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About the Mortgage Electronic Registry System

Posted on November 29, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Loan Help or Hindrance?

By Dr. David Edward Marcinko MBA, CMP™

[Editor-in-Chief]

According to their website, Mortgage Electronic Registry System [MERS] is an innovative process that simplifies the way mortgage ownership and servicing rights are originated, sold and tracked. Created by the real estate finance industry, MERS eliminates the need to prepare and record assignments when trading residential and commercial mortgage loans www.MERSInc.org Sounds good, right?

State Laws

Unfortunately, property law is handled on a state-by-state basis and digital MERS may not be a legal replacement for paper. In fact, MERS use may devalue the physical paper trail and lead to lost or misplaced loan documents [aka: admissible evidence].

Assessment

As a financial advisor for more than 15 years, and a former certified financial planner for more than a decade, who resigned due to the industry’s lack of fiduciary accountability, I appreciated this issue deeply

www.MedicalBusinessAdvisors.com

Full Disclosure:

I am also the Founder and CEO of www.CertifiedMedicalPlanner.com; an online certification, licensure and educational program for financial advisors and medical management consultants working in the healthcare space; who are always fiduciary advisors.

Conclusion

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

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

Healthcare Organizations: www.HealthcareFinancials.com

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Filed under: CMP Program, Financial Planning, iMBA, Inc., Information Technology, Mortgage Electronic Registry System, Op-Editorials | Tagged: certified medical planner, CMP, commercial mortgage loans, david marcinko, home loans, MERS, Mortgage Electronic Registry System, mortgage ownership, real-estate, residential mortgage loans, www.certifiedmedicalplanner.com, www.medicalbusinessadvisors.com | 2 Comments »

What is the Role of a Physician-Focused Financial Advisor?

Posted on November 22, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Changing Times – Demand Changing Roles

By Dr. David Edward Marcinko MBA, CMP™

Editor-in-Chief

www.HealthcareFinancials.com

As a financial advisor for more than 15 years, it has been my experience that many doctors who require assistance in developing a comprehensive personal financial plan also need help with implementing any investment planning recommendations. While perhaps not so true before the “flash-crash” of 2008-09, the issue seems especially true today as retirement portfolios have been decimated, and the specter of healthcare reform is no longer just a threat but a political reality. The mindset of hubris has been replaced by a tone of fear in many medical colleagues.

The Financial Advisors

Physician investors who develop an investment plan may use a competent financial advisor [FA] or other specialist in the investment area. A financial advisor can help clients understand their current financial situations and develop strategies for achieving their goals. Other FAs are specialists that help clients design and implement plans for investing. Still others use a more comprehensive approach to the entire financial planning process with extreme degrees of healthcare specificity

www.CertifiedMedicalPlanner.com

These Certified Medical Planners™ are fiduciaries at all times and put client needs first as registered investment advisors [RIAs], not commissioned sales agents or mere stock-brokers despite often confusing monikers.

Implementation

Implementation may be accomplished using professionally managed portfolios and mutual funds. The following shows how a plan may be implemented with an advisor assisting the physician-investor. The process may include:

• Developing investment policy and strategies

• Selecting and implementing managed portfolios and mutual funds

• Evaluating performance on a periodic basis

• Periodically reviewing and adjusting the investment plan as required

Note: The advisor may provide all of the investment services, or the physician investor may use other advisors in the process.

Example:

A financial planner has developed a number of financial planning recommendations for a client. One recommendation is to develop a written investment plan, review current investments, and implement changes. The planner has recommended an investment advisor experienced in selecting and monitoring managed portfolios and mutual funds. The financial planner will meet with the client and advisor initially and once each year to monitor the plan.

Example:

A financial planner has developed a financial plan for a client. The financial planner specializes in developing investment policy but not in implementing investments. The financial planner will use asset allocation software and develop a written long-term plan for the client. The doctor-client will work with a major brokerage firm to implement the plan using managed portfolios and mutual funds. The financial planner will monitor the brokerage firm and help the client evaluate performance.

Example:

A financial planner has developed a financial plan for a physician-client and will assist the client in developing asset allocation strategies. The planner has extensive knowledge in implementing the asset allocation strategies using managed portfolios and mutual funds. The planner will select and monitor the choices. The planner will provide the client with a quarterly performance report and meet with the client every six months to review the plan and strategies.

Assessment

Understanding the above is more critical than ever as physician-income continues to shrink going forward in the era of healthcare reform.

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. Do you seek professional assistance with your investing needs, or do you go-it-alone; why or why not? Then, subscribe to the ME-P. It is fast, free and secure.

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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

Physician Advisors: www.CertifiedMedicalPlanner.com

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Filed under: CMP Program, Financial Advisor Listings, Investing, Op-Editorials, Portfolio Management | Tagged: certified medical planner, CMP, david marcinko, fiduciary, financial advisor, financial planner, Financial Planning, Investing, registered investment advisor, RIA, www.certifiedmedicalplanner.com, www.healthcarefinancials.com | 4 Comments »

The ME-P Recommends: Financial Planning and Risk Management Handbooks

Posted on November 21, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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Filed under: Accounting, Book Reviews, Career Development, Estate Planning, Ethics, Financial Planning, iMBA, Inc., Insurance Matters, Portfolio Management, Practice Management, Practice Worth, Retirement and Benefits, Risk Management, Taxation | Tagged: CMS, david marcinko, Financial Planning, Health Economics, Health Insurance, HMO, Managed Care, medical endowments, medical risk management, medicare, physicians, Portfolio Management, PPO | 1 Comment »

On Medical Practice [Business] Succession Planning

Posted on November 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A Process of Financial Steps

By Dr. David Edward Marcinko, MBA CMP™

[Editor-in-Chief]

http://www.CertifiedMedicalPlanner.org

Succession planning is a dynamic process requiring current ownership and management to plan the medical practice or company’s future, and then implement the resulting plan. As a financial planner and advisor myself, I see many doctors and clients approach business [practice] succession planning initially through retirement planning. Once they understand the issues and realities of the tax laws, they are much more amenable to working out a viable succession plan. Many doctors and other clients have not clearly articulated their goals, but have many pieces of the plan that need to be organized and analyzed by the financial planner to meet their objectives, including both personal and financial issues.

A Step-Wise Process

The steps necessary for successful succession planning are as follows:

• Gathering and analyzing data and personal information

• Contacting the doctor [client’s] other advisors

• Valuing the medical practice or business

• Projecting estate and transfer taxes

• Presenting liquidity needs

• Gathering additional corporate information

• Identifying dispositive and financial goals

• Analyzing the needs and desires of nonfamily key employees

• Identifying potential ownership, physician-executive and/or management successors

• Making recommendations, modifying goals, and providing methodologies

• Assisting the doctor-client in implementation

Gathering and Analyzing Data and Personal Information

The first step in data collection is talking to the doctor or client, and explaining the process of gathering data. Most successful financial planners use a questionnaire to be sure to address all important information. The planner should gain an understanding of the interrelationships between the practice, family and the business and address each of these areas as separate parts of the same equation. Finding out how the practice or business operates and why it operates that way can help the planner determine whether change is necessary and how to go about implementing it. Other important elements to address include the environment in which the practice [business] operates, potential flaws in the current structure and operations, appropriate levels of key-person life insurance coverage, investment asset diversification, prior estate planning efforts, and existing legal contracts that may need modification.

A Timely Process

It may take some time, from weeks to months, for the client to gather the required information. The planner should be encouraging and should periodically check on the doctor-client’s progress. If it appears that the client may not be motivated to complete the questionnaires independently, the planner should schedule an appointment to help the doctor-client finish. The client may create obstacles because he or she does not want to talk about death or relinquish control of the practice or business. These are delicate topics, and the financial planner cannot force the client to face them. Still, the consequences of not carrying out personal financial and estate planning can be explained.

Understanding the Practice or Business

To be most helpful to the doctor-client, the financial planner must understand the client’s medical practice or business. Reviewing the history of the company, getting acquainted with its current operations, and becoming familiar with the industry is important. By reviewing financial statements, income tax returns, business plans, and all pertinent legal documents, the planner will be able to identify key areas to focus on during the engagement. Understanding the patient or customer base of the business is also important. For example, exploring the impact of the principal’s death on the patient [customer] base helps the financial planner understand what changes could occur in the business after the physician-owner’s death.

Fair Market Valuation

Next, the planner must translate the balance sheet to current fair market values and analyze the debt, capital structure, and cash flows. A review of accounts receivable, inventory, and any fixed assets should be included to determine whether there is sufficient collateral for a leveraged buy-out or other estate planning technique for succession planning. Also, the cash flow should be reviewed to see if new fixed payments such as debt repayments or dividend distributions could be made.

Contacting the Doctor-Client’s Other Advisors

After gathering the documents, it’s a good idea for the planner to contact the client’s attorney, accountant or tax advisor, bank or trust officer, insurance advisor, investment advisor, stockbroker, and other business advisors. As many key advisers as possible should be contacted early in the engagement to create a spirit of cooperation. A planner will benefit by creating team harmony and establishing himself or herself as the team leader. Additionally, a planner could be engaged by these professionals in the future, and a planner is a valuable source of referrals.

Valuing the Medical practice of Business

The next step in the succession planning process is computing the value of the practice or business. It may surprise the planner to hear what the doctor or client perceives as the value of the [practice] business at the beginning of the engagement. Likewise, the client may be surprised to hear what value could be placed on the business for estate tax purposes. The goal in valuation is determining the price at which the business would change hands between a willing buyer and a willing seller, assuming:

• The buyer is not under any compulsion to buy.

• The seller is not under any compulsion to sell.

• Both parties have reasonable knowledge of the relevant facts.

Revenue Ruling 59-60 (1959-1, CB 237

The IRS issued Revenue Ruling 59-60 (1959-1, CB 237), which lists several factors to be used in valuing a business:

• Nature and history of the practice or business

• Economic outlook and condition of the healthcare industry

• Book value and financial condition of the practice or business

• Earning capacity of the practice or business

• Dividend-paying capacity of the practice or business

• Value of any goodwill or other intangibles

• Value of similar stocks traded on open markets

• Degree of control represented by the size of the block of stock interest

Highest and Best Use

The IRS computes a value based on the “highest and best use” of the practice or business. This means that the business will be valued by the IRS at the highest possible value that can be reasonably justified. Valuation methods include the asset approach, income approaches, and market approach.

• Asset approach: This is primarily used for a business that is worth more if it is sold in pieces rather than as a whole. The tangible asset value is added to the intangible goodwill value.

• Income approaches: A business as a going concern has value in its ability to produce profits in the future. These profits represent a return on the investment. The value of the business is a function of expected profits and desired rate of return.

— Discounted future earnings method: Projected future earnings are discounted to present value.

— Discounted cash flow method: Cash that the owner can withdraw from the business is discounted to present value.

— Capitalization of earnings method: Expected earnings are divided by the capitalization rate.

— Capitalization of excess earnings method. Expected earnings that are not needed in the business are divided by the capitalization rate.

• Market approach: A business is worth what similar businesses sell for. Referred to as the comparable method of business valuation, this method should be used only when the comparable business is truly comparable.

Each of these primary methods has numerous variations that may provide a more desirable or justifiable value.

Assessment

When reviewing potentially taxable estates, the planner should analyze the opportunity to use favorable valuation discounts for loss of a key employee, lack of marketability, or possibly a minority discount for lack of control. Alternatively, planning recommendations can be made to avoid exposure to valuation premiums for control. The physician-owner may avail himself or herself of many of these discounts by reducing holdings to less than 50% prior to death.

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.

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Estate Planning, Financial Planning, Practice Management, Practice Worth, Retirement and Benefits | Tagged: david marcinko, Estate Planning, Financial Planning, medical pratice worth, retirement planning, www.healthcarefinancials.com | 3 Comments »

Financial Planning and Risk Management Handbooks from iMBA, Inc

Posted on November 6, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

For Doctors and their Financial Advisors

[By Staff Reporters]

For more on these topics, see the handbooks below:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

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

Filed under: Estate Planning, Financial Planning, Glossary Terms, Insurance Matters, Investing, Portfolio Management, Professional Liability, Retirement and Benefits, Risk Management | Tagged: david marcinko, Estate Planning, Financial Planning, Financial Planning for Physicians and Advisors, iMBA, Investing, Portfolio Management, retirement planning, Risk Management | 3 Comments »

Useful Managed Care Provider, Staffing, Activity and Financial Trends

Posted on November 5, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Part Two

By Dr. David Edward Marcinko MBA

[Publisher-in-Chief]

If you read this ME-P regularly or have read my earlier blogs, you know that I am writing a book on practice management for the private medical practitioner.

The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors]; third edition: www.BusinessofMedicalPractice.com

Link: Front Matter BoMP – 3

A recent story in the Chicago Tribune on the difficult business life of private practitioners today reminds me that I need to keep my nose to the grindstone.

For example, according to the sanofi-aventis Pharmaceutical Company Managed Care Digest Series, for 2008-10, the following patterns and comparative trend information has been empirically determined and may provide a basic starting point for medical practitioners to share business management, facilities, personnel, and records information for enhanced success www.managedcaredigest.com

Mid-Level Provider and Staffing Trends

Mid-level provider use increased among multi-specialty groups, especially in those with more than half of their revenue from capitated contracts. Use also rose with the size of the practice and was highest with OB/GYN groups.
Medical support staff for all multi-specialty groups fell and was lowest in medical groups with less than 10 full-time equivalent (FTE) physicians. However, groups with a large amount of capitated revenue actually added support staff. Smaller groups limited support staff.
Compensation costs of support staff increased and the percentages of total operating costs associated with laboratories, professional liability insurance, IT services, and imaging also increased. Support staff costs increase with capitation levels and more than half of all operating costs are tied to support staff endeavors.

Managed Care Activity and Contracting Trends

More medical group practices are likely to own interests in preferred provider organizations (PPOs) than in HMOs and the percentages of groups with managed care revenue continues to rise. Multi-specialty and large groups also derive more revenue from MCOs than single specialty or smaller groups.
Managed care has little effect on physician payment methods that are still predominantly based on productivity. Physicians were paid differently for at-risk managed care contracts in only a small percentage of cases.
Most medical groups (75%) participating in managed care medicine have PPO contracts. Group practices contract with network HMOs more often than solo practices. Single-specialty groups more often have PPO contracts.
Capitated lives often raise capitation revenues in large group practices. Group practices are more highly capitated than smaller groups or solo practices. Almost 30% of highly capitated medical groups have more than 15 contracts and 22% have globally capitated contracts.
Higher capitation is linked with increased risk contracting. Larger groups have more risk contracting than smaller groups.

