Hospitals in the RED

Posted on October 27, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Hospitals this year are seeing more red than black as growing financial challenges, like spiked labor costs and inflation on medical supplies, puts them on pace to have the worst financial performance into the pandemic thus far.

More than half of hospitals (53% of more than 900 sampled) are projected to have negative margins by the end of the year, compared to 39% in 2019, according to a September report from management consulting firm Kaufman Hall, on behalf of AHA. The firm put the median operating margin for hospitals at about -1%, which could mean service cuts, and for more vulnerable hospitals, including rural ones, closing their doors.

But why is the financial outlook so bleak for hospitals? A few factors are conspiring:

Labor costs: The top reasons hospitals are struggling financially in 2022 are “labor, labor, and labor,” said Kevin Holloran, senior director at Fitch Ratings. The healthcare labor shortage doesn’t just extend to nurses, but across the board.

Rising supply prices: Blame inflation. AHA reported that the “costs for energy, resins, cotton, and most metals surged in excess of 30%” between fall 2020 and early 2022.

Sicker patients, longer stays: Intensive care units across the country were overwhelmed with Covid-19 patients at the outset of the pandemic, but more recently hospitals have been caring for sicker non-Covid patients, said Aaron Wesolowski, AHA’s vice president for policy research and analytics

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OPERATIONS: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

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APPLE: Health Insurance?

Posted on October 26, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Bertalan Meskó, MD PhD

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Ben Wood, chief analyst at European CCS Insights predicts that Apple will enter the US health insurance market in partnership with a major insurer in 2024 – Forbes reported. 

The company already collects heaps of health data, such as blood pressure, blood oxygen levels, ECG readings and body temperature from the Watch, and through phone apps that help people regulate their medication or manage chronic conditions like diabetes. 

I hope you find the report useful!

Best regards,
Bertalan Meskó, MD
The Medical Futurist

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RELATED: https://www.kevinmd.com/2022/10/amazon-cvs-and-walmart-are-playing-health-cares-long-game.html

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

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

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MEDICARE: Expanding Dentistry?

Posted on October 25, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Dental coverage under Medicare could soon start expanding for seniors under a new proposal from the U.S. Centers for Medicare and Medicaid Services (CMS). Still, the proposed rules would not provide full coverage for regular dental care, which has been explicitly excluded from Medicare since the program’s founding in 1965.

“Traditional Medicare doesn’t cover routine preventive dental services, such as exams, cleanings, X-rays, nor more expensive services such as fillings, crowns or dentures,” said Meredith Freed, a Medicare expert with the Kaiser Family Foundation.

However, the new proposal would effectively open the door to Medicare potentially covering a wider array of dental services if medical science can demonstrate that oral health substantially improves the

READ: https://www.govinfo.gov/content/pkg/FR-2022-07-29/pdf/2022-14562.pdf

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

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PODCAST: Top Five Healthcare Consulting Firms

Posted on October 24, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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PODCAST: Help Your Medical Practice Embrace Population Health

Posted on October 23, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

CHANGE MANAGEMENT

By NextGen Healthcare

NextGen Healthcare Completes Integration of CoverMyMeds ...

With any organizational change, getting support from physicians, practice administrators, and clinical and office staff isn’t easy. The transition to a population health-based strategy is no different.

Find out how to educate and coach your staff to implement your population health program successfully — based on the real-world experience of Verlin Janzen MD, medical director at Hutchinson Clinic. Dr. Janzen has dedicated his career to implementing a population-health based strategy. To achieve his goals at Hutchinson Clinic, he had to overcome a major challenge—lack of buy-in from his colleagues.

PODCAST: https://www.healthsharetv.com/content/change-management-help-your-practice-embrace-population-health-nextgen-healthcare

Your thoughts are appreciated.

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HIT: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?s=books&ie=UTF8&qid=1287563112&sr=1-9

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What is a Medical OBL?

Posted on October 22, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Office Based Laboratories

By Health Capital Consultants, LLC

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DEFINITION: OBLs, also known as office-based endovascular centers, access centers, or office interventional suites, are physician offices wherein a number of services are offered.

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

Similar to ASCs, OBLs can be single specialty or multi-specialty and can have a number of ownership structures. However, unlike ASCs, OBL procedures (because they are located in a physician office) are reimbursed under the Medicare Physician Fee Schedule.

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OBLs are typically operated and utilized by vascular surgeons, interventional radiologists, cardiologists, or other specialists, and services provided include: cardiovascular, endovascular, venous, and non-vascular services; cardiac procedures, such as diagnostic coronary angiograms, coronary stenting, electro physiology services; device implants, including pacemakers, defibrillators, loop recorders, and biventricular pacers; lower extremity endovascular revascularizations, such as chronic total occlusion and complex limb salvage procedures; renal and mesenteric revascularizations; and, subclavian stenting.23 Of these procedures, peripheral vascular intervention, cardiac services, and interventional radiology made up the majority of the OBL market share in 2019.

While slower to materialize than ASCs, OBLs have increased rapidly over the past few years, for reasons similar to ASCs, e.g., opportunities for physician ownership, the “expedient patient experience” and “favorable outpatient procedural reimbursement.”

In 2020, the global OBL market was valued at $9 billion. Similar to ASCs, an increasing focus on outpatient procedures (due to their cost-saving potential)

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

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PODCAST: See the Future of Healthcare?

Posted on October 20, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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What is Health Insurance OUT OF NETWORK Medical Care?

Posted on October 19, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

What does out of network [OON] really mean?

OON – This phrase usually refers to physicians, hospitals or other medical providers who do not participate in a health insurer’s provider network.

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

This means that the provider has not signed a contract agreeing to accept the insurer’s negotiated prices.

MORE: https://www.healthinsurance.org/glossary/out-of-network-out-of-plan/

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

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HEALTHCARE: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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COLONOSCOPIES: Statistical Update

Posted on October 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA

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DEFINITION: A Colonoscopy and/or sigmoidoscopy are procedures that let your doctor look inside your large intestine. They use instruments called scopes. Scopes have a tiny camera attached to a long, thin tube. The procedures let your doctor see things such as inflamed tissue, abnormal growths, and ulcers.

EDITOR’S NOTE: The ME-P does not normally discuss medical or clinical matters. But, this report is noteworthy to all.

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About 15 million colonoscopies are performed in the US yearly as part of standard preventive care for adults over 45, but a new study has called into question whether all the footage from those tiny cameras is really necessary.

Over a 10-year period, people who had the screenings were 18% less likely to develop colon cancer than people who didn’t, according to the study in the New England Journal of Medicine. However, the risk of death from the cancer for both the screened and un-screened was about the same, hovering around 0.3%.

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What is Health Insurance Network STEERAGE?

Posted on October 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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What is health plan network steerage?

Network steerage is the practice of directing employees and members on your benefits plan to in-network doctors, hospitals, and other points of care. A network steerage strategy is crucial for healthcare payers who are looking to tackle high healthcare costs. An admirable goal.

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

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But, what is steerage – really?

The Centers for Medicare & Medicaid Services has raised concerns about a hospital practice known as “steerage”–which involves a provider buying commercial insurance coverage for patients who are already eligible for Medicare or Medicaid coverage in order to obtain higher levels of reimbursement.

IOW: The plan charges a fixed monthly fee so its members can receive health care. There will be a small co-payment for each doctor visit; however with the HMO, fees can be fore-casted unlike a fee-for-service insurance plan. Although freedom of choice is given up, out-of-pocket expenses are very low.

RELATED CONCERNS: https://www.fiercehealthcare.com/finance/cms-looking-for-data-practice-steerage-hospitals-voice-concern

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PODCAST: Healthcare Machine Learning Can Self Create / Improve Algorithms?

Posted on October 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Machine Learning is a Subset of Artificial Intelligence (AI) Where Computer Software Can Create and Improve on Algorithms on Its Own.

Machine Learning for Population Health

PODCAST: 'Hacking of the American Mind' | The Leading ...

By Eric Bricker MD

Healthcare Machine Learning Company ClosedLoop.ai is One of the Best at Applying Machine Learning to Population Health Data.

ClosedLoop.ai is So Good, They Won the CMS AI Challenge … Beating Out 300 Other Organizations Including IBM, the Mayo Clinic and Deloitte.

The Promise of Machine Learning in Population Health is to Better Predict Which People Will Benefit From an Intervention Because They Are at Greater Risk of a Complication of a Disease or an ER Visit or a Hospitalization.

ClosedLoop.ai Beautifully Applied Their Machine Learning Abilities to Create a Pandemic Risk Model That Helped a New York City Health Insurance Plan Identify Which Members Would Be Most Likely to Have Severe Complications of COVID-19.

As a Result, the Insurance Company Helped These Individuals Have Groceries and Prescription Medication Delivered to Them So They Could Stay at Home and Avoid Exposure to COVID.

There You Have It!  A Practical, Real-World Example of Machine Learning in Population Health That Literally Saved Some People’s Lives.

Disclaimer: Dr. Bricker is the Chief Medical Officer of Virtual Care Company First Stop Health.

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Social Security’s ‘taxable maximum’ Jumps 9%

Posted on October 15, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Social Security’s payroll tax cap was raised nearly 9% for 2023, meaning more income will face Social Security taxes next year, but the rise is unlikely to affect the solvency of the trusts underpinning the system.

Citing the increase in average wages, the Social Security Administration said the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $160,200 from $147,000 starting in January. The announcement was part of the release of the cost-of-living adjustment, or COLA. The taxable maximum for 2021 was $142,800.

Citing the increase in average wages, the Social Security Administration said the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $160,200 from $147,000 starting in January.

The announcement was part of the release of the cost-of-living adjustment, or COLA. The taxable maximum for 2021 was $142,800.

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OVERUSE: How Health System Characteristics Impact Health Care

Posted on October 15, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The high cost of health care in the United States is partially driven by an over-emphasis on low-value health care that is potentially harmful and offers little benefit to most patients.

New research by Jodi Segal, MD, and colleagues, advances efforts to solve the low-value care problem by placing a spotlight on health care system factors that likely contribute to an overuse of care. The work is analyzed in the latest NIHCM Research Insights. Key findings include:

  • Systems that are investor-owned, or have fewer primary care physicians, are more likely to be associated with the overuse of care. 
  • Systems that have major teaching hospitals are less likely to overuse care.  

To continue investigating, evaluating, and addressing the drivers of overuse, the research team updated their Overuse Index tool. This Index may be especially useful for health systems seeking to monitor care use performance over time. This study’s findings may support future research and interventions to increase the use of high-value care.

READ HERE: https://nihcm.org/publications/what-health-system-characteristics-are-associated-with-overuse-of-health-care-in-the-us

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

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COVID-19: US Extends Public Health Emergency Declaration

Posted on October 14, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Kanishka Singh

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WASHINGTON (Reuters) – The United States on Thursday extended the COVID-19 pandemic’s status as a public health emergency for another 90 days, thereby preserving measures like high payments to hospitals and expanded Medicaid.

READ: https://www.politico.com/news/2022/08/17/hhs-covid-health-emergency-00052509

The extension was announced by U.S. Health Secretary Xavier Becerra on Thursday. Last month, President Joe Biden said in an interview that “the pandemic is over,” which prompted criticism from health experts.

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PODCAST: The AWS Model for Healthcare Change?

Posted on October 14, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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

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PODCAST: IC-HRA [Individual Coverage – Health Reimbursement Arrangement] Explained

Posted on October 12, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Health Insurance Job Options

By Eric Bricker MD

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DEFINITION: ICHRA (we pronounce it “ick-rah”) stands for “Individual Coverage Health Reimbursement Arrangement” (not the common misnomer of individual coverage health reimbursement accounts)  and is available for employers to start using as of January 2020. ICHRA is an evolution of another type of HRA, called a QSEHRA, that was created in 2017. Both allow employers to reimburse employees tax-free for individual health insurance, but ICHRA represents a “super-charged” version of QSEHRA with higher limits and greater design flexibility that will appeal.

More: https://www.takecommandhealth.com/ichra-guide

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

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

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HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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Dr. Dave Marcinko at YOUR Service in 2022

Posted on October 11, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Join Our Mailing List

Book Marcinko for your Next Financial Planning Seminar, Meeting or Medical Business Event 

By Ann Miller RN MHA

Professor and physician executive David Edward Marcinko MBBS DPM MBA MEd BSc CMP® is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; Oglethorpe University, and Atlanta Hospital & Medical Center in GA; and the Aachen City University Hospital, Koln-Germany. He is one of the most innovative global thought leaders in health care business and entrepreneurship today.

Dr. Marcinko is a multi-degreed educator, board certified physician, surgical fellow, hospital medical staff President, Chief Education Officer and philanthropist with more than 400 published papers; 5,150 op-ed pieces and over 125+ international presentations to his credit; including the top 10 biggest pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

Dr. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner®, who was named “Health Economist of the Year” in 2001. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, management and trade publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News].

As a licensed insurance agent, RIA and SEC registered endowment fund manager, Dr. Marcinko is Founding Dean of the fiduciary focused CERTIFIED MEDICAL PLANNER® chartered designation education program; as well as Chief Editor of the HEALTH DICTIONARY SERIES® Wiki Project. His professional memberships include: ASHE, AHIMA, ACHE, ACME, ACPE, MGMA, FMMA and HIMSS.

Dr. Marcinko is a MSFT Beta tester, Google Scholar, “H” Index favorite and one of LinkedIn’s “Top Cited Voices”.

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PODCAST: The “Value Hole” in Health Insurance Plan Design

Posted on October 11, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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

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PODCAST: The MEDICARE COST REPORT Explained

Posted on October 11, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Not For Doctors – Not Managerial Cost Accounting

By Eric Bricker MD

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MORE: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

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PODCAST: Hospital Finance 101 [Full Service Healthcare]

Posted on October 9, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Steve Febus

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Hospital Finance 101: Understanding the Cost of Full-Service Healthcare in Pullman, WA Program by: Steve Febus, Pullman Regional Hospital Chief Financial Officer.

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PODCAST: https://www.youtube.com/watch?v=N-SumPdb2PI

RELATED: https://www.youtube.com/watch?v=3vNThT8RJiQ

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

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

HOSPITAL FINANCE: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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PODCAST: High Medical Debt Yet Hospitals Still Thrive!

Posted on October 7, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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“Best” Physician Focused Financial Planning and Medical Practice Management Books for 2022

Posted on October 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

[Doctor-Advisor]

CAREER DEVELOPMENT

Buy from Amazon

Learn How to Profit and Thrive in the PP-ACA Era

BOOK FOREWORD / TESTIMONIAL

Best Sellers

Product Details

Product DetailsProduct Details

Product DetailsProduct DetailsProduct Details

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

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

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PODCAST: Hospital Executives Confess Fee-For-Service Care Drives Costs

Posted on October 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

1) Fee-for-Services Motivates Hospitals to Increase Costs.
2) Medicare and Commercial Insurance Companies Have Not Changed That Motivation with ‘Value-Based’ Payments.
3) Hospital Prices Have NO Connection to the Underlying Cost of a Test or Procedure.
4) Most Don’t Even Know What the Underlying Test or Procedure Cost Is in the First Place.

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PODCAST: Healthcare Selling Strategies

Posted on October 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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

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Understanding the Mental Healthcare Regulatory Environment

Posted on October 5, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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Appreciating the Rules

[By Carol Miller; RN, MBA]

Carol S. MillerLocal counties and municipalities are the primary providers of state mental healthcare for patients who lack private insurance coverage for such care.

Both children and adults may be eligible to receive assistance.

These counties provide a wide range of psychiatric and counseling services to the residents in their community as well as other types of assistance such as:

  • treatment services related to substance abuse;
  • housing;
  • employment services;
  • information and education service;
  • referrals;
  • consultative services to schools, courts and other agencies;
  • after-care services; and other related activities.

mental

Rules and Regulations

Accordingly, regulations from federal, state, and county governments have an impact on the day-to-day operations, procedures and processes of a county mental health center. Traditionally, there are three main types of regulations.

Federal Regulations — The United States healthcare system is guided by programs such as those established under the Centers for Medicare and Medicaid (in the case of county mental health programs, Medicaid is especially important), Americans with Disabilities Act (ADA), Occupational Safety and Health Administration (OSHA), Health Insurance Portability and Accountability Act (HIPAA), and others.

State Regulations — These include general legislative guidelines, state management of benefits and reimbursement of the Medicaid program, and state allocations of budgets, which impact the centers’ operations.

County Regulations — Each county defines its own County Mental Health Program and decides which services will be provided or excluded.

Assessment

County facilities generally include outpatient clinics, county mental health programs, short-term psychiatric facilities, day-care centers, de-toxification centers, residential rehabilitation centers for substance abuse, long-term care psychiatric facilities, and Veterans Affairs (VA) psychiatric centers. The county centers may be co-located with other county services such as social services, occupational rehabilitation services, information technology services, human resources, maintenance services, and others or may be independently located.

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

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PODCAST: Doctors Split from Hospital

Posted on October 5, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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The Story of Tryon Medical Partners shows us that if doctors don’t like the way a hospital is running their practice, they can leave and be successful.

Specifically, the 88 mostly primary care doctors of Tryon Medical Partners sued Atrium Health, the hospital system that owned them, in order to leave and become independent in 2018.

Some of their grievances against the hospital system were:
1. The hospital replaced the nurses in their clinics with medical assistants.
2. The hospital increased the number of patients they needed to see per day and decreased their visit times.

Atrium agreed to let the doctors separate in exchange for dropping the lawsuit.

Just one year later Tryon Medical Partners began to offer Direct Primary Care to local employers and have signed up 30 companies.

The program has been a huge success because an independent primary care practice can work to provide better care at lower costs. Conversely, physicians associated with a hospital system are incentivized to increase healthcare costs.

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HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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

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PODCAST: Inflation Reduction Act [IRA] and Healthcare

Posted on October 4, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

THE AGENDA 2022 AND BEYOND!

By Eric Bricker MD

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FINANCIAL MANAGEMENT STRATEGIES: For Hospitals and Healthcare Organizations

Posted on October 2, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Managerial Accounting

TOOLS, TECHNIQUES, CHECKLISTS AND CASE STUDIES

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TEXT: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

Reviews

Navigating a course where sound organizational management is intertwined with financial acumen requires a strategy designed by subject-matter experts. Fortunately, Financial Management Strategies for Hospital and Healthcare Organizations: Tools, Techniques, Checklists and Case Studies provides that blueprint.
―David B. Nash, MD, MBA, Jefferson Medical College, Thomas Jefferson University

It is fitting that Dr. David Edward Marcinko, MBA, CMP™ and his fellow experts have laid out a plan of action in Financial Management Strategies for Hospital and Healthcare Organizations that physicians, nurse-executives, administrators, institutional CEOs, CFOs, MBAs, lawyers, and healthcare accountants can follow to help move healthcare financial fitness forward in these uncharted waters.
―Neil H. Baum, MD, Tulane Medical School

ORDER: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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HOSPITALS: Management, Operations and Strategies

Posted on October 2, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Tools, Templates and Case Studies

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Click to access foreword-phillips.pdf

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PODCAST: Medical Specialties with High Margin Hospital Power

Posted on September 30, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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https://medicalexecutivepost.com/2022/09/29/podcast-how-doctors-are-really-paid-in-2022/

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LAW: Introduced to Stop Medicare Physician Pay Cuts

Posted on September 29, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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Law Introduced to Stop Medicare Physician Pay Cuts

On September 13, 2022, Representatives Ami Berra (D-CA-7) and Larry Bucshon (R-IN-8) introduced the Supporting Medicare Providers Act of 2022 (H.R. 8800), which aims to infuse the Medicare Physician Fee Schedule (MPFS) with a 4.42% funding increase for 2023. With a bipartisan coalition of 12 co-sponsors, the bill would have the practical effect of negating the impending 4.42% cut to the MPFS conversion factor. This Health Capital Topics article will review the bill, discuss its support, and examine its potential implications. (Read more…)

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AHIP: Botox Marked Up 78% in Hospitals Over Pharmacies 

Posted on September 27, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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AHIP: Botox Marked Up 78% in Hospitals Over Pharmacies 

•  Botox markups: 78% in hospitals, 17% in physician offices
 •  Herceptin markups: 131% in hospitals, 40% in physician offices
 •  Keytruda markups: 104% in hospitals, 21% in physician offices
 •  Ocrevus markups: 59% in hospitals, 13% in physician offices
 •  Opdivo markups: 112% in hospitals, 18% in physician offices
 •  Prolia markups: 215% in hospitals, 49% in physician offices
 •  Remicade markups: 124% in hospitals, 15% in physician offices
 •  Rituxan markups: 85% in hospitals, 7% in physician offices
 •  Tecentriq markups: 95% in hospitals, 25% in physician offices
 •  Xolair markups: 76% in hospitals, 16% in physician offices

Notes: Drugs with the highest total spend in 2019, which are also commonly delivered through specialty pharmacies. The drug cost estimate in physician offices and hospitals does not include the cost of administering the drugs.
Source: AHIP, “Hospital Price Hikes: Markups for Drugs Cost Patients Thousands of Dollars,” February 2022

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

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

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

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PODCAST: United Health Group Acquisition of “Change Healthcare”

Posted on September 27, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

A DATA GOLDMINE

By Eric Bricker MD

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

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PODCAST: Nurses Go on Strike

Posted on September 23, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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HOSPITAL: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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UPDATE: SPACS, Markets and Covid-19 Fraud

Posted on September 21, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Chamath Palihapitiya, the billionaire investor who once claimed to be the next Warren Buffett, is winding down two of his special purpose acquisition companies (SPACs) and returning $1.5 billion to investors. It marks the symbolic end to the SPAC bubble that Palihapitiya is credited with instigating.

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  • Markets: Investors pre-gamed the Fed’s big interest rate decision coming this afternoon by sending stocks lower and Treasury yields higher; they’re sweating what’s expected to be the central bank’s third 75-basis-point hike in a row to tamp down inflation. Speaking of inflation, Ford’s stock had its worst day in 11 years after warning of $1 billion in extra supplier costs.

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Finally, the Justice Department charged 47 people for allegedly carrying out the single largest Covid relief fraud scheme to date. Feds say that by exploiting a program meant to feed needy Minnesota children, the defendants stole $250 million. Prosecutors say the fraud was committed by a network of individuals connected to the nonprofit Feeding Our Future and was overseen by the nonprofit’s founder, Aimee Bock. Feeding Our Future was one of a handful of organizations Minnesota trusted to oversee the distribution of meals to children in low-income families during the pandemic. Instead, prosecutors allege, the organization operated a “pay-to-play scheme” in which individuals submitted fake meal sites and children’s names, raking in government money with fraudulent invoices.

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PODCASTS: Signify Health Stock Market Debut

Posted on September 21, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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By Kyle Armbrester

By Eric Bricker MD

ME-P UPDATES

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PODCAST 2: https://www.youtube.com/watch?v=-1_mBZLsKvU

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PODCAST: Health Insurance Carrier Stock Performance Has Been Amazing!

Posted on September 20, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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DJIA: 32,197.59 at close ‎+436.05 (‎+1.37%)

NASDAQ: 12,032.42 at close ‎+469.85 (‎+4.06%)

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

RELATED: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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PODCAST: The “Common Bridge” Interviews Ken Cooper MD

Posted on September 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Rich Helppie

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Health Insurance Companies in the USA

Posted on September 12, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Some Representative Examples

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Conclusion

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

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

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

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

DOCTORS:

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

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

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

HOSPITALS:

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

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

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Product DetailsProduct Details

Filed under: Health Insurance | Tagged: | 4 Comments »

PODCAST: Avoiding Medical Nightmare Tyranny with John Bush

Posted on September 12, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Pete Quinones

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John joins Pete to talk about ways to use entrepreneurship, cryptocurrency and alliances to prevent the medical tyranny that is being thrust upon the world.

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PODCAST: The Pete Quinones Show: Episode 613: Avoiding This Medical Nightmare w/ John Bush (libsyn.com)

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

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Health Insurance Premium Fund Usage

Posted on September 12, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Where does the money go?

By http://www.MCOL.com

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Conclusion

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

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

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

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

DOCTORS:

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

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

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

HOSPITALS:

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

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

Product DetailsProduct Details

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Filed under: Health Insurance | Tagged: | Leave a comment »

PODCAST: How Extensive is Healthcare Prior Authorization?

Posted on September 10, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

A New Study

BY ERIC BRICKER MD

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

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MORE: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

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PODCAST: Google Starts a Health Insurance Stop-Loss Company

Posted on September 9, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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

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The Health Economics of INSULIN

Posted on September 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

Read the Grassley-Wyden Report

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

Your comments are appreciated.

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

THANK YOU

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Filed under: Drugs and Pharma, Health Economics, Health Insurance | Tagged: , | 6 Comments »

PODCAST: Reference Based Medical Pricing Negotiation

Posted on September 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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7 Best Practices in Reference-Based Pricing Negotiation

By Eric Bricker MD

1) Calculate Extent of Medicare Underpayment

2) Calculate Extent of Medicaid Underpayment

3) Compare Hospital Charity Care to Tax Benefits

4) Threaten to Publish Hospital Prices

5) Publish Email Addresses and Cell Phone Numbers for Hospital Board Members, CEOs and CFOs

6) Have Unions Assist in ‘Persuasion’

7) Threaten to Take Patients to Other States for Free

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

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Medicare Part C [Advantage Plan] Allegations & Investigations

Posted on September 6, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Office of Inspector General and the HHS

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READ REPORT: https://oig.hhs.gov/oei/reports/OEI-09-18-00260.asp

OIG: https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf

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

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PODCAST: How Healthcare Policy Sausage is Made

Posted on September 3, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

‘America’s Bitter Pill’ by Steven Brill … Contemporary History of Healthcare in America

BY ERIC BRICKER MD

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

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HOSPITALS: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

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Valuation of Remote Therapeutic Monitoring [Reimbursement Environment]

Posted on September 2, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

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By Health Capital Consultants, LLC

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VALUATIONS

Valuation of Remote Therapeutic Monitoring: Reimbursement Environment

The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and has a strong influence on physician reimbursement. In 2020, Medicare and Medicaid accounted for an estimated $829.5 billion and $671.2 billion in healthcare spending, respectively.

The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter, and being used as a benchmark for private reimbursement rates. (Read more…) 

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DICTIONARY: Health Economics and Finance

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PODCAST: Social Determinants of Health [Impact on Medical Training and Healthcare Costs]

Posted on September 1, 2022 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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As a result of SDOH problems, Johns Hopkins Hospital Trains Doctors That Have a Ton of Exposure to Diseases That Result from These Social Determinants of Health: 1) Endocarditis, 2) Hepatitis C, 3) HIV, 4) Pancreatitis, 5) Liver Cirrhosis, 6) Diabetes, 7) Heart Attack, 8) Stroke, 9) Infections, 10) Cancer, 11) Spinal Injuries, 12) Dialysis, 13) Diabetic Ketoacidosis and 14) Hypertensive Emergencies.

Johns Hopkins Hospital Also Loses Money When Treating These Diseases Caused by Social Determinants of Health.

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

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MORE: PODCAST: Social Determinants of Health

Mental: Social Determinants of Mental Health

Related: “Social Determinants of Health”

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

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

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