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Pre-Certification Works OR Doesn’t Work
BY ERIC BRICKER MD
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Filed under: Career Development, Health Economics, Health Insurance, Healthcare Finance, Managed Care, Videos | Tagged: Eric Bricker MD, pre-authorization, pre-certification, prior medical authorizations | Leave a comment »
ABOUT NOSE SWAB KITS
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BY. DR. DAVID EDWARD MARCINKO MBA
There are two types of tests for COVID-19. Viral tests tell you if you have a current infection, and antibody tests tell you if you’ve been previously infected.
If you’re experiencing symptoms or think you’ve been exposed to COVID-19, contact your health care provider or your state or local public health department to find out where you can get tested. Tests are available at many health centers and some pharmacies. Call in advance to see if an appointment is required. The testing process and timeline for results vary by location.
But – Rather than having a doctor or health professional get all up in your nostrils, you can swab yourself and get the results in less than an hour. At-home rapid tests (known as “antigen” tests) are less reliable than the lab-based PCR [polymerase chain reaction] test, but experts say they can be an extremely useful tool for allowing life to proceed semi-normally.
NOTE: PCR means polymerase chain reaction. It’s a test to detect genetic material from a specific organism, such as a virus. The test detects the presence of a virus if you have the virus at the time of the test. The test could also detect fragments of the virus even after you are no longer infected.
Problem is, in the US over-the-counter rapid tests are expensive and scarce.
CITE: https://www.r2library.com/Resource/Title/0826102549
Abbott Laboratories sells a two-pack for $24, and Quidel’s QuickVue sells a test for $15. But even if you are willing to shell out for one, good luck finding a rapid test on pharmacy store shelves or on e-commerce websites, where they’re often sold out.
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MU variant update: https://www.msn.com/en-us/health/medical/mu-variant-which-may-be-vaccine-resistant-in-all-50-states-after-nebraska-case/ar-AAOnMC4?li=BBnb7Kz
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Filed under: Alerts Sign-Up, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, LifeStyle, Quality Initiatives, Touring with Marcinko | Tagged: Abbott Labs, antigen tests, corona pandemic, covid, David Edward Marcinko, PCR tests, poyymerase chain reaction, QuickVue, Quidel | 4 Comments »
BY KFF
Prescription drug costs are a major concern for consumers and a fiscal challenge for public and private payers, representing 10% of national health spending and nearly 20% of health benefit costs for large employers and Medicare.
In response, lawmakers are considering a broad range of policy options, including one that would allow the federal government to negotiate prescription drug prices on behalf of Medicare beneficiaries and people enrolled in private plans, a proposal that has strong bipartisan public support.
CITE: https://www.r2library.com/Resource/Title/0826102549
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This brief describes the current status of drug price negotiation proposals, looks back at the history of proposals to give the federal government the authority to negotiate drug prices in Medicare, describes the negotiation provisions in key legislation (H.R. 3), and discusses the potential spending effects for the federal government and individuals.
READ: https://www.kff.org/medicare/issue-brief/whats-the-latest-on-medicare-drug-price-negotiations/
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Filed under: Drugs and Pharma, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: KFF, medicare, Medicare Drug Price Negotiations? | 1 Comment »
MODERN CONSIDERATIONS
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By Dr. David E. Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
EMERGING HYBRID PAYMENT MODELS
Current reimbursement structures involve the submission and payment of medical CPT® coded claims. But, some doctors feel they need to “up-code” to maximize revenue or “down-code” for fear of having a claim denied. Contradictory business goals bastardize the system into a payer versus provider tug-of-war, with patient care as a potential bargaining chip. Instituting quality metrics should be included in this equation and, a hybrid reimbursement model may be a viable option while integrating quality care metrics and reducing costs for all stakeholders.
CITE: https://www.r2library.com/Resource/Title/0826102549
This hybrid reimbursement system might use a two-payment structure.
For the first payment, claims would be paid at hypothetical rate of 60% within one week of submission.
The second payment, consisting of the remaining zero to 40% of some total maximum allowable fee, be paid quarterly. It would be based on scores like patient satisfaction and stewardship of healthcare resources by analyzing a statistically valid sample of patient encounters taken from the electronic health record.
Such a hybrid system would remove unnecessary steps, like re-submitting claims, and would lower the operational and administrative costs of claims processing. These changes would decrease operational cost and drive quality stewardship of the healthcare dollar.
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INVITATIONS: https://wordpress.com/post/medicalexecutivepost.com/246863
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Filed under: "Doctors Only", Accounting, Career Development, CMP Program, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Research & Development, Touring with Marcinko | Tagged: capitation, CPT codes, physician payment, Physician Reimbursement | Leave a comment »
IN THE USA
By Eric Bricker MD
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MORE: https://medicalexecutivepost.com/2021/07/28/mental-health-entrepreneurial-start-up/
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KIDNEY DIALYSIS
CITE: https://www.r2library.com/Resource/Title/0826102549
BY DR. ERIC BRICKER MD
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Filed under: Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: DaVita, end stage renal disease, Eric Bricker MD, ESRD, Fresenius, kidney disease, nephrology, renal dialysis | Leave a comment »
The Healthcare Industry is Filled with Commission Relationships Where Money Is Paid, But It Is Not Always Obvious.
BY RIC BRICKER MD
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: "Doctors Only", Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: Eric Bricker MD, health abuse, health fraud, healthcare commissions, insurance commissions | Leave a comment »
Study Finds COVID-19 Accelerated Physician Practice Acquisitions
By Health Capital Consultants, LLC
A recent study from Physicians Advocacy Institute (PAI), prepared by Avalere Health, associated the growing number of both physician practice acquisitions and employed physicians between 2019 and 2021 with the COVID-19 pandemic.
To study COVID-19’s impact on physician employment trends, the June 2021 study evaluated the IQVIA OneKey database that contains physician practice and health system ownership information.
To assess these trends at a national and regional level, Avalere researchers studied the two-year period from January 1, 2019 to January 1, 2021. (Read more…)
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Filed under: Breaking News, Experts Invited, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Avalere Health, covid, Health Capital Consultants LLC, IQVA One Key, PAI, pandemic, Physician Practice Acquisitions, PPMC | Leave a comment »
WHY NO GROWTH?
BY ERIC BRICKER MD
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MORE: https://medicalexecutivepost.com/2021/05/11/a-general-electric-physician-investor-update/
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Filed under: "Advisors Only", "Doctors Only", Book Reviews, Health Economics, Healthcare Finance, Information Technology, Videos | Tagged: Eric Bricker MD, GE, GE Healthcare, general electric, Jack Welch, Jeff Immelt | 3 Comments »
HOW DOCTORS GET PAID!
By Eric Bricker MD
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Filed under: Accounting, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: doctor pay, doctor paychecks, doctor salary, Eric Bricker MD, physician compensation, relative value units, RVU, RVUs | Leave a comment »
ANTI-KICKBACK STATUTE Overview and Impact
Do you want to learn more about the Stark Law and Anti-Kickback Statute Final Rules and how they impact your practice? Join us for a one-hour webinar, presented with Hancock Daniel.
By Health Capital Consultants, LLC
PODCAST: https://www.healthcapital.com/resources/stark-and-aks-final-rules-overview-and-impact
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Filed under: "Advisors Only", "Doctors Only", Accounting, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: Anti-Kickback Statute, Hancock Daniel, Health Capital Consultants LLC, Stark laws | Leave a comment »
BY HEALTH CAPITAL CONSULTANTS, LLC
Bundled Payment Model Success Unaffected by Type of Participation
Historically, Medicare has offered value-based payment models to healthcare organizations on both a voluntary and a mandatory participation basis. Because voluntary participants could self-select into programs to reduce spending, it was assumed that they achieved greater savings than mandated participants, but until recently, no data had tested this.
However, a June 2021 study in the Journal of the American Medical Association (JAMA) found no difference in risk-adjusted episodic spending between voluntary and mandatory payment model participants. (Read more…)
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Filed under: "Doctors Only", Accounting, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Accountable Care Organizations, ACOs, Bundled Medical Payments, capitation, Health Capital Consultants LLC, JAMA, value based care, VBC | Leave a comment »
BY DR. David Edward Marcinko MBA
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RELATED TEXTS: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/
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Filed under: "Advisors Only", "Doctors Only", Book Reviews, Career Development, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Practice Management, Practice Worth, Professional Liability, Touring with Marcinko | Tagged: Business of Medical Practice, david marcinko, healthcare business | Leave a comment »
On Medical Entrepreneurs
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BY ERIC BRICKER MD
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Filed under: Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Videos | Tagged: digital start-ups, Entrepreneurs, Eric Bricker MD, health start-ups, medical start-ups, Optum, United Healthcare | Leave a comment »
THREE CATEGORIES OF VBC
By Eric Bricker MD
Medicare Value-Based Payments (also Called Alternative Payment Models) to Hospitals Fall Into 3 Main Categories:
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Filed under: Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: ACA, ACO, Alternative Medical Payments, cpaitation, DRGs, Eric Bricker MD, Health Economics, Healthcare Finance, value based care, Value Based Medical Care, VBC | 1 Comment »
Congress Passed and the President Signed the Competitive Health Insurance Reform Act of 2020 (CHIRA)
By Eric Bricker MD
PODCAST: https://www.youtube.com/watch?v=AbOHzYTYbPM
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: anti-trust, CHIRA, Competitive Health Insurance Reform Act of 2020, healthcare anti-trust | 1 Comment »
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RELATED TEXTS: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/
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Filed under: "Doctors Only", Accounting, Book Reviews, Career Development, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, Insurance Matters, Quality Initiatives, Recommended Books, Touring with Marcinko | Tagged: David Edward Marcinko, hospitals, Hospitals & Healthcare Organizations, Hospitals and Healthcare Organizations, Physician Hospital Organization, rural hospitals | Leave a comment »
SPONSOR: http://www.CertifiedMedicalPlanner.org
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RELATED TEXTS: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/
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Filed under: "Ask-an-Advisor", Book Reviews, CMP Program, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, Investing, Portfolio Management, Practice Management, Risk Management, Touring with Marcinko | Tagged: Certified Medical Planner™, David E. Marcinko, Financial Planning, Investing, Portfolio Management | Leave a comment »
BY NIHCM
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Value-based care has the potential to transform health care, improving quality and access for millions of people, while addressing COVID-19 related disparities. As a result of the pandemic, many rural communities and communities of color face significant reductions in access to health care.
More than 8% of practicing physicians nationwide closed during COVID-19 despite 82 million Americans living in “health professional shortage areas.” The financial strain and burnout experienced by providers has fueled interest in accelerating the adoption of value-based care. As of 2017, only 34% of health care dollars were the result of value-based care payments. This low rate of adoption exists despite evidence tying payments to patient health outcomes and rewarding higher quality care leads to reduced costs.
This webinar brought together experts who are driving innovative initiatives, achieving excellence in health outcomes, and uncovering more effective ways to implement value-based care.
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Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: capitation, NIHCM, value based care, VBC | Leave a comment »
FOR HOSPITALS AND HEALTHCARE ORGANIZATIONS
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BY DR. DAVID E. MARCINKO MBA
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Filed under: Book Reviews, Health Economics, Health Insurance, Managed Care, Practice Management, Professional Liability, Quality Initiatives, Recommended Books, Risk Management | Tagged: david marcinko, hospitals, Hospitals and Healthcare Organizations | Leave a comment »
BY ERIC BRICKER MD
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MORE: https://medicalexecutivepost.com/2021/04/01/american-rescue-plan-act-of-2021/
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Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: American Rescue Plan, Eric Bricker MD | Leave a comment »
HOSPITAL FINANCES REVEALED
By Eric Bricker MD
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Accounting, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Interviews, Taxation, Videos | Tagged: Eric Bricker MD, Hospital CFO, Hospital Finances | Leave a comment »
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Certain Doctor Specialties Have Great Power within Hospital Systems Because They Generate High-Margin Patient Volume.
By Eric Bricker MD
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Filed under: "Doctors Only", Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Managed Care, Marketing & Advertising, Practice Management, Professional Liability, Videos | Tagged: competitive advantage, Eric Bricker MD, hospital bargaining power, hospital based physicians, physician bargaining power, physician competitive advantage, physician income, physician specialties, physician-executives, SCA | 1 Comment »
Medical Trend for 2020 is Estimated to be 6%.
Where Does That Number Come From?
Insurance Companies and Hospitals Negotiate Their Contracts Every 3-5 Years.
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Filed under: Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: Eric Bricker MD, Health Economics, Health Insurance, health insurance plans, health plans | Leave a comment »
TRANSFORMATIONAL HEALTH 2.0 SKILLS FOR DOCTORS
Third Edition
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Filed under: "Doctors Only", Accounting, Book Reviews, Career Development, Health Economics, Information Technology, Practice Management, Practice Worth, Touring with Marcinko | Tagged: business of medicine, Hashem; MD PhD, medical practice management, Practice Management | Leave a comment »
CMS RELEASES CY 2022 Physician Fee Schedule Proposed Rule
On July 13, 2021, the Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2022.
CITE: https://www.r2library.com/Resource/Title/0826102549
In addition to numerous payment updates in the MPFS, such as significant updates to the Merit-based Incentive Payment System (MIPS), new policies may preserve expanded telemedicine services through 2023 and clinicians may incur more difficulty earning bonuses under the Quality Payment Program (QPP) eligibility threshold. CMS also includes in the proposed rule a request for information to address COVID-19 vaccine reimbursement proposals. (Read more...)
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Filed under: "Doctors Only", Experts Invited, Health Economics, Health Law & Policy, Healthcare Finance | Tagged: CMS, Health Capital Consultants LLC, Medicare Physician Fee Schedule, MIPS, MPFS, Physician Fee Schedule, QPP, quality payment program, teleHealth | Leave a comment »
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BY DR. ERIC BRICKER MD
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Filed under: Career Development, Experts Invited, Health Economics, Healthcare Finance, Investing, Quality Initiatives | Tagged: Cigna, EBIDTA, Eric Bricker MD, executive compensation, healthcare activism, shareholder activism, Shareholder Activism in Healthcare, Tenet | 1 Comment »
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Filed under: Book Reviews, Funding Basics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Practice Management, Touring with Marcinko | Tagged: David Edward Marcinko, hospital medicine, Hospitals and Healthcare Organizations, not-for-profit hospitals, physician owned hospitals, specialty hospitals | Leave a comment »
BY ERIC BRICKER MD
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CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Videos | Tagged: charge master, Eric Bricker MD, Health Insurance, hospital charges, un-insured | Leave a comment »
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TEXTBOOK REVIEW
Drawing on the expertise of decision-making professionals, leaders, and managers in health care organizations, Hospitals & Health Care Organizations: Management Strategies, Operational Techniques, Tools, Templates, and Case Studies addresses decreasing revenues, increasing costs, and growing consumer expectations in today’s increasingly competitive health care market.
Offering practical experience and applied operating vision, the authors integrate Lean managerial applications, and regulatory perspectives with real-world case studies, models, reports, charts, tables, diagrams, and sample contracts. The result is an integration of post PP-ACA market competition insight with Lean management and operational strategies vital to all health care administrators, comptrollers, and physician executives. The text is divided into three sections:
Using an engaging style, the book is filled with authoritative guidance, practical health care–centered discussions, templates, checklists, and clinical examples to provide you with the tools to build a clinically efficient system. Its wide-ranging coverage includes hard-to-find topics such as hospital inventory management, capital formation, and revenue cycle enhancement. Health care leadership, governance, and compliance practices like OSHA, HIPAA, Sarbanes–Oxley, and emerging ACO model policies are included. Health 2.0 information technologies, EMRs, CPOEs, and social media collaboration are also covered, as are 5S, Six Sigma, and other logistical enhancing flow-through principles. The result is a must-have, “how-to” book for all industry participants.
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Filed under: "Doctors Only", Book Reviews, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Practice Management, Recommended Books, Research & Development, Risk Management, Touring with Marcinko | Tagged: David Edward Marcinko, Hospitals and Healthcare Organizations, not-for-profit hospitals, physician owned hospitals, specialty hospitals | Leave a comment »
| Health Insurance Business Harms Doctors, Patients and Hospitals –Inside Healthcare with Nate Kaufman– |
| Rich Helppie brings back healthcare expert and consultant, Nathan Kaufman, Managing Director of Kaufman Strategic Advisors. Rich and Nate talk about the current policy issues surrounding healthcare, and why the United States’ approach to health insurance, care and finance are woefully inadequate in today’s landscape. |
PODCAST: https://richardhelppie.com/nathan-kaufman/
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Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Health Economics, Health Insurance, healthcare business, Nate Kaufman, Richard Helppie | 1 Comment »
MedPAC Examines Private Equity Involvement in Medicare
By Health Capital Consultants, LLC
In 2020, at the request of the U.S. House Committee on Ways and Means (the Committee), the Medicare Payment Advisory Commission (MedPAC) began investigating the role that private equity (PE) plays in healthcare provided to Medicare beneficiaries.
CITE: https://www.r2library.com/Resource/Title/0826102549
In its June 2021 “Report to the Congress on Medicare and the Health Care Delivery System,” MedPAC included for the first time a chapter on PE’s effect on Medicare, wherein it discussed the findings and observations from its investigation and answered a number of questions posed by the Committee. This Health Capital Topics article will analyze MedPAC’s answers to those questions, review its investigation of PE’s role in healthcare, and summarize reactions from stakeholders. (Read more…)
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Filed under: "Doctors Only", Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Investing, Practice Worth | Tagged: Balance billing, Health Capital Consultants LLC, medicare, MedPAC, Private Equity Medicare | Leave a comment »
BY HEALTH CAPITAL CONSULTANTS, LLC
CMS Includes Several Changes in CY 2022 OPPS Proposed Rule
On July 19, 2021, CMS released the proposed rule for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Centers (ASCs) for calendar year (CY) 2022. The proposed rule builds on President Joe Biden’s July 9, 2021 executive order on “Promoting Competition in the American Economy,” as it relates to increasing access and price transparency in the healthcare industry.
CITE: https://www.r2library.com/Resource/Title/0826102549
In a press release regarding the proposed rule, CMS stated their commitment to addressing the persistent health inequities in the U.S. and finding opportunities to improve data collection that will lead to policy changes to help meet the health needs of patients. (Read more…)
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Filed under: "Doctors Only", Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: ambulatory surgery center, ASC, CMS, Health Capital Consultants LLC, OPPS, Outpatient Prospective Payment System | Leave a comment »
UHG Uses Those Doctors for their NEW Harmony Network That They Sell as an HMO Insurance Product to Employers.
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Filed under: Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Practice Management, Practice Worth, Professional Liability, Videos | Tagged: Eric Bricker MD, UHC, United Health Group | 1 Comment »
By Eric Bricker MD
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Filed under: Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters | Tagged: agent, agent-principal conflict, Eric Bricker MD, fiduciary, FWA, healthcare abuse, insurance agents, medical fraud, principal | Leave a comment »
15 Self-Funded Employers Analyzed Their Pharmacy Claims Data in Conjunction with the Commonwealth Fund and Discovered the Following Regarding their PBM FormularIES
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Filed under: "Doctors Only", Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance | Tagged: Eric Bricker MD, PBM, PBMs, Pharmacy Benefit Mangers | Leave a comment »
HEALTH PLAN EQUALS ALIGNMENT INNOVATION
By Eric Bricker MD
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Filed under: "Ask-an-Advisor", Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Practice Management, Videos | Tagged: Eric Bricker MD, healrth plans, health insurance plans | Leave a comment »
Hospitals and Health Care Organizations
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Navigating a course where sound organizational management is intertwined with financial acumen requires a strategy designed by subject-matter experts. Fortunately, Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studiesprovides that blueprint.
―David B. Nash, MD, MBA,Jefferson Medical College, Thomas Jefferson University
It is fitting that Dr. David Edward Marcinko, MBA, CMP™ and his fellow experts have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizationsthat physicians, nurse-executives, administrators, institutional CEOs, CFOs, MBAs, lawyers, and healthcare accountants can follow to help move healthcare financial fitness forward in these uncharted waters.
―Neil H. Baum, MD, Tulane Medical School
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Dr. David Marcinko MBA CMP™
[Founding CEO and President]
The concept of a self-taught and student motivated, but automated outcomes driven classroom may seem like a nightmare scenario for those who are not comfortable with computers. Now everyone can breathe a sigh of relief, because the Institute of Medical Business Advisors just launched an “automated” final examination review protocol that requires no programming skill whatsoever.
In fact, everything is designed to be very simple and easy to use. Once a student’s examination “blue-book” is received, computerized “robotic reviewers” correct student assignments and quarterly test answers. This automated examination model lets the robots correct tests and exams, while the students concentrate on guided self-learning.
READ: https://medicalexecutivepost.com/2020/07/09/robo-examiners-let-cmp-candidates-take-control/
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Filed under: Career Development, CMP Program, Financial Planning, Health Economics, Healthcare Finance, Retirement and Benefits, Risk Management, Touring with Marcinko | Tagged: Certified Medical Planner™, CMP, David Edward Marcinko | Leave a comment »
Johns Hopkins Hospital Listed the Cost of 61 Lab Tests on Doctors’ Computer Screens … While They Were Ordering Labs. By Dr. Eric Bricker MD Results: –Just Seeing the Cost of the Lab Test DECREASED the Number of Labs Ordered Per Patient by 9%. –Doctors Also SUBSTITUTED a Lower Cost Lab Test for a Higher Cost Lab Test 10,000 Times. The Doctors Were NOT Clinically Directed to Change Their Behavior. The Doctors’ Pay Was NOT Affected by Their Lab Ordering Either Way. This Study Illustrates How Giving Doctors Cost Information in a Setting of Clinical and Financial Independence AUTOMATICALLY Decreases Healthcare Waste. Doctors Can Be Much Better Stewards of Healthcare Dollars … and the Technological Innovation Needed is Minimal. Disclosure: Dr. Bricker is the Chief Medical Officer of Virtual Care Company First Stop Health. YOUR COMMENTS ARE APPRECIATED. Thank You *** |
Filed under: Drugs and Pharma, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Information Technology, Videos | Tagged: blood tests, cost lab tests l, eHR, eMR, Eric Bricker MD, lab tests, medical lab test costs, medical laboratory tests, physician behavior | Leave a comment »
Households 1% Poorer in Last 10 Years Because Family Premiums Up 71%
YOUR THOUGHTS ARE APPRECIATED.
CITE: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: employer sponsored health insurance, Eric Bricker MD, fringe benefits, Health Insurance, healthcare coverage | Leave a comment »
TEXTBOOK RELEASE AND REVIEW
Navigating a course where sound organizational management is intertwined with financial acumen requires a strategy designed by subject-matter experts. Fortunately, Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studiesprovides that blueprint.
―David B. Nash, MD, MBA,Jefferson Medical College, Thomas Jefferson University
It is fitting that Dr. David Edward Marcinko, MBA, CMP™ and his fellow experts have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizationsthat physicians, nurse-executives, administrators, institutional CEOs, CFOs, MBAs, lawyers, and healthcare accountants can follow to help move healthcare financial fitness forward in these uncharted waters.
―Neil H. Baum, MD, Tulane Medical School
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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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Filed under: Accounting, Book Reviews, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Practice Management, Taxation, Touring with Marcinko | Tagged: david marcinko, Financial Management Strategies for Hospitals, hospital finance, hospital finance strategies, hospital financial management | Leave a comment »
Current Partners Not Aligned With PLAN Goals
BY DR. ERIC BRICKER MD
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Health Insurance Carriers Are Misaligned by Owning PBMs That Make More Money in Rebate Kick-Backs When the Employee Health Plan Spends More Money on Expensive Prescription Drugs.
Doctors Are Misaligned When They *Are Employed by Hospitals That Tie Test and Procedure Ordering Volume to Doctor Compensation.
Hospitals are Misaligned When They Buy Physician Practices and Raise the Prices for In-Office Testing and Procedures by 300%… Even Though NOTHING Has Changed Other Than the Sign on the Door.
Accordingly, True Employee Health Plan Innovation is ALIGNMENT Innovation That Provides Care Outside the of the Status Quo Fee-for-Service System.
Onsite Clinics, Near Site Clinics, Direct Primary Care and Capitated Virtual Care All Provide Real Alignment Innovation for Employee Health Plans.
ASSESSMENT: Your comments are appreciated.
CITE: https://www.r2library.com/Resource/Title/0826102549
THANK YOU
***
Filed under: "Doctors Only", Breaking News, Career Development, Events-Planner, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: capitation, Direct Primary Care, Eric Bricker MD, fee for service, FFS, Health Insurance, Near Site Clinics, Onsite Clinics, PBMs, tele health, telemedicine, virtual care | Leave a comment »
WHY THEY DO NOT CARE?
By Eric Bricker MD
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Your comments are appreciated.
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Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: CEOs, Eric Bricker MD, health care, Health Insurance, health plans | Leave a comment »
THE SHERLOCK COMPANY
This podcast features a brief discussion by colleague Doug B. Sherlock CFA, Senior Health Care Analyst and President, Sherlock Company http://www.sherlockco.com featuring his insights into the quarterly financial reports of health plans, for the first quarter 2021.
PODCAST: https://www.healthsharetv.com/content/first-quarter-2021-health-plan-financial-results-podcast
Your thoughts are appreciated.
Citation: https://www.r2library.com/Resource/Title/0826102549
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Filed under: Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: Douglas B. Sherlock CFA, Health Plan Financial Results, health plans, MCOL, Sherlock Company | Leave a comment »
HSA Update 2021
By Michael Thompson
High-deductible health plans have been popular, but it’s becoming clear they are not right for all employees, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
PODCAST: https://www.healthsharetv.com/content/michael-thompson-use-high-deductible-health-plans
Your thoughts are appreciated.
THANK YOU
INVITATIONS: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
CONTACT: Ann Miller RN MHA
MarcinkoAdvisors@msn.com
Ph: 770-448-0769
Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/
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Filed under: Experts Invited, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Touring with Marcinko, Videos | Tagged: By Michael Thompson, david marcinko, health savings account, high deductible health care plans, HSA, HSAs | 2 Comments »
INDUSTRY RANKINGS
BY DR. ERIC BRICKER MD
Specifically, Forrester Research Says That Customer Service is ‘Poor’ at Blue Cross of Texas and Illinois, Blue Shield of California, CareFirst Blue Cross, Anthem, United Healthcare, Cigna and Aetna.
Hospital Billing Customer Services Is Bad Too.
Hospital Billing Complexity is So Troublesome to Patients, that 40% Say They Avoid Preventive Care and Screening Tests Just to Avoid the Billing Headache.
Healthcare Customer Service is Terrible Because Health Insurance Companies and Hospitals Do Not Need Good Billing Customer Service to Be Successful, As Demonstrated by High and Rising Health Insurance Stock Prices and Large and Growing Hospital System Revenue.
For Health Insurance Companies and Hospitals, Not Fixing Their Poor Customer Service May Be a Calculated Business Decision.
Implications: To Help Make Their Employees’ Lives Better, Employers May Need to 1) Hire a Healthcare Navigation Company or 2) Deliver More Care to Their Plan Members Outside of the Traditional Health Insurance and Hospital Systems… and Avoid the Terrible Customer Service All Together.
Disclaimer: Dr. Bricker is the Chief Medical Officer of Virtual Care Company First Stop Health and is the Former Co-Founder of Compass Professional Health Services.
Your thoughts and comments are appreciated.
THANK YOU
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Filed under: Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Videos | Tagged: Aetna, Cigna, customer service, Eric Bricker MD, forrester research, Health Insurance, health insurance industry, insurance industry | Leave a comment »
RURAL HEALTHCARE CENTERS & VBC
Learn about the financial risk associated with Value-Based Care models and mechanisms to deal with the financial risk.
By National Rural Health Resource Center
PODCAST: https://www.healthsharetv.com/content/financial-risk-value-based-care-models
RELATED: https://medicalexecutivepost.com/2021/04/29/payments-in-value-based-contracts-were-ffs-based/
Your thoughts are appreciated.
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INVITATIONS: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
CONTACT: Ann Miller RN MHA
MarcinkoAdvisors@msn.com
Ph: 770-448-0769
Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/
THANK YOU
***
Filed under: Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Touring with Marcinko, Videos | Tagged: David Edward Marcinko, Rural Health Care, value based care, value based care financial risk, VBC | 2 Comments »
MANAGEMENT STRATEGIES, OPERATIONAL TECHNIQUES, TOOLS, TEMPLATES AND CASE STUDIES
TEXTBOOK 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
ASSESSMENT: Your comments and thoughts are appreciated.
INVITATIONS: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
CONTACT: Ann Miller RN MHA
MarcinkoAdvisors@msn.com
Ph: 770-448-0769
Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/
THANK YOU
***
Filed under: Book Reviews, Career Development, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Managed Care, Marketing & Advertising, Practice Management, Retirement and Benefits, Risk Management, Touring with Marcinko | Tagged: David Edward Marcinko, EHRs, Hospitals and Health Care Organizations, insurance, Malpractice Liability, Risk management MDs | Leave a comment »
Dr. David Edward Marcinko is Speaking Up
Dr. David Edward Marcinko MBA CMP® enjoys personal coaching and public speaking and gives as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world.
These have included lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, keynote lectures at city and statewide financial coalitions, and annual keynote lectures for a variety of internal yearly meetings.
His talks tend to be engaging, iconoclastic, and humorous. His most popular presentations include a diverse variety of topics and typically include those in all iMBA, Inc’s textbooks, handbooks, white-papers and most topics covered on this blog.
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INVITATIONS: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
CONTACT: Ann Miller RN MHA
MarcinkoAdvisors@msn.com
Ph: 770-448-0769
Second Opinions: https://medicalexecutivepost.com/schedule-a-consultation/
DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/
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Filed under: Career Development, Experts Invited, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, Interviews, Investing, Managed Care, Media Mentions and PR, Touring with Marcinko | Tagged: auditions, David Edward Marcinko, Financial Planning, Investing, Practice Management, public speaking, speaking | Leave a comment »
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 