PODCAST: Hospital Cost to Charge Ratios Explained

By Eric Bricker MD

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CITE: https://www.r2library.com/Resource/Title/082610254

Medical Cost Accounting: https://medicalexecutivepost.com/2022/08/30/understanding-medical-cost-accounting/

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IRS: A Late PayPal Gift for 2023 Tax Returns

GOODBYE FORM 1099-Ks

By Staff Reporters

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The IRS just said it is again delaying the implementation of a 2021 law that requires payment platforms such as Venmo, Paypal or Cash App to send tax forms called 1099-Ks to anyone who received more than $600 in the current tax year. 

It’s the second consecutive year the IRS has delayed enacting the new regulation, after the tax agency last year pushed off the new law until 2023. On Tuesday, the IRS said it will push the regulation back another year “to reduce taxpayer confusion” after hearing from taxpayers, tax professionals and payment processors.

CITE: https://www.r2library.com/Resource/Title/082610254

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IRS: Gift and Estate Tax Exempt Limits Increased

By Staff Reporters

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Annual Gift Tax Exclusion Increased

Currently, you can give any number of people up to $17,000 each in a single year without taxation. For 2024, this will be increased to $18,000. For married couples, $36,000 will be available to be given to beneficiaries, tax-free, beginning next year.

Lifetime Gift Tax Exemption

Additionally, the IRS has announced that the lifetime estate and gift tax exemption will increase to $13.61 million in 2024. If a gift exceeds the annual limit ($17,000 this year, $18,000 in 2024), that does not automatically prompt a gift tax. The difference is simply taken from the person’s lifetime exemption limit and no taxes are owed.

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DAILY UPDATE: IRS Zaps Debt as Stock Markets Ascend!

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Americans who owe back taxes will be given an incentive to pay up after the Internal Revenue Service it would waive nearly $1 billion in late-payment penalties. Roughly 4.6 million individual taxpayers who owe for tax years 2020 and 2021 will be eligible for the penalty relief. The IRS is extending the olive branch because it stopped sending out many collection letters during the pandemic. It hoped the letter halt would help struggling taxpayers and reduce its backlog. The long absence of these computer-generated letters had big consequences for taxpayers. Americans’ debt on unpaid back taxes had been growing with interest and penalties, and many were likely in the dark about just how much they owed.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500 index was up 27.81 points (0.6%) at 4,768.37; the Dow Jones Industrial Average was up 251.90 points (0.7%) at 37,557.92; the NASDAQ Composite® (COMP) was up 98.03 points (0.7%) at 15,003.22.
  • The 10-year Treasury note yield (TNX) was down about 3 basis points at 3.924%.
  • The CBOE® Volatility Index (VIX) was down 0.03 at 12.53.

Energy shares extended an early week rally behind a continued rebound in WTI Crude Oil futures (/CL), which rose for a fifth straight day and ended near a three-week high above $74 per barrel.

Banks and retailers were also particularly firm. The S&P 500 Retail Select Industry Index (SPSIRE) surged over 2% and ended at its highest level in over 10 months.

And, Tuesday’s big winner was Affirm, whose shares skyrocketed 15% after the buy now, pay later company announced it’s expanding its Walmart partnership to include the retailer’s self-checkout kiosks.

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IRS Inheritance Rule Change and the “Delta Dental” Data Breach

By Staff Reporters

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The IRS is demanding billions from small business who took this credit ...

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The IRS Quietly Changed the Rules on Children’s Inheritance

The IRS just issued Revenue Ruling 2023-2, which had a substantial impact on estate planning, particularly where an irrevocable trust is involved.

In the last decade or so, more families have begun utilizing irrevocable trusts to protect their assets from spend-down in order to qualify for government benefits, such as Medicaid and VA Aid and Attendance. Prior to the issuance of this ruling, it was unclear whether assets passing to beneficiaries through an irrevocable trust would receive a step-up in basis, thereby eliminating any capital gains taxes that would otherwise be owed.

Historically, assets that are disposed of during an individual’s lifetime are subject to capital gains taxes on the increase in value of that asset over time. The amount of capital gains owed is determined largely by the difference between the value at the time of purchase and the value at the time of transfer.

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Delta Dental of California data breach exposed info of 7 million people

“Delta Dental of California and its affiliates are warning almost seven million patients that they suffered a data breach after personal data was exposed in a MOVEit Transfer software breach.Delta Dental of California provides 24 months of free credit monitoring and identity theft protection services to impacted patients to mitigate the risk of their exposed data.”

LINK: https://tinyurl.com/bp4u2chv

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SECTION 179 DEDUCTIONS: Physicians Avoiding IRS Tax Mistakes

By Staff Reporters

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DEFINITION: Section 179 of the U.S. IRS code is an immediate expense deduction that business owners can take for purchases of depreciating business equipment instead of capitalizing and depreciating the asset over a period of time. The Section 179 deduction can be taken if the piece of equipment is purchased or financed and the full amount of the purchase price is eligible for the deduction.

CITE: https://www.r2library.com/Resource/Title/082610254

Not understanding parameters – Eligible property and annual limits

Medical practices may make mistakes by not fully understanding which types of property qualify for a Section 179 deduction. Section 179 is applicable only to assets used for business purposes. Failing to allocate assets properly can lead to improper deductions.

Eligible property for Section 179 may include:

  • Equipment, X-Ray, computers, fax machines, telephones, and other business property
  • Furniture and fixtures
  • Off-the-shelf-software that is used for business operations
  • Improvements to real-estate such as roofs, heating, ventilation, and air-conditioning.

Section 179 limits are updated annually, so it is important for doctors and practice owners to be aware of these limits and to plan accordingly.

Source: Natalie Westfall, Physicians Practice [12/4/23]

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INCOME: It Depends on the Meaning of the Word?

By Staff Reporters

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Incomes Keep Rising| Concrete Construction Magazine

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DEFINITION: Income is the money you receive in exchange for your labor or products. Income may have different definitions depending on the context—for example, taxation, financial accounting, or economic analysis. For most people, income is their total earnings in the form of wages and salaries, the return on their investments, pension distributions, and other receipts. For businesses, income is the revenue from selling services, products, and any interest and dividends received with respect to their cash accounts and reserves related to the business. Economists have different definitions of income and different ways of measuring it, from focusing on earnings, savings, consumption, production, public finance, capital investment or other topics … Maybe?

