ME-P SYNDICATIONS:
WSJ.com,
CNN.com,
Forbes.com,
WashingtonPost.com,
BusinessWeek.com,
USNews.com, Reuters.com,
TimeWarnerCable.com,
e-How.com,
News Alloy.com,
and Congress.org
BOARD CERTIFICATION EXAM STUDY GUIDES
Lower Extremity Trauma
[Click on Image to Enlarge]
The “Medical Executive-Post” is about connecting doctors, health care executives and modern consulting advisors. It’s about free-enterprise, business, practice, policy, personal financial planning and wealth building capitalism. We have an attitude that’s independent, outspoken, intelligent and so Next-Gen; often edgy, usually controversial. And, our consultants “got fly”, just like U. Read it! Write it! Post it! “Medical Executive-Post”. Call or email us for your FREE advertising and sales consultation TODAY [678.779.8597] Email: MarcinkoAdvisors@outlook.com
ePodiatryConsentForms.com
“Providing Management, Financial and Business Solutions for Modernity”
Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
By Eric Bricker MD
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
Filed under: "Doctors Only", Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Healthcare Finance, Quality Initiatives, Research & Development, Retirement and Benefits, Risk Management, Videos | Tagged: Eric Bricker MD, Medical Treatments, Medical Treatments Have Unknown Effectiveness | Leave a comment »
By Eric Bricker MD
***
***
CITE: https://www.r2library.com/Resource/Title/082610254
COMMENTS APPRECIATED
Thank You
***
***
****
Filed under: "Doctors Only", Accounting, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance | Tagged: Eric Bricker MD, Healthcare claimants, healthcare costs, high cost healthcare, High Cost Healthcare Claimants | Leave a comment »
By Free Market Medical Association
***
***
CITE: https://www.r2library.com/Resource/Title/082610254
COMMENTS APPRECIATED
Thank You
***
***
***
Filed under: "Doctors Only", Career Development, Ethics, Events-Planner, Glossary Terms, Health Economics, Healthcare Finance, Videos | Tagged: Capitalism, Cristin Dickerson MD, Entrepreneurs, FMMA, Free Market Medical Association, health regulation vs entrepreneurship, healthcare entrepreneurship, healthcare requlation, matrix healthcare, medical entrepreneurship, Per Bylund, physician entrepreneurship | Leave a comment »
MANAGEMENT STRATEGIES, TOOLS TEMPLATES AND CASE STUDIES
***
Hospitals and Health Care Organizations is a must-read for any physician and other health care provider to understand the multiple, and increasingly complex, interlocking components of the U.S. health care delivery system, whether they are employed by a hospital system, or manage their own private practices.
The operational principles, methods, and examples in this book provide a framework applicable on both the large organizational and smaller private practice levels and will result in better patient care. Physicians today know they need to better understand business principles and this book by Dr. David E. Marcinko and Professor Hope Rachel Hetico provides an excellent framework and foundation to learn important principles all doctors need to know.
―Richard Berning, MD, Pediatric Cardiology
… Dr. David Edward Marcinko and Professor Hope Rachel Hetico bring their vast health care experience along with additional national experts to provide a health care model-based framework to allow health care professionals to utilize the checklists and templates to evaluate their own systems, recognize where the weak links in the system are, and, by applying the well-illustrated principles, improve the efficiency of the system without sacrificing quality patient care. … The health care delivery system is not an assembly line, but with persistence and time following the guidelines offered in this book, quality patient care can be delivered efficiently and affordably while maintaining the financial viability of institutions and practices.
―James Winston Phillips, MD, MBA, JD, LLM
***
***
***
PURCHASE: https://www.amazon.com/dp/B00BC9IIUM?ref_=k4w_oembed_faGUzLlJ9ojLIx&tag=kpembed-20&linkCode=kpd
***
Filed under: "Doctors Only", Accounting, Book Reviews, Career Development, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Professional Liability, Recommended Books, Research & Development, Risk Management | Tagged: David E. Marcinko, Healthcare CEOs, Hospitals and Healthcare Organizations, Industrial Organizations, Medical COOs, Medical CXOs | 1 Comment »
By Staff Reporters
***
***
A survey was recently conducted by Centivo of 805 US adults ages 18-64 with employer-sponsored private health insurance. The survey found that respondents were willing to accept the following conditions in exchange for significant cost savings:
• 50% would accept referrals for specialists as a requirement.
• 47% would select a primary care physician (PCP) from a defined list.
• 30% would give up their current PCP.
• 28% would stop seeing a current specialist.
