Eligibility for Health Insurance Coverage as of 2014

Posted on March 14, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Among the Currently Un-insured for Selected United States

Conclusion

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Filed under: Health Insurance | Tagged: ACA, HIE, HIE's, ObamaCare, PP-ACA | 1 Comment »

American’s Personal Experience with the PP-ACA

Posted on March 7, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

The Law of the Land

By www.MCOL.com

More:

Assessment

So, tell us your personal experi9ence with the ACA

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Our ME-P Recommended Books Review

Posted on March 2, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Purchase today and Profit in 2014

By Ann Miller RN MHA

[Executive-Director]

Conclusion

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###

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Who Gets Government Aid thru the HIEs?

Posted on February 12, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

The Premium Assistance Tax Credit

By Lon Jefferies MBA CFP®

The Premium Assistance Tax Credit (PATC) is designed to help “lower” income individuals and families pay for health insurance plans purchased through the new health care exchange program.

However, more people may qualify for government assistance when purchasing health care through the exchange than may realize.

Terms and Definitions

The program defines “lower” income as households that earn less than 400% of the Federal Poverty Level (FPL), which is based on the number of individuals in the home. In 2013, the FPL for a single individual was $11,490.

Similarly, the FPL for a household of two people was $15,510 and the FPL for a home of four individuals was $23,550. Consequently, at least some premium assistance credit is available for individuals earning less than $45,960, couples earning less than $62,040, and a household of four earning less than $94,200. (Click here for more information on the Federal Poverty Level for households of various size.)

It’s important to note that for the purposes of the assistance program, income is defined as modified adjusted gross income. This means that a taxpayer’s adjusted gross income will include all Social Security benefits received (whether it was taxable or not), and all bond interest (tax-exempt or not). This factor will reduce a person’s eligibility for aid if he begins receiving Social Security before age 65 (at which point he qualifies for Medicare and can no longer participate in the health care exchange).

A Reverse Calculation

The amount of aid the government will provide is essentially calculated in reverse – the maximum amount that an individual or family can owe is calculated, and the government will pay the remaining premium. This table shows the Premium Assistance Tax Credit thresholds based on income relative to the Federal Poverty Level:

###

Income Relative To FPL:	Premiums Limited To:
Up to 133% of FPL	2% of household income
133% to 150% of FPL	3% to 4% of income
150% to 200% of FPL	4% to 6.3% of income
200% to 250% of FPL	6.3% to 8.05% of income
250% to 300% of FPL	8.05% to 9.5% of income
300% to 400% of FPL	9.5% of income

###

Example:

For example, assume John is a single 62-year-old living in Utah and making $30,000 per year. (Again, remember that when calculating the PATC, it really doesn’t matter whether John’s $30,000 of income is from employment, a Social Security benefit, or a combination of the two.) John’s income is 261% of the FPL amount for singles [($30,000/$11,490) * 100], so this puts his threshold between 8.05% and 9.5% of his income. His exact threshold is 11/50ths of the way between 250% and 300% of the FPL, so his maximum premium is 11/50th of the way between 8.05% and 9.5%, which means his maximum premium is 8.37% of his $30,000 income, or $2,511 per year ($210 per month). This is the most John will need to pay for an adequate health insurance plan.

What is Adequate Health Insurance?

What is deemed an adequate health insurance plan? The next relevant figure in the calculation involves determining the cost of the second least expensive Silver plan in the state. This can be determined by obtaining a quote at www.healthcare.gov. Assuming John lives in Salt Lake County, the second least expensive Silver plan available to him cost $5,100 per year ($425 per month). Whether or not John decides to purchase this exact policy, the $5,100 annual cost of the plan is significant.

Since the second least expensive Silver plan available to John cost $5,100, but the most John will be required to pay is $2,511 per year (8.37% of his income), the PATC program will cover the cost difference of $2,589. This amount will be the tax credit available to John for purchasing any health insurance policy through the exchange.

However, this does not mean that John is required to actually purchase and utilize the second least expensive Silver plan available to him. If John is so inclined, he can purchase a less expensive policy and he will still receive the $2,589 tax credit determined to be available to him.

Nevertheless, since the policy is less expensive, John would need to cover less of the cost of the inferior policy out of his own pocket. Similarly, John could also purchase a more expensive policy, but his tax credit would still be $2,589 and he would need to cover the additional cost of the superior policy with his own money.

Assessment

People are still familiarizing themselves with the options available within the health care exchange. Many will be surprised by their eligibility for assistance, and the amount of government aid available. Determining whether you qualify for a Premium Assistance Tax Credit will help you evaluate the attractiveness of the program.

More: Understanding Basics of the Health Insurance Exchanges [HIEs]

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Filed under: Health Insurance | Tagged: federal poverty level, Health Information Exchanges, HIE's, Lon Jefferies, Obamacare subsidies, PATC, Premium Assistance Tax Credit | 14 Comments »

Enrollment, Coverage and the PP-ACA

Posted on February 7, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

For Medicaid

By www.MCOL.com

Assessment

1. Aetna CEO: Only 11% Of ObamaCare Signups Have Been Uninsured
2. The Individual Mandate for Health Insurance in the U.S.
3. Survey of Americans’ Preparations for Health Care in Retirement
4. Medi-Cal at a Crossroads: What Enrollees Say About the Program
5. The Affordable Care Act: The Exchanges Go Live

Conclusion

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Filed under: Health Insurance | Tagged: ACA, Health Insurance, Medicaid, ObamaCare, PP-ACA | 12 Comments »

How “Leaner” Hospitals Can Be Profitable in 2014

Posted on January 31, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Our Newest Textbooks with Checklists

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

BOOK FOREWORD / TESTIMONIAL

###

Filed under: "Doctors Only", Book Reviews, Breaking News, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology | Tagged: 6 sigma, Dr. David Edward Marcinko MBA, Healthcare Organizations, hospitals, Hospitals and Healthcare Organizations, medical clinics, Six Sigma | 15 Comments »

National Health Expenditure Growth

Posted on January 16, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

A Report from the Office of the Actuary

Source: Centers for Medicare & Medicaid Services

According to the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary, overall national health expenditures grew at an annual rate of 3.7 percent in 2012, marking the fourth consecutive year of low growth. Health spending as a share of gross domestic product fell slightly from 17.3 percent in 2011 to 17.2 percent in 2012.

Private Insurance

Private health insurance spending growth remained low. Private health insurance spending continued to grow at a low rate, increasing 3.2 percent in 2012 compared to 3.4 percent growth in 2011. Medicare spending growth continued to be low. Despite a large uptick in Medicare enrollment, Medicare spending growth slowed slightly in 2012, increasing by 4.8 percent compared to 5.0 percent growth in 2011.