Financial Profile Trends

Medicare fee-for-service reimbursement is decreasing. Highly capitated groups incur high consulting fees.
The share of total gross charges for OB/GYN groups associated with managed care at-risk contracts is rising while non-managed care, or not-at-risk charges are declining.
Capitated contracts have little effect on the amount of on-site office non-surgical work. Off-site surgeries are most common for surgery groups, not medical groups.
Half of all charges are for on-site non-surgical procedures.
Highly capitated medical groups have higher operating costs and lower net profits.
Groups without capitation have higher laboratory expenses than those who do.
Physician costs are highest in orthopedic surgery group practices. Generally, median costs at most specialty levels are rising and profits shrinking.

Assessment

Obviously, the above information is only a gauge since regional differences, and certain medical sub-specialty practices and carve-outs, do exist.

Part One: Useful Managed Care Patterns and Procedural Utilization Trends

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: "Doctors Only", Book Reviews, Career Development, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Information Technology, Managed Care, Practice Management, Recommended Books, Touring with Marcinko | Tagged: Business of Medical Practice, capitation, david marcinko, healthcare administration, HMOs, hope hetico, Managed Care, PPOs, Practice Management, www.BusinessofMedicalPractice.com | 1 Comment »

Events Planner: November 2010

Posted on November 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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Events-Planner: NOVEMBER 2010

By 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 Medical Executive-Post is still a relative newcomer. But today, we have almost 175,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. 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.

So, enjoy the Medical Executive-Post and this monthly Events-Planner with our compliments.

A Look Ahead this Month: Now, the important dates:

November 07: World Congress Health Innovation Meeting. Alexandra, VA

November 08: Patient Centered Medical Homes and ACOs, Hartford, CT

November 08: Medical Compliance Meeting in a Post Reform World, Baltimore, MD

November 11: Conducting Effective internal Medical Investigations, HCCA, Orlando, FL

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

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Insurance and Risk Management Strategies for Physicians and Advisors

Posted on October 30, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A Vital Handbook for Doctors

[By ME-P Staff Reporters and their Consulting Advisors]

For practicing physicians, selecting a knowledgeable insurance advisor and developing a comprehensive personal and corporate risk management plan can be a daunting task. As a consequence of today’s litigious environment in the healthcare industry, physicians must now carefully assess their personal and practice risks as they seek to be indemnified should an event or cause of action occur. This process requires integrated knowledge of the healthcare industrial complex, as well as the rapidly changing insurance industry.

The Reality

Fortunately, Insurance and Risk Management Strategies for Physicians and Advisors confronts the reality that insurance planning in healthcare is decidedly more complex than most other businesses or professions and, in an easy-to-understand manner, explains to physicians and insurance professionals the background, theory, and practicalities of medical risk management and insurance planning.

Certified Medical Planner® Dr. David Edward Marcinko and his team of contributing authors go into great depth on the growing range of insurance planning options in order to assist physicians, and their advisors, to choose the “right” course that balances risk, cost, time, outcome as well as his or her own personal risk tolerance life style.

Insurance and Risk Management Strategies for Physicians and Advisors is ideal for medical professionals and the insurance advisors who seek to serve them, as well as for financial planners, insurance agents and healthcare business advisors wishing to re-educate and help doctors by adding lasting value to their client relationships.

Assessment

Includes tools, templates, case studies, glossary of terms, and examples required to make insurance issues “come alive” in a real world setting

From the Foreword:

“Insurance and Risk Management Strategies for Physicians and Advisors is an essential textbook because it explains to physicians and insurance professionals the background, theory, and practicalities of medical risk management and insurance planning. The insurance haze is lifted by dual-degreed editor, and Certified Medical Planner© Dr. David Edward Marcinko, and his team of contributing authors.

Insurance and Risk Management Strategies for Physicians and Advisors fulfills its promise as a peerless tool for physicians wanting to make good decisions about the risks they face. It is also ideal for financial planners, insurance agents and healthcare business advisors wishing to re-educate and help doctors by adding lasting value to their client relationships. With time at a premium for all, and so much information packed into one well-organized resource, this book should be on the desk of every physician, or financial advisor serving the healthcare space.

Simply stated, if you read this compelling text with a mind focused on the future, the time you spend will be amply rewarded.”

Lloyd M. Krieger, MD, MBA
Rodeo Drive Plastic Surgery
The Rodeo Collection
421 North Rodeo Drive
Beverly Hills, CA 90210
Phone: 310.550.6300
Fax: 310.550.6363
Email: lkrieger@ucla.edu
http://www.RodeoDrivePlasticSurgery.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Book Reviews, CMP Program, Insurance Matters, Professional Liability, Recommended Books, Risk Management | Tagged: david marcinko, hope hetico, insurance, Insurance and Risk Management Strategies for Physicians and Advisors, Risk Management Strategies Doctors | 7 Comments »

Useful Managed Care Patterns and Procedural Utilization Trends

Posted on October 27, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Part One of Two

By Dr. David Edward Marcinko MBA

[Publisher-in-Chief]

If you read this ME-P regularly or have read my earlier blogs, you know that I am writing a book on practice management for the private medical practitioner.

The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors]; third edition: www.BusinessofMedicalPractice.com

Link: Front Matter BoMP – 3

And, a recent story in the Chicago Tribune on the difficult business life of private practitioners today reminds me that I need to keep my nose to the grindstone.

For example, knowing your medical contract negotiation objectives, gathering information on the choices of contracts and discount payment systems, and understanding the pitfalls to watch for when evaluating a contract are the keys to any successful negotiation process.

Reimbursement Contract Negotiations

According to the sanofi-aventis Pharmaceutical Company Managed Care Digest Series, for 2008-10, the following pattern and trend comparative information has been empirically determined and may provide a basic starting point for practitioners to share business management, facilities, personnel, and other records for enhanced contract negotiation success.

www.managedcaredigest.com

Procedural Utilization Trends

Among all physicians in a single-specialty group practice, invasive cardiologists averaged the most encounters with total hospital inpatient admissions down from the prior year. However, encounters rose for cardiologists in multispeciality group practices.
Echocardiography was the most commonly performed procedure on HMO seniors, followed by coronary artery bypass graft surgery. Group practices performed cardiovascular stress tests for circulatory problems most often.
CT studies of the brain and chest were the most common studies for HMO seniors, while MRI head studies were the most common diagnostic test on commercial HMO members.
Colonoscopy was the most common digestive system procedure on senior HMO members, while barium enemas were more common on commercial members.
Hospital admission volume decreased for allergists, family practitioners, internists, OB/GYNs, pediatricians, and general surgeons.
Internists ordered more in-hospital laboratory procedures than any other physicians in single-specialty groups.
Non-hospital MD/DOs used in-hospital radiology services most frequently, continuing a three-year upward trend.
Pediatricians averaged the most ambulatory encounters, down from the prior year.
Non-hospitalist internists ordered a higher number of in-hospital laboratory procedures than any other single medical specialty group, but allergists and immunologists increased their laboratory usage.
The number of ambulatory encounters increased for general surgeons, while group surgeons had the most cases. Capitated surgeons, of all types, had a lower mean number of surgical cases than surgeons in groups without capitation. Surgeons in internal medical groups also had more cases than those in multi-specialty groups.
The average number of total office visits per commercial and senior HMO visits fell, along with the number of institutional visits for both commercial and senior HMO members.
The average length of hospital stay for all commercial HMO members increased to 3.6 days but decreased to 6 days for all HMO members.
The total number of births increased for commercial HMO members served by medical group practices, and decreased for solo practitioners.
More than one-third of all medical groups use treatment protocols, rising from the year before. Multi-specialty groups were more likely to use them than single-specialty groups, who often develop their own protocols. The use of industry benchmarks to judge the quality of healthcare delivery also increased.
Outcome studies are most common at larger medical groups, and multi-specialty groups pursue quality assurance activities more often than single-specialty groups.
Provider interaction during office visits is increasingly coming under scrutiny. Patients approve of cardiologists more frequently than allergists and ophthalmologists.

Assessment

Obviously, the above information is only a gauge since regional differences, and certain medical sub-specialty practices and carve-outs, do exist.

Part Two: Useful Managed Care Provider, Staffing, Activity and Financial Trends

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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FINANCE:Financial Planning for Physicians and Advisors
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Filed under: "Doctors Only", Book Reviews, Career Development, CMP Program, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Practice Management, Quality Initiatives, Research & Development | Tagged: Business of Medical Practice, david marcinko, DOs, EHRs, EMRs, healthcare administration, HMO, hope hetico, Managed Care, Managed Care Digest Series, MDs, medical outcomes, medical practice management | 2 Comments »

Engage the ME-P for your Physician-Advisor Social Media Strategy

Posted on October 16, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

The ME-P is at your Service

By Ann Miller RN MHA [Executive Director]

Do you need to engage physicians and/or their related financial advisors and management consultants? Learn how to use the ME-P’s social media tools to conduct research and create product and brand awareness.

Our ME-P Platform

Accordingly, use the ME-P platform, surveys, polls, publishing, posting and commenting platform, and other advanced online tools like web-casts and pod-casts to reach this highly active advisory and /or physician community:

Target physicians and advisors in the healthcare space.
Engage physicians and advisors quickly using ME-P’s unique social media tools.
Analyze the results of your campaigns in days, not weeks.

Assessment

For more info: MarcinkoAdvisors@msn.com

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The ME-P Recommends [Our Newest Book Review]

Posted on October 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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

Book Review and Order Placement

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

“Live” Website Community

www.BusinessofMedicalPractice.com

About the Editor-in-Chief

Dr. David Edward Marcinko, a former residency director, department chairman, and hospital vice-president in Atlanta GA, retired from clinical practice at the age of 45 after selling his Ambulatory Surgery Center to a public company. As a fellow and board certified surgeon, he authored more than two dozen medical and business textbooks in three languages, teaching and operating in the EuroZone, co-founding a pre-IPO PPMC, and forming a series of successful internet ventures while still maintaining a 60 hour work week.

His companies have created dozens of cognitive products in the last few years that maintain a comfortable lifestyle that started from his home office after retirement. Dr. Marcinko picked up an MBA degree, became a certified financial planner and insurance agent, and developed a cult following thru collaborative on-ground and online education for physicians, financial advisors and management consultants. A social media pioneer and publisher, this Medical Executive-Post is an influential syndicated blog with thousands of content contributions from nationally know experts.

Dr. Marcinko is a highly sought after futurist and speaker in the areas of health economics, financial planning, medical practice management and related entrepreneurial e-insights for intersecting sectors in the healthcare industrial complex.

Edited with Professor Hope Rachel Hetico of the Institute of Medical Business Advisors [iMBA] Inc www.MedicalBusinessAdvisors.com

Financial Planning and Risk Management Handbooks for Doctors

Filed under: Book Reviews, Career Development, iMBA, Inc., Practice Management, Recommended Books | Tagged: Business of Medical Practice, david marcinko, hope hetico, www.BusinessofMedicalPractice.com | 3 Comments »

Understanding the Medical Records R[e]Volution

Posted on October 13, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

It’s Not All about Electronic Records

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

Introduction

To understand the medical records revolution that has occurred this decade, put your self for a moment in the position of a third-party payer; ie; a private insurance company, Medicare or Medicaid etc.

For example, you want to know if Dr. Joel Brown MD actually gave the care for which he is submitting a [super] bill or invoice. You want to know if that care was needed. You want to know that the care was given to benefit the patient, rather than to provide financial benefit to the provider beyond the value of the services rendered.

www.BusinessofMedicalPractice.com

Of Doubts and Uncertainty

Can you send one of your employees to follow Dr. Brown around on his or her office hours and hospital visits? Of course not! You cannot see what actually happened in Dr. Brown’s office that day or why Dr. Black ordered a PET scan on the patient at the imaging center. What you can do however, is review the medical record that underlies the bill for services rendered from Dr. Blue. Most of all, you can require the doctor to certify that the care was actually rendered and was indicated. You can punish Dr. White severely if an element of a referral of a patient to another health care provider was to obtain a benefit in cash or in kind from the health care provider to whom the referral had been made. You can destroy Dr. Rose financially and put him in jail if his medical records do not document the bases for the bills he submitted for payment.

The Payment Paradigm Shift

This nearly complete change in function of the medical record has precious little to do with the quality of patient care. To illustrate this medical records evolution/revolution point, consider only an office visit in which the care was exactly correct, properly indicated and flawlessly delivered, but not recorded in the office chart. As far as the patient was concerned, everything was correct and beneficial to the patient. As far as the third-party payer is concerned, the bill for those services is completely unsupported by required documentation and could be the basis for a False Claims Act [FCA] charge, a Medicare audit, or a criminal indictment. We have left the realm of quality of patient care far behind.

Provider Attitude Adjustments Required

Instead, medical practitioners must adjust their attitudes to the present function of patient records. They must document as required under pain of punishment for failure to do so. That reality is infuriating to many since they still cling to the ideal of providing good quality care to their patients and disdain such requirements as hindrances to reaching that goal. They are also aware of the fact that full documentation can be provided without a reality underlying it. “Fine, you want documentation? I’ll give you documentation!”

Computer Charting and eMRs

Some doctors have given in to the temptation of “cookbook” entries in their charts, canned computer software programs or eMRs listing all the examinations they should have done, all the findings which should be there to justify further treatment. Many have personally seen, for example, hospital chart notes which describe extensive discussion with the patient of risks, alternatives and benefits in obtaining informed consent when the remainder of the record demonstrates the patient’s complaint that the surgeon has never told her what he planned to do; operative reports of procedures done and findings made in detail which, unfortunately, bear no correlation with the surgery which was actually performed.

Assessment

Whether electronic medical records (eMRs) will be helpful regarding fraud prevention, in the future is still not known. But, it is at best naive and more frequently closer to a death wish to think that a practitioner can beat the system, with handwritten notes, computer generated records, or fabricated eMR documentation.

Conclusion

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Filed under: "Doctors Only", Information Technology, Practice Management | Tagged: Business of Medical Practice, david marcinko, EHRs, EMRs, medical charts, medical records, www.BusinessofMedicalPractice.com | 4 Comments »

Take Our ME-P Reader Survey

Posted on October 10, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Tell Us What You Think?

By Ann Miller RN MHA

[Executive-Director]

MarcinkoAdvisors@msn.com

We believe we have the most intelligent readers and subscribers online today!

And so, please take a few minutes and kindly let us know how and why you like or dislike this blog. Your opinions and feedback are very important to us. Please use the comment space far below.

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ME-P Disclaimer

We are not all doctors, financial advisors or medical management consultants. But, we do have informed, experienced and personal opinions; sometimes strong, ignorant, or biased. Everything you read here on this blog is the author’s personal opinion, not specific managerial or financial advice. And, we are by no means an expert on anything. We don’t intend to mislead, but our facts, figures, and calculations can be incomplete, inaccurate or plain wrong. The word “you” in a post doesn’t mean literally you, the reader. In most cases it means the author. Please be sure to double check everything if you decide to act on anything we wrote about. The bottom line is this: please don’t blame the ME-P for anything you do.

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Filed under: CMP Program, Financial Planning, Glossary Terms, iMBA, Inc., Marketing & Advertising, MAST-HEAD, Practice Management, Recommended Books, Sponsors, Surveys and Voting | Tagged: certified medical planner, david marcinko, financial advisors, medical executive post, Practice Management, www.CertifiedMedicalPlanners.com | Leave a comment »

Financial Planning for Physicians and Advisors

Posted on September 25, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Our Handbook

By Ann Miller RN, MHA

Managed care and government-led initiatives to control health care costs have decreased physician compensation. Physicians must now carefully plan their practices and seek financial security in a manner that is markedly different from other professionals. To do so, physicians and their advisors must be well informed about the growing range of financial planning options to choose the course that balances risk, cost, time horizon, outcome and their own personal economic style. This innovative guide confronts the reality that personal financial planning for physicians is decidedly more complex than it is in other professions.

Financial Planning for Physicians and Advisors

This handbook describes a personal financial planning program to help doctors avoid the perils of harsh economic sacrifice. It outlines how to select a knowledgeable financial advisor and develop a comprehensive personal financial plan, and includes important sections on: insurance and risk management, asset diversification and modern portfolio construction, income tax and retirement planning, and succession and estate planning. When fully implemented with a professional’s assistance, this book will help physicians and their financial advisors develop an effective long-term financial plan.

Assessment

http://www.jblearning.com/catalog/0763745790/

Conclusion

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Filed under: Book Reviews, CMP Program, Financial Planning, Recommended Books | Tagged: Certified Medical Planner™, david marcinko, Financial Planning, Financial Planning for Physicians and Advisors, hope hetico, www.certifiedmedicalplanner.com | 2 Comments »

Share Your Thoughts and News with the ME-P

Posted on July 31, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Submit Your Cognitive Stuff

By Ann Miller RN, MHA

[Executive-Director]

Feel free to post, comment or submit health economics, physician focused financial planning or medical practice management news and related press releases, along with images (for which you own the copyright), to us at: MarcinkoAdvisors@msn.com

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Filed under: Alerts Sign-Up | Tagged: ann miller, david marcinko, Health Economics, hope hetico, medical practice management, physician focused financial planning | Leave a comment »

Defining Electronic Medical Record Systems

Posted on July 5, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Does Linguistic Obfuscation Exacerbate our Use Ambivalence?

[By Dr. Richard J. Mata; CIS, CMP™]

[By Dr. David E. Marcinko; MBA, CMP™]

The 2003 Institute of Medicine (IOM) Patient Safety Report [1] described an EHR [2] as encompassing:

a longitudinal collection of electronic health information for and about persons;
[immediate] electronic access to person- and population-level information by authorized users;
provision of knowledge and decision-support systems [that enhance the quality, safety, and;
efficiency of patient care] with support for efficient processes for health care delivery.

The IOM Report

A 1997 IOM report, The Computer-Based Patient Record: An Essential Technology for Health Care, provides a more extensive definition:

A patient record system is a type of clinical information system, which is dedicated to collecting, storing, manipulating, and making available clinical information important to the delivery of patient care. The central focus of such systems is clinical data and not financial or billing information. Such systems may be limited in their scope to a single area of clinical information (e.g., dedicated to laboratory data), or they may be comprehensive and cover virtually every facet of clinical information pertinent to patient care (e.g., computer-based patient record systems).

The HIMSS Model

The EHR definitional model document developed by the Health Information and Management Systems Society (HIMSS, 2003) includes:

“a working definition of an EHR, attributes, key requirements to meet attributes, and measures or ‘evidence’ to assess the degree to which essential requirements have been met once EHR is implemented.”

The IOM Model

Another IOM report, Key Capabilities of an Electronic Health Record System [Tang, 2003], identifies a set of eight core care delivery functions that EHR systems should be capable of performing in order to promote greater safety, quality and efficiency in health care delivery:

8 Core Principles

Today, we realize that the eight core capabilities that Electronic Health [Medical] Records should possess are:

— Health information and data. Having immediate access to key information – such as patients’ diagnoses, allergies, lab test results, and medications – would improve caregivers’ ability to make sound clinical decisions in a timely manner.
— Result management. The ability for all providers participating in the care of a patient in multiple settings to quickly access new and past test results would increase patient safety and the effectiveness of care.
— Order management. The ability to enter and store orders for prescriptions, tests, and other services in a computer-based system should enhance legibility, reduce duplication, and improve the speed with which orders are executed.
— Decision support. Using reminders, prompts, and alerts, computerized decision-support systems would help improve compliance with best clinical practices, ensure regular screenings and other preventive practices, identify possible drug interactions, and facilitate diagnoses and treatments.
— Electronic communication and connectivity. Efficient, secure, and readily accessible communication among providers and patients would improve the continuity of care, increase the timeliness of diagnoses and treatments, and reduce the frequency of adverse events.
— Patient support. Tools that give patients access to their health records, provide interactive patient education, and help them carry out home monitoring and self-testing can improve control of chronic conditions, such as diabetes.
— Administrative processes. Computerized administrative tools, such as scheduling systems, would greatly improve hospitals’ and clinics’ efficiency and provide more timely service to patients.
— Reporting. Electronic data storage that employs uniform data standards will enable health care organizations to respond more quickly to federal, state, and private reporting requirements, including those that support patient safety and disease surveillance.” [3]

Assessment

With all the confusion surrounding terms like quality improvement and “meaningful use” which can mean major Federal dollars to the coffers of a medical practice, clinic or hospital; are we still confused about basic definitional terms?

And, does eMR linguistic obfuscation exacerbate our use ambivalence and encourage physician/dentist eMR avoidance?

Conclusion

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References:

[1] See http://www.himss.org/content/files/PatientSafetyFinalReport8252003.pdf.

[2] EHR (electronic health record) is often used interchangeably with EMR (electronic medical record). In this discussion, EHR will be used consistently.

[3] See http://www.iom.edu/.

Filed under: Glossary Terms, Information Technology, Practice Management | Tagged: david marcinko, EHRs, electronic health records, electronic medical records, EMRs, health information technology, HIMSS, HIT, IOM, Richard Mata, www.healthcarefinancials.com | Leave a comment »

Understanding Absolute Investment Returns

Posted on July 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Exploiting Market Inefficiencies

By J. Wayne Firebaugh CPA, CFP® CMP™

By Dr. David E. Marcinko MBA, CMP™

Source: www.HealthcareFinancials.com

This class of investments seeks to exploit market inefficiencies and generate positive returns regardless of broader market performance. Often, investments in this class are made through the use of hedge funds. Hedge funds will often employ leverage, short-selling, and arbitrage to take advantage of pricing distortions in their targeted strategy area.

Relation to Healthcare Endowments

When investing an endowment’s assets in this category, the physician director or money manager should be aware of fee structures that commonly include performance-related incentive fees, hurdle rates, and claw-back clauses. The endowment managers should also remember that these types of investments generally have much less transparency than other asset classes with which they may be more familiar.

Assessment

Finally, since many of these investments are offered only to accredited investors, the physician or investment manager is often free to pursue much more aggressive strategies than would otherwise be pursued for retail or lay customers.

Conclusion

But, can we [anyone] exploit market inefficiencies? Is the market efficient or inefficient? What about Modern Portfolio Theory [MPT] or the Arbitrage Pricing Model? Did we really learn anything from the market crash of 2008?

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Filed under: Investing, Portfolio Management | Tagged: Alternative Investments, Arbitrage Pricing Model, david marcinko, efficient market hypothesis, EMH, hedge funds, Modern Portfolio Theory, Wayne Firebaugh | Leave a comment »

How the ME-P Views Client Engagements and Consultations

Posted on July 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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An Expert Led – Future Focused Firm – Enhancing Doctor and Advisory Practices

By Ann Miller RN, MHA

[Executive Director]

ME-P consultants use advanced analytics, medical practice intelligence, education, deep experiential insight and publications to deliver measurable value across the full continuum of the independent health care administration and integrated economics and financial services space. Our team includes DOs, CPAs, MDs, DPMs, MBAs, PhDs, CFAs, MSFSs, CFPs®, RNs, CMPs™ and health care leaders, business leaders and CXOs. All have extensive strategic, operational, academic, technological, business and financial experience, certifications and licenses.

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Typical Clients

Our clients include medical practices, hospitals and health systems; financial advisory firms RIAs and BDs; pharmaceutical companies, academic medical centers and physician organizations; private equity and investment firms, health insurance providers and medical device manufacturers are included. We help build a foundation for improving care delivery, related financial services sector performance and overall matrix or organizational advancement through the systems we implement. And, we enable our clients to:

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Through value-added analysis and intelligence, our healthcare business solutions become key tools and drivers for your current and future plans www.HealthcareFinancials.com

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What benchmarks do you use for consulting engagements? Are doctors and FAs more or less likely to retain a consulting firm in today’s competitive environment? Are these two consulting sectors more or less integrated today than yesterday?

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Filed under: Career Development, CMP Program, Experts Invited, iMBA, Inc., Media Mentions and PR | Tagged: david marcinko, financial services, healthcare consultants, ME-P, medical executive post, medical practice management, Practice Management, seminars, speaker's, www.certifiedmedicalplanner.com, www.healthcarefinancials.com | Leave a comment »

How eMR Vendors May Mislead You

Posted on June 21, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Challenging Assertions

By Shahid N. Shah MS

As the physician executive of your medical practice, it’s your job to challenge any eMR vendors’ assertions about why you need an eMR, especially during the selection and production demonstration phase.

Information Availability [Anytime – Anywhere]

The most important reason for the digitization of medical records is to make patient information available when the physician needs that information to either care for the patient or supply information to another caregiver.

Electronic medical records are not about the technology but about whether or not information is more readily available at the point of need.

Reasons to Purchase?

In no particular order, the major reasons given for the business case of eMRs by vendors include:

• Increase in staff productivity
• Increase of practice revenue and profit
• Reduce costs outright or control cost increases
• Improve clinical decision making
• Enhance documentation
• Improve patient care
• Reduce medical errors

Assessment

So, doctors beware! Challenge vendor “authority.”

Editor’s Note

Shahid N. Shah is an ME-P thought leader who is writing Chapter 13: “Interoperable e-MRs for the Small-Medium Sized Medical Practice” [On Being the CIO of your Own Office] for the third edition of the best selling book: Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] to be released this fall by Springer Publishers, NY. He is also the CEO of Netspective Communications, LLC.

www.BusinessofMedicalPractice.com

Conclusion

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

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Filed under: Information Technology, Media Mentions and PR, Recommended Books | Tagged: Business of Medical Practice, david marcinko, digital medical records, EHRs, electronic medical records, EMRs, Netspective Communications, Shahid Shah, www.BusinessofMedicalPractice.com | 9 Comments »

On American Health Care and Financial Services Competitiveness

Posted on May 31, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A MEMORIAL DAY OPINION – EDITORIAL

[Innovation – Not Nationalization – Can Again Lead]

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

[Publisher-in-Chief]

By Hope Rachel Hetico; RN, MHA, CPHQ, CMP™

[Managing Editor]

Ann Miller; RN, MHA

[Executive-Director]

On this 2010 Memorial Day weekend, please allow us to directly reflect for a moment on the decline of the healthcare, banking and financial services industry in America. And; then somewhat indirectly comment on the hopeful emergence of the web 2.0 phenomena of which we all are a part. The competitive applicability to these sectors should be appreciated by the insightful ME-P reader.

Collapse of Command and Control Monopolies and Oligarchies

Old monopolies everywhere are crumbling because of tougher new competitors and the transparency wrought by electronic connectedness. For example, our old newspaper has to compete with the internet, your electric utility company battles low-cost local start-ups, telephone companies must begin installing fiber optic lines to fend off cable companies; and RIAs and fiduciary focused financial advisors [FAs] will supplant BDs and stock brokers in the financial services sector.

www.CertifiedMedicalPlanner.com

The airline industry collapsed a few years ago, the banking industry has just collapsed, and the auto industry is recovering as we pen this post. [We have a particular affinity for the auto sector however, as the son of a UAW member and step-daughter of Michiganders]. Regardless, the rush to more intense competition cannot be stopped. As a doctor, FA or other business competitor; you either keep pace or get crushed by quasi-oligarchic organizations like the American Medical Association [AMA], American Podiatric Medical Association [FPMA], American Dental Association [ADA], American Osteopathic Medical Association AOMA], Financial Planning Association [FPA], Certified Financial Planner Board of Standards [CFP BoS], College for Financial Planning [CFP] or the National Association of Personal Financial Advisors [NAPFA], etc. What have they, and Wall Street, done for you … lately? Scandal, taint, doubt, lost-credibility, a business-as-usual ennui, lethargy and ruin! Enter www.Sermo.com

Link: https://healthcarefinancials.wordpress.com/2009/04/19/calling-for-cfp%c2%ae-fiduciary-status-real-education-and-higher-duty/#comment-4136

Health Insurance Companies

In the last-generation of health insurance companies and related fraternal medical organizations, patients exercised great control over physician selection, had quicker access to specialists and encountered fewer restrictions on care. The reverse was true with financial services. But, because of advancing technology, aging demographics, intense R&D, global manufacturing, and escalating domestic HR costs – competitive market forces against traditional and structured staff model managed care companies – many industry analysts [like us] predicted growth would decline [Yes, greed was also involved as healthcare was presumed a recession-proof sector; and didn’t we all own behemoth big-pharma and HMO stocks in our 401-K, and 403-B plans]? But now, many former stock-brokers and FAs are going rogue; er – independent!

