PODCAST: The RAND Corporation Found that Commercial Health Insurance Plans Pay Hospitals 241% What Medicare Pays

The RAND Corporation Found that Commercial Health Insurance Plans Pay Hospitals 241% What Medicare Pays.

But Also That It Varies from 150% to 400%.

Dr. Boram (Kim) Park, MD - Dallas, TX | Internal Medicine

BY ERIC BRICKER MD

Health Insurance Companies Paid for Hospital Outpatient Services at an Even Higher Average Rate of 293% of Medicare.

A Detailed Look at the RAND Analysis Reveals that the ‘Basket’ of Services at Each Hospital Had Very Little Data.

For Example, the RAND Study’s Data for the Baylor Scott & White Hospital System in Dallas – Fort Worth Represented Only 0.4% of the Hospital’s Total Revenue.

For the Texas Health Hospital System Also in Dallas – Fort Worth, the RAND Study’s Data Only Represented 0.96% of the Hospital’s Total Revenue.

That Sample Size Is Likely Too Small to Make Accurate Comparisons from One Hospital System to Another Regarding their Commercial Insurance Prices Relative to Medicare.

ASSESSMENT: Your thoughts and comments are appreciated.

THANK YOU

***

ON RURAL HEALTHCARE PROVIDERS

Executive Order Expands Tele-Medicine to Ease Burden

By Health Capital Consultants, LLC

On August 3, 2020, President Donald Trump signed an executive order aimed at expanding access to care through two avenues: telemedicine and eased financial burdens on rural providers.

Health Disparities Continue to Plague Rural Areas

And so, our colleagues for this Health Capital Topics article will discuss the executive rule and the subsequent agency actions on these fronts.

READ: https://www.healthcapital.com/hcc/newsletter/08_20/HTML/EXEC/convert_executive_telemedicine_access_expansion_8.20.20.php

ASSESSMENT: Your thoughts are appreciated.

THANK YOU

***

ORDER [3rd. edition] TEXTBOOK: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

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The Business of Medical Practice [3rd. edition]

SPONSOR: http://www.CertifiedMedicalPlanner.org

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PODCAST: The Covid 19 Pandemic and Mental Health

Including Substance Use Issues

By Dr. David E. Marcinko MBA CMP© and staff reporters

The COVID-19 pandemic has spurred—and aggravated—a range of mental health and substance use issues in the United States.

In this episode of Critical Point, Milliman’s Stoddard Davenport discusses the rising demand for mental health services and how different populations are being affected. Stoddard also highlights recent statistics on the topic and what the road ahead may look like for mental health in America.

PODCAST LINK: https://www.healthcaretownhall.com/?p=10186

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Community Mental Health Programs and Resources: https://healthcarefinancials.files.wordpress.com/2019/05/mental-health-dr.-marcinko.pdf

Social Determinant of Health: https://www.healthsharetv.com/content/webinar-recap-social-determinants-health-turning-potential-actual-value

See the source image

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NAACOS Recognizes Three ACOs for Health Care Improvement Efforts

Essentia Health, Ochsner Accountable Care Network, and Primaria Health win NAACOS Leaders in Quality Excellence Awards

[By David Raths]

At its Spring 2021 Conference, the National Association of Accountable Care Organizations (NAACOS) recognized three ACOs for their outstanding work to improve patient care in their communities.

DEFINITION: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO

NAACOS said the three inaugural winners exemplify how ACOs across the country are improving care by addressing food insecurity, making house calls to reduce preventable emergency department visits, and engaging patients in preventive services.

NAACOS 2017 Spring Conference - arcadia.io

LINK: https://www.hcinnovationgroup.com/policy-value-based-care/accountable-care-organizations-acos/article/21219825/naacos-recognizes-three-acos-for-care-improvement-efforts

Product Details

DICTIONARY: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

Your thoughts are appreciated.

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***

CDC Mask Update

President Biden Talks Up Benefits of Vaccines After New Mask Guidance

By Dr. David E. Marcinko MBA CMP®

It is time to practice smiling with your teeth again, because the CDC just updated its mask-wearing guidance yesterday from “mostly always” to “mostly just inside.” The agency said that fully vaccinated folks can do the following activities sans masks:

  • Dine outside with non-roommates
  • Go on walks, hikes, or bike rides alone or with household members
  • Attend small, outdoor events, even if some attendees haven’t been vaccinated.

Why now?

29% of Americans are fully vaccinated, and almost 43% have received 1+ dose. Plus, researchers’ understanding of Covid-19 has come a long way since every Amazon package was treated like an Area 51 special delivery, and public health experts say it’s rare for the virus to spread outdoors.

Chenue Her's tweet - "Helpful and easy to follow graphic from the CDC on  the new mask and vaccination guidelines. " - Trendsmap

MIT Experts Speak: https://www.msn.com/en-us/money/other/six-foot-social-distancing-rule-misses-bigger-risks-mit-experts-say/ar-BB1g7bx1?li=BBnb7Kz

Vaccines Need a Marketing Refresh

The pace of vaccinations has slowed down in the US, and the Biden administration hopes that FOMO from seeing vaccinated friends tandem-biking (as friends do) will spur the un-jabbed to act.

Assessment: In the words of President Biden, “For those who haven’t gotten their vaccine yet…this is another great reason to go get vaccinated now.”

Your thoughts are appreciated

THANK YOU

***

What is Your Teaching Philosophy?

 Here is My Teaching Philosophy

[By Dr. David Edward Marcinko MBA]

Although any learner-centered teaching philosophy, or Boyer Model of scholarship, is constantly in flux, the mission of a public or private educator is: [1] to promote positive learning; [2] to motivate students, staff and graduates; [3] to provide a strong foundation for lifelong learning; and in modernity [4] to enhance career and life-work opportunities; to [5] improve bottom-line financial metrics, and [6] to collaborate on a national and global basis.

However, because we are specifically operating in the rapidly changing healthcare, business management, investing, finance, economics and education milieu, even deeper experiential insight is needed.

Developing NEW Teaching AND Education Skills FOR Business and Healthcare 2.0

Medicine and healthcare business today is different than a generation ago, and all educators and healthcare professionals need new skills to be successful.

Traditionally, the physician – like the classroom professor – was viewed as the “captain of the ship”. Today, their role may be more akin to a ship’s navigator, utilizing clinical, teaching skills and knowledge to chart the patient’s, or student’s, course through a confusing morass of requirements, choices, rules and regulations to achieve the best attainable clinical or didactic outcomes.

This new teaching paradigm includes many classic business school principles, now modified to fit the PP-ACA, the era of health reform, and modern technical connectivity. Thus, a Professor, Chair or Dean must be a subtle guide on the side; not bombastic sage on the stage.

These, newer teaching philosophies must include:

  • Negotiation – working to optimize appropriate curricula, services and materials;
  • Team play – working in concert with others to coordinate education delivery within a clinically appropriate and cost-effective framework;
  • Working within the limits of competence – avoiding the pitfalls of the generalist teacher versus the subject matter expert that may restrict access to professors, texts and facilities by clearly acknowledging when a higher degree of didactic service is needed on behalf of the student;
  • Respecting different cultures and values – inherent in the support of the academic Principle of Autonomy is the acceptance of values that may differ from one’s own. As the US becomes more culturally heterogeneous, educators and medical providers are called upon to work within, and respect, the socio-cultural and/or spiritual framework of patients, students and their families; 
  • Seeking clarity on what constitutes marginal education – within a system of finite resources; providers and professors are called upon to openly communicate with students and patients regarding access to marginal education and/or treatments.
  • Supporting evidence-based practice – educators, like healthcare providers, should utilize outcomes data to reduce variation in treatments and curriculum to achieve higher academic efficiencies and improved care delivery;
  • Fostering transparency and openness in communications – teachers and healthcare professionals should be willing, and prepared, to discuss all aspects of care and academic andragogy; especially when disclosing problems or issues that arise;
  • Exercising decision-making flexibility – treatment algorithms, templates and teaching pathways are useful tools when used within their scope; but providers and professors must have the authority to adjust the plan if circumstances warrant;
  • Becoming skilled in the art of listening and interpretingIn her ground-breaking book, Narrative Ethics: Honoring the Stories of Illness, Rita Charon, MD PhD, a professor at Columbia University, writes of the extraordinary value of using the patient’s personal story in the treatment plan. She notes that, “medicine practiced with narrative competence will more ably recognize patients and diseases; convey knowledge and regard, join humbly with colleagues, and accompany patients and their families through ordeals of illness.” In many ways, attention to narrative returns medicine full circle to the compassionate and caring foundations of the patient-physician relationship. The educational analog to this book is, The Ethics of Teaching [A Casebook], co-edited by my teacher and colleague Deborah Ware Balogh PhD of the University of Indianapolis.

***

The Ohio State University
 Photo by Kevin Fitzsimons

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Assessment

Finally, these thoughts represent only a handful of examples to illustrate the myriad of new skills that tomorrow’s healthcare professionals, and modern educators, must master in order to meet their timeless professional obligations of compassionate patient care and contemporary teaching effectiveness.

Dr. Marcinko Teaching Philosophy

CHAIR: Chair 3.0 Philosophy Dr. Marcinko

Conclusion

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

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

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

***

Product DetailsProduct Details

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The Integrated Patient-Centered Medical Home Model

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Tools for Transforming Our Healthcare

By Matias A. Klein

[VP, General Manager, Clinical Quality and Collaboration, Portico Systems]

The patient-centered medical home (PCMH) continues to attract increasing attention from many industry stakeholders. The PCMH model has the potential to enhance the US healthcare system by rejuvenating primary care in a way that improves clinical outcomes, lowers costs, promotes wellness, and increases patient and physician satisfaction.

PCMH Pilot Programs

PCMH pilots are currently being tested in almost all states, including a 3-year Medicare medical home demonstration project overseen by the Centers for Medicare & Medicaid Services. However, few organizations have scaled the PCMH across their entire healthcare network, and the existing implementations appear to remain focused on care management at the expense of patient wellness. The value of focusing equally on promoting wellness (although an underappreciated nuance in the implementation of a PCMH) is a critical factor in effectively leveraging the PCMH model to improve clinical outcomes and the US healthcare system.

Centered on the Patient

The PCMH model, as its name suggests, is centered on the patient. The underlying thought is that if a comprehensive, longitudinal view of a patient is taken throughout a patient’s lifespan, the patient’s health could be better “managed” and better aligned with best medical practices. It is well documented that physicians do not consistently or frequently apply evidence based, recommended care to patients. Therefore, a major goal of the PCMH model is to improve the consistent application of evidence-based guidelines and best practices, by making longitudinal information about the patient available to providers and to patients – including any risks and recommended “intervention opportunities.” And although adherence to best practices in disease management is crucial, the PCMH model also focuses on preventing costly episodes by promoting and incentivizing wellness.

PCPs = Medical Homes

To effectively manage a patient’s health and promote wellness, primary care physicians – designated as medical homes – need to act as health “quarterbacks” or “coaches.” In such a role, these physicians will assist in aggregating a patient’s health information, making best practices transparent, offering health education and counseling, as well as coordinating the provisioning of any healthcare services the patient may need. With physicians spending significant time coaching and making critical clinical decisions, these services will be delivered with the support of care management nurses, who will handle the majority of the information processing and operational activity.

An Innovation in Care

The PCMH model is an important innovation in care delivery and has the potential to reduce medical and administrative costs, while improving the quality of care. However, how to implement the PCMH model within a care-delivery system remains unclear. Providers need the requisite infrastructure and capabilities at their locations to meaningfully participate in a PCMH. Patients must be engaged over long periods of time in proactively managing and improving their health. Outcomes and quality must be objectively measured to optimize the delivery of best possible patient care.

Potential Value

To realize the potential value of the PCMH, three distinct stakeholders – patients, providers, and health plans – must work in a collaborative way. Getting these stakeholders synchronized (i.e., aligned in their goals, using interoperable tools, and collaborating on an operational level) is no small feat but can be accomplished with the smart application of technology. Bringing these three stakeholder groups together on a common, collaborative technology platform results in what some are beginning to call the integrated PCMH. The integrated approach to the PCMH can best ensure that implementing a PCMH model does not create additional administrative burdens to health plans or provider organizations.

An integrated PCMH provides a framework for stakeholders to collaborate in a transparent fashion, and where quality, best practices, and outcomes are incentivized. The integrated PCMH also provides a pathway being awarded a medical home designation.

Vertical Integration Deployment

The key to deploying an integrated PCMH is an end-to-end vertical integration of the care-delivery process – that is, a process in which the provider network management, automation, information exchange, and analytics solutions are tightly integrated with patient and provider information. With so much complexity and so many “moving parts” in the delivery of the PCMH model, this end-to-end vertical integration is a practical solution that enables effective coordination of care and accurate measurement of quality: with such system integration, the provider network (e.g., the health plan) can bring economies of scale to even the smallest provider offices to optimize the quality of care delivery.

The 5 Keys

The five key components for such an integrated PCMH are:

  1. A source-of-truth for mapping medical home – designated providers, patients, as well as  the associated relationships with health plans and other medical professionals; a central medical home fact checking is critical for effectively identifying, managing, and communicating with medical home and their networks.
  2. A set of collaborative workflows that align stakeholders with best practices, incentives, and quality measures reporting; these collaborative workflows help each stakeholder understand where a given patient is in the care-delivery process, potential intervention opportunities, why certain interventions are being emphasized, and what incentives are available for executing specific interventions.
  3. An infrastructure for clinical integration and distribution of intervention opportunities, clinical reference content, education, alerts, and reminders. This infrastructure allows all stakeholders to have access to up-to-date, accurate patient information; it aligns stakeholders and helps reduce or eliminate duplication of procedures and tests.
  4. Interoperable clinical applications and collaboration tools to enable patients and physicians to engage in medical home processes; these tools – which include electronic medical records, e-prescribing, e-labs, secure e-mail, personal health records, and document management and exchange technology – can help manage health information, assist with decision-making, and improve communication between patients, providers, and health plans.
  5. Incentive management and analytics tools for modeling, setting, measuring, and rewarding incentives based on quality measures and outcomes; these tools must span the entire PCMH delivery process and are required for objectively evaluating and optimizing the performance of a medical home.

When considering the multiplicity of stakeholders, information, software systems, and knowledge that has to be coordinated in the context of a PCMH model, implementing a medical home pilot and scaling it to a full-blown network may seem a daunting task. The integrated PCMH offers a real-world solution for deploying a scalable and flexible infrastructure for the management of this emerging care-delivery model.

Assessment

Early evaluations of the PCMH model show promising, albeit inconclusive, outcomes. The integrated PCMH model offers a practical road map for deploying a management system that will enable objective measurement of PCMH performance and outcomes.

Conclusion

Although the jury is still out on the ultimate value of the PCMH, deploying an integrated PCMH system can help position PCMH pilots in a way that enhances their flexibility and scalability to support full-scale network transformation.

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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What is Physician Board “Certification” & “Eligibility”?

WHAT IS PHYSICIAN BOARD CERTIFICATION AND BOARD ELIGIBILITY?
Courtesy: https://lnkd.in/drrYKeT

BOARD CERTIFICATION (Boarded, Diplomate): A doctor who is board certified has pursued advanced training in his or her specialty and has passed a qualifying examination; a doctor who is board eligible has received the training but has not taken or passed the exam.
DHIMC: https://lnkd.in/e9AmEhd

BOARD ELIGIBLE: Describes a physician who is eligible to take the specialty board examination by virtue of being graduated from an approved medical school, completing a specific type and length of training, and practicing for a specified amount of time. Some HMOs and other health facilities accept board eligibility as equivalent to board certification, significant in that many managed care companies restrict referrals to physicians without certification.
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PARSING “MEDICAL NECESSITY” IN HEALTH CARE

PARSING “MEDICAL NECESSITY” IN HEALTH CARE
Courtesy: https://lnkd.in/eBf-4vY
Terms and Definitions to Debate

DHIMC: https://lnkd.in/e9AmEhd
FOREWORD: https://lnkd.in/gywd_Ad

MEDICALLY NECESSARY CARE: The supplies and services used to diagnose and treat a medical condition within the standards of good medical care. The revenues from health insurance premiums spent to pay for the medical services covered by the plan. Usually referred as a ratio, such as 0.95, which means that 95% of premiums were spent on purchasing medical services. The goal is to keep this ratio below 1.00–preferably in the 0.75, range, since the insurance plan’s profit comes from premiums.

MEDICALLY NEEDY: Patients eligible for Medicaid whose medical bills and total income is below certain limits.

MEDICALLY UNNECESARY CARE: That part of a stay in a facility [case manager] determined as excessive to diagnose and treat a medical condition in accordance with the standards of good medical practice and the medical community. Excessive may be because stay was too long or available in a less costly or more efficient setting.

BUSINESS, FINANCE, INVESTING & INSURANCE TEXTS FOR DOCTORS:
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***

How Does Herd Immunity Really Work?

Patterns of Virus Spread

******

Top Child Health Concerns

Circa: 2020

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Pass Your Foot & Ankle Surgical Board Exams

PASS ALL YOUR FOOT & ANKLE SURGICAL BOARD CERTIFICATION EXAMS
Courtesy: www.PodiatryPrep.org

PURCHASE * PREPARE * PASS
Electronic Study Guides to Pass the 1st. Time

NEXT-GEN SAMPLE COGNITIVE STYLED “ORAL” COMPUTERIZED QUESTIONS
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BEWARE – Medical Business and other Scammers

2021 Annual [Faux] Registration Letter

By Staff reporters

Below is a copy of a letter that some colleagues and clients have been receiving and asking us about.

This letter is not from a government agency and is not real. See the sections highlighted in yellow.

Please do not pay anything to this company. Thanks!

We recently received this notice.

It is untrue.

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VBC via CMS

By Staff Reporters

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Corona Virus [Pictorial] Update?

An Info-Graphic?

By Staff Reporters

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Election Day – A Medical Perspective

VOTE SAFELY

By Staff Reporters

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COACHING MEDICAL COLLEAGUES IN BUSINESS & FINANCIAL PLANNING

COACHING MEDICAL COLLEAGUES IN BUSINESS & FINANCIAL PLANNING
https://lnkd.in/eBf-4vY
For Doctors – By Doctor Colleagues – Confidential Mentoring

By Dr. David E. Marcinko MBA CMP

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DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE
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DHITS: https://lnkd.in/eWx3WjZ

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MY “AVATAR”: https://lnkd.in/d6BU-TQ

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The Pandemic “SAF[ER]” Classroom?

NOT Absolutely 100% Safe – But Much Saf[er]?

By Anonymous

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Inside the “Fall” of the CDC?

By Pro Publica

LINK:

https://www.propublica.org/article/inside-the-fall-of-the-cdc?utm_source=pocket-newtab

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Your thoughts are appreciated!

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Prevalence of Cardio-Vascular [Heart] Disease by Income level

CIRCA: 1999-2016

By http://www.MCOL.com

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The Economic Impact of Lung Diseases

Among US Workers

By: http://www.MCOL.com

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20 Cognitive Biases That Affect Decision Making

Screwed-Up Decision Making

[By Staff reporters]

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The COVOD-19 Vaccine Race?

Get Ready – Get Set – Go!

By staff reporters

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Some Perverse Incentives in the Healthcare System

Perverse Incentives in the Healthcare System

By Paul Thomas MD

There are perverse incentives in the healthcare system. As a part of my mission to provide affordable and accessible health care in Detroit and beyond, it needs to be said that the middlemen in healthcare inflate the cost of the care that you receive.Anthem Revenue $104 Billion (2019)

Cigna Revenue $154 Billion (2019)
United Revenue $242 Billion (2019)
Aetna Revenues $69.6 Billion (2019)

Cigna CEO salary $18.9 million (2018)
United CEO salary $21.5 million (2018)
Aetna CEO salary $18.7 million (2017)

The total annual healthcare spending in the US is over $3.6 trillion annually.

  • Healthcare spending on administration: 34%
  • Healthcare spending on physician salary: 8.6%

When your doctor can’t get you the tests/imaging/procedures/surgery/medication you NEED, remind yourself that the middle management, the CEOs, the lobbyists for health insurance company did NOT swear an oath to put your health above money.

Your doctor did.

************

Doctors are missing sleep, skipping vacation, answering calls on weekend and holidays, missing important family events, and otherwise working tirelessly to keep you healthy.

All of that’s to say that I firmly believe in the power of the doctor-patient relationship and removing the middlemen from this equation.

THANK YOU

UN-NECESSARY ANTIBIOTIC PRESCRIBING

In the USA

By http://www.MCOL.com

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CORONA VIRUS DEATHS [update]

Related Eco-Systems

By staff reporters

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What is the “Herd Immunity Threshold”?

What is the Herd Immunity Threshold = HIT?

By staff reporters

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READ MORE:

“Medical Management and Health Economics Education for Financial Advisors”

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How New Vaccines are Developed?

Approved and Manufactured [Phases 1, 2 and 3]

By staff reporters

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“Medical Management and Health Economics Education for Financial Advisors”

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Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

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New Index Ranks Hospitals’ Community Benefit


N
ew Index Ranks Hospitals’ Community Benefit

By Health Capital Consultants, LLC

On July 7, 2020, the Lown Institute, a nonpartisan think tank, announced the initial release of its new ranking system for hospitals. Called the “Hospitals Index,” this ranking analyzes not just the quality of care and patient outcomes but also the hospital’s civic leadership and avoidance of overuse, ideas that harken back to the core mission and vision of the Lown Institute itself.

Founded in 1973, the Institute advocates for a healthcare system that “rejects low-value care, incentivizes healing over profits, promotes health equity, and honors the value of the clinician-patient relationship.” (Read more…)

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“Medical Management and Health Economics Education for Financial Advisors”

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Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

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2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

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***

Ten Commandments of Logic

A List of 10 “Thou Shalt Nots”

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The AJPH Continues

AJPH 
Dear Dr. David Marcinko,

 

This month, AJPH continues to publish and promote COVID-19 papers that discuss the impact of the pandemic on the future of public health. Please visit the compiled list of our COVID-19 articles. The July issue also focuses on topics related to abortion, misinformation and structural racism and redlining. Here are a few of the many articles in the July 2020 issue:

 

·  Podcast: COVID-19: Are We In This Pandemic All Together?

·  The Public Health We Need

· Public Health Perspective in the Times of COVID-19

· COVID-19: The First Post-Truth Pandemic

· Accurate Statistics on COVID-19 Are Essential for Policy Guidance and Decisions

· Producing Independent, Systematic Review Evidence: Cochrane’s Response to COVID-19

· Will There Be an Epidemic of Corollary Illnesses Linked to a COVID-19–Related Recession?

·  Teaching Public Health Will Never Be the Same

·  Abortion Trends in Georgia following Enactment of the 22-Week Gestational Age Limit

· Structural Racism, Historical Redlining, and Risk of Preterm Birth in New York City.

 

Also, as we maintain physical separation, check out the June issue of AJPH via e-Reader or Kindle. The mission of AJPH is to advance public health research, policy, practice and education. Toward that goal, the journal also produces monthly podcasts available in English, Spanish and Chinese at ajph.org. The monthly podcasts also are on iTunes and Google Play. Be on the lookout for more timely research from AJPH, and consider subscribing or becoming an APHA member for full access.

Stay safe,

 

 

Alfredo Morabia, MD, PhD

Editor-in-chief, AJPH

@AlfredoMorabia

@AMJPublicHealth

MASKS

Masks,

By Anonymous

I love freedom and personal liberty. But I also don’t want to contract or share COVID-19.

Nashville just started mandatory masks in public today. I wear a seat belt – will comply with mask  requirement.

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Monthly Percentage Change in Health Care Utilization

By Specialty – CIRCA 2019-2020

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ENTER A HEALTHCARE ENTREPRENEURIAL BUSINESS “DISRUPTOR” FOR 2020

ENTER A HEALTHCARE ENTREPRENEURIAL BUSINESS “DISRUPTOR” FOR 2020
Courtesy: https://lnkd.in/eBf-4vY

A New Initial Public Offering [I.P.O.]

On January 30, 2020, 1Life Healthcare, Inc. (One Medical) went public, opening at $14 per share, and closing at $22.07 per share. The innovative San Francisco-based direct primary care organization more closely resembles a technology start-up than a traditional healthcare organization.

LINK: https://lnkd.in/eZxrhtp

Their membership model service provides “seamless access” to primary medical care services at “calming offices,” 24/7 virtual care, and 21st century technology (e.g., a mobile application that allows patients to schedule appointments and message their providers).


And so, here is a report from colleagues over at Health Capital Consultants, LLC.
ESSAYhttps://lnkd.in/gVqDVR4
Your thoughts and comments are appreciated.

BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:
1 – https://lnkd.in/ebWtzGg
2 – https://lnkd.in/ezkQMfR
3 – https://lnkd.in/ewJPTJs
THANK YOU
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RISKY CORONA VIRUS ACTIVITIES

Rankings

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Interesting ranking of risky activities in terms of catching covid as ranked by four Public Health physicians (Dr. Matthew Sims, Dr. Dennis Cunningham, Dr Mimi Emig, Dr Nasir Husain) from Michigan.

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Thank You Nurses

Our COVID-19 Heroes

[By staff reporters]

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Assessment: Your thoughts are appreciated.

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PODCAST: “UNIVERSAL PRECAUTIONS” EXISTED LONG BEFORE THE CORONA VIRUS

WHAT’S OLD – IS NEW AGAIN?

Courtesy: www.CertifiedMedicalPlanner.org

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Dr. David E. Marcinko MBA

Universal Precautions refer to the medical practice of avoiding contact with patients’ bodily fluids, by means of the wearing of nonporous articles such as medical gloves, goggles, and face shields.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

The infection control techniques were essentially good hygiene habits, such as hand washing and the use of gloves and other barriers, the correct handling of hypodermic needles, scalpels, and aseptic techniques.

Following the AIDS outbreak in the 1980s the US CDC formally introduced them in 1985–88. Every patient was treated as if infected and therefore precautions were taken to minimize risk.

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PODCAST: https://www.bing.com/videos/search?q=universal+precautions&&view=detail&mid=CF8A605C252259D0DA6FCF8A605C252259D0DA6F&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3Duniversal%2Bprecautions%26FORM%3DHDRSC3

ASSESSMENT: Your thoughts and comments are appreciated.

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SDOH – Building the Case

Why SDOH?

[By MCOL.com and staff reporters]

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Happy National Osteopathic Medicine Week 2020

My Fond Memories

By Dr. David E. Marcinko MBA

National Osteopathic Medicine Week takes place April 19-25, 2020. It is a special time where the osteopathic medicine profession comes together to help educate the world about what osteopathic medicine is.

At first glance, the difference between DOs and MDs is difficult to distinguish. They’re both fully licensed physicians, trained in diagnosing and treating illnesses and disorders and providing preventive care.

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But, the foundation of osteopathic medicine is that people are more than just the sum of their body parts.

Learn more about National Osteopathic Medicine Week and how you can share your DO pride. 

Assessment: I trained at several DO hospitals in my early career for which I am very grateful.

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BUSINESS TEXTS FOR PHYSICIAN-EXECUTIVES AND MEDICAL CXO:

1 – https://lnkd.in/eEf-xEH

2 – https://lnkd.in/e2ZmewQ

Product DetailsProduct DetailsProduct Details

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Be Aware of Your Cognitive Biases!

Top Fifty [50] to Know

[By staff reporters]

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Assessment: Your thoughts are appreciated.

THANK YOU

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The Health Care “DISRUPTORS”

A NEW I.P.O

BY HEALTH CAPITAL CONSULTANTS, LLC

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On January 30, 2020, 1Life Healthcare, Inc. (One Medical) went public, opening at $14 per share, and closing at $22.07 per share. The innovative San Francisco-based direct primary care organization more closely resembles a technology start-up than a traditional healthcare organization.

The membership model service provides “seamless access” to primary care services at “calming offices,” 24/7 virtual care, and 21st century technology (e.g., a mobile application that allows patients to schedule appointments and message their provider).

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HEALTH CARE DISRUPTIVE INNOVATORS

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A new report from our colleagues over at Health Capital Consultants, LLC:

LINK: https://www.healthcapital.com/hcc/newsletter/02_20/HTML/IPO/convert_ipo_hc_topics.php#_edn4

ASSESSMENT: Your thoughts are appreciated.

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SHELTER-IN-PLACE?

What it is – How it works?

Courtesy: www.CertifiedMedicalPlanner.org

“Shelter-in-Place” means to seek safety within the building one already occupies, rather than to evacuate the area or seek a community emergency shelter.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

The American Red Cross says the warning is issued when “chemical, biological, or radiological contaminants may be released accidentally or intentionally into the environment” and residents should “select a small, interior room, with no or few windows, taking refuge there.”

LINK: https://www.redcross.org/get-help/how-to-prepare-for-emergencies/make-a-plan.html

And now, the term is being applied to the Corona Virus?

PODCAST: https://www.bing.com/videos/search?q=shelter+in+place+guidelines&ru=%2fvideos%2fsearch%3fq%3dshelter%2520in%2520place%2520guidelines%26qs%3dSC%26form%3dQBVR%26sp%3d2%26pq%3dshelterin%2520place%26sk%3dSC1%26sc%3d8-15%26cvid%3d000A236DFD934AABAAEEEED387ED7CF9&view=detail&mid=D278D62B859D2B5DF00AD278D62B859D2B5DF00A&&FORM=VDRVRV

Yet, it is a politically contentious issue.

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sip

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LINK: https://www.msn.com/en-us/news/us/ny-gov-cuomo-says-no-to-new-york-citys-shelter-in-place-proposal/ar-BB11n0Yv?li=BBnbcA1&ocid=SK2LDHP

Assessment: Your thoughts and comments are appreciated.

THANK YOU

***

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SO – EXACTLY WHAT IS A HUMAN SNEEZE?

About “STERNUTATION”

Courtesy: www.CertifiedMedicalPlanner.org

A Silly Question Until Covid-19!

A “Sternutation” is a sudden involuntary expulsion of air from the lungs through the nose and mouth due to irritation of the nasal passage.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

A sneeze is not always related to an underlying medical condition. It may be caused by:

  • Nasal irritants (dust, pepper, pollen etc)
  • Sudden exposure to bright light
  • Breathing cold air
  • Object struck in nose.

Self-treatment helpful in some less- serious cases include:

  • Change the furnace or air conditioner filters
  • Do not have pets in the house if allergic to animal dander
  • Wash linens in very hot water (at least 130 degrees Fahrenheit) to kill dust mites
  • Vacuum and dust frequently
  • Use a good humidifier especially at night, if the air is too dry
  • Drink plenty of water if suffering from flu/common cold.

See a doctor if you notice the following :

  • Fever greater than 101.3 F (38.5 C)
  • Fever lasting five days or more or returning after a fever- free period
  • Shortness of breath
  • Wheezing
  • Severe sore throat, headache or sinus pain
  • Allergy does not resolves in a few days.

See a doctor immediately if you notice:

  • Sneezing is continuous
  • Causes severe ear pain, drowsiness.

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PODCAST: https://www.bing.com/videos/search?q=sneeze&&view=detail&mid=C4DA4CD281B4AD36C2A5C4DA4CD281B4AD36C2A5&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3Dsneeze%26FORM%3DHDRSC3

VIDEO: https://www.msn.com/en-us/video/science/see-how-a-mask-affects-how-a-cough-travels/vi-BB13AQBH?ocid=SK2LDHP

Assessment: Your thoughts and comments are appreciated.

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BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

Product DetailsProduct DetailsProduct Details

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Medical Laboratory Test SENSITIVITY “versus” SPECIFICITY

Obvious Covid-19 Implications

By Dr. David Edward Marcinko; MBA, CPHQ, CMP

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We’ve discussed biologic false positives and false negatives before on this ME-P.

LINK: https://medicalexecutivepost.com/2019/09/14/what-are-false-positive-and-false-negative-tests/

Courtesy: www.CertifiedMedicalPlanner.org

So, now is the time to discuss and conquer the medical laboratory concepts of Sensitivity and Specificity.

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Sensitivity and specificity are statistical measures of the performance of a binary classification test, also known in statistics as a classification function, that are widely used in medicine.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

  • Sensitivity (also called the true positive rate, the recall, or probability of detection in some fields) measures the proportion of actual positives that are correctly identified as such (e.g., the percentage of sick people who are correctly identified as having the condition).
  • Specificity (also called the true negative rate) measures the proportion of actual negatives that are correctly identified as such (e.g., the percentage of healthy people who are correctly identified as not having the condition).

LINK: https://www.differencebetween.com/difference-between-sensitivity-and-vs-specificity/

NOTE: The terms “positive” and “negative” don’t refer to the value of the condition of interest, but to its presence or absence; the condition itself could be a disease, so that “positive” might mean “diseased”, while “negative” might mean “healthy”.

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And so, colleague Michael Lawrence Langan MD opines on a much deeper level.

ESSAY: https://disruptedphysician.blog/2016/11/19/diagnostic-testing-101-1-the-importance-of-sensitivity-specificity-and-diagnostic-test-accuracy-5/

Assessment: Your thoughts and comments are appreciated.

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BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

MEDICAL SENSITIVITY “versus” MEDICAL SPECIFICITY

Covid-19 Implications?

cropped-dem
Dr. David E. Marcinko MBA
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Sensitivity and specificity are statistical measures of the performance of a binary classification test function widely used in medicine.
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• SENSITIVITY (true positive rate, recall, or probability of detection) measures the proportion of actual positives that are correctly identified (percentage of sick people identified as having the condition).
• SPECIFICITY (true negative rate) measures the proportion of actual negatives that are identified (percentage of healthy people identified as not having the condition). LINK: https://lnkd.in/eJqhQYc
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NOTE: “Positive” and “Negative” don’t refer to the value of the condition, but to its presence or absence; so that “positive” might mean “diseased”, while “negative” might mean “healthy”.
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ESSAY: https://lnkd.in/e_Wb6-d Your thoughts and comments are appreciated.
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BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS
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THANK YOU
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Hand Washing Techniques for Public Health

Mitigating Covid–19 with Soap and Water

By staff reporters

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MORE: https://medicalexecutivepost.com/2011/12/06/celebrating-national-hand-washing-awareness-week-2011/

FACILITIES: https://medicalexecutivepost.com/2009/07/31/hand-washing-for-healthcare-facilities/

SURGICAL: https://www.bing.com/videos/search?q=surgical+scrub&&view=detail&mid=26877EB599539A1537E226877EB599539A1537E2&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3Dsurgical%2Bscrub%26FORM%3DHDRSC3

Assessment: Your thoughts are appreciated

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THANK YOU

 

 

“Flattening the Curve” of COVID-19 Infections

WHAT IT IS – HOW IT WORKS?

Courtesy: www.CertifiedMedicalPlanner.org

Our message on Corona Virus so far has been “don’t panic.” For the vast majority of individuals, Corona Virus is not an existential threat.

However, the rapid rate of the virus’s spread has the potential to overwhelm our health system and cause a lot of problems.

And so, colleague Aaron E. Carroll MD MS explains the infection curve, right here.

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PODCAST: https://theincidentaleconomist.com/wordpress/flattening-the-curve-of-coronavirus-infections/

Assessment: Your thoughts and comments are appreciated.

covid-19-curvesv3

BUSINESS, FINANCE AND INSURANCE TEXTS FOR DOCTORS

1 – https://lnkd.in/ebWtzGg

2 – https://lnkd.in/ezkQMfR

3 – https://lnkd.in/ewJPTJs

THANK YOU

***

Human Health Behavior TRENDS and COVID-19 Thoughts

Human Health Behavior and COVID-19 Thoughts

Courtesy: www.CertifiedMedicalPlanner.org

Here are 3 theories and 1 “rule” for the healthcare industrial complex that may help explain how the sector may not work correctly; from trauma, to epidemiology and  to Corona; all the time.

1 – Berkson’s Paradox: Strong correlations can fall apart when combined with a larger population.

For example, among motorcycle crash victims wearing helmets are more likely to be seriously injured than those not wearing helmets. But, that’s because most crash victims saved by helmets did not need to become hospital patients, and those without helmets are more likely to die before becoming a hospital patient.

2 – Group Attribution Error: Incorrectly assuming that the views of a group member, like a physician, reflect those of the whole group in a different discipline.

3 – Baader-Meinhof Phenomenon: Noticing an idea or word every where you look as soon as it’s brought to your attention in a way that makes you overestimate its prevalence.

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LINK:

https://www.bing.com/videos/search?q=BAADER-MEINHOF+PHENOMENON&&view=detail&mid=7DA25E95466C56098E5A7DA25E95466C56098E5A&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3DBAADER-MEINHOF%2BPHENOMENON%26FORM%3DHDRSC3

The 90-9-1 Rule: In social media networks, 90% of users just read content, 9% of users contribute a little content, and 1% of users contribute almost all the content.

QUERY: Does Social Media really give a false impression of what ideas are popular or “average.”

THINK: Corona Virus?

ASSESSMENT: Your thoughts and comments are appreciated.

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TEXTS FOR PHYSICIAN EXECUTIVES:

1 – https://lnkd.in/eEf-xEH

2 – https://lnkd.in/e2ZmewQ

THANK YOU

***

Understanding the 2020 Corona Virus Economic Crisis

Understanding the 2020 Corona Virus Economic Crisis

By William Poole

Dear Dr. David E. Marcinko,

Thank you for your interest in the Merk Perspective.

Merk Senior Economic Adviser and former St. Louis Fed President William Poole shares his thoughts on how to assess the economic impact of the Corona virus, pointing out in what ways it is different from past crises.

There are several aspects of the crisis that deserve separate attention. Many will seem obvious but nonetheless need to be made explicit to yield a thorough analysis.

MORE: https://www.merkinvestments.com/insights/2020/2020-03-12.php?utm_source=merk&utm_medium=link&utm_campaign=merk-campaign&registered=yes

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Assessment: Your thoughts are appreciated.
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Best Wishes,

Axel Merk
President and Chief Investment Officer
Merk Investments

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

 

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