Source: Centivo Via PR Newswire, March 16, 2022
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
Filed under: Career Development, Health Insurance, Healthcare Finance, Practice Management, Quality Initiatives | Tagged: 30% of Adults Surveyed Would Give Up Their Current PCP, Centivo, family medicine, Health Insurance, PCP, Primary Care Doctors, primary care physicians, primary care providers | Leave a comment »
By Eric Bricker MD
***
1) Traditional Medicare: Health Insurance for Seniors 65 and older. Medicare Part A is coverage for hospital services. Medicare Part B is coverage for doctor, physical therapist and other provider services and for outpatient services such as labs and imaging.
2) Medicare Advantage: Health Insurance for Seniors 65 and older administered through a private health insurance company. It is sometimes referred to as Medicare Part C. It can be chosen instead of Traditional Medicare and often includes Dental Insurance, Vision Insurance, Hearing Aid Insurance and Prescription Drug Coverage.
3) Medicare Part D Prescription Coverage: Additional insurance for people on Traditional Medicare to cover their prescription medications as well. Medicare Part D is administered by private insurance companies.
4) Medicare Supplement Plans: Insurance that can be purchased in addition to Traditional Medicare to cover the expenses that Traditional Medicare does not cover, such as hospitalization deductibles and Medicare Part B co-insurance.
5) Medicaid: The health insurance program administered by each state for it’s economically disadvantaged residents. It is funded in part by the Federal Government and in part by each state. It is administered by private health insurance companies.
6) Affordable Care Act (ACA) Exchange Plans: Health insurance for people under 65 who make too much money to qualify for Medicaid, but do not received health insurance through their employer. ACA Exchange Plans are subsidized by the Federal Government and administered by private insurance companies.
***
***
COMMENTS APPRECIATED.
Thank You
Subscribe to the Medical Executive-Post
***
***
***
****
Filed under: Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Videos | Tagged: ACA, Affordable Care Act., Eric Bricker MD, Health Insurance, Medicaid, medicare, Medicare Advantage, Medicare Part C, Medicare Part D, medigap, Prescription Insurance Coverage | Leave a comment »
***
A basic understanding of hospital finance is crucial as leaders continue to create policy that shapes healthcare financing. This updated 30,000-foot view of hospital finance is intended to shed some light on the complex system.
By The Center for Health Affairs
***
***
CITE: https://www.r2library.com/Resource/Title/082610254
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
****
Filed under: "Doctors Only", Accounting, Experts Invited, Health Economics, Healthcare Finance, Videos | Tagged: hospital finance, Hospital Finance 101, The Center for Health Affairs | Leave a comment »
BY HEALTH CAPITAL CONSULTANTS, LLC.
DEFINITION: The False Claims Act, also called the “Lincoln Law”, is an American federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal Government’s primary litigation tool in combating fraud against the Government. The law includes a provision that allows people who are not affiliated with the government, called “relators” under the law, to file actions on behalf of the government. Persons filing under the Act stand to receive a portion of any recovered damages.
CITE: https://www.r2library.com/Resource/Title/0826102549
***
DOJ Recoveries for False Claims Act Cases Doubled in 2021
On February 1, 2022, the U.S. Department of Justice (DOJ) announced their recovery of $5.6 billion in settlements and judgments from civil cases involving fraud and false claims for fiscal year (FY) 2021. Over $5 billion was recouped from the healthcare industry for federal losses alone, and included recoveries from drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.
***
This figure is more than double the amount of healthcare-related recoveries secured in FY 2020, which totaled $1.8 billion. (Read more…)
***
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
Filed under: "Doctors Only", Accounting, Career Development, Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance | Tagged: DOJ, false claims act, Health Capital Consultants LLC, health fraud, Lincoln Law, qui tam, relators | 1 Comment »
****
There are a zillion digital health companies on the market, each praising their own solution/product as they can. It is up to the market to decide if these are any good. But how would patients, hospital systems, clinics or even investors decide on their added value? With the help of experts.
It is the 4th time we collect The TOP100 Digital Health Companies. A curated list of the best companies of the thousands we encounter while doing our work at The Medical Futurist. Of them, we chose a hundred that represent the following key values: mindset for innovation, truly disruptive technology, viable business model and a clear dedication to digital health.
Take care,
Berci
Bertalan Meskó, MD
The Medical Futurist
***
YOUR COMMENTS ARE APPRECIATED.
***
Filed under: "Doctors Only", Breaking News, Experts Invited, Health Insurance, Healthcare Finance, Information Technology, Practice Management | Tagged: Bertalan Meskó, Digital Health, Digital Health Companies, medical futurist | Leave a comment »
By Eric Bricker MD
Their 8 Point Strategy Included: 1) CDHP, 2) Centers-of-Excellence, 3) Narrow Network, 4) Rx Formulary Changes, 5) Spousal Surcharge, 6) COBRA Members to the Exchange, 7) 2nd Opinion Program … AND 8) Moved Health Plan Control from HR to a Chief Medical Officer AND Kept a Short Leash on their ASO Carrier.