The Totals for MC/MD

Total Medicare spending per enrollee grew by only 0.7 percent in 2012. Medicaid spending continued to grow at a historically low rate. Total Medicaid spending grew 3.3 percent in 2012. While an increase over 2011, this increase still represents historically low overall growth rates tied to improved economic conditions, as well as efforts by states to control costs.

Rx Drugs

Prescription drug spending growth was low. Retail prescription drug spending slowed in 2012, growing only 0.4 percent as the result of numerous drugs losing their patent protection, leading to increased sales of lower-cost generics. Nursing home spending growth slowed.

Assessment

Spending for freestanding nursing care facilities and continuing care retirement communities increased by only 1.6 percent in 2012, down from 4.3 percent growth in 2011, due to a one-time Medicare rate adjustment for skilled nursing facilities.

Conclusion

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Reviewing National Health Expenditures

Posted on January 15, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Average Annual Percent Change from the Previous Year

By www.MCOL.com

Conclusion

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ACOs and Marketplace Competition

Posted on January 3, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

An Estimation of Material Impact

By www.MCOL.com

Assessment

Conclusion

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Filed under: Health Insurance, Practice Management | Tagged: Accountable Care Organizations, ACOs, ACOs and Marketplace Competition | 12 Comments »

My Experience with ObamaCare

Posted on December 27, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Not a Unique Story – to Date

By Rick Kahler CFP® http://www.KahlerFinancial.com

Like millions of Americans, I jumped on Healthcare.gov on October 1 to view the long-anticipated plans on the insurance exchanges mandated by the Affordable Healthcare Act, known as Obamacare. I needed a new healthcare plan and purposely held off buying one in September to compare the coverage and prices of an Exchange plan.

My disappointment paralleled that of thousands of other Americans wanting to do the same. After six tries that day, I gave up. I tried the site multiple times for each of the next six days. No luck.

The Short Form

Finally, on the seventh day, the site actually let me start an application. I chose to go with the “short” form since I was certain I would not qualify for a subsidy.

The short form application took 30 minutes to fill out. There were very few questions about health, just whether anyone in the household smoked. A number of questions had me wondering if I was applying for a passport. These included my Social Security number, race, citizenship, relationships to everyone in the family, and whether I was ever incarcerated.

When I reached the end of the form, I hit “submit,” anticipating that plan options and costs would appear. Instead, I was sent back to the starting page of the form. After 60 minutes of trying to get out of this endless loop, I gave up.

Three More Weeks of Trying

For the next three weeks, I went to the site at least once a day. I was never able to get past the endless loop to view plans or prices. I took a two-week break.

On November 14, I tried again. Success! Well, sort of. No endless loop. Instead, the site said it lost my original application and I needed to complete a new one. After another 60 minutes filling out the application, I ended up stuck in a loop again, unable to view plans or prices, much less choose one.

Giving Up

Frustrated, I decided to give it a rest until the site re-launched on December 1. I figured I would still have plenty of time to meet the December 15 deadline for enrollment.

On December 1, I eagerly popped onto the site. Not only was the site not functional, it had lost my application for the third time.

I gave up.

Enter the Insurance Broker

I phoned my insurance broker. She was able to give me all the information I had tried to get out of healthcare.gov for the past 60 days. She also said my insurance company was canceling my current plan. Obamacare deemed the coverage substandard because it did not cover pregnancy, mental health costs, and pediatric dental and vision costs. Although I don’t want or need any of that coverage, Obamacare gives me no choice.

Prices

My old policy cost $1,192 a month. The new one costs $1,506, which includes $59 a month in mandated surcharges on non-exchange policies to help fund Obamacare. My maximum family out-of-pocket expenses must also increase $208 a month. The total potential increase is a staggering $524 a month.

###

A Skeptic

As someone who listened with great skepticism as politician after politician promised that Obamacare would lower health care costs, lower our deficit, and guarantee we could keep any existing plan, I feel sadly vindicated. In March 2010, when Congress passed Obamacare, I paid $660 a month for health care that had better coverage than I have now. For that same coverage today, my premium would be $2,450 a month.

Assessment

Unfortunately, my story is not unique. It is ubiquitous to the average American who has health insurance. Our elected officials and government agencies failed us miserably. So far, there appears to be no relief in sight.

More

Conclusion

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Filed under: Health Insurance | Tagged: ACA, Health Insurance, ObamaCare, Patient Protection and Affordable Care Act, PPACA, Rick Kahler CFP® | 21 Comments »

Percentage of Americans Putting Off Medical Treatment Because of Costs

Posted on December 14, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Do we really know?

www.MCOL.com

Assessment

Conclusion

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Filed under: Health Economics, Health Insurance | Tagged: health costs, medical costs, Percentage of Americans Putting Off Medical Treatment Because of Costs | 10 Comments »

What is Form 834?

Posted on December 12, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

President Obama’s Most Important Number

[By Staff Reporters]

This is an “834 EDI transmission.”

Health Insurers sometimes call it, more simply, “an 834.” It is a technical, back-end reporting tool that consumers never see on the Federal Website. It is meant to be read by computers, not human beings. It’s the form that tells the insurer’s system who you are and what you need. And, it might be the new health-care law’s biggest problem.

Insurers report that, in some cases, 834s are coming in wrong. That’s a much more serious problem than the online traffic bottlenecks that have dominated coverage of the health-care law’s rollout.

Washington Post Article:

This is an “834 EDI transmission.” Insurers sometimes call it, more simply, “an 834.” It is a technical, back-end reporting tool that consumers never see. It is meant to be read by computers, not human beings. It’s the form that tells the insurer’s system who you are and what you need. And it might be the new health-care law’s biggest problem.

What is the ANSI 834 Enrollment Implementation Format?

The 834 Transaction is the HIPAA-compliant Benefit Enrollment and Maintenance Transaction. Its purpose is to electronically transmit enrollment and dis-enrollment information.

In 2004, DHCS implemented a 4010 834 solution, however, this was implemented along with a supplemental transaction that held eligibility history.

The HIPAA 5010 version of all transactions is scheduled to be implemented on January 1st, 2012. DHCS will implement a compliant 5010 834 on this date. The current FAME file will continue to be made available for a short period of time after this date to allow plans time to transition. Once this transition period has been completed the FAME file will no longer be made available to managed care plans.

Impacted Covered Entities

Internal DHCS program areas and DHCS Health Plan trading partners.

