MARCINKO’s Upcoming WEBINARS from MentorHealth

Posted on January 23, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

Vital Financial Texts for Doctors

Posted on January 22, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

http://www.CertifiedMedicalPlanner.org

PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET

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[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

Front Matter with Foreword by Jason Dyken MD MBA

Enter the CMPs

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Filed under: Book Reviews, CMP Program, Financial Planning, iMBA, Inc., Insurance Matters, Practice Management, Risk Management | Tagged: david marcinko, Financial Planning, Risk Management | Leave a comment »

Deciding Whether To Refer a Colleague to a Physician Health Program

Posted on January 12, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

Given the authority that PHPs often have over the ability of physicians to practice medicine, their power is enormous and not necessarily wielded appropriately. Deciding Whether To Refer a Colleague to a Physician Health Program J. Wesley Boyd, MD, PhD Physicians should exercise caution in referring a possibly impaired colleague to a physician health progr… […]

Deciding Whether To Refer a Colleague to a Physician Health Program, Oct 15 –

AMA Journal of Ethics – J. Wesley Boyd, M.D., PhD — Disrupted Physician

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Filed under: Ethics, iMBA, Inc. | Tagged: AMA Journal of Ethics, J. Wesley Boyd MD, PhD, Physician Health Program | Leave a comment »

Technology and Health Knowledge — Global Health information Technology

Posted on January 3, 2017 by Dr. David Edward Marcinko MBA MEd CMP™

Technology and Health Knowledge

By Kelsey and Will

I remember back in 2010 we had our annual family reunion in Arkansas at my grandparents house. My grandfather was in his rocking chair watching T.V as I sat on the couch completely engaged in whatever I was doing on my cell phone.

My grandfather looks over at me and asks, “What you got there […]

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Technology and Health Knowledge — Global Health information Technology

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:

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

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Filed under: iMBA, Inc., Information Technology, Videos | Tagged: Global Health information Technology, Technology and Health Knowledge | 1 Comment »

What is the Secondary Stock Market?

Posted on December 30, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

The Primary versus Secondary Stock Markets

By Dr. David E. Marcinko MBA

http://www.CertifiedMedicalPlanner.org

The purchase of common stock in an IPO (initial public offering) is facilitated through the use of members an investment bank underwriting syndicate or selling group. This is known as the primary market and the proceeds of sale go directly to the issuing company.

Six months later however, if a doctor wants to sell his shares, this would be accomplished in the secondary market. The term secondary market refers to trading in outstanding issues as the proceeds do not go to the issuer, but to the current owner of the securities, such as the physician investor.

Therefore, the secondary market provides liquidity to doctors who acquired securities in the primary market. After a doctor has acquired securities in the primary market, he wants to be able to sell the securities at some point in the future in order to acquire other securities, buy a house, or go on a vacation. Such a sale takes place in the secondary market. The medical investor’s ability to convert the asset (securities) into cash is heavily dependent upon the secondary market.

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Assessment

All investors would be hesitant to acquire new securities if they felt they would not subsequently have the ability to sell the securities quickly at a fair price in the secondary market.

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: CMP Program, iMBA, Inc. | Tagged: primary market, secondary market | Leave a comment »

On Rising Interest Rates

Posted on December 15, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

By Charles Schwab

What They Could Mean for You

The FMOC rose interest rates today.

So, what does this mean for all of us?

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More:

Videos:

Videos of fed raises interest rates

Assessment

Be aware that although the FED does indeed control overnight and short-term IRs; it is the market-place that controls longer-term rates. So, don’t fret.

-Dr. David Edward Marcinko MBA

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: iMBA, Inc., Investing | Tagged: Federal Reserve Bank, FOMC, interest rates | 3 Comments »

Contribute to the Medical Executive-Post

Posted on December 10, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Contribute to the Medical Executive-Post and Tell Us What You Think

We’re open to all kinds of related subjects on the business of medical practice, healthcare economics and finance, HIT and personal financial planning and investing for doctors and all medical professionals.

***.

***

So, if you’d like to comment or be a featured guest on our blog, or know of a great post we should feature or re-print, just let us know by emailing me!

Ann Miller RN MHA

MarcinkoAdvisors@msn.com

BROADCAST YOURSELF!

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Filed under: iMBA, Inc. | Leave a comment »

What’s a “Tombstone”Ad?

Posted on December 1, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Tombstone Advertising and the Securities Prospectus

By Dr. David E. Marcinko MBA CMP™

Despite certain SEC restriction, some idea of potential demand for a new securities issue can be gauged and have a bearing on pricing decisions.

For example, as CEO of a medical instrument company, or interested investor, would you rather see a great deal of interest in a potential new issue or not very much interest?

http://www.CertifiedMedicalPlanner.org

There is however, one kind of advertisement that the underwriter can publish during the cooling off period. It’s known as a tombstone ad. The ad makes it clear that it is only an announcement and does not constitute an offer to sell or solicit the issue, and that such an offering can only be made by prospectus. SEC Rule 134 of the 1933 Act itself, refers to a tombstone ad as “communication not deemed a prospectus” because it makes reference to the prospectus in the ad. Tombstones have received their name because of the sparse nature of details found in them. However, the most popular use of the tombstone ad is to announce the effectiveness of a new issue, after it has been successfully issued. This promotes the success of both the underwriter, as well as the company.

http://www.HealthDictionarySeries.org

Since distributing securities involves potential liability to the investment bank, it will do everything possible to protect itself. So, near the end of the cooling off period, a meeting is held between the underwriter and the corporation. It is known as a due diligence meeting. At this meeting they both discuss amendments that are going to be necessary to make the registration statement complete and accurate. The corporate officers and the underwriters sign the final registration statement. They have civil liability for damages that result from omissions of material facts or misstatements of fact. They also have criminal liability if the distribution is done by use of fraudulent, manipulative, or deceptive means. Due diligence takes on a whole new meaning when incarceration from a half-hearted underwriting effort; can occur. The investment bank strives to ensure that there have been no material changes to the issuer or the terms of the issue since the registration statement was filed.

Again, as a physician, how would you feel if you were an investment banker raising capital for a new pharmaceutical company that had developed a drug product that was highly marketable. But, on the day after the issue was effective, there was a major news story indicating that the company was being sued for patent infringement? What effect do you think that would have on the market price of this new issue? It would probably plunge. How could this situation have been prevented? The due diligence meeting is more than a cocktail party or a gathering in a smoke filled room. Otherwise, the company would require specially trained people, to do a patent search lessening the likelihood of this scenario. At the due diligence meeting, work is done on the preparation of the final prospectus, but the investment bank does not set the public offering price or the effective date at this meeting. The SEC will eventually set the effective date for the registration and it is on that date that the final offering price will be determined.

Once the SEC sets the effective date, sales may be executed and money can be accepted by the investment bank. It is at this time that the final prospectus, similar to the red herring but without the red ink and with the missing numbers, is issued. A prospectus is an abbreviated form of the registration statement, distributed to purchasers, on and after the effective date of the registration. It is not the same as the registration statement. A typical registration statement consists of papers that stand more than a foot high; rarely does a prospectus go beyond 40 or 50 pages. All purchasers will receive a final prospectus and then it becomes permissible for the underwriter to provide sales literature.

Two Requirements

In addition to the requirement that a prospectus must be delivered to a purchaser of new issues no later than with confirmation of the trade, there are two other requirements which physicians, medical professionals and healthcare executive investors should know.

90-day: When an issuer has an initial public offering (IPO), there is generally a lack of publicly available material relating to the operations of that issuer. Because of this, the SEC requires that all members of the underwriting group make available a prospectus on an IPO for a period of 90 days after the effective date.

40-day: Once an issuer has gone public, there are a number of routine filings that must be made with the SEC so there is publicly available information regarding the financial condition of that issuer. Since additional information is now available, the SEC requires that, on all issues other than IPOs, any member of the underwriting group must make available a prospectus for a period of 40 days after the effective date.

Assessment

In the event that the investment bankers misgauged the marketplace, and the issue moves quite slowly, it is possible that information contained in the prospectus would be rendered obsolete by the SEC. Specifically, the SEC requires that any prospectus used more than 9 months after the effective date, may not have any financial information more than 16 months old. It can however, be amended or stickered, with updated information, as needed.

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

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Filed under: CMP Program, iMBA, Inc., Investing | Tagged: certified medical planner, David E. Marcinko, Securities Prospectus, Tombstone"Ad | Leave a comment »

Tom Price for HHS Secretary & Seema Verma for CMMS

Posted on November 30, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

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Obamacare critic for HHS

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Trump nominates Rep. Tom Price for HHS secretary

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Trump picks Seema Verma to head Centers for Medicare and Medicaid Services

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Filed under: iMBA, Inc. | Tagged: Centers for Medicare & Medicaid Services, CMS, Medicaid, medicare, Seema Verma, Tom Price | 14 Comments »

Join Us on Linked-In

Posted on November 26, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

INSTITUTE OF MEDICAL BUSINESS ADVISORS [iMBA] INC

[Capitalism, Health Care Enterprise and Entrepreneurship]

David E. Marcinko MBBS DPM FACFAS MBA MEd BSc CMP®

[Chief Executive and Education Officer]

David E. Marcinko MBBS DPM FACFAS MBA MEd BSc

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Filed under: Breaking News, Career Development, iMBA, Inc. | Tagged: David Edward Marcinko, Dr. David Marcinko, Linked-In | Leave a comment »

Non-Native Language Perils in Health Care

Posted on November 21, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

NON-NATIVE LANGUAGE PERILS

[Staff reporters]

Communication risk to immigrants with limited non-native language proficiency is a growing concern.