CITE: https://www.r2library.com/Resource/Title/082610254
Special Thanks to Dr. Steven Goldberg for Publishing His Company’s Experience in an Academic Journal.
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
***
Filed under: "Doctors Only", Career Development, Experts Invited, Glossary Terms, Health Economics, Healthcare Finance, Videos | Tagged: Eric Bricker MD, Health Plan Cost Reduction, Quest Diagnostics, Steven Goldberg | 1 Comment »
By Dr. Eric Bricker MD
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
CITATION: https://www.r2library.com/Resource/Title/0826102549
***
***
***
Filed under: "Doctors Only", Ethics, Experts Invited, Health Economics, Healthcare Finance, Quality Initiatives | Tagged: ealthcare Price versus Quality, Eric Bricker MD, Healthcare Price versus Quality Disconnect, healthcare quality, medical quality | Leave a comment »
WHAT IT IS – HOW IT WORKS?
Citation: https://www.r2library.com/Resource/Title/0826102549
YOUR COMMENTS ARE APPRECIATED.
SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
****
****
THANK YOU
***
Filed under: Glossary Terms, Health Economics, Healthcare Finance, Investing | Tagged: David Edward Marcinko, direct indexing, Index Funds | Leave a comment »
By Dr. David E. Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
***
***
A recent ValuePenguin survey found out-of-pocket costs for COVID-19 tests on average varied by age groups as follows:
• Gen Zers (ages 18-25): $125
• Millennials (ages 26-41): $142
• Gen Xers (ages 42-56): $101
• Baby boomers (ages 57-76): $59
Source: ValuePenguin, “COVID-19 Testing Survey: Americans Talk Out-of-Pocket Charges, Bill Negotiations, Barriers,” February 14, 2022
CITE: https://www.r2library.com/Resource/Title/082610254
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
Filed under: CMP Program, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, LifeStyle | Tagged: baby boomers, Certified Medical Planner™, CMP, corona, covid, covid spend, covid tests, Gen Xers, Millennial Spend on COVID-19 Tests?, Millennials, out pocket covid, ValuePenguin | Leave a comment »
By Staff Reporters
DEFINITION: An accountable care organization (ACO) is a group of doctors, hospitals, and other health care providers that work together on your care. Their goal is to give you — and other people on Medicare — better, more coordinated treatment. The largest effort in payment innovation in Medicare is a portfolio of accountable care organization (ACO) programs that include the Medicare Shared Savings Program (MSSP), the Next Generation model, and Comprehensive End Stage Renal Disease model. But drawbacks include limited choice as some patients will have trouble finding doctors outside of a specific group. The shortage of options could lead to higher patient costs. And, referral restrictions as ACOs provide doctors incentives to refer to specialists within the group.
CITE: https://www.r2library.com/Resource/Title/082610254
***
***
In a recent survey from AKASA healthcare finance leaders ranked the biggest challenges in recruiting and retention within the revenue cycle as healthcare organizations navigate significant staffing gaps across the board.
Great Resignation: https://medicalexecutivepost.com/2022/03/08/healthcare-industry-hit-with-the-great-resignation-retirement/
• #1: Competitive market for talent (71%)
• #2: Vaccine mandates (42%)
• #3: Employee burnout (41%)
• #4: Rapid employee turnover (40%)
• #5: Limitations to offer remote work (23%)
Source: AKASA via PR Newswire, February 23, 2022
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
BUSINESS of MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko
***
Filed under: "Doctors Only", Accounting, Career Development, Ethics, Health Economics, Health Insurance, Healthcare Finance | Tagged: Accountable Care Organizations, ACO, ACOs, AKASA, great resignation, MCOL, PR Newswire | 1 Comment »
By Staff Reporters
***
• Among patients aged 19-35, mental health conditions were the most common diagnosis associated with emergency ground ambulance in the period 2016-2020.
• Throughout the period 2016-2020, advanced-life-support (ALS) accounted for a larger percentage of emergency ground ambulance claim lines than basic-life-support (BLS) services. For example, in 2020, 51.5% of emergency ground ambulance claim lines were associated with ALS compared to 48.5% associated with BLS.
• Individuals 65 years and older were consistently the largest age group associated with emergency ground ambulance services, though their share of the distribution decreased from 37.7% in 2016 to 34% in 2020.