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WASHINGTON (Reuters) – The U.S. Supreme Court is set on Tuesday to consider a challenge to the legality of a tax targeting owners of foreign corporations that could undermine efforts at imposing a wealth tax on the very rich in a case that has already sparked controversy over a call for Justice Samuel Alito to recuse.

The justices are due to hear arguments in an appeal by Charles and Kathleen Moore – a retired couple from Redmond, Washington couple – of a lower court’s decision rejecting their challenge to the tax on foreign company earnings, even though those profits had not been distributed.

The one-time “mandatory repatriation tax” (MRT), which applied to taxpayers owning at least 10% of certain foreign corporations, was part of a 2017 Republican-backed tax bill signed into law by former President Donald Trump.

At issue in the case is whether this levy on unrealized gains is allowed under the U.S. Constitution’s 16th Amendment, which enabled Congress to “collect taxes on incomes.” The Moores, backed by the Competitive Enterprise Institute and other conservative and business groups, contend that “income” means only those gains that are realized through payment to the taxpayer, not a mere increase in the value of property.

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SCOTUS: “Quadrillion-Dollar” IRS Tax Code Question?

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

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SCOTUS will hear the “quadrillion-dollar” question?

Kicking off the Supreme Court this week will hear oral arguments today for a case that could upend the US tax code.

In Moore v. United States, the justices will be asked to decide whether the federal government can tax certain “unrealized gains”—assets that have yet to be sold.

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DAILY UPDATE: Interest Rate Cuts, CPA Holidays Spending Watch and the Markets

By Staff Reporters

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Wall Street is gearing up for rate cuts. Yep! Twenty months after the Federal Reserve began a historic campaign against inflation, investors now believe there is a much greater chance that the central bank will cut rates in just four months than raise them again in the foreseeable future.

Interest-rate futures indicated last week a roughly 60% chance the Fed will lower rates by a quarter-of-a-percentage point by its May 2024 policy meeting, up from 29% at the end of October, according to CME Group data. The same data has pointed to four cuts by the end of the year. And, investors, battered by the Fed’s efforts to slow the economy, have reacted by driving the S&P 500 up nearly 9% this month. That is despite the wagers reflecting different possible paths for the economy, not all of them favorable for stocks.

Of course, investors look ahead to the release this week of key US inflation data that could provide a guide for the Federal Reserve’s plans for interest rates going into the new year.

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

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Read: Can AI save accounting? (the Journal of Accountancy)

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Here is where the major benchmarks ended:

  • The S&P 500 Index was down 8.91 points (0.2%) at 4,550.43; theDow Jones Industrial Average® (DJI) was down 56.68 points (0.2%) at 35,333.47; the NASDAQ Composite® was down 9.83 points (0.1%) at 14,241.02.
  • The 10-year Treasury note yield (TNX) was down about 10 basis points at 4.387%.
  • CBOE Volatility Index® (VIX) was up 0.23 at 12.69.

Transportation shares were among the weakest performers Monday, and energy was also soft behind a drop in crude oil futures. Weakness in many retail stocks suggested some concern over consumer spending given high interest rates and slower job growth. The S&P Retail Select Index (SPSIRE) fell 0.6% but is still up 8.2% for the month. Consumer discretionary and real estate shares were among the few gainers.

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MORTGAGE RATES: Elevated on Black Friday!

By Staff Reporters

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Elevated mortgage rates are set to keep sellers of previously owned homes out of the market heading into next year, but sales will “bottom out” in early 2024, Fannie Mae said this week, before a rebound the following year.

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Mortgage rates hovered near 8 percent as recently as October, the highest level it has hit since the turn of the millennium, which has scared used homeowners from selling their homes as many prefer to stay in lower rates secured in years past. This “lock in effect,” as Fannie Mae analysts describe it, has added to a depleted supply of homes available for buyers and helped push up prices.

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DAILY UPDATE: Thanksgiving Travel Gas Prices Down – Narrow Traffic Lanes Safer – Walgreens Pharmacies Closed as the Stock Markets Roar

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Thanksgiving is a trading holiday. Both the New York Stock Exchange and the Nasdaq are closed. Black Friday, one of the biggest shopping days of the year, is a half day for the stock market. Both stock exchanges close at 1:00 p.m. ET, with eligible options trading until 1:15 p.m. Normal trading hours resume on the Monday after Thanksgiving, also known as Cyber Monday, when many online retailers host major sales.

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Thanks to plummeting prices at the pump, US drivers will save a collective $1.2 billion this Thanksgiving travel period, and day, compared to last year, according to GasBuddy. The average price per gallon is down nearly 46 cents from a year ago, and more than 50,000 stations now show gas prices at $2.99/gallon or less.

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Narrow traffic lanes are safer than wide ones. Researchers at Johns Hopkins analyzed more than 1,000 streets in seven major cities across the US and found that narrower roads mitigated traffic collisions in certain conditions. The study did not find a significant difference between roads 9-feet wide and those 10- or 11-feet wide, but it did conclude that traffic accidents increase 1.5x when a road widens from 9 feet to 12 feet. Traffic fatalities are the leading cause of death for Americans aged 1–54.

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Walgreens will close most of its pharmacies and stores on Thanksgiving Day for the first time in the company’s history, executives said last Thursday. The move to close more than 8,700 stores for the federal holiday comes as some Walgreens workers staged a three-day walkout this fall to push for improved working conditions and increased staffing numbers, Reuters reported.

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Here is where the major benchmarks ended on Wednesday:

  • The S&P 500 Index was up 18.43 points (0.4%) at 4,556.62, near a four-month high close; the Dow Jones Industrial Average®(DJI) was up 184.74 points (0.5%) at 35,273.03; the NASDAQ Composite was up 65.88 points (0.5%) at 14,265.86.
  • The 10-year Treasury note yield (TNX) was down about 1 basis point at 4.41%, after earlier dropping to a two-month low under 4.37%.
  • CBOE Volatility Index (VIX) was down 0.50 at 12.85.

