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DAVID EDWARD MARCINKO IS AT YOUR SERVICE IN 2020-2021
INVITATION:
TO SCHEDULE A SEMINAR, SPEAKING ENGAGEMENT, POD OR VLOG-CAST:
Contact: Ann Miller RN MHA CMP®
MarcinkoAdvisors@msn.com
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Filed under: Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc., Investing, Touring with Marcinko | Tagged: Daivd Marcinko | 1 Comment »
Payor Savings Evidence?
New Evidence for Private Payor Savings Through Bundled Payments
A new RAND Corporation study on bundled payments in the private sector was published in the March 2021 issue of Health Affairs. The study analyzed data from over 2,000 procedures performed as part of a direct payment program by Carrum Health between 2016 and 2020, and found significant savings from this bundled payment program, without any significant changes in quality. This study adds important evidence to the argument in favor of bundled payments and is especially important because it examines the under-studied area of bundled payment models from commercial payment systems. (Read more…)
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Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: bundled care, bundled payments, episodes care | Leave a comment »
Amazon’s New Moves in Healthcare
By Health Capital Consultants, LLC
Amazon, the largest e-commerce company in the world, has made large, strategic moves over the past several years to make a place for themselves in healthcare. This article will review Amazon’s most recent advancements in the industry, including those related to Amazon’s voice-controlled personal assistant, Alexa, and Amazon’s employee healthcare system, Amazon Care, and how this non-healthcare company is changing the industry. (Read more…)
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Filed under: Health Economics, Health Insurance, Healthcare Finance, Information Technology | Tagged: Amazon, Amazon Healthcare | Leave a comment »
Healthcare Provisions in the American Rescue Plan
By Health Capital Consultants, LLC
On March 11, 2021, President Joe Biden signed into law the American Rescue Plan Act of 2021 (ARPA). The law looks to alleviate the burden felt by the millions of people who lost their employer-sponsored health insurance over the first six months of the pandemic and assist the hardest-hit communities through the extension of the Patient Protection & Affordable Care Act (ACA) and Consolidated Omnibus Budget Reconciliation Act (COBRA) subsidies, expanding Medicaid coverage, increasing funding for behavioral health, ramping up COVID-19 vaccines and testing, providing financial relief for rural providers, and enacting other individual and healthcare system protections. (Read more…)
Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc. | Tagged: American Rescue Plan Act, ARPA | Leave a comment »
Changes Due to Activity
[By staff reporters]
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Filed under: Health Economics, Health Insurance, iMBA, Inc., LifeStyle | Tagged: activity, mortality, obesity | Leave a comment »
Filed under: Health Economics, Health Insurance, iMBA, Inc. | Tagged: deductibles, Health Insurance, premiums | Leave a comment »
CMS Reimbursement Reductions 2021
By staff reporters
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MORE:
Anesthesiology, -21 percent
Physician assistant, -21 percent
General surgery, -20 percent
Cardiology, -19 percent
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Filed under: Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc. | Tagged: CMS, CMS reductions, CMS reimbursements | 1 Comment »
FINANCIAL OPINIONS OF MEDICAL PRACTICE FAIR MARKET VALUE [FMV]
Courtesy: https://lnkd.in/eBf-4vY
Plastic Surgery-Medical Practice Worth, Valuation, Sales & Succession Planning
For doctor-colleagues, buying or selling a practice may be the biggest financial transaction of their lives. Reasons for appraising practice worth include: sales, merger, succession, retirement and estate planning; partnership disputes and divorce; or as an important tool for organic growth and strategic planning.
DHEF: https://lnkd.in/dqdbWM9
FOREWORD: https://lnkd.in/ecwZWxu
However, the transaction is fraught with many pitfalls to avoid and no medical specialty seems immune; especially when it comes to contentious fair market value [FMV] appraisals.
ESSAY: https://lnkd.in/eujJySP
MAXIMIZATION: https://lnkd.in/dG8UYaa
BLUNDERS: https://lnkd.in/etgDpqr
Your comments are appreciate.
BUSINESS, FINANCE, INVESTING & INSURANCE TEXTS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
THANK YOU
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Filed under: Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc. | Tagged: fair market valuation, FMV | Leave a comment »
ON “PRUDENCE” IN FINANCE AND INVESTMENT MANAGEMENT
Courtesy: https://lnkd.in/eBf-4vY
TERMS & DEFINITIONS FOR PHYSICIANS
PRUDENT BUYER: The efficient purchaser of market balance between value and cost.
PRUDENT MAN RULE: An 1830 court case stating that a person in a fiduciary capacity (a trustee, executor, custodian, etc) must conduct him/herself faithfully and exercise sound judgment when investing monies under care. “He is to observe how men of prudence, discretion and intelligence manage their own affairs, not in regard to speculation, but in regard to the permanent distribution of their funds, considering the probable income as well as the probable safety of the capital to be invested.” Allows for mutual funds and variable annuities.
PRUDENT INVESTOR RULE: A fiduciary is required to conduct him/herself faithfully and exercise sound judgment when investing monies and take measured and reasonable investment risks in return for potential future rewards. Allows for mutual funds, stocks, bonds, variable annuities asset allocation & Modern Portfolio Theory.
DHEF: https://lnkd.in/dqdbWM9
FOREWORD: https://lnkd.in/ecwZWxu
BUSINESS, FINANCE, INVESTING & INSURANCE TEXTS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
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If They Speak Out About Lack of Gear
By Staff Reporters
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LINK:
Your thoughts are appreciated
THANK YOU
Filed under: Health Economics, Health Insurance, Health Law & Policy, Practice Management | Tagged: corona virus, fired doctors, fired nurses, pandemic unemployment | Leave a comment »
The SEC Filing
SIGNIFY HEALTH Goes Public
By Signify Health
https://lnkd.in/ePKNEak
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Filed under: Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc. | Tagged: SEC, Signify Health | Leave a comment »
RESEARCH REPORT
The Effects of Medicare Buy-In Policies for Older Adults on Health Insurance Coverage and Health Care Spending
December2020 (corrected February 2021)
LINK:
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Filed under: Health Insurance | Tagged: medicare, Medicare Part C | 1 Comment »
NBER WORKING PAPER SERIES
THE HEALTH COSTS OF COST-SHARING
Working Paper: 28439
http://www.nber.org/papers/w28439
DHEF: https://lnkd.in/dqdbWM9
NATIONAL BUREAU OF ECONOMIC RESEARCH
1050 Massachusetts Avenue
Cambridge, MA 02138
February 2021
Filed under: Experts Invited, Health Economics, Health Insurance | Tagged: cost sharing, employee cost sharing, Health Insurance | Leave a comment »
BUSINESS & MANAGEMENT TEXTBOOKS OF INTEREST TO SAVVY PHYSICIANS
Courtesy: https://lnkd.in/eBf-4vY
Health Economics, Finance, Accounting, Investing, HR and Insurance; etc.
BOOKS: https://lnkd.in/dys_xQz
INVITATION: https://lnkd.in/d2SefCY
SPEAKING TOPIC LIST: https://lnkd.in/e7WrDj9
MY “AVATAR”: https://lnkd.in/d6BU-TQ
Thank You
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Filed under: Career Development, Glossary Terms, Health Economics, Health Insurance, iMBA, Inc. | Tagged: Health Economics, Health Insurance, Healthcare Finance | Leave a comment »
Top 15 Earning Managers for 2020
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Filed under: Health Economics, Health Insurance | Tagged: hedge funds | 2 Comments »
Your comments are appreciated.
THANK YOU
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Filed under: Drugs and Pharma, Health Economics, Health Insurance | Tagged: insulin, insulin cost | Leave a comment »
What Else is New?
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EHR Vendor Pays $18M to Settle Kickback Allegations | MedPage Today
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Filed under: Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology | 2 Comments »
WHAT ARE “LIMITS” OF MALPRACTICE INSURANCE LIABILITY?
Courtesy: https://lnkd.in/eBf-4vY
HEALTH ECONOMICS DICTIONARY:
DEFINITION: What the insurance company will pay on a doctor’s behalf in the event of a claim. If your limits of liability are “$1,000,000 / $3,000,000” it would mean that the insurance company would pay a maximum of $1 million per occurrence and $3 million per year for claims.
For further clarification, refer to the examples below and assume limits of liability of 1,000,000 / $3,000,000:
· In one year you have 4 lawsuits each for $800,000:
The insurance company pays $3,000,000 and you are responsible for $200,000.
· In one year you have 2 lawsuits each for $2,000,000:
The insurance company pays $2,000,000 ($1 million each) and you are responsible for $2,000,000 ($1 million each).
· In one year you have 9 lawsuits each for $20,000:
The insurance company would pay everything.
However, most states have minimum requirements for limits of liability should you have hospital privileges. And so your thoughts are appreciated.
BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
Thank You
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Filed under: Health Economics, Health Insurance, Health Law & Policy | Tagged: malpractice, malpractice insurance | 1 Comment »
DISCLOSURE OF CASH PRICE
SECTION 1.
(a) In this section, “hospital” means a hospital: (1) licensed under Chapter 241; or (2) owned or operated by this state or an agency of this state. (b) A hospital shall disclose the hospital’s cash price for each health care service regularly provided by the hospital. The required disclosure must be made: (1) by posting the prices on the Internet website of the hospital; or (2) if the hospital does not have an Internet website, by providing the prices in writing on request to any person.
SECTION 2. This Act takes effect September 1, 2021.
Filed under: Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc. | Tagged: hospital cash price | 1 Comment »
A Rapid Rise in COVID-19 Cases?
By CDC.gov
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Filed under: "Doctors Only", Drugs and Pharma, Health Insurance | Tagged: corona variants, Covid-19 | 2 Comments »
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Filed under: Health Economics, Health Insurance | Tagged: Medicare budget | Leave a comment »
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Filed under: Health Economics, Health Insurance | Tagged: corona pandemic, health insurers' profits, US Health Insurers' Profits Amid the Pandemic | Leave a comment »
New Years Resolutions 2021 [Repost]
By Nathan Kaufman • 1st Managing Director at Kaufman Strategic Advisors
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Filed under: Experts Invited, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Nate Kaufman | Leave a comment »
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COVID-19 and Long Term Care Facilities
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Filed under: Health Insurance | Tagged: Covid-19, LTC insurance, pandemic | Leave a comment »
Not Inflation Protected
By Federal Register
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Filed under: Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc. | Tagged: federal register, Physician Reimbursement | Leave a comment »
THE BUSINESS OF MEDICAL PRACTICE AND HOSPITAL MANAGEMENT
BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
HOSPITAL MANAGEMENT & BUSINESS TEXTS FOR PHYSICIANS AND CXOs:
1 – https://lnkd.in/eEf-xEH 2 – https://lnkd.in/e2ZmewQ
“DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE”
DHEF: https://lnkd.in/dqdbWM9
DHIMC: https://lnkd.in/e9AmEhd
DHITS: https://lnkd.in/eWx3WjZ
MORE: https://lnkd.in/eVGcji5
THANK YOU
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Filed under: Financial Planning, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, iMBA, Inc. | Tagged: “Investment Planning for Financial Professionals” | Leave a comment »
COVID-19 [NIHCM]
By staff reporters
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Filed under: Drugs and Pharma, Glossary Terms, Health Economics, Health Insurance | Tagged: corona disparity, covid racism | 1 Comment »
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Filed under: Health Economics, Health Insurance, iMBA, Inc. | Tagged: ACOs, CMS, Value-Based care, VBID | Leave a comment »
Healthcare Transparency
By Health Capital Consultants, LLC
On October 29, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Transparency in Coverage final rule. This long-anticipated final rule stems from President Donald Trump’s June 2019 executive order on “Improving Price and Quality Transparency” and builds upon the hospital Outpatient Prospective Payment System (OPPS) price transparency requirements released in November 2019.
These requirements came under fire in a lawsuit filed by the American Hospital Association (AHA), Association of American Medical Colleges (AAMC), Children’s Hospital Association (CHA), and Federation of American Hospitals (FAH), against the Department of Health and Human Services (HHS); the requirements were upheld by the courts in June 2020 and the lawsuit is being appealed by the plaintiffs. (Read more…)
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Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc. | Tagged: Health Capital Consultants LLC, healthcare transparency | Leave a comment »
Estimated Impacts
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Filed under: Health Economics, Health Insurance | Tagged: corona economics, covod economic impact | Leave a comment »
CIRCA 1969 = Morristown Memorial Hospital, NJ, USA
By Anonymous
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“DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE”
DHEF: https://lnkd.in/dqdbWM9
DHIMC: https://lnkd.in/e9AmEhd
DHITS: https://lnkd.in/eWx3WjZ
MORE: https://lnkd.in/eVGcji5
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I rotated thru this facility back when I was at Temple University
Dr. David Edward Marcinko MBA
ME-P Editor-in-Chief
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Filed under: Health Economics, Health Insurance, Touring with Marcinko | Tagged: David Marcinko MBA, hospital bill | Leave a comment »
An Info-Graphic?
By Staff Reporters
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Filed under: Glossary Terms, Health Economics, Health Insurance, Quality Initiatives | Tagged: corona, corona virus deaths, pandemic | 1 Comment »
Self Immolation
[By staff reporters]
A veteran committed suicide by setting himself on fire in front of a New Jersey VA clinic after staff at the clinic repeatedly failed to ensure he received adequate mental health care, an investigation of the death found.
Department of Veterans Affairs staff canceled an appointment Charles Ingram had in fall 2015 because a provider was unavailable, didn’t follow up to reschedule, and when he walked into the clinic to ask for an appointment, they didn’t schedule it until three months later, the VA inspector general found.
Ingram, a 51-year-old Gulf War veteran, had been approved to receive treatment at a non-VA facility, but no one at VA contacted him or scheduled the appointment.
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Filed under: Ethics, Health Insurance, Health Law & Policy | Tagged: VA, Veteran Suicide in Front of VA Hospital | 7 Comments »
[By Staff Reporters]
As a doctor, you have a unique position in society and the ability to help your fellow man/woman during the most frail, jubilant and sacred times of human life; even unto the end.
HELP a Veteran today!
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Assessment
Similarly, as a financial advisor, you have a unique position in society and the ability to help your fellow man/woman during their most financially fragile times of life; even unto the end.
So, be a fiduciary advisor; not just a Registered Representative, commissioned sales person, or agent.
HELP a Veteran today!
More: Are You Providing Pro Bono Financial Advice? [Voting Poll and Survey]
MORE: VA Cost Accounting
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
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Although this book targets physicians, I was pleased to see that it also addressed the risk management, financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable.
Captain CASH Unit Iraq [retired] – Cecelia T. Perez RN [Hospital Operating Room Manager, Ellicott City, Maryland
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Filed under: Career Development, Ethics, Financial Planning, Health Insurance, iMBA | Tagged: Help a Veteran, pro bono financial planning, pro-bono medical care, VETERAN'S DAY 2018 | 8 Comments »
Medicare cuts by specialty 1/1/2021
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Filed under: Health Economics, Health Insurance, Health Law & Policy | Tagged: medicare, Medicare cuts by specialty | Leave a comment »
By Howard Green MD
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Health Insurance industry redistributing unlimited cash from patient premiums into the Georgia US Senate run off election to prevent a Democrat Senate Majority from removing the health insurance exemption to Federal antitrust, monopoly, price fixing and collusion McCarran Ferguson laws.
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Filed under: Health Insurance, Health Law & Policy, iMBA, Inc. | Tagged: Health Insurance, Howard Green MD, McCarran-Ferguson Act | Leave a comment »
ADVERSE SELECTION:
By staff reporters
The tendency of people who are less than standard health insurance risks to seek or continue insurance to a greater extent than other individuals. This so called “selection against the insurer”, or “anti-selection”, is a form of stacking the deck and is also found in the tendency of policy owners to take advantage of favorable options in health insurance or managed care contracts.
Or, a particular health plan, whether indemnity or managed care, is selected against by the enrollee, and thus an inequitable proportion of enrollees requiring more medical services are found in that plan.
Example: Low enrollee out-of-pocket costs might lure those individuals requiring more health services into an HMO rather than an indemnity-plan because the former does not have a deductible.
Therefore, the HMO would have a greater proportion of less-healthy enrollees, thereby driving up costs and increasing financial risks. Also occurs with one of the following:
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“DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE”
DHEF: https://lnkd.in/dqdbWM9
DHIMC: https://lnkd.in/e9AmEhd
DHITS: https://lnkd.in/eWx3WjZ
MORE: https://lnkd.in/eVGcji5
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Filed under: Health Insurance, Health Law & Policy | Tagged: adverse selection | Leave a comment »
Free Market Health Care = NOT!
By Nate Kaufman
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Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: free market medicine | 1 Comment »
COACHING MEDICAL COLLEAGUES IN BUSINESS & FINANCIAL PLANNING
https://lnkd.in/eBf-4vY
For Doctors – By Doctor Colleagues – Confidential Mentoring
By Dr. David E. Marcinko MBA CMP
BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE
DHEF: https://lnkd.in/dqdbWM9
DHIMC: https://lnkd.in/e9AmEhd
DHITS: https://lnkd.in/eWx3WjZ
INVITATION: https://lnkd.in/d2SefCY
SPEAKING TOPIC LIST: https://lnkd.in/e7WrDj9
MY “AVATAR”: https://lnkd.in/d6BU-TQ
Thank You
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Filed under: Financial Planning, Health Economics, Health Insurance, iMBA, iMBA, Inc., Professional Liability, Quality Initiatives, Recommended Books, Risk Management | Tagged: coach, Daivd Marcinko, physician coaching, Physician mentoring | Leave a comment »
ProPublica
The thousands of “Trumpcare” ads Facebook and Google have published show that the shadowy “lead generation” economy has a happy home on the platforms — and even big names like UnitedHealthcare take part.
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Filed under: Health Economics, Health Insurance, iMBA, Inc. | Tagged: Trump-Care | Leave a comment »
The Top Five States with the Lowest Adult Un-Insurance Rates
CIRCA 2019
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Filed under: Health Economics, Health Insurance, Health Law & Policy | Tagged: State health insurance rates | Leave a comment »
Employer Rankings
[By staff reporters]
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“Medical Management and Health Economics Education for Financial Advisors”
CMP® CURRICULUM: https://lnkd.in/eDTRHex
CMP® WEB SITE: https://lnkd.in/guWSApq
Your thoughts and comments are appreciated.
BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
THANK YOU
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Filed under: Health Insurance | Tagged: America's Health Insurance Plans, Health Insurance | Leave a comment »
Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Health Capital Consultants LLC, medicare, Medicare Hospital Payments, Private Insurance | 1 Comment »
“America First Healthcare Plan”
By Robert Gergely MD
Yesterday, The President @POTUS outlined his plans for “America First Healthcare Plan”.
In 45 min. in front of Medical Professionals he brilliantly outlined a free market, competitive and PATIENTS centered philosophy for Medical Care in America. For those who care please view the video. you can find it here:https://lnkd.in/e9pxR-U
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THANK YOU
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Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: "America First Healthcare Plan", Robert Gergely MD | Leave a comment »
Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: Fraud and Abuse Costs and Cases Rose, Health Capital Consultants LLC, healthcare fraud, medical fraud | 3 Comments »
PART C
By John Kelly
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Medicare Advantage Plans (Private Medicare) are sold on a county-by-county basis. Attached is the market penetration of MA (compared to traditional FFS Medicare) for every county in the USA.
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Wonder why Medicare Advantage Premiums are going down (on average)? Because premiums are one of the measures by which the elderly decide what to purchase. Even though premiums are declining, not all MA plans are ‘cheaper’ than traditional FFS Medicare. Caveat Emptor.
It is also interesting to note that 3 carriers – Humana, UHC and BCBS Affiliates — cover 60% of all MA plan subscribers and use national networks of providers to offer broad service availability (compared to smaller plans, PSP’s and other narrow network options).
Medicare premiums per beneficiary typically exceed $10,000 per year. With effective ingenious use of benefit design, prior authorization, incentives, PBM contract rebates, etc., — there is a lot of money to be made in Medicare Advantage plans — accounting for the rapid growth in these plans over the last decade.
Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: Medicare Advantage Plans, Medicare Part C | 2 Comments »
Physician Practices Weathering the Storm of COVID-10?
By staff reporters
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Filed under: Health Economics, Health Insurance, Health Law & Policy | Tagged: corona, pandemic, pandemic unemployment | Leave a comment »
WITH ADJUDICATION CONSIDERATIONS
By Anonymous MD
Now you will learn and know just one reason why doctors are pulling their hair out, felling stress, burn out and may even consider suicide?
Only 54 pages of steps for one electronic claim.
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REPEAT: FOR EVERY PATIENT CLAIM
AETNA® – We are not glad we met ya!
Filed under: Health Insurance, iMBA, Inc. | Tagged: Aetna, medical billing, medical insurance claims | 1 Comment »
Survey Highlights on Pre-Certification
By wedi
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“DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE”
DHEF: https://lnkd.in/dqdbWM9
DHIMC: https://lnkd.in/e9AmEhd
DHITS: https://lnkd.in/eWx3WjZ
MORE: https://lnkd.in/eVGcji5
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Filed under: Glossary Terms, Health Economics, Health Insurance | Tagged: pre-certification, Prior Authorization, WEDI | 2 Comments »
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