Source: Fair Health Via PR Newswire, “Ground Ambulance Services in the United States,” February 23, 2022
***
Comments Appreciated
THANK YOU
Subscribe to the Medical Executive-Post
***
***
***
Filed under: Accounting, Glossary Terms, Health Economics, Healthcare Finance | Tagged: Advanced Life Support, Basic Life Support, BLS, Fair Health, mental health, Private Healthcare Claims | Leave a comment »
By Eric Bricker MD
Article in the Journal of the American Medical Association
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
Filed under: Career Development, Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: AMA, american medical association, employee benefits, Eric Bricker MD, Health Insurance, health insurance benefits, hospital benefits, medical benefits | Leave a comment »
SPONSOR: http://www.CertifiedMedicalPlanner.org
ORDER HERE: https://www.r2library.com/Resource/Title/0826102549
THANK YOU
***
Filed under: Accounting, Book Reviews, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Touring with Marcinko | Tagged: David Edward Marcinko, Dictionary of Health Economics and Finance | Leave a comment »
The Basis for Hospital Reimbursement and Sepsis Reimbursement
By Eric Bricker MD
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
Filed under: "Doctors Only", Ethics, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: charge capture, Eric Bricker MD, healthcare costs, hospital reimbursement, medical coding, MS-DRG, sepsis | 1 Comment »
By Staff Reporters
***
***
Source: Wheel, “The Great ReExamination: Examining the Pandemic’s Challenging Working Conditions for Doctors and Nurses,” March 2022
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
Filed under: Health Insurance, Healthcare Finance, Information Technology, LifeStyle | Tagged: medical school, medical school virtual care training, Tele-Health, virtual care training, virtual health | Leave a comment »
By Eric Bricker MD
An accumulator is a running total of money you’ve paid towards your out-of-pocket max for covered services. This includes any copayments, coinsurance, and other health care costs, but not your monthly premium payments.
CITE: https://www.r2library.com/Resource/Title/082610254
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
****
Filed under: Accounting, Alerts Sign-Up, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Videos | Tagged: accumulator, doctor payments, Eric Bricker MD, Health Insurance, healthcare costs, hospital payments, out pocker costs | 1 Comment »
| A Professional and Personal look at Health Insurance, with Karl Albrecht |
| Rich talks with the president of Action Benefits, Karl Albrecht about the state of Health Insurance. Albrecht also gives a candid insight to his personal fight with pancreatic cancer and how being a Health Insurance executive as well as a patient, has given him a unique perspective on how things work, and how they could improve. |
BY RICHARD HELPPIE
PODCAST: https://richardhelppie.com/karl_albrecht/
YOUR COMMENTS ARE APPRECIATED.
Thank You
***
***
***
Filed under: Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: Health Insurance, HSAs, Karl Albrecht, Richard Helppie | Leave a comment »
By Staff Reporters
***
***
• UnitedHealth Group: 765K new lives
• Centene Corporation: 338K new lives
• CVS Health/Aetna: 323K new lives
• Humana: 315K new lives
• Bright Health: 109K new lives
Source: The Chartis Group, “Medicare Advantage Enrollment Continues to Surge in an Increasingly Complex and Competitive Landscape,” February 2022
***
***
***
Filed under: Accounting, Experts Invited, Health Economics, Health Insurance, Healthcare Finance | Tagged: Bright Health, Centene, CVS Health/Aetna, For-Profit Medicare Advantage Plan Growth 2022, Medicare Advantage, Part C, United Health Group | Leave a comment »
By Health Capital Consultants, LLC
***
Study: Most Physician Compensation Plans Still Productivity-Based
A study conducted by the RAND Corporation and published in the January 2022 issue of the Journal of the American Medical Association (JAMA) seeking to determine whether health systems primarily incentivize volume or value in their physician compensation models found that almost all physicians are still compensated through a volume-based model that rewards productivity over the value of care provided.
CITE: https://www.r2library.com/Resource/Title/0826102549
These study results are in direct contradiction to the longstanding narrative that the U.S. healthcare delivery system is shifting away from volume-based reimbursement and toward VBR. (Read more…)
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
***
Filed under: "Doctors Only", Career Development, Experts Invited, Glossary Terms, Health Economics, Healthcare Finance | Tagged: ACO, AMA, doctor pay, Health Capital Consultants LLC, physician compensation, physician pay, Physician Productivity Pay, physician salary, Rand, VBR | Leave a comment »
Balance Medical Billing
By Dr. David E. Marcinko MBA CMP®
The No Surprises Act is looking to make the practice of out of network balance billing a thing of the past.
CITE: https://www.r2library.com/Resource/Title/0826102549
***
***
Beginning in 2022, there will be few situations in which a patient can receive a bill for out-of-network care they believed would be covered by their insurance company. This new rule should especially benefit patients in emergency situations who don’t have the time or luxury to dig up the details on every provider they encounter.
CONGRESS: https://www.congress.gov/bill/116th-congress/house-bill/3630/
The No Surprises Act also requires insurance companies to provide patients with at least 90 days of coverage if an in-network provider moves out of network. That way, patients aren’t forced to switch providers immediately if such a move happens while they’re in the middle of a treatment plan.