Communications services and technology were among the strongest performers Wednesday. Food and beverage companies were also firm. Energy shares were among the weakest performers Wednesday behind a drop of over 1% in WTI Crude Oil futures (/CL). ), which fell following reports OPEC delayed a weekend meeting until November 30th, a possible reflection of cartel members struggling to reach consensus over production cuts. WTI crude ended just under $77 a barrel, down 19% from a 2023 high above $95 in late October.

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Our iMBA e-Book Sales and Service

The Institute of Medical Business Advisors is a leading national scope provider of healthcare economics, finance, investing, managerial accounting, policy, management and business administration education and medical practice management textbooks, reports, hand-books, dictionaries, journals, white-papers, fair-market valuations [FMV] and legal advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution. iMBA helps the nation’s financial, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.A virtuous “win-win” situation for all concerned.

Link: https://medicalexecutivepost.com/me-pr-a-new-feature/

The firm serves universities, medical, business, graduate and nursing schools; physicians, dentists, attorneys and legal societies – accountants, financial service providers, stock brokers, RIAs, wealth and hedge fund managers – emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related academic entities.

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US Credit Card Balances & Microsoft Stock Both Jump

By Staff Reporters

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US credit card balances have jumped to a record $1.08 trillion, according to the New York Federal Reserve.

Nevertheless, Stocks rose for the seventh straight day on Tuesday, giving the NASDAQ and S&P 500 their longest winning streaks since 2021. The surge was fueled by a rally in Big Tech and a growing consensus that the Federal Reserve Bank is done raising interest rates. Chief among the tech revelers was Microsoft, which finished the day at an all-time high amid strong demand for its cloud computing services.

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HEALTHCARE: Business News

By Staff Reporters

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House Democrats want CMS to better monitor Medicare Advantage plans’ use of AI tools to ensure they don’t allow an unusually high level of restrictive and repeated denials.


Kaiser Permanente continues to rebound from a rough 2022 and pulled in $239 million in net income in Q3. That marks a dramatic turnaround from the $1.5 billion net loss the integrated system had seen a year prior.

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


And … during the Milken Institute’s Future of Health Summit Monday, former HHS Secretary Alex Azar and current department chief Xavier Becerra sparred over the Biden administration’s approach to negotiating Medicare drug prices.

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Finally, family physicians utilizing value-based payment (VBP) models reported burnout relief in a study from EHR company Elation Health and the American Academy of Family Physicians. Burnout among providers decreased once practices passed a threshold of 75% financial investment in VBP models.

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US TREASURY: Short Term T-Notes Auction

By Staff Reporters

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Even though the Federal Reserve announced its interest rate decision yesterday, Jerome Powell wasn’t the government official investors were most anxious to hear from.

Instead, he was upstaged by Treasury Secretary Janet Yellen, who gave an update on the size of upcoming bond auctions. Although many were concerned about the US selling new debt into a market where interest rates are high and demand for bonds has flagged (pushing yields way up), the market liked what she had to say.

Yellen explained that the government would focus on shorter-term notes rather than longer-term ones, which prompted a rally for 10 and 30 year bonds.

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

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M&As: In Healthcare

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Hospital and health system deal activity is finally starting to rebound following a pandemic-era plunge, according to consulting firm Kaufman Hall, but hospitals are increasingly citing “financial distress” as the reason behind the deals.

In more than a third of the 18 hospitals and health systems deals made in Q3 2023—including mergers and acquisitions (M&A) and partnerships—at least one party cited financial distress as the impetus for the transaction. That figure is “well above historical benchmarks,” according to the firm.

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

“Hospitals and health systems have been under extreme financial pressure since 2022, when median operating margins remained in negative territory for the full year,” Kaufmann Hall analysts wrote in an October 12 report. “These challenges are reflected in the 39% percent of announced transactions in Q3 in which a party has cited, or publicly available information has enabled Kaufman Hall to infer, an element of financial distress as a transaction driver.”

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PODCAST: Why Hospitals Cry “Poor”

By Eric Bricker MD

“Cross Subsidization”

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Our iMBA e-Book Sales and Service

The Institute of Medical Business Advisors is a leading national scope provider of healthcare economics, finance, investing, managerial accounting, policy, management and business administration education and medical practice management textbooks, reports, hand-books, dictionaries, journals, white-papers, fair-market valuations [FMV] and legal advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution. iMBA helps the nation’s financial, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.A virtuous “win-win” situation for all concerned.

Link: https://medicalexecutivepost.com/me-pr-a-new-feature/

The firm serves universities, medical, business, graduate and nursing schools; physicians, dentists, attorneys and legal societies – accountants, financial service providers, stock brokers, RIAs, wealth and hedge fund managers – emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related academic entities.

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What is GAAP?

HOW IT WORKS

By Dr. David E. Marcinko MBA CMP®

http://www.MarcinkoAssociates.com

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Generally Accepted Accounting Principles

As a new physician investor, it’s important to know the distinctions between like measurements because the market allows firms to advertise their numbers in ways not otherwise regulated. Often companies will publicize their numbers using either GAAP or non-GAAP measures. GAAP, or generally accepted accounting principles, outlines rules and conventions for reporting financial information. It is a means to standardize financial statements and ensure consistency in reporting.

When a company publicizes its earnings and includes non-GAAP figures, it means it wants to provide investors with an arguably more accurate depiction of the company’s health (for instance, by removing one-time items to smooth out earnings). However, the further a company deviates from GAAP standards, the more room is allocated for some creative accounting and manipulation.

When looking at a company that is publishing non-GAAP numbers, new physician investors should be wary of these pro forma statements, because they may differ greatly from what GAAP deems acceptable.

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

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The Core GAAP Principles

GAAP is set forth in 10 primary principles, as follows:

  1. Principle of consistency: This principle ensures that consistent standards are followed in financial reporting from period to period.
  2. Principle of permanent methods: Closely related to the previous principle is that of consistent procedures and practices being applied in accounting and financial reporting to allow comparison.
  3. Principle of non-compensation: This principle states that all aspects of an organization’s performance, whether positive or negative, are to be reported. In other words, it should not compensate (offset) a debt with an asset.
  4. Principle of prudence: All reporting of financial data is to be factual, reasonable, and not speculative.
  5. Principle of regularity: This principle means that all accountants are to consistently abide by the GAAP.
  6. Principle of sincerity: Accountants should perform and report with basic honesty and accuracy.
  7. Principle of good faith: Similar to the previous principle, this principle asserts that anyone involved in financial reporting is expected to be acting honestly and in good faith.
  8. Principle of materiality: All financial reporting should clearly disclose the organization’s genuine financial position.
  9. Principle of continuity: This principle states that all asset valuations in financial reporting are based on the assumption that the business or other entity will continue to operate going forward.
  10. Principle of periodicity: This principle refers to entities abiding by commonly accepted financial reporting periods, such as quarterly or annually.

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What is EBITDA? It is Not GAAP

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Earnings before interest, taxes, depreciation, and amortization

A company’s earnings before interest, taxes, depreciation, and amortization is an accounting measure calculated using a company’s earnings, before interest expenses, taxes, depreciation, and amortization are subtracted, as a proxy for a company’s current operating profitability. Though often shown on an income statement, it is not considered part of the Generally Accepted Accounting Principles by the SEC.

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EBITDA Formula | Calculator (Examples with Excel Template)

READ: https://www.investopedia.com/terms/e/ebitda.asp

Your thoughts and comments are appreciated.

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HOSPITALS: Price Discrepancies Exposed!

By Health Capital Consultants, LLC

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On September 18, 2023, the Journal of the American Medical Association (JAMA) published a study comparing online hospital pricing and pricing given over the telephone for shoppable hospital services. Hospitals in the U.S. are required to post pricing online for specified services, but it was unknown whether or not hospitals quoted the same prices to telephone callers as they posted online.

This Health Capital Topics article will discuss the topic of price discrepancy and the difficulties with cost comparison. (Read more…) 

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Physician Assets, Liabilities and Personal Net Worth

How are Assets and Liabilities Related to Doctor Net Worth?

cropped-dem

Dr. David E. Marcinko MBA  

Before the relationship among financial assets, liabilities and net worth can be examined, some based definitions must be understood. 

LINK: http://www.CertifiedMedicalPlanner.org

[A] Short-Term Assets

Short-term goals (less than 12 months) require liquidity or short-term assets. These assets include cash, checking and saving accounts, certificates of deposit, and money market accounts. These accounts have two things in common. The principal is guaranteed from risk of loss, and pay a very low interest rate.  As an investment, they are considered substandard and one would only keep what is actually needed for liquidity purposes in these accounts.           

[B] Long-Term Assets

Longer-term assets (more than 12 months) include real estate, mutual funds, retirement plans, stocks, and life insurance cash value policies. Bonds may also be an appropriate long-term investment asset for a number of reasons, for example, if you are seeking a regular and reliable stream of income or if you have no immediate need for the amount of the principal invested. Bonds also can be used to diversify your portfolio and reducing the overall risk that is inherent in stock investments. 

[C] Short-Term Liabilities

Short-term liabilities (less than 12 months) include credit card debt, utility bills, and auto loans or leasing. When a young doctor leaves residency and starts practice, the foremost concern is student debt. This is an unsecured debt that is not backed by any collateral, except a promise to pay. There are recourses that an unsecured creditor can take to recoup the bad debt. Usually, if the unsecured creditor is successful obtaining a judgment, it can force wages to be garnished, and the Department of Education can withhold up to ten percent of a wages without first initiating a lawsuit, if in default.  It is also probable that young medical professionals have been holding at least one credit card since their sophomore year in college.  Credit card companies consider college student the most lucrative target market and medical students hold their first card for an average of fifteen years. There are several other types of other unsecured debt, including department store cards, professional fees, medical and dental bills, alimony, child support, rent; utility bills, personal loans from relatives, and health club dues, to name a few.  

[D] Long-Term Liabilities

A secured debt, on the other hand, is debt that is pledged by a specific property. This is a collateralized loan. Generally, the purchased item is pledged with the proceeds of the loan. This would include long-term liabilities (more than 12 months) such as a mortgage, home equity loan, or a car loan. Although the creditor has the ability to take possession of your property in order to recover a bad debt, it is done very rarely. A creditor is more interested in recovering money. Sometimes, when borrowing money, there may be a requirement to pledge assets that are owned prior to the loan.  

For example, a personal loan from a finance company requires that you pledge all personal property such as your car, furniture, and equipment.  The same property may become subject to a judicial lien if you are sued and a judgment is made against you. In this case, you would not be able to sell or pledge these assets until the judgment is satisfied.

A common example of a lien would be from unpaid federal, state or local taxes. Doctors can be found personally liable for unpaid payroll taxes of employees in their professional corporations.  Be aware that some assets and liabilities defy short or long-term definition. When this happens, simply be consistent in your comparison of financial statements, over time. 

[E] Personal Physician Net Worth

Once the value of all personal assets and liabilities is known, net worth can be determined with the following formula: Net worth = assets minus liabilities. Obviously, higher is better.  In The Millionaire Next Door, Thomas H. Stanley, PhD, and William H. Danko give the following benchmark for net worth accumulation. Although conservative for physicians of a past generation, it may be more applicable in the future because of current managed care environment.

Here is the guide: Multiple your age by your annual pre-tax income from all sources – except inheritances – and divide by ten. 

Real-Life Medical Example: As an HMO pediatrician, Dr. Curtis earned $ 60,000 last year. So, if she is 35, her net worth should be at least $ 210,000.

How do you get to that point? In a word, consume less, save more and watch the student loans. Stanley and Danko found that the typical millionaire set aside 15 percent of earned income annually and has enough invested to survive 10 years, at current income levels if he stopped working.  Now, if Dr. Curtis lost her job tomorrow, how long could she pay herself the same salary? 

[F] Common Liability Management Mistakes

 A common liability management mistake is not recognizing when you are heading for trouble. If doctors are paying only the minimum payments on credit card debt, while continuing to charge purchases at a rate faster than the pay-down, trouble is brewing. If you don’t categorize your debt, you could find yourself paying down non-priority debt while ignoring priority debt.

A priority debt is one that is essential or subject to serious consequences, if not paid. Examples include rent, mortgage payments, utility bills, child support, car payments, unpaid taxes, and other secured debt. If in one month, a doctor had to choose between paying his accounting bill or his rent, it would be essential to pay the rent. 

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Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)Invite Dr. Marcinko

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CERTIFIED MEDICAL PLANNER™: Helping Physicians Financially Thrive to Avoid the “Doctor Effect”

By Dr. David Edward Marcinko, MBA CMP

CEO: D.E. Marcinko & Associates, Inc.

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SPONSOR: http://www.CERTIFIEDMEDICALPLANNER.org

BEWARE MEDICAL PRACTITIONERS

Several years ago a group of highly trusted and deeply experienced financial services professionals and estate planners noted that far too many of their mature physician clients, using traditional stock brokers, management consultants and financial advisors, seemed to be less successful than those who went it alone. These Do-it-Yourselfers [DIYs] had setbacks and made mistakes, for sure. But, the ME Inc doctors seemed to learn from their mistakes and did not incur the high management and service fees demanded from general or retail one-size-fits-all “advisors.”

In fact, an informal inverse relationship was noted, and dubbed the “Doctor Effect.” In others words, the more consultants an individual doctor retained; the less well they did in all disciplines of the financial planning and medical practice management, continuum.

Of course, the reason for this discrepancy eluded many of them as Wall Street brokerages and wire-houses flooded the media with messages, infomercials, print, radio, TV, texts, tweets, and internet ads to the contrary. Rather than self-learn the basics, the prevailing sentiment seemed to purse the holy grail of finding the “perfect financial advisor.” This realization was a confirmation of the industry culture which seemed to be: Bread for the advisor – Crumbs for the client!

And so, at D.E. Marcinko & Associates, our informed cadre’ of technology focused and highly educated doctors, nurses, financial advisors, attorneys, accountants, psychologists and educational visionaries decided there must be a better way for healthcare colleagues to receive financial planning advice, products and related management services within a culture of fiduciary responsibility.

We trust you agree with this ME Inc, and Certified Medical Planner™ consulting philosophy, as illustrated  on our website.

WEBSITE: http://www.MARCINKOASSOCIATES.com

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RISK MANAGEMENT FOR PHYSICIANS

https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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U.S. INCOME: Falling

By Staff Reporters

For the third straight year, US incomes fell, according to new Census Bureau data. In 2022, the median household income fell to $74,580, adjusted for inflation. That’s a 2.3% decline from 2021’s median estimate of $76,330, according to the Census Bureau. And the latest figures mark a 4.7% drop from a 2019 peak of $78,250.

Meanwhile, earnings for both part-time and full-time workers fell 2.2% between 2021 and 2022. For full-time, year-round workers, median earnings dropped 1.3% in 2022.

One small bright spot: The Gini index, a measure of income inequality, modestly improved. The income gap between high- and low-income households decreased by 1.2% between 2021 and 2022, marking the first annual decrease since 2007.

GINI INDEX: https://medicalexecutivepost.com/2022/09/24/what-is-the-gini-index/

In all, though, the latest Census data provides a snapshot of American households’ economic troubles, and the abundance of cash-strapped workers has created new challenges for CFOs.

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DAILY UPDATE: America’s Health Insurance Plans, Auto Insurance and New Car Costs & the Markets

By Staff Reporters

Yesterday was the first day of trade group America’s Health Insurance Plans 2023 Consumer Experience & Digital Health Forum, a two-day conference focused on emerging digital health innovations and how they’re changing the consumer experience of the US healthcare system.

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RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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According to Bankrate’s extensive research, the average cost of auto insurance in the U.S. is $2,014 per year. Minimum coverage, on the other hand, has an average annual cost of $622. However, car insurance is like a fingerprint. Although your circumstances may seem similar, your personalized rating factors will cause your premium to vary from that of friends, family and the national average. Still, knowing the average cost of car insurance might give you the information you need to ensure you’re not overpaying for this necessary financial protection

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The average cost of new cars is now well over $48,000—up almost $6,000 from two years ago and about $10,000 from September 2020, according to Kelley Blue Book.

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Here is where the major benchmarks ended:

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DAILY UPDATE: Rothification and the Markets

By Staff Reporters

REMINDER

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Starting in 2026, high-income earners over the age of 50 who make more than $145,000 can no longer make catch-up contributions to regular 401(k)s. Instead, those catch-ups will head to Roth accounts. That carries significant tax implications.

MORE: https://taxfoundation.org/blog/what-rothification-means-for-tax-reform/

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

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Here is where the major benchmarks ended yesterday:

  • The S&P 500® Index (SPX) was down 25.56 points (0.6%) at 4,461.90; the Dow Jones Industrial Average (DJIA) was down 17.73 points at 34,645.99; the NASDAQ Composite was down 144.28 points (1.0%) at 13,773.61.
  • The 10-year Treasury note yield (TNX) was down about 2 basis points at 4.272%.
  • CBOE’s Volatility Index (VIX) was up 0.42 at 14.22.

While tech was the weakest performing sector Tuesday, consumer discretionary and communication services shares were also lower. Energy shares led sector gainers Tuesday as oil prices continued to rise.

The Philadelphia Oil Service Index (OSX) gained more than 2% and ended at its highest level since April 2019. WTI crude futures, the U.S. benchmark, extended gains to near $90 a barrel after OPEC, in a report, slightly increased its forecasts for global consumption in 2023 and 2024.

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National Report Up-Coding Fraud Day

AUGUST 21st

By Dr. David Edward Marcinko MBA CMP

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It’s National Report Upcoding Fraud Day, an initiative started in 2017 to support whistleblowers of Medicare fraud, which costs the US billions of dollars each year. If you need any encouragement to report suspected healthcare fraud (like upcoding or inflated Medicare reimbursement claims), here’s your chance.

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

What Is Upcoding?

Upcoding is defined as having a doctor or billing person assign an inaccurate billing code to a medical procedure or treatment. It’s done to increase the reimbursement to that physician.

Beyond that, CPT codes are 5-digit codes that tell billing and insurance companies what was done to you while in that physician’s care. It may sound straightforward, but with around 7,800 codes in use, it isn’t hard to get things mixed up or to miss the fact that they overcharged you for a service.

Sometimes the mistake is made in error. In other situations, the office or hospital may mix it up intentionally. Most often, intentional miscoding happens when the facility is billing Medicaid or Medicare. Again, this may not seem like a big deal for you since the government covers it, but it may still affect your ability to get the healthcare that you need.

MORE: https://medicalexecutivepost.com/2022/11/05/medical-billing-down-and-up-coding/

And so, National Report Upcoding Fraud Day is on August 21st. An initiative by Joel Hesch, a former attorney with the Department of Justice. Hesch and a passionate advocate for whistleblowers, created the day for anyone looking to report healthcare fraud. He wanted to make it easier, so everyone could get the process right. The day generates awareness and detailed steps on how the general public can report unethical healthcare providers. Fraudsters siphon off $65 billion each year in Medicare fraud through inflated reimbursement claims. Upcoding is one of the most rampant types of healthcare fraud that must end.Hesch draws on his 15 years as an attorney in the D.O.J. to support and encourage whistleblowers to come forward. The most successful claims have two things in common – facts and the use of proper reporting channels. National Report Upcoding Fraud Day aims to empower anyone with a legitimate case for claims.

RELATED: https://medicalexecutivepost.com/2013/06/05/understanding-the-spoils-of-healthcare-fraud-and-abuse/

MORE: https://medicalexecutivepost.com/2023/06/29/daily-update-healthcare-fraud-schemes-up-as-the-dow-dips-down/

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SIX TYPES: OF Financial Professionals

By Aleksandar Stojanović, MSc

Here’s a brief insight before the explanations:

  • 𝗖𝗙𝗢𝘀 are heavily invested in strategic planning, leadership, and risk management, often overlooking the entire financial spectrum.
  • 𝗖𝗼𝗻𝘁𝗿𝗼𝗹𝗹𝗲𝗿𝘀 play a key role in accounting, financial reporting, and regulatory compliance, ensuring financial integrity.
  • 𝗙𝗣&𝗔 𝗠𝗮𝗻𝗮𝗴𝗲𝗿𝘀 focus on financial modeling, analytical skills, and business acumen to drive business growth.
  • 𝗜𝗻𝘁𝗲𝗿𝗻𝗮𝗹 𝗔𝘂𝗱𝗶𝘁𝗼𝗿𝘀 specialize in risk management, regulatory compliance, and analytical tasks to ensure internal control.
  • 𝗙𝗶𝗻𝗮𝗻𝗰𝗲 𝗔𝗻𝗮𝗹𝘆𝘀𝘁𝘀 are adept at financial modeling, analytics, and reporting to support data-driven decisions.
  • 𝗔𝗰𝗰𝗼𝘂𝗻𝘁𝗮𝗻𝘁𝘀 emphasize accounting skills, financial reporting, and regulatory compliance for precise record-keeping.

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Now, generally, CFOs and FP&A Managers might spend more time connecting to business stakeholders for strategic decisions, while Controllers and Internal Auditors focus more on regulatory and compliance tasks.

Finance Analysts and Accountants are more involved in financial modeling and reporting.

These titles and responsibilities can be interchanged in some job descriptions, and the weight of these skills also depends on the industry and project.

But this breakdown is still quite helpful when planning career paths or understanding the roles within a finance department.

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

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High-Earning Americans to Lose 401(k) Tax Deduction in 2023

By Staff Reporters

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Changes to a popular 401(K) tax deduction are set to hit millions of high-earning Americans from next year. Workers over the aged of 50 are entitled to make catch-up contributions to their 401(K)s worth up to $7,500 this year. The annual cap on all contributions is $30,000. 

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

But from 2024, those earning over $145,000 will no longer be able to put these catch-up payments into a traditional 401(K).  Instead, the money will be only funneled into a Roth IRA account, according to new rules passed through Congress in December. 

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PODCAST: Health Insurance Company Profits

“Inter-Company Eliminations” – Healthcare Managerial Accounting

BY ERIC BRICKER MD

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IRA: Inherited Rules Change

By Staff Reporters

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The Internal Revenue Service is allowing people who inherited an individual retirement account after 2019 to skip a required minimum distribution [RMD] this year, but most still must empty the account within 10 years. The IRS issued the new guidance last week.

There has been confusion surrounding the rules for inherited IRAs ever since the Secure Act of 2019 eliminated the so-called “stretch IRA” for most non-spouse beneficiaries. The old rules had allowed beneficiaries of inherited IRAs to stretch their required minimum distributions over their own lifetimes, permitting decades of tax-free or tax-deferred growth in some cases.

Under the Secure Act of 2019, most non-spouse beneficiaries must now empty their inherited IRA by the end of the 10th year following the original owner’s death. When the law was first passed, experts interpreted it to mean that all the money could be withdrawn in year 10 if so desired, said Ed Slott, CPA and founder of IRAHelp.com 

Yet in early 2022, the IRS proposed stricter rules that would apply to someone who inherited an IRA from a person who had already begun taking RMDs; in that case, the recipient must continue taking distributions on an annual schedule. In other words, if the RMD tap had already been turned on, Slott said, it couldn’t be turned off following the original owner’s death, and beneficiaries had to keep withdrawing every year and paying income tax on the amount withdrawn.

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PODCAST: The FOUR PERCENT Spending Rule with Challenge?

Still Valid or Not?

PLUS the “RULES of 72, 78 and 115″ Explained”

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

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What Is The 4% Rule? How Much Money Do I Need To Retire? - YouTube

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The 4% Rule is a practical rule of thumb that may be used by retirees to decide how much they should withdraw from their retirement funds each year; according to Investopedia.

READ: https://www.investopedia.com/terms/f/four-percent-rule.asp#:~:text=The%20Four%20Percent%20Rule%20is%20a%20rule%20of,account%20balance%20that%20keeps%20income%20flowing%20through%20retirement.

The purpose of adopting the rule is to keep a steady income stream while maintaining an adequate overall account balance for future years. The withdrawals will consist primarily of interest and dividends on savings.

CITE: https://www.r2library.com/Resource/Title/082610254

READ: https://www.financial-planning.com/news/kitces-smart-fix-for-the-4-rule#:~:text=The%20purpose%20of%20the%204%25%20rule%20is%20to,when%20it%20provides%20superior%20outcomes%20in%20all%20situations.

CHALLENGE: But, experts like Mike Kitces are divided on whether the 4% withdrawal rate is the best option. Many, including the creator of the rule, say that 5% is a better rule for all but the worst-case scenario.

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RULES of 72, 78 and 115: https://medicalexecutivepost.com/2020/11/22/the-rules-of-72-78-and-115/

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PODCAST: https://www.bing.com/videos/search?q=4+percent+rule&&view=detail&mid=5B0C2D1CABA12C7CF6075B0C2D1CABA12C7CF607&&FORM=VRDGAR&ru=%2Fvideos%2Fsearch%3Fq%3D4%2Bpercent%2Brule%26FORM%3DHDRSC3

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IRS: “No More Door Knocks”

By Staff Reporters

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 The IRS will not come to the front / back door 

The tax agency will no longer make unannounced visits to taxpayers’ homes or businesses to collect payments due (in most cases). The IRS said it was halting the controversial practice, which has been around since at least the 1950s, to protect its agents’ safety.

Instead, the agency will send letters requesting that the taxpayer schedule an appointment. In specific cases, such as to deliver a summons or subpoena or seize assets, an unannounced visit may still occur, but there are only a few hundred of those each year compared to tens of thousands of the more routine visits, according to Reuters.

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CMS: Projected National Health Expenditures to Surpass $7 Trillion Dollars

By Health Capital Consultants, LLC

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Projected National Health Expenditures to Surpass $7 Trillion

On June 14th, 2023, CMS released health insurance enrollment and national health expenditure (NHE) projections for 2022 through 2031.

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

The NHE, which is published annually, is the official U.S. estimate of insurance enrollment and health spending. CMS projects that from 2022 to 2031, the NHE’s annual growth rate of 5.4% will surpass the U.S. gross domestic product (GDP) annual growth rate of 4.6%. As a result, health spending as a share of the U.S. GDP is set to jump from 18.3% in 2021 to 19.6% in 2031.

This Health Capital Topics article will review the notable findings from CMS’s projection report. (Read more…) 

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Congress Mulling Medicare Site-Neutral Payment Policy

By Health Capital Consultants, LLC

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Congress Mulling Medicare Site-Neutral Payment Policy

Congress is actively considering several bills related to site-neutral payment that has hospitals across the U.S. significantly concerned. The proposed legislation would lower the price that Medicare pays hospitals for common outpatient services, such as x-rays and general checkups, and match what it pays outpatient facilities such as physician offices. Facilities that are owned by hospitals (known as hospital outpatient departments, or HOPDs) earn more than twice what an independent outpatient facility earns for providing the same services.

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

This Health Capital Topics article will review the changes that are being considered by Congress, as well as the responses from stakeholders. (Read more…)

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MORE Personal BUDGET Rules for Doctors

Personal Physician Budgeting Rules

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

NOTE: The US debt-ceiling bill just passed, June 1, 2023. So, here are some budgeting rules for doctors and medical professionals.

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Budgeting is probably one of the greatest tools in building wealth. However, it is also one of the greatest weaknesses among physicians who tend to live a certain lifestyle. This includes living in an exclusive neighborhood, driving an expensive car, wearing imported suits and a fine watch, all of which do not lend themselves to expense budgeting. Only one in ten medical professionals has a personal budget. Fear, or a lack of knowledge, is a major cause of procrastination.

The following guidelines will assist in this microeconomic endeavor:

  1. Set reasonable goals and estimate annual income. Do not keep large amounts of cash at     home, or in the office. Deposit it in a money market account for safety and interest.
  1. Do not pay bills early, do not have more taxes withheld from your salary than you owe, and develop spending estimates and budget fixed expenses first. Fixed expenses are usually contractual, and may include housing, utilities, food, telephone, social security, medical, debt repayment, homeowner’ or renter’s insurance, auto, life and disability insurance, and maintenance, etc.
  1. Make variable expenses a priority. Variable expenses are not usually contractual, and may include clothing, education, recreational, travel, vacation, gas, entertainment, gifts, furnishings, savings, investments, etc.
  1. Trim variable expenses by 10-15 percent, and fixed expenses, when possible. Ultimately, all fixed expenses get paid and become variable in the long run.
  1. Use carve-out or set-asides for big ticket items and differentiate “wants from needs.”
  1. Know the difference between saving and investing. Savers tend to be risk adverse and     investors understand risk and takes steps to mitigate it.
  1. Determine shortfalls or excesses with the budget period.
  1. Track actual expenses.
  1. Calculate both income and expenses as a percentage of the total, and determine if there    is a better way to allocate resources. Then, review the budget on a monthly basis to determine if there is a variance. Determine if the variance was avoidable, unavoidable, or a result of inaccurate assumptions, and take needed corrective action.

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Verify Your Budget and Follow a Financial Plan

The process of establishing a budget relies heavily on guesswork, and the use of software or “apps”, that seamlessly track expenditures and help your budget and your financial plan become more of reality. Most doctors underestimate their true expenses, so lumping and best guesses on expense usually prove very inaccurate. Personal financial software and mobile phone applications make the verification of budgets easier. Once your personal accounts are setup, free apps like MINT.com will let give you a detailed report on where your money is going and the adjustments you must make. Few professions make larger contributions to the Internal Revenue Service than physicians and the medical profession. It is very important to categorize different budget categories not only to be proactive about your expenses, but also to accurately reflect the effect your different expenditures have on your real savings capability. All expense dollars are not equal.

For example, a mortgage payment, which is mostly interest expense in the early years, is likewise mostly tax deductible. Spending money on your family vacation is typically not tax deductible. Itemized deductions, which are deductions that a US taxpayer can claim on their tax return in order to reduce their Adjustable Gross Income (AGI), may include such costs as property taxes, vehicle registration fees, income taxes, mortgage expense, investment interest, charitable contributions, medical expenses (to the extent the expenses exceed 10% of the taxpayers AGI) and more.

Employing a qualified certified medical planneR® that utilizes a cash-flow based financial planning software program may help the physician identify their actual after-tax projected cash flow and more accurately plan their future.

ASSESSMENT: Your thoughts are appreciated.

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

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

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

THANK YOU

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What is a “Structured” Settlement?

What it Is – How it Works?

[By Staff Reporters]

A structured settlement (sometimes called a “periodic payment settlement”) is a claim settlement under which some of the proceeds will be payable in deferred installments in lieu of immediate cash.

Meaning

What does that mean to you? Settlements paid in the form of a single lump sum, especially in catastrophic injury cases, place claimants, and their families, in the position of having to manage money which may be intended to provide for a lifetime of medical and income needs.

Most people are not experienced in handling large sums of money and as a result, the money is often either spent too quickly or invested leaving little or nothing to cover the future needs of the seriously injured person.

History

Structured settlements were developed in order to create a more stable financial footing for claimants.  In 1982, the use of structured settlements was encouraged by Congress and special tax code was written. Instead of receiving a single lump sum, guaranteed payments can be made to you over time, through the purchase of an annuity, to better meet your financial needs.

IRS

The Internal Revenue Service determined that since the money you receive through a structured settlement is compensation for an injury, you will never pay taxes on any of the payments (principal or interest). There are two primary articles of legislation governing the tax treatment of structured settlements.

For more information regarding tax treatment of structured settlements, please visit the following pages: IRC 104 (a)(2) and IRC 130.  For other legislative actions and tax codes related to structured settlements, please click on one of the following links:  The Periodic Payment Settlement Act of 1982, 468B, 72(u) or 5891.

Schedules

Payments from a structured settlement can be scheduled for any length of time, even for your lifetime. Payment designs can include bi-weekly, monthly, quarterly or annual payments as well as future lump sums. Ongoing payments can be in level amounts or can keep up with inflation by using a Cost of Living Adjustment (“COLA”). Since you work with the Structured Settlement Consultant to determine the payment design, you can remain confident that your future financial needs are addressed.

If a single lump sum payment is taken as compensation for an injury, it is tax-free but any additional income (called “Interest Income”) you receive from investing the lump sum will be taxable. The bottom line is that structured settlements provide you with a unique opportunity to take advantage of an investment without risk OR tax consequences.

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policies

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Assessment

At the core of the federal tax code’s explicit recognition of structured settlements is the concept of” constructive receipt”.

For a concise explanation about Congress’ intent and how the Internal Revenue Service has traditionally interpreted the application of constructive receipt, click here for the National Structured Settlement Trade Association (NSSTA) brochure, Structured Settlements: Explaining Constructive Receipt.

To download the NSSTA brochure, Structured Settlements and Qualified Assignments: How Federal Tax Rules Benefit all Parties in a Claim, click here.

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.

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

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:

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

ORDER: https://www.crcpress.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

Supreme Court Justices Hear False Claims Act Case

By Health Capital Consultants, LLC

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On April 18th, 2023, the U.S. Supreme Court heard oral arguments in two False Claims Act (FCA) cases, which cases center on the necessary state of mind needed to violate the FCA.

This Health Capital Topics article will review the oral arguments in the combined cases and how the justices seem posed to rule based on their questions and comments during the session. (Read more…)

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JUST IN: CA Doctor Settles FCA Allegations for $23.9 Million

A plastic surgeon in Beverly Hills, along with his son, and medical practices and billing company, have agreed to pay $23.9 million to resolve allegations that they violated the False Claims Act by submitting or causing the submission of false claims to both Medicare and Medicaid.

The civil settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Act by parties who worked for the plastic surgeon (Dr. Aronowitz) and his associated medical practices and businesses. Whistleblowers include TDP, a billing company; Dr. Jason Morris, a podiatrist; and Harold Bautista, a billing department employee. Under the qui tam provisions, a private party can file an action on behalf of the government and receive a portion of any recovery.

Source: Sierra Sun Times [4/29/23]

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VENTURE CAPITAL FUNDING: Slowing Down in Health Care!

By Staff Reporters

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Venture capital funding in the digital health space cooled significantly in 2022 following a red-hot 2021; according to Healthcare Brew. Overall, digital health companies raised $15.3 billion last year, down substantially from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to research from Rock Health, a seed fund that supports digital health startups.

Analysts predict investors will still put a good amount of money into digital health in 2023, particularly in alternative care, drug development technology, and software that reduces physician workload. But investors will likely pull dollars away from a few specific sectors this year.

“There is definitely more diligence, a little bit more skepticism in the investments that are made. So you tend to see investments go slower because diligence is taking longer or investors are being a little bit more conservative,” Adriana Krasniansky, head of research at Rock Health, told Healthcare Brew.

Direct-to-consumer products. The first sector in which Krasniansky expects to see funding slow this year is direct-to-consumer (DTC) products. One reason is that with recession fears, “Consumer spend is not as readily available,” Krasniansky said.

But Apple’s new data privacy rules are also partially to blame. As of April 2021, apps sold through Apple’s App Store must ask users for permission to track activity, and users can opt out. That tracking data is crucial for advertisers to create personalized ads.

“Apple’s privacy measures have impacted customer acquisition costs, making the DTC channel more challenging for a lot of startups—and not just digital health startups,” said Krasniansky.

READ: https://www.healthcare-brew.com/stories/2023/02/21/digital-health-hesitancy?cid=30649741.22835&mid=349b552221c994e2540a304649746d7c&utm_campaign=hcb&utm_medium=newsletter&utm_source=morning_brew

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ORDER: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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MEDICARE / MEDICAID: Physician Acceptance Down

By Staff Reporters

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Physicians Who Accept Medicare, Medicaid at All-time Low of 65%

Reduced Medicare and Medicaid payments are having more physicians considering reducing those patient bases, according to Medscape’s “Physician Compensation Report” for 2023. Sixty-five percent of physicians surveyed said they would continue treating current Medicare or Medicaid patients and take on new ones, according to the report. Medscape said it is the lowest percentage it has seen in its annual compensation reports. Five years ago, 71 percent of physicians said they would continue treating current Medicare or Medicaid patients and take on new ones. 

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

For the report, Medscape collected responses from 10,011 physicians across more than 29 specialties. The data was collected between Oct. 7, 2022, and Jan. 17, 2023. Eight percent of physicians surveyed said they would not take on new Medicare patients, and 5 percent said they would not take new Medicaid patients. Four percent said they will stop treating some or all of their current Medicare patients and will not take on new ones, and 3 percent said the same about Medicaid patients. Twenty-two percent said they have not yet decided how they will move forward regarding Medicare and Medicaid patients, according to the report. 

Source: Andrew Cass, Becker’s Payer Issues [4/18/23]

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PODCAST: Accounting Deception in Health Care

Examples of Exploitation and Deception?

BY ERIC BRICKER MD

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