5010 834 Documents

5010 834 Generic Test Data Overview (pdf)

General FAME Documents

FAME Data Element Dictionary (pdf)

MEDICARE PART D INFORMATION

Project Information

DHCS Medicare Part D information web page

MMA Part D Carrier Cross Reference Table (pdf)

File Layouts

MMEF 2100 Medicare Part D layout (pdf)

MMEF REC Medicare Part D layout (pdf)

Assessment

Conclusion

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Filed under: Drugs and Pharma, Health Insurance, Information Technology, Risk Management | Tagged: ACA, Accountable Care Act, Form 834, Medicare Part D, PP-ACA | Leave a comment »

Take the Accountable Care Organization 2013 e-Poll

Posted on December 10, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

TAKE THE POLL

www.MCOL.com and Accountable Care News are conducting the 2013 Accountable Care e-Poll. Please respond by 5 PM Pacific, Friday December 13th, 2013. Results will be emailed to participating respondents upon request.

e-Poll

You can take the e-poll by going to: http://aco2013.questionpro.com/
The e-poll asks the following questions:

Please indicate your perspective:
Is your organization involved with ACOs- including development, operation, or contracting arrangements?
When would you estimate ACOs would have a material impact in your marketplace:
If ACO Medicare pilots are not ultimately successful, will that cause commercial and Medicaid ACO arrangements to generally fail as well?
What will be the impact of the newly enrolled individuals coming into the system as a result of Medicaid expansion and the health insurance exchanges?
How confident are you that ACOs will actually generate the necessary savings?
Will bundled payments prove to be a more effective delivery and payment reform model than ACOs?

Assessment

Again, to take the e-poll now, go to: http://aco2013.questionpro.com/

Conclusion

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Filed under: Health Insurance, Managed Care, Voting Polls | Tagged: ACA, Accountable Care Organizations, PP-ACA | 3 Comments »

ME-P Picks [Public Viewpoints on Health Reform and Policy]

Posted on December 9, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters and related sources

By http://www.MCOL.com

Delolitte Employer Poll Gives Grades From 500 employers Regearding Healthcare Reform

33% would give a grade of an A or B
38% say a C is an appropriate letter grade
29% believe a D or F would be more appropriate
22% of employers say the ACA will reduce costs by the year 2019
19% said it will improve quality of care by the year 2019
50% of respondents said it will widen access to health insurance.

Source: Deloitte

Some more new Lists:

Assessment

Visit: www.CertifiedMedicalPlanner.org

Conclusion

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Should HHS Secretary Kathleen Sebelius be Replaced?

Posted on November 26, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

A Voting and Opinion Poll

[By Ann Miller RN MHA]

We are all aware that critics are calling for the head of Kathleen Sebelius after the clumsy online rollout of the PP-ACA.

And so, we ask:

Assessment

After you vote; please leave a cogent opinion, too.

Conclusion

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Filed under: Health Insurance, Health Law & Policy, Voting Polls | Tagged: ACA, Health Insurance, HHS, HIE's, Kathleen Sebelius, ObamaCare | 15 Comments »

Is HEALTHCARE.GOV Fundamentally Flawed?

Posted on November 16, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

You Decide

By Ayo Fathiah

Hello Dr. David Edward Marcinko,

My name is Ayo, I’m the mother of two beautiful kids and one of the Americans that was relying on healthcare.gov to provide me with a reasonably priced health insurance.

I came across your ME-P articles when researching what exactly has gone wrong with the website. I was one of the millions that tried to sign up during the first days after the launch and couldn’t get through due to a bunch of errors. While I’m still trying to find the best insurance for my family, I just wanted to share with you some stats showing why the website was a major flop.

***

And, I thought it might be interesting to your readers, because I saw a many readers talking about it. Isn’t it surprising that less than 1% of people that went on the website signed up for an insurance?

The Website

1.) Had extremely low login success rates. 2.) Long delays and time outs 3.) Confusing Error Messages 4.) Non-functional calculators 5.) Scrambled insurance information 6.) Spouses reported as children 7.) Plan pricing misreported.

Assessment

Leading to the larger questions:

Will enrollment glitches become provider glitches?
Will people who enrolled with the glitchy show up at hospitals with no insurance?
Will the information of those who enrolled be at risk?

DANGER: Centralized data SSN Address Ages Names Health conditions Family History

Leads to centralized power over everyday Americans

Good: if we can make an efficient healthcare system

Bad: Governmental Abuse, and all the data an identity thief could want

But this problem runs deeper than just a website… Because the numbers just don’t add up.

Universal healthcare is important, but crony capitalism doesn’t solve anything.

Citations:

Conclusion

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Filed under: Health Insurance, Health Law & Policy, Information Technology | Tagged: ACA, HealthCare.Gov, ObamaCare, Patient Protection and Accountable Care Act, PP-ACA | 7 Comments »

The PP-ACA from Medicine to Dentistry

Posted on November 15, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Obamacare and Dentistry

[By D. Kellus Pruitt DDS]

It seems that problems with the PP-ACA have migrated from traditional medicine to the world of dentistry.

“MaineCare dentists hit with massive fines for minor clerical errors, they say – Some clinics face more than $200,000 in penalties under a new audit system that threatens to wipe out services for kids.”

-Joe Lawlor [Staff writer] Portland Press Herald [November 6, 2013]

http://www.pressherald.com/news/MaineCare_dentists_hit_with_massive_fines_for_minor_clerical_errors__they_say_.html

“The new system gives auditors, who work for a private contractor, financial incentives to find small errors by paying them more for each mistake they discover.” Maine adopted the auditing system to comply with the federal Affordable Care Act, otherwise known as Obamacare.

Lawlor continues: “The audits are intended to root out fraud and abuse, but dentists told the Portland Press Herald that auditors are finding typographical or clerical errors that do not compromise patients’ care or defraud the government.”

A Clawback?

Dr. Michael Dowling, co-owner of Falmouth Pediatric Dentistry, tells the Herald, “This is not finding fraud and abuse. This is a clawback. They (state officials) are trying to take back money that we billed them legitimately.”

Still want to help the poor so much that you are willing to take your chances with the ACA auditing system, Doc?

Dentists facing bankruptcy

According to Lawlor, some dentists are actually facing bankruptcy because of ridiculously expensive fines over minor errors. Other Maine dentists who are otherwise willing to work for charity-level fees in order to help children who have nowhere else to turn, are dropping out of MaineCare. President Obama’s plan to use outrageous fines to fund the state and federal coffers, as well as the bonuses of ambitious auditors, is destined to fail.

How can the Affordable Care Act [PP-ACA] possibly make care more affordable for children with toothaches, if it runs off all the dentists?

Assessment

Is it beginning to look to you like Obamacare might have been designed to serve the interests of unaccountable healthcare stakeholders rather than the interests of doctors and patients – the healthcare principals? Why do we put up with this crap, Doc?