With today’s higher immigrant population in the United States, more medical practices are treating patients with limited English language proficiency.

All medical professionals and clinicians now run the risk of not properly communicating medical risk information to these populations.

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Assessment

In fact, a recent study shows that materials that include visual aids are being used by medical practices to effectively communicate with the patient.

Source: Garcia-Retamero, Rocio, and Mandeep, K. Dhami. “Pictures Speak Louder Than Numbers: On Communicating Medical Risks To Immigrants With Limited Non-Native Language Proficiency.” Health Expectations 14.(2011): 46-57. CINAHL Plus with Full Text Web 27 Apr. 2012

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: iMBA, Inc., Risk Management | Tagged: Garcia-Retamero, Mandeep K. Dhami, Non-Native Language Perils in Health Care | Leave a comment »

How to find a competent investment advisor?

Posted on November 17, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

By Rick Kahler MSFS CFP®

Is investing fun? Certainly—for some of us who think number-crunching is more exciting than, say, gardening or watching “Game of Thrones.” Yet, as crucial as investing is for creating financial independence, most people don’t enjoy it.

Fortunately, understanding the investment process in detail isn’t a requirement to successful investing, any more than being a physician is a requirement for good health.

The Research

Research suggests a correlation between good health and investing in one’s health by getting regular physicals. Similarly, research shows people who engage professional money management have a significantly higher chance of investment success than those who do it themselves or rely on financial salespeople for guidance.

Unfortunately, it’s easier to find a competent doctor than a competent investment adviser. You know those with M.D. after their names must have passed stringent education and licensing requirements. Yet almost anyone can put “investment adviser” on a business card.

Few Regulations

Despite the lack of legal requirements, there are many competent investment professionals with wide education and strong skills. You just need to look beyond the designations after their names to find them.

Some things to look for:

Education. Look for someone with a Chartered Financial Analyst (CFA) designation or a master’s degree in finance. The CFA designation is the gold standard for an investment professional, often requiring three years of education and four years of experience. As an alternative, look for education in finance or financial planning.
Experience. The less formal education an investment adviser has, the more experience I would look for. Someone with 40 years of experience and a solid track record may be a better choice than a new graduate with a master’s degree in finance. Look for a balance of education and experience.
Broadly diversified investments, both by asset class and globally. At a minimum, look for an adviser whose average or model portfolio includes a broad array of global stocks of very small to very large companies, a global assortment of high quality and high yield government and corporate bonds, a commodity index fund, and a global fund of real estate investment trusts (REITS). More sophisticated advisers may include a small percentage of the portfolio in various investment strategies, sometimes called alternative investments, with solid long-term track records.
A long-term track record that equals or exceeds popular benchmarks. Investing is one of the few professions where earning an “average” return over 20 years puts someone in the top 3% of all managers.
Uses low-cost mutual funds. The average equity mutual fund charges 1.35% annually. An equivalent index fund can charge as low as 0.10%. When it comes to investing, low fees are usually the best move.
Communication. Look for someone who doesn’t talk down to you, but who can make complex strategies easy to understand. Also, ask to see sample investment reports to be sure they are understandable and easy to follow.
Tailors portfolios to you. The best constructed portfolio in the world is no good if you panic in a downturn and instruct the adviser to sell out. It’s critical to find an investment adviser who will take time to understand your needs and your emotional tolerance for risk.
A fiduciary relationship to you. It’s essential to choose a financial adviser who represents you, with no conflict of interest from sales or commissions. The safest pick is someone who is compensated only by fees for their advice and services.

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Assessment

When you find a professional investment adviser who meets these qualifications, you have one thing left to do. Your biggest challenge may be to let go of any fears or need to control and trust the adviser to work for you.

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

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Filed under: iMBA, Inc. | Tagged: Rick Kahler CFP® | 1 Comment »

Welcome Original Thinkers

Posted on October 28, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Welcome Original Thinkers

By Nina Martin – Dreamer nina@wotquiz.com

Hi Dr. David E. Marcinko,

I’m reaching out to you because I thought you and the readers of Medical Executive-Post News [Trends, Info & Insights for Savvy Doctors and Their Advisors] might like to take and share a short fun personality quiz we call Welcome Original Thinkers or the WOT Quiz.

www.wotquiz.com

Kimberly-Clark thrives on original thinking and we are currently recruiting original thinkers to add to our teams. We’ve launched a new recruitment campaign, “Welcome Original Thinkers,” to find great talent that can help us solve problems and create solutions before consumers even know they need them. I’ve put all the info including videos, images and more on this microsite:

www.wotquizinfo.com

Be sure to let me know what kind of Original Thinker you are (I’m a Dreamer) and if you post, tweet or share, please use the hashtags #wot, #wotquiz and #welcomeoriginalthinkers

Assessment

Also, please send me the link as I’d love to share it with my team. I’m here if you have any questions. Thanks so much!

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

[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

[Dr. Cappiello PhD MBA] [Foreword Dr. Krieger MD MBA]

Front Matter with Foreword by Jason Dyken MD MBA

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Filed under: iMBA, Inc. | Tagged: Kimberly-Clark, Nina Martin, Welcome Original Thinkers | 1 Comment »

Texas VA medical center accused of falsifying veteran wait times

Posted on October 18, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. Eowyn

Another VA scandal for Obama’s record. From Fox News: A Houston VA hospital altered records to hide lengthy patient waiting lists even as a national scandal regarding treatment of veterans was unfolding, a federal watchdog charged in a scathing report released this week. Officials at the Michael E. DeBakey VA Medical Center in Houston and […]

Texas VA medical center accused of falsifying veteran wait times — Fellowship of the Minds

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

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Filed under: iMBA, Inc. | 4 Comments »

“New Paradigm” is a business model not a medical model

Posted on September 3, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

327518caf4de6ca81321ea8b469a3d42

By Michael Langan MD

“I’m only here for a four day evaluation”– T-shirt sold at Talbott Recovery Center The New York Times article below written by Robert Dupont advocates coercion to facilitat…

img1-9

“New Paradigm” is a business model not a medical model

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

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Filed under: iMBA, Inc. | Leave a comment »

An Open Letter to Senator Elizabeth Warren Regarding Laboratory Developed Tests, Physician Health Programs and Institutional Injustice

Posted on August 24, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

[By Michael Lawrence Langan MD]

I can think of nothing more institutionally unjust than an unregulated zero-tolerance monitoring program with no oversight using unregulated drug and alcohol testing of unknown validity. But that…

An Open Letter to Senator Elizabeth Warren Regarding Laboratory Developed Tests, Physician Health Programs and Institutional Injustice

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

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Filed under: Ethics, iMBA, Inc., Risk Management | Tagged: Elizabeth Warren, Michael Lawrence Langan MD, physician health programs | Leave a comment »

On MACRA

Posted on August 19, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

By ACR and AAN

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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: iMBA, Inc. | 4 Comments »

PHI RansomWare Just Went Up!

Posted on July 26, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

[By Darrell K. Pruitt DDS]

Expect malware entrepreneurs to charge what the market will bear, again and again.

“OCR Releases Guidance on Ransomware: ‘Your Money or Your PHI’”. By Dianne J. Bourque for The National Law Review,” July 12, 2016

http://www.natlawreview.com/article/ocr-releases-guidance-ransomware-your-money-or-your-phi

Bourque: “A key component of the guidance provides a ransomware attack that encrypts a Covered Entity’s ePHI is presumed to be a breach. As ransomware can infect a Covered Entity’s entire system, this presumption may lead to enormous breach notification obligations.”

Bourque adds: “OCR indicates that when ePHI is encrypted as a result of a ransomware attack, a breach has occurred because the ePHI encrypted by the ransomware was acquired (i.e., unauthorized individuals took possession of the information) and is thus a ‘disclosure’ not permitted under the HIPAA Privacy Rule has occurred.”

When patients are notified of data breaches – for any reason – many will quietly change providers. According to The Ponemon Institute, loss of future income is the most costly result of lawfully reporting data breaches…. and ransomware attacks are at “epidemic” levels. I have heard dentists are paying the ransom quickly.

The disincentives to do the right thing were overwhelming providers even before the OCR’s recent ruling. Such is the ugly nature of extortion.

Assessment

Cha-ching!

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: iMBA, Inc., Information Technology, Pruitt's Platform | Tagged: D. Kellus Pruitt DDS, Dianne J. Bourque, HIPAA, malware entrepreneurs, OCR, PHI, RansomWare | Leave a comment »

Reputation Economics [Book Review]

Posted on June 30, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

[By Jaan Sidorov MD]

An Interesting Book

Reputation Economics by Joshua Klein builds on the observation that humans ultimately prefer to trade goods with persons they genuinely trust. The invention of money as a medium of exchange may have solved a lot of inconveniences, but it also distanced the seller and the buyer.

He suggests that our Information Age is ironically ushering in a return of barter, where many goods and services can be directly exchanged between parties who create a track record of their trustworthiness online.

Interestingly, your personal identity doesn’t need to be part of that reputation. And if barter isn’t available, enter cryptocurrency like Bitcoin, which preserves anonymity but commands trust.

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, iMBA, Inc. | Tagged: Bitcoin, Jaan Sidorov MD, Joshua Klein, Reputation Economics | Leave a comment »

The Precision Medicine Initiative

Posted on June 26, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

A New Era of Medicine

[By Staff Reporters]

When The White House announced their Precision Medicine Initiative last year, they referred to precision medicine as “a new era of medicine,” signaling a shift in focus from a “one-size-fits-all-approach” to individualized care based on the specific characteristics that distinguish one patient from another.