DOCTORS: https://www.elixirehr.com/what-the-no-surprises-act-means-for-healthcare-providers/
Now, the No Surprises Act does have its limitations. Patients can still get a bill for out-of-network care if they visit an urgent care clinic for non-emergency purposes. Also, if consumers are informed that the care they’re about to receive is out of network and they give written consent to move forward, then they may get billed for that care even once the new rule takes effect.
CMS: https://www.cms.gov/nosurprises
YOUR COMMENTS ARE APPRECIATED.
***
***
Thank You
***
***
Filed under: "Doctors Only", Accounting, Breaking News, Career Development, CMP Program, Estate Planning, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care | Tagged: Balance billing, Certified Medical Planner™, CMP, David Edward Marcinko, medical balance billing, No Surprise Act, Surprise billing | 2 Comments »
IS PRIVATE EQUITY BUYING DOCTORS ILLEGAL?
By Eric Bricker MD
***
***
YOUR COMMENTS APPRECIATED
Thank You
***
***
Filed under: Accounting, Career Development, Ethics, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Investing, Videos | Tagged: Blackstone, corporate practice medicine, KKR, PPMC, Private Equity, Private Equity Medicare, VCs, Venture Capital | Leave a comment »
BY JONATHAN MASE R.N.
***
***
Being an entrepreneur is not necessarily easy, and many people that try to become entrepreneurs wind up failing. It’s important to recognize the risk of failure before you decide to walk down this path. Being an entrepreneur is very rewarding, and you can find success if you can do things right.
Keep reading to learn about common entrepreneurial mistakes that you can avoid to give yourself a better chance of realizing your entrepreneurial goals.
READ: https://jonathanmase.wordpress.com/2021/08/06/common-entrepreneurial-mistakes/
Your comments are appreciated.
THANK YOU
MD Entrepreneurs: https://medicalexecutivepost.com/2021/07/29/minnovation-for-physician-entrepreneurs/
***
****
Filed under: Career Development, Events-Planner, Funding Basics, Health Economics, Healthcare Finance, iMBA, Inc., Interviews | Tagged: entrepreneur mistakes, entrepreneurial MDs, Entrepreneurs, Jonathan Mase, Physician Entrepreneurs | Leave a comment »
By Eric Bricker MD
***
***
CITE: https://www.r2library.com/Resource/Title/082610254
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
****
Filed under: "Doctors Only", Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: economic rent seeking, Eric Bricker MD, medical rent seeking, rent seeking | Leave a comment »
Surprise Medical Bills Outlawed?
By Eric Bricker MD
****
***
https://medicalexecutivepost.com/2021/11/03/balance-billing-the-emerging-no-surprise-act/
QPA DEFINITION: The qualifying payment amount is generally the median of contracted rates for a specific service in the same geographic region within the same insurance market as of January 31, 2019. The rate will be adjusted per the Consumer Price Index for All Urban Consumers (CPI-U).
CITE: https://www.r2library.com/Resource/Title/0826102549
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko
***
***
Filed under: "Ask-an-Advisor", Accounting, Events-Planner, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care | Tagged: Eric Bricker MD, in-network, network billing, out-network, QPA, qualifying payment amount, Surprise billing, surprise medical billing | 1 Comment »
***
The US Federal Government Does NOT Process Medicare Claims.
By Eric Bricker MD
****
***
CITE: https://www.r2library.com/Resource/Title/082610254
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
***
Filed under: "Doctors Only", Accounting, Career Development, Events-Planner, Health Economics, Health Insurance, Healthcare Finance, Practice Management, Videos | Tagged: Eric Bricker MD, Guidewell, MACs, medicare, Medicare Administrative Contractors, Medicare payment, Noridian, Novitas | Leave a comment »
***
Dr. Eric Bricker Explains How Medicare Can Take Money Back from Hospitals if it Wants. If the Hospital Thinks Medicare is Being Unfair, the Appeals Process Takes 3 Years!
***
BY ERIC BRICKER MD
***
****
***
***
***
Related: On Medicare Bureaucratization
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
Filed under: "Doctors Only", Accounting, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Managed Care, Op-Editorials, Professional Liability, Videos | Tagged: CMS, Eric Bricker MD, hospital Medicare, Hospital Medicare appeals, hospital payments, Medicare appeals, Medicare Payment Bureaucracy, Medicare Take-Back, Rick Kahler CFP® | 1 Comment »
BY DR. DAVID E. MARCINKO MBA CMP®
THE NEXT GENERATION OF FIDUCIARY FOCUSED FINANCIAL PLANNING AND MEDICAL MANAGEMENT ADVICE FOR DOCTORS
****
VISIT: http://www.CERTIFIEDMEDICALPLANNER.org
CURRICULUM: Enter the CMPs
BE AWARE ALL ADVISORS … NEXT GEN FINANCIAL ADVICE IS HERE?
