Health Economics | The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants

Celebrating our 1,500th Medical Executive-Post

Posted on May 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Even More to Come in the Years Ahead

By Ann Miller; RN, MHA

[Executive-Director]

This ME-P is an information sharing portal for the integrated healthcare industrial complex, medical practice management and financial planning and advisory communities.

We have a search engine to help find essays and follow the breaking news that interests you for this space. Our articles, gossip, videos, books, journals, dictionaries, alerts and related information are continuously updated and ranked by users.

[picapp align=”none” wrap=”false” link=”term=newspapers&iid=7280686″ src=”a/0/b/d/Portrait_of_a_fbd9.jpg?adImageId=12663513&imageId=7280686″ width=”380″ height=”572″ /]

Publish on the ME-P

And, just recently we’ve celebrated our 1,500^th post. Of course, as a participative service, you can publish an article directly on the site or comment on an existing item. You can also vote for an article or a group that captures your interest in order to increase its visibility on the site.

Join Us

But, you must be a member to post; so join us today. We’ve come a long way in less than 3 years, with a lot farther to go!

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Always Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Marketing & Advertising, Sponsors | Leave a comment »

25 or so – Unintended Consequences of Healthcare Reform

Posted on May 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Protean, Pervasive, Prolonged and Painful

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Definition of the Term

Much like the physical laws of nature, action begets consequences, which are usually known, unknown or disregarded by human foibles.

According to Robert Norton, the law of unintended consequences, often cited but rarely defined, is that actions of people—and especially of government—always have effects that are unanticipated or unintended. Economists and other social scientists have heeded its power for centuries; for just as long, politicians and popular opinion have largely ignored it.

My List

And so, regardless of your political affiliation or opinion on healthcare reform in America, passed on March 21 2010 [Patient Protection and Affordable Care Act], there is a plethora of unintended consequences with the [any] new law. So, please indulge me in a bit of healthcare administration prescience:

Healthcare costs will be shifted to doctors in the form of lower reimbursement with higher practice overhead costs for private physicians, and with fewer office employees and more ancillary business and service line extensions.
Hospital based physicians like pathologists, radiologists, anesthesiologists, emergency department doctors and hospitalists will demand, and receive, higher salaries.
Fewer [under populated] primary care physicians with more [over populated] PAs, nurse practitioners and DNPs; with a blunted medical establishment oligopoly.
Higher health insurance costs for employers and most patients, especially young adults without a commensurate increase in aggregate risk.
Medical care access impediments for most Americans, but improvements for those previously uninsured.
Health 2.0 electronic connectivity for the masses with medical data “internet-neutrality”.
Continued rise of evidence based medicine and crowd-sourced healthcare information.
Higher costs for DME, instruments and drugs; particularly in the filed of human genomics and personalized pharmaceuticals.
Increased acceptance of MSAs, HSAs, concierge medicine, private-pay and other direct cash payment methods for medical care.
Realization that eMRs do not improve patient care or reduce costs as “meaningful use” is diluted.
An enterprise wide health data breach of epic proportions, with in-numerable smaller security breaches despite the HIPAA laws.
Long term macro-economically induced national inflation with weakness in the US dollar
Poor quality digital manipulation of medical information with eMR specific inflation due to ARRA and HI-TECH.
Increased national unemployment with widespread underemployment for some Americans.
Modified value added taxation in addition to increased federal tax brackets, rates and related others.
Promotion of outcomes reimbursement models, values based healthcare [episodes of care] and various micro-capitation derivatives.
Many more community hospitals, which lost 12 cents/dollar spent on Medicare and 35 cents/dollar on Medicaid patients last year, will close.
Medicare will become the defacto health insurance, much like public housing, food stamps, the USPS and public transportation.
There will be fewer viable alternatives to commercial health insurance, other than Medicare and Medicaid, since the antitrust exemption for health insurers was not repealed.
The impact of changing to ICD-10 for medical records coding and billing, will be as significant across the industry, as was Y2K and will push many other HIT projects to lower priority.
New HIPAA 5010 requirements will present substantial changes in the content of the data submitted with claims as well as the data available in response to electronic inquiries.
The Obama health insurance “police” program will be a policy failure, but a job creator.
Medical practices, often a doctor’s largest financial asset, will go down in value jeopardizing personal retirement plans.
Medicine’s lost professional status will become complete as healthcare becomes commoditized and future grass-roots caregivers are neutered.
Your 2 cents here.

[picapp align=”none” wrap=”false” link=”term=healthcare+professionals&iid=99522″ src=”0095/4e612b02-300a-4dfc-b17c-f2d0d0947cfc.jpg?adImageId=12656185&imageId=99522″ width=”380″ height=”429″ /]

Assessment

In order to be politically correct – not a known trait for me – I will adopt a scientist’s perspective and omit any value judgment regarding the above [positive or negative] unintended consequences.

www.BusinessofMedicalPractice.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. 25 consequences not listed? Add your 2 cents. What else can you think of? Am I correct, or not, and how do you feel about the above?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Career Development, Health Economics, Health Insurance, Healthcare Finance, Op-Editorials, Practice Management, Research & Development | 7 Comments »

Late April 2010 Edition of Plan Management Navigator

Posted on May 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

ADVERTISEMENT

On Medicare and Medicaid Plan Processing Costs

By Erin Sawchuk

Dear ME-P Readers

Please find attached the late April 2010 Edition of Plan Management Navigator.

Medicare and Medicaid Plans

In this month’s edition, we identify and test some of the potential interrelationships between claims processing costs and other functions for Medicare and Medicaid Plans. This analysis draws on data from the 2009 Sherlock Expense Evaluation Report.

Bench Mark Updates

Also included in this analysis is an update on our progress on our various benchmarking universes. Participation is up this year, we think due to public policy changes and economic weakness.

Link: Navigator Late April 2010[1]

Assessment

Please let us know if you are interested in joining our Medicare, Medicaid or TPA universes.

Sherlock Company

P.O. Box 413

Gwynedd, PA 19436

www.sherlockco.com

215-628-2289 – Phone

erinsawchuk@sherlockco.com

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Alerts Sign-Up, Breaking News, Career Development, Health Economics, Managed Care, Sponsors | Tagged: Douglas Sherlock CFA, Erin Sawchuk, Medicaid, medicare, Plan Management Navigator, Sherlock Expense Evaluation Report | 1 Comment »

On Medicare and Medicaid Cost Drivers

Posted on April 29, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Health Plan Management Navigator

By Douglas B. Sherlock; CFA

Dear ME-P Readers

Please find attached below the Mid April 2010 Edition of Plan Management Navigator.

In this month’s edition, we estimate the strength of cost drivers for claims processing in Medicare and Medicaid plans. We quantify the relationships of claims processing to simple algebraic expressions and operational metrics within the Claim and Encounter Capture and Adjudication function.

Assessment

Also included in this analysis is an update on our progress on our various benchmarking universes. Participation is up this year, we think due to public policy changes and economic weakness. Please let us know if you are interested in joining our Medicare, Medicaid or TPA universes.

Erin Sawchuk

Sherlock Company

P.O. Box 413

Gwynedd, PA 19436

www.sherlockco.com

215-628-2289 – Phone

erinsawchuk@sherlockco.com

Conclusion

Link: Navigator Mid April 2010

And so, 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, be sure to subscribe. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Alerts Sign-Up, Health Economics, Health Insurance, Healthcare Finance | Tagged: Douglas B. Sherlock CFA, Erin Sawchuk, Health Economics, health plans, Medicaid, medicare, Plan Management Navigator, Sherlock Company | 4 Comments »

Update on Medicaid and Medicare Advantage Plans

Posted on April 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The Impact of Health Care Reform

[By Christopher de Garay]

Please find attached below, the Early April 2010 edition of Plan Management Navigator.
Link: Navigator April 2010

Review

In this month’s edition, we review how health care reform will impact the top line of plans offering government managed care programs such as Medicare Advantage and Medicaid. Combined with new minimum health benefit ratios, these pressures will force health plans to look at their administrative expenses. In the next several issues of Navigator, we will look at specific operational metrics and their impact on functional areas such as claims processing.

2010 Benchmark Studies

This edition of Navigator also summarizes the timing for the 2010 benchmarking studies, which includes a new Third-Party Administrator universe.

Christopher de Garay
Senior Health Care Analyst
Sherlock Company
www.sherlockco.com
215-628-2289 Phone
215-542-0690 Fax
cgaray@sherlockco.com
P.O. Box 413
Gwynedd, PA 19436

Editor’s

If your plan would like to consider participation, we invite you to give Chris a call at 215-628-2289 or email him at sherlock@sherlockco.com.

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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Alerts Sign-Up, Health Economics, Health Insurance, Managed Care, Research & Development | Tagged: Christopher de Garay, DHHS, Managed Care, Medicaid, medicare, Medicare Advantage, Sherlock Company, TPA | 12 Comments »

Taxing Sin to Modify Behavior and Raise Revenue‏

Posted on April 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

NIHCM Expert Voices

By Nancy Chockley PhD [President & CEO]
[NIHCM Foundation]

Sin taxes on tobacco and alcohol have a long history in the U.S., and many credit cigarette taxes as being the single most effective strategy in achieving our dramatic reductions in smoking. Similar taxes have been proposed in recent years as one weapon in our fight against rising obesity rates, and a new study has just added support for this policy by showing that higher prices for sweetened sodas are associated with lower caloric intake, lower weight, and better health.

Rationale Reviews

In his essay, Dr. Jonathan Gruber reviews the rationales for and experience with sin taxes for cigarettes and alcoholic beverages, and offers his insights on using sin taxes to combat obesity.

http://www.nihcm.org/pdf/ExpertVoices_Gruber_April2010.pdf

Related Others

Other recent “Expert Voices” essays on health reform include:

William Vogt, RAND Corporation, “Hospital Market Consolidation” (November 2009)http://www.nihcm.org/pdf/EV-Vogt_FINAL.pdf
Genevieve Kenney, Urban Institute, “Uninsured and Eligible for Public Coverage” (November 2009) http://nihcm.org/pdf/EV-Kenney_FINAL.pdf
Eric Jensen, Consultant, and Lenny Mendonca, McKinsey & Company, “Why America Spends More on Healthcare” (November 2009)http://nihcm.org/pdf/EV_JensenMendonca_FINAL.pdf

Assessment

I hope you enjoy reading these essays and those that follow, down-line.

