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PODCAST: How to be a DEBT FREE Direct Primary Care Physician?

Posted on July 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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DEFINITION: The DPC model was created to allow for a singular focus upon the Primary Care Physician-2-Patient relationship. To achieve this, DPC removes the hassles and overhead expenses created by insurance and replaces it with a fixed monthly membership fee. This simplified approach frees the physician from meaningless paperwork and allows them to only see 8-10 patients a day. This level of personalized engagement allows them to develop a meaningful and enduring relationship with each patient.

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

By James Hawkes MD

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Dr. James Hawkes grew up in a large family. His father was a U.S. diplomat, which exposed him to different models of healthcare. In addition to exposure, his grandmother encouraged him to become a doctor. He followed her recommendation but to his surprise, the definition of a good doctor wasn’t about improving patients’ quality of life it was about hierarchies, documentation, administrative requirements, and quality measures.

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Shortly after saying goodbye to the traditional healthcare model, he launched his own direct care practice. Fast forward to today, he is a 100% debt-free direct care physician. He shares his story of how it’s possible to achieve this goal.

PODCAST: https://healthcareamericana.com/episode/how-to-become-a-debt-free-direct-care-physician/

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Filed under: "Doctors Only", Career Development, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Videos | Tagged: Debt Free Direct Primary Care, Direct Primary Care, DPC, James Hawkes MD, physician, primary care | 1 Comment »

PODCAST: “Real ACOs Haven’t Been Tried Yet!”

Posted on July 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

What is an Accountable Care Organization?

DEFINITION: ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings.

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

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QUESTION: What happens when you’re a healthcare policy wonk and the pilot study for your pet program has failed miserably?

ANSWER: You declare “Success!” in the editorial pages of the New England Journal of Medicine and demand that the program become nationwide and mandatory. I kid you not. This is exactly what happens.

Thankfully, Anish Koka is vigilant and explains the blatant obfuscations and manipulations that the central planners engage in to have their way.

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And so, In this video, Anish and colleague Michel Accad, MD, will reveal the machinations, take the culprits to task, and discuss pertinent questions regarding health care organization:

Does “capitation” reduce costs?

Do employed physicians necessarily utilize fewer resources?

What happens when a HMO and a traditional fee-for-service health system operate side-by-side in a community?

BMC and Accountable Care - Boston Medical Center

Enjoy!

PODCAST: http://alertandoriented.com/real-acos-havent-been-tried-yet/

Your thoughts are appreciated.

THANK YOU

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Filed under: Career Development, Ethics, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Op-Editorials, Practice Management, Videos | Tagged: Accountable Care Organizations, ACO, ACOs, Anish Koka, capitation, fee for service, FFS, HMO, Michael Accad MD, NEJM | Leave a comment »

ACOs: Regulatory Environment Scrutiny

Posted on July 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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Because of the federal government’s preference for, and reliance on the success of, accountable care organizations (ACOs), some ACOs assume their legal status shields the organization from legal scrutiny on all issues.

However, since the 2010 advent of ACOs, the law has adapted uniquely to these organizations. This fourth installment of a five-part series on the valuation of ACOs will discuss this unique regulatory environment in which ACOs operate. (Read more…)

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Filed under: "Doctors Only", Accounting, CMP Program, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Practice Management, Practice Worth | Tagged: Accountable Care Organizations, ACO, ACOs, HCC, Health Capital Consultants | Leave a comment »

ACOs: A Brief History of Accountable Care Organizations

Posted on July 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

ACOs to the Rescue – Not Yet!

By Dr. David E. Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

According to the Health Dictionary Series of administrative terms; valuation expert 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 [personal communication]

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Enter the PP-ACA

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

More recently, Donna Marbury writing in Medical Economics, revealed that 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.

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Commercial Contracts

Commercial ACO contracts are not limited by any specific legislation, only by the contract between the ACO and a commercial payer. In addition to shared savings models which may not be in effect for another 3-5 years, Commercial ACOs may incentivize lower costs and improved patient outcomes through reimbursement models that share risk between the payer 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. And, nearly any healthcare enterprise can integrate and become an ACO, larger enterprises, may be best suited for ACO status.

Medicare Contracts

On Medicare ACOs

Assessment

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.

More:

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

[Foreword Dr. Phillips MD JD MBA LLM] *** [Foreword Dr. Nash MD MBA FACP]

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Filed under: "Doctors Only", Accounting, Career Development, CMP Program, Health Economics, Health Insurance, Healthcare Finance, Touring with Marcinko | Tagged: Accountable Care Organizations, ACOs, CMP™ Course, Dr. David E. Marcinko | 1 Comment »

DAILY UPDATE: Mike Bloomberg, Arianna Huffington and Andreessen Horowitz as Stock Markets Tread Lightly

Posted on July 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
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REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

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Most medical students at Johns Hopkins University won’t have to pay tuition anymore thanks to a $1 billion gift from Michael Bloomberg.

