatoday.in/coronavirus

INDIA RATIONING: https://www.msn.com/en-us/health/medical/who-to-be-saved-who-not-to-be-inside-a-hospital-during-indias-covid-19-crisis/ar-BB1golnK?li=BBnb7Kz

ASSESSMENT: Your thoughts are now appreciated.

ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

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***

On Nursing Capitation Reimbursement?

Partial-Risk Medicare Nursing Capitation Economics is Still Not Working!

By Dr. David E. Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

Capitated reimbursement is predominantly, but not exclusively, within the realm of physician providers. But, a decade ago Community Nursing Organization project examined an innovative approach to community nursing and ambulatory care services for Medicare beneficiaries. The hypothesis was that provision of such services would promote the timely and appropriate use of health care and to reduce the use of costly acute care services.

Organizations participating in the CNO demonstration were paid a fixed per-member-per-month capitated rate for covered services. But, the participating CNOs were only at risk under capitation for a subset of Medicare benefits [partial-capitation or carve-out]. The financial incentive was to minimize utilization covered under the capitated payment, but not necessarily to minimize utilization of services not covered because traditional Medicare, not the CNO, would be at risk.

Assessment

Final results indicated that the CNO model under partial capitation led to increased Medicare costs based on findings consistent across several analytic approaches. The cost differences between treatment and control or reference groups persisted after the application of increasingly complex risk-adjustment methods.

Moreover, the differences increased over time and were robust to changes in the way CNO participation was defined.

Lastly, there was no statistically significant evidence of increase in physical or social functioning of the treatment group, as compared with the control group. CNOs cost more without providing any health benefits along dimensions measured

[Source: Voluntary Partial Capitation: The CNO Medicare Demonstration Project, Austin Frakt, Steve Pizer, Robert Schmitz, and Soeren Mattke – Health Care Financing Review 2005).

Your thoughts are appreciated.

CAPITATION ECONOMICS WHITE-PAPER: https://healthcarefinancials.files.wordpress.com/2008/11/capitation-actuarial-medical-econometrics.pdf

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Product Details

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THANK YOU

***

Free Market Medicine in 2021?

By James Dunavant

One thing for certain about 2020 is that uncertainty was everywhere.

So, we now ask:

  • What will 2021 look like for the free market medical movement?
  • Will the political landscape move toward more centralized control of healthcare under a Biden presidency?
  • Will a more conservative-leaning Supreme Court strike down the Affordable Care Act?

There are so many unknowns. Entrepreneurs are always navigating through a world of uncertainty and the government always has a tendency to make things more uncertain.

LINK: https://fmma.org/free-market-medicine-in-2021/

CONCIERGE MEDICINE: https://medicalexecutivepost.com/2009/07/07/enter-the-zombie-medical-practices/

ASSESSMENT: So what do you think? Your thoughts are appreciated.

Free Market Medical Association

THANK YOU

***

Why are CERTIFIED MEDICAL PLANNER® Textbooks SO DARN Popular?

[By Dr. David Edward Marcinko MBA CMP®]

http://www.CertifiedMedicalPlanner.org

OK – I was a Certified Financial Planner® before my academic team launched the Certified Medical Planner™ online and on-ground chartered education and board certification designation program a few years ago. I am now CFP reformed and in remission.

MORE: Enter CPMs

Enter the Certified Medical PlannerChartered Designation

Today, we are of course, gratified that Certified Medical Planner™ mark notoriety is growing organically in the healthcare, as well as financial services, industry.

Even uber-blogger Mike Kitces MSFS, MTAX, CFP, CLU, ChFC, RHU, REBC, CASL has taken note of us in his musings on the Nerd’s Eye View website. And, the reality is that there are a growing number of CFP educational programs at the post-CFP niche market level.

But, none for healthcare industrial complex: for doctors … by doctors!

Popularity of our Text Books

However, it is our modern, innovative and proprietary Certified Medical Planner™ textbooks and dictionaries that have exploded in the academic marketplace.