Phone: 202-296-4426
email: nihcm@nihcm.org
Website: www.nihcm.org

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Taxation | Tagged: alcohol tax, cigarette tax, Dr. Jonathan Gruber, Eric Jensen, Genevieve Kenney, Lenny Mendonca, Nancy Chockley, NIHCM Foundation, William Vogt | 8 Comments »

Understanding Efforts to Promote Lower-Cost Physicians

Posted on March 31, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

May Be Based on Misleading Profiles – According to Rand Study

By Staff Reporters

It is increasingly common for insurance plans to encourage patients to receive care from physicians who keep medical costs lower. However, this ethos may be based on unreliable estimates of doctor performance and may not achieve the intended savings, according to a new RAND Corporation press release and study.

PR Link: http://www.rand.org/news/press/2010/03/17/?ref=homepage&key=t_doctor_cash

About the Study

Funding for the study was provided by the U.S. Department of Labor. Other authors of the study are Elizabeth A. McGlynn PhD of RAND, Dr. Ateev Mehrotra of RAND and the University of Pittsburgh School of Medicine, and J. William Thomas of the University of Southern Maine.

About Rand Health

RAND Health, a division of the RAND Corporation, is the nation’s largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics. RAND Health is the developer of COMPARE (Comprehensive Assessment of Reform Efforts), a one-of-a-kind online resource that provides objective analysis about national health care reform proposals. Visit www.randcompare.org to learn more.

Conclusion

And so, 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, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Career Development, Health Economics, Managed Care, Practice Management | Tagged: DOM, Dr. Ateev Mehrotra, Elizabeth McGlynn, Health Economics, J. William Thomas, Rand, USDOL | 2 Comments »

About Guardian24/7 Premium Global Concierge Medical Care

Posted on March 25, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

What it is – How it works

[By Staff Reporters]

According to their website and TV infomercials, the principals of www.Guardian247.com developed the medical systems and protocols for the President of the United States [POTUS], senior White House officials and members of the President’s cabinet to ensure the best possible medical care anywhere in the world.

Today, the convergence of telemedicine technologies and reliable telecommunications has enabled a business model for this same level of service to be brought to the private sector – for the first time.

Telemedicine Enabled

Utilizing state of the art telemedicine broadband capability, and pre-positioned medical equipment, a team of former White House physicians administer services that are purportedly nearly as effectively as if they were on location, saving hours of time and anxiety for routine medical needs – and possibly saving a life in an emergency situation.

Like an Emergency Room

The company favors a core concept known as A ReadyRoom™ that is an installation of medical equipment, supplies and medications pre-placed and installed in a client’s primary residence and/or remote vacation home, jet or yacht. Custom-tailored to the needs and the client and his/her family and location, the ReadyRoom’s™ state of the art technology allows Guardian’s physicians to direct the proper use of the medicine, supplies and equipment either via telephonic or through advanced video teleconferencing links. The model is reminiscent of an emergency room; always on-call, available for use and expensive.

Assessment

For those who recognize that their most important asset – is their health – this company has a serious concierge medicine type solution that is not available to the masses. As CEO of Guardian 24/7, Jonathan Frye leads the company’s efforts to provide presidential-level medical care to clients; anywhere and anytime.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Career Development, Ethics, Health Economics, Information Technology, Media Mentions and PR, Research & Development | Tagged: A ReadyRoom™, concierge medicine, Jonathan Frye, POTUS, telemedicine, www.Guardian237.com | 7 Comments »

About the Managed Care Digest Series

Posted on March 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Where Information Becomes Intelligence™

By Staff Reporters

The sanofi-aventis Managed Care Digest Series^® is part of their continuing commitment to provide the healthcare industrial complex with the latest and most essential information on the evolution of medical care.

The Series, available online or in print, provides key benchmarking data that can help assess value, control costs, and develop business strategies.

Assessment

According to ME-P Publisher-in-Chief, Dr. David Edward Marcinko:

I have been a user of the Managed Care Digest series for more than a decade. The depth and breadth of information is astounding. I especially appreciate the data driven and graphical interface nature of the publication; as well as its’ cost—free!

I suggest all medical professionals, healthcare economists, business experts and financial advisors – read it and reap!

And so, give em’ a click www.ManagedCareDigest.com and tell us what you think?

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Filed under: Book Reviews, Career Development, Health Economics, Health Insurance, Healthcare Finance, Managed Care | Tagged: david marcinko, Managed Care Digest, sanofi-aventis | 1 Comment »

Why eMRs Won’t Improve Patient Care or Reduce Costs

Posted on March 13, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Deus Ex Machina – NOT

By Staff Reporters

Question

Have electronic medical records made a difference in patient care?

Answer

According to a new study looking at the digital medical record adoption of 3,000 hospitals, electronic records have made little difference in healthcare costs or the quality of medical care.

Assessment

That’s discouraging, considering that the government is investing billions of dollars into the technology.

Related posts from Kevin Pho MD:

Conclusion

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Career Development, Health Economics, Information Technology, Op-Editorials, Practice Management | Tagged: EHRs, electronic health records, electronic medical records, EMRs, kevin pho, medical records | 5 Comments »

I’m Not Economically Bashing JHU … But!

Posted on March 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

In My Opinion … Hospital Charges Not 4 Me

Dr. David Edward Marcinko; MBA

[Editor-in-Chief]

On February 09, 2010, journalist Maggie Mahar posted an excellent op-ed piece on The Health Care Blog. In fact; I am now compelled to address one aspect of it. The essay was titled: “Massachusetts’ Problem and Maryland’s Solution”.

Assuredly, I’ve no beef with Maggie, her economic machinations or reporting. In fact, I am a fan and encourage all ME-P readers and subscribers to “read it and reap.’

Link: http://www.thehealthcareblog.com/the_health_care_blog/2010/02/massachusetts-problem-and-marylands-solution-we-dont-have-to-wait-for-washington-part-2.html#comments

Maggie Speaks

In her essay, Maggie says the following to which I agree. It is well known to me as a Balti-moron. For, I lived in the bowels of inner-city Baltimore when this legislation went down, back-in-the-day:

“While health care reformers argue about what it would take to “break the curve” of health care inflation, the state of Maryland has done it, at least when it comes to hospital spending. In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission. When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients.

For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson at $984, while letting Johns Hopkins, in Baltimore Maryland, charges $1,555. For a basic chest X-ray, St. Joseph’s asks $81 and Hopkins’ is allowed to charge $155. The differences reflect Hopkins’s higher costs as a teaching hospital and the fact that it cares for generally sicker patients.”

Of Invoices, Charges and Cost Shifting – Oh My!

I do have a beef with the above charges, which are not necessarily costs, which are not necessarily what is ultimately paid by a third-party insurer, or patient. This cost shifting is not unique to JHU, of course, but mention of the “Johns” just caught my eye as I admit that I’ve been away from my hometown of Baltimore, Maryland for 35 years.

Oh my; don’t get me wrong. I loved the place and played stick-ball in JHU’s parking lot on Broadway in Upper Fells Point when I was a kid. I was seen in the ER, at a young age, for a forehead laceration. I even met two of the greatest physicians in the world there.

J. Alex Haller Jr. MD – the world famous Children’s-Surgeon-in-Charge of Johns Hopkins Hospital, and pectus excavatum surgical pioneer, from 1964 until 1997. As well as pediatric heart surgeon Helen Brooke Taussig MD (1898 – 1986), developer of a famous operation to alleviate “blue baby” syndrome, and who first warned the public on the dangers of thalidomide.

Link: https://healthcarefinancials.wordpress.com/2009/09/01/off-road-touring-with-dr-marcinko-part-vii/

However, as a health insurance agent and advocate of HD-HCPs for more than a decade, who has direct economic “skin-in-the-insurance game”, I would rather go to suburban St. Joe’s medical center for non-traumatic, non-emergent care – if I had my druthers. The neighborhood is safer and the quality can’t be much different. After all, a basic chest x-ray … is a basic chest x-ray, and an uncomplicated overnight stay … is an overnight stay etc, ceteris paribus.

RememberParetto’s 80/20 economic principle of the “vital few and trivial many”? Most of us [trivial many] will not need JHU care [vital few]. And, that’s a good thing!

The fact that JHU is a teaching hospital that generally cares for sicker patients has tremendous societal implications with positive “trickle-down” innovative benefits for the masses. But, not for me as one doctor-purchaser of healthcare services who knows better. I refuse to pay freight charges for the “full JHU monty”.

I just can’t afford it under my definition of medical / business school derived quality health care.

The correct diagnosis, necessary care and proper treatment with f/u and ancillaries; at the most convenient venue; by the appropriate level medical provider; in an appropriate time-frame, and at the right price.

Assessment

JHU is an outstanding healthcare entity in Baltimore, but perhaps even more so for the poor and/or rich; not us “tweeners”.

For the middle class, it is expensive care whose reputation for quality may actually be declining.

In fact, some JHU employee’s still living “back in the hood” tell me that it is “getting larger, but not better.”

Link: https://healthcarefinancials.wordpress.com/2010/01/10/a-story-all-doctors-and-patients-should-re-read/

Quality guru, Bob Wachter MD, where are you?

http://community.the-hospitalist.org/blogs/wachters_world/about.aspx

PS: I am a former CPHQ myself [Certified Physician in Healthcare Quality].

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Health Economics, Health Insurance, Op-Editorials, Quality Initiatives | Tagged: david marcinko, Edward Miller MD, hospital cost shifting, Johns Hopkins University, Maggie Mahar, Maryland Health Services Cost Review Commission, medical care quality, Robert Wachter, The Health Care Blog, www.thehealthcareblog.com | 6 Comments »

Political Primer on Healthcare Reconciliation

Posted on February 27, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

What it is – How it Works

By Staff Reporters

Several ME-P readers have contacted us for a definition of the term “reconciliation” and what it means in the current political debates and the recent Healthcare Summit in Washington, DC.

Definition,

According to Wikipedia, Reconciliation is a legislative process intended to allow consideration of a contentious budget bill without the threat of filibuster. Introduced in 1974, reconciliation limits debate and amendment, and therefore favors the majority party. Reconciliation also exists in the House of Representatives, but because the House regularly passes rules that constrain debate and amendment, the process has had a less significant impact on that body.

Healthcare Significance

“In 2009 the House and Senate each passed separate healthcare reform bills. The Senate bill passed only after all 60 members of the Democratic caucus voted for cloture to stop an attempted Republican filibuster. Negotiations to produce a compromise bill acceptable to majorities in both houses were thrown off track by Republican Scott Brown’s victory in the Massachusetts.

After Brown’s victory, the Democratic caucus no longer had enough votes to stop a Senate filibuster of the compromise bill. An alternative plan was for the House to pass the Senate bill verbatim, and for each house to pass another bill that would embody the compromises agreed to in the negotiations. This separate piece of legislation, which might possibly include a public option, would require use of the reconciliation procedure in the Senate.”

