FORM ADV is a Must Read for Selecting a Financial “Advisor”

Form ADV – The Essential Document

Dr. David Edward Marcinko MBA - WEGO Health Awards Nominee

By Dr. David Edward Marcinko MBA CMP©

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Under law, financial advisors and planners must provide you with a form ADV Part II or a brochure that covers the same information.  Even if a brochure is provided, ask for the ADV.  While it is acceptable, even desirable, for the brochure to be easier to read than the ADV, the ADV is what is filed with the appropriate state or SEC.  If the brochure reads more like a slick sales brochure or the information in the brochure glosses over the items on the ADV to a high degree, one should consider eliminating the advisor from consideration.

FIDUCIARY: https://medicalexecutivepost.com/2020/06/15/the-new-fiduciary-rule/

Registering with a state or SEC gives an advisor a fiduciary duty to the client.  This is a high standard under the law. 

There are several types of advisors who are exempt from registering and filing an ADV. 

First, there are registered representatives (brokers).  Brokers have a fiduciary responsibility to their firms regardless of whether they are statutory employees or independent contractors. Not the client.

Second are attorneys and accountants whose advice is “incidental” to their legal or accounting practices. But, why would one hire someone whose advice is “incidental” to his primary profession?  A top-notch advisor is a full-time professional and should be registered.  One should insist that their advisor be registered.

CFP: https://medicalexecutivepost.com/2016/11/18/why-we-cannot-assume-cfp-equals-fiduciary/

The ADV will describe the advisor’s background and employment history, including any prior disciplinary issues.  It will describe the ownership of the firm and outline how the firm and advisor are compensated.  Any referral arrangements will be described.  If an advisor has an interest in any of the investments to be recommended, it must be listed as well as the fee schedule.  There is also a description of the types of investments recommended and the types of research information that is used.

ASSESSMENT: A review of the ADV should result in an alignment of what the advisor said during the interview and what is filed with the regulators.  If there is a clear discrepancy, choose another advisor.  If it is unclear, discuss the issue with the advisor.

Your thoughts and comments are appreciated.

Form ADV | Moneygrow.com | Registered Investment Advisor ...

SEC Headquarters
100 F Street, NE
Washington, DC 20549
(202) 942-8088

TEXTBOOK ORDER: ORDER Textbook: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

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

THANK YOU

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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”

CMP® CURRICULUM: https://lnkd.in/eDTRHex
CMP® WEB SITE: https://lnkd.in/guWSApq

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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On Immigrant Entrepreneurs and the USA

Shape the Start-Up Economy

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What is the “Butterfly” Effect?

What is it – How it works

[By Dr. David E. Marcinko MBA and staff reporters]

The butterfly effect refers to a concept that small causes can have large effects. Initially, it was used with weather prediction but later the term became a metaphor used in and out of science.

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[Copyright 2019 iMBA, Inc. All rights reserved. USA.]

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The term, closely associated with the work of Edward Lorenz, is derived from the metaphorical example of the details of a tornado (the exact time of formation, the exact path taken) being influenced by minor perturbations such as the flapping of the wings of a distant butterfly several weeks earlier. Lorenz discovered the effect when he observed that runs of his weather model with initial condition data that was rounded in a seemingly inconsequential manner would fail to reproduce the results of runs with the unrounded initial condition data. A very small change in initial conditions had created a significantly different outcome.

NOTE: Edward Lorenz is not to be confused with the scientist Max Lorenz: https://medicalexecutivepost.com/2018/01/26/about-the-lorenz-curve/

In Chaos Theory

In chaos theory, the butterfly effect is the sensitive dependence on initial conditions in which a small change in one state of a deterministic nonlinear system can result in large differences in a later state.

In Psychology / Psychiatry

Although I first learned about the Butterfly Effect is high school physics class, I also later learned that it relates to psychological/psychiatry in medical school. It seems the effect serves as a metaphor for life in a chaotic world. Specifically, it suggests that small events can have very large psychological / psychiatric effects.

In Insurance and Risk Management

As a health economist, and  former financial advisor, I also know that the Butterfly Effect is related to the insurance and financial service industries; as weill as risk management theory in general.

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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™

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Assessment: Your thoughts are appreciated.

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Invite Dr. Marcinko

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American Society of Appraisers 2016-17 Election Results

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NEW ASA OFFICERS

[By Jennifer M. Aguilar]

Marketing and Communications Assistant

American Society of Appraisers

11107 Sunset Hills, Suite 310, Reston, VA 20190

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

Hello ME-P Readers and Subscribers,

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

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

Thank you in advance for sharing this information.

Conclusion

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:

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

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Where There’s Smoke?

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Cytisine versus Nicotine Replacement Therapy

[By staff reporters and Rena Xu]

Doctors and financial advisors know that motivation is often half the battle of behavior change.  In the battle against nicotine addiction however, motivation alone may not be enough.  Mass media campaigns have helped to raise awareness about the dangers of smoking. We’ve even mentioned them on this ME-P

But, for the majority of smokers who already want to quit, the question remains: how?

smoke

Where There’s Smoke: Cytisine versus Nicotine Replacement Therapy

Assessment

We thought the non-healthcare readers of this ME-P might enjoy seeing how a practicing doctor is “detailed”; or informed about a new drug or treatment. In the past, drug “reps” accomplished this task in the office; “eye-2-eye” with folders and flip-charts, etc.

Today; not so much in the digital era!

And, insightful FAs realize the similarity to “wholesalers” in the financial services industry.

More:

Chest pain

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:

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Ten Irish Inventions that Changed the World

Celebrating St. Patrick’s Day – Seriously

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With St. Patrick’s Day here, we thought we’d share this infographic that explores ten of the greatest Irish inventions ever.

Source: GoIreland.com

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:

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

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In Case of ME-P Technical Emergency

Medical Executive-Post Disaster Preparedness Instructions

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By Ann Miller RN MHA [Executive-Director]

It occurrs to us that if this ME-P blog’s RSS feed fails (due to Feedburner troubles) those who subscribe that way won’t know it.

So, here’s a big hint: we rarely go a day without a post. It’s probably been years since we’ve gone two days without one. So, if you don’t see the ME-P in your reader for a day or two, check the site. We will have posted instructions for how to regain the RSS feed, or otherwise communicate what we’re doing to resolve the interruption.

By the way, another way to find out what is going on in an ME-P technical emergency is to contact me:

MarcinkoAdvisors@msn.com

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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

     Our Newest Textbook Release

Buy from Amazon

Learn How to Profit and Thrive in the PP-ACA Era

BOOK FOREWORD / TESTIMONIAL

Celebrating our National Holiday

Thanksgiving Day 2011

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As Americans enjoy Thanksgiving and its turkey, stuffing, cranberries, potatoes and pumpkin pies, we’ve compiled the facts and figures about our national holiday, just in time for the beginning of the holiday shopping season.

Source: Creditdonkey.com

Conclusion                

And so, 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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

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STD Risk Factors to Consider in Public Health

For Men and Women

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There are many factors that affect those at risk for contracting an STD. Many times individuals don’t know or understand which things put them at risk of infection. Some STD’s can be transmitted in surprising ways. For those at risk, regular comprehensive testing can help prevent unintended transmissions. Furthermore, early diagnosis of some STD’s can greatly improve treatment options and avoid hassles associated with full blown infection.

Sensitive Topic

This public service announcement may be a sensitive subject for some ME-P readers. So, the graphic below attempts to use a bit of humor to highlight important things to remember for those who are sexually active.

If you’re concerned about STD’s or want to know more, see please your physician or visit the STD Testing page for additional information.

Assessment

Brought to you by www.HealthTestingCenters.com

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:

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

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Stock Market Collapse or Earth Quake?

On the Road, Again!

By Dr. David Edward Marcinko MBA

[Editor-in-Chief]

A 5.8-magnitude earthquake rattled the East Coast on August 23rd and continued to produce aftershocks for several days. At least 18 aftershocks ranging in magnitude from 4.5 to as little as 2.0 followed the strongest earthquake to strike the East Coast since World War II, according to the US Geological Survey.

Aftershocks are smaller tremors that take place in the weeks and possibly months following a major earthquake like the one centered in Mineral, Virginia. They are usually felt in a smaller area than the original quake. The largest of the aftershocks so far was a 4.5-magnitude quake, according to the USGS. Tens of millions of people from Georgia to Canada were jolted by the initial tremor.

We felt it here in Atlanta too, as well as my home town of Fell’s Point, in Baltimore, Maryland [just north of Washington, DC], where I was visiting Johns Hopkins Hospital, engaging clients and lecturing at the time.

St. Patrick’ Church

Here is a reference file photograph of St. Patrick’s Roman Catholic Church in Baltimore, Maryland, before the quake and just down the street a bit from Johns Hopkins Hospital, toward the waterfront district.

 

Enter the Tremors

Now, here is the church on August 23rd, 2011, after a finial at the top edge of the spire fell, shattering a manhole cover far below.

The Damage Today

Fortunately, no one was injured.

This remaining damage is now the problem on this historic building.

Assessment

However, some ME-P readers and www.MedicalBusinessAdvisors.com clients are wondering if the finial collapse was due solely to the quake, or might the recent world-wide stock market tremors be involved in some way – you decide?

Conclusion

And so, 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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

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Fun Facts for Father’s Day

Sunday June 19 2011

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By bradsdeals.com

Did you know that in the United States there are twice as many hardware stores and three times as many sporting good stores than men’s clothing stores? Or, that we spend most of our Father’s Day cash on taking Dad out to eat?

Assessment

Heck, did you know that Father’s Day not only has an official flower, but that there’s actually a debate about which flower it should be? Neither did we! 

 

Conclusion

And so, 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:

Health Dictionary Series: http://www.springerpub.com/Search/marcinko

Practice Management: http://www.springerpub.com/product/9780826105752

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest ME-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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

Sponsors Welcomed: And, credible sponsors and like-minded advertisers are always welcomed.

Link: https://healthcarefinancials.wordpress.com/2007/11/11/advertise

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ME-P is Sponsored by the Certified Medical Planner™ Program

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Advisors and Consultants Raising the Bar to Physician Specificity

By Ann Miller; RN, MHAcmp-logo

Welcome to the virtual community of physician focused financial advisors and accountable medical management consultants.

 

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

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Agenda for Financial Healthcare Change

coinsQuality Guru John Wennberg MD Targets Health Economics

By Staff Reporters

According to the New England Journal of Medicine, and as reported by blogger Matthew Holt in December 2008, the Dartmouth Atlas team has offered an “Agenda for Change” which laid out some practical tactics – for reducing medical practice variation – leading  to more standardized care patterns and rational economic spending.

Link: http://www.healthcarefinancenews.com/news/controlling-variations-spending-critical-healthcare-reform

The Original Pioneer

Written by oft cited John Wennberg MD (the godfather of medical practice variation research), Shannon Brownlee [author of the seminal book “Overtreated”] and colleagues, the “Agenda” includes financial incentives for Medicare providers that would share savings resulting from better organizing patient care and improving outcomes and efficiencies especially for people managing chronic conditions.

www.MedicalBusinessAdvisors.com

Note: Efficiency here means the best outcomes and quality at the lowest cost and resource utilization; and we might add at the most appropriate venue, delivery vehicle and time.

www.HealthDictionarySeries.com

Assessment

Until now, experts have blamed the healthcare growth in spending on advances in medical technology, but Elliott Fisher MD, another one of the study’s authors, says that differences in financial growth rates across regions show that advancing technology is only part of the explanation.

IOW: Controlling financial variations in spending, like those clinical variations in medical care via EBM, is critical to any type of healthcare reform.

Be sure to download and read the 25 page report here.

Link: http://www.dartmouthatlas.org/topics/agenda_for_change.pdf

Conclusion

Your thoughts and comments on this Medical Executive-Post are appreciated.

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Events-Planner: March 2009

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Events-Planner: MARCH 2009

Staff Writersradar2

“Keeping track of important health economics and financial industry meetings, conferences and summits”

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us! The Executive-Post is a newcomer. But today, we have almost 12,500 visitors per month from all over the country. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily.  And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and financial advisory intervention. And so, enjoy the Executive-Post and our monthly Events-Planner with our compliments. 

 

A Look Ahead this Month

March 1: Print Edition Healthcare Journalism: If you would like to “step-up-your-game” and be considered as a peer-reviewed contributor to the third print edition of: The Business of Medical Practice [Advanced Profit Maximizing Techniques for Savvy Doctors]; contact Ann at: MarcinkoAdvisors@msn.com. There are several chapter topics still available. Now, the important dates:

Please send in your meetings and dates for listing in the next issue of our Events-Planner.

MarcinkoAdvisors@msn.com

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

Subscribe Now: Did you like this Medical Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. It’s free. You can unsubscribe at any time. Security is assured.

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About Phreesia Practice Access Management

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What it is – How it Works

[By Staff Reporters]horizontal-nurses

Phreesia is an intentional misspelling of a flower (Freesia) and is a medical office access management product that replaces a physician’s traditional patient data-gathering clipboard with a free easy-to-use wireless touch-screen device called a PhreesiaPad. Everything else required [absent the broadband internet connection], including a wireless network, is supplied by the company

www.Phreesia.com

Customizable

Patient interviews can be as short or as long as desired by the physician. On average, a patient interview will take anywhere from 2 to 6 minutes. The PhreesiaPads come with a built-in tracking device as well as multiple anti-theft warning signs to prevent theft. The PhreesiaPad does not operate outside a physician’s office. They are reportedly very durable and rugged. However, if one does happen to break, it is replaced free of charge

Benefits

  • Capture optimized and comprehensive patient information.
  • Enable patients to verify, rather than re-enter, previously recorded information.
  • Conduct pre-visit personalized interactive patient interviews in the waiting room.
  • Completed interviews automatically printed as a report for physician review.
  • Engage patients while they wait.
  • Offer up-to-date health education relevant to patient medical concerns.
  • Provide patients with practical information for healthy living. 
  • Display custom messages about the medical practice.
  • Better prepare patients for office appointments.
  • Ensure important information is acquired.
  • Automate current HIPAA, Medicare and patient payment agreements.

Assessment

Phreesia is not a substitute for clinician-patient dialogue. However, patients often find it easier to confide sensitive information to a computer than directly to a clinician (i.e. alcohol use, drug use, psychiatric evaluation, depression, etc.). Additionally, Phreesia encourages a more structured, meaningful clinician-patient conversation by better preparing providers and better informing patients in advance of every visit.

More Info

110 East 23rd Street
Suite 400
New York, NY 10010
Phone: 888-654-7473

Fax: 646-607-1776
info@phreesia.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. One comment was that this device resembled the Amazon Kindle electronic reader. Early-adopter insight is 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

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Medicare Audit Triggers

Understanding Healthcare Fraud and Abuse Complaints

By Staff Reporters

ho-journal7According to Patricia Trites PhD, complaints are the most common way that a Medicare audit can be triggered. Anyone can register a complaint. Physicians can report their colleagues, whether competitors in the same town or partners / associates. The literature mailed by Medicare encourages seniors and their family members to report their healthcare providers, if there is any suggestion of inappropriate billing activities.

Beneficiary Literature

Literature has been sent out in beneficiary information and in their Explanation of Medical Benefits [EOB]. The following is an example of information that patients have access to through the Internet.

Fraud and Abuse

NHIC Medicare is responsible for overseeing how your health care dollars are spent. This involves watching how physicians and suppliers submit bills. NHIC works with the Health Care Financing Administration (HCFA-CMS), Office of Inspector General (OIG), Federal Bureau of Investigation (FBI) and the United States Attorney’s Office, to develop suspected fraud and abuse cases. This team approach has resulted in numerous criminal convictions and civil monetary recoveries.

Patients: We Need Your Help!

While the vast majority of providers are honest, there are some who defraud and abuse the system — misusing money that supports your health care. Fraud adversely affects everyone in the form of higher health care costs. With your help, we can identify abusers and halt this costly waste of your health care dollars.

Fraud can take many forms — some obvious and some not so obvious. Fraudulent acts include, but are not limited to, practices like:

· Billing for services or supplies that are not provided or requested.

· Billing for non-covered services as if they were covered services.

· Misrepresenting a patient’s diagnosis.

· Submitting false claims.

· Paying for referral of patients.

· Altering claim forms and records. 

These are just a few examples of the most obvious forms of fraud. Other activities are not so obvious but are fraudulent acts nonetheless. These include changing the date of service so that it falls within a patient’s coverage period, or billing for services over a period of days when all treatment was given during one visit.

How Patients Can Help Detect Fraud

Patients are in a good position to detect and report Medicare fraud and abuse. Patients should read the Explanation of Medicare Benefits (EOMB) forms carefully. Make sure that the information on their EOMBs matches the services received. For example, patient should:

· Look at the type and number of services provided.

· Look at the dates services were provided.

· Look at the services billed to determine if received. Look at the Medicare payment to the doctor or supplier to determine if he or she was paid for more services than received or was paid for services not needed.

· Do not lend your Medicare card to anyone. If your card is lost or stolen, report it to your nearest Social Security office immediately.

What to Do If You Suspect Fraud (Patients)

If you know or suspect that a physician, supplier or hospital may be committing fraud or abuse, or if you would like someone from Medicare to talk to your group about Medicare fraud and what you can do to help stop it, please write or call your local Medicare carrier.

Assessment

Link: www.HealthcareFinancials.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

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

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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About XYZmoAmerica.com

Digital Solutions for Healthcare

ADVERTISEMENTdigital-signature4

By Jared Sayovitz

XYZmo digital signature solutions is a leading technology provider for universal, digital signature solutions, which secure and optimize your healthcare administration and business documents.

The Urgent Need

Paper-based processes are rapidly being replaced by electronic workflows. Whenever paper is involved, a large amount of time and money is wasted and security risks increase. Most companies today automate their business process and document workflow procedures, leaving the approval stage the only component that requires the use of paper. Signing the original electronic document saves companies on labor, faxing and mailing costs. Additionally, digital signatures safeguard electronic documents and files by allowing the authentication of the signatory and verification of the original document content.

Healthcare Space Solutions

XYZmo provides medical e-Signature, e-Sealing & healthcare e-Verification solutions for:

  • e-Prescriptions.
  • e-Patient registration.
  • Integration into Electronic Health Records (eHRs).
  • Physician orders.
  • Mobile signing.
  • Informed consent.
  • Business to business processes.
  • Purchase order approvals.

Contact Info

Jared Sayovitz

Xyzmo – 5909 West Loop South

Suite 555 – Bellaire, TX 77401

Phone: 713.482-6793 and e-Mail: jared@xyzmoamerica.com

website: www.xyzmo.com

Assessment

Digital white-papers:

http://www.xyzmo.com/en/resource-center/Pages/digital-signature-white-papers.aspx

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated; especially from any early HIT adopters.

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

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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A Six Sigma Emergency Department Case Report

Emergency Department Diversions

By Staff Writersbiz-book1

According to Daniel L. Gee MD MBA, Scottsdale Healthcare in Arizona used consultants from Creative Healthcare USA on a recent project, rather than doing a full deployment of Six Sigma in its organization, to analyze its problem of emergency department (ED) “diversions.”

Emergency Department Diversions

Diversions happen when emergency departments are too full in capacity to handle acute emergencies and a decision is made to close its doors to patients and ambulances are diverted elsewhere. The issue of closed and diverted emergency rooms is a growing nationwide phenomenon because of fewer EDs and a growing aged and uninsured population. The consultants, using Six Sigma principles, mapped the ED process and found multiple bottlenecks that have a direct effect on the probability of evoking a “diversionary” status in the emergency room.

Out of Control Bottlenecks

One bottleneck process deemed “out of control,” in Six Sigma jargon, was the issue of bed control. A process is considered “in control” when operating within acceptable specification limits. It was found that the average transfer time for a patient admitted to a hospital bed from the emergency department was 80 minutes, of which half of this time, a bed is available and waiting. The process was a significant “waste of time” and, moreover, complicated by an Administrative Nurse “inspector” locating beds on different floors.

Sig Sigma Tenants

Two tenements of Six Sigma level of quality were violated: one is that having an inspection is a correction for an inefficient process and two, the more steps involved the less is the potential yield of a process. Through this revelation, the hospital eliminated the Administrative Nurse, reduced cycle time by 10% in bed control, and improvement ED throughput with greater turnover thereby, improving revenue by nearly $600,000.

Little’s Law

The addition of a nurse inspector and waiting patients in a busy ED is an example of “Little’s Law” or sometimes referred to as the first fundamental law of system behavior. When more and more inputs are put into a system, such as more ED patients and an additional nurse employee, and when there is variation in their arrival time (no control over patient arrivals) or process variation (different people doing the same things differently), there becomes an exponential rise in “cycle time.” Productivity of the system begins to fall and inefficiency and variation creeps in.

Assessment

An examination of the project types to which health care provider organizations have utilized Six Sigma methodology reveals almost any hospital or medical clinic process is a candidate.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Is Six Sigma a real medical quality control initiative that’s here to stay; or just another passing fad?

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  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Hospital-Based Home Care Agencies

An Emerging and Evolving Industry

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

By Thomas A. Muldowney; MSFS, CLU, ChFC, CFP® CMP™

By Hope Rachel Hetico; RN, MHA, CPHQ™, CMP™ho-journal8

Over the past decade, the home care industry has evolved away from agencies that are affiliated with hospitals and toward independent, non-facility-based agencies.

 

The Numbers

The number of home care agencies in the U.S. fell nearly 10% in this period, to 13,313 in 2006 from 14,670 in 1996. But, as the total number of home care agencies slipped over these 10 years, the number of agencies that were hospital-based plunged by more than one-third, to 1,636 from 2,563 in 1997.

Assessment

And, hospital-based home care agencies accounted for just 12.3% of all agencies in 2007-08, down notably from 17.0% in 1997.

More: www.HealthcareFinancials.com

Conclusion

Your thoughts and comments on this Medical Executive-Post are appreciated.

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

Our Other Print Books and Related Information Sources:

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Medicaid Supplemental Needs Trusts

Filling a Growing Space

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

By Thomas A. Muldowney; MSFS, CLU, ChFC, CFP® CMP™

By Hope Rachel Hetico; RN, MHA, CPHQ™, CMP™dhimc-book2

Some states now allow family and friends (not the individual Medicaid applicant) of a disabled individual to establish a trust, either inter vivos or testamentary, that permits distributions of income or principal without jeopardizing the beneficiary’s right to Medicaid, Supplemental Security Income, and other public benefits.

Of Trusts and Trustees

The trust allows the trustee discretion to make payments directly to the provider of goods and services for the beneficiary’s benefit to supplement public benefits. The beneficiary may be a disabled person of any age who is expected to have long-term needs (medical, social, psychological, and so on).

The Limits

There are no limits on the amount of income or principal that otherwise may be expended on the beneficiary’s behalf. After the disabled beneficiary’s death, the state has no right of recovery against the funds remaining in the trust because the trust was funded with the assets of someone other than the disabled beneficiary. The trust is truly supplemental; its assets may pay for lifestyle comforts, but not for any expense covered under Medicaid.

Assessment

Thus, a son or daughter could establish such a trust to provide additional comforts to a parent in a Medicaid-paid nursing home without jeopardizing that parent’s right to continuing Medicaid support. Upon the death of the parent, the trust remainder can then revert to the child.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

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

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Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Medicaid Trusts

Debunking the Myths

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

By Thomas A. Muldowney; MSFS, CLU, ChFC, CFP® CMP™

By Hope Rachel Hetico; RN, MHA, CPHQ™, CMP™fp-book1

Some advisors, doctors, clients, patients and elders may believe that one way of avoiding the consumption of their assets, which they will use for nursing home care, is by transferring their resources into trusts. By putting their assets in trusts, elders and others believe that these assets will not be exposed to unwanted use and will be protected from claims by nursing home providers.

OBRA 1993 and DRA 2005

However, federal and state laws have severely reduced the use of trusts for this purpose; OBRA ’93 provided many of these restrictions. DRA’05 reduced it even more. Under this and earlier legislation, corpus and income of an inter vivos (a living trust) or self-settled trust are deemed to be resources of the grantor (and his or her spouse) even if the terms of the trust give full power of income and principal distribution to the trustee. (If any person creates a trust, even one that is irrevocable, that provides income to the original grantor, the trust is considered a grantor trust and will not work as an asset protection trust against the claims of lawful creditors – such as Nursing homes or medical providers.) 

Eliminated Trusts

Furthermore, certain trusts, including those in which the beneficial interest terminates when the beneficiary becomes institutionalized (conversion trusts) and those that require remaindermen approval for distributions of principal to the lifetime beneficiary (condition precedent trusts), have been eliminated as asset protection trusts.

Approved Trusts

Other trusts have been expressly approved. These include supplemental care trusts for disabled individuals not yet age 65, income assignment trusts for people affected by state income caps, and pooled fund accounts managed by nonprofit corporations.

Ancillary Benefits

The OBRA legislation also appears to have continued to make it possible to create irrevocable trusts in which the grantor retains only the income and the trustee has no discretion to distribute principal. By eliminating a trustee’s discretion to distribute principal, these trusts effectively protect the trust assets from being deemed legally available to the grantor for nursing home costs. Only the mandated income payments could legitimately be considered by state social service agencies.

The Advisor’s Role

Therefore, a financial planner of advisors can recommend “income-only” Medicaid qualifying trusts to those clients who wish to dispose of assets in order to qualify for Medicaid. The client can establish such a trust and receive its income. The income in excess of a personal needs allowance, determined on a state-by-state basis, and must be spent on medical costs. If the income amount is less than the client’s medical needs, the balance of the medical cost will be paid by Medicaid (unless the client lives in an income “cap” state). The trust corpus will not be available, as it has, in effect, been given away. The client’s purpose to protect principal has been carried out.  DRA’05 extends the look-back to sixty months. 

Assessment

So even income only trusts are under scrutiny if they were established as a means by which a grantor expected to qualify for Medicaid. Thus, if an income only trust is established, it must be established long before the application for Medicaid and before the 60 month look-back period.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

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

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Geriatric Care Management

Information for Advisors

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

By Thomas A. Muldowney; MSFS, CLU, ChFC, CFP® CMP™

By Hope Rachel Hetico; RN, MHA, CPHQ™, CMP™dhimc-book4

According to the Dictionary of Health Insurance and Managed Care”, www.HealthDictionarySeries.com geriatric care managers (GCMs) and case managers (CMs), including those working with licensed agencies, often develop an initial assessment; design and implement plans; investigate and identify available LTC resources; supervise aides and LTC services; coordinate family support consistent with its resources; and accommodate client needs, preferences, and budget. GCMs and CMs may be the most important contact with many elders on a regular basis, because they are generally familiar with available private and public resources.

Long Term Care Plans

An LTC plan that includes the coordination of all services (legal, medical, social, financial, and so on) has to be developed, implemented, monitored, and modified as necessary. Low-cost or medically insured services should be incorporated into the care plan when available and appropriate. The GCM is usually the best person to coordinate these services.

Private LTC Management and Insurance

Private LTC management has become an industry. The industry is fragmented, but it is starting to operate on a national scale. Services for elders are available from diverse sources. GCMs often run their own licensed agencies or care-management companies. CMs work in licensed private agencies and for government, not-for-profit, and religious agencies.

Assessment

But, the question remains, is there a real need for LTC insurance, or are there better economic and societal ways to deal with this financial issue?

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated.

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

Our Other Print Books and Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Nursing Home Administration Survey

Managerial Results for 2007 – Just Released

Staff Writersho-journal14

· The total number of licensed nursing home beds eligible to receive only Medicare reimbursement climbed 17.9% in 2007, to 74,996 from 63,595 the previous year, the seventh consecutive annual increase.

·  For the seventh straight year, the number of licensed nursing home beds per 1,000 people age 65 or older fell, to 45.5 in 2007 from 46.2 in 2006.      

·  In 2007, 21.1% of nursing home residents underwent rehabilitation services, up more than four percentage points from 17.0% in 2006.

· Nearly two-thirds (66.0%) of all nursing home residents were dispensed psychoactive medications in 2007, up from 63.4% in 2006, the highest share of the seven medications tracked.

· Between 2006 and 2007, total patient revenue per nursing home per year increased another 3.3%, to $7.9 million from $7.7 million, the third consecutive annual rise.

· The number of hospital-based skilled nursing facilities (SNFs) in the U.S. fell substantially in 2006, to 1,025 from 1,233, the third consecutive annual drop.

· In 2007, the total number of assisted living facilities (ALFs) in the U.S. grew another 2.1%, to 14,157 from 13,871. Since 2004 (12,500), the number ofALFs has climbed 13.3%.

· Following five consecutive years of growth, the total number of home care agencies operating in the U.S. fell fractionally in 2007, to 13,309 from 13,333 in 2006.

· Of patients treated by chain not-for-profit home care agencies, 63.5% were Medicare beneficiaries in 2007, up fractionally from 63.2% in 2006, the highest share among the six ownership types profiled.

· The average number of physical therapists per home care agency rose to 2.3 in 2007 from 2.2 in 2006, the only job title profiled that recorded a growth during this period.

*Acknowledgements

The editors and author acknowledges Verispan LLC, Yardley, Pa., as the research and reporting source for this data, reprinted with permission and based on information gathered by mail and telephone surveys gathered and effective as of December 31, 2008, unless otherwise noted.  It was commissioned, sponsored and underwritten in an arm’s length fashion by the Managed Care Digest Series of sanofi-aventis, Bridgewater, NJ, and developed and produced by Forte Information Resources, LLC, Denver, Colorado.

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

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The Certified Physician Executive

CPE / CHE

Staff Writers

56400743

The Certified Physician Executive or Certified Healthcare Executive designations, from the Certifying Commission in Medical Management (CCMM: 4890 West Kennedy Blvd., # 200, Tampa, Florida 33609-2575 813-287-8944), may be earned by those physicians, or lay professionals, with the requisite requirements in education, and demonstrated special competence and professional experience in the field of medical management.

Requirements

Specific requirements for certification include: (1) current stature as a physician (MD/DO), or working lay professional; (2) completion of the American College of Physician Executive’s Graduate Program in Medical Management (GPPM), OR, completion of an accredited graduate management degree program (i.e., MBA, MHA, MPH, etc.), OR completion of 200 hours of management education with 120 hours of a core curriculum from the GPMM; (3) at least one year of medical management experience; and (4) completion of an approved week long CPE tutorial program.

Assessment

Upon receipt of the CPE designation, diplomate, fellowship and distinguished fellowship status may be sought.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Is this certification needed; or not?

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

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Events-Planner: December 2008

Events-Planner: December 2008

DECEMBER 2008

Staff Writers

“Keeping track of important health economics and financial industry meetings, conferences and summits”.

Welcome to this issue of the Medical Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us; the Executive-Post is still a newcomer – we’ve just turned 1 years old!  Today, the website has almost 10,000 visitors per month from all over the country. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily.  And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and advisory intervention.
So, enjoy the Executive-Post and our monthly Events-Planner with our compliments.
 

 

A Look Ahead this Month

December 1: Print Edition Healthcare Journalism: If you would like to “step-up-your-game” and be considered as a peer-reviewed contributor to the third print edition of: The Business of Medical Practice [Advanced Profit Maximizing Techniques for Savvy Doctors];  contact Ann at: MarcinkoAdvisors@msn.com. There are several chapter topics still available. Now, the important dates:

Dec 2: Executive Forum on the Patient Centered Medical Home, World Congress Center, Washington, DC.

Dec 4: Medical Financial Management, Financial Research Assocs, Chicago, Ill.

Dec 4: Annual World Healthcare Innovation & Technology Conference [WHIT 4.0] World Congress Center, Washington, DC.

Dec 4: Annual Forum on Medical Device and Diagnostic Reimbursement  and Medicare Coverage , Centers for Business Intelligence, San Diego, CA.

Dec 7-11:  ASHP Midyear Meeting, Orlando, FLA.

Dec 8-10: World Healthcare Innovation & Technology Congress (provider and payer technology).

Dec 9-11: Health Technology Assessment World Europe, London, UK.

Dec 10-12: Course on Advanced Methods of Cost-Effectiveness Analysis, St. Annes College, Oxford UK.

Please send in your meetings and dates for listing in the next issue of our Events-Planner.

MarcinkoAdvisors@msn.com

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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The Healthcare Capital Budgeting Crisis

Your Vote Counts 

Staff Reporters

Did you know that South Carolina’s Department of Health and Environmental Control [SCDHEC] will likely close some of its rural health clinics due to the state’s budget woes? It’s true; according to reports from The State of Columbia, SC. Moreover, the SCDHEC would also offer early retirement to its employees.

Hospital Bankruptcies

On another front, hospitals filing bankruptcy last quarter included: a two-hospital system in Honolulu; one in Pontiac, MI; Trinity Hospital in Erin, Tennessee; Century City Doctors Hospital in Beverly Hills, Lincoln Park Hospital in Chicago, and four hospital system Hospital Partners of America, in Charlotte. 

Private Medical Practice Impact

And, according to consultants from the Institute of Medical Business Advisors, in Atlanta [www.MedicalBusinessAdvisors.com], similar negative impacts have occurred in private medical practices, and clinics, as well.

Assessment

Will the current economic crisis have a chilling effect on your healthcare organization’s capital spending?

Conclusion

Please vote.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com or Bio: http://www.medicalbusinessadvisors.com/marcinkobio.asp and www.stpub.com/pubs/authors/MARCINKO.htm

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State Mandated Health Insurance Laws

A Growing Listho-journal1

By Staff Reporters

State laws inform health insurers what health coverage they must offer as state mandates. For example, if a state says “behavioral health coverage,” then health insurance policies issued in that state must provide coverage for behavioral health benefits for the insured and dependents But, recall that no two states impose the same set of mandates, and coverage changes regularly. So, here is a list:

Alabama

  • Alcohol treatment
  • dependent coverage (from the moment of birth, including abnormalities)
  • mammograms
  • open selection of pharmacy

Alaska

  • Alcohol/drug treatment
  • dependent coverage (from the moment of birth, including abnormalities, and those who are adopted)
  • mammography
  • pap smears
  • prostate cancer screenings
  • phenylketonuria

Arizona

  • Dependent coverage (from the moment of birth, including those who are physically or mentally handicapped, and those who are adopted) mammography
  • outpatient care
  • home health care
  • mastectomy reconstruction
  • emergency care
  • diabetes self-management; mail-order pharmacies may not be required
  • prescription contraceptives (exceptions exist for religious employers)

California

  • Alcohol/drug/nicotine treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • lead screening for children
  • preventative care for children
  • home health care
  • infertility treatment
  • mastectomy and other reconstruction
  • diabetes self-management
  • pap smears
  • temporomandibular joint disorder
  • prosthetic devices
  • osteoporosis
  • off-label drugs
  • DES effects
  • prostate cancer screening

Colorado

  • Alcohol treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including those with abnormalities, and those who are adopted)
  • mammography
  • home health care
  • hospice care
  • maternity coverage for women
  • pregnancy complications
  • prostate cancer screenings
  • coverage may not be denied to an individual solely on the basis that the individual casually or professionally participates in skiing or snowboarding activities

Connecticut

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • home health care
  • comprehensive rehabilitation
  • occupational therapy
  • long-term care
  • metabolic disorders
  • mastectomy reconstruction
  • breast implant removal
  • diabetes
  • ambulance services
  • cancer
  • accidental ingestion of controlled drugs

Delaware

  • Mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities)
  • cancer screening (including Pap tests, mammograms, ovarian cancer, and prostate screenings)
  • lead screening
  • children’s immunizations

District of Columbia

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities and preventive care)
  • mammography
  • Pap tests

Florida

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • second surgical opinions
  • HIV testing/infection
  • fibrocystic breast disease
  • ambulatory surgical care
  • mastectomy
  • reconstructive surgery
  • home health care
  • acupuncture
  • mammograms
  • diabetes
  • temporomandibular joint disorders
  • osteoporosis

Georgia

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • pregnancy complications
  • mammography
  • Pap tests
  • bone marrow transplants
  • prostate cancer screening
  • diabetes
  • heart transplants
  • outpatient services
  • osteoporosis
  • chlamydia screening
  • pharmacy open choice

Hawaii

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities, those who are mentally or physically handicapped, and those who are adopted,)
  • maternity expenses if employee covered for past nine months
  • mammography
  • in vitro fertilization
  • contraceptive services
  • emergency services
  • telehealth

Idaho

  • Dependent coverage (from the moment of birth
  • including abnormalities
  • those who are mentally or physically handicapped, and those who are adopted)
  • if mastectomy covered so must mammography be
  • elective abortions must be excludable
  • involuntary complications of pregnancy

Illinois

  • Alcohol treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • examinations of criminal assault or abuse victims
  • infertility when maternity is covered
  • mastectomy
  • reconstructive surgery
  • nonexperimental organ transplants
  • treatment for DES children
  • blood processing
  • temporomandibular joint disorders
  • ambulance service
  • off-label cancer drugs
  • fibrocystic breast disease
  • breast implant removal
  • colorectal cancer screening
  • diabetes

Indiana

  • Dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • mastectomy reconstruction
  • diabetes self-management
  • off-label drugs
  • infant screening exams where maternity is covered
  • prostate cancer screening
  • colorectal cancer exams
  • morbid obesity
  • pervasive developmental disorders
  • mental health

Kansas

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities, and adopted children)
  • mammograms
  • Pap smears
  • emergency care

Kentucky

  • Alcohol treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities)
  • mammography and reconstruction where mastectomy is covered
  • ambulatory surgery care
  • home health care
  • long-term care
  • bone marrow transplants
  • temporomandibular joint disorders
  • endometriosis
  • diabetes self-management
  • off-label cancer drugs
  • hearing aids and related services

Louisiana

  • Dependent coverage (from the moment of birth, including abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • Pap tests
  • ambulatory surgery care
  • immunizations for children
  • mastectomy reconstruction
  • diabetes self-management
  • prostate cancer screening
  • emergency care
  • off-label cancer drugs
  • outpatient surgery
  • use of mail-order pharmacies cannot be mandatory

Maine

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities, and those who are adopted)
  • mammography
  • home health care
  • AIDS coverage (cannot be more restrictive than for other illnesses)
  • mastectomy reconstruction
  • diabetes self-management
  • Pap tests
  • outpatient services
  • off-label cancer and HIV drugs
  • prostate cancer screening
  • breast prostheses for mastectomies
  • clinical trials
  • emergency services

Maryland

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities, and adopted children or grandchildren)
  • hospice care
  • home health care
  • child wellness
  • metabolic disorders
  • mammograms
  • infertility if maternity is covered
  • certain blood products
  • mastectomy reconstruction
  • diabetes
  • prostate cancer screenings
  • temporomandibular joint disorders
  • outpatient care
  • osteoporosis
  • pharmacy of choice
  • tuberculosis
  • off-label drugs
  • contraceptives
  • chlamydia screening
  • hospice care
  • emergency care

Massachusetts

  • Alcohol/drug treatment (only if you have more than five employees)
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities, and those who are adopted)
  • mammography
  • infertility treatments
  • home health care
  • pregnancy and childbirth
  • hospice care
  • ABMT (treatment for breast cancer)
  • preventive care for children
  • enteral nutrition
  • DES-related conditions
  • diabetes management
  • Pap tests
  • off-label drugs for HIV/AIDS
  • scalp hair prostheses
  • cardiac rehabilitation

Michigan

  • Dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped)
  • mastectomy reconstruction and prosthetics
  • emergency care
  • off-label cancer drugs
  • hospice care

Minnesota

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • home health care
  • well-baby care
  • emergency care
  • some diabetes treatment
  • prenatal care
  • mammograms and other cancer screening
  • breast-implant-related conditions
  • reconstructive surgery
  • exposure to DES
  • phenylketonuria
  • port wine stains
  • Lyme disease
  • Pap tests
  • temporomandibular joint disorders
  • outpatient care
  • off-label cancer drugs
  • fibrocystic breast disease
  • scalp hair prostheses

Missouri

  • Alcohol/drug treatment
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • preventive care for children
  • bone marrow transplants
  • reconstructive surgery after mastectomy
  • phenylketonuria
  • diabetes self-management
  • speech or hearing loss
  • elective abortions may be covered only under separate policy riders for which additional premiums are paid

Mississippi

  • Alcohol treatment
  • dependent coverage (from the moment of birth, including abnormalities and those who are physically or mentally handicapped)
  • temporomandibular joint disorders
  • open choice of pharmacy
  • off-label cancer drugs
  • mammography
  • diabetes
  • dental anesthesia

Montana

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • home health care
  • inpatient care for breast surgery
  • mastectomy reconstruction
  • phenylketonuria
  • metabolic disorders
  • open choice of pharmacy

Nebraska

  • Mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped)
  • childhood immunizations
  • mammograms
  • emergency care
  • off-label cancer and HIV/AIDS drugs
  • temporomandibular joint disorders
  • diabetes
  • abortions only to prevent death of mother
  • use of mail-order pharmacies can’t be mandatory

New Hampshire

  • Mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted)
  • nonprescription enteral formulas
  • mammograms
  • bone marrow transplants
  • mastectomy reconstruction
  • diabetes self-management
  • certain hair-loss prostheses
  • dental anesthesia

New Jersey

  • Alcohol treatment
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped)
  • mammography
  • Pap smears
  • second and third (sometimes) surgical opinions
  • reconstructive breast surgery and prostheses
  • home health care
  • blood tests
  • glaucoma tests
  • adult immunizations
  • wellness examinations
  • childhood immunizations for plans with over 49 enrollees
  • metabolic disorders
  • bone marrow transplants
  • maternity care
  • hemophilia blood products
  • diabetes self-management
  • lead poisoning screenings
  • prostate cancer screening
  • colon screening
  • open choice of pharmacy
  • off-label drugs
  • dental anesthesia

New Mexico

  • Dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • childhood immunizations
  • diabetes
  • Pap tests
  • ambulance service for childbirth

Nevada

  • Alcohol/drug treatment
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • mastectomy
  • reconstructive surgery and prosthetics
  • enteral formulas and special food products ordered by a physician
  • diabetes self-management
  • Pap tests
  • temporomandibular joint disorders
  • pregnancy and childbirth

New York

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped and those who are adopted)
  • mammography
  • home health care
  • preadmission tests
  • second surgical opinions
  • infertility treatment
  • preventive pediatric care
  • prescription enteral formulas
  • mastectomy reconstruction
  • maternity care
  • diabetes self-management
  • Pap tests
  • emergency care
  • nursing home care
  • hospice care
  • off-label cancer drugs

North Carolina

  • Dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted or foster children)
  • mammography
  • Pap tests
  • mastectomy reconstruction
  • diabetes self-management
  • prostate cancer screening
  • open choice of pharmacy
  • off-label cancer drugs

North Dakota

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • free choice of pharmacy
  • prostate cancer screening
  • temporomandibular joint disorder
  • dental anesthesia

Ohio

  • Alcohol/drug treatment
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammograms
  • Pap tests

Oklahoma

  • Dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • childhood immunizations
  • mastectomy reconstruction
  • diabetes
  • bone density tests
  • dental anesthesia
  • prostate surgery side effects
  • prostate cancer screenings

Nevada

  • Alcohol/drug treatment
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • mastectomy
  • reconstructive surgery and prosthetics
  • enteral formulas and special food products ordered by a physician
  • diabetes self-management
  • Pap tests
  • temporomandibular joint disorders
  • pregnancy and childbirth

Pennsylvania

  • Alcohol/drug treatment
  • dependent coverage (including those who are mentally or physically handicapped)
  • annual gynecological exams and Pap smears
  • mammograms
  • mastectomy reconstruction and prosthetics
  • phenylketonuria
  • diabetes self-management

Rhode Island

  • Alcohol/drug treatment, mental health coverage, dependent coverage (including those who are adopted)
  • home health care
  • pediatric preventive care
  • mammograms
  • mastectomy reconstruction and prosthetics
  • new cancer therapies
  • diabetes
  • Pap tests
  • second surgical opinions
  • infertility treatments
  • bone marrow donor testing abortion may be covered only under a separate rider, and only if mother endangered, rape, or incest

South Carolina

  • Dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • off-label cancer drugs
  • gynecological exams
  • mammograms
  • mastectomy reconstruction
  • Pap tests
  • prostate cancer screenings
  • emergency care
  • open choice of pharmacy

South Dakota

  • Dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • phenylketonuria
  • open choice of pharmacy
  • diabetes self-management
  • emergency care

Tennessee

  • Dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • mastectomy reconstructions
  • phenylketonuria
  • diabetes
  • prostate cancer screening
  • emergency care

Texas

  • Alcohol/drug treatment
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are physically or mentally handicapped, and those who are adopted)
  • coverage for AIDS (including HIV and HIV-related conditions)
  • infertility including in vitro fertilizations where pregnancy/childbirth is covered
  • childhood immunizations
  • mammograms
  • mastectomy reconstruction
  • diabetes
  • prostate cancer screening
  • temporomandibular joint disorders
  • free choice of pharmacy
  • home health care
  • telemedicine
  • emergency care

Utah

  • Dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • metabolic disorders
  • maternity benefits for birth mothers in adoptions
  • genetic information may not be used for purposes other than treatment

Vermont

  • Alcohol treatment
  • mental health coverage
  • dependent care coverage (from the moment of birth, including abnormalities, those with physical or mental handicaps, and those who are adopted)
  • mammography
  • certain cancer therapies
  • diabetes self-management
  • home health care
  • metabolic disorders
  • craniofacial disorders

Virginia

  • Alcohol/drug treatment
  • mental health coverage
  • dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • pregnancy treatment after rape or incest
  • HDC/ABMT (breast cancer treatment)
  • Pap tests
  • temporomandibular joint disorders
  • emergency care
  • early intervention therapies for children
  • open choice of pharmacy
  • off-label drugs
  • contraceptives
  • mastectomy reconstruction
  • hemophilia
  • diabetes
  • prostate cancer screening
  • cancer pain
  • hospice care

Washington

  • Alcohol/drug treatment
  • dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • home health care
  • mammography
  • breast reconstruction
  • hospice care

West Virginia

  • Dependent coverage (from the moment of birth, including abnormalities and those who are adopted)
  • home health care
  • primary care nursing
  • rehabilitation services
  • mammograms
  • diabetes
  • Pap tests
  • temporomandibular joint disorders
  • emergency care
  • childhood immunizations
  • cannot cancel if diagnosed with AIDS

Wisconsin

  • Dependent coverage (from the moment of birth, including those with abnormalities, those who are mentally or physically handicapped, and those who are adopted)
  • mammography
  • diabetes supplies
  • HIV drugs
  • home health care
  • kidney disease treatments
  • skilled nursing care
  • maternity care
  • emergency care
  • open choice of pharmacy

Wyoming

  • Dependent coverage (from the moment of birth, including abnormalities and those who are mentally or physically handicapped, and those who are adopted)

###

Alcohol Treatment: http://www.altamirarecovery.com/alcohol-treatment/

Conclusion

What do you think? As always, your thoughts and comments on this Executive-Post are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com or Bio: http://www.medicalbusinessadvisors.com/marcinkobio.asp and www.stpub.com/pubs/authors/MARCINKO.htm

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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New Medical Informed Consent Dilemma

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Emerging Problems

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]dem21

According to the Dictionary of Health Insurance and Managed Care, informed consent is the oral and written communication process between a patient and physician that results in the agreement to undergo a particular procedure, surgical intervention or medical treatment.

Unfortunately, a lack of standardization surrounding this process represents a major risk for patients and surgeons, and may lead to inaccurate patient expectations, lost or incomplete consent forms, missing encounter documentation and delays in critical surgeries and procedures.

History: Render S. Davis of Emory University [2008 recipient of the Health Care Ethics Consortium’s Heroes in Healthcare Ethics Award] writes for us in the Business of Medical Practice www.MedicalBusinessAdvisors.com that the concept of informed consent is rooted in medical ethics and codified as a legal principle. It is based on the assertion that a competent person has the right to determine what is done to him or her [self-regulated autonomy].

Rationale: The American Medical Association recommends that its members disclose and discuss the following with their patients:  

  • The patient’s diagnosis, if known,
  • The nature and purpose of a proposed treatment or procedure,
  • The risks and benefits of a proposed treatment or procedure,
  • Alternatives (regardless of cost or health insurance coverage),
  • The risks and benefits of the alternative treatments and,
  • The risks and benefits of not the procedure.

The requirements for informed consent are spelled out in statutes and case law in all 50 states. It is a necessary protocol for all hospitals, medical clinics, podiatry practices and ASCs.

Inadequacy of Traditional Consent Forms-to-Date

The typical informed consent process, particularly one that relies solely on traditional generic consent forms, is often inadequate, incomplete or offers the potential for not fully explaining and documenting a particular procedure to a given patient. 

Traditional consent forms are subject to errors and omissions, such as missing signatures (patient, provider or witness), missing procedure(s), and missing dates that place the validity of consent at risk. Lost or misplaced forms may result in delayed or postponed procedures often at the expensive of costly operating room time. Moreover, far too many forms are generic in nature and wholly unsuited for a specific patient or increasingly sophisticated medical procedure.

Patient Safety Background

According to the Institute of Medicine’s [IOM] repot, To Err is Human, more than 1 million injuries and nearly 100,000 deaths occur annually in the United States due to mistakes in medical care. Wrong patient, wrong-side, wrong-procedure and wrong-toe surgery are particularly egregious. In fact, these are among several other “never-events” that Medicare, and an increasing number of private insurance companies are refusing to reimburse.

Based on the need to make healthcare safer, the Agency for Healthcare Research and Quality (AHRQ) undertook a study to identify patient safety issues and develop recommendations for “best practices”.

AHRQ Evidence Report

The AHRQ report identified the challenge of addressing shortcomings such as missed, incomplete or not fully comprehended informed consent, as a significant patient safety opportunity for improvement.

The authors of the AHRQ report hypothesized that better informed patients “are less likely to experience errors by acting as another layer of protection.” And, the AHRQ study ranked a more interactive informed consent process among the top 11 practices supporting more widespread implementation.

General Accounting Office report found that malpractice insurance premiums were relatively flat for most of the 1990’s, but projections began to increase dramatically to 2010.

Results of Improper Informed Consent

Failure to obtain adequate informed consent, depending on state law, may place surgeons, resident, fellows, ambulatory and office surgery centers, medical clinics and hospitals at risk for litigation ranging from medical negligence to assault and battery.

Proceedings Involving Informed Consent

Informed consent is often a factor in medical malpractice litigation. Some attorneys note that physicians are liable, and that plaintiffs may be able to recover damages, in cases involving improper informed consent, even if the procedure is successful. Inadequate informed consent is often cited as a secondary cause in malpractice complaints and anecdotal evidence suggests this strategy may be especially pursued in podiatric malpractices cases.

Avoiding Litigation

The AMA advises its membership of the following regarding informed consent:  

“To protect yourself in litigation, in addition to carrying adequate liability insurance, it is important that the communications process itself be documented. Good documentation can serve as evidence in a court of the law that the process indeed took place. A timely and thorough documentation in the patient’s chart by the physician providing the treatment and/or performing the procedure can be a strong piece of evidence that the physician engaged the patient in an appropriate discussion.”

Impact of Comprehensive Informed Consent Forms

Another study found that providing informed consent information to patients in written form increased comprehension of the procedure. It was also hypothesized that: 

  • Better informed patients are more compliant with medical advice and recover faster.
  • Informed consent discussions strengthen physician-patient relationships and increase patients’ confidence in their doctor.
  • Well informed patients are more engaged in their own care, and are thus less likely to experience surgical errors than more passive, or less informed patients. 

Medical Ethics

The ethical foundation of informed consent is based on the creation of an environment that supports respect for patients and protects their right to autonomous, informed participation in all collaborative Healthcare 2.0 decisions. 

Assessment 

Thus, the essence of the informed consent problems of modern medicine today!

More: http://www.ePodiatryConsentForms.com 

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About Waterfront Media

Revolution Health plus Everyday Health

Staff Writers

According to the New York Times on October 3rd, Revolution Health Network just merged with Everyday Health Network; a publisher that owns several health Web sites.

A Threat to WebMD

In a deal that threatens WebMD’s dominance in the online health care space, the new $300 million valuation would give the combined companies enough US traffic to compete with WebMD; now considered the market leader in the online health category

Waterfront Media

The new company will operate under the name Waterfront Media, which runs several sites called the Everyday Health Network, while the Revolution Health Web sites will be absorbed into that network

Assessment

WebMD has also been expanding, as it recently announced that it would acquire the site QualityHealth.com for $50 million and an additional $25 million based on performance.

Conclusion

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Politics of Healthcare

Join Our Mailing List

Biden versus Palin

[By Staff Reporters]

Enter the PFCD

The “Partnership to Fight Chronic Disease” recently entered the political arena when it expressed disappointment at last week’s vice-presidential debate; saying Senator Joe Biden and Governor Sarah Palin did not address one of the nation’s most pressing economic issues; the rising cost of healthcare.

The Next Financial Casualty?

Earlier this week, former US Secretary of Health and Human Services Tommy Thompson held a conference call to discuss why healthcare could be what they called “the next financial casualty” in the current economic crisis.

Assessment

The Partnership to Fight Chronic Disease is a national coalition of patients, providers, and community organizations dedicated to raising awareness of the impact of chronic disease in the US. So, is the PFCD correct on this point; did the VP candidates abrogate this issue? Your comments and thoughts are appreciated.

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™

***

Events-Planner: October 2008

Events-Planner: October 2008

OCTOBER 2008

Staff Writers

“Keeping track of important health economics and financial industry meetings, conferences and summits.”  

Welcome to this issue of the Executive-Post and our Events-Planner. It contains the latest information on conferences, news, and relevant resources in healthcare finance, economics, research and development, business management, pharmaceutical pricing, and physician/entity reimbursement!  Watch for a new Events-Planner each month.

First, a little about us; the Executive-Post is still a newcomer – we just turned 1 years old!  Today, the website has almost 10,000 visitors per month from all over the country. We have been a successful collaborative effort, thanks to your contributions.  As a result, we are adding new resources daily.  And, we hope the website continues to provide the best place to go for journals, books, conferences, educational resources, tools, and other things you need to establish the value your healthcare consulting and advisory intervention.
So, enjoy the Executive-Post and our monthly Events-Planner with our compliments. 

 

A Look Ahead this Month

October 1: Print Edition Healthcare Journalism: If you would like to “step-up-your-game” and be considered as a peer-reviewed contributor to the third print edition of: The Business of Medical Practice [Advanced Profit Maximizing Techniques for Savvy Doctors]; just contact Ann at MarcinkoAdvisors@msn.com There are several chapter topics still available. More important dates:

Please send in your meetings and dates for listing in the next issue of our Events-Planner.

MarcinkoAdvisors@msn.com

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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Advantages of IMAs

A Doctor’s Case against Mutual Funds

By Dr. David Edward Marcinko; MBA CMP

Publisher-in-Chief

The case against Mutual Funds [MFs], and in favor of Individually Managed Accountants [IMAs]:

  • No unrealized capital gains
  • The ability of the physician-investor to dictate or organize a portfolio around current stocks
  • The manager is not obliged to buy additional securities, no matter how much money pours in
  • The physician’s portfolio is not subject to a pooled mentality
  • A physician-investor can own a specified number of securities without over diversifying
  • Lower fees and Lower commissions as portfolio grows
  • Ongoing customization in step with world trends
  • Hands-on or hands-off philosophy, as the investor prefers
  • Custom diversification blend-in strategies for low-basis stocks
  • Individual doctor recognition as to tax consequences.

Assessment

How true, false or parsed are the above perspectives?

Conclusion

Your comments are appreciated?

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

Subscribe Now: Did you like this Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Copyright 2008 iMBA Inc: All rights reserved, USA, unless otherwise noted. Use is restricted to Executive-Post subscribers only. No redistribution is allowed. To avoid violation of iMBA Inc copyright restrictions and redistribution policy, please register for your own free Executive-Post membership. Detailed information and registration links are available at:

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Referrals: Thank you in advance for your electronic referrals to the Executive-Post

 

Launching iGuard.org

Institute for Safe Medication Practices

Staff Reporters

A new patient-oriented Web site is scheduled for release this fall to reduce mix-ups over drug names.

The ISMP

The Web site is a partnership of the nonprofit Institute for Safe Medication Practices, and online health service www.iGuard.org, which will send users email alerts about drug-name confusion.

Dug Mix-Ups Not Rare

According to an Associated Press report on September 2nd, nearly 1,500 commonly used drugs have names so similar to at least one other medication that they’ve already caused mix-ups.

Patient Harm

And, according to a major study by the U.S. Pharmacopeia, at least 1.5 million Americans are estimated to be harmed each year from a variety of medication errors, and name mix-ups are blamed for a quarter of them.

The Food and Drug Administration [FDA] – which currently rejects more than a third of proposed names for new drugs because they’re too similar to old ones – is preparing a pilot program that would shift more responsibility to manufacturers to guard against name confusion.

The Site

According to the website, iGuard.org is a healthcare service initiative that helps monitor the safety of medications (including prescription drugs, over-the-counter drugs, nutritional supplements and herbal extracts).

iGuard.org reportedly will help patients stay safer by:

  • Checking the safety of medications, and screening for drug-drug and drug-disease interactions.
  • Alerting members and doctors (optional) as important safety information arises for medications.
  • Provide accessible medication summaries for healthcare teams.
  • Help patients learn and share treatment satisfaction and side effect information within its social community.

Assessment

The goal of the site is to spell-out how to better test for potential mix-ups before companies seek approval to sell their products.

Conclusion

Your thoughts and comments are appreciated.

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

Subscribe Now: Did you like this Executive-Post, or find it helpful, interesting and informative? Want to get the latest E-Ps delivered to your email box each morning? Just subscribe using the link below. You can unsubscribe at any time. Security is assured.

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Copyright 2008 iMBA Inc: All rights reserved, USA, unless otherwise noted. Use is restricted to Executive-Post subscribers only. No redistribution is allowed. To avoid violation of iMBA Inc copyright restrictions and redistribution policy, please register for your own free Executive-Post membership. Detailed information and registration links are available at:

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Meet a Sponsor

Foot and Ankle Research Consortium, Inc.

Date: September 1, 2008

PRESS RELEASE: FARC, Inc

Atlanta, Georgia USA

The Executive-Post at www.HealthcareFinancials.com is now proudly sponsored, in-part, by the Foot and Ankle Research Consortium, Inc.

FARC is a leading provider of CD-ROMS, books and e-learning tools for orthopedic and podiatric medicine and surgery of the foot, ankle and leg. Since 1992, FARC has been producing the most effective and innovative method of preparing for all Podiatry and Orthopedic Surgery related board examinations; written and oral – qualified and certified. This includes, among others:  

  • The American Board of Podiatric Surgery [ABPS]
  • The American Board of Podiatric Orthopedics
  • The American Board of Primary Podiatric Medicine [ABPOPPM]
  • The American Podiatric Medical Specialties Board [APMSB]
  • The American Board of Lower Extremity Surgery [ABLES]
  • The National Board of Podiatric Medical Examiners [Parts II and III of PMLexis].  

And, FARC now includes the latest information for all Board Re-certification Examinations, C.Ped and Diabetic Wound Care/Infection and Ulcer Management.

Purchase – Prepare – Pass

For more information, please visit: www.PodiatryPrep.com

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 “Easy to Use”

www.PodiatryPrep.com

770.448.0769

How to Interview a Portfolio Manager?

Selection Criteria Critical for Physicians

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief and former certified financial plannerdem2]

Recently in the Atlanta area, two high-profile financial advisors and portfolio investment managers have been charged with client embezzlement, malfeasance, and more!

The first was Kirk Wright, a Harvard-educated fund manager who was convicted last week in a fraud scheme that bilked investors out of tens of millions of dollars.  He later hanged himself, according to the Fulton County Georgia medical examiner’s office.  A federal jury convicted Wright last week on all 47 counts of mail fraud, securities fraud and money laundering stemming from a scam run through his firm, International Management Associates. High-profile clients included sports-stars, celebrities and several well-known local physicians.

The second, Frederick J. Barton, received a Securities and Exchange Commission (SEC) civil action letter on June 3rd, 2008. Barton, formerly a registered representative of a national, registered broker-dealer and two entities he controlled: TwinSpan Capital Management, LLC (TwinSpan), an investment adviser formerly registered with the Commission, and Barton Asset Management, LLC (Barton Asset Management). The Commission alleges that, between 1999 and 2007, Barton, acting individually or through TwinSpan or Barton Asset Management, engaged in three separate securities frauds-including one involving a patient suffering from Alzheimer’s disease-and through his misconduct obtained over $3 million in ill-gotten gains. The Commission further alleges that he then spent his ill-gotten gains, among other things, to send his children to an exclusive private school, fund his own investment portfolio, and service his credit card debts. 

Manager Selection

So, how can the medical professional reduce the potential for similar behavior from his/her portfolio manager?

The first way is to skip the middle-man and “do-it-yourself.” But, doctors are sometimes hard-pressed to following this directive because of time constraints, knowledge paucity, fear/greed and/or disinterest; among other reasons.

The second way, of course, is to outsource the task by hiring a financial advisor. But, how do you find a financial advisor (easy), and more importantly, how do you discern a good fit (personally and professionally)? Still, there is no guarantee of honesty or capability.

But, your odds can be improved with insider knowledge of the financial services industry; a common-theme of the ME-P. And so, the following checklist may be a good place to start the selection, or triage process.  

SAMPLE: Engagement Letter

Mr. Joseph H. Sample

Vice President

Medical Capital Management of Nevada, LLC

RE: Letter to Request Pre-Interview Information from Portfolio Manager

Dear [Mr. Name]:

Thank you for agreeing to meet with us on [date, time] in our office. We are in the process of interviewing several portfolio investment managers.

So that we may obtain consistent information in our evaluation, we would appreciate the coverage of specific areas during your presentation. We are particularly interested in information regarding your approach to investment management in the following areas:

Investment philosophy and approach

• Describe your management style and any changes you have made over the past decade.

• Describe your investment decision-making process.

• Do you make the decisions or do you rely on others, and if so, who?

• Describe your sources of research.

• What contact, if any, do you have with the management of companies in which you invest?

• Briefly describe the sell disciplines employed by you and your firm.

• Describe whether/how you use top-down or bottom-up approaches to investment selection.

• Are you value or growth orientated; hedged or not; domestic or international?

Track record

• Please supply performance data by 5, 10 and 15-year intervals.

• Please supply performance records compared to benchmarks you feel appropriate.

• If balanced management, please provide performance data by asset class.

• Provide MPT or APT statistics such as beta, alpha, standard deviations, etc.

• What are your cash holdings; fully invested or selectively invested at various times?

• Turnover history and number of securities, industries and sectors; are guidelines in place?

• Typical portfolio percentage of largest ten positions.

Firm/advisor background

Please provide us with information regarding your background, including general information about the organization. In particular, please cover:

• The stability of ownership, managers, analysts or others directly involved in management.

• Who makes the investment decisions and how the firm dictates policy to managers?

• A description of expenses, including management fees, commissions, and other expenses.

• A detailed description of the growth of money under management over the past ten years.

• Please discuss the flexibility in design and management of a client’s portfolio by managers.

• If your firm is multidisciplined, what are your areas of expertise?

• Who is the custodian of securities? Does the firm have insurance?

Manager background

Please provide the resume(s) of the manager(s) as well as information about the manager’s style and consistency. Additional items of interest include:

• The manager’s record with other firms, if employed less than ten years.

• How the manager does research, including use of analysts and outside research?

• Regarding the decision process, what steps does the manager actually take?

• Manager’s ownership status in the firm?

• History of asset growth under the specific manager.

• Examples of past successes and failures on investment decisions.

Statistics

Please provide the following statistical information:

• Price/earnings ratios compared to market

• Price/book ratios compared to market

• Average earnings growth data

• Average market cap of companies in portfolio

• Average dividend yield information

• Average maturity and/or duration of fixed-income portfolios (and how this is managed)

• Average credit rating of fixed-income portfolios

• Where short-term funds are invested

Communication

• How often do you provide portfolio and performance reports?

• How do you compare performance to the market? What benchmarks do you use?

• Who will meet with us (and how often)?

• Who is the primary and secondary contact?

• Does the firm provide investment newsletters or promotional literature, with sample?

• Is the portfolio manager(s) available to meet or discuss issues with the client or advisor?

Compliance

• Are you a fiduciary? Will you sign-off as same?

• Are you a stoke-broker or registered representative?

• What securities licenses do you hold?

• Are you independent?

• Who is your broker-dealer?

• Who is your custodian and clearinghouse?

• Are you a RIA or RIA representative?

• May we please see you ADV Parts I, II, III

• May we review a sample investment policy statement?

• May we see your CRD report?

• Must we sign an arbitration clause?

• What educational degrees have earned?

• What financial/securities designation do you hold?

• What peer-reviewed or non-peered reviewed material have you published, and where? 

• What medical specificity do you possess?

• Do you hold the AIF® and/or AIFA® designations, and adhere to its code-of-ethics?

• Are you a [CMP] Certified Medical Planner™?

• Are you a [CFP] Certified Financial Planner™ with health economics knowledge?

• How do/can you demonstrate you specific knowledge on the heath care space?

Thank you.

Dr. Michael B. Sample; MD/DO

Managing Partner – Medical Associates of Nevada, PC  

Assessment

Some financial advisors, insurance agents, portfolio and wealth managers speak of “prospecting”, “hunting” or “screening” clients. In fact, potential doctor-clients are often, not-so-charmingly called, “prospects”.

Don’t you think it’s about time that the “tables-are-turned” by informed medical professionals, as the “hunted-becomes-the-hunter”, by the informed physician? Triage well, and always remember; caveat emptor and vendor emptor!

What other criteria should be included in this engagement letter, or personal interview itself? What has been your experience with portfolio manager selection? How do you select same, and what has been your success rate? Why don’t you do-it-yourself? Please comment and opine.

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:

Product DetailsProduct DetailsProduct Details

Product Details  Product Details

Frank A. Cappiello; MBA

About:

Financial Planning for Physicians and Advisors [second edition] 

fp-book3

Financial Planning for Physicians and Advisors is essentially a “how-to book” on finance, financial planning and related topics for healthcare providers. 

Fortunately for patients, medicine requires a high degree of professional training, both in terms of science and technology. Unfortunately for providers, it affords little time for acquiring medical practice management skills, or learning about the financial aspects of business or investment planning. 

More to the point, this is an unusual textbook on financial planning for two reasons:

  1. First, it is a detailed guide for physician’s seeking the complex road to success and profit in the confusing healthcare industrial complex.  Rarely does one see such clarity of presentation, without the usual jargon that often discourages those trying to learn such a foreign and forbidding subject, as finance.  
  2. Second, the subject matter is focused for medical providers who work in one of the fastest growing industries in the United States.

The contributors hope that by integrating both disciplines of finance and medical management, they will help foster affordable and profitable healthcare for our nation, which is so entrepreneurial, yet aging. I

In my thirty-five years on Wall Street, I have observed that physicians are particularly disadvantaged when it comes to anything regarding finance. 

Most medical professionals have enough on their mind practicing their specialty and keeping up with healthcare technology and practice trends, that planning for their financial future is often forgotten. 

Financial planning and good investment practices require a solid background of how companies work in the “real world”, and an awareness of how they function within the economy. These economic essentials are vital to understanding business, as principles like budgeting, risk management, cash flow analysis, fiscal benchmarking and rudimentary accounting are presented in this book. 

Furthermore, the necessity of keeping up with state and federal insurance legislation, the Health Insurance Portability and Accountability Act and other complex managed care contracting issues, places a continual burden on the individual practitioner, group or medical network seeking to stay abreast of current developments.  

But, the text focuses on financial planning and how the healthcare professional can increase personal knowledge and skills in this area. The coverage is both broad and yet detailed, ranging from basic macroeconomic factors that affect our national economy, such as the Gross Domestic Product (a single figure that summarize the business activity of the US), to the more mundane activities of maintaining cash flow, tax reduction strategies, home mortgages and even correcting credit card reporting errors. 

More sophisticated topics include: debt and equity investment vehicles, derivatives, mutual fund and hedge fund investing, portfolio management and risk analysis, and the new laws on tax, retirement and estate planning.

The book rightly concludes with practice succession planning for doctors, and begins with a chapter on the psychological meaning of money itself.

It seems to me that all those in healthcare are well-served by reading this book with its format and step-by-step setup process for financial success, in terms of starting and ultimately surviving in a complicated business full of pitfalls and misinformation.  

Most useful will be the extremely detailed table of contents that allows the user to quickly pinpoint an area of interest, and get started answering a problem. 

Simply put, my recommendation is to read: Financial Planning for Physicians and Advisors, and “reap”

Frank A. Cappiello; MBA
President, McCullough, Andrews & Cappiello, Inc
10751 Falls Road Suite 250
Lutherville, MD  21093
Distinguished Visiting Professor of Finance
Loyola College, Maryland

Former Wall $treet Week with Louis Rukeyser Guest and Host

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:

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

Product Details  Product Details

Anthony Silva MD MBA

About:

The Business of Medical Practice [first edition]

In the current healthcare insurance crisis, THE BUSINESS OF MEDICAL PRACTICE (Profit Maximization for Savvy Doctors) is a first edition textbook of specific value to all medical practitioners, since declining re-imbursements, increasing expenses, federal regulations, and even Wall Street are all raising havoc with physician income and patient care.   

Contrary to conventional wisdom, we do not believe that draconian free market competition will dramatically reduce healthcare costs, for three reasons.

  • First, it is difficult to define medical quality.
  • Second, a perfectly competitive marketplace does not exist.
  • Thirdly, American society is not ready for the brutally rational efficiencies of the business world.
  • “Above all else”, medicine is a uniquely personal experience.  

On the other hand, we are pragmatic and realize that practicing healthcare providers of all independent degree designations (allopathic, osteopathic and podiatric physicians, dentists, optometrists, chiropractors, psychologists, physician assistant’s, physical therapists and nurse practitioners), must learn to better compete in the next decade. Ultimately, practitioners who seek to be clinically and economically responsible are the wave of future. It is the physician-executive with MBA or managerial training, who can best direct future systems of autonomous care, with improved outcomes for patient, payer and physician alike. 

The information in this text will help achieve this goal and is most applicable to the solo or small group practice; or for those who aspire to be decision makers.  

For the employed physician or resident, it will also serve as a blueprint for what can still be achieved. And, for the practice administrator, it will serve as a guide to the next generation of medical networks, IPAs or more complex large group management endeavors. 

THE BUSINESS OF MEDICAL PRACTICE (Profit Maximization for Savvy Doctors) is written in prose form, using non-technical jargon, without the need to document every statement with a citation from the literature. This allows a large amount of information to be condensed into a single and practical volume. It also allows the reader to comprehend an important concept in a single reading session, with a deliberate effort to include germane examples with updated information. The interested reader is then able to research selected topics. Overlap of material has also been reduced, but important concepts are reviewed for increased understanding.  

The textbook itself is divided into major three major sections, written by 20 contributing authors, and with the concepts developed in Section II (quantitative) and Section III (contemporary), building on those of Section I (qualitative). Each section is then divided into multiple parts, for a total of 25 logically progressive, yet stand-alone, chapters. 

Chapter 1 briefly reviews the history of healthcare economics in the United States; from the days of private pay, to indemnity insurance and the “golden era of medicine”, to contemporary managed care. Chapter 2 discusses the uses and abuses of restrictive covenants in physician employment contracts, since more than 40% of the nations’ contemporary physicians are now employees rather than independent practitioners. Chapter 3 focuses on office labor cost reduction tactics through permanent outsourcing and employee leasing options, as human resource management is the major expense driver of any medical practice. Chapter 4 surveys the management information technology (hardware and software) required for the modern digital office, while Chapter 5 extols nuances of proper CPT coding and documentation in a skeptical payer climate. The basics of capitation contracting econometrics are examined in Chapter 6. Chapter 7 provides strategies for effective managed care relations by understanding, obtaining, negotiating and servicing managed care contracts, and Chapter 8 represents a legal discourse on non-clinical risk management issues, as Section I is concluded. 

Section II begins the quantitative aspects of the book, as Chapter 9 investigates the perils of indiscriminate cash flow control in rising, declining and neutral growth environments. Chapter 10 presents basic concepts of fixed and variable office cost behavior, among others, while Chapter 11 reviews activity-based-costing as a watershed concept to most physicians that has become the costing method of choice in the hyper competitive environment. Chapter 12 explores advanced cost-volume accounting techniques, emphasizing the non-traditional contribution margin approach to the income statement, with numerous spreadsheet examples to enhance understanding. Chapter 13 introduces vital financial methods to calculate and augment return on office investment and its resulting residual income. Chapter 14 on financial ratio analysis represents the economic benchmarking equivalent of the clinical outcomes chapter; and surveys the typical office for lost sources of profit. Chapter 15 highlights the business philosophy required to create real practice equity value in an era of healthcare mergers and acquisitions, while Chapter 16, on practice valuation techniques, concludes the section and emphasizes the discounted cash flow method of appraisal since bricks and mortar are becoming increasingly worth less. It is an important chapter for the retiring practitioner in the quest for a proper payoff after years of hard work.  

Section III of the book begins with Chapters 17 and 18 and provides utilization review, and clinical benchmarking information respectively. Chapter 19 discloses the contentious issue of medical anti-trust and the ERISA managed care exemption. Chapter 20 offers a sobering musing on change management and the new role of the physician as follower, rather than leader, of the healthcare revolution. Chapter 21 critiques Wall Street’s newest security machination, the PPMC as the initial euphoria, debacle and future of this business model is discussed using real-life examples. Chapter 22 redefines the standard of medical care to incorporate insurer financial restraints, while Chapter 23 similarly opines on the ethical and moral issues of managed medical care. Chapters 24 presents important asset protection strategies useful in an increasing litigious atmosphere, and Chapter 25 rightly concludes the third section, and book, with a discussion on choosing the business management advisor that represents the best fit for both the office milieu and individual practitioner. 

In conclusion, as you read, study and reflect on this challenging textbook, remember the guiding philosophy of Eric Hoffer: “In a time of drastic change; it is the learners who will inherit the future. The learned find themselves equipped to live in a world that no long exits”. 

Good medicine, Good business and Good day!  

Anthony Silva; MD, MBA

Anesthesiology Department

Emory-Northlake Regional Medical Center

Emory University Goizueta School of Business

Atlanta Georgia, USA

Speaker: If you need a moderator or a speaker for an upcoming event, Dr. David Edward Marcinko; MBA – Editor and Publisher-in-Chief – is available for speaking engagements. Contact him at: MarcinkoAdvisors@msn.com

 

Product Details

Third Edition 2011

Michael J. Stahl; PhD

FOREWORD

Dictionary of Health Insurance and Managed Care

dhimc-book2

Q: Why do we need the Dictionary of Health Insurance and Managed Care?

And, why do payers, providers, benefits managers, consultants and consumers need a credible and unbiased source of explanations for their health insurance needs and managed care products?

The answer is clear!  Healthcare is the most rapidly changing domestic industry. The revolution occurring in health insurance and managed care delivery is particularly fast. Some might even suggest these machinations were malignant, as many industry segments, professionals and patients suffer because of them. And so, since knowledge is power in times of great flux, codified information protects us all from physical, as well as economic harm.

For example, federal government forecasts reveal that total expenditures on health services will surpass $2 Trillion in 2007, and account for 17% of Gross Domestic Product. As a country, we spend dramatically more total dollars on healthcare, and more as a percent of the economy, than we did two decades ago. Along with these growing expenditures, the government is assuming greater control.

Currently, almost 50% of healthcare costs are under Federal and/or State mandates through Medicare and Medicaid entitlement programs. The recent prescription drug program and implementation of the Health Insurance Portability and Accountability Act adds more confusion to medical providers and facilities, insurance agents, health plans and patients.

This tumult occurred so rapidly that we can no longer assume operative definitional stability. The resulting chaos is as expected.  Fortunately, the Dictionary of Health Insurance and Managed Care provides desperately needed nomenclature stability to health insurance policy issues and managed care procedural concerns.

With almost 10,000 definitions, abbreviations, acronyms, and references, the Dictionary is the most comprehensive and authoritarian compendium of its kind, to date. 

Healthcare economist Dr. David Edward Marcinko, and his colleagues at the Institute of Medical Business Advisors, Inc., should be complimented for conceiving and completing this laudable project.

The Dictionary of Health Insurance and Managed Care lifts the fog of confusion surrounding the most contentious topic in the healthcare industrial complex, today.  

My suggestion therefore, is to “read it, refer to it, recommend it, and reap”. 

Michael J. Stahl; PhD
Director, Physician Executive MBA Program
William B. Stokely Distinguished Professor of Business
The University of Tennessee
College of Business Administration
609 Stokely Management Center
Knoxville, TN 37996-0570 USA

 

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