Conclusion

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Filed under: Health Insurance, Information Technology, Professional Liability, Pruitt's Platform | Tagged: Affordable Care Act., D. Kellus Pruitt DDS, Joe Lawlor, Michael Dowling, ObamaCare, Obamacare and Dentistry, Portland Press Herald, PP-ACA | 5 Comments »

Stakeholder Changes for Involvement in Medical Homes [2012-13]

Posted on November 10, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Update on the Patient Centered Medical Home Movement

By: www.MCOL.com

The medical home, also known as the patient-centered medical home (PCMH), is a team based health care delivery model led by a physician, PA, NP or ANP that provides comprehensive and continuous medical care to patients with the goal of obtaining maximized health outcomes. It is “an approach to providing comprehensive primary care for children, youth and adults”.

The provision of medical homes may allow better access to health care, increase satisfaction with care, and improve health. Joint principles that define a PCMH have been established through the cohesive efforts of the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP), and American Osteopathic Association (AOA).

Assessment

With a medical home, care coordination is an essential component of the PCMH. Care coordination requires additional resources such as health information technology, and appropriately trained staff to provide coordinated care through team-based models.

Additionally, payment models that compensate PCMHs for their effort devoted to care coordination activities and patient-centered care management that fall outside the face-face patient encounter may help encourage coordination.

More:

Conclusion

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Filed under: Career Development, Health Insurance, iMBA, Inc., Practice Management | Tagged: American Academy of Family Physicians, American Academy of Pediatrics, American Osteopathic Association (, ANP, medical homes, NP, PA, Patient Centered Medical Homes | 10 Comments »

Video on Wall Street’s View on Prospects for the Health Care Industry

Posted on November 7, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Nashville Health Care Council

[By staff reporters]

The Nashville Health Care Council’s recent signature: “Wall Street’s View on Prospects for the Health Care Industry” panel discussion and video, offers timely insights and forecasts for Nashville’s $70 billion health care industry.

Video link: http://www.healthsharetv.com/content/wall-streets-view-prospects-health-care-industry

Assessment

The effects of the PP-ACA are still being revealed under the law of unintended consequences.

Conclusion

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Filed under: Career Development, Health Insurance, Investing, Videos | Tagged: Prospects for the Health Care Industry, The Nashville Health Care Council, Wall Street and Healthcare | 2 Comments »

Healthcare News TV Videos

Posted on November 3, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Announcing More New Videos:

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

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Filed under: Drugs and Pharma, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | 1 Comment »

Percentage with Private Health Insurance 2013

Posted on November 1, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

An Infographic

By www.MCOL.com

Conclusion

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Artistic Occupations without Health Insurance

Posted on October 27, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Health Insurance Cost Update

By www.MCOL.com

More:

Conclusion

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Filed under: Health Insurance | Tagged: Health Insurance, health insurance for artists | Leave a comment »

2014 Forecast of Medical Per Capita Claims

Posted on October 21, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Cost Increases by Plan Type

By www.MCOL.com

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More:

Seeking Authors for our new “Financial Planning for Doctors and Health Professionals” Textbook

Conclusion

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Filed under: Health Insurance, Healthcare Finance | Tagged: FFS, HDHPs, health insurance plans, HMO, Medical Per Capita Claims, PPO, www.MCOL.com | Leave a comment »

How to Transition into Medicare?

Posted on October 11, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

The Timing, Costs, and Factors to Know

By Lon Jefferies MBA CFP® http://www.NewWorthAdvice.com

Did you know that the choices you make during your first year of Medicare eligibility will have long-term financial consequences? Yes, it is true!

And unfortunately, most people and even medical professionals have to make these decisions at a time when they are only beginning to familiarize themselves with a complex program.

The Rules

If you don’t follow Medicare’s enrollment rules, you may pay lifelong penalties for coverage. You have a seven-month window to enroll in Medicare as you turn 65. This window begins three months before the month of your birthday, includes the month of your birthday, and continues for the following three months.

The Parts

Part A

In most cases, you should sign up for Medicare Part A, which covers hospital stays, when you turn 65, even if you have other health insurance coverage. There is no cost for this coverage as long as you have 40 quarters of work in which you paid FICA taxes.

However, be aware that you are not allowed to contribute to a health savings account (HSA) if you are receiving benefits from Medicare. Thus, you may want to defer beginning Part A to continue building up your HSA balance to help offset future healthcare costs not covered by Medicare.

Part B

Medicare Part B covers services and supplies that are needed to diagnose or treat medical conditions, and health care to prevent illness. The standard monthly premium for Part B in 2013 is $104.90, but individuals with a modified adjusted gross income (MAGI) more than $85,000 and couples with a MAGI more than $170,000 pay more.

The premium ranges from $146.90 to $335.70 for those with incomes above the thresholds. If you have group health insurance through your own or a spouse’s employer, you may want to delay beginning Part B.

However, for this to be done without penalty, be sure to enroll in Part B coverage within eight months of the time your employment ceases. Otherwise, for every 12-month period that you could have been enrolled in Medicare Part B but were not, you will pay a 10 percent penalty on your Part B premium for life.

Part D

Medicare Part D covers prescription drugs. This coverage is usually purchased at the same time as Part B. Part D monthly premiums vary by plan. However, higher-income beneficiaries (singles with a MAGI over $85,000 and couples with a MAGI over $170,000) pay from $11.60 to $66.60 more each month.

There is also a late enrollment penalty for Part D that is one percent of the “national base beneficiary premium” ($31.17 in 2013) multiplied by the number of full months you went without drug coverage.

Part C

Note that Medicare Part C is not a separate benefit. Part C, sometimes referred to as a Medicare Advantage Plan [MAP], is the portion of Medicare that allows private health insurance companies to provide Medicare benefits.

Part C is an alternative method for obtaining the same coverage that Part A and Part B provide, but do so through private insurance providers with different rules, costs and coverage restrictions. You can also get Part D as part of the benefits package if you choose. Although significant research is required, determining whether Part C is a viable option for you is simply a matter of considering your health, the medical services you use regularly, your prescription drug medications, and your budget.

Assessment

Medicare is a complex program. Enrolling on time and making informed decisions about coverage can save you thousands of dollars each year during retirement.

Conclusion

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Filed under: Health Insurance | Tagged: HSA, http://www.NewWorthAdvice.com, Lon Jefferies, medicare, Transitioning to Medicare? | 6 Comments »

Marketplace HIE Enrollment Update

Posted on October 5, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

In Selected States

[By www.MCOL.com]

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Conclusion

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Filed under: Health Insurance, Information Technology | Tagged: health exchanges, Health Insurance, HIE's, HIT, insurance exchanges, state marketplaces, www.MCOL.com | 6 Comments »

How affordable is the new health care law – Really?

Posted on October 3, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Calculate your costs

[By Staff Reporters]

The Affordable Care Act is going to change health care for tens of millions of Americans.