Of Minutia

No matter whether the House votes on reconciliation or the Senate bill first, the Speaker can ensure that the health care bill is signed into law before reconciliation. (The dirty little secret of Congress is that even if the House votes to pass the Senate health care bill tomorrow, the Speaker has unilateral power to hold that bill at her desk until January 3rd of next year before sending it to the President and starting the 10-day Constitutional veto clock).

Assessment

The Republican leader in the Senate, Mitch McConnell, said: “Using reconciliation would be an acknowledgment that there is bipartisan opposition to their bill, another in a series of backroom deals, and the clearest signal yet that they’ve decided to completely ignore the American people.” according to the New York Times, February 19, 2010.

Other opponents of Democratic legislative initiatives in the 111th Congress began to refer to reconciliation as the “nuclear option, although that term had previously been used to refer only to a majoritarian procedure to effect a formal change in Senate rules.

[picapp align=”none” wrap=”false” link=”term=politics&iid=8096056″ src=”4/f/a/7/Obama_Hosts_BiPartisan_83e0.jpg?adImageId=10759098&imageId=8096056″ width=”380″ height=”257″ /]

Note: Cloture is the only procedure by which the Senate can vote to place a time limit on consideration of a bill or other matter, and thereby overcome a filibuster. Under the cloture rule (Rule XXII), the Senate may limit consideration of a pending matter to 30 additional hours, but only by vote of three-fifths of the full Senate, normally 60 votes.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: cloture, fillibuster, healthcare reform, Healthcare Summit, obama, reconciliation, Scott Brown | 7 Comments »

Health Care and the Economy

Posted on February 22, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The National Governors Association Meeting

By Staff Reporters

The National Governors Association (NGA)—a bipartisan organization of the nation’s governors—promotes visionary state leadership, shares best practices and speaks with a unified voice on national policy.

Healthcare Politics

The nation’s governors gathered this weekend to address critical issues, including health care reform and the economy. The Governors met with President Obama, members of the Administration, business executives and other experts for discussions on a host of issues and challenges facing states.

Opening Session

This 2010 winter meeting began with a robust opening plenary session highlighting the role states can play in improving health care delivery systems to provide cost-efficient and effective health care to all Americans.

http://www.nga.org/portal/site/nga/menuitem.b14a675ba7f89cf9e8ebb856a11010a0

Conclusion

And so, your thoughts and comments on this ME-P are appreciated; especially our colleague Somnath Basu, PhD. Be sure to visit and watch the online video discussions, as well.

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Breaking News, Career Development, Health Economics, Health Insurance, Health Law & Policy | Tagged: CMS, Health Economics, Health Insurance, healthcare, healthcare financing, healthcare reform, National Governors Association, obama | 2 Comments »

Save Fewer Lives or Save Lives More Efficiently?

Posted on February 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

An Economics Argument

By Austin Frakt PhD

The Incidental Economist

Originally Posted: 14 Feb 2010 03:58 AM PST

Let’s say the cost per saved life due to providing an additional individual with health insurance is X dollars (Tyler Cowen says X = $9 million; I say that’s an overestimate). If one thinks X is too high, what’s the right policy response? One answer is to extend insurance to fewer people. The other is to try to reduce the cost of care so that X is lower.

The Differential

There is a huge difference between these two responses. I won’t go into all of them now. One important difference I want to highlight is that if we simply reduce the number who will become insured then the rest of us are still left paying exorbitant health care costs. Thus, two problems remain, many are left uninsured and health care costs are still too high.

Cost Reductions

On the other hand, if the policy response is to reduce the cost of care then we all win. More of the uninsured can be insured for some level of funding and the rest of us can benefit from lower health care costs. That’s a double victory.

Assessment

That health reform is too expensive is not a good argument for doing less of it*. It is an argument to do more. The provision of health care will not become more efficient under the status quo. And, the status quo (with perhaps minor tweaks to it) is what we will get if health reform does not pass this year. But, if reform does pass it sets the stage for more reforms, and ones that focus on costs.

*Note: I’m not saying I think it is too expensive. But if you do think it is I do not find that a convincing argument not to do it.

Link: http://theincidentaleconomist.com/save-fewer-lives-or-save-lives-more-efficiently/?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+TheIncidentalEconomist+%28The+Incidental+Economist+%28Posts%29%29

Conclusion

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

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Health Insurance | 1 Comment »

Shopping for Health Software

Posted on February 3, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Some Doctors Get Buyer’s Remorse

By D. Kellus Pruitt; DDS

Dear Huffington Post Investigative Fund

As a dentist, I read Emma Schwartz’s “Shopping for Health Software, Some Doctors Get Buyer’s Remorse” with interest.

It was like watching a slow, grinding train wreck from a still safe, but shrinking distance.

http://www.huffingtonpost.com/2010/01/29/shopping-for-health-softw_n_442651.html

Duped Physicians

The numerous stories about physicians who lost hundreds of thousands of dollars because of bad software purchases – including the case where some doctors alleged they were locked out of their patients’ medical records – is awe inspiring if one isn’t mandated to live the misery. I hope it’s a long, long time before paper dental practices are outlawed. If as Ms. Schwartz describes, broad-band interoperability fails to save money for physicians where it makes sense, I promise that dentists will never invest in interoperability beyond occasionally purchasing a new fax machine, telephone, or postage stamps. Dentistry simply isn’t emergency room medicine, and non-productive technology is especially costly if it fails to function properly.

A Volatile Industry

Steven Lazarus, president of consulting company Boundary Information Group, was quoted:

“This is a very volatile industry. Any product doctors buy could be bought or changed within two years.”

You want to see volatile? Try explaining that to thousands of disappointed dentists in solo practices – one disagreeable SOB at a time.

A Canadian Illustration

Believe it or not, there’s still more kinetic energy behind the train wreck – even without mentioning data breach bankruptcies. As illustrated by Schwartz’s example of Canada-based MedcomSoft, even if a company’s EHR system is CCHIT-certified, bankruptcy can occur unexpectedly – again leaving doctors holding the bag. To stay in business, providers who lose money on EHRs either must cut corners or increase fees to cover the loss … volatile!

A Dentist’s Question

Why, oh why, would a dentist want to spend $40,000 on software including thousands of man-hours in transition, just to risk pulling this tangled, expensive mess down on top of one’s practice? And – for what? There is no return on investment beyond the stakeholders in the EHR industry – which is ultimately paid by unrepresented patients through their healthcare in higher medical fees. As one can imagine, dentists are staying away from EHRs in droves.

For example, what does it mean that there are few if any advertisements for electronic dental records in industry journals, junk mail ads or Internet venues? I think it means that the Father of Economics Adam Smith is quietly warning ambitious, would-be dental software salespeople that their dangerous and expensive products will get them thrown out of dental offices.

The ADA

But then again, I could be wrong. Here is what Dr. John Findley, the immediate past president of the American Dental Association, told ADA Reporter Judy Jakush in a September 2008 interview a month before taking office:

“The electronic health record may not be the result of changes of our choice. They are going to be mandated. No one is going to ask, ‘Do you want to do this?’ No, it’s going to be, ‘You have to do this.’ That’s why we absolutely need the profession to be represented in the discussions about EHR to make sure our ideas are enacted to the greatest extent possible.”

To me, that’s scary. It smells a lot like tyranny.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Career Development, Health Economics, Information Technology, Pruitt's Platform | Tagged: ADA, Boundary Information Group, CCHIT, Darrell Pruitt, eDRs, EHRs, Emma Schwartz, EMRs, Huffington Post, john findley, Judy Jakush, MedComSoft, Steven Lazarus | 1 Comment »

A Skeptical View of the ‘National Summit on Health Care Fraud’

Posted on February 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Seeking Real Results; not Empty Rhetoric

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

All our ME-P readers and subscribers are aware of the ‘National Summit on Health Care Fraud’, at the National Institutes of Health (NIH), held on January 28, 2010 in Bethesda, Maryland. The much publicized summit discussed ways to eliminate fraud, waste and abuse in the US health care system.

A major speaker, of course, was US Secretary of Health and Human Services [DHSS] Kathleen Sebelius.

In My Opinion

IMHO, the summit was more political posturing and “nibbling at the margins”, than innovative thought leadership. Much like a hawkish politician with a platform against crime; who can argue with the proposition?

But, how do we actually reduce fraud and abuse? In other words, how can we achieve real results, and not just more anti-fraud rhetoric?

Here are two considerations, currently on the books, that need hard enforcement:

1. Medicare Integrity Program

The MP-P allows the DHHS to contract with non-governmental organizations, known as Medicare Program Safeguard Contractors, to carry out fraud and abuse detection, cost report audits, utilization review, provider payment determinations, and provider education, and to create a list of durable medical equipment subject to prior authorization for reimbursement.

Under this program, the Centers for Medicare and Medicaid Services (CMS) must implement regulations for contracting procedures.

2. Beneficiary Incentive Program

Under the BIP, Medicare beneficiaries are encouraged to report any suspicious billing activities. When a claim results in collection of funds of at least $100, the beneficiary may be paid a portion of the collections, up to $1,000 for each occurrence. Since this process does not require the same amount of time and resources associated with whistleblowing actions, there has been activity generated by senior groups leading to various enforcement actions.

This program has allowed the Medicare carriers to send notices to patients, which encourages them to call, report, and possibly be rewarded if the report results in action.

Assessment

The first step in fighting healthcare fraud and abuse is to know which laws apply in specific cases.

The next step is formulating policies and procedures to ensure that all workforce members understand how to comply and what their individual responsibilities are in maintaining a sound healthcare business organization.

The third step is enforcement and punishment; less talk and more action!

Assessment

The most effective way to accomplish all of this is through the implementation of a medical practice compliance program, and more specifically, the augmentation of the above two programs currently in existence.

Channel Surfing the ME-P

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Breaking News, Ethics, Health Economics, Health Law & Policy, Op-Editorials | Tagged: Beneficiary Incentive Program, Centers for Medicare and Medicaid Services, CMS, DHHS, Dr. Marcinko, Kathleen Sebelius, Medicare Integrity Program, Medicare Program Safeguard Contractors, National Summit on Health Care Fraud, NIH | 14 Comments »

Do Prices Drive Regional Medicare Spending Variations?

Posted on January 31, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A New Study Says – Apparently Not

By ME-P Staff Reporters

Per capita Medicare spending is more than twice as high in NewYork City and Miami than in places like Salem, Oregon.

How muchof these differences can be explained by Medicare’s payingmore to compensate for the higher cost of goods and servicesin such areas?

The Study

According to Daniel J. Gottlieb, Weiping Zhou, Yunjie Song, Kathryn Gilman Andrews, Jonathan S. Skinner and Jason M. Sutherland – not much!

The Answer

The authors analyzed Medicarespending after adjusting for local price differences in 306Hospital Referral Regions. The price-adjustment analysis resultedin less variation in what Medicare pays regionally, but notmuch.

The findings suggest that utilization—not localprice differences—drives Medicare regional payment variations,along with special payments for medical education and care forthe poor.

Assessment

http://content.healthaffairs.org/cgi/content/full/hlthaff.2009.0609v1

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Healthcare Finance | Tagged: Daniel J. Gottlieb, Hospital Referral Regions, Jonathan S. Skinner and Jason M. Sutherland, Kathryn Gilman Andrews, medicare, Weiping Zhou, www.HealthAfairs.org, Yunjie Song | 2 Comments »

Questioning [Physician’s] Upward Social Mobility and the State of the Union Address

Posted on January 29, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Broad Consensus Seems Impossible for Medical Professionals – and Everyman

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

While an undergraduate student at Loyola University in Maryland, I learned from my Jesuit teachers and philosophers that a couple of centuries ago, the decider of all matters of importance in Jerusalem was the Great Sanhedrin, or a council of 71 judges. The council met most every day except on festivals and the Sabbath. It functioned as sort of a combination of the Supreme Court, Congress and a political debate boiler room.

Incorrect Unanimity

As one might imagine, the Sanhedrin’s members normally disagreed as they hammered out their daily opinions; much like today’s political debates over healthcare reform. But occasionally they came to a unanimous decision, and they had an amazing and very wise rule when that occurred: The decision was immediately overturned because the sages believed that a unanimous conclusion among so many individuals just had to be wrong.

THINK: The US Senate and Congress

Rules for Upward Mobility

Anyway, I was thinking about the Sanhedrin’s rule after last night’s 2010 State of the Union address by President Barrack H. Obama while I was considering the current state of the economic union for doctors – specifically. The translation is easy for non-physicians [everyman] as well; so bear with me.

Anyway, I was struck by the fact that if there was one grand unified theory which gets at least 90-100% agreement from current generations of America’s medical and lay punditocracy – it is the rules for upward [medical professional] mobility.

These rules, especially for second generation Americans like me, were:

A medical degree [college education] leads to a lucrative profession [job] and a satisfying lifestyle.
[Working hard], or practicing long hours, means your income will grow.
Devotion to medicine, or your job, will produce a comfortable retirement.
Your children will follow your career path [job] and create a lasting legacy

The Paradigm Shift

Today, with a national unemployment rate hovering around 10%, doctors and everyman may need to reconsider the above unwritten rules that have governed our upward mobility since the end of World War II. As the son of a GM auto worker – I did decades ago – and still do.

For example, from 1945 to 2000, various private and public health insurance mechanisms were developed, along with the idea that health insurance was a fringe benefit in lieu of the wage and price controls instituted after the war. Today it is even considered a “right” by some.

Nevertheless, the doctor-class was a surrogate for the affluent American upper middle class lifestyle, and a type of perpetual prosperity machine that created wealth.

There were periodic general economic dislocations of course, like the recessions of the mid-1970s and early 1980s, and the rise of managed care in the early 1990s. But, wealth seemed to compound for physicians, and progress always resumed its upward trajectory. This was especially true for all medical professional during the “golden age of medicine” [circa 1965-1990, approx].

After all, wasn’t [isn’t] healthcare considered a recession proof business? Perhaps no more!

The Physician Net-Worth Numbers

Then: I was involved in study a few years ago [September 16, 2008] which determined that the average 47 year-old physician, earning $180,000 annually, needed to amass a net-worth of about $5.5-M in order to maintain the same lifestyle throughout retirement at age 65.

Link: http://www.hcplive.com/finance/publications/pmd/2005/92/3951

Link: www.CertifiedMedicalPlanner.com

Now: Today, with the DJIA down about 30% from its’ October 2008 high, is this retirement / employment scenario still possible? Are our opinions Sanhedrin-like?

And remember, the estate tax laws sunset back to their original rates in 2011. Moreover, many financial advisors, like me, believe income tax rates and brackets will increase going forward; along with increasingly onerous regulations for small businessmen and women like physicians and private medical practitioners. New business innovations of all stripes will also be adversely affected.

Full Disclosure: I am founder of the Certified Medical Planner™ online education program for financial advisors and medical management consultants.

Assessment

And so, I ask, do the rules of upward mobility for physicians or everyman still apply; or have they changed? Why or why not? If so, is the change permanent or temporary, and is it for the positive or negative. Please consider financial, societal and/or generational implications.

IOW: Is President Barack H. Obama correct?

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: "Ask-an-Advisor", Career Development, Financial Planning, Funding Basics, Health Economics, Health Law & Policy, Investing, Op-Editorials, Retirement and Benefits | Tagged: Great Sanhedrin, Loyola, Marcinko, obama, physician net worth, social mobility, State of the Union | 5 Comments »

Capital Formation for Hospitals

Posted on January 24, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Strategic Expenditures

[By Calvin W. Wiese; MBA, CMA, CPA]

[By Dr. David E. Marcinko MBA CMP]

Some of the most important strategic decisions hospital executives make are related to capital expenditures. Almost every hospital has capital investment opportunities that are far in excess of their capital capacity. Capital investments are bets on the future. How these capital bets are placed has long-lasting implications. It is of utmost importance that hospitals bet right.

Strategic Importance of Capital Investing

Hospitals are capital intensive businesses. Hospital buildings are unique structures that require large amounts of capital to construct and maintain. Inside these buildings are pieces of expensive equipment that have fairly short lives. Technological innovations continually drive demand for new and more expensive equipment and facilities. The ability to continually generate capital is the lifeblood of hospitals. In order to compete and succeed, it’s imperative for hospitals to continually invest in large amounts of capital equipment and expensive facilities.

Profit Driven

Capital investment is fueled by profit. In order to continually make the necessary capital investments, hospitals must be profitable. Hospitals unable to generate sufficient profit will fail to make important capital investments, weakening their ability to compete and survive.

Capital Opportunity Selection

Hospital managers bear important responsibility in choosing which capital investments to make. There are always more capital opportunities than capital capacity. In many cases, capital opportunities not taken by hospitals create openings for others with capital capacity to fill the vacuum. By not taking such opportunities, hospitals are weakened, and their operating risk increases.

Stewardship

Stewardship is a term that aptly describes the responsibility borne by hospital managers in making capital investments. The New Testament parable of the talents describes this kind of stewardship. In this story, a merchant entrusted three managers with money to invest. One manager was given five units, another two, and a third one. At the end of the investment period, the two managers given five units and two units reported a 100% return. The manager given one unit reported zero return — he was fired and his unit was given to the first manager.

This is stewardship — and hospital managers are stewards of their organizations’ assets. Too often, not-for-profit hospital managers hold an erroneous view of the returns expected of them. Like the third manager in the parable, they think zero return on equity is acceptable. They understand capital investment funded by debt needs to cover the interest on the debt, but they view capital investments funded by equity as having no cost associated with the equity. From an accounting perspective, they are right. From a stewardship perspective they are dead wrong — just like the third manager in the parable.

Here’s why: as stewards, they are responsible for managing the entrusted assets. They can either put these assets at risk themselves, or they can put those assets in the market and let other managers put them at risk. If they choose to put them at risk themselves, and then they have the mandate of creating as much value from putting them at risk as they would realize if they put them in the market for other managers to put at risk. They have the duty to realize returns that are equivalent to the returns they could realize in the market; otherwise, they should just put them in the market. They can either invest in hospital assets or work the assets themselves, or they can invest in financial market assets so others can work the assets. When they choose to invest in hospital assets, the required return is not zero. That’s the return they get fired for. The required return is equivalent to market returns.

MORE: Capital Formation Hospitals SAMPLE DEM

Assessment

Thus, when evaluating performance of hospital management teams, the minimum acceptable performance level is return on equity that is equivalent to the return that could be realized by investing the hospital assets in the market. And when evaluating a capital investment opportunity, it is important to apply a capital charge equivalent to the hospital’s weighted cost of capital — a measure that imputes an appropriate cost to the equity portion of the capital along with the stated interest rate for the debt portion of the capital structure.

CASE MODEL: CASE MODEL

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Career Development, Funding Basics, Health Economics | Tagged: Calvin Wiese, capital investments, hospital, hospital capital formation, www.healthcarefinancials.com | 3 Comments »

OSHA Financial Cost Analysis Software

Posted on January 21, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

About the “Safety Pays” Program

By Staff Reporters

A financial cost analysis can be performed by anyone using the OSHA software program, Safety Pays. This software can be found and downloaded at no cost by accessing the website: http://www.osha.gov/pls/oshaweb/searchresults.category?p_text=safety%20pays&p_title=&p_status=CURRENT

A Free Software Program

The program was developed to assist employers in assessing the impact of occupational illness and injuries on their profitability. Utilizing this software program and profit/loss data from the www.bizstats.com website on physician practices – reveals a number of startling statistics that illustrate how cost effective implementing an OSHA safety program can be for a medical practice, clinic, hospital or emerging healthcare organization (EHO).

Assessment

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Healthcare Finance, Quality Initiatives | Tagged: clinic, EHO, hospital, OSHA, Safety Pays | 1 Comment »

Healthcare Reform and the US Constitution

Posted on January 17, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Consider this Proposed 28^th Amendment

Submitted by Cecelia T. Perez; RN

Author Unknown

For too long we have been too complacent about the workings of Congress. Many citizens have no idea that Congress members can retire with the same pay after only one term, that they didn’t pay into Social Security, and that they specifically exempted themselves from many of the laws they have passed (such as being exempt from any fear of prosecution for sexual harassment); while ordinary citizens must live under those laws.

The Healthcare Reform Exemption

The latest is to exempt themselves from the Healthcare Reform that is being considered … in all of its forms. Somehow, that doesn’t seem logical. We do not have an elite class that is above the law. I truly don’t care if they are Democrat, Republican, Independent or whatever. The self-serving must stop. This is a good way to do that. It is an idea whose time has come.

Proposed 28th Amendment to the United States Constitution:

“Congress shall make no law that applies to the citizens of the United States that does not apply equally to the Senators and Representatives; and, Congress shall make no law that applies to the Senators and Representatives that does not apply equally to the citizens of the United States.”

Assessment

Each person contact a minimum of twenty people on their address list, in turn ask each of those to do likewise. Then in three days, all people in The United States of America will have the Message. We ask you to pass this idea to your friends for their consideration.