“Although inefficiencies in any business often open up in the short term, and can be greatly exploited by creative and visionary entrepreneurs – as in most business structures – market forces will prevail in the long run”.

Leo F. Mullin, MBA

[Former CEO – Delta Airlines]

Next-Gen with “Fly”

Fortunately, a new generation of enlightened physician and FA entrepreneurs is coming “out-of-the-shadows” as new-wave web 2.0 corporations and RIAs are becoming more flexible, competitive and market responsive. Simultaneously, monolithic and collectivist political ideas keep trying to regulate the medical and financial services workplace with rules, regulations and contracts to control entire populations. Yet, in the new healthcare economy, this new generation of doctors and FAs with “fly,” is headed toward more competition; not less – with more collaboration with patients and clients – regaining self autonomy.

Physician and FA Advocates

Meanwhile, as medical professionals, FAs and patient advocates, we must all choose between staying flexible to ride out tough times – or – adopting a hard, brittle line that will crack under the pressure of competition. We know where we stand at the ME-P, do you?

Flexibility and Virtual Reality

In recent years, many large corporations and top-down business models were not market responsive and change was not inherent in their DNA. These traditional organizations represented a rigid or “used-to-be” mentality, not a flexible or “wanna-be” mindset; according to business columnist Alan Webber. Some financial advisory corporations, and today’s emerging health 2.0 initiatives, may possess the market nimbleness that cannot be recreated in a controlled or collectivist [nationalistic] environment. And so, going forward, it is not difficult to imagine the following new rules for the new financial and virtual medical ecosystem.

[A] Rule No. 1

Forget about “SEC suitability and FINRA rules”, large office suites, surgery centers, fancy equipment, larger hospitals and the bricks and mortar that comprised traditional medical practices or financial product delivery systems. One doctor or niche focused FA with a great idea, good bedside manners or competitive advantage, can outfox a slew of public servants, the AMA, SEC, ADA or FINRA “faux copy-cat examiners”, while still serving the public – and patients – and making money. It’s now a unit-of-one economy where “Me Inc.”, is the standard. Physicians and FAs must maneuver for advantages that boost their standing and credibility among patients, peers, payers, customers and clients. Examples include patient satisfaction surveys; outcomes research analysis, evidence-based-medicine, physician economics credentialing and true integrated fiduciary-focused financial planning.

However, we should also realize the power of networking, vertical integration and the establishment of virtual RIAs or medical practices, which come together to treat a patient, or help a client, and then disband when a successful outcome is achieved. Job security is earned with more successful outcomes; not necessarily a degree, automatic AUMs, certifications or onsite presence. In fact, some competition experts, like Shirley Svorny PhD, a professor of economics and chair of the Department of Economics at California State University, wonder if a medical degree is a barrier – rather than enabler – of affordable healthcare.

Link: https://healthcarefinancials.wordpress.com/2009/01/08/medical-licensing-obstacle-to-affordable-quality-care

Others even presume the establishment of virtual medical schools and hospitals, where students and doctors learn and practice their art on cyber-entities that look and feel like real patients, but are generated electronically through the wonders of virtual reality units. The same can be said for the financial services industry, although much farther down-line given its current slow rate of real education and quasi-professional acceptance.

[B] Rule No. 2

Challenge conventional wisdom, think outside the traditional box, recapture your dreams and ambitions, disregard conventional gurus and work harder than you have ever worked before. Remember the old saying, “if everyone is thinking alike, then nobody is thinking”. Do collective-nistas and nationalized healthcare advocates react rationally; or irrationally? [THINK: Wall Street, medical unions]

[C] Rule No 3

Differentiate yourself among your healthcare and financial advisory peers. Do or learn something new and unknown by your competitors. Market your accomplishments and let the world know. Be a non-conformist. Conformity is an operational standard and a straitjacket on creativity. Doctors and FAs should create and innovate, not blindly follow organization or political “union” leaders [shop stewards, BDs, etc] into oblivion.

[D] Rule No 4

Realize that the present situation is not necessarily the future. Attempt to see the future and discern your place in it. Master the art of the quick change with fast but informed decision making. Do what you love, disregard what you don’t, and let the fates have their way with you. Then, decide for yourself if you are of this ilk – and adhere to any of the above rules? Or, just become an employed [government, BD] doctor or FA shill. Just remember that the political party, or monopoly that can give you a job, can also take it away [THINK: LB, ML, Wachovia, national healthcare, etc].

Memorial Day Considerations

Finally, on this Memorial Day weekend, consider that life and career is a journey, and that in this country we have the choice to ponder or pursue any, and all of the above options, and more. We have the ability to think, cogitate and ruminate, as we have done here today. So – please – thank those who have helped turn this idealistic philosophy, into pragmatic daily reality.

For us personally, we thank Bonze Star Medal Winner Captain Cecelia T. Perez, RN. Now – ponder and consider – who do you thank? If no one has impacted you up-close on this Memorial Day weekend and national holiday, please visit our military channel to reflect, comment and opine.

Link: https://healthcarefinancials.wordpress.com/category/military-medicine

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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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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Filed under: Career Development, CMP Program, Military Medicine, Op-Editorials, Sponsors | Tagged: ADA, alan webber, AMA, ann miller, AOA, APMA, BD, broker-dealers, bronze star award, business competition, cecelia perez, certified financial planner, certified medical planner, CFP, CFPBoS, CMP, College Financial Planning, david marcinko, dentists, doctors, FA, financial advisor, financial planning association, financial services, financial services sector, FPA, health 2.0, healthcare, hope hetico, labor unions, Managed Care, Memorial Day, NAPFA, national healthcare, osteopaths, physicians, podiatrists, RIA, RIAs, stock-brokers, UAW, Wall Street, web 2.0 | 10 Comments »

What is the Medical Executive-Post?

Posted on May 22, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

What is our Blog – How does it Work?

By Ann Miller; RN, MHA

[Executive-Director]

The Medical Executive-Post is an independent information sharing portal for the integrated healthcare industrial complex, medical practice management and financial planning and advisory communities. We have a search engine to help find essays and follow the breaking news that interests you for this space.

Our articles, gossip, videos, books, journals, dictionaries, alerts and related essays and information are continuously updated and ranked by users thru more than 50 topical channels. And, we are sponsored by the www.MedicalBusinessAdvisors.com

[picapp align=”none” wrap=”false” link=”term=blog&iid=306845″ src=”0303/0000303556.jpg?adImageId=12802899&imageId=306845″ width=”337″ height=”506″ /]

Assessment

Of course, this means he ME-P is a participatory service: you can publish an article directly on the site or comment on an existing item. Or, we can edit, re-write and proof-read for you. You can also vote for an article or a group that captures your interest in order to increase its visibility on the site. And, you may virtually matriculate online at www.CertifiedMedicalPlanner.com

Each ME-P page also offers an RSS feed that allows you to subscribe to receive the information that appears there in the reader of your choice. But, you must subscribe for full functionality.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. How can we make the ME-P better and more useful to you? What new features would you like to see?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Exploring Career Change for Physicians

Posted on May 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

ADVERTISEMENT

About the Medical Fusion Conference

By Staff Reporters

Physician career change is the focus of the Medical Fusion conference. Non-clinical jobs, medical journalism, medical informatics, physician entrepreneurs, medical device development, and venture capital are all topics that will be covered at this exciting new event.

For all Specialties and Physicians

Whether you are a medical resident who wants to learn about all of the possibilities available to you or a retired physician looking for entrepreneurial side ventures, this is the conference for you. Medical Fusion reports to supply the tools necessary to take your career to the next level.

Non-Clinical Careers

Medical Fusion is for physicians interested in exploring non-clinical career opportunities. Designed to teach physicians how to leverage their medical training and expand their careers, participants receive training from experts with practical knowledge on a variety of non-clinical subjects.

A Tool Box 4 a Black Bag

Medical Fusion is designed as a “tool box” for the modern physician. Clinical physicians today need to know how to leverage their clinical training in new and unique ways. Medical Fusion provides broad exposure to a variety of niche areas, leaving participants with practical steps to begin crafting the career they’ve always wanted. Come learn from physicians who’ve already developed their own unique careers.

Assessment

Medical Fusion is a new medical event for physicians, by physicians.

Link: http://medfusionconf.com/home/tabid/122/Default.aspx

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Are you a physician seeking a career change away from clinical medicine? Tell us your experiences to-date. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe. It is fast, free and secure.

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Filed under: "Doctors Only", Career Development, iMBA, Inc., Sponsors | Tagged: careers for doctors, david marcinko, entrepreneurial MDs, medical career change, Medical Fusion, non clinical medicine, physician jobs | 1 Comment »

Good Night H. Ed Roberts MD

Posted on April 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Medical Inventor, Bio-Engineering Pioneer and Colleague

[September 13, 1941 – April 1, 2010]

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

According to Wikipedia, Henry Edward “Ed” Roberts MD was an American engineer, entrepreneur and medical doctor who designed the first commercially successful personal computer in 1975. He is most often known as the “father of the PC.” He founded Micro Instrumentation and Telemetry Systems [MITS]) in 1970 to sell electronics kits to model rocketry hobbyists, but the first successful product was an electronic calculator kit that was featured on the cover of the November 1971 issue of Popular Electronics magazine. The calculators were very successful and sales topped one million dollars in 1973. But, a brutal calculator price war left the company deeply in debt by 1974. Roberts then developed the Altair 8800 personal computer that used the new Intel 8080 microprocessor. This was featured on the cover of the January 1975 issue of Popular Electronics, and hobbyists flooded MITS with orders for this $397 computer kit. Bill Gates and Paul Allen joined MITS to develop software and Altair BASIC was Microsoft’s first product. Roberts sold MITS in 1977 and retired to Georgia where he farmed, studied medicine and eventually became a small-town doctor after commencing medical school at age 39.

Link: http://en.wikipedia.org/wiki/Ed_Roberts_(computer_engineer)

My Connection to Ed

Almost 20 years ago, I co-founded a small medical education software company, for a tiny niche market. My partner was a computer “whiz kid”. I was the chief executive, brain-child and enfant terrible. We are still in business today.

Nevertheless, I decided to contact Ed because I had just received my first PC [Intel® 286 microprocessor] from a publishing company who had contracted with me to write a medical textbook; remember DOS and WordPerfect? I was also very familiar with Microsoft lore, especially relative to business thought and competitive analysis. Regular readers of the ME-P may even recall my mention of attending lectures by Michael Porter PhD [father of competitive analysis] while dating a girl who was attending Wharton Business School while I was a medical student in Philadelphia, back-in-the-day.

Anyway, I took it upon myself to write Ed for some advice. Remember, this was before the commercial internet was widely available. I used medicine as a mutual point of interest. Anyway; after no response, the incident was quickly forgotten because of a busy lifestyle, new medical practice, book-project, etc. I follow-upped about a year later and this time received an encouraging written reply from Ed. I treasure the letter to this day, almost as much as the ones I have from Louis Rukeyser [TV fame-died in 2006] and his uber-investor guest, Sir John Marks Templeton [son is a surgeon] who died in 2008. In 2005, Templeton wrote a brief memorandum predicting that within five years there would be financial chaos in the world. It was eventually made public in 2010.

Assessment

Ed practiced as an internist until his death, in Cochran – a city near Macon, GA. The population was 4,455 at the 2000 census. It is a very poor county in South Georgia, and many, if not most of Ed’s patients were on Medicaid and/or Medicare. He loved them dearly, and they loved him, too!

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Although perhaps not as famous as Gates and Allen; we say with all due respect and admiration – good night Dr. Roberts – and thank you for the personal computer … your love of medicine and mankind … and for reaching out to me so very long ago!

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Filed under: Information Technology, Op-Editorials, Touring with Marcinko | Tagged: Altair 8800, Altair Basic, Basic, Bill Gates, david marcinko, DOs, Ed Roberts, Intel, Intel 286, Intel 8080, John Templeton, Louis Rukeyser, microsoft, Mike Porter, MITS, Paul Allen, PC, Popular Electronics | 2 Comments »

Tax Freedom Day

Posted on April 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Celebrating April 9th, 2010

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Each day the Tax Foundation reports the date when Americans have on average worked enough to cover taxes. For the year 2010, today the 99th day of the year, or April 9th, is Tax Freedom Day.

2007’s Comparison Triad

Tax Freedom Day this year is two weeks earlier when compared with 2007. This occurs for three principal reasons. First, the recession has reduced tax revenue. Second, there were temporary tax cuts for 2009 and 2010. Third, in 2010 the partial loss of itemized deductions and the exemption phase out for higher-income taxpayers are both eliminated. In addition, there is at present no estate tax.

Now Consider the Debt Burden

However, if the $1.3 trillion deficit is considered, the picture changes substantially. If the government were to collect sufficient revenue to balance the budget, then Tax Freedom Day would be May 17, 2010.

Assessment

As the $1.3 trillion US budget deficit is financed; all taxpayers will either be required to pay interest on that amount or eventually pay off that debt. With the deficit considered, Tax Freedom Day would be the latest since World War II.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. What about a national flat tax? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Accounting, Alerts Sign-Up, Taxation | Tagged: david marcinko, IRS, Tax Foundation, tax freedom day, US deficit | 1 Comment »

ME-P PodCasts Coming Soon

Posted on April 3, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

First Audio – Then Video

By Staff Reporters

The Medical Executive-Post will soon begin producing pod-casts featuring interviews with interesting physicians, financial advisors and/or management consultants.

So, if you are in the healthcare administrative space, or have a related product or service to offer, and/or would like to be interviewed, or want to recommend a physician, advisor or consultant to be spotlighted, please send your suggestions to us.