Are you a financial planner, insurance agent or investment advisor seeking to assist your physician clients with medical practice enhancement solutions, along with healthcare targeted financial planning services, but don’t know where to turn for help?
OR, maybe you’ve already had a bad experience with a young physician or astute healthcare professional client that was actually more informed than you in these areas?
CITE: https://www.r2library.com/Resource/Title/0826102549
OR, a doctor/nurse client who demanded a true fiduciary advisor [not fee-based advice, with no dual licenses and no arbitration clauses] documented in writing].
Read this decade old Federal Government report to learn what can happen when your advisor is not an informed Certified Medical Planner© designated medical management practitioner.
Then, become a Certified Medical Planner© and thrive by helping others …. first!
GOV: https://oig.hhs.gov/fraud/docs/alertsandbulletins/consultants.pdf
True yesterday … more true today.
****
***
CONTACT: Ann Miller RN MHA CMP®
Phone: 770-448-0769
EMAIL: MarcinkoAdvisors@msn.com
***
Filed under: "Advisors Only", "Ask-an-Advisor", Career Development, CMP Program, Financial Advisor Listings, Financial Planning, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Investing, Risk Management, Sponsors | Tagged: Certified Medical Planner™, CMP, CMP Curriculum, fee-only, fiduciary financial advice, financial advisors, financial planners | Leave a comment »
Indications for 2022
BY HEALTH CAPITAL CONSULTANTS, LLC
***
2021 M&A in Review: Indications for 2022
After an understandable slowdown in 2020, due to the onset of the COVID-19 pandemic, merger & acquisition (M&A) activity in the healthcare industry accelerated in 2021, and the industry is expected to continue the high number of deals and high deal volume in 2022.
***
***
This Health Capital Topics article will review the U.S. healthcare industry’s M&A activity in 2021, and discuss what these trends may mean for 2022. (Read more…)
***
CITE: https://www.r2library.com/Resource/Title/0826102549
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
Filed under: "Ask-an-Advisor", Accounting, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care | Tagged: Covid-19, Health Capital Consultants LLC, healthcare mergers acquisitions, HEALTHCARE: 2021 M&A in Review, M&As | Leave a comment »
FOR HEALTHCARE ENTREPRENEURS
By Eric Bricker MD
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive Post
***
***
***
***
Filed under: Career Development, Experts Invited, Glossary Terms, Health Economics, Healthcare Finance, Investing, Videos | Tagged: Digital Health, digital health market segmentation, digital health markets, doctor entrepreneurs, Eric Bricker MD, health market segmentation, healthcare entrepreneurs, medical entrepreneurs, Physician Entrepreneurs | Leave a comment »
By Staff Reporters
***
A recent AKASA survey of 514 chief financial officers and revenue cycle leaders at hospitals and health systems in the U.S. found:
• Entry-level revenue cycle talent (0-5 years): On average, costs $2,167 for recruitment and takes 84 days to fill vacant roles.
• Mid-level revenue cycle talent (6-10 years): On average, costs $3,581 for recruitment and takes 153 days to fill vacant roles.
• Senior-level revenue cycle talent (10+ years): On average, costs $5,699 for recruitment and takes 207 days to fill vacant roles.
Source: AKASA via PR Newswire, “Survey: Recruitment Costs, Long Hiring Timelines Negatively Impact Healthcare Finance Teams”, January 26, 2022
***
***
***
Filed under: Experts Invited, Health Law & Policy, Healthcare Finance, Managed Care | Tagged: AKASA, Hospital Revenue Cycle Recruitment, hospitals, MCOL, RCR, revenue recruitment | Leave a comment »
Phil Fisher Was One of the Greatest Entrepreneurial Investors of the 20th Century and a Source of Wisdom for Warren Buffett
By Eric Bricker MD
****
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
CITE: https://www.r2library.com/Resource/Title/0826102549
***
Filed under: Accounting, Book Reviews, Career Development, Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Information Technology, Investing, Research & Development, Videos | Tagged: CDHP, cost accounting, Eric Bricker MD, managerial accounting, Metrics for Successful Healthcare Companies, Phil Fisher, TeleDoc, UHC, Warren Buffett | Leave a comment »
As part of the Affordable Care Act of 2010
CMS changed its hospital readmission penalty methodology
BY ERIC BRICKER MD
****
***
COMMENTS APPRECIATED
Thank You
SUBSCRIBE TO THE MEDICAL EXECUTIVE-POST
***
***
***
Filed under: "Doctors Only", Accounting, Career Development, Experts Invited, Funding Basics, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance | Tagged: ACA, Affordable Care Act, CMS, CMS readmission penalties, Eric Bricker MD, hospital penalties, Hospital Re-Admissions, hospital readmission penalty methodology | Leave a comment »
By Staff Reporters
