PODCAST: Elective Surgery is Seasonal!

By Eric Bricker MD

1) Patients Have Met their Deductible and OOP Max.

2) They Do Not Have To Take Time Off of Work for Recovery.

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

However, Is This the Best Time of Year to Have Surgery for Patients?

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NUMBER of Physicians in the USA

By Staff Reporters and US Census Bureau

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Physicians in The U.S.A. in 2019

 •  Emergency medicine physicians: 13,741
 •  Radiologists: 19,421
 •  Other Physicians: 698,316
 •  Surgeons: 48,495
 •  Physician assistants: 107,710
 •  Podiatrists: 7,568
 •  Audiologists: 14,517

Source: U.S. Census Bureau, March 2022

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PODCAST: Is Direct Medical Specialty Care Even Possible?

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DEFINITION: Direct Medical Specialty Care (DMSC) is an innovative alternative payment model improving access to high functioning healthcare with a simple, flat, affordable membership fee.  No fee-for-service payments.  No third party billing.  The defining element of DPC is an enduring and trusting relationship between a patient and his or her primary care provider.  Patients have extraordinary access to a physician of their choice, often for as little as $70 per month, and physicians are accountable first and foremost their patients.  DPC is embraced by health policymakers on the left and right and creates happy patients and happy doctors all over the country!

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

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By Doug Geinzer

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Doug Geinzer, Founder and President of High Performance Providers, specializes in high-cost, steerable surgeries. During the episode, Geinzer and host Chris Habig discuss the direct alignment between the specialty care community and the direct primary care community, as well as Geinzer’s job as a consultant to surgeons.

PODCAST: https://healthcareamericana.com/episode/is-specialty-direct-care-possible/

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PODCAST: How To Understand U.S. Healthcare?

Follow The Money!

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By Jonathan Burroughs MD MBA

For those seeking to better understand the US healthcare system, national healthcare consultant Dr. Jonathan Burroughs suggests playing a game of “follow the money.” He asserts that whenever healthcare appears illogical, following the money will make it all rational and clear. The U.S. spends 2x as much money as the rest of the industrialized world, yet its citizens do not live as long as they do in 36 other nations. Dr. Burroughs gives an overview on how to fix the system.

Dr. Burroughs has worked with over 1,100 hospitals across the country to help healthcare leaders navigate the 21st century. He is a popular national speaker, who speaks to the impact of healthcare reform on hospitals, physicians and patients. Jonathan is a healthcare legal expert, who has participated in over 65 cases across the country. He is the winner of the James A Hamilton Award in 2016 awarded by the American College of Healthcare Executives titled “Redesign the Medical Staff Model”. This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

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STO LOT Spring Greetings = Life to 100 Hundred Years?

About Centenarians

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By Dr. David Edward Marcinko MBA CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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DEFINITION: A centenarian is a person who has reached the age of 100 years. Because life expectancy worldwide are below 100 years, the term is invariably associated with longevity. In 2012, the United Nations estimated that there were 316,600 living centenarians worldwide.

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

Sto Lat (One Hundred Years) is a traditional Polish song that is sung to express good wishes, good health and long life to a person. It is also a common way of wishing someone a happy birthday in Polish. Sto lat is used in the Spring, many birthdays and on international days of language.

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What Percentage of the Population Lives to 100?

According to the Social Security Administration, the overall chances of living to 100 aren’t actually that great. And, according to the World Economic Forum, there are over 500,000 centenarians among the 7.9 billion people worldwide. That means that only a 0.006% of the population is 100 or more.

Here are a few additional facts from the most recently available information from the Society of Actuaries and the Social Security Administration:

  • One out of three males and one out of two females who are in their mid-50s today will live to be 90.
  • For a couple who is 65 today, there is a 50% chance that one person will be alive at 92.
  • If you have lived to be 65, you will likely live another 20 years, on average.
  • If you live to be 75, the average life expectancy is 88.
  • If you live to be 85, the average life expectancy is 92.
  • And, if you live to be 95, the average life expectancy is 98.

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SURVEY: 39% of Medical Providers Conduct Covid-19 Screens Via Tele-Health

By staff Reporters

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39% of Providers Conduct Covid-19 Screens Via Telehealth

In a recent survey providers were asked what types of patient care they deliver via telehealth. The survey found:

 •  Conduct primary care visits (75%)
 •  Conduct chronic care visits (72%)
 •  Order prescription refills (64%)
 •  Conduct COVID-19 screenings (39%)
 •  Conduct urgent care visits (38%)
 •  Address mental health concerns (36%)
 •  Conduct follow-up after a procedure or surgery care (28%)

Source: UnitedHealth Group, “Telehealth Use Will Outlive the Pandemic for Health Care Providers, Survey Shows,” March 15, 2022

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PODCAST: Economic Cycles in Healthcare

By Eric Bricker MD

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PODCAST: 50% of Medical Treatments Have Unknown Effectiveness

By Eric Bricker MD

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

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PODCAST: High Cost Healthcare Claimants

By Eric Bricker MD

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

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PODCAST: The Dartmouth Atlas of Healthcare

Geographic Variation in Spine Surgery

By Dr. Eric Bricker MD

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MORE: https://www.dartmouthatlas.org/

John Wennberg MD: https://tdi.dartmouth.edu/about/our-people/directory/john-e-wennberg-md-mph

CHECKLISTS: https://medicalexecutivepost.com/2009/01/20/a-homer-simpson-moment-of-clarity-on-medical-quality/

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PODCAST: Matrix of Healthcare Regulation VS Entrepreneurship

By Free Market Medical Association

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

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PODCAST: High Per-Capita Metropolitan Healthcare Costs

SPUR INNOVATION

The Dallas Morning News Reported that Healthcare Costs Per Capita in the Dallas-Fort Worth Metro Area are Higher than New York City, Houston, Miami, Chicago, Atlanta and Washington, D.C.

By Eric Bricker MD

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

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INDUSTRIAL ORGANIZATION: For Hospitals, Clinics and Healthcare CXOs, CEOs, CMOs and CTOs, etc.

MANAGEMENT STRATEGIES, TOOLS TEMPLATES AND CASE STUDIES

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Reviews:

Hospitals and Health Care Organizations is a must-read for any physician and other health care provider to understand the multiple, and increasingly complex, interlocking components of the U.S. health care delivery system, whether they are employed by a hospital system, or manage their own private practices.

The operational principles, methods, and examples in this book provide a framework applicable on both the large organizational and smaller private practice levels and will result in better patient care. Physicians today know they need to better understand business principles and this book by Dr. David E. Marcinko and Professor Hope Rachel Hetico provides an excellent framework and foundation to learn important principles all doctors need to know.
―Richard Berning, MD, Pediatric Cardiology

… Dr. David Edward Marcinko and Professor Hope Rachel Hetico bring their vast health care experience along with additional national experts to provide a health care model-based framework to allow health care professionals to utilize the checklists and templates to evaluate their own systems, recognize where the weak links in the system are, and, by applying the well-illustrated principles, improve the efficiency of the system without sacrificing quality patient care. … The health care delivery system is not an assembly line, but with persistence and time following the guidelines offered in this book, quality patient care can be delivered efficiently and affordably while maintaining the financial viability of institutions and practices.
―James Winston Phillips, MD, MBA, JD, LLM

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PURCHASE: https://www.amazon.com/dp/B00BC9IIUM?ref_=k4w_oembed_faGUzLlJ9ojLIx&tag=kpembed-20&linkCode=kpd

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PODCAST: Training the Next Generation of Public Health Professionals

By American Journal of Public Health

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DEFINITION: Public health is “the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals”.

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

CDC: https://www.cdcfoundation.org/what-public-health

PODCASTS: https://www.apha.org/what-is-public-health

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READ HERE: https://ajph.aphapublications.org/doi/10.2105/AJPH.2022.306756

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Healthcare Career Positions With The Highest Demand

By Staff Reporters

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AKASA: Healthcare Positions With The Highest Demand

 •  Registrars: 59.6%
 •  Billing specialists: 54.7%
 •  Follow-up: 42.4%
 •  Front staff: 38.7%
 •  Central scheduling: 37.8%
 •  Denial specialists: 37.1%
 •  Authorization staff: 36.1%
 •  Claims specialists: 35.2%
 •  Collections: 34.4%
 •  Financial counselors: 26.9%
 •  Cash posters: 25.2%
 •  Underpayments: 17.8%
 •  Patient advocates: 11.7%
 •  Pre-filing: 7.7%

Source: AKASA Via PR Newswire, March 17, 2022

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

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Why 75+ Years of American Finance Should Matter to Physician Investors

A Graphic Presentation [1861-1935] with Commentary from the Publisher

By Dr. David Edward Marcinko FACFAS MBA CPHQ CMP™

http://www.CertifiedMedicalPlanner.org

As our private iMBA Inc clients, ME-P subscribers, textbook and dictionary purchasers, seminar attendees and most ME-P readers know, Ken Arrow is my favorite economist. Why?

About Kenneth J. Arrow, PhD

Well, in 1972, Nobel Laureate Kenneth J. Arrow, PhD shocked Academe’ by identifying health economics as a separate and distinct field. Yet, the seemingly disparate insurance, asset allocation, econometric, statistical and portfolio management principles that he studied have been transparent to most financial professionals and wealth management advisors for years; at least until now.

Nevertheless, to informed cognoscenti, they served as predecessors to the modern healthcare advisory era. In 2004, Arrow was selected as one of eight recipients of the National Medal of Science for his innovative views. And, we envisioned the ME-P at that time to present these increasingly integrated topics to our audience.

Healthcare Economics Today

Today – as 2022 passes – savvy medical professionals, management consultants and financial advisors are realizing that the healthcare industrial complex is in flux; along with the Russian war, domestic inflation and this dynamic may be reflected in the overall flagging economy.

Like many laymen seeking employment, for example, physicians are frantically searching for new ways to improve office revenues and grow personal assets, because of the economic dislocation that is Managed Care, Medi Care and Obama Care [ACA], the depressed business cycle, etc.

Moreover, the largest transfer of wealth in US history is – or was – taking place as our lay elders and mature doctors sell their practices or inherit parents’ estates. Increasingly, the artificial academic boundary between the traditional domestic economy, financial planning and contemporaneous medical practice management is blurring.

I’m Not a Cassandra

Yet, I am no gloom and doom Cassandra like I have been accused, of late. I am not cut from the same cloth as a Jason Zweig, Jeremy Grantham or Nouriel Roubini PhD, for example.

However, I do subscribe to the philosophy of Hope for the Best – Plan for the Worst.

And so dear colleagues, I ask you, “Are the latest swings in the economic, healthcare and financial headlines making you wonder when it will ever stop?”

The short answer is: “It will never stop” because what’s been happening isn’t any “new normal”; it’s just the old normal playing out before a new audience; sans the war.

What audience?

The next-generation of investors, FAs, management consultants and the medical professionals of Health 2.0.

How do I know all this?

History tells me so! Just read this work, and opine otherwise, or reach a different conclusion.

Evidence from the American Financial Scene, circa 1861-1935

The work was created by L. Merle Hostetler in 1936, while he was at Cleveland College of Western Reserve University (now known as Case Western Reserve University). I learned of him while in B-School, back in the day.

At some point after it was printed, he added the years 1936-1938. Mr. Hostetler became a Financial Economist at the Federal Reserve Bank of Cleveland in 1943. In 1953 he was made Director of Research. He resigned from the Bank in 1962 to work for Union Commerce Bank in Cleveland. He died in 1990.

The volume appears to be self published and consists of a chart, approximately 85′ long, fan-folded into 40 pages with additional years attached to the last page. It also includes a “topical index” to the chart and some questions of technical interest which can be answered by the chart.

Link: http://fraser.stlouisfed.org/75years

Assessment

And so, as with Sir John Templeton’s [whose son is an MD] four most dangerous words in investing (It’s different this time), Hostetler effectively illustrates that it wasn’t so different in his era, and maybe—just maybe—it isn’t so different today for all these conjoined fields.

Conclusion      

Your thoughts and comments on this ME-P are appreciated. While not exactly a “sacred cow,” there is a current theory that investors will experience higher volatility and lower global returns for the foreseeable future.

In fact, it has gained widespread acceptance, from the above noted Cassandra’s and others, as problems in Europe persist and threats of a double-dip recession loom. But, how true is this notion; really?

Is Hostetler correct, or not; and why?

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

Our Other Print Books and Related Information Sources:

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

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HEALTHCARE ENTREPRENEURS: “Top 10” Challenges

By Staff Reporters

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PODCASTS: All You Need to Know About Government Healthcare

By Eric Bricker MD

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1) Traditional Medicare: Health Insurance for Seniors 65 and older. Medicare Part A is coverage for hospital services. Medicare Part B is coverage for doctor, physical therapist and other provider services and for outpatient services such as labs and imaging.

2) Medicare Advantage: Health Insurance for Seniors 65 and older administered through a private health insurance company. It is sometimes referred to as Medicare Part C. It can be chosen instead of Traditional Medicare and often includes Dental Insurance, Vision Insurance, Hearing Aid Insurance and Prescription Drug Coverage.

3) Medicare Part D Prescription Coverage: Additional insurance for people on Traditional Medicare to cover their prescription medications as well. Medicare Part D is administered by private insurance companies.

4) Medicare Supplement Plans: Insurance that can be purchased in addition to Traditional Medicare to cover the expenses that Traditional Medicare does not cover, such as hospitalization deductibles and Medicare Part B co-insurance.

5) Medicaid: The health insurance program administered by each state for it’s economically disadvantaged residents. It is funded in part by the Federal Government and in part by each state. It is administered by private health insurance companies.

6) Affordable Care Act (ACA) Exchange Plans: Health insurance for people under 65 who make too much money to qualify for Medicaid, but do not received health insurance through their employer. ACA Exchange Plans are subsidized by the Federal Government and administered by private insurance companies.

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PODCAST: Hospital Finance 101

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A basic understanding of hospital finance is crucial as leaders continue to create policy that shapes healthcare financing. This updated 30,000-foot view of hospital finance is intended to shed some light on the complex system.

By The Center for Health Affairs

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

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DOJ Recoveries for False Claims Act Cases Doubled in 2021

BY HEALTH CAPITAL CONSULTANTS, LLC.

DEFINITION: The False Claims Act, also called the “Lincoln Law”, is an American federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal Government’s primary litigation tool in combating fraud against the Government. The law includes a provision that allows people who are not affiliated with the government, called “relators” under the law, to file actions on behalf of the government. Persons filing under the Act stand to receive a portion of any recovered damages.

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

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DOJ Recoveries for False Claims Act Cases Doubled in 2021

On February 1, 2022, the U.S. Department of Justice (DOJ) announced their recovery of $5.6 billion in settlements and judgments from civil cases involving fraud and false claims for fiscal year (FY) 2021. Over $5 billion was recouped from the healthcare industry for federal losses alone, and included recoveries from drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.

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This figure is more than double the amount of healthcare-related recoveries secured in FY 2020, which totaled $1.8 billion. (Read more…)

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PODCAST: The Successful Quest Diagnostics Employee Health Plan Cost Reduction Case-Report

By Eric Bricker MD

Their 8 Point Strategy Included: 1) CDHP, 2) Centers-of-Excellence, 3) Narrow Network, 4) Rx Formulary Changes, 5) Spousal Surcharge, 6) COBRA Members to the Exchange, 7) 2nd Opinion Program … AND 8) Moved Health Plan Control from HR to a Chief Medical Officer AND Kept a Short Leash on their ASO Carrier.

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

Special Thanks to Dr. Steven Goldberg for Publishing His Company’s Experience in an Academic Journal.

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PODCAST: The Healthcare Price versus Quality Disconnect

By Dr. Eric Bricker MD

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

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PODCAST: Healthcare “Certificate of Need” Laws Explained

By Eric Bricker MD

C.O.N. Legislation is Not New!

Certificate of need laws are state-level regulations that require healthcare institutions to obtain approval from state officials before moving forward on large capital expenditure projects, such as the construction of a new facility or the purchase of expensive new equipment.

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

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INVESTING: “Direct Indexing” Definition

WHAT IT IS – HOW IT WORKS?

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

Direct Indexing at Vanguard - FiPhysician

READ: https://smartasset.com/investing/direct-indexing#:~:text=Advantages%20of%20Direct%20Indexing%201%20Tax%20Efficiency.%20Direct,Social%20Criteria%20Customization.%20…%204%20Lower%20Costs.%20

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The Millennial Spend on COVID-19 Tests?

By Dr. David E. Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Millennials Spent the most on COVID-19 tests ($142)

A recent ValuePenguin survey found out-of-pocket costs for COVID-19 tests on average varied by age groups as follows:

 •  Gen Zers (ages 18-25): $125
 •  Millennials (ages 26-41): $142
 •  Gen Xers (ages 42-56): $101
 •  Baby boomers (ages 57-76): $59

Source: ValuePenguin, “COVID-19 Testing Survey: Americans Talk Out-of-Pocket Charges, Bill Negotiations, Barriers,” February 14, 2022

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

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ACCOUNTABLE CARE: Competitive Market for Talent is Biggest Challenge in Recruiting

By Staff Reporters

DEFINITION: An accountable care organization (ACO) is a group of doctors, hospitals, and other health care providers that work together on your care. Their goal is to give you — and other people on Medicare — better, more coordinated treatment. The largest effort in payment innovation in Medicare is a portfolio of accountable care organization (ACO) programs that include the Medicare Shared Savings Program (MSSP), the Next Generation model, and Comprehensive End Stage Renal Disease model. But drawbacks include limited choice as some patients will have trouble finding doctors outside of a specific group. The shortage of options could lead to higher patient costs. And, referral restrictions as ACOs provide doctors incentives to refer to specialists within the group.

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

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In a recent survey from AKASA healthcare finance leaders ranked the biggest challenges in recruiting and retention within the revenue cycle as healthcare organizations navigate significant staffing gaps across the board.

Great Resignation: https://medicalexecutivepost.com/2022/03/08/healthcare-industry-hit-with-the-great-resignation-retirement/

 •  #1: Competitive market for talent (71%)
 •  #2: Vaccine mandates (42%)
 •  #3: Employee burnout (41%)
 •  #4: Rapid employee turnover (40%)
 •  #5: Limitations to offer remote work (23%)

Source: AKASA via PR Newswire, February 23, 2022

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

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The “Fair Health” Study of Private Healthcare Claims

By Staff Reporters

Three [3] Key Findings

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 •  Among patients aged 19-35, mental health conditions were the most common diagnosis associated with emergency ground ambulance in the period 2016-2020.
 •  Throughout the period 2016-2020, advanced-life-support (ALS) accounted for a larger percentage of emergency ground ambulance claim lines than basic-life-support (BLS) services. For example, in 2020, 51.5% of emergency ground ambulance claim lines were associated with ALS compared to 48.5% associated with BLS.
 •  Individuals 65 years and older were consistently the largest age group associated with emergency ground ambulance services, though their share of the distribution decreased from 37.7% in 2016 to 34% in 2020.

Source: Fair Health Via PR Newswire, “Ground Ambulance Services in the United States,” February 23, 2022

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PODCAST: How Prescription Drug Coverage Really Works

By Eric Bricker MD

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


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Hospital Employment Declining

ARE WE SURPRISED?

By Staff Reporters

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Hospital Employment Declined 2.5% in 2020-Q2

 •  Health care employment levels declined from 22.2 million in 2019 to 21.1 million in 2020
 •  Health care employment levels rebounded to 21.8 million in 2021-Q2
 •  Dentist offices employment declined 10% in 2020-Q2
 •  Skilled nursing facility employment declined 8.4% in 2020-Q2
 •  Hospital employment declined 2.5% in 2020-Q2

Source: JAMA Health Forum, “US Health Care Workforce Changes During the First and Second Years of the COVID-19 Pandemic,” February 25, 2022

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PODCAST: Dysfunctional Employee Healthcare Benefits

By Eric Bricker MD

Article in the Journal of the American Medical Association

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“Dictionary of Health Economics and Finance”

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Product Details

ORDER HERE: https://www.r2library.com/Resource/Title/0826102549

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PODCAST: “Charge Capture” Medical Coding and Healthcare Costs

The Basis for Hospital Reimbursement and Sepsis Reimbursement

By Eric Bricker MD

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PODCAST: More on Health Insurance from a Medical Technology CEO

A Professional and Personal look at Health Insurance, with Karl Albrecht
Rich talks with the president of Action Benefits, Karl Albrecht about the state of Health Insurance. 

Albrecht also gives a candid insight to his personal fight with pancreatic cancer and how being a Health Insurance executive as well as a patient, has given him a unique perspective on how things work, and how they could improve.
Image

BY RICHARD HELPPIE

PODCAST: https://richardhelppie.com/karl_albrecht/

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“For-Profit” Medicare Advantage Plan Growth

By Staff Reporters

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Chartis: For-Profit Medicare Advantage Plan Growth 2022

 •  UnitedHealth Group: 765K new lives
 •  Centene Corporation: 338K new lives
 •  CVS Health/Aetna: 323K new lives
 •  Humana: 315K new lives
 •  Bright Health: 109K new lives

Source: The Chartis Group, “Medicare Advantage Enrollment Continues to Surge in an Increasingly Complex and Competitive Landscape,” February 2022

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PHARMACISTS PODCAST: Job Effectiveness?

By Staff Reporters

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54% of Pharmacists Lack Time to Complete Their Job Effectively

According to the “2022 Medication Access Report“:

 •  54% of pharmacists said they lack time to complete their job effectively.
 •  Of the 54%, 81% cited inadequate staffing and 73% cited time-consuming administrative tasks.
 •  Physicians felt strained by unprecedented demands, with 42% reporting burnout and 69% feeling depressed.

Source: CoverMyMeds via PR Newswire, February 8, 2022

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Most Physician Compensation Plans Still Productivity-Based

By Health Capital Consultants, LLC

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Study: Most Physician Compensation Plans Still Productivity-Based

A study conducted by the RAND Corporation and published in the January 2022 issue of the Journal of the American Medical Association (JAMA) seeking to determine whether health systems primarily incentivize volume or value in their physician compensation models found that almost all physicians are still compensated through a volume-based model that rewards productivity over the value of care provided.

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

These study results are in direct contradiction to the longstanding narrative that the U.S. healthcare delivery system is shifting away from volume-based reimbursement and toward VBR. (Read more…) 

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BALANCE BILLING: The Emerging “No Surprise” Act

Balance Medical Billing

By Dr. David E. Marcinko MBA CMP®

CMP logo

The No Surprises Act is looking to make the practice of out of network balance billing a thing of the past.

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

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No Surprises Act: New Law to Protect Against Surprise ...

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Beginning in 2022, there will be few situations in which a patient can receive a bill for out-of-network care they believed would be covered by their insurance company. This new rule should especially benefit patients in emergency situations who don’t have the time or luxury to dig up the details on every provider they encounter.

CONGRESS: https://www.congress.gov/bill/116th-congress/house-bill/3630/

The No Surprises Act also requires insurance companies to provide patients with at least 90 days of coverage if an in-network provider moves out of network. That way, patients aren’t forced to switch providers immediately if such a move happens while they’re in the middle of a treatment plan.

DOCTORS: https://www.elixirehr.com/what-the-no-surprises-act-means-for-healthcare-providers/

Now, the No Surprises Act does have its limitations. Patients can still get a bill for out-of-network care if they visit an urgent care clinic for non-emergency purposes. Also, if consumers are informed that the care they’re about to receive is out of network and they give written consent to move forward, then they may get billed for that care even once the new rule takes effect.

CMS: https://www.cms.gov/nosurprises

YOUR COMMENTS ARE APPRECIATED.

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PODCAST: The Causes of High Healthcare Costs Explained

By Eric Bricker MD

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

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PODCAST: On the Corporate Practice of Medicine Laws

IS PRIVATE EQUITY BUYING DOCTORS ILLEGAL?

By Eric Bricker MD

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Healthcare Industry Hit with the Great Resignation & Retirement

Healthcare Industry Hit with the Great Resignation & Retirement

BY HEALTH CAPITAL CONSULTANTS, LLC

The COVID-19 pandemic has served as a catalyst for two current healthcare workforce trends: the Great Retirement and the Great Resignation.

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

While the Great Resignation among physicians and other clinicians has been well reported, a potential onslaught of retirements by senior executives may further impact hospitals and health systems at an already precarious time.

Should you quit, or wait to be fired?

This Health Capital Topics article will discuss some of the key challenges and issues surrounding healthcare’s Great Retirement and Great Resignation. (Read more…) 

YOUR COMMENTS ARE APPRECIATED.

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

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

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Common Entrepreneurial Mistakes

BY JONATHAN MASE R.N.

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Being an entrepreneur is not necessarily easy, and many people that try to become entrepreneurs wind up failing. It’s important to recognize the risk of failure before you decide to walk down this path. Being an entrepreneur is very rewarding, and you can find success if you can do things right.

Keep reading to learn about common entrepreneurial mistakes that you can avoid to give yourself a better chance of realizing your entrepreneurial goals. 

READ: https://jonathanmase.wordpress.com/2021/08/06/common-entrepreneurial-mistakes/

Your comments are appreciated.

THANK YOU

MD Entrepreneurs: https://medicalexecutivepost.com/2021/07/29/minnovation-for-physician-entrepreneurs/

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PODCAST: Hospital “Out-Patient” Department Pricing Explained

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Hospitals Are Paid More for SAME SERVICE in Outpatient Department Than Doctors Are Paid in Office.

For Example, the SAME Echocardiogram Costs $600 in a Hospital Outpatient Department and $250 in a Doctor’s Office.

By Dr. Eric Bricker MD

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PODCAST: Economic “Rent-Seeking” in Health Care

By Eric Bricker MD

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

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PODCAST: The No Surprises [Medical Billing] Act

Surprise Medical Bills Outlawed?

By Eric Bricker MD

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https://medicalexecutivepost.com/2021/11/03/balance-billing-the-emerging-no-surprise-act/

QPA DEFINITION: The qualifying payment amount is generally the median of contracted rates for a specific service in the same geographic region within the same insurance market as of January 31, 2019. The rate will be adjusted per the Consumer Price Index for All Urban Consumers (CPI-U).

MORE: https://medicalexecutivepost.com/2017/01/07/a-small-step-forward-on-surprise-medical-care-balance-billing/

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

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

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

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PODCAST: Medicare Outsources Paying Claims

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The US Federal Government Does NOT Process Medicare Claims.

By Eric Bricker MD

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

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PODCAST: Health Insurance and Benefit Consultant Traits

THREE SUCCESSFUL TRAITS FOR BROKERS

By Eric Bricker MD

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

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PODCAST: Medicare Payment Bureaucracy Uncertainty

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Dr. Eric Bricker Explains How Medicare Can Take Money Back from Hospitals if it Wants. If the Hospital Thinks Medicare is Being Unfair, the Appeals Process Takes 3 Years!

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BY ERIC BRICKER MD

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Related: On Medicare Bureaucratization

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The CERTIFIED MEDICAL PLANNER® Program Curriculum

BY DR. DAVID E. MARCINKO MBA CMP®

CMP

THE NEXT GENERATION OF FIDUCIARY FOCUSED FINANCIAL PLANNING AND MEDICAL MANAGEMENT ADVICE FOR DOCTORS

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VISIT: http://www.CERTIFIEDMEDICALPLANNER.org

CURRICULUM: Enter the CMPs

BE AWARE ALL ADVISORS … NEXT GEN FINANCIAL ADVICE IS HERE?

CMP logo

Are you a financial planner, insurance agent or investment advisor seeking to assist your physician clients with medical practice enhancement solutions, along with healthcare targeted financial planning services, but don’t know where to turn for help?

OR, maybe you’ve already had a bad experience with a young physician or astute healthcare professional client that was actually more informed than you in these areas?

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

OR, a doctor/nurse client who demanded a true fiduciary advisor [not fee-based advice, with no dual licenses and no arbitration clauses] documented in writing].

Read this decade old Federal Government report to learn what can happen when your advisor is not an informed Certified Medical Planner© designated medical management practitioner.

Then, become a Certified Medical Planner© and thrive by helping others …. first!

GOV: https://oig.hhs.gov/fraud/docs/alertsandbulletins/consultants.pdf

True yesterday … more true today.

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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™
Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™
Product Details

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CONTACT: Ann Miller RN MHA CMP®

Phone: 770-448-0769

EMAIL: MarcinkoAdvisors@msn.com

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