Assessment

Right-Click Here To Download [Beta-test audio sample]

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On Employer Based Health Insurance Premium Costs

Posted on March 15, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

One Client’s Comparative Expense Analysis Experience

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

A colleague posted an interesting essay recently on his blog The Incidental Economist. Austin Frakt PhD is a health economist with an educational background in physics and engineering. After receiving a PhD in statistical and applied mathematics, he spent four years at a research and consulting firm conducting policy evaluations for various federal health agencies. Here is the post.

Link: http://theincidentaleconomist.com/index.php?s=Kaiser%2FHRET+

The Survey

In his essay, Austin reported these figures from a cited survey:

“The 2009 Kaiser/HRET employer health benefits survey found that employees pay 17% of the $4,824 annual premium for single coverage and 27% of the $13,375 annual premium for family coverage (all average figures)”.

Case Report Model

So, if the survey is correct, it got me thinking about how much a long-time client paid as a doctor-employer, when she last practiced in a certain medical group back in 2000. And, especially about how much she would be paying today if still in business with the same group. This brief case-report with comparative expense analysis [CEA} is the up-shot.

My Client’s Story

Her health insurance premium costs including doctor-partners, was about $13,500 annually, per employee. This was a sunk cost, but an above the AGI line deductible business expense to the practice and entirely employer paid as a fringe benefit [all valid corporate expenses are deductible as there is no AGI line on a business tax return]. She and her three partners were both very magnanimous to their employees, and naïve. They became virtually insolvent a few years later and were bought out by a larger medical group for a pittance. Today, they are grunt employee doctors in a 25 plus physician group practice.

My Numbers

Now, if I crunched the numbers correctly as an citizen economist, on my HP12-C calculator, using health insurance inflation rates of 3%, 5% and 7% respectively for a decade [low], she would be now be paying somewhere between $18,143 and $21,990 and $26,556 in 2010 [dangerously assuming linear economics]. Each of her 15-18 employees at the time was a female, head of household, with 1-4 dependents of their own; no singles. Her own family unit included a professional husband and young daughter in private elementary school. They were the most health conscious of the bunch.

Her Situation

So, she left the group in 2000, and we transitioned her to solo private practice with a HD-HCP indemnity-styled [better] plan that pays 100% after her $5,000, and later $10,000, deductible. She has 100% prescription drug coverage, no OB coverage and no networks, second opinions or pre-certification requirements. Today, she has more than $50-K in the savings portion [cash account earning 3.5%, tax deferred].

Her Reaction

As she just turned age 55, there as was significant jump in her family coverage premiums from about $1,350/quarter to $1,650/quarter! Of course, her carrier offered a ten percent discount to $1,485 quarter, when she pitched a fit, and completed a health and wellness survey which “they” verified.

My Intervention

So, I used my “insider” knowledge as a doctor, financial advisor and insurance agent and went back to the open market place for coverage. Her new direct halth insurance coverage [she used a non-fiduciary insurance agent intermediary previously] is better, and her premium is only $1,248/quarter or about $5,000 annually to age 58. Bye, bye insurance agent. Link: www.CertifiedMedicalPlanner.com

Now, if we use the non-inflated [a conservative unlikely scenario] 27% employee premium contribution for the present value projections of $18,143 and $21,990 and $26,556 today – each employee would be responsible for about $4,898, $5,937 and $7,170 respectively [please again recall both our conservative nature and the repeat danger of linear economic assumptions].

Where Did the Money Go?

So, under the 3-5% health insurance inflation scenario, my client would have been contributing about $5,417 for her heath insurance. This is very close to what she is annually paying now! So, where did the much larger employer’s contribution portion of the money go? Probably to overhead costs, marketing, advertising, sales and commissions, HR, high-risk pool premiums, ie … down the drain?

What did my client do with the monetary difference? Well, she paid all family doctor and drug bills that were under the high-deductible threshold; some went to her annual family health club membership dues, covered extras and various “wants and nice-to-haves”, and the remainder of course, went into her savings account portion. In other words … not down the drain.

There is an additional $1.000 “catch up” savings provision for those over age 55. She paid it – to herself.

The Road Ahead – More Expensive

I informed my colleague-client that there likely will be another big premium jump when she turns 58, 60 and age 62 respectively. We will report back to ME-P readers on market competition and related health insurance pricing at that time, ceteris paribus.

Assessment

Does the competitive open marketplace find a way to reduce HI costs– sooner or later? High Deductible HealthCare Plans were launched as a temporary pilot project in 1997 and initially sold poorly. In the past few years however, there has been a boom in HD-HCPs and the pilot project was made permanent. What other HI innovations may be in the future?

Of course, President Obama was against them in his original healthcare reform plan. But, now in his weakened political position, they seem acceptable to him. So, go figure. Utility depends on political winds, not economic efficacy, I suppose.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: CMP Program, Health Insurance, iMBA, Investing, Practice Management | Tagged: AGI, Austin Frakt, CMP, CMP Program, CMP www.CertifiedMedicalPlanner.com, david marcinko, fiduciary, HD-HCPs, Health Insurance, high deductible health care plans, HSAs, incidental economist, insurance agents, Kaiser/HRET, MSAs | 7 Comments »

Congratulations Harry Markopolos

Posted on March 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

A Future SEC Chairman?

By Dr. David Edward Marcinko; MBA, CMP™

[Editor-in-Chief]

www.CertifiedMedicalPlanner.com

Harry Markopolos is finally taking his victory lap. He is out hustling a new book about his nearly decade-long pursuit of Bernie Madoff, and rightful criticism of the Securities Exchange Commission [SEC].

And, he’s been on a whirlwind media and PR tour of sorts: CNBC, MSNBC, “The Daily Show with Jon Stewart”, etc. Still, we’ve written about him before on this ME-P

No Schadenfreude

According to one trade magazine essay, Markopolos finally seems relaxed and at peace. Bernie Madoff is in jail. The Feds are closing in on his accomplices. Markopolos clearly is having some fun. After being ignored for so long, he’s finally the center of attention – on his terms.

But to be sure, schadenfreude was not a philosophy taught to Harry and I, while students back-in-the-day, at Loyola University Maryland.

http://www.fa-mag.com/fa-news/5322-harry-markopolos-sec-chairman.html

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. In my opinion, Harry would be a much better SEC chairman than Mary L. Schapiro, the 29th SEC Chairman [January 2009] -or- Christopher Cox, the 28th Chairman [June 2005].

Dare I say it … I’m just wild about Harry.

So, FAs, investors and doctor colleagues; what do you think about Harry? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

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

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Filed under: Breaking News, CMP Program, Ethics, Health Law & Policy, Investing, Op-Editorials | Tagged: Bernie Madoff, Christopher Cox, david marcinko, Harry Markopolos, Mary L. Schapiro, SEC, www.certifiedmedicalplanner.com | 2 Comments »

About the Managed Care Digest Series

Posted on March 14, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Where Information Becomes Intelligence™

By Staff Reporters

The sanofi-aventis Managed Care Digest Series^® is part of their continuing commitment to provide the healthcare industrial complex with the latest and most essential information on the evolution of medical care.

The Series, available online or in print, provides key benchmarking data that can help assess value, control costs, and develop business strategies.

Assessment

According to ME-P Publisher-in-Chief, Dr. David Edward Marcinko:

I have been a user of the Managed Care Digest series for more than a decade. The depth and breadth of information is astounding. I especially appreciate the data driven and graphical interface nature of the publication; as well as its’ cost—free!

I suggest all medical professionals, healthcare economists, business experts and financial advisors – read it and reap!

And so, give em’ a click www.ManagedCareDigest.com and tell us what you think?

Conclusion

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

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

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

Filed under: Book Reviews, Career Development, Health Economics, Health Insurance, Healthcare Finance, Managed Care | Tagged: david marcinko, Managed Care Digest, sanofi-aventis | 1 Comment »

Letter from the Editor-in-Chief

Posted on March 13, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Help Support the ME-P

You were among of the first; the early adopters if you will. You saw the troubling state of healthcare, medical economics, private practice and the financial services community in our country.

And, you believed in the ME-P and our “new-wave” brand of informed and collaborative investigative journalism to do something about it.

Our History

For the last three years, the ME-P has played the role of educator, watchdog and advocate for medical practice management and financial planning transparency, scrutinizing powerful people, systems and institutions that would prefer to stay out of the spotlight, highlighting the fine print that might otherwise slip past cash-strapped physicians and their consulting advisors.

As newsrooms across the country contract, in-depth investigations are viewed as a luxury that many print publications can’t afford. Journalists are getting kicked off their beats. And, when they do, we are there to help pick up the virtual baton.

The Pioneers

We’re pioneering a new, no-profit e-model, helping spearhead a movement to reinvigorate investigative and non-clinical healthcare administrative and business journalism in this country.

But, we need the support of our most loyal readers – concerned members of the healthcare industrial complex, like you – to spread the word about our mission. If you value our investigations and essays, you will tell five colleagues about the ME-P, today.

Participatory Power

You’ll see our stories in your inbox every day, so you know the types of issues we’re tackling. Our reporting speaks for itself – but we need your help to get the word out about where it’s coming from. We need your participation and collaboration to tell your colleagues.

Our Request

I’ll bet you believe in the power of investigative journalism just as much as I do. So, please tell five [5] of your colleagues that they can stay on the leading edge of the groundbreaking stories that shine a light on the unbiased nexus of medical practice and financial planning, in plain English.

Assessment

In the modern Health 2.0 era, our goal is to “bridge the gap between medical mission and profit margin.”

Join the ME-P Nation today … and tell us what you think! Thank you for standing up for investigative healthcare journalism. Thank you for supporting the Medical Executive-Post. Now go; please tell five [5 … or more] colleagues to subscribe. It’s fast, free and secure.

Support Independent Journalism – Donate

www.e-junkie.com/ecom/gb.php?c=cart&i=641232&cl=109140&ejc=2

Conclusion

NOTE: If you need a moderator or speaker for an upcoming event, we are available for seminar or speaking engagements.

Contact: MarcinkoAdvisors@msn.com

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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

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

Filed under: "Advisors Only", "Doctors Only", Marketing & Advertising, Media Mentions and PR, Op-Editorials, Sponsors | Tagged: collaborative medicine, david marcinko, health 2.0, Health Economics, healthcare journalism, medical practice management, participatory care, www.healthcarefinancials.com, www.healthdictionaryseries.com, www.medicalbusinessadvisors.com, www.MedicalExecutivePost.com | Leave a comment »

New Regulations Needed For Financial Planners?

Posted on March 12, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

So Says New Coalition

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

The Financial Planning Coalition [FPC] is pushing for a law that would require anyone calling themselves a financial planner to meet certain ethical and educational standards and to register with the Securities and Exchange Commission [SEC].

About the FPC

According to its’ website, the Financial Planning Coalition is a collaboration of Certified Financial Planner Board of Standards (CFP Board), the Financial Planning Association® (FPA), and the National Association of Personal Financial Advisors (NAPFA) to advise legislators and regulators on how to best protect consumers by ensuring financial planning services are delivered with fiduciary accountability and transparency. Americans have grown leery of those who work in financial services.

Currently, financial planning (the process of advising individuals and families across a range of personal finance topics in addition to investment advice) is unregulated as a profession, resulting in major gaps in current laws. So, is it really a “profession” many ask – void of any significant barrier to entry?

The Financial Planning Coalition intends to work with Congress to produce legislation that puts the interests of clients first and enables consumers to identify a trusted financial adviser.

To learn more about the Financial Planning Coalition’s purpose and mission, click here to read, or download the Statement of Understanding [PDF].

SEC Wrong Oversight Agency?

According to this report in Financial Advisor magazine, an advertiser-driven trade journal:

the standards would be set by a public oversight board that would be funded by small registration fees paid by the financial planners, said Robert Glovsky, chair of the Certified Financial Planner Board of Standards during a conference call today. The CFP Board, as well as the Financial Planning Association and the National Association of Personal Financial Advisors makes up the coalition.

Exemptions

However, brokers and insurance agents would not be forced to register as financial planners, but those who held themselves out as financial planners would have to meet the required minimum competency and ethics standards or stop using the financial planner title.

Assessment

And so, as we have noted, written, preached and warned for more than a decade – anyone can call themselves a financial planner, or financial advisor; so beware medical colleagues.

More: http://www.fa-mag.com/fa-news/5314-new-regs-needed-for-financial-planners-coalition-says.html

NOTE: The fiduciary definitional standard conundrum was not even addressed in the article or by the committee, as far as I know. Moreover, note that SEC oversight was in place before, during and now after the Bernie Madoff scandal – so enough said about competency! www.HealthDictionarySeries.com

Conclusion

Your thoughts and comments on this ME-P are appreciated. What do you think FAs, and CFPs®? Should all become an RIA or ERISA styled fiduciary? Or, will this be another CFP® lite fiasco?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

Disclaimer: I am a former certified financial planner and CEO of the online www.CertifiedMedicalPlanner.com program for fiduciary advisors working in the healthcare space.

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

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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

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

Filed under: "Ask-an-Advisor", Breaking News, Career Development, Ethics, Financial Planning, Op-Editorials | Tagged: CFP, CMP, david marcinko, FA, financial planning association, Financial Planning Coalition, FPA, insurance agents, NAPFA, National Association of Personal Financial Advisors, RIA, Robert Glovsky, SEC, stock-brokers, www.certifiedmedicalplanner.com | 14 Comments »

I’m Not Economically Bashing JHU … But!

Posted on March 9, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

In My Opinion … Hospital Charges Not 4 Me

Dr. David Edward Marcinko; MBA

[Editor-in-Chief]

On February 09, 2010, journalist Maggie Mahar posted an excellent op-ed piece on The Health Care Blog. In fact; I am now compelled to address one aspect of it. The essay was titled: “Massachusetts’ Problem and Maryland’s Solution”.

Assuredly, I’ve no beef with Maggie, her economic machinations or reporting. In fact, I am a fan and encourage all ME-P readers and subscribers to “read it and reap.’

Link: http://www.thehealthcareblog.com/the_health_care_blog/2010/02/massachusetts-problem-and-marylands-solution-we-dont-have-to-wait-for-washington-part-2.html#comments

Maggie Speaks

In her essay, Maggie says the following to which I agree. It is well known to me as a Balti-moron. For, I lived in the bowels of inner-city Baltimore when this legislation went down, back-in-the-day:

“While health care reformers argue about what it would take to “break the curve” of health care inflation, the state of Maryland has done it, at least when it comes to hospital spending. In 1977, Maryland decided that, rather than leaving prices to the vagaries of a marketplace where insurers and hospitals negotiate behind closed doors, it would delegate the task of setting reimbursement rates for acute-care hospitals to an independent agency, the Maryland Health Services Cost Review Commission. When setting rates, the Commission takes into account differences in labor markets and how much a hospital pays in wages; the amount of charity care the hospital does; and whether it treats a large number of severely ill patients.

For example, the Commission sets the price of an overnight stay at St. Joseph Medical Center in suburban Towson at $984, while letting Johns Hopkins, in Baltimore Maryland, charges $1,555. For a basic chest X-ray, St. Joseph’s asks $81 and Hopkins’ is allowed to charge $155. The differences reflect Hopkins’s higher costs as a teaching hospital and the fact that it cares for generally sicker patients.”

Of Invoices, Charges and Cost Shifting – Oh My!

I do have a beef with the above charges, which are not necessarily costs, which are not necessarily what is ultimately paid by a third-party insurer, or patient. This cost shifting is not unique to JHU, of course, but mention of the “Johns” just caught my eye as I admit that I’ve been away from my hometown of Baltimore, Maryland for 35 years.

Oh my; don’t get me wrong. I loved the place and played stick-ball in JHU’s parking lot on Broadway in Upper Fells Point when I was a kid. I was seen in the ER, at a young age, for a forehead laceration. I even met two of the greatest physicians in the world there.

J. Alex Haller Jr. MD – the world famous Children’s-Surgeon-in-Charge of Johns Hopkins Hospital, and pectus excavatum surgical pioneer, from 1964 until 1997. As well as pediatric heart surgeon Helen Brooke Taussig MD (1898 – 1986), developer of a famous operation to alleviate “blue baby” syndrome, and who first warned the public on the dangers of thalidomide.

Link: https://healthcarefinancials.wordpress.com/2009/09/01/off-road-touring-with-dr-marcinko-part-vii/

However, as a health insurance agent and advocate of HD-HCPs for more than a decade, who has direct economic “skin-in-the-insurance game”, I would rather go to suburban St. Joe’s medical center for non-traumatic, non-emergent care – if I had my druthers. The neighborhood is safer and the quality can’t be much different. After all, a basic chest x-ray … is a basic chest x-ray, and an uncomplicated overnight stay … is an overnight stay etc, ceteris paribus.

RememberParetto’s 80/20 economic principle of the “vital few and trivial many”? Most of us [trivial many] will not need JHU care [vital few]. And, that’s a good thing!

The fact that JHU is a teaching hospital that generally cares for sicker patients has tremendous societal implications with positive “trickle-down” innovative benefits for the masses. But, not for me as one doctor-purchaser of healthcare services who knows better. I refuse to pay freight charges for the “full JHU monty”.

I just can’t afford it under my definition of medical / business school derived quality health care.

The correct diagnosis, necessary care and proper treatment with f/u and ancillaries; at the most convenient venue; by the appropriate level medical provider; in an appropriate time-frame, and at the right price.

Assessment

JHU is an outstanding healthcare entity in Baltimore, but perhaps even more so for the poor and/or rich; not us “tweeners”.

For the middle class, it is expensive care whose reputation for quality may actually be declining.

In fact, some JHU employee’s still living “back in the hood” tell me that it is “getting larger, but not better.”

Link: https://healthcarefinancials.wordpress.com/2010/01/10/a-story-all-doctors-and-patients-should-re-read/

Quality guru, Bob Wachter MD, where are you?

http://community.the-hospitalist.org/blogs/wachters_world/about.aspx

PS: I am a former CPHQ myself [Certified Physician in Healthcare Quality].

Conclusion

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INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Health Economics, Health Insurance, Op-Editorials, Quality Initiatives | Tagged: david marcinko, Edward Miller MD, hospital cost shifting, Johns Hopkins University, Maggie Mahar, Maryland Health Services Cost Review Commission, medical care quality, Robert Wachter, The Health Care Blog, www.thehealthcareblog.com | 6 Comments »

The ME-P as Provocateur

Posted on March 6, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

On Publishing Information and Entertainment

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

As avid blogger Darrell K. Pruitt DDS recently noted, this past quarter brought in a large number of monthly hits, readers and subscribers to the ME-P; and we are grateful. The traffic boost was mainly due to interest in eMRs and the financial essays of Somnath Basu PhD, especially during current political turmoil in Washington, DC involving both sectors simultaneously. The common element was the provocation of diverse opinions.

Audience Centric Philosophy

Through a focused attention on our target audience, we’ve come to understand that information and entertainment are inseparable in all but a theoretical sense.

For example, you’re reading this sentence because it entertains or interests you. That it is also informative may be a reason why it interests you, but entertainment and information are nevertheless inexorably linked.

A sure way to entertain is to be provocative. Apparently some people really like to debate the value of eMRs, healthcare reform and the financial services industry. And, we appreciate multiple links from prominent bloggers, essays and journalists, too. Don’t misunderstand. We do not publish for the sake of provocation and we do lightly self-censor. But, we publish to advance our own thinking and understanding. That we also entertain and invite debate is an additional benefit.

Self Motivation Mission to Inform

Our posts and comments are motivated to correct the record and to infuse an unbiased debate over both healthcare and financial reform with the best evidence available. In the process, we learn much. Hence, though we may entertain, we are motivated by a desire to inform and “bridge the gap between medical mission and profit margin” in the Health 2.0 era.

Assessment

We’d even go so far as to say that anyone who does not agree is attempting to fool you with clever theory that belies the practical truth. According to Austin Frakt PhD, of the Incidental Economist, if you fall for it … that only proves our point!

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

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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

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

Filed under: Ethics, Op-Editorials, Quality Initiatives | Tagged: Austin Frakt, Darrell Pruitt, david marcinko, EHRs, EMRs, health 2.0, Somnath Basu | 1 Comment »

ME-P Joins Up with SocialVibe

Posted on March 2, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

What it is – How it works

By Hope Rachel Hetico; RN, MHA

[Managing Editor]

SocialVibe is a new networking website with over 1,000,000 members. It was founded by Joe Marchese, Brandon Mills and David Levy, and aims to reward publications like the ME-P through donations to their charity of choice.

How it Works

After joining SocialVibe, in addition to creating a personal profile, users are asked to select their favorite cause to support and to choose a sponsor. Once they have done so, they can earn points for themselves, which can be redeemed for a variety of different perks and money for their respective charities by posting their “badge” to another social networking site. The more a SocialVibe user’s networking site is visited, the more points they are able to earn.

The Badge

A badge is defined as “a distinguishing emblem or mark worn to show membership or achievement.”

The SocialVibe badge brings members together with their favorite brand and charity. The badges are customized to be the member’s own [ie, ME-P] but all consist of their brand sponsor logo, cause logo, member profile picture and a personalized message. The Badge is one of the most powerful tools that SocialVibe members have at their disposal to share both their brand and charity messages across their various publishing blogs and social networks. An appealing and inviting aspect of a SocialVibe member’s social networking profile, the Badge helps spark a conversation between a SocialVibe member and their friends regarding the brand a member has chosen to feature on their Badge.

Economic Impact

Once the badge has been created, members put them on their social networking site and/or blogs. For example, with each view the badge gets on our ME-P site, we will earn points. These points contribute to a larger donation to the American Red Cross which is our charity-of-choice. With SocialVibe, our readers make a positive, measurable impact for the Red Cross just by completing branded activities. In just over a year’s time, the SocialVibe community has raised over $700,000 for over forty different non-profits. We hope to do our part, too!

Assessment

Conclusion

And so, your thoughts and comments on this ME-P sponsorhip are appreciated. Feel free to click on the SV badge located on our left middle home page side-bar; you’ll know what to do, thereafter. 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.

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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

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

Filed under: Ethics, Media Mentions and PR, Sponsors | Tagged: Brandon Mills, David Levy, david marcinko, hope hetico, Joe Marchese, medical executive post, SocialVibe | Leave a comment »

The FDA and eMR Regulation?

Posted on March 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

One HIT Futurist’s Opinion

By Staff Reporters

A few years ago, Shahid N. Shah wrote that the FDA should be paying closer attention to healthcare IT systems and consider regulating those systems; in other words – regulating them the same as any other drug, medical device or foodstuff.

After all, some healthcare IT systems can kill just as easily as inappropriate medical care.

Link: http://www.healthcareguy.com/2010/02/24/thank-goodness-the-fda-could-start-regulating-healthcare-it-systems/

Our View

We agree that hospital IT systems and eMRs can, do, and will kill when not used or implemented properly.

And, it’s a shame that we may need the government to improve quality; but perhaps the fear of regulation will do the trick. In fact, we’ve also warned of similar adverse unintended consequences of eMRs and related HIT systems, previously on this ME-P.

Link: https://healthcarefinancials.wordpress.com/2009/12/23/will-electronic-records-raise-the-legal-standard-of-care-and-increase-malpractice-risk/#comments

About Shahid Shah

Shahid is CEO of Netspective, a Java/.NET consultancy that specializes in healthcare IT with an emphasis on e-health, EMRs, data integration, and legacy modernization. He is also a valued thought-leader for the ME-P, who will be contributing the HIT chapter for the third edition of our best selling book: www.BusinessofMedicalPractice.com to be released later this Spring.

Conclusion

And so, your thoughts and comments on this ME-Pare appreciated. Should eMRs be regulated by the FDA? Does the FDA need to put even more on its plate and has it done a good job until now? Do we really need more governmental intervention in healthcare?

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BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: "Doctors Only", Health Law & Policy, Information Technology, Op-Editorials, Practice Management | Tagged: david marcinko, EHRs, EMRs, FDA, healthcare information technology, HIT, Shahid Shaw, www.BusinesofMedicalPractice | 18 Comments »

Who Can Join the Medical Executive-Post?

Posted on February 20, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

More about the ME-P

By Ann Miller; RN, MHA

[Executive-Director]

Although this online resource is focused on physicians and their financial advisors, anyone involved in the financial services industry or healthcare space, including chiropractors, dentists, podiatrists and osteopaths, nurses, medical assistants, medical practice managers, residents and fellows, medical and nursing students, and allied healthcare professionals are welcome to become part of the Medical Executive-Post community.

We also invite accountants, attorneys, economists and financiers, and all sorts of healthcare administrator types, including CFOs, CEOs, and CXOs. All opinions and viewpoints are valued.

Can I Join If I Provide Expert Services to Physicians?

Yes, anyone who can offer professional advice to physicians managing the business aspects of their medical practice is encouraged to join. You will find it advantageous to your own successful career to provide valuable advice and content through the many channels available at the ME-P. This includes direct and indirect communicating to physicians and advisors you meet on this website.

You also have the opportunity to post expert articles on topics pertinent to private medical practice, and financial planning, and you can purchase advertisement placed directly on the site. Regular contributors of quality information will be granted free membership, should a membership fee ever be instituted. And, physician or financial advisory members learning of your expertise may request services on a more formal basis.

Is Membership to the ME-P Free?

There is no fee to join us; however a fee may be instituted at a later date for access to premium resources and other privileges, but a portion of the ME-P will always be free to the greater community-at-large.

Is Personal Information Safe On the ME-P Site?

Yes, your personal information including your name, email and other contact information will remain secure. Your information will never be sold, traded or revealed to anyone without your express consent. You may choose anonymity, or an online alias instead of your real name, to remain confidential on the site. You choose which profile details to reveal to the other members on the site.

Can I Contribute My Experience To Other ME-P Members?

Yes, you can share your expertise in a number of ways, including responding to posts, writing a regular post or other articles, and sharing your knowledge in the Channel Forums. You may also indicate your interest in becoming a mentor to other physician or FA members seeking such a relationship.

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. How can we serve our integrated community, better?

Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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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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Sponsors Welcomed

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

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Filed under: Alerts Sign-Up, Career Development, iMBA, Inc., MAST-HEAD, Media Mentions and PR, Sponsors | Tagged: CFP, david marcinko, financial advisors, Financial Planning, health 2.0, Health Economics, medical executive post, medical practice management, www.MedicalExecutivePost.com | Leave a comment »

Seeking your Medical Practice Management [Horror] Story

Posted on February 11, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Help us Find a Case Report Learning Experience

By Ann Miller; RN, MHA

We at the ME-P have been reporting for the past four years on the troubles in which medical professionals often find themselves while running a private medical practice. It’s difficult for doctors to stay abreast of the healthcare industrial complex, or always select the right consultants. And, it’s often more difficult – once consultants are retained – to have expectations met or exceeded.

Often, it is a matter of not knowing, what you don’t know.

Difficult Doctor Clients

And, it is true that doctors make difficult clients in some instances. This occurs because some are desperate for practice enhancement solutions, but don’t know where to turn for help? Others, may have had a prior negative experienced with a business consultant, or management guru, more interested in their bottom line than the doctor’s success?

Assessment

Read this Federal Government report to learn what can happen when your consultant is not an informed medical management practitioner. Although almost a decade old, its’ premise is still fresh today [ie., buyer beware]!

Full Article: http://oig.hhs.gov/fraud/docs/alertsandbulletins/consultants.pdf

Call to Action

To illustrate the problem, we’re looking to shine a light on the [un] lucky doctor who has dealt with poor managerial advice from a consultant, or had a bad experience with one. Give us the gory details and journalistic 5Ws of your ordeal so that others may learn. You may be named, or remain anonymous, as you wish.

Submissions

Please submit your best [worst] case study exprience to me at: MarcinkoAdvisors@msn.com If appropriate, we will publish in an upcoming edition of the ME-P, so that we might all humbly learn from you.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

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

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Filed under: "Doctors Only", Career Development, Practice Management, Research & Development | Tagged: david marcinko, medical management consultants, medical practice management, Practice Management, www.certifiedmedicalplanner.com | Leave a comment »

On the Cash Conversion Cycle for Healthcare Organizations

Posted on February 7, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding Why Cash Flow is King

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

The manager, administrator or COO of a hospital’s working capital, or physician executive of a private medical practice, strives to optimize the amount of cash on hand to ensure daily operations. Too much cash generates little return, while too little may jeopardize the healthcare enterprise, incur borrowing costs or cause missed investment opportunities.

Also, the extent to which current assets cover current liabilities, determines whether the entity is considered liquid and thus able to meet its payment obligations on time.

The Balancing Act

When faced with the management balancing act of current assets and current liabilities, the alternative with the highest net present value (NPV) and internal rate of return (IRR) is typically selected. This is often a difficult balancing act since providing healthcare services generates little immediate cash, and then cash receipts are variable depending upon payers or other third parties.

Yet, each hospital or practice distribution transaction requires immediate liquid cash for employees, vendors, debt holders, and investors in the form of dividend payouts or retained earning disbursements. The cash conversion cycle (CCC) length measured in days is composed of two ratios:

The first is the average inventory holding period (ending inventory divided by revenues per day),
The second is the collection period (ending ARs divided by revenue per day). For both ratios, faster is better.

CCC Averages

Sample CCCs for an industry-average hospital (45 days average-non-electronic) are:

1. hospital admission to patient discharge (5 days);

2. patient discharge to hospital bill completion (5 days);

3. hospital bill completion to insurance (third-party administrator or TPA) payor receipt (5 days);

4. receipt by TPA to mailing of hospital payment (25 days);

5. payment mailed to receipt by hospital (3 days); and

6. payment receipt by hospital to bank deposit (2 days).

Assessment

Naturally, healthcare managers, administrators, physicians and hospital executives should be interested in motivating changes in the behavior of staff such that processes within the control of the enterprise can be streamlined and completed in less time.

For example, a day or two reduction in the amount of time it takes from patient discharge to hospital bill completion, as achieved with the use of electronic charts and medical records systems, can significantly increase cash flow. Likewise, the use of electronic funds transfers and/or lock box collection mechanisms can reduce the amount of time it takes for an account receivable to make it into the bank.

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Accounting, Healthcare Finance | Tagged: cash conversion cycle, cash flow, collection period, david marcinko, Internal Rate of Return, inventory, inventory holding period, IRR, medical collections, NetPresent Value, NPV | 1 Comment »

Healthcare Organizations [A Journal on CD-ROM]

Posted on February 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Journal of Financial Management Strategies

By Ann Miller; RN, MHA

[Executive-Director]

ADVERTISEMENT

www.HealthcareFinancials.com

All hospitals, healthcare systems and organizations use a variety of teaching, educational and didactic techniques to bring value to patients, payers, providers, governments and third-party intermediaries. This Intellectual Capital is the sum total of all knowledge and expertise used to serve society and stakeholders. Leaders, CXOs and employees provide almost all of this Intellectual Capital.

Our Beliefs

We believe that Healthcare Organizations: [Journal of Financial Management Strategies] adds to this Intellectual Capital by guiding you, empowering your organization, and creating value for your patients, employees, investors and clients by bridging the intersection of medical mission and profit margin.

Our Vision

To be the pre-eminent interpretive guide for financial management strategies, and the enduring business analytics guide for all healthcare organizations; and to promote related enterprise-wide health economics initiatives.

Our Mission

Healthcare Organizations: [Journal of Financial Management Strategies] promotes and integrates academic and applied research, and serves as a multi-disciplined forum for the dissemination of economic, financial, business, management, IT and administration information to all healthcare organizations; both emerging and mature.

Assessment

Our goal is: “Bridging the Intersection of Medical Mission and Profit Margin”

Conclusion

So, feel free to give em’ a click and be sure 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.

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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

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

Filed under: Book Reviews, CMP Program, Research & Development, Sponsors | Tagged: david marcinko, HO:JFMS, www.certifiedmedicalplanner.com, www.healthcarefinancials.com, www.healthdictionaryseries.com, www.medicalbusinessadvisors.com, www.MedicalExecutivePost.com | Leave a comment »

About the StatCom Hospital Initiative

Posted on January 19, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Impending Health 2.0 Media Launch Eagerly Anticipated

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

Recently, I caught up with Dave Pritchard [Director of Corporate Recruiting] for a conversation about StatCom and its’ impending new-media Health 2.0 launch for core hospital products.

The telephone call followed two recently featured publications that have been well received by ME-P readers and those industry-insiders seeking hospital related patient operations performance and augmentation solutions:

Here is a synopsis of the company and products.

About StatCom

StatCom is an early stage high-growth healthcare software company located in Alpharetta, GA. As a division of Jackson Healthcare [www.JacksonHealthcare.com] – with more than 60 employees – it is regarded as one of Atlanta’s fastest growing companies. It recently partnered with the Center for Health Care Transformation [CHCT] founded by Newt Gingrich.

Video: http://www.statcom.com/videos/newt-gingrich-hospital-management-video.aspx

Core Products

StatCom’s next generation hospital operations system incorporates technology, methodology and mindset changes into a proven scheduling solution that delivers substantial bottom-line and quality improvement results to hospitals.

The company’s Hospital Operating System^TM is a comprehensive patient throughput solution, developed to achieve maximum operational performance and substantial reductions in average length of stay (ALOS), while greatly enhancing patient and staff experiences. Actions across the hospital are prioritized, allowing patients to flow at their best possible rate with respect to service, quality, safety and resource consumption.

Transforming Patient Throughput

In once case, a StatCom customer is reported to have reduced average length of stay by 14%, realizing $8.6 million in savings, an 11.2% increase in volume and with a total impact of $10.3 million. By optimizing the whole, StatCom is striving to help hospitals achieve a significant competitive advantage by increasing bed turnover, accelerating discharges and reducing diverts and delayed cases; especially in order and patient logistics for the Operating Room and Emergency Room departments; typical bottlenecks for most hospitals.

Excerpts:

David P: We’re saying that social media has empowered patients, politicians and employers … so therefore hospitals need to pay more attention.

David M: We agree that all stakeholders need to pay more attention to healthcare social media. And those like you in HIT, and the pharma, biotech and related DME sectors have been working hard to understand how to revise business strategies and engage the enterprise … and customers … about it.

Today, “health 2.0” is everyone’s business. We wish you well in your new social media experiment to launch Statcom’s hospital operations software.

For more information:

www.statcom.com

800.930.0870

Conclusion

And so, your thoughts and comments on this ME-P are appreciated; especially from COOs, CTOs and hospital administrators. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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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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Sponsors Welcomed

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

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

Filed under: Alerts Sign-Up, Information Technology, Marketing & Advertising, Media Mentions and PR, Op-Editorials, Quality Initiatives, Research & Development, Videos | Tagged: Center for Health Care Transformation, CHCT, david marcinko, David Pritchard, health 2.0, Jackson Healthcare, Newt Gingrich, Statcom | Leave a comment »

Hospital Materials Management Information Systems [Part 2]

Posted on January 8, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Fundamentals of Software Implementation

By David J. Piasecki; CPIM

By Hope Rachel Hetico; RN, MHA

Dr. David Edward Marcinko; MBA

www.HealthcareFinancials.com

The singular focus of any Hospital Materials Management Information System (HMMIS) is to deliver significant improvements in the ability of hospital facilities, networks, and other healthcare organizations to optimize the processes and work flows associated with materials management systems and reduce the costs related to inventory, durable medical equipment, pharmaceuticals and supply chain management (SCM).

Understanding Strategies

Strategically, hospitals must exploit contemporary technologies and connectivity with suppliers and trading partners to:

improve patient care and safety,
increase efficiency,
drive down costs, and
optimize inventory levels.

Software Implementation

As with the selection process written about previously, ERP software implementation may also require outside assistance. Whether you use consultants from the software vendor, a business partner, or an independent firm, the implementation plan will likely be the same. It’s very important to listen to consultants and be prepared to dedicate the resources outlined in the implementation plan. A common mistake made by healthcare entities going through their first major implementation is to underestimate the complexity of their operations, the extent of system setup and testing, and the impact the implementation will have on their operation.

ERP Implementation

Here is an outline of a common scenario in single-hospital ERP implementations.

The consultants warn of the consequences of not dedicating adequate resources.
Management publicly agrees but privately thinks the consultants are crying wolf.
Implementation fails or goes poorly.
Management claims “how could we have known?”

Don’t let this be you. The only thing to assume about the implementation is that it that it will be much more difficult than expected, it will take longer than you expected, and it will cost more than expected.

Like most other projects, the success of a software implementation will be based upon the skill of the people involved, training, planning, and the effort put forth. Plan to have the most knowledgeable employees heavily involved in the system setup and testing.

Testing Programs

Adequate time should be dedicated to make sure every aspect of every process is thoroughly tested. An example of a detailed testing program is listed below:

Does the purchase order [PO] receipt screen have all the information needed to perform the receipt such as vendor item number, item description, unit of measure?
What happens when we receive more than the PO quantity?
What happens when we receive less than the PO quantity?
What happens when we enter multiple receipts against the same line?
What happens if someone tries to change the PO quantity after we have entered a receipt?
What happens if one changes the PO quantity at the same time we are entering a receipt?
What happens when we reverse a receipt?
What happens when we reverse a receipt after it has been paid?
What happens if the ordered unit of measure is different from the stocking unit of measure?
What happens when we receive an early shipment?
What happens when we try to receive against a cancelled PO?
What happens when we change the receipt location?

After the system has been thoroughly tested, employee training begins. Remember, dealing with unexpected issues is the norm; you don’t also need to be training employees after the system is supposed to be operating.

Hands-On Training

The training should consist of hands-on training and include written procedures for the tasks performed. For most positions, make sure that each employee has entered the equivalent of at least a full day’s transactions during the training. Using an actual day’s transactions is a good way to make sure the variety of transactions an employee is likely to encounter have been experienced. The most common mistake made in training is a lack of adequate repetition. Just because someone was able to perform the task once, during a training session on a Saturday three weeks prior to “going-live” does not mean they will be able to perform the task with system start-up. If they have repeated the task many times over a series of training sessions, they are much more likely to remember how to do it.

Assessment

Watch the data. During and immediately after the implementation it is incredibly important to watch the data and make sure everything is working as planned. Monitor the status of orders, purchase orders, and delivery orders paying specific attention to “stuck orders” or other exceptions. Conduct some aggressive cycle counting of fast-moving items to make sure transactions are working correctly.

Conclusion

So, tell us what you think about your hospital’s SCM software implementation? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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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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Sponsors Welcomed

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

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

Filed under: Information Technology | Tagged: david marcinko, David Piasecki, DME, durable medical equipment, ERP, HIT, HMMIS, hope hetico, IT, SCM, supply chain management, www.healthcarefinancials.com | 1 Comment »

Hospital Materials Management Information Systems [Part 1]

Posted on January 7, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Fundamentals of Inventory Software Selection

By David J. Piasecki; CPIM

By Hope Rachel Hetico; RN, MHA

By Dr. David Edward Marcinko; MBA

Understanding Strategies

Strategically, hospitals must exploit contemporary technologies and connectivity with suppliers and trading partners to:

improve patient care and safety,
increase efficiency,
drive down costs, and
optimize inventory levels.

Software Selection

Software selection and implementation services have become big business for consulting firms as well as the software vendors themselves. Even with outside assistance, selecting the right software for hospital operations and having a successful implementation can be an extremely difficult undertaking. Horror stories of failed enterprise resource planning (ERP) system implementations are unfortunately very common. Anyone who frequently reads business publications have read stories where large healthcare corporations, posting smaller than forecasted profits, cite problems associated with the implementation of a new software system as one of the causes. Whether these claims are legitimate or not is up to debate. What is true is that hospitals are highly dependent on information systems and failures in the selection and implementations of systems can result in anything from a minor nuisance to a complete operational shutdown.

Those unfamiliar with business inventory management software should be prepared to be bombarded with acronyms and buzz words. E-business, web-enabled, E-procurement, E-fulfillment, E-manufacturing, collaborative, modular, and scaleable are just a sampling of the terms used to describe (sell) hospital software inventory products.

Inventory Tracking Software

Healthcare enterprise inventory tracking software with implementation ranges in price from a few thousand dollars to millions. In fact, up until recently, if you were a medical clinic with annual revenues of less than $200 million, many of the top enterprise software vendors didn’t even consider you a potential customer. Fortunately, this arrogance has been tempered recently due to economic conditions (primarily the software vendors’ cash flow). Unlike five years ago, when the software vendors felt they held all the cards, today it is truly a buyer’s market. No matter how big or small an entity, many vendors will be vying for software dollars. That’s the good news. The bad news is that you must sift through all these products to find the one that best meets your business needs.

Process Definition

The most important part of the software selection process is defining the processes within your health organization and determining functionality that is critical to your medical operation. Many times clients get distracted by the bells and whistles and forget about their core healthcare business functions. As a healthcare entity in the DME distribution fulfillment business – focus on functionality related to order processing, as well as warehouse and transportation management. Be wary of the software vendor that claims packages that work equally well in all environments. Most software packages are initially designed with specific situations in mind; asking the vendor about their biggest customers will often give you an idea as to the type of operation the software was designed to work in.

Product Functionality

When you look at the detailed functionality of a product it will be important to have listed detailed functionality requirements of your healthcare operation. This is where hospitals often make mistakes by emphasizing functionality that they currently don’t have, but would like, and overlooking core healthcare processes that their current system handles well.

Example:

For example, if you are awestruck with functionality that allows remote access to a medical charting system from an Internet browser on an ambulatory device – and as a result – overlook critical functionality related to order entry or demand planning, you may end up with a system that provides great visibility to the fact that patient revenues are failing. Never assume a software package “must” be capable of handling something considered a standard function. Some examples of detailed functional requirements are as follows:

E-commerce capabilities
Multi-facility demand planning
Postponement and configure-to-order functionality
Forecasting and demand planning
Back-order processing
Lot or serial number tracking
Forward pick location replenishment
Batch or wave order picking
Returns processing
Back flushing DME inventory
Co-product processing
Outsourcing specific operations
Multiple stocking units of measure
Product substitutions
Blanket orders
Shipment consolidation
Multi-carrier rate shopping and manifesting
First-in first-out processing

Assessment

Don’t settle for “yes, we can do that” responses from the software vendor. It’s your responsibility to verify that not only can they do it, but also that they can do it to the level required. Ask detailed questions as to exactly how it works in their system. Look at the specific programs used to achieve the task and verify that the data elements required to achieve the task are present. Don’t allow the software vendor to sidestep your questions by retreating into obfuscating technical jargon

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

Filed under: Information Technology | Tagged: CCHIT, david marcinko, David Piasecki, DME, ERP, HIT, HMMIS, hope hetico, Inventory Software, SCM, supply chain management, www.healthcarefinancials.com | 1 Comment »

Understanding the Healthcare Integrity and Protection Data Bank

Posted on January 4, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Healthcare Fraud and Abuse Data Collection Program

By Patricia Trites; MPA, CHBC, CPC

The Healthcare Integrity and Protection Data Bank (HIPDB) were created to coordinate information with the National Practitioner Data Bank (NPDB). Currently, health plans, health maintenance organizations, and federal and state agencies are required to report final adverse actions taken against healthcare providers on a monthly basis.

The NP Database

The database operates under the auspices of DHHS, the Health Resources and Services Administration, and the Bureau of Health Professions. The Secretary of DHHS is responsible for operating this data bank in the same fashion as the NPDB.

Adverse Actions

Five types of final adverse actions against a healthcare provider, supplier, or practitioner are reported into this data bank:

1. civil judgments in federal or state court related to the delivery of a healthcare item or service;

2. federal or state criminal convictions related to the delivery of a healthcare item or service;

3. actions by federal or state agencies responsible for licensing and certification;

4. exclusions from participation in a federal or state healthcare program; and

5. any other adjudicated actions or decisions that the secretary of DHHS establishes by regulations.

Assessment

These actions must be reported, regardless of whether the subject of the report is appealing the action. Federal and state agencies, hospitals, and health plans are permitted to query the HIPDB. This will also lead to increased activities by other federal agencies, including the Internal Revenue Service and the Federal Trade Commission, which can lead to civil and criminal penalties.

Conclusion

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Filed under: Ethics, Quality Initiatives, Research & Development | Tagged: david marcinko, DHHS, FTC, healthcare abuse, healthcare fraud, Healthcare Fraud and Abuse Data Collection Program, NPDB National Practitioner Data Bank, Patricia Trites, www.healthcarefinancials.com | 3 Comments »

Sign-Up for the ME-P and Get our Free Widget

Posted on January 3, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Secure e-mail Delivery with a Widget for your Website

By Ann Miller; RN, MHA

[Executive-Director]

If you haven’t had a chance to sign up for the Medical Executive-Post yet, you really should. You’ll get a helpful daily email reminder when breaking news occurs, or when important posts go up on the site. Plus; recently added new features like classified ads, job posts, “ask-the-advisor”, videos, voting polls, surveys and much more!

Many Related Topic Channels

With more than 50 topic channels to select, the ME-P is sure to professionally inform and illuminate your day; almost each and every day. So, also feel free to review our top-left column, and top-right sidebar materials, links, URLs and related sites.

And, get a free ME-P widget for your website, too!

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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

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

Filed under: iMBA, Inc., Marketing & Advertising, Sponsors | Tagged: david marcinko, Health Economics, Healthcare Finance, healthcare reform, medical executive post, obama | Leave a comment »

Events Planner: January 2010

Posted on January 1, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

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Events-Planner: JANUARY 2010

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 Medical Executive-Post is still a relative newcomer. But today, we have almost 25,000 visitors and readers each month from all over the country, in addition to our growing subscriber base. 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 Medical Executive-Post and our monthly Events-Planner with our compliments.

A Look Ahead this Month

January 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 [Health 2.0 Profit Maximizing Techniques for Savvy Doctors]; contact Ann at: MarcinkoAdvisors@msn.com. There are several chapter topics still available. Now, the important dates:

Jan 10-14: Arizona Financial Services Society, Phoenix, AZ

Jan 11-12: Kinder Institute of Life Planning, Houston, TX

Jan 11-12: Investment Management Consultants Association, New York, NY

Jan 17-20: AICPA Advanced Personal Financial Planning Conference, Orlando, FLA

Jan 21-23: Symposium on Healthcare Payers and Providers, Las Vegas, NV.

Jan 25-27: EBM Leadership Conference, National Harbor, MD

Jan 25-28: Healthcare Leadership Summit, Dallas, TX

Jan 28-29: Money Management Institute, Bonita Springs, FLA

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

MarcinkoAdvisors@msn.com

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Filed under: Events-Planner | Tagged: david marcinko, Events-Planner | 1 Comment »

Barriers to Free Market Competition in Healthcare Delivery

Posted on December 13, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Why Supply and Demand Doesn’t Work in Medicine

By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

Much has been written here, and elsewhere, about free market competition in healthcare; especially in light of the current national political debates. Yet, these markets are not free.

Like Evolution – Healthcare Competition is Only a Theory

Perfectly competitive healthcare markets are not free; they exist only in economic theory as a useful comparative artifice. In reality, industries and markets have varying constraints on competition. The healthcare industry has often been characterized as unique with its many significant barriers to free market competition, such as market controls on price and quality.

According to colleague Robert James Cimasi, of Health Capital Consultants LLC, in St. Louis MO; there are three main reasons for these barriers in healthcare:

Competitive Healthcare Barriers

The nature of healthcare creates an unpredictable, urgent, and “infinite” level of demand.
The ubiquitous involvement of insurance companies, private and governmental, as intermediary organizations in the purchase of healthcare interferes with consumer motivations and consequently their choice of providers and services.
The difficulties in measuring healthcare quality and beneficial outcomes (both of quantifying and qualifying them) and the lack of information on the relative costs of healthcare providers and services also inhibit consumer selection, further removing incentives to providers to increase quality and lower costs.

Barriers to Healthcare Competition

Included among the many other barriers to competition in healthcare delivery are the following:

Patients don’t purchase services directly from providers;
Patients don’t compare prices between providers;
The government is the largest purchaser of healthcare;
Private purchasers often lack market power;
Patients, purchasers and providers lack information;
Occupational licensing;
Many providers have monopoly or near-monopoly power (yet antitrust laws prevent some potentially beneficial integration);
Providers are rewarded for increasing costs;
Capital investments are overly subsidized (It should be noted that Stigler argues that an industry will not use its power to collect money from the government unless the list of beneficiaries can be limited, due to the fact the amount of subsidies will be divided among a growing number of rivals.*
Certificate of Need (CON), regulation, and licensing laws are an entry barrier to competing and substitute providers and services; and
Exit barriers protect low-quality providers.

Assessment

Of course, the supply side is also flagrantly encouraged by excessive medical testing, procedural interventions and surgery; mostly excused by malpractice phobia as a well as the personal financial interests of involved stakeholders.

References

Stigler, George J. “The Theory of Economic Regulation.” The Bell Journal of Economics and Management Science. Vol. 2, No. 1 (Spring 1971): 5.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Health Economics, Managed Care, Op-Editorials | Tagged: david marcinko, Health Capital Consultants LLC, healthcare competition, healthcare economics, Robert Cimasi | 9 Comments »

Get an iMBA Inc Second Opinion

Posted on December 12, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Integrating Medical Practice Management with Personal Financial Planning

By Ann Miller; RN, MHA

[Executive-Director]

Second opinions are sometimes necessary in medicine because a misdiagnosis can have significant consequences.

Thru-put and Follow-up

The same is true for your medical practice and personal financial planning goals. Another perspective may help determine if your portfolio is properly aligned, or your practice efficiently designed to achieve your goals with complete thru-put and follow-up.

Assessment

Link: https://healthcarefinancials.wordpress.com/schedule-a-consultation/

Link: www.MedicalBusinessAdvisors.com

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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

Filed under: "Doctors Only", Experts Invited, iMBA, Inc., Media Mentions and PR, Sponsors | Tagged: david marcinko, iMBA, Inc., medical executive post, second opinions, www.medicalbusinessadvisors.com | Leave a comment »

BEWARE: Top Ten Mistakes Financial Advisors Make

Posted on December 6, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the “Cobbler’s Children are Barefoot” – Syndrome

Staff Reporters

Here is an article by Philip Palaveev recently published in a financial services trade industry magazine.

“Before helping others, put your own oxygen mask first.”

That’s what they say on airplanes when instructing passengers on what to do in an emergency. It makes a lot of sense: If you can’t breathe, you can’t help others.

Personal Issues

Unfortunately, an alarming number of financial advisors suffer from personal financial “issues” that can interfere with their ability to help their clients. Personal financial problems can indeed cloud advisors’ judgment and can prevent FAs from making much needed investments in the practice.

http://registeredrep.com/advisorland/marketing_selling/top_ten_financial_mistakes_financial_advisors_1124/index.html

Assessment

According to ME-P Publisher-in-Chief Dr. David E. Marcinko, MBA, a former certified financial planner and financial advisor himself;

“Far too many so-called “Financial Advisors” have no formal business management education and precious little real financial training from sources other than their Broker-Dealers or wire-houses; so this report comes as no surprise. The vast majority of stock-brokers are product sales men and women, period. So – always beware – dear medical colleagues and all readers.”

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, be sure to subscribe to the ME-P. It is fast, free and secure.

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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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Sponsors Welcomed

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

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

Filed under: Career Development, Financial Planning, Op-Editorials | Tagged: BDs, broker-dealers, david marcinko, financial advisors, Philip Palaveev, stock-brokers, wirehouses | 2 Comments »

The ME-P is Now “On-Call”

Posted on December 5, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Leveraging Us for Mutual Advantage

Staff Reporters

Now, for the first time, you can leverage the ME-P social network to engage our members and subscribers. Because over 150,000 readers already use the ME-P, you can reach the right experts faster and more cost-effectively than ever before.

ME-P Empowerment

The ME-P enables you to start private discussions with any group of medical professionals, or financial advisors, you wish. You can then:

• Test messaging and strategies in real-time.
• Quantify product adoption and service utilization.
• Confirm effectiveness of message dissemination.
• Identify new key influencers, and more.

Assessment

Only the ME-P gives you instant access to an active community of practicing financial advisors, consultants and medical professionals already discussing your products and services. The ME-P panels allow you to use new social media tools to gain real-world insights into the diagnostics, devices, financial products or drugs that matter most to you.

Now, let the ME-P be on call – for you – 24/7/365. Contact us today!

Sponsors Welcomed

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

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

Filed under: Career Development, Drugs and Pharma, iMBA, Inc., Marketing & Advertising, Sponsors | Tagged: david marcinko, medical executive post, Sponsors, www.HealthcareFinancials.wordpress.com | Leave a comment »

Understanding the Healthcare Fraud and Abuse Control Program

Posted on December 4, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

A Joint Project Between the OIG and DOJ

By Patricia Trites; MPA, CHBC, CPC

The Healthcare Fraud and Abuse Control (HCFAC) program is a joint project between the Office of Inspector General [OIG] and the Department of Justice (DOJ).

Functions

The primary functions are to coordinate federal, state, and local enforcement in controlling healthcare fraud, and to conduct investigations relating to delivery and payment of healthcare services, and oversee Medicare and Medicaid exclusions, civil money penalties, and the anti-kickback law. The program is also designed to provide opinions, alerts, and a means for reporting and disclosing final adverse actions against healthcare providers.

HIPAA Policies

HIPAA established the Health Care Fraud and Abuse Control Account within the Medicare Part A Trust Fund and funds DOJ and DHHS activities for operation of the HCFAC. In addition to federal appropriations, the fund receives a portion of funds collected from healthcare fraud and abuse penalties and fines. HIPAA also authorizes funds from general revenues for the Federal Bureau of Investigation (FBI) to combat healthcare fraud and abuse.

Assessment

Anti-fraud and abuse provisions were also included in the Balanced Budget Act of 1997 and the Deficit Reduction Act [DRA] of 2005, and annotated and

Conclusion

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Filed under: Career Development, Health Law & Policy, Healthcare Finance, Professional Liability | Tagged: anti-kickback, BBA, david marcinko, DOJ, DRA, FBi, HCFAC, healthcare abuse, healthcare fraud, HIPAA, Medicaid, medicare, OIG, Patricia Trites, Stark, www.healthcarefinancials.com | 17 Comments »

Promoting the “Minimum Necessary” Rule

Posted on November 30, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding HIPAA Security Standards

By Richard J. Mata; MD, MS

www.HealthcareFinancials.com

One concept that is stressed by HIPAA is the “minimum necessary” rule, which states the minimum use of personal health information [PHI] that can be used to identify a person, such as a social security number, home address, or phone number. Only the essential elements are to be used in transferring information from the patient record to anyone else that needs this information. This is especially important when financial information is being addressed. Only the minimum codes necessary to determine the cost should be provided to the financial department. No other information should be accessed by that department. Many institutions have systems where a registration or accounting clerk can pull up as much information as a doctor or nurse, but this is now against HIPAA policy and subject to penalties. The “minimum necessary” rule is also changing the way software is set up and vendor access is provided.

Chain of Custody

Another challenging task is keeping up with the number of people who access PHI, because the privacy regulations allow a patient to receive an accounting of anyone who has accessed their information, both internally [within your hospital, Emerging Health Organization, or medical practice) and externally [such as through your business associates]. The patient has the right to know who in the lengthy data chain has seen their PHI. This sets up an audit challenge for the medical organization, especially if the accountability is programmed internally. When other business associates use this PHI without documenting access to a specific patient’s PHI, no one would be accountable for a breach in privacy.

Enter the Designated Record Set

One way to track access is through a designated record set, which contains medical or mixed billing records, and any other information that a physician and/or medical practice utilizes for making decisions about a patient. It is up to the hospital, EHO, medical practice, or healthcare organization to define which set of information comprises “protected health information” and which does not, though logically this should not differ from locale to locale.

Assessment

Overlaps from the privacy regulations that are also addressed in the security regulations are access controls, audit trails, policies on e-mail and fax transmissions, contingency planning, configuration management, entity and personal authentication, and network controls. For more information about the Security Standards final rule, reference the Federal Register.

Conclusion

In the age of Twitter, IMing, blogging and texting, some young doctors are forgetting the basic fundamentals of patient privacy. 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, be sure to subscribe to the ME-P. It is fast, free and secure.

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Filed under: Health Insurance, Health Law & Policy, Information Technology | Tagged: david marcinko, designated record set, EMRs, HIPAA, minimum necessary rule, PHI, Richard Mata | 1 Comment »

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