But, what about the cost?

LET’S BEGIN

###

NOW CALCULATE

Whether you’re an individual who has health insurance or needs it, or a small business owner, you need to know how health care reform affects you.

What’s it going to cost? What’s happening in your state?

###

Link: http://www.nbcnews.com/health/how-affordable-new-health-care-law-really-calculate-your-cost-8C11296290

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Economics, Health Insurance, Health Law & Policy, Taxation | Tagged: ACA, Affordable Care Act., How affordable is new health care law?, Patient Protection and Affordable Care Act, PP-ACA | 13 Comments »

Understanding Basics of the Health Insurance Exchanges [HIEs]

Posted on October 2, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

The Four Basic Categories of the PP-ACA

By Rick Kahler CFP® http://www.KahlerFinancial.com

The opening date was yesterday, October 1, 2013. And today, the competition is lined-up and ready to go after bronze, silver, gold, and even platinum.

These competitors aren’t athletes, but insurance providers. The field they are entering is the new health insurance exchanges [HIEs] as mandated by Obamacare [ACA].

The New Year

Beginning January 1st 2014, nearly everyone in the US will need to have health insurance or pay a tax penalty. Those not insured through their employers can apply for coverage through these health insurance exchanges, also called “marketplaces.” Enrollment began October 1st, 2013 for coverage starting in January, 2014.

These exchanges are intended to make it easier to find insurance providers and compare their coverage and costs. Each state’s exchange website will list all the policies available in that state, with prices and policy provisions.

So far, over half of the states (including my State of South Dakota) have opted to use exchanges managed by the federal government instead of setting up their own.

The Four Basic [Colors] Categories

Bronze, silver, gold, and platinum describe the four basic categories of policies that will be available through the exchanges at different costs. Here is a very brief summary of each category.

Bronze

The least expensive option is a bronze plan, which might be the best choice for younger people with lower incomes and good health. The plan will pay 60% of health care costs and the insured will be responsible for 40%.

Silver

The second level, silver, will pay 70% of health care costs.

Gold and Platinum

Gold covers 80%, and a platinum plan covers 90%. Obviously, the categories with higher benefits also will have higher premiums.

The Essential Benefits

All these plans are required to cover “essential health benefits.” These include preventive and wellness care like cancer screening, chronic disease management, pediatric care, many prescription drugs, injury rehabilitation, mental health and addiction treatment, maternity and newborn care, hospitalization, and emergency services.

Companies are not allowed to deny coverage or charge more for those with pre-existing conditions. There are no lifetime benefit limits.

The Carrot and Stick Approach

The requirement to have health insurance coverage, the “stick” of Obamacare, is accompanied by a “carrot” in the form of federal subsidies to help pay insurance premiums. It’s estimated that two-thirds of Americans will be eligible for subsidies, which will be figured on a sliding scale. The upper limit for qualifying is four times the federal poverty level, which amounts to about $88,000 a year for a family of four.

Other Outlines

This ME-P summary is just the barest outline of the health care changes coming our way. To find out more, it’s a good idea to spend some time online, especially at two sites that offer a lot of helpful information.

The First site is the federal government website at www.HealthCare.gov. It provides links to the state exchanges, plus detailed information that for the most part is explained in straightforward, plain English.
The Second site is the Henry J. Kaiser Family Foundation at kff.org. An especially useful tool available here (http://kff.org/interactive/subsidy-calculator/) is a calculator to determine the federal subsidy that applies at your family’s income level.

Obamacare 2014

The elements of Obamacare that take effect in 2014 represent a huge shift in the way we cover health care costs. I strongly recommend that you start now to figure out what this will mean for you and your family.

###

Don’t wait until December and end up making hasty decisions in a last-minute rush. The more informed you are; the better insurance choices you can make.

Assessment

The changeover to the new insurance environment is likely to be chaotic and confusing. Navigating it will take some energy, commitment, and stamina. When all the scrambling is over, we can only hope the ultimate winners will be the American people.

Conclusion

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Filed under: Health Insurance, Information Technology | Tagged: ACA, Affordable Care Act., Healthcare Exchanges, Kaiser Family Foundation, ObamaCare, PP-ACA | 21 Comments »

Affordable Care Act HIEs at Launch

Posted on October 1, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Some Important Launching Information for Doctors and Business Owners

By Bobby Whirley CPA

[Whirley & Associates LLC – Alpharetta, GA]

Dear ME-P Readers,

The ACA (Affordable Care Act) requires employers to provide their workers with a notice about the state health insurance exchanges.

Today – October 1st is the deadline for providing these notices.

These exchanges will sell insurance to individuals who don’t get coverage through their employers. The exchanges are also available to medical practices and small businesses, which may or may not currently offer heath care coverage.

The Fines?

Some doctors or business owners are concerned about paying a fine of up to $100 per day under the general non-compliance penalty provisions.

The recent notice of the Affordable Health Care Act states that there will be no penalty. Please refer to http://www.dol.gov/ebsa/faqs/faq-noticeofcoverageoptions.html

If your medical practice, clinic or company is covered by the Fair Labor Standards Act (you have one or more employees, sales of over $500,000, and deal in interstate commerce), you must provide a written notice to your employees about the Health Insurance Marketplace by Oct 1, 2013.

Model Notices

The U.S. Department of Labor has two model notices to help employers comply. There is one model for employers who do not offer a health plan and another model for employers who offer a health plan or some or all employees.

More:

The model notices are also available in Spanish and MS Word format at http://www.dol.gov/ebsa/healthreform/

###

Assessment

Employers may use one of these models, as applicable, or a modified version. More compliance assistance information is available in a Technical Release issued by the US Department of Labor.

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Filed under: Accounting, Health Insurance, Health Law & Policy | Tagged: ACA, Affordable Care Act., Bobby Whirley CPA, Patient Protection and Affordable Care Act, PP-ACA, US Department of Labor | 21 Comments »

HDHP Enrollment Stats for 2008-2013

Posted on September 27, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Enrollment Stats for those Under Age 65

By www.MCOL.com

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Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Insurance | Tagged: HD-HCPs, high deductible health plans, High Deductible-HCPs | Leave a comment »

Do creepy anti-Obamacare ads defile an icon?

Posted on September 25, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Is Uncle Sam Under Attack?

via: The Joker

Featuring a bizarre Uncle Sam figure, these commercials are coming under fire from liberals as debasing a national figurehead.

###

[CLICK HERE FOR VIDEO]

http://www.youtube.com/watch?v=R7cRsfW0Jv8

More:

Creepy ads target Obamacare

Assessment

What do you think?

Conclusion

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Filed under: Health Insurance, Jokes and Puns, Op-Editorials, Videos | Tagged: 0bamacare, Do creepy anti-Obamacare ads defile an icon?, Generation Opportunity, Koch brothers, Uncle Sam | 13 Comments »

Upcoming Webinars and Health Administration Essays around the Net

Posted on September 14, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Some Topics of Interest for ME-P Readers

###

Assessment

Enjoy these informative private sector and government publications.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Career Development, Health Economics, Health Insurance, Healthcare Finance, Recommended Books, Research & Development | Tagged: Webinars | Leave a comment »

On Hospital Re-Admissions

Posted on September 13, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Counting Re-Admissions using an Infographic

By www.MCOL.com

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Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Insurance, Quality Initiatives | 2 Comments »

The Percentage of Covered Employees by Type of Health Plan

Posted on September 1, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

From 1988 to 2000

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Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Economics, Health Insurance, Retirement and Benefits | Tagged: health plans | 1 Comment »

Commercial Health Plans’ Medical Loss Ratio [2nd Quarter 2013]

Posted on August 17, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

By http://www.MCOL.com

The 85% Rule

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Conclusion

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Filed under: Health Economics, Health Insurance | Tagged: Commercial Health Plans' Medical Loss Ratio, medical insurance loss ratios | 3 Comments »

The High Deductible Health Plan Option?

Posted on July 22, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

As the Only Employer Health Benefit Choice!

By www.MCOL.com

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More

Conclusion

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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 Insurance | Tagged: Employer Health Benefit Choices, HDHPs, high deductible health plans, www.MCOL.com | 8 Comments »

Some Vital Survival Tools for Physicians and their Consulting Advisors

Posted on July 1, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

OUR BOOKS, TEXTS AND DICTIONARIES ARE VITAL SURVIVAL TOOLS FOR ALL PHYSICIANS … AND THEIR CONSULTING ADVISORS

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Filed under: Book Reviews, Financial Planning, Health Insurance, Practice Management, Risk Management | Tagged: financial advisors, physicians, Survival Tools for Physicians | Leave a comment »

Understanding the Impact of Regulations, Laws, and Healthcare Reform

Posted on June 17, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Consequences of the Accountable Care Act [PP-ACA]

By Dr. David Edward Marcinko MBA CMP™

[Editor-in-Chief]

There is a fair amount of activity that will take place in the next 24 months in response to ICD-10 transition, healthcare reform, Accountable Care Act (ACA), meaningful use compliance and its financial incentives, and other regulatory issues that will require system or software upgrades to support the new efforts.

Some ACA Examples

As an example, The Affordable Care Act is sure to significantly alter reimbursement structures and delivery of care.

Below are several areas that will be affected:

With the projected increase in patient volumes, the associated cost of about 62% will emanate from Medicare cuts: $162 Billion through reducing fee-for-service Medicare payments; $136 Billion from setting Medicare Advantage rates based on Fee-for-Service payments; and $36 Billion from cutting hospital Medicare/Medicaid disproportionate share.
Compliance reviews will be increased through the Recovery Audit Contractors (RACs) where Centers for Medicare and Medicaid Services (CMS) expect to obtain $2.9 Billion in additional savings. With the RAC in place, hospitals and providers need to increase their focus and attention in improving documentation quality and validating medical necessity to substantiate their reviews.
Reduced payments for readmissions and Medicare penalties for poor outcomes can and will affect the bottom line for both hospitals and providers in the future.
By 2015, more than 19 million uninsured will receive coverage and in 2016, another 11 Million uninsured will be insured. This will create more patients per hospital/provider and will require more full-time equivalents to support the revenue cycle process of registration, documentation, billing and collection.
With the ICD-10 conversion will create a more complex requirement for documenting diagnoses and will require software modifications for hospitals and providers as well as significant training.

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[Our Forthcoming Book]

More:

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: Book Reviews, Health Insurance, Health Law & Policy | 2 Comments »

Doubting the Accountable Care Organization B-Model

Posted on May 24, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

New Healthcare Business Model or Edsel Model?

By David Edward Marcinko MBA http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

Defined by Professor Michael Porter at Harvard Business School, value is defined as a function of outcomes and costs. Therefore to achieve high value we must deliver the best possible outcomes in the most efficient way, outcomes which matter from the perspective of the individual receiving healthcare and not provider process measures or targets.

Sir Muir Gray expanded on the idea of technical value (outcomes/costs) to specifically describe ‘personal value’ and ‘allocative value’, encouraging us to focus also on shared decision making, individual preferences for care and ensuring that resources are allocated for maximum value.

Healthcare Value and ACOs

According to our Medical Executive-Post Health Dictionary Series of administrative terms http://www.HealthDictionarySeries.org and health economist and colleague Robert James Cimasi MHA, ASA, AVA CMP™ of www.HealthCapital.com; an ACO is a healthcare organization in which a set of providers, usually large physician groups and hospitals, are held accountable for the cost and quality of care delivered to a specific local population.

ACOs aim to affect provider’s patient expenditures and outcomes by integrating clinical and administrative departments to coordinate care and share financial risk.

ACO Launch

Since their four-page introduction in the PP-ACA of 2010, ACOs have been implemented in both the Federal and commercial healthcare markets, with 32 Pioneer ACOs selected (on December 19, 2011), 116 Federal applications accepted (on April 10, 2012 and July 9, 2012), and at least 160 or more Commercial ACOs in existence today.

Federal Contracts

Federal ACO contracts are established between an ACO and CMS, and are regulated under the CMS Medicare Shared Savings Program (MSSP) Final Rule, published November 2, 2011. ACOs participating in the MSSP are accountable for the health outcomes, represented by 33 quality metrics, and Medicare beneficiary expenditures of a prospectively assigned population of Medicare beneficiaries.

If a Federal ACO achieves Medicare beneficiary expenditures below a CMS established benchmark (and meets quality targets), they are eligible to receive a portion of the achieved Medicare beneficiary expenditure savings, in the form of a shared savings payment.

Commercial Contracts

Commercial ACO contracts are not limited by any specific legislation, only by the contract between the ACO and a commercial payor.

In addition to shared savings models, Commercial ACOs may incentivize lower costs and improved patient outcomes through reimbursement models that share risk between the payor and the providers, i.e., pay for performance compensation arrangements and/or partial to full capitation.

Although commercial ACOs experience a greater degree of flexibility in their structure and reimbursement, the principals for success for both Federal ACOs and Commercial ACOs are similar.

###

Dr. David E. Marcinko with 1960 Ford Edsel

[The Edsel was an automobile marque that was planned, developed, and manufactured by the Ford Motor Company during the 1958, 1959, and 1960 model years. With the Edsel, Ford had expected to make significant inroads into the market share of both General Motors and Chrysler and close the gap between itself and GM in the domestic American automotive market. But, contrary to Ford’s internal plans and projections, the Edsel never gained popularity with contemporary American car buyers and sold poorly. The Ford Motor Company lost millions of dollars on the Edsel’s development, manufacturing and marketing].