While there continues to be immense excitement about its game-changing impact in terms of early diagnoses and targeting specific treatment options, the advancements in technology, which underlie this approach, may not always yield the best medical results.

Assessment

But, in some cases, low cost approaches, based on sound clinical judgment, are still the better option.

***

Screen-Shot-2016-06-22-at-9_03_35-AM

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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: iMBA, Inc. | Leave a comment »

Robert James Cimasi; MHA ASA CVA CMP® Named “Pioneer of the Profession”

Posted on June 25, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

[By staff reporters]

A Friend of the ME-P

cimasi

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HCC CEO Bob Cimasi Recognized as a “Pioneer of the Profession” under NACVA’s “Industry Titans” Awards

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Health Capital Consultants CEO Robert James Cimasi MHA ASA FRICS MCBA CVA CM&AA, CMP® has been named a “Pioneer of the Profession” by the National Association of Certified Valuators and Analysts (NACVA) and Consultants Training Institute as part of their Silver Anniversary recognition luncheon of valuation “Industry Titans,” held on June 10th. 2016, during the 25th Annual Conference in San Diego.

***

Mr. Cimasi joins valuation profession luminaries, including: Dr. Shannon P. Pratt, Chris Mercer, James R. Hitchner, Roger J. Grabowski, Richard Wise, Jay E. Fishman, Nancy Fannon, Honorable Judge David Laro, Howard Lewis, and Mel H. Abraham, along with fourteen others, in receiving this honor.

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Congratulations to Bob Cimasi and his fellow “Pioneer of the Profession” honorees from the HCC Team and ME-P Topics Staff.

***

Well Done!

CONGRATULATIONS – BOB

***

Filed under: iMBA, Inc. | Leave a comment »

American Society of Appraisers 2016-17 Election Results

Posted on June 11, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

NEW ASA OFFICERS

[By Jennifer M. Aguilar]

Marketing and Communications Assistant

American Society of Appraisers

11107 Sunset Hills, Suite 310, Reston, VA 20190

Direct (703) 733-2120 | Fax (703) 742-8471 | jaguilar@appraisers.org

Hello ME-P Readers and Subscribers,

The ASA is pleased to announce the results of ASA’s 2016-17 elections for the new International Officers, Board of Governors and Discipline Committee Officers and Members At-Large. Those elected will officially take office on July 1, 2016.

To learn more please see this PR attachment: ASA Election Results

Thank you in advance for sharing this information.

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 Insurance, iMBA, Inc., Uncategorized | Tagged: American Society of Appraisers, ASA, Jennifer M. Aguilar | 1 Comment »

$100-K Hearst Health Prize Call for Submissions

Posted on June 8, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

$100-K Hearst Health Prize Call for Submissions!

We are excited to announce that we are now accepting applications for the 2017 Hearst Health Prize for Excellence in Population Health. The winner will receive a $100,000 cash prize in recognition of outstanding achievement in managing or improving population health.

The Hearst Health Prize, in partnership with the Jefferson College of Population Health (JCPH), was created to help identify and promote promising new ideas in the field that will help to improve health outcomes. The goal is to discover, support and showcase the work of an individual, group, or institution that has successfully implemented a population health program or intervention that has made a measurable difference.

***

***

The deadline to apply is August 26, 2016. To apply or learn more about the Hearst Health Prize, click here.

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: iMBA, Inc., Research & Development | Tagged: David B. Nash MD MBA, Hearst Health Prize, Hearst Health Prize Call for Submissions | Leave a comment »

An FA Hayekian Defense of Evidence Based Medicine

Posted on May 18, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

A Reprint by Andrew Foy MD

A Hayekian Defense of Evidence-Based Medicine

***

[F.A. Hayek]

http://thehealthcareblog.com/blog/2016/05/11/a-hayekian-defense-of-evidence-based-medicine/

ABOUT

Andrew Foy is an academic cardiologist who is taking up blogging, again, for the instant gratification it brings while his real research is under peer-review. His Twitter account is @AndrewFoy82.

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: iMBA, Inc. | Tagged: evidence based medicine, FA Hayek | 1 Comment »

Inviting Patients to Read Their Doctors’ Notes

Posted on April 16, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

OVER HEARD IN THE DOCTOR’S LOUNGE

By Dr. David E. Marcinko MBA CMP™

In an OpenNotes study, researchers examined the impact on patients and doctors when patients were allowed access to their doctors’ notes via a secure Internet portal.

Through the use of surveys, patients’ benefits, concerns, and behaviors, as well as physicians workload, were measured.

The Study

Beth Israel Deaconess Medical Center (BIDMC) in Boston, Geisinger Health System (GHS) in Pennsylvania, and Harborview Medical Center (HMC) in Seattle were selected for this quasi-experimental year-long study.

The study included 105 physicians and 13,564 of their patients. Patients were notified when their notes were available, but whether or not to open the note was at their own discretion. The authors analyzed both pre- and post-intervention surveys from the physicians who completed the study; 99 physicians submitted both pre- and post-intervention surveys. Of the patients who viewed at least one note, 41 percent completed post-intervention surveys.

***

Almost 99 percent of patients at BIDMC, GHS, and HMC wanted to have continued access to their visit notes at the completion of the study; no physician elected to end this practice.

Assessment

Although a limited geographic area was represented, the positive feedback and clinically relevant benefits demonstrate the potential for a widespread adoption of OpenNotes.

Moreover, it may be a powerful tool in helping improve the lives of patients.

Citation: Inviting Patients to Read Their Doctors’ Notes: Author(s): Delbanco, T; Walker, J; Bell, SK and Darrer, JD et al: American College of Physicians, Annals of Internal Medicine, October 2012

Open Notes, a grantee of the Robert Wood Johnson Foundation, was developed to demonstrate and evaluate the impact on both patients and clinicians of fully sharing (through an electronic patient portal) all encounter notes between patients and their primary care providers.

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

http://www.BusinessofMedicalPractice.com

***

Filed under: iMBA, Inc., Practice Management | Tagged: Altered Medical Records, Bell, Darrer, Delbanco, JD, medical records, OpenNotes, Patients to Read Doctors' Notes, SK | 1 Comment »

Be a Journalist!

Posted on April 11, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Be a Journalist!

Via Megan McArdle:

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: iMBA, Inc., Jokes and Puns | Tagged: citizen journalist, journalist | Leave a comment »

Medication Use in Older Adults

Posted on April 6, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

http://www.MCOL.com

Including Supplements for 2005-2011

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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: iMBA, Inc., Research & Development | Tagged: Elderly drugs, Medication Use in Older Adults, Supplement Use in Older Adults | Leave a comment »

An Open Letter from the APHA Government Relations Director

Posted on April 5, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

National Public Health Week

By Don Hoppert
[APHA Government Relations Director]

Dear Dr. David E. Marcinko,

Sen. Tom Udall, D-N.M., and Rep. Lucille Roybal-Allard, D-Calif., are joining the audacious goal of creating the healthiest nation in one generation by introducing resolutions recognizing National Public Health Week and the importance of public health in our daily lives in supporting a strong, healthy nation.

While resolutions, such as the NPHW resolution, do not become laws, they function as statements of intent for Congress. This is an excellent opportunity to encourage your members of Congress to acknowledge the importance of public health, and potentially pave the way for additional support on other public health issues.

***

Send a message to your senators and representative urging them to support public health and co-sponsor the NPHW resolution!

Assessment

Note that the following representatives have already committed to joining the resolution as original co-sponsors:

•    Rep. Rob Wittman, R-Va.
•    Rep. Gene Green, D-Texas
•    Rep. Jim McGovern, D-Mass.

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

[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

[Mike Stahl PhD MBA] * [Foreword Dr.Mata MD] * [Dr. Getzen PhD]

***

Filed under: iMBA, Inc. | Tagged: APHA, Don Hoppert, National Public Health Week, NPHW resolution | Leave a comment »

Altered Medical Records – OLD SCHOOL!

Posted on March 14, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

ON ALTERED RECORDS

By Dr. David Edward Marcinko MBA CMP®

http://www.CertifiedMedicalPlanner.org

The health care provider should not alter the medical record under any circumstances.

The office, clinic or hospital must zealously guard its medical records from alterations by physicians or members of the nursing staff.

Even an inconsequential alteration will throw the validity of the entire record into question. If an entry must be changed, a single line should be drawn through the entry, taking particular care to make sure that the original entry is clearly legible. The new entry should be written above or next to the old entry, and the date of the new entry, as well as the name of the person making the entry, should be recorded. The entry must also be signed by that person.

Juries are very intolerant of altered medical records; and even innocent mistakes, such as the loss of a few pages of a record, will be construed as an intentional cover-up. Under no circumstances should materials such as liquid paper or other opaque liquids be applied to the record in order to correct any entry.

Assessment

The health care provider should not alter the medical record under any circumstances.

Conclusion

Is there an emerging migration back to paper medical records?

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

Foreword by: J. WESLEY BOYD MD PhD MA

Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

Filed under: Career Development, iMBA, Inc., Practice Management, Risk Management | Tagged: Altered Medical Records, Dr. David Marcinko, medical records | 1 Comment »

Comparing “Best-in-Class” Blue Cross Blue Shield Plans Against Their Peers

Posted on January 24, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Plan Management Navigator

By Douglas B. Sherlock CFA

sherlock@sherlockco.com

This issue of Plan Management Navigator contains a summary of our analysis comparing “Best-in-Class” Blue Cross Blue Shield Plans and the other Plans that we refer to as “Peer” Plans.

Best-in-Class Plans operated with costs, excluding Sales and Marketing and Medical Management that were 32% lower than their Peers.

Low Staffing Ratios was the primary driver in the Best-in-Class cost advantage, while Staffing Costs per FTE and Non-Labor Costs per FTE were also lower.

The functional area of Information Systems was key in superior Best-in-Class performance. Economies of scale played no role in the ranking.

Invitation to Participate in the 2016 Sherlock Benchmarking Study

Our highly valid, well-populated Benchmarks provide an unbiased ranking and helps prioritize activities that will have the greatest impact on improving your health plan’s overall operating performance.

The overwhelming proportion of health plans participating last year are participating this year, and we have added several plans. Please follow this link to see what last year’s participation looked like.

We will meet to finalize the content of the survey in February, distribute the survey forms in March, collect the completed surveys in May and publish beginning in late June or early July. Participation entails efforts on your part since useful outputs require relatively granular inputs. The cost is relatively modest.

Because of the calendar, if you are considering participation, please contact me as soon as convenient. We can answer questions and help get the paperwork out of the way.

Assessment

Thank you again for your continuing interest in the Sherlock Benchmarks. Please visit this link to find the January 2016 Plan Management Navigator.

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

HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET

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Filed under: Health Insurance, iMBA, Inc. | Tagged: Blue Cross Blue Shield Health Plans, Douglas B. Sherlock CFA, Health Insurance | 2 Comments »

Estimated New Cancer Types

Posted on January 23, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

By http://www.MCOL.com

http://www.BusinessofMedicalPractice.com

According to Gender and Type in 2016

ImageProxy

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: iMBA, Inc., Research & Development | Tagged: new cancer types, www.MCOL.com | 1 Comment »

The Role of MD/DOs in BIOLOGICAL and CHEMICAL Attacks

Posted on January 22, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Is there REALLY a Role … at all?

By Dr. David Edward Marcinko MBA

Title X of the USA PATRIOT Act contains several calls for strengthening the public health system. Section 1013(a)(4) calls for “enhanced resources for public health officials to respond to potential bioterrorism attacks.” Section 1013(a)(6) calls for “greater resources to increase the capacity of hospitals and local healthcare workers to respond to public health threats.”

PRE 9/11

Prior to September 11, 2001, the capacity of healthcare entities to respond to biological and chemical attacks by terrorists was quite limited. Strictly speaking, however, healthcare organizational preparedness plans are not as directly encumbered by the USA PATRIOT ACT, or by the Department of Homeland Security’s (DHS’s) Chemicals of Concern [COC] List, or the various steps of its Section 550 Program as some other industries. Nevertheless, healthcare organizations may have their sources of contaminants, such as: Mercury, Dioxin: DEHP (2-ethylhexyl), Volatile Organic Compounds and Glutaraldehyde, etc.

For some time now, the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) has also required hospitals to have a disaster preparedness plan mimicking the USA PATRIOT Act [personal communication, Kenneth A. Powers, Media Relations Manager, TJC].

Post 9/11

After September 11, 2001, “disaster preparedness” evolved into something that could more accurately be described as “emergency preparedness.” Experience in New York and Virginia has shown that there will be spillover outside the immediate geographic areas affected by a terrorist attack, which will affect suburban and rural hospitals.

Thus, the emphasis in emergency preparedness is on the coordination and integration of organizations throughout the local system. Hospitals and healthcare entities therefore need to revise existing plans for disaster preparedness to reflect the realities of potential terrorist threats. Mitigation against risk is essential to safeguard the financial position of an entity. Medical practices and healthcare entities can mitigate risks by developing an emergency preparedness plan.

The entity should start by identifying possible disaster situations, such as earthquakes and biological or chemical attacks that could affect the facility. Next, the entity should identify the potential damages that could occur to structures, utilities, computer technology, and supplies. After that, the entity should use resources currently available to safeguard assets, and then budget to acquire any additional materials or alterations required to secure the facility.

travel+airplane

Practices can take several steps to mitigate even in the absence of significant funding:

First, establish links with ‘first responders’ such as local law enforcement, fire departments, state and local government, other healthcare organizations, emergency medical services, and local public health departments.
Second, establish training programs to educate staff on how to deal with chemical and biological threats.
Third, make changes in their information technology to facilitate disease surveillance that might give warning that an attack has occurred. Information technology may be useful in identifying the occurrence syndromes such as headache or fevers that might not be noticed individually but in the aggregate would signal that a biological or chemical agent had been released.
Fourth, acquire access to staff and equipment to respond to biological and chemical attack through resource sharing arrangements in lieu of outright purchases.”

In addition to preparedness for an attack within its catchment area, a healthcare organization must be prepared for an attack on its own facility or office. They should assess the vulnerability of the heating, ventilation, and air conditioning (HVAC) systems to biological or chemical attack. The positioning of the air intake vents is especially important because intakes on roofs are fairly secure as compared to intakes on ground level.

One way to increase security is to restrict access to the facility. Some facilities are using biometric screening to restrict access to their facilities. Biometric screening identifies people based on measurements of some body part such as a fingerprint, handprint, or retina. The advantage of this approach is that there are no problems with forgotten badges, and biometric features cannot be shared or lost like cards with personal identification numbers (PINs).

flu+virus+2

Assessment

In preparing for a possible attack, healthcare entities should also examine the federal, state, and local laws that might affect their response to a biological or chemical attack.

And so, is there really a roll; at all?

Unfortunately, there is no central source of legislation, and an extensive search of many sources might be required to determine the legal constraints.

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

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors

[Best Practices from Leading Consultants and Certified Medical Planners™]

Foreword by: J. WESLEY BOYD MD PhD MA

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Filed under: Book Reviews, iMBA, Inc., Risk Management | Tagged: HIPPA, The Role of MDs in BIOLOGICAL and CHEMICAL Attacks, USA PATRIOT Act | Leave a comment »

TEAM BASED MEDICAL CARE RISKS

Posted on January 21, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

More on Why I Still Don’t Like It

DEM white shirt

[By David Edward Marcinko MBBS MBA CMP™]

Redundancy occurs when more than one person (or committee) has the responsibility to make a decision or assume a task. Redundancy in a team based care model becomes a problem when it allows tasks to be overlooked or decisions to be avoided. This happens when a person or committee assumes that someone else with responsibility for the same task will make the necessary decisions. This can be due to a misunderstanding, or it can be due to an intentional dodging of the task or decision.

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cropped-header

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Redundancy is best avoided by having only one person, lead physician or committee responsible for each task or decision. Since this is almost impossible in a hospital or large organization, there must be an unambiguous protocol for allocating tasks and decisions among the responsible personnel. The protocol must also establish a system for handling problems that the assigned personnel cannot solve.

Assessment

It is important that such problems be brought to the attention of a supervisor for reassignment to new personnel. Reassignment should not be done by first level personnel; reassignment at that level will make it impossible to prevent the dodging of unpleasant tasks.

More: Why I Rue the Hospital “Team-Based Medicine” Approach to In-Patient Care

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

Our New Textbook – “Take a Sneek Peek Inside” Now Available!

Risk Management, Liability Insurance and Asset Protection Strategies for Doctors and Advisors

[Best Practices from Leading Consultants and Certified Medical Planners™]

Foreword by: J. WESLEY BOYD MD PhD MA

Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

***

Filed under: iMBA, Inc., Risk Management | Tagged: david marcinko, Team based medcial care risks | 3 Comments »

The Importance of Talking about End-of-Life Care

Posted on January 20, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

By Samantha Wanner [VITAS Healthcare]

Watch this short animation to learn why advance directives are so important.

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What Do You Want?

It’s not easy, but the medical treatments you would want near the end of life need to be discussed with others. If you never bring up the topic and you were unexpectedly incapacitated and unable to speak for yourself, your medical wishes would never be known.

Despite the topic’s importance, only 27% of Americans report having talked with their families about end-of-life care. The best way to make your medical wishes known is to create an advance directive and share it with your family and your doctor.

Advance Directives

An advance directive is actually two legal documents that enable you to plan and communicate your end-of-life wishes. When you create your advance directive, you are being proactive about your medical care and sparing your loved ones from having to make difficult medical decisions in a time of crisis.

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end_of_life_infographic

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Assessment

Don’t wait for a crisis. Create your advance directive, share copies with your loved ones and doctor and keep your copy in an accessible location others can find.

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

Foreword by: J. WESLEY BOYD MD PhD MA

Harvard Medical School

Yale University

***

Filed under: Health Insurance, iMBA, Inc., Insurance Matters, Risk Management, Videos | Tagged: End of Life Care | 2 Comments »

How Much Will a Ticket Raise My Car Insurance Rates?

Posted on January 19, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

[By Dr. David E. Marcinko MBA]

Be careful out there!

A GMAC survey revealed that 1 in 5 drivers would not pass the written driver’s test if they took it today. And, getting a ticket will raise your car insurance rate, but by how much?

The Survey

The survey found that reckless driving triggers the highest hike — an average increase of 22 percent — yet many drivers aren’t even sure what constitute reckless driving?

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DEM in his 1990 Miata

***

Reckless Driving

Depending on state laws, reckless driving can be defined as: driving over 80 mph, driving too fast for weather conditions, knowingly driving in a way that endangers others.

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: iMBA, Inc., Insurance Matters | Tagged: auto insurance, reckless driving | Leave a comment »

The 5 – 100 Rule

Posted on January 17, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Don’t Fall Asleep on Variable Life Insurance Policies

DEM white shirt

[By Dr. David E. Marcinko MBA CMP®]

http://www.CertifiedMedicalPlanner.org

cmp-logo16

OK; I admit it. I held life insurance license for almost a decade. But, don’t hold that against me.

With any universal life insurance policy (and certainly all variable life policies), fluctuating rates of return, the actual timing of the premium payments, and potential internal policy changes by the insurance company, all contribute to results that will probably differ substantially from the original illustration. So, be sure to monitor them periodically.

The Rule

As a professor of health economics, I know the 5 – 100 Rule states that as a result of accounting for these elements, all initial projections of cash value beyond 5 years, will necessarily be 100 percent incorrect when compared to actuality.

***

1447962729383

[Don’t Fall Asleep on Variable Life Insurance Policies]

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Assessment

A prudent physician policy owner should therefore keep on top of any changes and react accordingly. If a policy owner ignores his/her policy for even 5 years, any adverse changes could be so drastic as to make rectifying them very costly.

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: iMBA, Inc., Insurance Matters | Tagged: 5-10 rule; life insurance | Leave a comment »

Reasons for Remaining Un-Health Insured

Posted on January 14, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

By http://www.MCOL.com

Among Adults 18-65

ImageProxy

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: iMBA, Inc. | Leave a comment »

PHYSICIAN-EXECUTIVE LEADERSHIP AND RISK MANAGEMENT

Posted on January 12, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

Human Nature, Medical Ethics and Modern Principles

By David Edward Marcinko FACFAS CMP® MBA MBBS
By Render S. Davis MHA CAE
By Hope Rachel Hetico RN MHA CPHQ CMP®
By Gary A. Cook EJD CFP® CLU RHU MSFS CMP®

In any textbook of gravitas on medical risk management, asset protection and insurance planning, a chapter on human nature is usually placed at the end of the book, or as an appendix, or an afterthought if included at all.

However, we elected to prominently place this material as the premier chapter of our textbook.

***

Why?

In the end, the success of any risk management endeavor ultimately comes down to changing human behavior – helping a doctor/nurse/technician alter whatever s/he was doing toward something that will better allow them to avoid errors and pursue quality care and practice management goals.

Yet, there is still remarkably little education or training for medical professionals focused directly on motivation or change theory, in any related area except psychiatry/psychology or perhaps professional liability.

Instead, doctors are increasingly turning to professional consultants to learn best practices on how to help them actually make the behavioral changes necessary to achieve their quality improvement and risk reduction goals; as we attempt to answer these questions.

The Queries:

Are you and your medical practice, or clinical, ready for change?
How to transition from [traditional] solo practitioner B-models to modern forms?
What are leadership, management and governance?
In group practices, how is leadership shared?
What issues need be considered when hiring a practice administrator or clinic CEO?
What is medical ethics and munificence? Why is it needed? How does it work?
What are the types of risk?
How are risks managed in the medical practice space?

***

Leadership Shortcomings

In addition, medical practitioners need to strive to avoid what Zenger and Folkman describe as the 10 most common leadership shortcomings based on a survey of 11,000 leaders. They include:

Lacks energy and enthusiasm
Accepts mediocre self performance
Lacks clear vision and direction
Poor judgment
Not collaboration
Not following standards
Resistant to new ideas
Doesn’t learn from mistakes
Lacks interpersonal skills
Fails to develop others.

Source: Zenger and Folkman: The Daily Stat: The 10 Most Common Failures of Business Leaders, Harvard Business Publishing, June 4, 2009.

More:

Assessment

Want to lean even more about hundreds of medical risk management topics? Order our newest text book, today!

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, Ethics, iMBA, Inc., Practice Management, Risk Management | Tagged: David E. Marcinko, medical ethics, medical leadership, medical risk management, Zenger and Folkman | 2 Comments »

The FIXATION on Financial Planning “Teams”

Posted on January 5, 2016 by Dr. David Edward Marcinko MBA MEd CMP™

“I Still HATE Teams”

DEMM high-def White

[By Dr. David Edward Marcinko CMP® MBA MBBS]

http://www.CertifiedMedicalPlanner.org

The Real Notion of Teams

I HATE teams. There I said it. Now; I repeat. I hate team sports, teams in medicine and especially teams in financial planning. I am NOT a team player; most doctors are independent minded and not team players.

On the other hand, my wife says that I am most assuredly a team player. But, that I just select my teams very carefully. She is much smarter than I; so perhaps she is correct!

Why I Rue the Hospital “Team-Based Medicine” Approach to In-Patient Care

Financial Planning

In financial planning, there seems to be a fixation … that a team is a financial planner [certified; or not] and an attorney; nice-but a couple and not really a team in the true sense of group development as first proposed by Bruce Tuckman PhD, in 1965.

In his model, Tucker maintained that four phases are all necessary and inevitable in order for the team to grow, to face challenges, to tackle problems, to find solutions, to plan work, and to deliver results [Forming – Storming – Norming – Performing].

Later, he added Adjourning to successfully complete the task and break up the team. Timothy Biggs PhD further added the Re-Norming stage to reflect a period where the team re-assembles, as needed. This put the emphasis back on the ME Inc or physician team leader – as too many ‘diplomats’ in a leadership role may prevent the team from reaching full potential.

Source: http://infed.org/mobi/bruce-w-tuckman-forming-storming-norming-and-performing-in-groups/

A Metaphor

This is why “team” must be more than a metaphor. It deserves more than lip service. Delivering client-centered, coordinated financial planning services and products demands true collaboration–a fully integrated team engaged in practices that involve each member at the top, highest and best use of their licensure and education; optimizing their contributions and maximizing their impact on the well being of the client [Boyer Model of Education].

In this context, board Certified Medical Planners™ may play a lead role going forward; along with other like-minded and educated professionals.

Unfortunately, the ranks of CMPs™ while growing; are still painfully small. But, in addition to true expertise, they link physician clients with appropriate providers and resources throughout the holistic professional life/practice planning continuum. They focus on the doctor-client’s totality — emotional, financial, risk and business management and psyche. As fiduciaries at all times; They advocate for the doctor client to connect him/her to the necessary resources, professional advisors and consultants who need to have their voices heard. Such successful, high-functioning financial planning teams give each member a voice.

The medical professional must be an active participant; not a passive bystander. This is not the norm in financial planning today where doctors are urged to hire a team quarterback. But, the NFL-QB is not a generalist at all; his arm is special and unlike all other teams players. He/she is unique, skilled and exceptional. A franchise player!

Past not Prologue

Fortunately, past is not prologue in the era of transparency, information at your fingertips, tablet PCs, Skype® and smart phones. To succeed in the hyper competitive new era of health reform requires education, involvement and active participation.

In short, a new model of physician focused advisor. No longer is there a free lunch of passivity for medical professionals; either as doctors or advisory clients themselves.

For financial planning in the new era of healthcare reform, and robo-advisors, successful doctors will assume the mantle of self-quarterback themselves.

***

[Go Team Go]

***

ME Inc., or Going it Alone – but with a Team

The physician, nurse, or other medical professional should easily recognize that there are a vast array of opportunities, obstacles, and pitfalls when it comes to managing one’s finances.

Still, with some modicum of effort, the basic aspects of insurance, investments, taxes, accounting, portfolio management, retirement and estate planning, debt reduction, asset protection and practice management can be largely self-taught. After all, it is NOT rocker science.

After all, anyone can purchase the exact same financial planning software that legions of FAs use, and there are many iterations on the market, as well. This concept is not unlike patients, using Dr. Google. No license required.

And TAMPs, relegate FAs to the role of “asset gather”; or should I say salesman/woman.

Why Physician-Investors Must Understand TAMPs

Informed Patient [Client]

So, an informed patient or client is ideal; is it not?

Yet, it is realized that nuances and subtleties can make a well-intentioned plan fall short. The devil truly is in the details. Moreover, none of these areas can be addressed in isolation. It is common for a solution in one area to cause a new set of problems in another.

Hourly Model

Accordingly, most health care practitioners would be well served to hire [independent, hourly compensated and prn] financial help.

Unlike some medical problems, financial issues may not cause any “pain” or other obvious symptoms. Medical professionals tend to have far more complex financial situations than most lay people. Despite the complexities of the new world of health reform, far too many either do nothing; or give up all control totally, to an external advisor. This either/or mistake can be costly in many ways, and should be avoided.

In reality, and at various time in their careers, the medical professional needs a team comprised of at least a financial analyst [CFA], lawyer, management consultant, risk manager [PhD actuary or insurance counselor] and accountant. At various points in time, each member of the team, or significant others, will properly assume a role of more or less importance, but the doctor must usually remain the “quarterback” or leader; in the absence of a truly informed other, or Certified Medical Planner™.

This is necessary because only the doctor [client] has the personal self-mandate with skin in the game, to take a big picture view. And, rightly or wrongly, investments dominate the information available regarding personal finance and the attention of most physicians. One is much more likely to need or want to discuss the financial markets with their financial advisor than private letter rulings by the IRS, or with their estate planning attorney or tax accountant.

So, while hiring for expertise is a good idea, there is sinister way advisors goad doctors into using all their retail services; all of the time. That artifice is – the value of time. Don’t fall for this out sourcing gambit!

How Doctors Pay for Wealth Management Services

***

[Not Going it Alone]

***

Assessment

True integrated physician focused and financial planning is at its core a service business, not a product or sales endeavor. And, increasingly money is more likely to be at the top of the list for providers as the healthcare environment is contracting.

So, eschewing the quarterback model of advice, and choosing to self-educate thru these new book and elsewhere, may be one of the best efforts a smart physician can make.

Enter the CMPs

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

[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

***

Filed under: CMP Program, Ethics, Financial Planning, iMBA, Inc., Practice Management | Tagged: Dr. Marcinko, financial planning team, physician focused financial planning, team healthcare | 1 Comment »

HISTORIC PURPOSE OF MEDICAL RECORDS and S.E.S.

Posted on December 31, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

An iMBA Inc., Review

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DEM white shirt

[By Dr. David Edward Marcinko CMP® MBA]

***

As little as a hundred years ago, detailed medical records were likely to have been compiled by medical researchers such as Charcot and Hughlings-Jackson. The medical record was an aide memoire for detecting changes in patients’ conditions over time, solely for the benefit of the physician in treating the patient.

As health care became more institutionalized, medical records became a communications device among health care providers. Doctors made progress notes and gave orders. Nurses carried them out and kept a record of patient responses. A centralized record, theoretically, allowed all to know what each was doing. The ideal was that if the doctor were unable to care for the patient, another physician could stand in his or her shoes and assume the patient’s care.

***

Enter Third Parties

Then pressures from third party payers occurred. As insurance and then government programs became larger players in the compensation game, they wanted to know if the care they were paying for was being delivered efficiently.

Why were these tests ordered?
Why weren’t these studies done?
Why had the patient remained hospitalized after his temperature had returned to normal for so many hours and no pain medications had been required?
Why couldn’t this pre-operative work be done on an outpatient basis?

Though the real push behind these questions was the desire to save money, utilization review also directly contributed to better patient care. A patient who was being given inefficient care was getting substandard care as well. Utilization review was mainly retrospective; denial of compensation was rarely imposed, and suasion by peers was the main effector of change. Though “economic credentialing” was shouted about, it rarely showed itself in public.

PP-ACA

Even health reform which openly admitted economic incentives as one of its motivators preferred to find some other reason for deciding not to reimburse, or admit Dr. Jones to its narrow panel of ACA, or other “skinny” network providers, or not renewing Dr. Smith’s contract an HMO. The medical record remained essentially a record of patient care which was good or not, efficient or not. If the record wasn’t complete, the doctor could always supplement it with an affidavit, use information from somewhere else, or provide explanations.

***

Socio Economic Status

Today, the concept known as Socio Economic Status [S.E.S.] is conceptualized as the social standing, or class of an individual or group. It is often measured as a combination of education, income and occupation. Examinations of socioeconomic status often reveal inequities in access to medical resources, plus issues related to privilege, power and control. SES is increasingly being considered as another payment component [CPT® codes] to medical providers, as reflected in the paper medical record, EMR and elsewhere.

Assessment

Have you encountered any Socio Economic Status initiative in your clinic, hospital or other medical institution?

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

***

[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

***

Filed under: iMBA, Inc., Practice Worth, Risk Management | Tagged: EMRs, Marcinko, medical records, Socio Economic Status | 2 Comments »

HUMANITARIAN WISDOM IN PATIENT CARE AS A MORAL IMPERATIVE AND …

Posted on December 29, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

…. A MEDICAL RISK MANAGEMENT TOOL in 2018!

***

DEM white shirt

[Dr. David Edward Marcinko CMP™ MBA MBBS]

http://www.CertifiedMedicalPlanner.org

EDITOR-IN-CHIEF

***

In SECTION ONE, of our newest textbook, on medical practitioner personal risk management issues, let us all recall the Canadian physician Sir William Osler MD, one of the founders of Johns Hopkins Hospital in my hometown of Baltimore Maryland, and where I played stickball in the parking lot as a kid. He left a sizeable body of wisdom that has guided many physicians in the practice of medicine. So, allow me to share with you some of that accumulated wisdom and the quotes that have served me well over the years.

From Dr. Osler, I learned the art of putting myself in the patient’s shoes. “The motto of each of you as you undertake the examination and treatment of a case should be ‘put yourself in his place.’ Realize, so far as you can, the mental state of the patient, enter into his feelings.” Osler further stresses that we should “scan gently (the patient’s) faults” and offer the “kindly word, the cheerful greeting, the sympathetic look.”¹

“In some of us, the ceaseless panorama of suffering tends to dull that fine edge of sympathy with which we started,” writes Osler in his famous essay “Aequanimitas.”² “Against this benumbing influence, we physicians and nurses, the immediate agents of the Trust, have but one enduring corrective — the practice towards patients of the Golden Rule of Humanity as announced by Confucius: ‘What you do not like when done to yourself, do not do to others.’”

Medicine can be both art and science as many physicians have discovered. As Osler tells us, “Errors in judgment must occur in the practice of an art which consists largely of balancing probabilities.”² Osler notes that “Medicine is a science of uncertainty and an art of probability” and also weighs in with the idea that “The practice of medicine is an art, based on science.”^3,4

Osler emphasized that excellence in medicine is not an inheritance and is more fully realized with the seasoning of experience. “The art of the practice of medicine is to be learned only by experience,” says Osler. “Learn to see, learn to hear, learn to feel, learn to smell, and know that by practice alone can you become expert.”⁵

Finally, some timeless wisdom on patient care came from Osler in an address to St. Mary’s Hospital Medical School in London in 1907: “Gain the confidence of a patient and inspire him with hope, and the battle is half won.”⁶

Osler has also imparted plenty of advice on the business of medicine. In “Aequanimitas,” Osler says there are only two types of doctors: “those who practice with their brains, and those who practice with their tongues.”⁷

***

In a valedictory address to medical school graduates at McGill University, Osler suggested treating money as a side consideration in a medical career.⁸ “You have of course entered the profession of medicine with a view of obtaining a livelihood; but in dealing with your patients let this always be a secondary consideration.”

“You are in this profession as a calling, not as a business: as a calling which exacts from you at every turn self-sacrifice, devotion, love and tenderness to your fellow man,” explains Osler in the address to St. Mary’s Hospital Medical School.⁶ “Once you get down to a purely business level, your influence is gone and the true light of your life is dimmed. You must work in the missionary spirit, with a breadth of charity that raises you far above the petty jealousies of life.”

It is not easy for doctors to combine a passion for patient care, a knowledge of science and the maintenance of business, according to Osler in the British Medical Journal.⁹ “In the three great professions, the lawyer has to consider only his head and pocket, the parson the head and heart, while with us the head, heart, and pocket are all engaged.”

While some aspects of practice may fall short or be devoid of appropriate financial remuneration, the giving of one’s time, expertise and experience in improving patient outcomes and the quality of their lives may be the greatest gift. “The ‘good debts’ of practice, as I prefer to call them … amount to a generous sum by the end of each year,” says Osler.⁹

***

http://www.BusinessofMedicalPractice.com

***

MEDICAL Ethics for Challenging Times

[Finding Your Moorings in an Era of Dramatic Change]

Marcinko Ethics

By Render S. Davis MHA

By David Edward Marcinko

***

And so, as you read and reflect on the chapter of SECTION ONE, always remember the words and wisdom of Dr. William Osler, and keep patient welfare as your first priority.

Dr. David Edward Marcinko; CMP™ MBA MBBS [Hon]

[Chief Executive Officer]

iMBA Inc., Norcross, GA

References

Penfield W. Neurology in Canada and the Osler centennial. Can Med Assoc J. 1949; 61(1): 69-73
Osler W. Aequanimitas. Chapter 9, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 159
Bean WB. William Osler: Aphorisms, CC Thomas, Springfield, IL, p. 129.
Osler W. Aequanimitas. Chapter 3, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 34
Thayer WS. Osler the teacher. In: Osler and Other Papers. Johns Hopkins Press, Baltimore, 1931, p. 1.
Osler W. The reserves of life. St. Mary’s Hosp Gaz. 1907;13 (1):95-8.
Osler W. Aequanimitas. Chapter 7, P. Blakiston’s Son and Co., Philadelphia, 1925, p. 124
Osler W. Valedictory address to the graduates in medicine and surgery, McGill University. Can Med Surg J. 1874; 3:433-42.
Osler W. Remarks on organization in the profession. Brit Med J. 1911; 1(2614):237-9.
Jacobs. AM: PMNews, April, 2015.

***

[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

***

Filed under: "Doctors Only", CMP Program, Ethics, Financial Planning, iMBA, Inc., Risk Management | Tagged: CMP, CMP Program, David E. Marcinko, Financial planning MDs, medical risk management, Render Davis | Leave a comment »

State Health Rankings

Posted on December 28, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

For 2015

By http://www.MCOL.com

*** ImageProxy

***

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

***

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

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

***

Filed under: Health Insurance, iMBA, Inc., Quality Initiatives | Tagged: State Health Rankings | 2 Comments »

R.I.P. Lon Jefferies MBA CFP®

Posted on December 24, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

***

Dear ME-P Readers and Subscribers

It is with a heavy heart that we inform you that Lon Jefferies passed away unexpectedly this weekend due to complications inherent with a seizure disorder. We are extremely saddened by Lon’s all-too-soon departure. He was a vital contributor to this Medical Executive-Post and Financial Planning industry writ large; and he will be greatly missed.

***

Lon Jefferies

http://www.NewWorthAdvice.com

***

As you know, Lon was an excellent financial planner and prolific blogger. To his credit – one of the variables he planned for – was the possibility of a life altering event such as this. With this foresight, Lon chose to align his financial planning services with his team at Net Worth Advisory Group. Lon’s plan ensures that each client can continue to receive the same high level of financial planning and assistance going forward, while allowing his beneficiaries to receive some residual income.

Our most sincere sympathies go out to Lon’s new bride Jen, his parents, and their families.

With best regards and sincere sympathy.

Dr. David Edward Marcinko MBA CMP® MBBS

[Publisher and Editor-in-Chief]

***

Filed under: Ethics, iMBA, Inc. | Tagged: Lon Jefferies MBA CFP® | 2 Comments »

Does organic food cause autism? Could Nicolas Cage movies make you more likely to drown? Six ways to misuse statistics

Posted on December 17, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

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Biostatistics Model

***

Filed under: iMBA, Inc. | 1 Comment »

The “Perfect” Holiday Gift for your Favorite Doctor – YES REALLY!

Posted on December 17, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

http://www.CertifiedMedicalPlanner.org

Now, is the perfect time of year to consider one, or all, of these texts as the perfect holiday gift for your favorite doctor, or allied health care professional.

Also, may be used as a client-prospecting tool for Financial Advisors, Wealth and Practice Managers, and CPAs, etc.

Smile, learn and prosper with iMBA in 2016.

*** holiday_gift ***

Last Generation Holiday Gift for MDs

***

RECENT BOOKS FROM iMBA, Inc.

Next Generation Holiday Gifts for MDs

***

Filed under: Book Reviews, Financial Planning, iMBA, Inc., Insurance Matters, Practice Management, Recommended Books, Retirement and Benefits | Tagged: Financial Planning, Holiday gifts, Investing, medical practice management, wealth management | Leave a comment »

Newer Thoughts on Long Term Care Insurance

Posted on December 16, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Most LTCI policies are SOLD… not Bought!

By Dr. David Edward Marcinko MBA CMP™

To be sure, physicians and Financial Advisors are aware that there is a sometime need to recommend a LTCI policy to clients. Of course, in such cases, it is a good idea to work with a low load provider (or the physician or client’s agent).

The Need?

Yet, most LTCI policies are sold by insurance agents for big commissions; not bought, and that most statistics used to sell LTCI policies are fear-based and half-truths. I know, as I was a licensed insurance agent for more than a decade.

Even the Department of Health and Human Services [DHHS] gets into the fear mongering on their website quoting that “about 70 percent of people over age 65 require some type of long-term care services during their lifetime”

Source: http://www.longtermcare.gov/LTC/Main_Site/Planning/Index.aspx

Department of Health and Human Services

This may be a deceptive statistic as it omits the length of long-term care needed in these 70% of cases. And, it is not 3+ years in all these cases [our estimate is closer to 2.5]. With the stamp of approval by the Supreme Court of the United States SCOTUS on the PP-ACA, we may be looking at social LTCI in the US like other social medicine countries and give up on private LTCI insurance altogether.

Other Countries

Germany introduced mandatory long-term care insurance in 1995. Japan and France also have a LTCI tax funded insurance plan. And, the poor utilization and growing risks associated with long-term care insurance, are leading a growing number of insurance agents, financial advisors and Certified Medical Planners™ to recommend alternatives to their clients.

***

Assessment

To be a thought-leader ahead of the curve, the newest aging trend is away from LTCI and toward sheltering at home – living at home and dying at home. Perhaps, this is the way it should be.

Dying should not be a for-profit industry.

http://www.CertifiedMedicalPlanner.org

More:

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

***

[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

***

Filed under: CMP Program, Ethics, Health Insurance, iMBA, Inc., Research & Development, Retirement and Benefits, Touring with Marcinko | Tagged: David E. Marcinko, long term care insurance, LTCI | 2 Comments »

Update on the FOMC and Interest Rates

Posted on December 7, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

What if the Fed DOESN’T Raise Rates?

By Michael A. Gayed CFA

***

With odds high for the Federal Reserve’s first rate hike in nearly a decade, and seemingly everyone predicting that rising rates are coming in the next few weeks, why in the world is the yield curve not steepening aggressively?

Something curious is happening

There is a mistaken notion out there that if the Fed raises rates, the cost of capital on everything is going to rise. This is far too simplistic a way of viewing the bond market. If the Fed raises rates and the market perceives it as being too early, then longer duration bond yields likely would actually fall and credit spreads likely would widen. In other words, some rates could fall because the Fed is raising short rates.

***

In a healthy environment, Fed hiking would coincide with a steepening yield curve, as growth and inflation expectations become more aggressively priced in. As of late, it seems as though the bond market vastly disagree with the Fed’s December timing.

Of course all this could change, as probabilities continuously change

So, if the Fed decides not to raise rates, and the yield curve continues to flatten, then something very serious may be underway in terms of 2016 economic expectations. It does seem plausible that from a cycle perspective, the era for passive buy and hold investing in large-cap stocks is nearing its end, allowing for more active alpha opportunities to present themselves.

This would likely translate into more volatility in equities, which we believe our alternative Morningstar 4 Star overall rated ATAC Inflation Rotation Fund (Ticker: ATACX, rating as of 9/30/15 among 234 Tactical Allocation Funds derived from a weighted average of the fund’s 3-year risk-adjusted return measures) is distinctly qualified to handle given our focus on being defensive in Treasuries at the right time.

Having said that, despite my own personal believe the Fed will raise rates, it is concerning to see how longer duration bonds are behaving.

The key needs to be a comeback in commodities and emerging market stocks

For the yield curve in the United States to steepen, and for the Federal Reserve to “get it right,” likely a surprise recovery is needed in cyclical growth sentiment. Commodities and emerging markets are among the most sensitive areas of the investable landscape to that, so it stands to reason that their movement would show the whites of the eyes of that happening. The issue however is that every time is looks like budding momentum is about to become more entrenched, that momentum quickly reverses and creates a false positive on rising growth expectations.

***

gears

***

Recent manufacturing data confirms that not much has changed on the growth side of the equation. So far, broader equities seem to not care given historically favorable December seasonality. That doesn’t mean one should not be considering this in an overall asset allocation policy.

Complicating-The European Central Bank

In many ways, crushing the Euro through more stimulus has the same effect as Federal Reserve tightening precisely because a rising Dollar is a contractionary force to exports. European stimulus is Fed tightening IF it results in a Dollar super-spike. Should that occur, the Fed would be more likely that not to not raise rates and actually do another round of stimulus.

Assessment

Insane sounding? Maybe. But; so is an environment where no amount of money printing seems to be accelerating the economy.

ABOUT

The ATAC Rotation Mutual Funds are managed by Pension Partners, LLC, an independent registered investment advisor. The strategies were developed by Co-Portfolio Managers Edward M. Dempsey, CFP® and Michael A. Gayed, CFA. The Funds rotate offensively or defensively based on historically proven leading indicators of volatility, with the goal of taking less risk at the right time.

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

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Filed under: Health Economics, iMBA, Inc., Investing, Practice Management, Recommended Books | Tagged: FOMC, interest rates, IRS, Michael A. Gayed CFA | 5 Comments »

Google Wants to Replace your Brain

Posted on February 23, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Enter the Robo-Advisors, Robo-Doctors and the Singularity?

[By Edward Bukstel]

ME-P SPECIAL REPORT

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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.

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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

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No More 10 and 90 Day Global Periods

Posted on February 15, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

New Changes on the [CMS Payment Reform] Horizon

[By Dreama Sloan-Kelly MD CCS]

Did you hear about the changes that are coming down the pike in regards to global services when billing for surgical procedures — be they in the office, in an ambulatory surgical center, or in the hospital?

CMS released their final 2015 Medicare Physician Fee Schedule (MPFS) ruling late last year. Embedded in this document was a proposal by CMS to get rid of both the 10 day and 90 day global periods! In fact, they want to do away with global period billing all together and have all procedures paid based on the work required to do the procedure itself — thereby billing for all post-surgical visits separately using E/M codes.

According to the final ruling, CMS proposes to transform all 10 day global services to ZERO global days starting in 2017. They will do the same in regards to 90 day global services starting in 2018. And, according to the U.S. Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) they have “identified a number of surgical procedures that include more visits in the global period than are being furnished”. They go on to say that they are “also concerned that post-surgical visits are valued higher than visits that were furnished and billed separately by other physicians such as general internists or family physicians”. Based on the final ruling, they plan to begin the transition as previously stated in 2017 after they have considered all comments.

The ruling goes on to state, “as the agency begins revaluation of services as 0-day global periods, we will actively assess whether there is a better construction of a bundled payment for surgical services that incentivizes care coordination and care redesign across an episode of care”. So let’s talk reality and my take on this change.

Over the past few weeks I have read a lot of articles on this subject from various pundits in the industry — they are actually arguing that this change will mean increased reimbursement when you combine the separate payment for the procedure itself along with the visit by visit billing for the post-surgical follow up care when compared to the current reimbursement rate.

***

Personally, I think they are all wrong for the following reasons:

Procedure Reimbursement Amount: This is the wild card. They are going to use the same RVU system that has always been used to calculate payment — but I guarantee you the payment for the procedure will not be anywhere near the reimbursement for the global package. I think the closest we could get to estimating the reimbursement rate of the procedure is to figure out what the current surgical care only rate would be (ie. as if you appended Modifier 54 to the procedure code). Beware that this rate would still encompass the pre-surgical evaluation — which I am assuming would be carved out since that is a part of the current global package they are trying to phase out.

Post Op Visits: Getting a patient to comply with medical visits is hard enough — now adding in the fact they would have to pay a copay each time — most often a specialty co-pay is going to make it even harder. Patient’s understand their follow up visits are currently covered in the cost for the surgery, and hence they tend to show up to these visits knowing they do not have any out of pocket expenses. If the proposed change comes to fruition many of the post-surgical visits may become cost prohibitive for a lot of patients and actually lead to a decrease in the number of follow up visits the patient actually schedules. Once the patient starts to feel better their motivation to return dwindles.

Lower Reimbursement Rate for Post-Surgical Visits: It is clearly stated in the CMS ruling that it is felt the post-surgical follow up care visits are paid at a higher rate than what a regular E/M visit would be paid for had the patient been seen by a primary care provider or an internist. That simple statement confirms to me that when the new procedure rate is combined with the individual visit payment rate, the overall reimbursement rate will be less than what is currently being paid.

So, how do you prepare?

First, stay on top of all bulletins coming from CMS in regards to this issue. Most of your medical societies and/or specialty societies have taken clear positions in regards to this matter — so be sure to stay in the loop and become a part of the process.

Run a report that allows you to pinpoint the average number of post-surgical follow up visits for your most billed procedures. This will give you an idea of the average number of follow up visits for particular procedures you know you will bill for if this transition does occur. Does this mean this number will be exact — NO — I would factor in a decrease of 15-20% for visits across the board based on the dynamics I previously described.

Lastly, begin creating a policy in regards to post-surgical follow up care that can act as an education tool for the patient, teaching them the important benefits of being compliant with their post-surgical care schedule and also warning them about the possible increase in out of pocket cost. Being transparent can go a long way into easing patient’s fear and encouraging their follow through.

As always I have included documentation for your library of information — you can find the CMS 2015 MPFS final ruling fact sheet HERE! I also created a brief video presentation on this hot topic HERE.

***

Channel Surfing the ME-P

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: Healthcare Finance, iMBA, Inc., Practice Management | Tagged: CMS global periods, CPT codes, Dreama Sloan-Kelly MD | Leave a comment »

2015 Medicare Part D [What it is = How it works]?

Posted on February 13, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Update on the Medicare prescription drug benefit program

[By Staff Reporters]

Medicare Part D, also called the Medicare prescription drug benefit, is a United States federal-government program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries. It was enacted as part of the Medicare Modernization Act of 2003 (which also made changes to the public Part C Medicare health plan program) and went into effect on January 1, 2006.

Medicare Part D Premiums

The monthly Medicare Part D base premium is set to pay 25.5 percent of the cost of standard coverage, established by bids submitted annually by Part D plans. CMS releases the Medicare Part D base premium in early August each year. Actual premiums are based on this set premium, but can vary greatly. The premium for 2014 was $32.42.

As of 2011, beneficiaries with higher incomes must pay a premium adjustment based on their income. This premium adjustment is called the Income-Related Monthly Adjustment Amount (IRMAA), and is paid directly to the Federal government (deducted from Social Security, Railroad Retirement Board, or Office of Personnel Management benefits).

Medicare Part D Deductible

The annual deductible for the standard Medicare Part D benefit was $310 in 2014, which is a decrease of $10 from the 2013 deductible. No Medicare drug plan may have a deductible more than $310 in 2014, although some plans may have a lower deductible or no deductible at all.

***

CMS Part D 2015 Standard Benefit Model Plan Details

Here are the highlights for the CMS defined Standard Benefit Plan changes from 2014 to 2015. The chart below shows the Standard Benefit design changes for plan years 2011, 2012, 2013, 2014 and 2015. This “Standard Benefit Plan” is the minimum allowable plan to be offered.

Initial Deductible: will be increased by $10 to $320 in 2015
Initial Coverage Limit: will increase from $2,850 in 2014 to $2,960 in 2015
Out-of-Pocket Threshold: will increase from $4,550 in 2014 to $4,700 in 2015
Coverage Gap (donut hole): begins once you reach your Medicare Part D plan’s initial coverage limit ($2,960 in 2015) and ends when you spend a total of $4,700 in 2015. In 2015, Part D enrollees will receive a 55% discount on the total cost of their brand-name drugs purchased while in the donut hole. The 50% discount paid by the brand-name drug manufacturer will still apply to getting out of the donut hole, however the additional 5% paid by your Medicare Part D plan will not count toward your TrOOP. Enrollees will pay a maximum of 65% co-pay on generic drugs purchased while in the coverage gap.
Minimum Cost-sharing in the Catastrophic Coverage Portion of the Benefit**: will increase to greater of 5% or $2.65 for generic or preferred drug that is a multi-source drug and the greater of 5% or $6.60 for all other drugs in 2015
Maximum Co-payments below the Out-of-Pocket Threshold for certain Low Income Full Subsidy Eligible Enrollees: will increase to $2.65 for generic or preferred drug that is a multi-source drug and $6.60 for all other drugs in 2015.

******

Medicare Part D Benefit Parameters for Defined Standard Benefit 2011 through 2015 Comparison
Part D Standard Benefit Design Parameters:	2015	2014	2013	2012	2011
Deductible – (after the Deductible is met, Beneficiary pays 25% of covered costs up to total prescription costs meeting the Initial Coverage Limit.	$320	$310	$325	$320	$310
Initial Coverage Limit – Coverage Gap (Donut Hole) begins at this point. (The Beneficiary pays 100% of their prescription costs up to the Out-of-Pocket Threshold)	$2,960	$2,850	$2,970	$2,930	$2,840
Total Covered Part D Drug Out-of-Pocket Spending including the Coverage Gap – Catastrophic Coverage starts after this point. See note (1) below.	$6,680.00 (1)	$6,455.00 (1)	$6,733.75 (1)	$6,657.50 (1)	$6,447.50 (1)
Out-of-Pocket Threshold – This is the Total Out-of-Pocket Costs including the Donut Hole. 2015 Example: $320 (Deductible) +(($2960-$320)25%) (Initial Coverage) +(($6680.00-$2960)100%) (Cov. Gap) = $4,700 (Maximum Out-Of-Pocket Cost prior to Catastrophic Coverage – excluding plan premium)	$4,700 $320.00 $660.00 $3,720.00 $4,700.00	$4,550 $310.00 $635.00 $3,605.00 $4,550.00	$4,750 $325.00 $661.25 $3,763.75 $4,750.00	$4,700 $320.00 $652.50 $3,727.50 $4,700.00	$4,550 $310.00 $632.50 $3,607.50 $4,550.00
Total Estimated Covered Part D Drug Out-of-Pocket Spending including the Coverage Gap Discount (NON-LIS) See note (2).	$7,061.76 plus a 55% brand discount	$6,690.77 plus a 52.50% brand discount	$6,954.52 plus a 52.50% brand discount	$6,730.39 plus a 50% brand discount	$6,483.72 plus a 50% brand discount
Catastrophic Coverage Benefit:
Generic/Preferred Multi-Source Drug (3)	$2.65 (3)	$2.55 (3)	$2.65 (3)	$2.60 (3)	$2.50 (3)
Other Drugs (3)	$6.60 (3)	$6.35 (3)	$6.60 (3)	$6.50 (3)	$6.30 (3)
Part D Full Benefit Dual Eligible (FBDE) Parameters:	2015	2014	2013	2012	2011
Deductible	$0.00	$0.00	$0.00	$0.00	$0.00
Copayments for Institutionalized Beneficiaries	$0.00	$0.00	$0.00	$0.00	$0.00
Maximum Copayments for Non-Institutionalized Beneficiaries
Up to or at 100% FPL:
Up to Out-of-Pocket Threshold
Generic/Preferred Multi-Source Drug	$1.20	$1.20	$1.15	$1.10	$1.10
Other	$3.60	$3.60	$3.50	$3.30	$3.30
Above Out-of-Pocket Threshold	$0.00	$0.00	$0.00	$0.00	$0.00
Over 100% FPL:
Up to Out-of-Pocket Threshold
Generic/Preferred Multi-Source Drug	$2.65	$2.55	$2.65	$2.60	$2.50
Other	$6.60	$6.35	$6.60	$6.50	$6.30
Above Out-of-Pocket Threshold	$0.00	$0.00	$0.00	$0.00	$0.00
Part D Full Subsidy – Non Full Benefit Dual Eligible Full Subsidy Parameters:	2015	2014	2013	2012	2011
Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $8,580 (individuals) or < $13,620 (couples) (4)
Deductible	$0.00	$0.00	$0.00	$0.00	$0.00
Maximum Copayments up to Out-of-Pocket Threshold
Generic/Preferred Multi-Source Drug	$2.65	$2.55	$2.65	$2.60	$2.50
Other	$6.60	$6.35	$6.60	$6.50	$6.30
Maximum Copay above Out-of-Pocket Threshold	$0.00	$0.00	$0.00	$0.00	$0.00
Partial Subsidy Parameters:	2015	2014	2013	2012	2011
Applied and income below 150% FPL and resources between $8,581-$13,300 (individuals) or $13,621-$26,580 (couples) (category code 4) (4)
Deductible	$66.00	$63.00	$66.00	$65.00	$63.00
Coinsurance up to Out-of-Pocket Threshold	15%	15%	15%	15%	15%
Maximum Copayments above Out-of-Pocket Threshold
Generic/Preferred Multi-Source Drug	$2.65	$2.55	$2.65	$2.60	$2.50
Other	$6.60	$6.35	$6.60	$6.50	$6.30
****** (1) Total Covered Part D Spending at Out-of-Pocket Threshold for Non-Applicable Beneficiaries – Beneficiaries who ARE entitled to an income-related subsidy under section 1860D-14(a) (LIS)

(2) Total Covered Part D Spending at Out-of-Pocket Threshold for Applicable Beneficiaries – Beneficiaries who are NOT entitled to an income-related subsidy under section 1860D-14(a) (NON-LIS) and do receive the coverage gap discount. For 2015, the weighted gap coinsurance factor is 90.693%. This is based on the 2013 PDEs (85.9% Brands & 14.1% Generics)

(3) The Catastrophic Coverage is the greater of 5% or the values shown in the chart above. In 2015, beneficiaries would be charged $2.60 for those generic or preferred multisource drugs with a retail price under $52 and 5% for those with a retail price greater than $52. As to Brand drugs, beneficiaries would pay $6.60 for those drugs with a retail price under $132 and 5% for those with a retail price over $132.
(4) The actual amount of resources allowable may be updated for contract year 2015.

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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

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Filed under: Health Insurance, iMBA, Inc. | Tagged: Medicare Part D, Medicare prescription drug benefits | 7 Comments »

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