***
| Average Annual Growth Rates of Spending, Utilization, and Prices • Spending per person: commercial insurers (3.2% per year); Medicare fee for service (1.8% per year) • Utilization per person: commercial insurers (0.4% per year); Medicare fee for service (0.5% per year) • Prices paid to providers: commercial insurers (2.7% per year); Medicare fee for service (1.3% per year). Notes: For hospitals and physicians’ services, 2013-2018 Source: Congressional Budget Office – January 2022 “The Prices That Commercial Health Insurers and Medicare Pay for Hospitals’ and Physicians’ Services” |
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: Annual Healthcare Growth Rates, CBO, commercial insurance, Congretional Budget Office, fee for service, Health Insurance, healthcare price, healthcare spending, healthcare utilization, MCOL, medicare | Leave a comment »
***
By Eric Bricker MD
***
Health Insurance Cost Has Risen 55% in the last 10 Years. The Annual Health Insurance Cost for Family Coverage is Now $21,000 Per Year
***
Dysfunctional Employee Benefits Article in Journal of the American Medical Association
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
CITE: https://www.r2library.com/Resource/Title/082610254
***
Filed under: Accounting, Book Reviews, Ethics, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Insurance Matters, Risk Management, Videos | Tagged: AMA, Annual Health Insurance Cost, Dysfunctional Employee Benefits, Eric Bricker MD, Health Insurance, Health Insurance Costs | 1 Comment »
By Eric Bricker MD
****
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
PODCAST: Medicare Bad Debt Reimbursement: https://www.youtube.com/watch?v=LMa4at0wlRU
***
***
***
***
Filed under: "Doctors Only", Accounting, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Quality Initiatives, Taxation, Videos | Tagged: cost accounting, diganostic related groups, DRGs, Eric Bricker MD, managerial accounting, Managerial Cost Accounting, medicare, medicare cost reporting | Leave a comment »
Income and Substitution Effects in Healthcare Economics
By Erice Bricker MD
***
***
CITE: https://www.r2library.com/Resource/Title/082610254
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
***
Filed under: "Doctors Only", Accounting, Experts Invited, Glossary Terms, Health Economics, Healthcare Finance | Tagged: doctor income, doctor salary, Eric Bricker MD, Health Economics, Income and Substitution Effects, physician income, physician salary | Leave a comment »
***
Best Practices from Leading Consultants and Certified Medical Planners™
SPONSOR: http://www.CertifiedMedicalPlanner.org
***
***
***
Filed under: "Advisors Only", "Doctors Only", Accounting, Career Development, CMP Program, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Information Technology, Insurance Matters, Investing, Portfolio Management, Practice Management, Practice Worth, Professional Liability, Recommended Books, Retirement and Benefits, Risk Management, Taxation, Touring with Marcinko | Tagged: CMP, CMP Program, financial planning doctors, finanical planning physicians, medical risk management, physician insurance, physician investing, physician liability, Risk Management | Leave a comment »
By Staff Reporters
Mark Cuban, not Congress, will give Americans cheaper prescription drugs
****
When universal health care fails to pass in Congress, there’s always Mark Cuban to fall back on. The billionaire and Dallas Mavericks owner launched an online pharmacy this week in order to combat the price gouging of prescription drugs by large pharmaceutical companies.
Citation: https://www.r2library.com/Resource/Title/0826102549
The Mark Cuban Cost Plus Drug Co. (MCCPDC) will offer more than 100 generic drugs that will be purchased directly from the manufacturers and sold online with a 15 percent markup across the board and a small pharmacist fee. For context, pharmaceutical companies generally mark prices up at least 100 percent and up to 1000 percent in some cases.
***
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
***
***
Filed under: Breaking News, Drugs and Pharma, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: Drugs, drugs costs, Eric Bricker MD, generic drugs, Mark Cuban, Mark Cuban Cost Plus Drug Co., PBM, Pharmacy Benefits Managers | Leave a comment »
ACCOUNTABLE CARE ORGANIZATIONS
By Staff Reporters
***
An AMA survey of 3,500 physicians finds steady growth of physician participation in accountable care organizations (ACO) and medical homes:
• Nearly one-third of doctors worked in practices participating in medical homes in 2020, up from 23.7% in 2014
• 42.7% of physicians were in practices that participated in a commercial ACO in 2020, up from 31.7% in 2016
• 29.5% of physicians were in practices took part in a Medicaid ACO, up from 20.9% in 2016
• Share of physicians in practices involved in Medicare ACOs has risen from 28.6% in 2014 to 36.7% in 2020
• 32.3% of doctors worked in practices participating in medical homes in 2020, up from 23.7% in 2014
Source: AMA Policy Research Perspectives report, “Payment and Delivery in 2020: Fee-for-Service Revenue Remains Stable While Participation Shifts in Accountable Care Organizations During the Pandemic.”
CITE: https://www.r2library.com/Resource/Title/082610254
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
Filed under: Alerts Sign-Up, Career Development, Glossary Terms, Health Economics, Healthcare Finance | Tagged: Accountable Care Organizations, ACO, AMA, AMA Policy Research Perspectives, Health Insurance, Medicaid, medical homes | Leave a comment »
By Staff Reporters
***
***
COMMENTS APPRECIATED.
Thank You
Subscribe to the Medical Executive-Post
***
Filed under: Breaking News, Health Economics, Healthcare Finance, Investing, LifeStyle | Tagged: bull market, covid, economy, NASDAQ, Netflix, omicron, S&P | Leave a comment »
By Staff Reporters
***
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
Filed under: Alerts Sign-Up, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, LifeStyle | Tagged: Activision Blizzard, energy, gaming, oil, stock markets | Leave a comment »
WHO KNEW?
By Staff Reporters
****
According to Wikipedia, in economics, inflation refers to a general progressive increase in prices of goods and services in an economy.[1] When the general price level rises, each unit of currency buys fewer goods and services; consequently, inflation corresponds to a reduction in the purchasing power of money.[2][3] The opposite of inflation is deflation, a sustained decrease in the general price level of goods and services. The common measure of inflation is the inflation rate, the annualised percentage change in a general price index.[4]
READ MORE: https://en.wikipedia.org/wiki/Inflation
CITE: https://www.r2library.com/Resource/Title/082610254
***
***
***
Healthcare Not a Part of the US Inflation Surge: Who Knew?
However, according to Jeff Goldsmith, overall health spending has only risen by 4.4% since January of 2020, and the percentage of GDP devoted to health has fallen by more than half a percent, from 18.1% pre-pandemic to 17.5% in October. This is despite four surges of COVID hospitalizations, overflowing ICUs and ERs, labor shortages, and other COVID-related stresses. Health system staffing levels are still nearly a half-million lower than they were pre-pandemic. Had the federal government not stepped in through the CARES Act, FEMA funding, and temporary suspensions of Medicare rate cuts, the nations’ hospitals would have been seriously damaged by COVID-related financial stresses, which are far from being over.
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
Filed under: "Advisors Only", "Doctors Only", Experts Invited, Glossary Terms, Health Economics, Healthcare Finance | Tagged: CARES Act, covid, FEMA, healthcare inflation, inflation, Jeff Goldsmith, medical inflation, medicare inflation | 1 Comment »
BY STAFF REPORTERS
***
***
COMMENTS APPRECIATED
Thank You
SUBSCRIBE TO THE MEDICAL-EXECUTIVE POST
***
***
Filed under: Alerts Sign-Up, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Investing, LifeStyle | Tagged: Aduhelm, Ali Mokdad, Biogen, covid, Investing, omicron, pandemic, stock markets | Leave a comment »
By Larry Culp
***
Hi David,
Earlier this week, GE’s Chairman and CEO Larry Culp shared a note with employees reflecting on GE’s priorities as we enter the new year. “Ten days into 2022, our work has already begun,” Larry said in his note. “I am excited for our road ahead.”
As we shared in November, GE is on a path to become three stronger, more focused companies positioned to lead in aviation, healthcare, and energy. Here are our priorities for the year ahead to take us there:
Click here to read more on each priority and share your feedback.
We look forward to discussing our 2021 results and progress with you during our earnings call on January 25th.
Wishing you the very best in 2022,
Steve
CITE: https://www.r2library.com/Resource/Title/082610254
***
COMMENTS APPRECIATED
Thank You
Subscribe to the Medical Executive-Post
***
***
Filed under: Alerts Sign-Up, Experts Invited, Health Economics, Healthcare Finance, Investing | Tagged: GE, Gemeral Electric, Investing, Larry Culp, Precision Health | 1 Comment »
By Staff Reporters
***
COMMENTS APPRECIATED.
Thank You
Subscribe to the Medical Executive-Post
***
****
Filed under: Alerts Sign-Up, Breaking News, Glossary Terms, Health Economics, Healthcare Finance, LifeStyle, Taxation | Tagged: Dimon, IRS, JP Morgan, Moderna, NASDAQ, omicron, pandemic, S&P, tax, Treasury | Leave a comment »
SPONSOR: http://www.CertifiedMedicalPlanner.org
SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
THANK YOU
***
Filed under: "Doctors Only", Accounting, Book Reviews, Career Development, CMP Program, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, iMBA, Inc., Managed Care, Practice Management, Recommended Books, Sponsors, Touring with Marcinko | Tagged: Certified Medical Planner™, CMP™ Course, david marcinko, Dr. David Edward Marcinko MBA CMP™, Financial Management Healthcare, Financial Management Hospitals | 1 Comment »
The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants 