BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on May 9, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
A look at the President’s expressed priorities and actions to date
By Todd Zigrang, MBA, MHA, FACHE, CVA, ASA
By Jessica Bailey-Wheaton, Esq.
Health Capital Consultants, LLC
On January 20, 2021, Joseph R. Biden, Jr. was inaugurated as the 46th president of the United States. Due to the COVID-19 pandemic, among other concerns and long-standing issues, health care has become a central political issue and was hotly contested during the 2020 presidential debates.
A look at President Biden’s expressed priorities, signed executive orders, cabinet nominations and agency appointments during his first months in office provides indications as to the future—at least the short-term future—of U.S. health care.
In the last few years, research has shown that deep learning can match expert-level performance in medical imaging tasks like early cancer detection and eye disease diagnosis. But there’s also cause for caution.
Other research has shown that deep learning has a tendency to perpetuate discrimination. With a health-care system already riddled with disparities, sloppy applications of deep learning could make that worse.
Posted on April 29, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
Fee-For-Service Physician Reimbursement Not to be Replaced Anytime Soon!
AN EXPOSE’
By Eric Bricker MD
VALUE BASED CARE PROPONENTS?
Definition: Value-Based Care (VBC) is a health care delivery model under which providers — hospitals, labs, doctors, nurses and others — are paid based on the health outcomes of their patients and the quality of services rendered. Under some value-based contracts, providers share in financial risk with health insurance companies. In addition to negotiated payments, they can earn incentives for providing high-quality, efficient care.
VBC differs from the traditional fee-for-service model where providers are paid separately for each medical service. While quality care can be provided under both models, it’s the difference in how providers are paid, paired with the way patient care is managed, that provides the opportunity for health improvements and savings in a VBC environment.
But – During a Panel Discussion Captured on YouTube at the 2019 HLTH Conference in Las Vegas, Blue Cross Blue Shield of Arizona CEO Pam Kehaly Admitted that Only 10% of the Payments in Value-Based Contracts Were Value-Based.
NOTE: Dr. Grace Torres-Hodges is a board certified podiatrist and has been in her own independent solo practice since 2001. She is on the surgical staff at Baptist, Gulf Breeze and Sacred Heart Hospitals as well as the Andrews Institute of Orthopedics & Sports Medicine. She completed her undergraduate studies at Vanderbilt University and was pursuing graduate studies in sports medicine at the United States Sports Academy prior to medical school. Dr. Torres-Hodges was an FPME scholarship student and received her medical degree from the New York College of Podiatric Medicine. Dr. Torres-Hodges completed her post graduate residency training in both medicine and surgery at St. Vincent’s Medical Center in Jacksonville, Florida.
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…)
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…)
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…)
Posted on March 31, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
Right Side VERSUS Left Side Cerebral Vascular Accidents
[By staff reporters]
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A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients [occlusive and hemorrhagic]. Within minutes, brain cells begin to die.A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.The good news is that strokes can be treated and prevented, and many fewer Americans die of stroke now than in the past.
Posted on February 27, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
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.
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.
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.
Posted on February 1, 2021 by Dr. David Edward Marcinko MBA MEd CMP™
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.
1. I will continue to verify any statements I make about the healthcare system by talking to physicians and operators with REAL-WORLD EXPERIENCE and not rely solely on statistical comparisons.
2. I will promote that there is a correlation between cost, quality, and access in today’s healthcare system. Those who believe health systems should approach anything close to Medicare breakeven advocate for low quality and significant service reductions.3. I will continue to promote the fact that whoever affiliates with the best doctors will win in the long run.
4. I will encourage my clients to avoid the attempt by payers and many industry desk jockeys (e.g., Rand Corp.) to commoditize healthcare delivery. The best doctors, services, and ultimately the best outcomes are not commodities; they come at a price.
5. I will not stand by and watch the payers, government, and the aforementioned academic knuckleheads destroy the hospital industry using the ‘value con’– they already destroyed the rural hospital sector.
6. I will only consider a health system to be under quality leadership if market share grows and profits meet or exceed the industry benchmark. I won’t accept ‘mission’ as an excuse.
The Biden Administration has put forth their healthcare plan, which seeks to expand access to affordable healthcare with the following:
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(1) upholding and expanding the Patient Protection and Affordable Care Act (ACA), to reduce the amount that consumers pay for health insurance on the individual marketplace; (2) offering a new, public insurance option similar to Medicare; (3) prohibiting the practice of “surprise billing”; (4) leveraging the Department of Justice’s (DOJ’s) and Federal Trade Commission’s (FTC’s) antitrust authority to target market concentration within the healthcare system; and, (5) driving down prescription drug prices by increasing competition for, and regulation, of pharmaceutical companies.
Posted on November 29, 2020 by Dr. David Edward Marcinko MBA MEd CMP™
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…)
Posted on November 11, 2020 by Dr. David Edward Marcinko MBA MEd CMP™
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.
Posted on November 9, 2020 by Dr. David Edward Marcinko MBA MEd CMP™
The McCarran–Ferguson Act
By Howard Green MD
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The McCarran–Ferguson Act, 15 U.S.C. §§ 1011-1015, is a United States federal law that exempts the business of insurance from most federal regulation, including federal antitrust laws to a limited extent.
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The McCarran–Ferguson Act was passed by the 79th Congress in 1945 after the Supreme Court ruled in United States v. South-Eastern Underwriters Association that the federal government could regulate insurance companies under the authority of the Commerce Clause in the U.S. Constitution and that the federal antitrust laws applied to the insurance industry.
-United States Federal Law
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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.
Posted on October 25, 2020 by Dr. David Edward Marcinko MBA MEd CMP™
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.
Posted on October 2, 2020 by Dr. David Edward Marcinko MBA MEd CMP™
“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
Posted on September 28, 2020 by Dr. David Edward Marcinko MBA MEd CMP™
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.
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