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Op-Editorials | Tagged: congress, healthcare reform, public option, social security, US Constitution | 2 Comments »

Who Admires the EU Healthcare Model?

Posted on January 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Not so Fast – Old Man

By Darrell K. Pruitt; DDS – el Viejo

Here’s something interesting I found on Courthouse News.com about Germany’s mandatory retirement age for dentists.

“EU Court OK’s Age Limits for Firefighters, Dentists” (no byline).

http://www.courthousenews.com/2010/01/14/European_Courts.htm

European Court of Justice

“The European Court of Justice released a ruling reconciling a ban on age discrimination with German age limits for firefighting and dentistry.”

The article continues:

“For dentists, the high court agreed with the national court that an age limit is justified by the need to protect patients from declining performance.”

As we wait for octogenarian Gordon Christensen DDS to discover and describe the lame “declining performance” claim in that statement, let me focus on the rest of the paragraph:

“But it said that such a limit must apply across the board, not only for panel-certified dentists within the public sector, but also for private practitioners.”

Touting the Next Generation of Dentists

It gets worse. The EU openly states that it intends to hand young dentists (and mid-level providers?) an immediate chance at making swell money with a huge demand for dental care that will arise when thousands of thriving dental practices across Europe close.

“The Court of Justice also agreed that such a limit is reasonable to provide work positions for young dentists, but only if it can be proven to fulfill this purpose.”

Assessment

Hell, I’ll probably still have kids in college if US HIT stakeholders fall in love with this plan. Not only that, but since thousands of dental practices like mine will be up for sale at the same time, the business I’ve built over the last 27 years will be worthless on the open market.

So what are my plans? I hope the ADA is adequately protecting Americans from such folly.

And – if not?

Porque hablo español, tengo la intención de mover el culo viejo a una ciudad en la costa en México y sacar dientes a los extranjeros ilegales a su regreso desde el norte. ¡Viva el NAFTA!

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Who agrees with the EU; why or why not? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Filed under: Career Development, Health Economics, Pruitt's Platform | Tagged: ADA, Darrell Pruitt, DDS, EU, European Union, Gordon Christensen DDS | 2 Comments »

Understanding Hospital Community Essentiality

Posted on January 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Views Differ on this Important Concept

[By Calvin W. Wiese; CPA, CMA, MBA]

An important component of hospital financial analysis is essentiality. Hospitals are unusual businesses that many times possess some form of essentiality to their communities. Healthcare is important to the economic vitality of every community. Many hospitals have served their communities for many years; it is not uncommon to find hospitals that have been continuously operating for more than 100 years in the same community.

Many Hospital Types

As we have discussed here and elsewhere, most hospitals are not-for-profit. In not-for-profit hospitals, no private party actually “owns” the hospital; control is vested in various boards, but no one explicitly “owns” a not-for-profit hospital. In a broad sense, communities own not-for-profit hospitals. They are considered “charities” with a “charitable purpose.” Though a not-for profit hospital may not have owners, it has many” stakeholders,” parties that have vested interests in the continuing success of the hospital.

Many Diverse Stakeholders

Many hospitals have broad and vast webs of stakeholders. Stakeholders are why hospitals rarely close or are shut down. Too many stakeholders have interests in the continuing successful operation of hospitals.

Hospital stakeholder relationships need to be considered in the analysis of essentiality. How strong are these relations? How many are there? How important is the continuing success of this hospital to these stakeholders?

Health Services Analysis

Another dimension of the essentiality is medical service analysis. For examples, how significant are the hospital’s services? If the hospital shuts down, what population segments would suffer? How significant is the population that would suffer? How much would they suffer?

Assessment

Analysis of hospital’s stakeholders and services should provide a credible view of the degree of essentiality associated with a hospital. Higher degrees of essentiality suggest higher likelihoods that hospitals, one way or another, will meet their commitments, particularly their payment commitments.

Conclusion

So, tell us what you think about your hospital’s essentiality? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: CMP Program, Health Economics, Healthcare Finance, Research & Development | Tagged: Calvin Wiese, hospitals, www.healthcarefinancials.com | 1 Comment »

Webinar on Doctors and the Economic Stimulus Package

Posted on January 12, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

An ME-P TV First

By Ann Miller; RN, MHA

[Executive-Director]

Recently, we caught up with Houston Neal – of Software Advice – who thought our ME-P readers would like to see their new podcast on eHR stimulus funds. In-as-much as they are still hearing from doctors who want to know how to take advantage of the stimulus, they’ve teamed up with the Chairman of HIMSS to help answer questions via webinar. The final clip is now live on the blog.

And the Question … Is?

After talking with hundreds of physician practices each month, their biggest question seems to be: “What does the economic stimulus package mean for me?”

Of course, practices understand that up to $45 billion is allocated to provide incentive for physicians to adopt eHRs. However, many questions remain about how and when providers will receive stimulus funds.

ME-P TV

The podcast, with Justin Barnes Chairman of the HIMSS Electronic Health Record Association and Vice President of Greenway Medical Technologies, seeks to answer these questions. The original presentation was delivered last week; however you can view the entire webinar here, as well.

In this hour webinar, we hope you’ll learn:

How the stimulus money will be paid out
What it takes to qualify for funding
Which specialties qualify for funding
How “meaningful use” is defined
What constitutes a “qualified EHR”

Assessment

There’s some great content here, so be sure to check it out.

http://www.softwareadvice.com/articles/medical/what-does-it-take-to-qualify-for-ehr-stimulus-funds-1122209/

Further Contact

512.364.0117
www.SoftwareAdvice.com
houston@softwareadvice.com

Conclusion

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Filed under: Health Economics, Health Law & Policy, Information Technology, Videos | Tagged: EHRs, Electronic Health Record Association, EMRs, Greenway Medical Technologies, HI-TECH, HIMSS, Houston Neal, Justin Barnes, stimulus package, www.SoftwareAdvice.com | 1 Comment »

Off Road Touring in Boston with Dr. Marcinko

Posted on December 31, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

How Doctors Get Paid

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Just before the Christmas Holidays, I flew up to Boston at the invitation of a pharmaceutical company to lead a managerial workshop entitled: “How Doctors Get Paid” [Treatment is only the beginning in the Changing Billing and Medical Reimbursement Climate].

Our goal was to inform drug representatives, and their regional managers, what value added information physician offices might expect from the pharmaceutical industry of the future.

Topics of Discussion

The two hour interactive workshop included team projects, flip chart exercises, a mock role-playing session and the customary [hopefully energetic] ppt presentation. Other topics of discussion included:

Health insurance payment evolution
Collapse of Medicare
Rise of managed care
Medical records documentation
ICD-9 and 10, HCPCS, DRGs and CPT® coding
ABNs, super-bills and HCFA 150 forms
Billing methodologies
Healthcare fraud, abuse and related policies
Capitation, HSAs, concierge medicine and RACs
Futuristic health 2.0 payment mechanisms, and more.

Assessment

Rest assured; these folks were a very knowledgeable and aggressive group; not like your father’s “detail men” of yore! They seek to … talk the talk, and walk the walk, of the Health 2.0 era.

Many thanks again to Helen, and Jon D, for the invite.

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Drugs and Pharma, Health Economics, Managed Care, Media Mentions and PR, Practice Management, Sponsors, Touring with Marcinko | Tagged: ABNs, concierge medicine, CPT codes, HCFA 1500, health abuse, health fraud, HSA, ICD-10, ICD-9, Managed Care, medicare, super bill | 3 Comments »

Around the Healthcare Financial Blog-O-Sphere

Posted on December 30, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

News and Economics Updates in Thirty Minutes or Less

By Staff Reporters

1. Unions pressure Democrats on health insurance tax
Associated Press via Google, December 10, 2009

2. Is there a doctor in the corporation? Maybe soon
Reuters, December 9, 2009

3. Sebelius Statement on Benefits of Health Insurance Reform for Businesses
HHS Press Release, December 3, 2009

4. Majority of employers would reduce health benefits to avoid proposed excise tax
Mercer Press Release, December 3, 2009

5. U.S. unemployed face higher healthcare premiums
Reuters, December 2, 2009

6. Public support for health-care reform is high, but some CFOs take a different view
CFO.com, December 1, 2009

7. Survey: Growing worker stress seen in benefits use
Associated Press via Google, November 30, 2009

8. Employers Play Dr. Mom to Limit Swine Flu Impact
Associated Press via Google, November 30, 2009

9. Health Care Savings Could Start in the Cafeteria
The New York Times, November 28, 2009

10. Ford, GM Face $2.5 Billion First VEBA Bill
Workforce Management, November 24, 2009

11. Plan credits healthy habits – Employer cuts costs by allowing workers to ‘earn’ lower rates
Business Insurance, November 23, 2009

12. Health Care: GE Gets Radical
Business Week, November 19, 2009

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Breaking News, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Monthly Reports | Tagged: Health Insurance, healthcare business, healthcare economics, Healthcare Finance | 4 Comments »

How a Few Private Health Insurers Are on the Way to Controlling Health Care

Posted on December 21, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Re-Post from Robert Reich; PhD

Staff Reporters

The healthcare public option is dead, killed by a handful of senators from small states who are mostly bought off by Big Insurance and Big Pharma -or- intimidated by these industries’ deep pockets and power to run political ads against them.

Assessment

Some might say it’s no great loss at this point because the Senate bill Harry Reid came up with contained a public option available only to 4 million people, which would have been far too small to exert any competitive pressure on private insurers anyway.

Link: http://robertreich.blogspot.com/2009/12/how-few-private-health-insurers-are-on.html

Conclusion

What do you think? Is Reich correct? Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

***

Filed under: Breaking News, Health Economics, Health Law & Policy, Op-Editorials | Tagged: big-pharma, Harry Reid, health reform, public option, Robert Reich | 3 Comments »

Barriers to Free Market Competition in Healthcare Delivery

Posted on December 13, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Why Supply and Demand Doesn’t Work in Medicine

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

Much has been written here, and elsewhere, about free market competition in healthcare; especially in light of the current national political debates. Yet, these markets are not free.

Like Evolution – Healthcare Competition is Only a Theory

Perfectly competitive healthcare markets are not free; they exist only in economic theory as a useful comparative artifice. In reality, industries and markets have varying constraints on competition. The healthcare industry has often been characterized as unique with its many significant barriers to free market competition, such as market controls on price and quality.

According to colleague Robert James Cimasi, of Health Capital Consultants LLC, in St. Louis MO; there are three main reasons for these barriers in healthcare:

Competitive Healthcare Barriers

The nature of healthcare creates an unpredictable, urgent, and “infinite” level of demand.
The ubiquitous involvement of insurance companies, private and governmental, as intermediary organizations in the purchase of healthcare interferes with consumer motivations and consequently their choice of providers and services.
The difficulties in measuring healthcare quality and beneficial outcomes (both of quantifying and qualifying them) and the lack of information on the relative costs of healthcare providers and services also inhibit consumer selection, further removing incentives to providers to increase quality and lower costs.

Barriers to Healthcare Competition

Included among the many other barriers to competition in healthcare delivery are the following:

Patients don’t purchase services directly from providers;
Patients don’t compare prices between providers;
The government is the largest purchaser of healthcare;
Private purchasers often lack market power;
Patients, purchasers and providers lack information;
Occupational licensing;
Many providers have monopoly or near-monopoly power (yet antitrust laws prevent some potentially beneficial integration);
Providers are rewarded for increasing costs;
Capital investments are overly subsidized (It should be noted that Stigler argues that an industry will not use its power to collect money from the government unless the list of beneficiaries can be limited, due to the fact the amount of subsidies will be divided among a growing number of rivals.*
Certificate of Need (CON), regulation, and licensing laws are an entry barrier to competing and substitute providers and services; and
Exit barriers protect low-quality providers.

Assessment

Of course, the supply side is also flagrantly encouraged by excessive medical testing, procedural interventions and surgery; mostly excused by malpractice phobia as a well as the personal financial interests of involved stakeholders.

References

Stigler, George J. “The Theory of Economic Regulation.” The Bell Journal of Economics and Management Science. Vol. 2, No. 1 (Spring 1971): 5.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Health Economics, Managed Care, Op-Editorials | Tagged: david marcinko, Health Capital Consultants LLC, healthcare competition, healthcare economics, Robert Cimasi | 9 Comments »

Understanding Medical Billing Methodologies

Posted on December 10, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Cash Conversion Cycle

[By Staff Reporters]

Most patients and financial advisors don’t have a clue about how doctor’s get paid in our current system; but it’s not by magic. Yet, a number of different steps occur during the processing of a medical claim that can be seen in a flow chart. Each step in the process can be mapped out and each is subject to claim payment-or-claim rejection. A payment time line for a typical FFS or PPO can also be subjected to a number of variables, depending on different factors including staff competency, time, outside vendors, information management, management decisions in general, or regulatory requirements. The total transit times may take weeks for electronic claims or up to two-years for some paper based claims.

First Make the Diagnosis

• ICD-9 alpha numeric code for disease classes, not billing.

• HHS offers ICD-9 [CM] for MDs and facilities.

• WHO-1900, updated every 3-10 years, e-ICD-10 [2013].

• Diagnostic Statistical Manual Mental Disorders, 4th Edition [DSM-IV].

Then Select the Current Procedure Terminology® Code

Medical, surgical and diagnostic task & service billing code numbers [5-digit] of AMA used by payers:

• Thousands updated annually

• Secretive with registered mark ®

• Office Visits: [brief, inter, extended, etc]

• # 99214 physical exam

• # 90658 H1N1 flu shot

• # 12002 one-inch laceration suture

• CDT® and HCPCS codes, too!

Document the Visit in Patient Progress Notes

Subjective:

“I was gardening and noticed my wrist was swollen and itched like crazy”

Objective:

A 4 inch linear red rash with circular oozing papules and swollen skin is present. Patient is wearing a small tennis bracelet which was tight.

Assessment:

Rule out rues dermatitidis versus nickel allergy.

Plan:

Soap soaks, with OTC calamine lotion with Rx oral diphenhydramine or [benadryl].

Submit the “Super Bill”

Not a “big bill” or expensive medical invoice; just an invoice

• Official standard billing form used by doctors submitting MC/MD claims.

• Also used by some private insurers and managed care plans.

• Contains patient demographics, diagnostic codes, CPT®, HCPC codes, etc.

• Generic billing form, like the generic HCFA 1500 claim form.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Accounting, Health Economics, Practice Management | Tagged: AMA, CDT, CMS, CPT, HCFA 1500, HCPCS, HHS, ICD-9, medical billing, medical coding, WHO | 4 Comments »

Physicians Seeking Financial Support from Hospitals

Posted on December 9, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Results of a New Survey

[By Staff Reporters]

Since domestic economic conditions began to deteriorate in September 2008, the number of doctors seeking financial support from hospitals has increased, according to a new report from the American Hospital Association.

Study Results

Overall: 70%
Physicians Seeking Increased Pay for On-Call or other Services Provided to Hospital: 79%
Physicians Seeking Hospital Employment: 74%
Physicians Seeking to Sell Their Practice: 36%
Physicians Seeking to Partner on Equipment Purchases: 26%
Other: 13%

Source: American Hospital Association. The Economic Crisis: Ongoing Monitoring of Impact on Hospitals: Results from an AHA Rapid Response Survey, August/September 2009. www.aha.org

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Economics, Monthly Reports, Practice Management | Tagged: AHA, American Hospital Association | 2 Comments »

A Healthcare Reform Budget Deficit Opinion Poll

Posted on December 2, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Deficit Neutral, or Not [You Decide]

By Ann Miller; RN, MHA

[Executive Director]

President Barack H. Obama just promised not to sign any health reform legislation that increases the federal deficit. This promise recognizes the rising public concern about a fiscal trend that, if left unchecked, could leave us with $19 Trillion Dollars in federal debt within a decade.

Of course, without the pledge, given the current dismal economic climate, health reform would be dead-in-the-water.

QUESTION: And so, is healthcare reform really deficit neutral?

Please VOTE:

Filed under: Breaking News, Health Economics, Health Law & Policy, Healthcare Finance, Voting Polls | Tagged: federal debt, federal deficit, health care reform deficity neutrality, health reform, obama, public plan | Leave a comment »

Thanksgiving “Food-for-Thought” on “Money Driven Medicine”

Posted on November 26, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

View the “Money-Driven Medicine” Video [A Free Streaming Download]

By Staff Reporters

During the month of November, Money-Driven Medicine will stream for free as part of the Watch-In! for America’s Health.

Based on Maggie Mahar’s Book

“Money-Driven Medicine” provides the essential analysis Americans need if they are to become knowledgeable participants in healthcare reform during these crucial days and in the years to come.

Assessment

Link: http://moneydrivenmedicine.org/watch-in

If you find this film to be a valuable tool, consider screening the DVD at your conference or professional event or in your community, association, school, workplace or place of worship.

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Ethics, Health Economics, Health Insurance, Healthcare Finance, Op-Editorials, Videos | Tagged: Maggie Mahar, Money Driven Medicine, watch-in, www.moneydrivenmedicine.org | 1 Comment »

Strategic Modern Portfolio Theory Considerations in Hospital Capital Formation

Posted on November 25, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Risk for Doctors and Financial Advisors

By Calvin W. Wiese; MBA, CPA

www.HealthcareFinancials.com

Hospital capital investments financial create risk. Risk is the uncertainty of future events. When hospitals make capital investments, they commit to costs that affect future periods. Those costs are known and relatively fixed. What are unknown are the benefits to be realized by those capital investments. For capital investments, risk is the certainty of future costs coupled with the uncertainty of future benefits. In some cases, while the future benefits are uncertain, there is a high degree of certainty that the benefits will exceed the costs. In these cases, risk can be very low.

Risk Re-Defined

Risk may be better defined as the degree to which the uncertainty of unknown benefits will exceed the known and committed costs. For example, when capital assets are purchased, both the burdens and the benefits of ownership are transferred to the owner. The burdens are primarily the costs associated with acquisition and installation. The benefits are primarily the revenues generated by operating the capital assets. Risk of ownership is created to the degree that the benefits are uncertain.

Managing Risk

Hospital managers and physician executives need to be skilled at putting hospital assets at risk. Without clear knowledge and understanding of the benefits and the burdens, hospitals can quickly find themselves at unacceptably high levels of risk. Risk must be continually assessed and evaluated in order to successfully put hospital assets at risk. Hospitals require many varied capital investments; their capital investments represent a risk portfolio. An effective combination of risky assets can often create risk that is less than the sum of the risk of each asset.

About MPT

Of course, financial managers have know this for years as a basic principle of Modern Portfolio Theory (MPT), first introduced by Harry Markowitz, PhD, with the paper “Portfolio Selection,” which appeared in the 1952 Journal of Finance. Thirty-eight years later, he shared a Nobel Prize with Merton Miller, PhD, and William Sharpe, PhD, for what has become a broad theory for securities asset selection; and hospital assets may be viewed as little different. Prior to Markowitz’s work, investors focused on assessing the rewards and risks of individual securities in constructing a portfolio. Standard advice was to identify those that offered the best opportunities for gain with the least risk and then construct a portfolio from them.

Following this advice, a hospital administrator might conclude that a positron emission tomography (PET) scanning machine offered good risk-reward characteristics, and pursue a strategy to compile a network of them in a given geographic area. Intuitively, this would be foolish. Markowitz formalized this intuition. Detailing the mathematics of diversity, he proposed that investors focus on selecting portfolios based on their overall risk-reward characteristics instead of merely compiling portfolios of securities, or capital assets that each individually has attractive risk-reward characteristics. In a nutshell, just as investors should select portfolios not individual securities, so hospital administrators should select a wide spectrum of radiology services, not merely machines.

Assessment

Savvy hospital managers will mitigate ownership risk by constructing their portfolio of risky assets in a manner that lowers overall risk.

Conclusion

And so, your thoughts and comments on this ME-P post are appreciated. How do you define financial risk in your healthcare organization? How do you manage and mitigate it? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Op-Editorials, Risk Management | Tagged: Calvin Wiese, david marcinko, financial advisors, financial risk, Harry Markowitz, Healthcare Organizations, hospital risk management, Merton Miller, Modern Portfolio Theory, MPT, William Sharpe, www.healthcarefinancials.com | Leave a comment »

Techno-philic versus Patient-phobic Medical Care

Posted on November 24, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Medicine Needs to get Back to Hands-on Basics, Rather than Focusing on Technology

By Staff Reporters

According to Rahul Parikh MD, there is plenty to criticize in our bungling trek toward health reform. Leaders on the right, left and at 1600 Pennsylvania Avenue have sidestepped the crucial conversation of controlling the cost of care, in favor of partisan rhetoric about “death panels” and “rationing care.”

Technophilic Doctors, Legislators and Patients

Worse, our entire focus seems to be toward technology and away from hands-on basic patient-philic care; starting with a detailed history and careful physical examination [remember Barbara Bates MD?]. And, all stakeholders are partly at fault.

Assessment

Here are a few related posts from Kevin Pho, MD.

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Career Development, Ethics, Health Economics, Information Technology, Quality Initiatives | Tagged: Barbara Bates, dealth panels, healthcare reform, kevin pho, Rahul Parikh, rationed care | 2 Comments »

Dear Doctor – “I’m from the Government and I’m Here to Help”

Posted on November 20, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Only-in-America

By Staff Reporters

CMS Cuts Medicare 21% for Doctors Unless Congress Acts

The Centers for Medicare and Medicaid [CMS] just reported to the American Medical News that the final 2010 Medicare physician fee schedule confirms 21.2% pay cut starting Jan. 1, 2010, unless Congress adopts legislation to avert it.

So, enter John Kerry to the Rescue

Kerry Bill Helps Physicians Borrow Money for eMRs

But to qualify for electronic health record government subsidies, to be paid in increments over five years starting in 2011, physicians must lay out a substantial sum, take a lease, or borrow the money. So, to make it easier for doctors to purchase eMR systems, Sen. John Kerry (D-Mass) has proposed legislation that would allow small practices to get loans backed by the Small Business Administration (SBA).

Moreover, a press release from Kerry’s office stated that the money could be spent on “computer hardware, software, and other technology that will assist in the use of electronic health records and prescriptions.”

Link: Continued at BNet Healthcare.

Assessment

Yet, health economist and ME-P Publisher-in-Chief Dr. David Edward Marcinko opined:

“Is this sleight-of-hand chicanery akin to stealing from Peter to pay Paul”?

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Breaking News, Health Economics, Health Law & Policy, Information Technology | Tagged: American Medical News, ARRA, CMS, david marcinko, EMRs, health information technology, HITECH, John Kerry, SBA | 3 Comments »

Investment Returns Drop for Nonprofit Healthcare Organizations

Posted on November 19, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Commonfund Report

By Roy Chernus
SK Communication, LLC for Commonfund

Did you know that nonprofit healthcare organizations reported average investment returns which dropped [minus] -21.2% in fiscal year 2008, ending December 31st 2008?

Results

Attached below is a press release with findings from the 2009 Commonfund Benchmarks Study of Healthcare Organizations. The 143 participating healthcare organizations represented total investable and Defined Benefit plan assets of $113.8 billion, comprising investable assets of $81.6 billion and $32.2 billion in DB plan assets.

Assessment
www.commonfund.org/Commonfund/Archive/CF+Institute/2009+0921+CBS+Healthcare+Press+Release.htm

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Investing, Portfolio Management, Retirement and Benefits | Tagged: commonfund, defined benefit plans, non-profit healthcare organizations, roy chernus | 3 Comments »

Part D Payer Shares of Prescriptions Dispensed Rise

Posted on November 18, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Increase for Eight Major Drug Classes

[By Staff Reporters]

The shares of all prescriptions dispensed covered by Medicare Part D rose by at least three percentage points, between midyear 2007 and midyear 2009, in each of eight major drug classes profiled.

Assessment

The largest percentage increases over this period were in the osteoporosis (to 26.9% in 2009 from 20.5% in 2007) and anti-platelet (to 28.4% from 22.5%) markets as of September 9, 2009.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: Drugs and Pharma, Health Economics, Managed Care | Tagged: medicare, Medicare Part D, Part D | 6 Comments »

Recovery Asset Contractor Survey Poll

Posted on November 17, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

RAC RESULTS TO-DATE [Beta]

By Staff Reporters

According to the Centers for Medicare and Medicaid Services [CMS], RACs collected about $1-B in improper payments during their recent beta testing period. Of these payments; 96% were over-payments, 4% were under-payments; and 77% of providers failed to appeal, 7% appealed successfully and 15% appealed unsuccessfully.

Going forward there will be a three year “look-back period”, and a 10% contingency payment level for the four regional RACs currently in the program:

Connolly Consulting
PRG-Schultz
HealthDataInsights
Diversified Collections Services

By 2010, the RAC program is scheduled to launch in all 50 states. And so, please cast your vote in our exlcusive ME-P RAC program survey poll.

Conclusion

Filed under: Ethics, Health Economics, Monthly Reports, Practice Management, Professional Liability, Quality Initiatives, Surveys and Voting | Tagged: CMS, CMS over-payments, CMS under-payments, Connolly, HealthDataINsights, PRG-Schulz, RAC, Recovery Asset Contractor | 19 Comments »

About Carena In-Home Medical Care

Posted on November 10, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

In-Home Medical Care Services for the Modern Era

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

We have written about the high cost, questionable quality and scheduling burden of emergency room visits on the Medical Executive-Post before. And, for some non-emergency or after-hours needs, the ER may possibly be one of the worst places to deliver medical care.

Enter Carena, Inc

Seattle-based Carena Inc. was founded in 2000 on the principle that expanding access to medical care improves outcomes and reduces costs. By providing around-the-clock medical care and education at a patient-identified time of need, Carena patients, clients and health plans are reported to experience lower costs while patients receive the right care – at the right time [www.CarenaMD.com].

A New [Old] Business Model

Carena is not an emergency room, not an urgent care center and not someplace patients go. This medical group delivers 24/7 house-calls both to render care and provide education for urgent medical needs.

House calls last as long as needed—often an hour—to make sure patients have the care and education needed to take control of their health.

The Carena model also offers medical care at the workplace enabling corporate clients to offer on-site care without the cost and space requirements of a typical employer-sponsored health clinic.

Home Visits in the Modern Era

Carena medical group physicians treat a wide range of urgent concerns. They carry an updated version of the traditional “doctor bag” filled with state-of-the art and portable instruments. For example, physicians have the equipment to suture minor cuts, deliver nebulizer treatments for asthma, or obtain lab samples. They run in-home rapid diagnostic tests for influenza, strep throat, and other medical issues. If X-rays or tests are needed, physicians coordinate scheduling and share results with patient PCPs. Electronic medical records are used throughout.

Always Open 24/7

Carena is always open. No waiting in the ER while doctors treat true emergencies. No wondering if other waiting patients are contagious.

Reduced Financial Shock.

Carena house calls are reported to costs about 30-35 percent less than a typical emergency room visit of about $1,500.

Another New Term

With apologies to my esteemed colleague Robert M. Wachter MD, the hospitalist guru at UCFS, Carena doctors are often called “housepitlists.”

Assessment

Carena is a medical company that provides a new model of health care delivery for innovative, self-insured companies. Internist Frances Gough MD is the Vice President of Product Development at Carena, Ted Conklin MD is the founder and Ralph C. Derrickson is President and CEO. Corporate clients for both Carena business models are Costco and the Microsoft Corporation of Redmond, WA.

Disclaimer

I own shares of MSFT common stock and am a professional member of MS-HUG.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Filed under: Career Development, Health Economics, Health Insurance, Managed Care, Practice Management, Research & Development | Tagged: Carena, Dr. Marcinko, emergency room, ER, house calls, housepitalist, in home medical care, PCP, Robert Wachter | 1 Comment »

A New Remote Patient Monitoring Device

Posted on November 8, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Next Step in RPM Solutions

[By Staff Reporters]

Long-term medical conditions create many challenges—for patients who have them, as well as for their attending physicians. This gadget reports to address those challenges

What it Is

The Intel® Health Guide is a comprehensive, next-generation remote patient monitoring (RPM) solution that combines an in-home patient device [the Intel Health Guide PHS6000] with the Intel® Health Care Management Suite; an online interface that allows clinicians to monitor patients and remotely manage care.

Reported Benefits

The benefits of the Intel Health Guide include patients who feel empowered to take a more active and positive role in their own care. For doctors, it enables more informed and personalized care—which may lead to better patient satisfaction. And it helps healthcare organizations to face the challenges of chronic care, increase efficiency, and achieve organizational objectives.

Assessment

In short, Intel® technology hopes to fulfill the promise of RPM, where interactive, data-rich telehealth helps to create timely, personalized and cost-effective care.

Disclaimer

The Intel® Health Guide requires an internet connection to enable communications with the patient’s care team and back-end data hosting. The Intel Health Guide is intended for use by patients under the guidance of a healthcare professional and is not intended for emergency medical communications or real-time patient monitoring.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

***

Filed under: "Doctors Only", Health Economics, Information Technology, Practice Management | Tagged: Intel, Intel Health Guide, remote patient monitoring | 1 Comment »

Uninsured and Eligible for Public Coverage

Posted on November 3, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Underlying Causes and Policy Solutions

Submitted Nancy Chockley
President and CEO
NIHCM Foundation www.nihcm.org

Policymakers working to reduce the number of persons without health insurance sometimes note the significant number of uninsured who are already eligible for public coverage but not enrolled. In this essay, Dr. Genevieve Kenney of the Urban Institute explores reasons behind this phenomenon and describes steps that can be taken to facilitate and encourage enrollment among eligible individuals. She stresses the importance of multi-faceted approaches that promote program awareness, simplify eligibility determination, and automate enrollment and renewal processes. As our country considers expansions in publicly funded coverage, these lessons should be top of mind in order to maximize program enrollment and reach as many uninsured people as possible.

Expert Voices

Other recent Expert Voices essays on health reform include:

Eric Jensen, Consultant, and Lenny Mendonca, McKinsey & Company, “Why America Spends More on Health Care” (November 2009)
Jonathan Gruber, PhD, Professor of Economics, Massachusetts Institute of Technology, “The Role of Individual Mandates in Health Reform” (January 2009).
Paul N. Van de Water, PhD, Senior Fellow, Center on Budget and Policy Priorities. “Scoring Health Legislation” (April 2009).

Assessment

I hope you enjoy reading this essay and the ones that follow.

Conclusion

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Alerts Sign-Up, Health Economics, Health Insurance, Research & Development | Tagged: Center on Budget and Policy Priorities, Eric Jensen, Genevieve Kenney, Jonathan Gruber, Lenny Mendonca, Nancy Chockley, NIHCM Foundation, Paul N. Van de Water, Urban Institute | 1 Comment »

About Archimedes.com

Posted on October 25, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Mathematic Model of Human Disease?

By Staff Reporters

No, we don’t mean the classical scientist of antiquity. Rather, Archimedes is an independent healthcare modeling organization located in San Francisco. Their core technology – the Archimedes Model – is a mathematical model of human physiology, diseases, interventions and healthcare systems. The Model is reportedly detailed, rigorously validated and made available for use by health plans, pharmaceutical companies, researchers, and other organizations to help understand and resolve vital clinical and administrative healthcare questions.

The Model

Founders

Archimedes was founded by industry veterans David Eddy MD PhD, and Len Schlessinger PhD.

Disease Entities

Currently the Model includes:

Diabetes and complications
Coronary artery disease
Hypertension
Congestive heart failure
Stroke
Dyslipidemia
Obesity
Metabolic syndrome
Asthma
Colon cancer
Breast cancer
Lung cancer

Other conditions are continuously being added.

Assessment

By using advanced methods of mathematics, computing, and data systems, the Model strives to enable managers, administrators, and policymakers to be better informed and to make smarter decisions than has previously been possible. So, give em’ a click and tell us what you think?

Link: http://archimedesmodel.com/index.html

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: "Doctors Only", Drugs and Pharma, Health Economics, Healthcare Finance, Research & Development | Tagged: Archimedes Model, Archimedes.com, David Eddy MD PhD, Len Schlessinger PhD, mathematical models, medical data systems | 1 Comment »

Why America Spends More on Healthcare

Posted on October 23, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A McKinsey Global Institute Review

By Nancy Chockley; PhD
President & CEO
NIHCM Foundation

Path breaking work by the McKinsey Global Institute (MGI) shows that, relative to other peer countries from the Organization for Economic Cooperation and Development, the U.S. spends nearly $650 billion more on health care than would be expected after adjusting for cross-country differences in wealth. Fully two-thirds of this added spending occurs in the outpatient sector.

Out-Patient Services

The highly profitable nature of many outpatient services coupled with the incentives of a fee-for-service payment system are contributing to greater intensity of outpatient care and helping to fuel this spending. In this essay, “Why America Spends More on Health Care,” Eric Jensen and Lenny Mendonca describe MGI’s work to examine all sectors of the American health care system and identify factors responsible for the higher-than-expected spending.

More Examples

Other recent Expert Voices essays on health reform include:

Jonathan Gruber, PhD, Professor of Economics, Massachusetts Institute of Technology, “The Role of Individual Mandates in Health Reform” (January 2009).
Paul N. Van de Water, PhD, Senior Fellow, Center on Budget and Policy Priorities. “Scoring Health Legislation” (April 2009).
Mark Fendrick, MD, University of Michigan Medical Center and Michael Chernew, PhD, Harvard Medical School, June 2009. “Value Based Insurance Design” (June 2009).
I hope you enjoy reading this essay and those that follow.

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Breaking News, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Op-Editorials, Research & Development | Tagged: Eric Jensen, Expert Voices, Harvard Medical School, Jonathan Gruber, Lenny Mendonca, Mark Fendrick, McKinsey Global Institute, Michael Chernew, Michigan Medical Center, MIT, Nancy Chockley, NIHCM, NIHCM Foundation, Paul N. Van de Water | 3 Comments »

Congressional Budget Office Healthcare Reports of Interest

Posted on October 18, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Ten [10] Aggregated CBO Reports

By Staff Reporters

Courtesy of Healthcare Town Hall:

Assessment

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Health Insurance, Healthcare Finance, Information Technology | Tagged: health information technology, health unsurance, healthcare costs, healthcare economics, healthcare reform, Healthcare Town Hall, ObamaCare, pharmaceutical pricing | 1 Comment »

Participating versus Non-Participating Doctors

Posted on October 15, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Medicare Medical Payment Schemes

By Staff Reporters

www.HealthcareFinancials.com

As of 1992, Medicare invoices are paid per resource-based relative value unit (RBRVU), and according to the lesser of the actual billed charges or the fee schedule amount. But, there are two types of medical providers: 1. Doctors who accept Medicare assignment only bill the patient for the co-payment, which is usually 20%. 2. Doctors who do not accept Medicare assignment are offered a lower fee schedule of 95% of the approved schedule, which is a 115% maximum fee limit of the approved schedule.

Example:

A participating physician’s approved fee schedule charge of $100 would yield $80 from Medicare and $20 from the patient. A non-participating (Non-Par) doctor with charges of $200, and with an approved fee schedule of $100, would yield: $109.25 = (.95 X $100) X 1.15 entirely from the patient.

If the Non-Par doctor selects payment type on a case-by-case basis, Medicare will pay its portion of the bill directly to the physician, but the doctor must accept the Non-Par fee schedule.

Assessment

Continuing our example yields: (.8 X $95) plus the patient’s co-payment of (.2 X $95), OR $76 plus $19 = $95.00.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: medicare, medicare providers, non-participating medicare physician, Participating medicare physician, RBRVU, resource-based relative value unit | 1 Comment »

Become a Published Print Author with Us

Posted on October 13, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

The Business of Medical Practice [3^rd Edition]

By Hope Rachel Hetico RN, MHA, CMP™

[Managing Editor]

Dear Colleagues and ME-P Champions

As you may know, we are commencing work on the third edition of our best selling book: The Business of Medical Practice

TOC 1st: http://www.amazon.com/Business-Medical-Practice-Maximizing-Doctors/dp/0826113117/ref=sr_1_8?ie=UTF8&s=books&qid=1231111232&sr=1-8

TOC 2nd: http://www.springerpub.com/prod.aspx?prod_id=23759

Invitation to Contribute

Accordingly, we would be honored for you to consider contributing a new or revised chapter, in your area of expertise, for a low-effort but high-yield contribution. Our goal is to help physician colleagues and management executives benefit from nationally known experts, as an essential platform for their success in the healthcare industry. Many topics are still available: [health accounting; law, policy and administration; Medicare fraud and abuse; cloud computing; and finance and economics, etc].

Support Always Available

Editorial support is available, and you would enjoy increasing subject-matter notoriety, exposure and public relations in an erudite and credible fashion. As a reader, or preferably a subscriber to the ME-P, your synergy in this space may be ideal. Time line for submission of a 5,000-7,500 word chapter is ample, and in a prose writing style that is “wide, not deep.”

A Health 2.0 Initiative

And, be sure to address health 2.0 modernity. Update chapters from the second edition are also available.

Definition: https://healthcarefinancials.wordpress.com/2008/09/12/emerging-healthcare-20-initiatives

Assessment

Please contact me for more details [MarcinkoAdvisors@msn.com], if interested [770.448.0769]. A best selling-book is rare; while a third-edition volume even more so. Join us in this project. Regardless, we trust you will remain apostles of our core ME-P vision, “uniting medical mission and financial profit margin”, and promoting it whenever possible.

Front Matter Link: frontmatter1advancedbusinessmedicine

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: "Advisors Only", "Doctors Only", Book Reviews, Breaking News, Career Development, Ethics, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Information Technology, Managed Care, Media Mentions and PR, Practice Management, Professional Liability, Quality Initiatives, Recommended Books | Tagged: acountants, american medical writers association, authors, contributors, doctors, experts, JDs, journalists, lawyers, managers, MBAs, MDs, PhDs, publishers, writers | Leave a comment »

Healthcare Reform Articles from Kevin Pho MD

Posted on October 11, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Aggregating Content – Disseminating Knowledge

By Ann Miller; RN, MHA

[Executive Director]

Here are five interesting new articles on the healthcare reform debates from colleauge Kevin Pho, MD.

Kevin practices at the Nashua Medical Group near the Massachusetts border. He is board certified in internal medicine and provides both comprehensive adult and primary care services.

Related posts:

Give them a click, read em’ and comment now.

Assessment

Remember, how we put things together – sets us apart!

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Op-Editorials, Research & Development | Tagged: barack obama, DPM, Health Insurance, healthcare reform, kevin pho, Max Baucus, MD, pho, podiatrist, podiatry, primary care, Uwe Reinhardt | 1 Comment »

Update on the Medicare Oriented Universe

Posted on October 3, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

October Plan Management Navigator

By Douglas B. Sherlock; MBA, CFA

Please find attached the October 2009 edition of our Plan Management Navigator.

Medicare-Orientated Universe

In this month’s edition, we update ME-P and all readers on the results for the Medicare-Oriented universe, and provide summary functional area breakouts as well as expense trends. Holding constant the universe, and the product mix offered, administrative expense growth was higher than last year.

For example, eleven Medicare-Oriented plans serving 1.1 million beneficiaries participated in this year’s benchmarking study. In addition, the results from Blue Cross Blue Shield Plans and Independent / Provider-Sponsored Plans are also summarized. With these additional plans, we provide selected information on health plans serving 2.1 million Medicare beneficiaries, comprising approximately 22% of Medicare Advantage members during 2008.

Assessment

The analysis is based on materials from our Sherlock Expense Evaluation Report (SEER) for the Medicare-Oriented Plans. Additional information about SEER is available at www.sherlockco.com/seer.shtml or by contacting me.

Link: Navigator 10-09

Channel Surfing

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Sponsors Welcomed

And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

Filed under: Breaking News, Health Economics, Monthly Reports, Research & Development | Tagged: Blue Cross Blue Shield Plans, Douglas B. Sherlock, Medicare Advantage, Plan Management Navigator, SEER, Sherlock Expense Evaluation Report, www.Sherlockco.com | 2 Comments »

Critical Expense Issues in Healthcare Reform

Posted on September 24, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

American Academy of Actuaries Report

By John Park

Health Care Analyst

Sherlock Company

jpark@sherlockco.com

ME-P Subscribers

Late last week, the American Academy of Actuaries released the attached paper discussing administrative functions and expenses. It is designed to provide an actuarial perspective relating to various components of comprehensive health care reform proposals.

Assessment

Sherlock Company benchmarks, as excerpted in the Plan Management Navigator, are cited in the paper and we thought you might find it of interest.

Link: American Academy Actuaries

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Filed under: Alerts Sign-Up, Breaking News, Health Economics, Health Insurance, Healthcare Finance, Managed Care, Research & Development | Tagged: American Academy of Actuaries, Healthcare Expenses, healthcare reform, John Park, Plan Management Navigator, Sherlock Company | 1 Comment »

« Previous Page — Next Page »

Subscribe MEDICAL EXECUTIVE-POST?

Member Statistics

ME-P Information & Content Channels

Ann Miller RN MHA [Managing Editor]

CERTIFIED MEDICAL PLANNER® program

Most Recent ME-Ps

PodiatryPrep.org

ME-P Free Advertising Consultation

Medical & Surgical e-Consent Forms

iMBA Inc., OFFICES

ME-P Publishing

SEEKING INDUSTRY INFO PARTNERS?

Reader Comments, Quips, Opinions, News & Updates

Start-Up Advice for Businesses, DRs and Entrepreneurs

Up-Trending ME-Ps

Capitalism and Free Enterprise Advocacy

OIG Fraud Warnings

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Increase for Eight Major Drug Classes

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Share this:

Calendar

Advertising Info:

Book Offerings:

Dictionary Offerings:

Dr. David Marcinko [Publication List]

Education Online:

Health Dictionary Series Wiki Project

Lower Extremity Medicine & Surgery

Pending NIHCM Grant Applications:

Practice Lists:

Professor Marcinko

Related Blogs: