More on Why I Still Don’t Like It

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.

***

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[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™

Among Adults 18-65

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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 »

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]

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

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!

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!

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DEM white shirt

[Dr. David Edward Marcinko CMP™ MBA MBBS]

http://www.BusinessofMedicalPractice.com

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

***

***

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

http://www.NewWorthAdvice.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

***

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™

***

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

****

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

***

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.

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

* 8

Filed under: iMBA, Inc. | 14 Comments »

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.

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

* 8

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

“Vesalius on the Verge”

Posted on February 11, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

The Book and the Body

[By Dr. David Edward Marcinko MBA]

“Vesalius on the Verge: The Book and the Body” explores the groundbreaking work of 16th century professor and physician Andreas Vesalius, who changed the way that human anatomy was taught forever with “De humani corporis fabrica (On the fabric of the human body)”.

The book did two things not seen before: it corrected errors in the conception of the human body that existed for over a millennia, and it combined text with artistic illustration, which enabled interactive learning.

Where else can you see a first edition of the 1543 published text, a desiccated body juxtaposed with a full skeleton, and a contemporary recreation of Vesalius’ dissection table?

Plan your visit today! #muttermuseum #vesalius #anatomy #medicine #rarebooks” By muttermuseum on Instagram

***

Source: tumblr_inline_nhs0feL7wW1qzgziy

***

Assessment:

I went to medical school in Philadelphia PA, and visited the Mutter Museum many times. If you’ve never been there – I urge you to check it out!

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: Book Reviews, Ethics, iMBA, Inc. | Tagged: Anatomy Dissection, David Edward Marcinko, Mutter Museum, Vesalius, Vesalius on the Verge | 1 Comment »

Publishing Impact of the ME-P Website

Posted on February 8, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Who needs it … What for?

[By Ann Miller RN MHA]

What’s the point of publishing your essays, thoughts, comments and articles on this ME-P?

Today, many physicians, FAs and health economic experts still don’t have the potential to express themselves to a large audience. By adding articles to their own blogs, with poor attendance, they deprive a wide audience of the opportunity to familiarize themselves with their works.

That’s why material from our ME-P website is available to all English-speaking inhabitants of the world. Some website owners even visit our web portal to pick up or re-post the best articles to place on their own websites.

Why publish with the ME-P?

All this is interesting, but what is the use of the website to an author? So, here is what you get by publishing with us:

• A unique method of promoting your website, self, financial advisory or medical practice; or ideas. If your essay is really interesting – many others will want to read our related books, white-papers and texts; so you will become well-known among our readers.

• The content of our website is automatically placed on other main web sources via RSS feeds. By this you can attract a wide range of readers – and with little effort. The readers will get acquainted with your thoughts, articles and the personal data you share in your included profile.

• Our website is a great launching pad for new doctors, starting academics, medical practitioners, FAs, CPAs, health economists and fledgling writers. By publishing your articles here, you will be able to raise your prestige among colleagues and ME-P readers.

• You may use any free articles from our website to fulfill your own web project (you must add a link to our original material) via RSS feeds. The probability that someone will be interested in you is increased many times.

• Everyday our website is visited by many people, and their numbers are growing constantly. By adding articles the number of your readers will grow in geometric sequence.

• Once placed on the ME-P, your essay will stay on our website [almost] forever. All published materials [probably] will not be deleted with the lapse of time. This means that many years later – your articles will be still available to everyone.

Assessment

The number of ME-P subscribers and regular visitors is growing rapidly. And, the traffic to our authors’ web sources are growing too. Join us – we welcome all authors who are willing to cooperate with our vision and mission!

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

* 8

Filed under: Experts Invited, iMBA, Inc. | Tagged: ME-P, medical executive post | 1 Comment »

Overview of Hospital Information Systems Architecture

Posted on January 22, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

On Configurations and Varieties

[By Brent Metfessel MD MIS]

Hospitals can use a variety of configurations for HIS implementation depending on business needs and budgetary constraints.

Staffing needed for these systems can range from a few full-time equivalents (FTEs) per 100 beds for very basic off-site processing systems to 15 or more FTEs per 100 beds for sophisticated systems that attempt to combine several architectures into one system (e.g., combination of client-server systems with mainframe processing). Resource use and customizability tend to vary in tandem; the greater the flexibility of the system to meet unique user needs, the greater the cost outlay for capital and/or additional FTEs.

***

Relationship of Resource Use and Customizability Based on System Architecture Selected

Values range from one (low) to four (high) stars
Architecture	Hospital resource use	Customizability
Off-site processing	*	*
Turnkey systems	**	**
Mainframe systems	***	***
Client-server	***	****

***

The Possibilities

The basic system architecture possibilities are as follows:

Off-site (remote) processing: In this case the hospital contracts with a vendor external to the hospital. The hospital sends data over to the vendor site where the actual processing takes place. When processing is complete, the vendor sends the data back to the hospital, usually in electronic form.

Turnkey systems: A vendor provides the hospital with systems that are “pre-packaged” so that hospital-based system development is minimal. Limited customization of the system is possible using systems analysts or programmers.

Mainframe systems: Most applicable to large hospitals, this configuration is highly centralized. A large and powerful computer performs basically all the information processing for the institution and connects to multiple terminals that communicate with the mainframe to display the information at the user sites. Hospital IT departments usually use in-house programmers to modify the core operating systems or applications programs such as billing and scheduling programs.

Client-server systems: In this configuration one or more “repository” computers exist, known as “servers,” that store large amounts of data and perform limited processing. Communicating with the server(s) are client workstations that perform much of the data processing and often have graphical user interfaces (GUIs) for ease of use. Both customizability and resource use is high, depending on the desired sophistication.

Many clinical information systems that process data directly related to patient care use this configuration. For instance, the Veterans Health Administration, which has implemented what is likely the largest integrated healthcare information system in the United States, uses client-server architecture. Known as the Veterans Health Information Systems and Technology Architecture (VistA), this system provides technology infrastructure to about 1,300 care facilities, including hospitals and medical centers, outpatient facilities, and long-term care centers. VistA utilizes a client-server architecture that links together workstations and personal computers using software that is accessed via a graphical user interface.

Overall, for hospitals that have the financial and manpower resources for a significant investment in IT, client-server architectures are the fastest-growing and typically the most preferred of the system architectures, due in large part to their local adaptability and flexibility to meet changing hospital and medical center needs.

Broad Categories

The above architectures are broad categories. Modifications and combinations of the above also exist, such as the use of client-server technology with mainframe systems and the addition of wireless technology, smart phones, laptop PCs and tablets, and various personal digital assistants (PDAs) to supplement the core computing functionality.

In considering the optimal architecture for a hospital, management needs to take into account factors such as size of the institution, desired sophistication of the application, IT budget, and anticipated level of user community involvement.

Assessment

Another important aspect of HIS is the need for integration. Often, different hospital departments have their own stand-alone systems — such as a Laboratory Information System (LIS) and pharmacy systems — that do not communicate with each other. Duplicate data may be kept in separate systems, creating additional work to enter the data multiple times.

In an integrated system, each departmental system communicates with the other systems through either a centralized or decentralized. A computerized physician order entry (CPOE) system, for example, would be much less effective if it did not communicate electronically with the pharmacy system that would process the medication orders.

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

NOTES: Resource use refers to the need for FTEs and hospital capital expenditure. Customizability refers to the ability for users to alter the system structure or function to meet the unique needs of the institution.

Filed under: iMBA, Inc., Information Technology | Tagged: graphical user interfaces, GUI, health information technolgy, HIT, hospital information systems, Mainframe systems, Veterans Health Information Systems and Technology Architecture, VistA | 4 Comments »

An Educational Niche Resource Supporting Doctors and their Consulting Advisors

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

By Eugene Schmuckler PhD MBA MEd CTS [Academic Provost]

www.CertifiedMedicalPlanner.org

About the Medical Executive-Post

We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants.

We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”

More: Letterhead.iMBA_Inc.

***

Enter the Certified Medical Planners™

There is no certification program, course of study or professional designation for FAs who wish to enter the lucrative financial planning space serving physicians and healthcare professionals.

That’s why the R&D efforts of our governing board of physician-directors, accountants, financial advisors, academics and health economists identified the need for integrated personal financial planning and medical practice management as an effective first step in the survival and wealth building life-cycle for physicians, nurses, healthcare executives, administrators and all medical professionals.

Now – more than ever – desperate doctors of all ages are turning to knowledge able financial advisors and medical management consultants for help. Symbiotically too, generalist advisors are finding that the mutual need for extreme niche synergy is obvious.

But, there was no established curriculum or educational program; no corpus of knowledge or codifying terms-of-art; no academic gravitas or fiduciary accountability; and certainly no identifying professional designation that demonstrated integrated subject matter expertise for the increasingly unique healthcare focused financial advisory niche … Until Now!

Enter the Certified Medical Planner™ charter professional designation. And, CMPs™ are FIDUCIARIES, 24/7.

Video: http://vimeo.com/84247360

An Interview with Bennett Aikin AIF®

Physician-Investors and the “F” Word

More:

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

How may we assist you?

← Back

Thank you for your response. ✨

Filed under: "Doctors Only", Career Development, CMP Program, Experts Invited, Health Economics, iMBA, Inc., Investing, Portfolio Management, Practice Management | Tagged: certified medical planner, fiduciary, Financial Planning, Institute Medical Business Advisors, medical practice management | 1 Comment »

On Hospital Endowment Fund Management

Posted on January 8, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A Case Model Example

[By Dr. David Edward Marcinko MBA]

http://jsomers.net/blog/dictionary

Just as the field of medicine continuously changes, so too does the field of endowment management.

Endowment managers continue to increase their knowledge of the science and expand their skill in the art.

However, successful endowment managers will continue to focus on the areas that they can control in order to minimize the risk of the areas they cannot.

***

So, here is a case model to show you how it is done.

[Case Model]

Endowment Fund

***

Invite Dr. Marcinko

***

Channel Surfing the ME-P

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

***

Filed under: CMP Program, iMBA, Inc., Investing, Portfolio Management | Tagged: Dr. David Edward Marcinko MBA CMP™, hospital endowments, Investing, Portfolio Management | 2 Comments »

About Crowd-Med [Case Review Service]

Posted on December 23, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

***

DR. DAVID EDWARD MARCINKO MBA

[By ME-P Staff Reporters]

CrowdMed Company Background

CrowdMed purports to harnesses the wisdom of crowds to collaboratively solve even the world’s most difficult medical cases quickly and accurately online.

The company offers individuals, insurance providers, and self-insured corporate customers the ability to more quickly diagnose medical conditions and reduce healthcare costs without compromising care.

***

The results speak for themselves?

Since launching publicly in April 2013, CrowdMed has helped solve hundreds of medical cases for patients around the world, and this number is quickly growing as word spreads of the new service. On average, these patients had been sick for 8 years, seen 8 doctors, and incurred more than $50,000 in medical expenses. Despite the difficulty of their cases, more than half of these patients tell us that the crowd successfully brought them closer to a correct diagnosis or cure.

Anyone can submit a case on the CrowdMed website for free (with a $50 refundable deposit), or along with a cash compensation offer to draw more attention to their case. They use incentives to increase participation, and the overall quality and confidence levels of suggested diagnoses. Thousands of people with diverse backgrounds in medicine, health care, education and research have already joined the crowd, and they are continually recruiting new medical and disease experts to help solve cases.

During early testing of the CrowdMed platform, the founder [Jared] submitted his own sister’s [Carly] anonymous case information to the crowd to test the system. More than 300 people participated, evaluating the same symptoms that had been provided to Carly’s original doctors. In just three days, the crowd gave Jared their answer: Fragile X-associated primary ovarian insufficiency

Founded by veteran technology entrepreneur Jared Heyman and based in San Francisco, CA, CrowdMed has received more than $2.4 million in funding from some of Silicon Valley’s top venture capital firms including NEA, Andreessen Horowitz, Greylock Partners, SV Angel, Khosla Ventures and Y Combinator. The company’s advisors have founded and run some the world’s most successful online healthcare companies including WebMD. CrowdMed graduated from Y Combinator’s Winter 2013 class, and was officially launched during the TEDMED 2013 conference in Washington DC.

You can read more about CrowdMed’s leadership team click here.

More:

Assessment

Check em’ out today: http://blog.crowdmed.com

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: "Doctors Only", Ethics, Experts Invited, iMBA, Inc., Research & Development, Touring with Marcinko | Tagged: crowd-med, david marcinko, Wisdom of Crowds | 3 Comments »

Why You’re Probably Using the Wrong [Medical] Dictionary [er…ah…Tchotchkes?]

Posted on December 21, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

About the iMBA Inc, Health Glossary and Administration Dictionary Series … with Book Reviews

[By Staff Reporters]

***

The Health Dictionary Series of Administrative Terms and Definitions

According to James Somers, the way we use an ordinary [medical] dictionary is to look up words, acronyms or initialisms we’ve never heard of; or whose sense we’re unsure of, or need more clarification or spelling direction. Makes sense!

But, you would never look up health administration industry specific words or terms in an ordinary medical dictionary — words like HL7, “meaningful-use”, “skinny networks”, managed care organization, hospital cloud computing, patient portal, stop-loss ratio, economic externality, PHO, MPT, SAR-BOX, Fama-French, US Patriot Act, the Treynor index, Asset Pricing Theory, PP-ACA, or ACOs — because all you’ll learn is nothing about what they mean.

Extreme Utility – Not just tchotchkes!

You would need an industry specific dictionary of health administration terms and definitions, right? And, preferably designated as a Doody’s Core Title for credibility, and written by leading experts.

So; try these 3 dictionaries for 10,000 health 2.0 administration terms and definitions, EACH.

Dictionary of Health Insurance and Managed Care
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security

Dictionary Forewords

More:

Forget the Paper Weights

According to Wikipedia, a tchotchke (/ˈtʃɒtʃkə/ CHOCH-ka) is a small bauble or miscellaneous item. The word has long been used by Jewish-Americans and in the regional speech of New York City and elsewhere. Tchotchkes are often given at Chanukkah as part of a game.

The word may also refer to free promotional items dispensed at financial services trade shows, medical conventions, and similar large events. They can also be sold as cheap souvenirs which are sometimes called “tchotchke shops”.

***

Not a Throw-Away

But, if you want to give your hospital, medical clinic or physician clients an advertising item that’s both useful and handy at the same time, try using these dictionaries. Make an IMPACT, and forget those paper-weights.

As a Financial Advisor [FA], or drug rep, you can represent your eagerness to be there for clients and prospects anytime they need your service by having the dictionaries engraved or placing your business card, inside. Plus, they serve as a great addition to a wonderfully decorated medical office or home library. It is an item they will refer to again and again; not just throw-away.

Give one … or all three … they are so reasonably priced.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Dictionary Health Economics and Finance://www.r2library.com/Resource/Title/082610254
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Book Reviews, Glossary Terms, iMBA, Inc. | Tagged: Dr. David Marcinko, health administration dictionaries, Health economics and finance; health insurance and managed care, health IT and security, tchotchke | Leave a comment »

About the INSTITUTE OF MEDICAL BUSINESS ADVISORS, Inc.

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

About

INSTITUTE OF MEDICAL BUSINESS ADVISORS, Inc.

***

The Institute of Medical Business Advisors, Inc provides a team of experienced, senior level consultants led by iMBA Chief Executive Officer Dr. David Edward Marcinko MBA CMP™ MBBS [Hon] and President Hope Rachel Hetico RN MHA CMP™ to provide going contact with our clients throughout all phases of each project, with most of the communications between iMBA and the key client participants flowing through this Senior Team.

iMBA Inc., and its skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research and support staff of CPAs, MBAs, MPHs, PhDs, CMPs™, CFPs® and JDs to maintain a thorough and extensive knowledge of the healthcare environment.

The iMBA team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.

The iMBA Inc project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients. Over the years, our industry specialization has allowed iMBA to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available. iMBA Inc’s specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the public health, health economics, management, administration, and financial planning and consulting fields.

iMBA Inc’s information resources and network of healthcare industry textbook resources enhanced by our professional consultants and research staff, ensure that the iMBA project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.

Ann Miller RN MHA

www.MedicalBusinessAdvisors.com

Financial Advisor Education Letterhead CMP™

Solicitation Letterhead.iMBA, Inc

Sample iMBA Engagements

iMBA Seminar Topics

***

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

Filed under: Career Development, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Investing, Portfolio Management, Professional Liability, Recommended Books, Retirement and Benefits, Risk Management | Tagged: career planning, David Edward Marcinko, Financial Planning, Health Economics, Investing, Portfolio Management, practice administration, Practice Management, practice valuation | 1 Comment »

The Economic Impact of Alzheimer’s Disease

Posted on December 6, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Economic Projections

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: iMBA, Inc. | 1 Comment »

2014 Midterm Elections [Information Project VOTE Today]

Posted on November 4, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Election Day: November 4, 2014

[By iMBA, Inc and the ME-P]

We at iMBA Inc., the ME-P and WordPress.com have teamed up with the The Pew Charitable Trusts, who, along with Google, and election officials nationwide, have developed the The Voting Information Project (VIP).

Together, we’re offering cutting-edge tools that give you access to the customized information you need to cast a ballot on or before Election Day and then tell the world you voted by embedding the custom WordPress.com I Voted badge.

Click on the link below to find out more about this important iniaitive so that you and WordPress.com users across America can ensure that your voices are heard on Election Day.

Since 2004, iMBA, Inc., and WordPress have set out with an ambitious goal in mind — to democratize publishing and put state-of-the-art tools in front of publishers both large and small across the planet. We believe strongly in this vision because when more people have access to powerful tools on the web, that in-turn empowers them to do great things and publish amazing content. We feel the same way when it comes to democratizing, well, democracy — and in just a few weeks, citizens across the United States will have a unique opportunity to flex their political muscle and vote in the 2014 Midterm Elections.

For our part, we want to provide our US-based users a set of resources to help them make a smart, informed decision when it comes to who they will vote for. We also want to provide a toolkit so that they can get more information on where to vote, which issues are at stake and of course, after voting occurs, a way to show their pride and encourage others to go get out the vote.

We’ve teamed up with the good folks from The Pew Charitable Trusts, who, along with Google, and election officials nationwide, have developed the The Voting Information Project (VIP). Together, we’re offering cutting-edge tools that give voters access to the customized information they need to cast a ballot on or before Election Day. The Voting Information Project is offering free apps and tools that provide polling place locations and ballot information for the 2014 election across a range of technology platforms. The project provides official election information to voters in all 50 states and the District of Columbia and voters can find answers to common questions such as “Where is my polling location?” and “What’s on my ballot?” through the convenience of their phone or by searching the web.

The only way a set of resources will be effective is if they make it into the right hands, so if you’re eligible to vote in the US Midterm Elections, take advantage of these tools and share them with your readers.

After you vote, either by mail, or in early voting, OR on Election Day, please embed the I Voted badge into your WordPress.com site or other blog and share it with your audience, along with friends throughout your social network. Here’s how to install the I Voted badge:

Go to your blog’s dashboard.
Look under the Appearance menu for the “Widgets” option.
Locate the “I Voted” widget and drag it to the sidebar of your choosing.
Give the widget a title (optional) and hit the save button. Your badge will now be displayed for all your readers to see.

Voting is our most fundamental responsibility as citizens — without it, our American democracy wouldn’t exist. WordPress.com is an ME-P and iMBA Inc., platform that gives everyday people the ability to share their voice and we’re asking you to take advantage of this voice — by exercising your right to vote. We’re asking you for your help to spread the word, encourage participation and get out the vote on November 4th, 2014.

If you have any questions, please let them in the comments and we’ll be sure you help wherever we can. Thanks!

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

Product Details

Filed under: iMBA, Inc. | Tagged: 2014, election day, mid-term elections, November 4, vote | 1 Comment »

Why Medical Professionals Need a Financial Plan?

Posted on September 4, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

We don’t plan to fail – We fail to plan

[By Dr. David Edward Marcinko MBA CMP™]

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

Our newest textbook COMPREHENSIVE FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS [Best Practices from Leading Consultants and Certified Medical Planners™] will shape the physician-focused financial planning landscape for the next-generation of Health 2.0 medical professionals and their financial advisors.

Why Now?

We created this innovative textbook because the healthcare industry is rapidly changing and the financial planning ecosystem has not kept pace. Traditional insurance-commission and sales-driven generic advice is yielding to a new breed of deeply informed fiduciary advisor, and educated consultant, or Certified Medical Planner (CMP™). Internet and social media of the last decade demonstrates that medical providers are becoming accustomed to the need for knowledgeable advice. And so, financial planning is set to be transformed by “market disruptors” that will soon make an impact on the $2.8 trillion healthcare marketplace for those financial advisers serving this sector.

We are at the leading edge of this positive disruption — also known as niche based Financial Planning 2.0 — that over time will see today’s command-controlled financial services industry becomes a wide open academic marketplace. And, a growing cadre of specialty entrants is poised to shake up the industry drawing billions of dollars in revenue from traditional broker-dealer organizations while building lucrative new markets.

For example, an iMBA Inc survey points to the growing need for financial advisors to serve current and future medical professionals thanks to their eagerness to seek premium financial planning solutions from non-traditional sources and providers; like the online Certified Medical Planner™ charter designation program. The industry is ripe for a shakeup and physician focused financial planning will soon have its own new brands. We aim to be among the first-movers and top tier names in the industry.

How We Are Different?

COMPREHENSIVE FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS [Best Practices from Leading Consultants and Certified Medical Planners™] will change this niche industry sector by following eight important principles.

1. First, we have assembled a world-class editorial advisory board and independent team of contributors and reviewers and asked them to draw on their experiences in contemporaneous healthcare focused financial planning. Like many of their physician and nurse clients, each struggles mightily with the decreasing revenues, increasing costs, automation, SEC scrutiny and higher physician-client expectations in today’s competitive financial advisory and technological landscape. Yet, their practical experience and physician focused education, knowledge and vision is a source of objective information, informed opinion and crucial information to all consultants working with doctors and medical professionals in the financial services field.

2. Second, our writing style allows us to condense a great deal of information into one volume. We integrate bullet points and tables; pithy language, prose and specialty perspectives with real world examples and case models. The result is an oeuvre of integrated financial planning principles vital to all modern physicians and allied healthcare professionals.

3. Third, to the best of our knowledge, this is the first peer-reviewed book of its type, as we seek to follow traditional medical research and journal publishing guidelines for best practices. We present differing viewpoints, divergent and opposing stake-holder perspectives, and informed personal and professional opinions. Each chapter has been reviewed by one to three outside independent reviewers and critical thinkers. We include references and citations, and although we cannot rule out all biases, we do strive to make them transparent to the extent possible.

4. Fourth, our perspective is decidedly from the physician-client side of the equation. More specifically, as consultants to medical professionals, we champion the physician-investor over the financial advisor. And, to the extent that both sides ethically succeed; we hope all concerned “do well – by doing good”. This is unique in the fee and commission driven financial services industry. Much like the emerging patient-centered care initiative in medicine, we call it client-centered advice.

5. Fifth, it is important to note that deep specificity and niche knowledge is needed when advising physicians and healthcare providers. And so, we present information directly from that space, and not by indirect example from other industries, as is the unfortunate norm. Medical case models, healthcare industry examples, and anecdotal insights from the Over Heard in the Doctor’s Lounge, and Over Heard in the Advisor’s Lounge features, are also included. Finally, personalized financial planning for all medical professionals is our core, and only focus.

6. Sixth, this textbook represents an academic template for about 25 percent [125/500 credit hours] of the Certified Medical Planner™ chartered professional online certification program curriculum. It is useful for those studying, auditing, or considering matriculation for this prestigious designation mark.

7. Seventh, we include a glossary-of-terms specific to the text, a list of comprehensive advice sources, and three illustrative physician-specific financial plan examples additionally available by separate order.

8. Finally, as editor, we prefer engaged readers who demand compelling content. According to conventional wisdom, printed texts like this one should be a relic of the past; from an era before instant messaging and high-speed connectivity. Our experience shows just the opposite. Applied physician focused personal financial planning literature, from informed fiduciary sources, is woefully sparse; just as a plethora of generalized internet information makes that material less valuable to doctor clients.

***

A Seminal Work

And so, rest assured that COMPREHENSIVE FINANCIAL PLANNING STRATEGIES FOR DOCTORS AND ADVISORS [Best Practices from Leading Consultants and Certified Medical Planners™] will become a seminal book for the advancement of personal financial planning and related personal micro-economic principles in this niche ecosystem.

In the years ahead, we trust these principles will enhance utility and add value to your book. Most importantly, we hope to increase your return on investment by some small increment.

If you have any comments or would like to contribute material or suggest topics for future editions please contact me.

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Book Reviews, CMP Program, Financial Planning, iMBA, Inc., Touring with Marcinko | Tagged: certified medical planner, CMP™ Course, david marcinko, Financial Planning | 2 Comments »

Can Doctors Trust the Stock Market [Video]?

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

Ascel Bio on Forecasting Infectious Disease Outbreaks

Posted on August 25, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

My Invitation to Join the Ascel Bio BOD?

Dear Dr. Marcinko,

I found your name in a search for new board directors and advisors to my company. I am president of a disease forecasting and outbreak warning company named Ascel Bio.

The Firm

My company has had tremendous technical success in developing software that can forecast infectious disease outbreaks.

We’ve invented technology that turns hospitals (specifically their electronic health records) into RADAR Stations for Infectious Disease. We’ve also invented outbreak detection and measurement technology that we use to deliver something akin to an AccuWeather style service. We have good validation with federal customers and in use in a hospital setting in Colorado. And, we’ve had some good success as well in trial use with a major EHR provider, and interest from others.

Status

But, we’re still small and are really stuck in gaining the next 10 hospital users. I’m writing because I am curious whether you might be able to offer suggestions that would help us solve the puzzle.

About Ascel Bio LLC

Ascel Bio is a private disease forecasting company founded in 2010. It is an industry pioneer with a corporate mission to halve the morbidity and mortality of infectious diseases over the next 25 years. The company uses advanced predictive systems combined with the judgment of astute clinicians in building its forecasts.

***

Assessment

I wanted to explain our business, seek your thoughts, and see if there might be cause for engagement. If you have a moment to speak with me, I’d be grateful for your time.

Research Reports:

Kind regards,

Ascel Bio

James Tunkey

More

Why I’m Joining the Physician Nexus Medical Advisory Board

Conclusion

I will f/u privately on this invitation. But, your thoughts and comments on the 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.

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Breaking News, iMBA, Inc., Risk Management | Tagged: Ascel Bio, Ebola Report, Global Flu Report 2014, Infectious Disease Outbreaks, James Tunkey | 9 Comments »

Is it Fire Drill Time for Physician Investors?

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

Catastrophes and “Black Swans” Happen

An ME-P Special Report

By Lon Jeffereis MBA CFP® CMP®

History tells us that over a long enough time span catastrophes are likely to occur. Fires, flooding, earthquakes – none can be prevented and all can be potentially devastating. While these events can’t always be avoided, we can prepare for these “black swans.”

Running practice fire drills enables us to act appropriately during misfortune while maintaining emergency food storage ensures we won’t starve when tragedy strikes.

Just as physical calamity can turn lives upside down, financial upheaval can lead to an unrecoverable loss. Fortunately, we have the ability to prepare for financial uncertainty in the same way we prepare for other exposures. As the current bull market is now both the fourth longest in history (64 months) and the fourth largest (+192% gain), now would be a perfect time to ensure you are prepared for the next market pullback.

Run a Portfolio Fire Drill

You can run a fire drill for your portfolio by understanding the loss potential of your holdings. It is critical to recognize that the amount of volatility your portfolio will experience in declining market environments is dependent on your asset allocation – how much of your account is invested in stocks vs. bonds. The larger the percentage of stocks in a portfolio, the more the portfolio’s value will increase during bull markets but decrease when the market declines. Let’s look at the historical performance and risk levels of a range of diversified stock-to-bond ratios:

Asset Allocation – Risk & Return (1970-2013)

***

Portfolio Allocation	Average Annual Return	Large Loss 08′
100% Stocks	10.85%	-39%
80% Stocks20% Bonds	10.33%	-30%
60% Stocks40% Bonds	9.99%	-20%
50% Stocks50% Bonds	9.76%	-15%
40% Stocks60% Bonds	9.49%	-11%
20% Stocks80% Bonds	8.85%	-4%

***

After determining the asset allocation of your portfolio, ask yourself how you would respond to another market correction like we experienced in 2008. For this exercise, considering loss in dollar terms is particularly productive. For instance, if 80% of your portfolio is invested in stocks, you might be able to convince yourself that you could sustain a 30% loss. However, supposing you have $500k invested, a 30% loss would mean your portfolio is suddenly depleted to $350k — $150k of hard earned money just evaporated. To many, the thought of losing $150k is more uncomfortable than the thought of a 30% loss.

Next, picture every media outlet sending warnings day after day about how the market is only going to get worse. Imagine yourself checking what the markets are doing multiple times a day and constantly being disappointed that it is another day of losses.

Lastly, visualize your occasional friend, neighbor or family member bragging about how he got out of the market before the collapse and telling you how you are a fool for not doing so.

***

[Accidents Happen]

How would you respond in such an environment? Would you have a hard time sleeping or digesting your food? It’s critical to be honest with yourself. If you would stray from your long-term investment strategy by selling after a market drop and waiting for the market to recover, your current portfolio may be too aggressive. If so, scale back the assertiveness of your portfolio by reducing your stock exposure now because selling stocks during a market decline is the last thing you want to do.

Sound financial planning suggests individuals should scale back the assertiveness of their portfolio as they approach retirement. While a young worker with 30 years until retirement can afford to be aggressive and has time to recover if a large loss in suffered, a person who is closer to retirement can’t afford to endure a significant loss right before the invested funds are needed to cover life expenses.

Maintain an Emergency Financial Storage

As stocks and bonds are the long-term portion of your investment portfolio, cash equivalents are your tool for dealing with short-term spending needs. Before even investing, everyone should have an emergency reserve holding enough cash to cover three to six months of expenses. These funds should only be tapped in the event of a job loss or a medical emergency.

Be Prepared

Additionally, investors who are taking withdrawals from their portfolio in order to meet cash flow needs should also have the equivalent of two years of necessary withdrawals in cash at all times. These funds should be used to cover living expenses during the next market correction. Having this emergency financial storage will prevent you from having to take withdrawals in a down market and allow your portfolio time to recover.

Assessment

No one knows when the next bear market will come. However, just like winter follows every fall, market corrections will ultimately come after every bull market. Preparing for such a financial downturn will ensure you act appropriately when the time comes and prevent financial catastrophe.

BOOK: Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

BOOK:

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Filed under: Financial Planning, iMBA, Inc., Portfolio Management, Risk Management | Tagged: asset allocation, Black Swans, Lon Jefferies MBA CFP® | Leave a comment »

Update on Hospital Cafeteria Plans 2014

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

Will that be Cash or Taxable Benefits?

[By Dr. David Edward Marcinko MBA]

Under hospital cafeteria plans, each eligible employee may choose to receive cash or taxable benefits, or, or an equivalent of qualified, non-taxable, fringe benefits. The amounts contributed by the employer are not taxable to the employee. In effect, the employee pays for the benefits with before-tax dollars. They remain non-taxable even though the employee could have elected to receive those amounts in cash.

An additional benefit for both employee and employer is that nontaxable cafeteria plan benefits are not subject to FICA taxes, thus saving 7.65% on amounts that would otherwise be under the Social Security wage base.

However, if the employee does not use all of the monies that are diverted into the cafeteria plan, the unused amounts are forfeited.

The Essence

The essence of a hospital cafeteria plan is that it permits each participating employee to choose among two or more benefits. In particular, the employee may “purchase” non-taxable benefits by forgoing taxable cash compensation.

This ability of participating employees, on an individual basis, to select benefits fitting their own needs, and to convert taxable compensation to non-taxable benefits, makes the cafeteria plan an attractive means of offering benefits to employees. Other qualified employee benefits, described above, are excluded from cafeteria plans.

Non-taxable benefits

Cafeteria plans may include the following non-taxable benefits:

401 (k) retirement plan
health and accident insurance
adoption assistance
dependent care assistance
group term life insurance including premiums for coverage over $50,000.

Cafeteria plans and healthcare

It is always to the tax advantage of an employee to receive employer-provided health and accident benefits in a tax-free form, rather than paying them with after tax money. Note there is the potential drawback of employees thinking of health care benefits as an implicit condition of employment instead of true non-cash compensation.

Because of increases in healthcare costs, employers are not always willing or able to provide coverage for all of an employee’s medical expenses. This means many employees must often pay for a portion of their medical costs under a co-pay provision. If an employee is fortunate, the employer may establish a cafeteria plan to allow the employee to fund the co-pay healthcare costs with before-tax dollars.

Example:

For example, if an employee must spend $3,000 annually to provide healthcare coverage for his or her dependents, then the income-tax savings to the employee could be as much as $1129.50 annually, if the employee is in the 30% tax bracket ($900 in income taxes and $229.50 of FICA taxes). The employer saves $229.50, the 7.65% of gross pay “matching” FICA taxes.

***

Cafeteria plans and other nontaxable benefits

A cafeteria plan may be expanded to cover more than just medical benefits. It may offer participants a choice between one or more nontaxable benefits, and cash resulting from the employer’s contributions to the plan or the employee’s voluntary salary reduction. Participants in cafeteria plans are sometimes given a choice of using vacation days, selling them to the employer and then getting cash for them, or, buying additional vacation days. Some cafeteria plans also include one or more reimbursement accounts, often referred to as “flexible spending accounts” or “benefit banks.”

Under these plans, cash that is forgone by an employee, by means of a salary reduction agreement or other agreement, is credited to an account and drawn upon to reimburse the employee for uninsured medical or dental expenses, or for dependent-care expenses. Many cafeteria plans include both insurance coverage options and reimbursement accounts.

BOOK: Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: iMBA, Inc., Retirement and Benefits | Tagged: CAFETERIA PLAN, Update on Hospital Cafeteria Plans | 2 Comments »

Happy Independence Weekend

Posted on July 6, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Happy Independence Weekend Greetings to our Readers and Subscribers for 2014

From the Medical Executive-Post

***

Filed under: iMBA, Inc., LifeStyle | 1 Comment »

Enter the CERTIFIED MEDCIAL PLANNERs™

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

By Eugene Schmuckler PhD MBA MEd CTS

[Academic Provost iMBA Inc., and the CMP™ Online Charter Certification Program]

***

CERTIFIED MEDICAL PLANNER™ CHARTERED PROFESSIONAL DESIGNATION AND CERTIFICATION PROGRAM DESCRIPTOR AND CURRICULUM

A Working-White Paper

[Enter the Informed Voice of a New Generation of Fiduciary Advisors for Healthcare]

As the financial planning industry grows, and quality information is available on the internet, medical professionals have more access to information than ever before. At the same time, the growing number of consulting generalists – leads to a troubling counter trend – more financial advisors means less differentiation to being a financial advisor. Perhaps this is the reason for the embarrassing number of, valid and specious, financial industry certifications in existence today?

Enter the Institute of Medical Business Advisors, Inc and its’ life-long learning Certified Medical Planner™ initiative.

FOCUS ON LIFE-LONG LEARNERS

The INSTITUTE OF MEDICAL BUSINESS ADVISORS [iMBA] INC., provides a team of experienced, senior level educators and consultants, led by Chief Executive and Medical Officer – Dr. David Edward Marcinko FACFAS MBA CMP™ and Chief Academic Officer and Dean – Eugene Schmuckler PhD MBA M.Ed CTS, to construct individually focused curricula for Life-Long Learners [LLLs]. This curriculum is used throughout all phases of Certified Medical Planner™ program matriculation. iMBA Inc., and its staff of teaching professionals, have decades of experience and didactic repute, supported by an unsurpassed in-bound research library, to augment knowledge of the integrated healthcare and financial services environment.

Thus, the iMBA Inc., team provides superior online education in an asynchronous, cost-effective manner, by focusing on academic solutions for the unique needs of each adult-learner. This vast niche network of cognitive and human resources ensures that the Certified Medical Planner™ instructional team maintains the highest level of current and future competence regarding industry trends to serve as the foundation for each adult-learner e-engagement.

Link: Down Load Free White Paper Enter the CMPs

More: Mike Kitces; MSFS, MTAX, CFP^®, CLU, ChFC, RHU, REBC, CASL

What Comes After CFP Certification? Finding Your Niche Or Specialization With Post-CFP Designations

Conclusion:

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:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

***

Filed under: CMP Program, iMBA, Inc. | Tagged: certified medical planner | 1 Comment »

Does Health Care Contribute to Health?

Posted on April 1, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

And … How much does it cost?

By staff reporters

As Ezra Klein noted, The Bipartisan Policy Center included this infographic in their report on obesity and its economic consequences (PDF).

Assessment

Is this graphic even accurate?

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Health Economics, Healthcare Finance, iMBA, Inc. | Tagged: healthcare costs, healthcare economics | 2 Comments »

New “Physician-Focused” Financial Planning Book Reviewers Needed

Posted on March 24, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Discerning the “Best Emerging Practices” in Financial Planning for Doctors and Health Professionals

www.CertifiedMedicalPlanner.org

By Ann Miller RN MHA AdviceforDoctors@Outlook.com

[ME-P Executive Director]

The Medical Executive-Post occasionally fact-checks and codifies the posts and comments of our readers, subscribers and other experts in order to present them in book form. This is a form of academic, or cognitive, crowd-sourcing. It might also be called a form of private Wikipedia styled information gathering. We may use it to create new books, up-date prior books, or fill in the gaps of books-in-progress.

Book Reviewers

And so, we are requesting informed [MD-DO-DDSs] doctors and [FA, CFP, CPA, CMP, PhD, CFA or MBA] related folks, or other knowledgeable readers and subscribers to review the Table of Contents of our current project, now under review. We wish to ensure no important topics of interest are omitted for modernity. Editorial writing and assistance will be provided.

Our ME-P Book Review Format:

An easy to follow, and typical book review format, usually starts with the preliminaries such as stating the title of the book, its author, place of publication, publisher, date of publication, and the number of pages. This is completed by us.

What follows next is the making of an introduction to at least give the readers a preview of the review. It is sometimes followed by background information of the book in order to set out criteria in judging a book.

This includes the author’s basic information such as the era in which he wrote the book, or how it relates to his life experience.

Then it is followed by writing a short summary of the content or text of a novel, history book, or any other type of book.

Testimonials, Too!

Crafting a brief, 2-3 sentence, informal testimonial is also needed.

Assessment

This is highly confidential peer-reviewed styled publishing; do not disclose material. MarcinkoAdvisors@msn.com

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Book Reviews, CMP Program, iMBA, Inc. | Tagged: certified medical planner, CMP™ Course, financial advisor, Financial Planning | 2 Comments »

Join the ME-P [Membership Drive]

Posted on March 13, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

A Call to Increase Membership Rolls and Activity Levels

By Ann Miller RN MHA

[Executive-Director]

Dear Readers and Members,

We have some important updates for you!

Subscriber Map

We are making it easier to connect with physicians, management consultants and FAs from all 50 states, and beyond, in real-time fashion.

Channels

We currently have over 50 topic channels for your interest. You may post de-novo or comment on an existing post.

Dynamic Content

We are working on ensuring there is dynamic content on the site. This includes but is not limited to:

Latest activity constantly being updated
New blog posts added by members and non-members
New people of all stripes online at any given time
New member spotlight interviews
New videos added to breaking news
New polls and events added daily
New discussions by group moderators

Video News

We want to save our members time. We are going to the major websites to find the latest medical, management, financial planning, investing and HIT news.

We also seek to find related analog videos and upload them to the site.

ME-P Membership Drive

We are looking to add to our ME-P subscriber rolls in this membership drive. We need physician, medical management and FA subscribers and contributors to take us to new heights.

If you are interested, or know of someone who might be interested, please refer them to us, ask them to subscribe and/or reply to this post – or me – directly at: MarcinkoAdvisors@msn.com

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: "Advisors Only", "Doctors Only", iMBA, Inc., Media Mentions and PR | Tagged: ME-P, ME-P membership drive, medical executive post, www.MedicalExecutivePost.com | 4 Comments »

Healthcare Business Trends of Greatest Impact for 2014

Posted on February 21, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

According to Healthcare Professionals

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: iMBA, Inc., Practice Management | Tagged: future of healthcare, Healthcare Business Trends, transformational medicine | Leave a comment »

Percentage of Families with Medical Care Financial Burdens

Posted on February 11, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

The CDC Definition

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

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: iMBA, Inc. | Tagged: ACA, CDC, health care finances, medical bankruptcy, medical care financial burdens | Leave a comment »

Before You Jump to a Full-Fledged EMR Check Out Other Options [Part 2]

Posted on February 5, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

HIT: PART TWO

By Shahid Shah MS

Wowsa!

What a year [2013] in the HIT business?

Because of all the talk about EMRs and medical records software you’ll have many reasons to start immediately looking for an EMR vendor.

Try to resist that urge and look at broader non-EMR solutions that can help remove some of the non-clinical burdens from your staff in 2014:

Fax Server – a fax server allows you to centrally manage all incoming and outgoing faxes. Since most medical practices live on fax, this is one of the fastest investments you can recoup.
Shared drives – start using shared drives either using your existing software or you can purchase inexpensive “network disks” for a few hundred dollars to share business forms, online directories, reports, scanned charts, and many other files.
Online backups and Internet PACS storage – there are online tools like JungleDisk.com that allow you to store gigabytes of encrypted data into the Internet “cloud” for just a few dollars a month.
E-mail (beware of HIPAA, though) – internal office messaging and email is a great place to start. If you haven’t started your office automation journey here you should. If you’re going to use it for patient communications you’ll need to make sure you have patient approvals and appropriate encryption. If you’re on Gmail today and you want to have customers immediately be able to communicate with you on Gmail, that’s generally HIPAA compliant because communications between two Gmail accounts stays within the Google data center and is not sent unencrypted over the Internet.
E-Prescribing – e-prescribing is a great place to start your automation journey because it’s a fast way to realize how much slower the digital process is in capturing clinical data. If e-prescribing alone makes you slower in your job, EMRs will likely affect you even more. If you’re productive with e-prescribing then EMRs in general will make you more productive too.
Office Online and Google Apps (scheduling, document sharing) – Google and Microsoft® have some very nice online tools for managing contacts (your patients are contacts), scheduling (appointments), dirt simple document management, and getting everyone in the office “on the same page”. Before you jump into full-fledged EMRs see if these basic free tools can do the job for you.
Modular clinical groupware – this is a new category of software that allows you to collaborate with colleagues on your most time-consuming or most-needy patients and leave the remainder of them as-is. By automating what’s taking the most of your time you don’t worry about the majority of patients who aren’t.
Patient registry and CCR bulletin boards – if you’re just looking for basic patient population management and not detailed office automation then patient registries and CCR databases are a great start. These don’t help with workflow but they do manage patient summaries.
Document imaging – scanning and storing your paper documents is something that affects everyone; all scanners come with some basic imaging software that you can use for free. Once you’re good at scanning and paper digitization you can move to “medical grade” document managements that can improve productivity even more.
Clinical content repository (CMS) – open source systems like DrupalModules.com and Joomla.org do a great job of content management and they can be adapted to do clinical content management.
Electronic lab reporting – if labs are taking up most of your time, you can automate that pretty easily with web-based lab reporting systems.
Electronic transcription – if clinical note taking is taking most of your time, you can automate that by using electronic transcribing.
Speech recognition – another “point solution” to helping with capturing clinical notes; you can get a system up and running for under $250.
Instant Messaging (IM) – IM gives you the ability to connect directly with multiple rooms within your office using free software; if you want, you can also connect with patients and other physicians during work hours.

Assessment

Can you think of any others?

Part One: Before you Jump to a Full-Fledged EMR Check out Other Options [Part 1]

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: iMBA, Inc., Information Technology | Tagged: EHRs, EMRs, Shahid N. Shah | Leave a comment »

Understanding Economics of the Medical Practice Profit Motive

Posted on January 26, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Wither the Patient-Assembly Line Product Mentality

By Dr. David Edward Marcinko MBA CMP™

[Editor-in-Chief]

A cost-volume-profit relationship exists in any healthcare entity and emphasizes the point that the goal of an efficient emerging healthcare organization (EHO) should be profit optimization, rather than revenue or volume maximization.

The profit of any healthcare facility is what’s left after all financial outflows are removed from all financial inflows. This optimization is reached at the point where patient volume, fee per patient, and costs per patient produce highest profit, not the highest revenue.

This is the point of maximum efficiency and is where you want to be. It can be described in the equation below.

The Profit Equation

Medical profit traditionally can be defined by the equation:

Profit = (Price x Volume) – Costs

or P = (P x V) – C

whereas:

Revenue = Price x Volume

or R = PV

Making more Money

To make more money and increase profits, the [physician-executive] doctor must increase price (if possible), increase volume (if possible), or decrease costs (if possible); and ideally the doctor should perform all three maneuvers simultaneously.

Assumptions

If we assume that only costs are under the doctor’s control (a not altogether valid strategy), any strategic financial planning process that ignores them will not be beneficial.

A more efficient doctor addresses cost and volume together; but at some point, more volume does not equal more profit. This point is known as the average cost per patient and should be determined and known for each doctor, service segment, clinic, or hospital.

If visually graphed, the curve would be “U” shaped with both arms extending upward and the hump pointed downward at its most efficient point on the long-range average cost (LRAC) curve.

This tangent is the point of maximum efficiency and this is where the healthcare entity should be, as seen diagrammatically below.

Figs 1 and 2

Working harder by taking on more patients, performing additional procedures, or working additional hours in this scenario will not get the clinic, hospital, or medical practice ahead, only further behind and less economically efficient.

Thus, the main goal for all EHOs is profit improvement, not just revenue improvement …. DO-H!

The Cost Volume Relationship

Once the fixed and variable costs of a medical practice or hospital clinic are known, the effects of changes in volume on its cost structure can easily be determined.

This is known as the cost-volume relationship, as seen diagrammatically below.

Figs 1 and 2

Cost-Volume-Profit Analysis

Once a basic understanding of medical cost behavior has been achieved, the techniques of cost-volume-profit analysis (CVPA) can be used to further refine the managerial cost and profit aspects of the office business unit. They can also help illustrate the important differences between the traditional office net income statement and the more contemporary contribution margin income statement.

***

Assessment

CVPA is thus concerned with the relationship among prices of medical services, unit volume, per unit variable costs, total fixed costs, and the mix of services provided.

MORE: Negotiating CVPA

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

LEXICONS: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
PODIATRISTS: www.PodiatryPrep.com
BLOG: www.MedicalExecutivePost.com

References:

[1] See www.google.com/sear ch?hl=en&q=average+cost+per+unit+diagram.

Filed under: iMBA, Inc., Practice Management | Tagged: cost-volume-profit relationships, Dr. Marcinko, Economics of Medical Practice, EHO, emerging health organizations, Medical Profit motive | 3 Comments »

On the Growing Population [Mental] Health Cohorts

Posted on January 22, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

[By Carol Miller RN MBA]

Increased and Diversified Patient Populations

It is well know that patient populations at community mental health centers are on the rise and this rise is associated with different groups or classifications of individuals. Some centers may or may not have experienced increases in these specific classifications previously; however, they are increasing in many centers today and will continue in the future.

For example:

Older Adults

There is an unprecedented number of older adults who are experiencing substance abuse issues, depression, anxiety, or dementia-related behavioral and psychiatric symptoms along with a multitude of medical issues as well as complicated medication regimens that frequent these centers across the United States. The current clinic healthcare workforce is not prepared to address this influx of patients and their associated special needs at these centers.

Youngsters

Another category, children and teenagers, is also on the rise. This can be attributed to more schools referring students, more families seeking care for their children, more emphasis being placed upon mental health treatments and medications, or a combination of things.

Minorities

Minorities, such as Hispanics, Latinos, African American, and others are somewhat reluctant to seek behavioral health treatment because of the associated cultural stigma surrounding mental health. However, when these same individuals have a combined physical and mental healthcare related need, they are seeking care at community centers.

PTSD

Finally, others seeking care have had terrorism scares, are Veterans with Post Traumatic Stress Disorder (PTSD) and other affiliated behavioral symptoms, or have been afflicted with a long term mental or emotional issue from the impact of natural disasters that caused a lost loved one, home, pet, or job.

Assessment

Many of these individuals not only have mental health issues but also have one or many medical health issues creating a complex case.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: iMBA, Inc. | 1 Comment »

The Business of Christmas 2013

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

X-Mass Illustrated

With Christmas today, we thought it would be fun to post an infographic on the business of Christmas.

From the explosive growth of online shopping to the top selling Christmas gifts of different decades, we’ve got it covered.

Conclusion

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Filed under: Breaking News, iMBA, Inc. | Tagged: The Business of Christmas, X-mass | 4 Comments »

Seeking Securities Analysts, Stock-Brokers and Investment Bankers for New “Financial Planning Textbook for Doctors”

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

Planning our newest major textbook

By Ann Miller RN MHA [ph-770-448-0769]

[Executive-Director]

Dear Stock Brokers, IBs and Securities Analysts,

Greetings from the Institute of Medical Business Advisors, in Atlanta, Georgia.

Historical Review

As you may know, we released: Financial Planning Handbook for Physicians and Advisors, some time ago. It has enjoyed much success and acclaim in the medical and financial service sectors.

Recently, we have been asked to produce the next edition of this book for our target market of physicians, nurses, medical professionals, healthcare administrators – and those in the financial services sector who target this large and fertile, but rapidly changing niche market.

Why Now?

Urgency for the update has been prompted by ARRA, HI-TECH, the flash-crash of 2008 and the day-crash of 2011; by social, macro-economic and demographic changes; by political fiat and especially the PP-ACA.

Our medical colleagues are frustrated, afraid and fearful for their financial futures. They WANT informed advice.

Thus, true integrated financial planning information that targets this market – very expertly and specifically – is greatly needed.

The Invitation

And so, we ask if you are interested in contributing an updated vision of an existing book chapter.

INVESTMENT BANKING-SECURITIES-MARKETS-MARGIN
HOSPITAL EMPLOYEE BENEFITS AND STOCK OPTIONS
INVESTMENT POLICY STATEMENT CONSTRUCTION

Not to worry – The original MS-WORD® chapter files are archived and available for use. We will forward it to you, upon assignment acceptance.

And, we are again fortunate that our Editor-in-Chief will be Dr. David Edward Marcinko FACFAS MBA CMP™ along with Professor Hope Rachel Hetico RN MHA CMP™ serving as Managing Editor.

They opined at a recent interview for the ME-P.

” … We have entered into an emerging era in the financial planning ecosystem. It is a new era where one size does not fit all; and off-the-shelf financial products and mass sales customization is no long adequate for physicians and medical professionals; or their related generic financial planners or wire-house advisors.

It is a period of rapid change, shifting reimbursement paradigms and salary reductions that focus the healthcare industrial complex on pay-for-performance [P4], compensation for value and quality care; rather than procedures performed and quantity of care.

All must learn to do more with less professionally; and plan their personal financial lives more efficiently than ever before. Mistakes will be more difficult to overcome and the wiggle room that high income earning physicians, nurses and medical professionals used to enjoy is being narrowed by demographic, economic, social, technological and political fiat.

This emerging financial planning analog follows the health industry’s fiscal metamorphosis …”

Style Instructions

The look and feel, format and style, and font and size of the book will remain the same. We use endnotes, not foot notes; and include mini-case reports or illustrative case models. It will be a major text; not a handbook.

Timeline for submission is about 3 months. Additional time is available, if needed, for a comprehensive update. But, we are trying to avoid running too far along into 2014 in order to avoid income tax season and the related time constraints on all concerned.

A Pleasure – Not Burden

This should be a pleasurable project for you; and not anxiety provoking.

So, if you are a medically focused and experienced financial advisor with an: MBA, CFP®, PhD, MD, DDS, MSA/MS, CPA, RN, CMP®, DO, JD and/or CFA degree or designation, etc; please let me know if you are interested in updating and revising our chapters. OR, authoring a new to the world chapter.

Your Payback

In return for your conscientious industry, you will receive a complimentary edition of the entire textbook; be listed on this ME-P as thought-leader with related book advertising content attributed to you; and given e-exposure to our almost 600,000 readers and ME-P subscribers …. Such the deal!

And, you will be added to our roster of experts for potential referrals, interviews, pod-casts and other marketing efforts

Assessment

Regardless of your decision, we remain apostles promoting your core vision of physician focused financial planning whenever possible.

Or, you may suggest another possible author- writer-expert contributor; if you wish.

Just let me know; ASAP [MarcinkoAdvisors@msn.com]

Thank you.
ANN
ANN MILLER RN MHA
[Executive-Director]
INSTITUTE OF MEDICAL BUSINESS ADVISORS, INC.
Suite #5901 Wilbanks Drive
Norcross, Georgia, 30092-1141 USA
[Ph] 770.448.0769

NOTICE: This invitation is not for all readers of the ME-P. It is a privilege invitation intended for those who possess the needed credentials, as decided by us, with an inclination to serve. We reserve the right to accept or reject contributors, and content, at our own non-disclosed discretion.

Filed under: "Advisors Only", Career Development, CMP Program, Financial Planning, iMBA, Inc., Investing, Portfolio Management, Recommended Books, Retirement and Benefits, Taxation | Tagged: About iMBA Inc., authors needed, certified medical planner, CMP, Dr. David Marcinko, financial planning for doctors, hope hetico, invitation | 18 Comments »

The AHRMM Stance on Comparative Effectiveness Research [CER]

Posted on December 19, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Association for Healthcare Resource & Materials Management

By Adam Higman

By Brian Mullahey

By Kristin Spenik

By Jerzy Kaczor

http://www.SoyringConsulting.com

In today’s hospital setting, data and healthcare information is the most accessible it has ever been making it necessary for healthcare professionals to assess and evaluate its accuracy. Additionally, the healthcare supply chain is filled with “me-too” products with often dubious improvements in clinical efficacy over competitive and legacy products.

The AHRMM Issues & Legislative Committee

AHRMM’s Issues & Legislative Committee has advocated the usage of Comparative Effectiveness Research (CER) to offer substantial, evidence-based data to aid healthcare organizations in their purchasing decisions. CER data includes unbiased conclusions regarding healthcare products and supplies, after having compared the advantages, usefulness, and possible harm of numerous pharmaceuticals, medical devices, equipment, surgical procedures, and tests for specific disease states and treatments of care.

Goals

By utilizing the CER-provided data, materials management professionals can :

Warrant top-performing Value Analysis Committees
Verify the cost-effectiveness and ability of salvaging “single use items”
Regulate Medical/Surgical products
Capitalize information technology efforts to decrease expenditures and inaccuracies
Change supplies, services, and technologies to lower budget-friendly, clinically-acceptable options that endure needed specifications
Convert to supplies, services, and technologies that produce better patient outcomes at a lower total cost that meets needed specifications
Prioritize capital expenditures
Use third-party benchmarking tools to get the most out of resources ²

More:

Take the DME Inventory Switching Challenge!

Conclusion

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Filed under: iMBA, Inc. | Tagged: Association for Healthcare Resource & Materials Management, CER, comparative effectiveness research, DME, DMEPOS, durable medical equipment | Leave a comment »

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

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

By Staff Reporters and related sources

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

Delolitte Employer Poll Gives Grades From 500 employers Regearding Healthcare Reform

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

Source: Deloitte

Some more new Lists:

Assessment

Visit: www.CertifiedMedicalPlanner.org

Conclusion

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Filed under: Health Insurance, Health Law & Policy, iMBA, Inc. | Tagged: Dr. Marcinko, Health Insurance, healthcare reform, HealthCare.Gov | 2 Comments »

The State of Retail Clinics

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

In 2010

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Assessment

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
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PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
PODIATRISTS: www.PodiatryPrep.com
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Alerts Sign-Up, iMBA, Inc., Practice Management | Tagged: healthcare clinic, minute clinic, outpatient centers, retail clinics, urgent care | 5 Comments »

An Open Call for ME-P Support

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

A Letter with Advanced Appreciation

By Ann Miller RN MHA [Executive-Director]

MarcinkoAdvisors@msn.com

Dear ME-P Readers,

As the holidays approach and the year winds down, we’re reminded of how much each of you brings to the ME-P and our work.

We couldn’t do what we do so effectively without the subscribers to our daily news and book purchasers, the comments on our stories, the participants in our groups – the people who not only read our ME-P posts, but think about them, talk about it with friends and colleagues, support and push for change based on what they read.

Donate

We hope you agree that we’ve worked hard this year to deliver on our mission. It’s been a year in which we didn’t hesitate to take on the biggest subjects from the NSA ObamaCare encryption mess to Medicare Part D, from the HIEs to the latest abuses by the CFP-BOD on fiduciary terms, advisor payment definitions and conflicts of CEU interest.

If you value this work, I hope we can count on you to show your support at this season by becoming a ME-P subscriber, reader and donor.

Assessment

With many thanks and best wishes for the holidays.

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Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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PRACTICES: www.BusinessofMedicalPractice.com
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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Breaking News, Ethics, iMBA, Inc. | Tagged: An Open Call for ME-P Support, ME-P, Medical Executve-Post, support us | Leave a comment »

Symptoms prior to Out-of-Hospital cardiac arrests

Posted on November 30, 2013 by Dr. David Edward Marcinko MBA MEd CMP™

Of those with symptoms