More:

Update

Junking the Merit-Based Incentive Payment System (MIPS) would undoubtedly let the proverbial air out of the MACRA balloon, dealing a significant blow to the value-based reimbursement shift; right?

Assessment

Although nearly any healthcare enterprise can integrate and become an ACO, larger enterprises, may be best suited for ACO status.

Larger organizations are more able to accommodate the significant capital requirements of ACO development, implementation, and operation (e.g., healthcare information technology), and sustain the sufficient number of beneficiaries to have a significant impact on quality and cost metrics.

Conclusion

But, will this new B-Model work? Isn’t leading doctors in a shared collaborative effort a bit like herding cats? And, what about patients, HIEs, outcomes management, data analytics and … Population Health via our colleague David B. Nash MD MBA of Thomas Jefferson University, often considered the “father” of Pop Health?

OR, what about the developing IRS scandal and full PP-ACA launch in 2014? Will it affect federal funding, full roll-out, or even repeal of the entire Act?

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Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Research & Development | Tagged: ACA, Accountable Care Organization, CMS, David Nash, edsel, HealthCapital.com, HIE's, Medicaid, medicare, Medicare Shared Savings program, Population Health, robert james cimasi | 16 Comments »

Purchase ME-P Textbooks, Handbooks and Dictionaries to Thrive

Posted on May 23, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Our Library is Growing … thanks to you

By Ann Miller RN MHA

[ME-P Executive-Director]

We have been publishing the Medical Executive-Post for more than eight years now. And, with almost 3,000 formal posts, by the nation’s brightest experts, we have a treasure trove of information available to you.

So now, for the first time, all this information – and more – has been codified, updated, copy-righted and copy-protected in print form for your purchase and use. All have been edited by our Publisher – Dr. David Edward Marcinko and Professor Hope Rachel Hetico.

Just click on an image below to order.

Assessment

Purchase our white papers, too: https://medicalexecutivepost.com/white-papers/

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Book Reviews, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, Information Technology, Practice Management, Professional Liability, Risk Management | Tagged: david marcinko, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, HIT, Hope Heticl, medical executive post, medical risk management, Practice Management | 3 Comments »

Healthcare Promises [aka ACA]

Posted on May 15, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

On the Affordable Care Act

By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com

“I’m not sure what’s wrong or what kind of surgery you need, but we have to operate right now.”

If you heard this from your doctor, you’d jump off the examination table and run for the door. Yet that’s essentially the approach the President and Congress used three years ago to pass a bill, optimistically called the Affordable Care Act, which was the largest transformation of the U.S. health care system in our lifetime.

The Debate

During the frenzied debate our elected leaders made many promises as to the amazing benefits this legislation would bestow on Americans. After listening to speeches from President Obama, Speaker of the House Nancy Pelosi, and President of the Senate Harry Reid, I recounted those promises in this blog on March 21, 2010.

The Promises

Let’s revisit those promises.

All Americans will now receive affordable, or free, quality health care.
No one will ever be denied coverage.
No one will ever go into bankruptcy because of the costs of health care.
There will be increased access to health care for 95% of Americans.
There will be no decline in the quality of health care.
Health care costs will go down.
Health insurance coverage will be affordable to the middle class.
There will be no decline in Medicare benefits.
Insurance premiums will decline for the middle class.
It will unleash unprecedented entrepreneurial opportunity for the economy.
The deficit will decline, saving taxpayers $1.3 trillion.
It will cut $500 billion of waste, fraud, and abuse out of Medicare.
No government funds will be used to fund abortion.

Are these promises coming true? Many of them are pending full implementation of the act in 2014. Others have fallen flat or encountered the law of unintended consequences.

Business Owner’s

I’ve heard recently from several owners of small businesses about their increased health insurance costs. In addition to premium increases of nearly 50% over the past two years, they are seeing increased administrative costs from what one person called the “insanity and complexity” of the new regulations.

Businesses with fewer than 50 employees aren’t required to provide health insurance. The incentive for owners of businesses close to that threshold is to keep employee numbers below 50, which means curtailing growth or even laying people off.

Those without employer-provided insurance are supposed to be able to shop for coverage in new health care exchanges, beginning this October. However, half the states have chosen to rely on the federal government instead of setting up their own exchanges.

This has brought criticism even from former supporters like Democratic Senator Max Baucus of Montana, who helped write the health care bill. He is concerned that the exchanges will not open on time and consumers won’t have the information they need to use them. He told the Huffington Post that Obamacare is headed for a “train wreck.”

ACA Cost Estimates

The proponents said the ACA would cost $938 billion over 10 years. In addition to the promised Medicare savings, this was to be covered by a total tax increase of $562 billion over 10 years. This included a Medicare tax of 3.8% on dividends, rents, interest, and investment income on individuals and small business earning over $250,000.

The Office of Management and Budget, however, places the cost at $1.8 trillion over 10 years, resulting in a shortfall of around $900 billion.

Assessment

Whether Obamacare becomes the wild success the proponents guaranteed is yet to be seen. However, what we’ve seen so far isn’t promising. We as consumers would be well advised to pay close attention and ask tough questions before we accept this drastic surgery.

More

Conclusion

Are these promises coming true? 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.

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Filed under: Health Insurance, Health Law & Policy | Tagged: ACA, Affordable Care Act., Harry Reid, Max Baucus, Obama care | 15 Comments »

The status of African American insurance coverage

Posted on April 8, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

A Struggling PP-ACA Sector

The Affordable Care Act has developed into one of the critical pivots on which the success of President Obama’s second term is expected to turn. Yet, one sector that’s already struggling is African Americans.

In 2012, 17.4 percent of non-Hispanic African Americans were uninsured. More critically, only 55.9 percent of African Americans are expected to continue to live in good health, while a more or less healthy life is expected in 69.4 percen of white Americans.

###

Assessment

These and other alarming facts were revealed by the National Health Interview Survey of the Center for Disease Control and Prevention, and corroborated by data from the U.S. Census Bureau. Both these agencies were data sources for this infographic, which takes a closer look at the health insurance situation of African Americans.

Conclusion

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Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc. | Tagged: African Americans, CDC, National Health Interview Survey, Obama care, PP-ACA, U.S. Census Bureau | 1 Comment »

A Visual on Health Entitlement Spending

Posted on April 4, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

A Story in Six Charts

By Nancy Chockley PhD www.NIHCM.org

Between the fiscal cliff, sequestration, a potential government shut down and the debt ceiling, Washington is experiencing a seemingly endless succession of budgetary crises.

Although health entitlement programs are often on the table in negotiations, there has been little agreement on the scope and direction of meaningful reform. The recent slowdown in health spending growth may strengthen the impulse on some fronts to delay action, but long-term projections leave little doubt that federal health spending will continue to be a major contributor to our fiscal woes.

Assessment

This chart story pulls together essential facts on how much the federal government is spending on mandatory health care programs, how that spending affects the budget, and the hard spending and revenue trade-offs necessary to improve our fiscal outlook.

chart story

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: Health Entitlement Spending, Nancy Chockley PhD, www.MIHCM.org | 2 Comments »

How to Handle Incurred But Not Reported Health Insurance Claims [Webinar]

Posted on April 2, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

###

Event Information

[Live Audio Conference – Webinar]

Presenter: Dr. David Edward Marcinko; MBA CMP™

http://www.audioeducator.com/speakers/index/speaker/600

###

Conference Date: Tue, Apr 02, 2013

Aired Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT

Length: 60 Minutes

Product Description

###

Here’s How to Augment Bottom-Line Revenues by Understanding IBNR Healthcare Claims

One of most relevant financial issues of the PP-ACA and contemporary healthcare and medical reimbursement is known as Incurred But Not Reported (IBNR) healthcare claims. IBNR claims are an indirect result of prospective payments systems, the insurance industry and commercial risk contracts, and to some extent fee-for-service medicine. IBNR claims represent a risk and an opportunity for managed care companies, healthcare organizations, clinics, physicians and related medical providers alike.

Join this enlightening event presented by expert speaker Dr. David Edward Marcinko MBA CMP™ who will provide you detailed insights on IBNR claims so that you do not face any compliance risk and optimize your organization’s bottom line.

Here is a brief sample of some details you may learn:

Historical Review
What Is an IBNR Claim?
IBNR Problems for Healthcare Organizations
IBNR Claims — Management Volume and Consequences
Inadequate Cash Flows
Reserve Shortfalls and Fiscal Instability
Inaccurate Pricing
Administrative Cost Increases
Regulatory Sanctions
Managed Care Organization Exacerbation of IBNR Claims
IBNR from a Net Present Value Perspective
Tax Strategies for IBNRs

IRS Rules and Regulations
IBNR Tax Qualifications for Managed Care Organizations
How Managed Care Organizations Intensify IBNRs
How Does IBNR Affect Net Present Value?

IBNR Challenges and Solutions

1. Tax and Court Penalties

IRC Section 4958
Excess Benefit Definition
Taxes under Section 4958

2. Tax Deductibility

Potential Solutions to the IBNR Challenge
IBNR Calculations and Methodology

Actuarial Data Analysis
Open Referral Analysis
Historic Cost Analysis

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Who should attend? All charge-master coordinators, coding personnel, billing and claims transaction personnel, internal auditing personnel; and financial and compliance personnel! And, all administrators, accountants, comptrollers, office managers, billing clerks and physician-executives, CFOs, CXOs and other interested parties.

###

http://www.audioeducator.com/medical-coding-billing/ibnr_problems-040213.html

ORDER HERE FOR WEBINAR

Filed under: Accounting, Health Insurance, Practice Management, Videos | Tagged: capitation, commercial risk contracts, Dr. Marcinko, fee-for-service medicine, Health Insurance, healthcare claims, IBNR, Incurred But Not Reported, PPSs, prospective payments systems | 1 Comment »

Medicare Inpatient Profitability in US Hospitals

Posted on March 14, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

The Impending Need for Cost-Efficiency

[By Objective Health]

Medicare patients often account for the largest proportion of inpatient volume for an average US hospital. With the exception of outlier cases, Medicare inpatient services are adjusted for wage rates and reimbursed as a single predetermined payment across the country.

Over the next few years, Medicare is expected to substantially reduce growth in payment rates, thereby pressuring hospitals to become more cost-efficient.

###

Assessment

This infographic highlights the need for hospitals to manage costs, showing that there is a wide variation in Medicare inpatient profit across US hospitals, which is primarily driven by differences in Medicare cost per case.

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 | Tagged: Hospitals and Healthcare Organizations, medicare, Objective Health, Profitability of US Hospitals | 3 Comments »

Understanding the Pre-Reform Impact of Self-Pay Patients

Posted on March 12, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

On Us Hospitals

Source: Objective Health

Pre-reform, many hospitals experience significant uncompensated care costs from self-pay patients.

###

This infographic illustrates the variation in self-pay uncompensated care costs across US hospitals and regions.

Assessment

Despite the uncompensated care risk, 1/6th of self-pay inpatients are scheduled admissions, though their procedures are much less elective than the procedures of the insured.

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: admissions, direct pay medicine, hospitals, Objective Health, self-pay patients, uncompensated care | Leave a comment »

Why are Medical Bills so High [video]

Posted on March 10, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

______________________________

TIME’s Best Cover Story … Ever?

###

TIME magazine just dedicated its current issue to just one article: “Bitter Pill: Why Medical Bills Are Killing Us.”

###

The article, written by Time contributor Steven Brill, is required reading for all healthcare providers, administrators, legislators, patients — basically, everyone; especially readers of this ME-P.

The article is too comprehensive to summarize in one blurb, but Mr. Brill did a good job of describing its origins to Jon Stewart on The Daily Show.

Throughout all of the discussions during the Obamacare debate, the focus was usually on who should pay the medical bills. Brill said, “We never asked the first question: Why are the bills so high?”

###

Assessment

We wish we could say we thought of this, but it was Matt Yglesias who did.

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, Health Insurance, Healthcare Finance, Videos | Tagged: Bitter Pill: Why Medical Bills Are Killing Us.”, healthcare costs, Jon Stewart, Matt Yglesias, The Daily Show., TIME magazine, Why are the medical bills so high | 3 Comments »

“The Doctor’s Dilemma”

Posted on March 2, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

On Hospital Monopolistic Powers

By Ann Miller RN MHA

As George Bernard Shaw, whose works include “The Doctor’s Dilemma” might have put it, that any lawmaker would grant hospitals monopolistic powers plus the freedom to price as they see fit is enough to make one despair of political humanity.

C.O.N.

And, here is a post on Certificates of Need, too.

http://www.ncsl.org/issues-research/health/con-certificate-of-need-state-laws.aspx

Conclusion

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

Our Other Print Books and Related Information Sources:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

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

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

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

Filed under: Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc. | Tagged: Certificate of Need, CON, George Bernard Shaw, Hospital Monopolistic Powers, The Doctor’s Dilemma | Leave a comment »

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Here’s How to Augment Bottom-Line Revenues by Understanding IBNR Healthcare Claims

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