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

Here’s where the major benchmarks ended:

The S&P 500 index^®(SPX) rose 4.13 points (0.1%) to 5,576.98; the Dow Jones Industrial Average^® ($DJI) fell 52.82 points (0.1%) to 39,291.97; the NASDAQ Composite^® ($COMP) climbed 25.55 points (0.1%) to 18,429.9.
The 10-year Treasury note yield increased two basis points to 4.29%.
The CBOE Volatility Index^® (VIX) inched up to 12.49, still near recent lows.

What’s up

Tesla rose 3.71%, putting the company squarely in the green year to date as investors continue to celebrate the automaker’s strong delivery numbers.
Corning rose yet another 3.76%, extending the glassmaker’s gains as it quickly becomes the new hot AI stock du jour.
Kymera Therapeutics shot 23.40% higher after its partner Sanofi gave the go-ahead for further studies of its experimental skin disease treatment.
Jumia Technologies soared 29.79% after Benchmark analysts initiated coverage of the African e-commerce company with a “buy” rating.
Sony rose 4.46% on the news that it has nothing to do with the merger of Paramount and Skydance as shareholders celebrate dodging a Paramount-shaped bullet.

What’s down

Albemarle dropped 8.76% after Baird analysts warned that lower lithium demand will translate to lower profits for the miner in its upcoming second quarter.
BP sank 4.80% after management warned of lower-than-expected profits and a writedown of its German refining facility to the tune of up to $2 billion.
Helios Technologies fell 10.94% on the news that the CEO of the industrial manufacturer had been placed on paid leave for potentially violating the company’s code of ethics.
Helen of Troy plummeted 27.73% after the Hydro Flask maker announced terrible earnings and lowered its fiscal year outlook.
UiPath fell 6.90% on the announcement that the software company will cut 10% of its workforce.

CITE: https://tinyurl.com/2h47urt5

OpenAI’s venture fund and Arianna Huffington’s Thrive Global are jointly funding a new startup that aims to build an AI health coach to promote healthier lifestyles.

Function Health, a health tech company focused on preventive medicine, recently closed a series A round led by Andreessen Horowitz (a16z) Bio + Health along with a slew of celebrity investors.

And … made possible by the American Rescue Plan, the Biden administration is putting $27.5 million toward women’s behavioral health.

CITE: https://tinyurl.com/tj8smmes

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EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

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Filed under: "Ask-an-Advisor", "Doctors Only", Breaking News, Drugs and Pharma, Ethics, Experts Invited, Financial Planning, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors, Touring with Marcinko | Tagged: Andreessen Horowitz, Bloomberg, CBOE, DJIA, function health, Huffington, JHU, Johns Hopkins, Marcinko, medical fraud, NASDAQ, openAI, opioids, S&P 500, SPX, textbooks, thrive global, TNX, VIX, WSJ | Leave a comment »

PRIVATE EQUITY: Ownership in Physician Practices

Posted on July 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By NIHCM

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Private equity acquisition of physician practices continues to grow nationwide. New research focused on specialists in dermatology, gastroenterology, and ophthalmology shows the impact of the trend.

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

Novel evidence by NIHCM grantee Jane Zhu, MD, and her team, reveals shifts in workforce composition and hiring patterns after private equity firms obtain physician practices. The researchers’ findings are particularly important for policymakers and practices considering selling to private equity firms. Highlights include:

A significant yearly increase in the number of advanced practice providers at private equity-acquired practices, specifically nurse practitioners and physician assistants.
In acquired practices, entering clinicians replaced exiting clinicians at a higher rate than at non-private equity-acquired practices.

This work adds to the research team’s previous findings, including the geographic variations in private equity ownership across six medical specialties, and the impact of private equity on health care costs and utilization.

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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Filed under: "Doctors Only", Alternative Investments, Career Development, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Practice Management, Research & Development | Tagged: equity, Jane Zhu, NIHCM, Ownership in Physician Practices, Private Equity, private practice | Leave a comment »

DAILY UPDATE: Health Insurers & Hospital Mergers with Light Stock Market Trading

Posted on July 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?

REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

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Here’s where the major benchmarks ended:

The CBOE Volatility Index^® (VIX) climbed slightly to 12.37.

The S&P 500 index^®(SPX) rose 5.66points (0.1%) to 5,572.85; the Dow Jones Industrial Average^® ($DJI) dropped 31.08 points (0.1%) to 39,344.79; the NASDAQ Composite^® ($COMP) gained 50.98 points (0.3%) to 18,403.74.

The 10-year Treasury note yield (TNX) was roughly flat at 4.27%.

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