In fact, they are now redacted in thousands of medical, graduate, law and B-schools and libraries, as well as colleges and universities throughout the nation. This includes the Library of Congress, National Institute of Health and  the Library of Congress.

What Gives?

We have been told that this textbook popularity and publishing success is because of their balanced and peer-reviewed nature; something not very widespread in the financial services industry that is prone to gross and overstated advertising, salesmanship and marketing hyperbole. And, for this we are very gratified.

But, is there another reason our books are so popular?

A bit of networking and research suggests that interested folks may be eschewing the actual course work in favor of just the high quality textbooks! UGH!

Another reason may be that our books and curricula are kept fresh and updated on our corporate website: http://www.MedicalBusinessAdvisors.com

Assessment

So, what do you think? Matriculation with the professional mark versus self study without the designation mark. Please opine.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™ 8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Product DetailsProduct Details

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

Product DetailsProduct Details

Adult Learners and Students:

Product DetailsProduct DetailsProduct Details

***

CEO ADMITS: Payments in Value-Based Contracts Were Actually Fee-For-Service Based

Fee-For-Service Physician Reimbursement Not to be Replaced Anytime Soon!

AN EXPOSE’

Image result for eric brixcker

By Eric Bricker MD

VALUE BASED CARE PROPONENTS?

Definition: Value-Based Care (VBC) is a health care delivery model under which providers — hospitals, labs, doctors, nurses and others — are paid based on the health outcomes of their patients and the quality of services rendered. Under some value-based contracts, providers share in financial risk with health insurance companies. In addition to negotiated payments, they can earn incentives for providing high-quality, efficient care.

VBC differs from the traditional fee-for-service model where providers are paid separately for each medical service. While quality care can be provided under both models, it’s the difference in how providers are paid, paired with the way patient care is managed, that provides the opportunity for health improvements and savings in a VBC environment.

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

MEDICAL EXECUTIVE-POST REVIEW:

Advocacy: https://medicalexecutivepost.com/2015/10/19/the-case-for-value-based-medical-care/

Status: https://medicalexecutivepost.com/2018/12/07/the-state-of-value-based-care-vbc/

Transition: https://medicalexecutivepost.com/2017/08/06/transitioning-to-value-based-medical-care-payments/

Physicians: https://medicalexecutivepost.com/2016/02/03/value-based-care-vbc-and-physician-performance/

THE SHOCKING EXPOSE’

But – During a Panel Discussion Captured on YouTube at the 2019 HLTH Conference in Las Vegas, Blue Cross Blue Shield of Arizona CEO Pam Kehaly Admitted that Only 10% of the Payments in Value-Based Contracts Were Value-Based.

So, what gives?

VIDEO: https://www.youtube.com/watch?v=PfAxOpyP-sA

Your thoughts are appreciated.

Product Details

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

THANK YOU

***

Unable to Afford Health Care?

BRI Board Chairman Sally Pipes Takes a Closer Look

By Richard Walker

Yes, Says Gallup, but Maybe Not!

A recent Gallup poll finds Americans are unable to afford health care. But, a closer look at the data suggests otherwise.

sally_head_shot

What Health-Care Affordability Crisis?

LINK: https://www.nationalreview.com/2021/04/what-health-care-affordability-crisis/

Your thoughts are appreciated.

THANK YOU

***

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Congress Ignores Doctor Shortages?

Medicare-Funded Residency Positions

Bonner Cohen | DeSmog

[By Bonner R. Cohen]

Congress bypassed an opportunity in recently enacted COVID-19 relief bills to significantly increase the number of Medicare-funded residency positions at hospitals.

In the last package, which amounted to $1.4 trillion in government spending and was signed by President Trump on December 31, lawmakers set aside $120 million for 1,000 new physician training slots over the next five years. There was a more ambitious bill on the table that would have added 15,000 residencies over the next five years, but it failed to make it into the giant year-end coronavirus relief package.

“The increase of 1,000 slots is a good first step but a far cry from what is needed,” said David Balat, director of the Right on Health initiative at the Texas Public Policy Foundation.

Your thoughts are appreciated.

THANK YOU

***

Direct Pay Specialties Outside of DPC

Eschewing Third Party Insurance Payers

Dr Grace Torres-Hodges, DPM, FACFAOM - Appointments ...

By Dr. Grace Torres-Hodges

VIDEO: https://www.youtube.com/watch?v=HwZmQxdV5v0

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.

Dr. David E. Marcinko MBA

[Editor-in-Chief]

Direct Primary Care for Local Governments - John Locke ...

Your thoughts are appreciated.

Product Details

Link: 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

THANK YOU

***

AMAZON’S New Move in Health Care

By Health Capital Consultants, LLC

Amazon, the largest e-commerce company in the world, has made large, strategic moves over the past several years to make a place for themselves in healthcare.

This article will review Amazon’s most recent advancements in the industry, including those related to Amazon’s voice-controlled personal assistant, Alexa, and Amazon’s employee healthcare system, Amazon Care, and how this non-healthcare company is changing the industry.

LINK: https://www.healthcapital.com/hcc/newsletter/03_21/HTML/AMAZON/convert_amazon_moves_healthcare_3.25.21.php

RELATED: https://medicalexecutivepost.com/2018/09/07/investors-have-misdiagnosed-amazons-push-into-the-pharmacy-business/

MORE: https://medicalexecutivepost.com/2018/03/07/how-amazon-could-lose-its-health-care-bid/

Your thoughts are appreciated.

Product Details

THANK YOU

***

“Real ACOs haven’t been tried yet!”

ON ACCOUNTABLE CARE ORGANIZATIONS

[By Staff Reporters]

What happens when you’re a healthcare policy wonk and the pilot study for your pet program has failed miserably?  You declare “Success!” in the editorial pages of the New England Journal of Medicine and demand that the program become nationwide and mandatory.

I kid you not.  This is exactly what happens.

Thankfully, colleague Mike Accad MD and Anish Koka are vigilant and explain the blatant obfuscations and manipulations that the central planners engage in to have their way.

LINK: “Real ACOs haven’t been tried yet!”

YOUTUBE: https://www.youtube.com/watch?v=_b6GPBUoCuo

Your thoughts are appreciated.

Product Details

THANK YOU

***

More on Concierge, Retail, Cash Pay and Boutique Medicine; etc [SAM’S CLUB]

Sam’s Club Launches Innovative Pilot to Help Make Healthcare More Affordable

 

cropped-dem

By Dr. David E. MarcinkoMBA

I devoted a full chapter of my book; “The Business of Medical Practice” to concierge and boutique medicine, retail medicine, direct, cash and private pay medicine; etc. We included terms and definitions, process and methodologies, marketing and advertising, and examples, etc. In fact, who knew I was so prescient and the landscape would finally begin evolving.

For example, we recently learned about Sam’s Club offering targeted “bundles” of health care services collaborating with Humana. https://lnkd.in/ejHGGzk

And, earlier, we learned of Amazon’s new virtual / primary care clinic model. And of course, in the past couple of weeks, Walmart’s (Sam’s affiliate) opening their freestanding clinics, along with new behavioral health services, as well.

 ******

Assessment: Your thoughts are appreciated.

THANK YOU

Product DetailsProduct Details

***

DAVID EDWARD MARCINKO IS AT YOUR SERVICE IN 2021

DAVID EDWARD MARCINKO IS AT YOUR SERVICE IN 2020-2021

INVITATION:

Invite Dr. Marcinko

TO SCHEDULE A SEMINAR, SPEAKING ENGAGEMENT, POD OR VLOG-CAST:
Contact: Ann Miller RN MHA CMP®
MarcinkoAdvisors@msn.com
770-448-0769
Thank You
***

On “Bundled” Medical Payments

Payor Savings Evidence?

New Evidence for Private Payor Savings Through Bundled Payments

A new RAND Corporation study on bundled payments in the private sector was published in the March 2021 issue of Health Affairs. The study analyzed data from over 2,000 procedures performed as part of a direct payment program by Carrum Health between 2016 and 2020, and found significant savings from this bundled payment program, without any significant changes in quality. This study adds important evidence to the argument in favor of bundled payments and is especially important because it examines the under-studied area of bundled payment models from commercial payment systems. (Read more…) 

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Amazon’s New Moves in Health Care

Amazon’s New Moves in Healthcare

By Health Capital Consultants, LLC

Amazon, the largest e-commerce company in the world, has made large, strategic moves over the past several years to make a place for themselves in healthcare. This article will review Amazon’s most recent advancements in the industry, including those related to Amazon’s voice-controlled personal assistant, Alexa, and Amazon’s employee healthcare system, Amazon Care, and how this non-healthcare company is changing the industry. (Read more…)

***

American Rescue Plan Act of 2021

Healthcare Provisions in the American Rescue Plan

By Health Capital Consultants, LLC

On March 11, 2021, President Joe Biden signed into law the American Rescue Plan Act of 2021 (ARPA). The law looks to alleviate the burden felt by the millions of people who lost their employer-sponsored health insurance over the first six months of the pandemic and assist the hardest-hit communities through the extension of the Patient Protection & Affordable Care Act (ACA) and Consolidated Omnibus Budget Reconciliation Act (COBRA) subsidies, expanding Medicaid coverage, increasing funding for behavioral health, ramping up COVID-19 vaccines and testing, providing financial relief for rural providers, and enacting other individual and healthcare system protections. (Read more…)

On Physician [Un] Match Day 2021

UN-Match day 2021

By Staff Reporters

DEFINITION: Match Day is a term used widely in the graduate medical education community to represent the day when the National Resident Matching Program or NRMP releases results to physician applicants seeking residency and fellowship training positions in the United States.

Unmatched physicians

So many physicians this year didn’t match, just like any other yesteryear.

* All have gone to medical school after being 1-10 top percent of their premedical courses.
* All have finished medical school .
* All of them have passed their USLME exams, but they didn’t match.

Medicine is calling for all of them, but they won’t be practicing medicine.

Why?

Limited number of spots for the new residents.
We know that there is shortage but we let these doctors not practice medicine.
Such an irony.

Assessment

  • Let these doctors practice in a supervised environment!
  • Your comments are appreciated

THANK YOU

Hospital Price Transparency 2021

ARE FINES TOO LITTLE – TOO LATE?

[By staff reporters]

***

MORE:

https://www.cms.gov/hospital-price-transparency

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Mortality and Activity

Changes Due to Activity

[By staff reporters]

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On Health Insurance Premiums and Deductibles RISING!

 

2020 Employer Health Benefits Survey – Summary of Findings

The Diderot Effect?

What is it?

[By staff reporters]

The Diderot Effect is a social phenomenon related to consumer goods. It is based on two ideas.

The first idea is that goods purchased by consumers will align with their sense of identity, and, as a result, will complement one another.

The second idea states that the introduction of a new possession that deviates from the consumer’s current complementary goods can result in a process of spiraling consumption.

The term was coined by anthropologist and scholar of consumption patterns Grant McCracken in 1988, and is named after the French philosopher Denis Diderot, who first described the effect in an essay.

MORE: https://medicalexecutivepost.com/2021/01/25/the-prosperity-paradox/

Assessment

Your thoughts are appreciated.

Thank You

***

The Medicare Cost Control Paradox

WHAT IS THE “MEDICARE COST CONTROL EFFICIENCY” PARADOX?

The 800 Pound Gorilla in the Medical Treatment Room

Blogger Ezra Klein opined more than a decade ago that one of the dirty little secrets of the health-care system is that Medicare has done a much better job controlling costs than private health insurers. It is a paradox!

DEFINITION: A paradox is a seemingly absurd or self-contradictory statement or proposition that when investigated may prove to be well founded or true.

QUERY: But, what about Medicare, cost control efficiency, today?

Medicare Will Not Cover These 6 Medical Costs

LINK: https://www.msn.com/en-us/money/insurance/medicare-will-not-cover-these-6-medical-costs/vi-BB1g6Oes

Your thoughts are appreciated.

THANK YOU
***

CMS Reimbursement Reductions

CMS Reimbursement Reductions 2021

By staff reporters

***

 MORE:

Anesthesiology, -21 percent
Physician assistant, -21 percent
General surgery, -20 percent
Cardiology, -19 percent

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FMV of the Medical Practice?

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.

DHEF: https://lnkd.in/dqdbWM9
FOREWORD: https://lnkd.in/ecwZWxu

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.

ESSAY: https://lnkd.in/eujJySP
MAXIMIZATION: https://lnkd.in/dG8UYaa
BLUNDERS: https://lnkd.in/etgDpqr
Your comments are appreciate.

BUSINESS, FINANCE, INVESTING & INSURANCE TEXTS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
THANK YOU
***

Doctors and Nurses FIRED During the US Pandemic

If They Speak Out About Lack of Gear

By Staff Reporters

***

LINK:

https://www.bloomberg.com/news/articles/2020-03-31/hospitals-tell-doctors-they-ll-be-fired-if-they-talk-to-press

Your thoughts are appreciated

THANK YOU

On “SIGNIFY HEALTH”

The SEC Filing 

SIGNIFY HEALTH Goes Public

https://www.dallasnews.com/business/health-care/2021/02/11/signify-health-goes-public-with-7-billion-valuation-as-ceo-says-company-is-long-on-dallas/

By Signify Health

https://lnkd.in/ePKNEak

***

RED CROSS Day History

RED CROSS DAY

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.

Learn more: https://bit.ly/2LgtfQY

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The Real Cost of Health Care “Cost Sharing”

NBER WORKING PAPER SERIES

THE HEALTH COSTS OF COST-SHARING

  • Amitabh Chandra
  • Evan Flack
  • Ziad Obermeyer

Working Paper: 28439

http://www.nber.org/papers/w28439

DHEF

DHEF: https://lnkd.in/dqdbWM9

NATIONAL BUREAU OF ECONOMIC RESEARCH

1050 Massachusetts Avenue

Cambridge, MA 02138

February 2021

BUSINESS & MANAGEMENT TEXTBOOKS OF INTEREST TO SAVVY PHYSICIANS

BUSINESS & MANAGEMENT TEXTBOOKS OF INTEREST TO SAVVY PHYSICIANS
Courtesy: https://lnkd.in/eBf-4vY

Health Economics, Finance, Accounting, Investing, HR and Insurance; etc.
BOOKS: https://lnkd.in/dys_xQz

 


INVITATION: https://lnkd.in/d2SefCY
SPEAKING TOPIC LIST: https://lnkd.in/e7WrDj9
MY “AVATAR”: https://lnkd.in/d6BU-TQ
Thank You
***

Hedge Fund Titans

Top 15 Earning Managers for 2020

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The Health Economics of INSULIN

Read the Grassley-Wyden Report

Grassley-Wyden Insulin Report (FINAL).pdf (senate.gov)

Your comments are appreciated.

THANK YOU

***

Malpractice Insurance “Policy Limits”

WHAT ARE “LIMITS” OF MALPRACTICE INSURANCE LIABILITY?

Courtesy: https://lnkd.in/eBf-4vY

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.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
Thank You
***

Hospitals and Price Transparency

DISCLOSURE OF CASH PRICE

SECTION 1.

(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.

The PROSPERITY Paradox

Paradox of Prosperity

“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”.

LINK: https://www.amazon.com/Dictionary-Health-Economics-Finance-Marcinko/dp/0826102549/ref=sr_1_6?ie=UTF8&s=books&qid=1254413315&sr=1-6

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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 

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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.

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iMBA, Inc Seminar Topics

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[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

Product DetailsProduct Details

[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]

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[PRIVATE MEDICAL PRACTICE BUSINESS MANAGEMENT TEXTBOOK – 3rd.  Edition]

Product Details

  [Foreword Dr. Hashem MD PhD] *** [Foreword Dr. Silva MD MBA]

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https://davidedwardmarcinko.com/speaking/

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How Does Herd Immunity Really Work?

Patterns of Virus Spread

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Medicare and the Growing Federal Budget

A Growing Share

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US Health Insurers’ Profits Amid the Pandemic

BOOM!

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MEDICAL PRACTICE VALUATION BLUNDERS

COMMON MEDICAL PRACTICE VALUATION BLUNDERS TO AVOID?

Courtesy: www.CertifiedMedicalPlanner.org

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.

LINK: https://www.amazon.com/Dictionary-Health-Economics-Finance-Marcinko/dp/0826102549/ref=sr_1_6?ie=UTF8&s=books&qid=1254413315&sr=1-6

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.

WHITE PAPER: https://healthcarefinancials.files.wordpress.com/2011/12/medical-practice-valuation-blunders1.pdf

Your thoughts are appreciated.

BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS:

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

The Economic Schools of Thought

In Chart Review Form

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Conclusion

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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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Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

***Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

 

What is BIDEN CARE?

Bidencare: The President-Elect’s Healthcare Plan

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By Health Capital Consultants, LLC
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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.
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Hodja Nasreddin and Behavioral Economics [Gains and Losses]

The Difference

[By Anonymous]

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!

NOTE: Why backward? http://mullahnasruddin.com/?p=1927

Assessment: Your thoughts are appreciated.

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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The CORONA PANDEMIC 2020 – 2021

Defense versus Offense

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What is Anscombe’s Quartet?

The Need for Data Visualization

Courtesy: www.CertifiedMedicalPlanner.org

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.

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

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.”

So, always plot that data!

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PODCAST: https://www.bing.com/videos/search?q=Anscombe%e2%80%99s+Quartet%3a+&&view=detail&mid=68A62E7AB26B2B6EE69668A62E7AB26B2B6EE696&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3DAnscombe%25e2%2580%2599s%2BQuartet%253a%2B%26FORM%3DHDRSC3

Assessment: Your thoughts and comments are appreciated.

Product DetailsProduct DetailsProduct Details

BUSINESS TEXTS FOR PHYSICIAN-EXECUTIVES AND MEDICAL CXOs

1 – https://lnkd.in/eEf-xEH

2 – https://lnkd.in/e2ZmewQ

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Historic Physician Reimbursement Trends

Not Inflation Protected

By Federal Register

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Health Economics and Finance

THE BUSINESS OF MEDICAL PRACTICE AND HOSPITAL MANAGEMENT

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs

HOSPITAL MANAGEMENT & BUSINESS TEXTS FOR PHYSICIANS AND CXOs:

1 – https://lnkd.in/eEf-xEH 2 – https://lnkd.in/e2ZmewQ

“DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE”
DHEF: https://lnkd.in/dqdbWM9
DHIMC: https://lnkd.in/e9AmEhd
DHITS: https://lnkd.in/eWx3WjZ
MORE: https://lnkd.in/eVGcji5

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Systemic Racism & Health Care, COVID & Treatment

COVID-19 [NIHCM]

By staff reporters

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https://nihcm.org/publications/systemic-racism-health-care-covid-treatment?utm_source=NIHCM+Foundation&utm_campaign=c7ef174251-EMAIL_CAMPAIGN_2020_12_02_02_53&utm_medium=email&utm_term=0_6f88de9846-c7ef174251-167744768

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Value Based Insurance Design?

VBID – Epic Fail

By Staff reporters***

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CMS Final Rule Brings Transparency to Healthcare Industry

Healthcare Transparency

By Health Capital Consultants, LLC

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…) 

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Covid-19 Economic Impact in the USA

Estimated Impacts

By http://www.MCOL.com

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