MEDICINE: Emergent Care

SOME PHYSICIAN WORK FOR FREE

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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What is an Emergency Medicine Physician?

An emergency medicine physician is a medical doctor who specializes in the diagnosis, treatment, and management of acute and life-threatening medical conditions that require immediate intervention. These physicians work in hospital emergency departments, urgent care centers, and other acute care settings, where they provide rapid assessment, stabilization, and treatment to patients of all ages with a wide range of medical emergencies.

Emergency medicine physicians are trained to handle diverse medical emergencies, including trauma, cardiac emergencies, respiratory distress, severe infections, neurological emergencies, and obstetric emergencies, among others. They play a vital role in the front line management of medical emergencies, ensuring that patients receive prompt and appropriate care to improve outcomes and save lives.

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Classic: Emergent Room or Emergency Department care is the provision of immediate medical service offering outpatient care for the treatment of acute and chronic illness and injury. It requires a broad and comprehensive fund of knowledge to provide such care. Excellence in care for patients with complex and or unusual conditions is founded on the close communication and collaboration between the urgent care medicine physician, the specialists and the primary physicians.

Modern: Urgent care does not replace your primary care physician. An urgent care center is a convenient option when someone’s regular physician is on vacation or unable to offer a timely appointment. Or, when illness strikes outside of regular office hours, urgent care offers an alternative to waiting for hours in a hospital Emergency Room.

Examples: Chest pain, bleeding that cannot be stopped and loss of consciousness; etc.

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SOME ER DOCTORS WORK FOR FREE

The new president of emergency medicine for the Alberta Medical Association says Emergency Room physicians already coping with long hours, staff shortages and jammed waiting rooms are also being obligated, in some cases, to work for free. Dr. Warren Thirsk says the government has yet to follow through on a promise to reimburse emergency room doctors for so-called “good faith” payments.

“There’s been lots of excuses, but the bottom line is no one has actually received a penny for those suspended good-faith payments,” Thirsk said in an interview. “On average, every emergency physician in this province is out thousands of dollars for free work.” Good-faith payments reimburse ER doctors when they see patients who don’t have identification and can’t prove an Alberta Health Care Insurance Plan billing number.

Thirsk said the United Conservative government stopped those payments when it ripped up the master agreement with the AMA in early 2020. He said it promised to bring back those payments when the two sides agreed to a new deal in September 2022. But to date that hasn’t happened, he said.

“I’m legally and morally bound to look after you [if] you’re unidentified [as a patient],” said Thirsk, an emergency room doctor at Edmonton’s Royal Alexandra Hospital.

“I’m going to look after you because it’s the right thing to do no matter what the problem is.”

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HEALTH ECONOMICS: Podcast and Research Paper Presentations

By Staff Reporters

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RESEARCH PAPER: https://scholar.harvard.edu/files/mankiw/files/economics_of_healthcare.pdf

PODCAST: https://tinyurl.com/wdyk65mw

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

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PODCAST: Hospital Healthcare Finance Explained

By Eric Bricker MD

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

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HEALTH INSURANCE: Marketing and Behavioral Economics

DR. DAVID EDWARD MARCINKO MBA MEd CMP

By Staff Reporters

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DEFINITION: Behavioral economics is grounded in empirical observations of human behavior, which have demonstrated that people do not always make what neoclassical economists consider the “rational” or “optimal” decision, even if they have the information and the tools available to do so.

For example, why do people often avoid or delay investing in 401ks or exercising, even if they know that doing those things would benefit them? And why do gamblers often risk more after both winning and losing, even though the odds remain the same, regardless of “streaks”?

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

By asking questions like these and identifying answers through experiments, the field of behavioral economics considers people as human beings who are subject to emotion and impulsivity, and who are influenced by their environments and circumstances.

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The state and federal governments and health insurance companies are harnessing lessons from a still-emerging academic field of behavioral economics to nudge clients and customers into spending more money.

“Behavioral economics was developed by incorporating ideas from psychology into standard economic theories,” said Cait Lamberton, a professor of marketing at the University of Pennsylvania’s Wharton School. “If you see a deal that is available for only a short amount of time [like Medicare open enrollment periods], and thus pay more than you usually would, standard economics would say you’ve made an irrational decision. Behavioral economics says that no, what your brain is doing is responding to scarcity.”

These seemingly irrational choices are called “biases,” many of which can affect how we shop. For example, “loss aversion” makes us hypersensitive to losing money and more likely to buy something like whole life insurance for children.

The “decoy effect” makes us more likely to choose between two sub-optimal options when a third, even worse option is presented. For example, Medicare Part D providers may offer a decoy like an high costs, which may make the cheaper Medicare Part C with more [so-called] benefits look more appealing.

Most companies are well aware of these tendencies and how they drive our decisions. So to save money customers, patients and clients need to understand how the purchasing and shopping experience has been engineered to exploit our biases.

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DICTIONARY: Health Economics and Finance

BY DR. DAVID E. MARCINKO MBA

http://www.MARCINKOASSOCIATES.com

Designated a Doody’s Core Title!

“”Medical economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, insurance, mathematics and statistics, public health, provider recruitment and retention, Medicare, health policy, forecasting, aging and long-term care, are all commingled arenas.

The Dictionary of Health Economics and Finance will be an essential tool for doctors, nurses and clinicians, benefits managers, executives and health care administrators, as well as graduate students and patients? With more than 5,000 definitions, 3,000 abbreviations and acronyms, and a 2,000 item oeuvre of resources, readings, and nomenclature derivatives? it covers the financial and economics language of every health care industry sector.””
– From the Preface by David Edward Marcinko

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HEALTH SHARING AGREEMENTS: Are They Health Insurance -OR- Not?

By Staff Reporters

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Health care sharing is not insurance, but the plans count as insurance under the Affordable Care Act (ACA). That means more affordable healthcare benefits while avoiding the tax penalty for going uninsured. Other pros of health care sharing over insurance include: Lower cost. Monthly costs of health sharing are usually much lower than insurance premiums, although the rules are different for what’s covered. Also, the annual “unshared amount” is much, much lower than deductibles on lower-premium or catastrophic insurance plans. Your choice of provider. There are no network requirements, and you provide your health sharing card as coverage. If a doctor won’t accept your plan and you have to pay out-of-pocket, health sharing plans reimburse your expense.s

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

Now, the caveats: Health care sharing plans aren’t required to cover pre-existing conditions, such as cancer, diabetes, or lifestyle-related conditions like smoking. Those who have them may be declined membership or won’t have the conditions fully covered for a year or more. Health care sharing also doesn’t typically cover the essential health benefits like wellness exams or mental health counseling.

Yet, at least 1.7 million Americans are involved in a health sharing agreements despite a lack of protections (KFF Health News).

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Understanding the “Language” of Healthcare Finance, IT, Economics, Investing and Insurance

By Ann Miller RN MHA CMP

Courtesy: http://www.CertifiedMedicalPlanner.org

The ME-P is Doing Its’ Part with Comprehensive Dictionaries and Glossaries

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

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DICTIONARY: Health Economics and Finance

BY DR. DAVID E. MARCINKO MBA

Designated a Doody’s Core Title!

“”Medical economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, insurance, mathematics and statistics, public health, provider recruitment and retention, Medicare, health policy, forecasting, aging and long-term care, are all commingled arenas.

The Dictionary of Health Economics and Finance will be an essential tool for doctors, nurses and clinicians, benefits managers, executives and health care administrators, as well as graduate students and patients? With more than 5,000 definitions, 3,000 abbreviations and acronyms, and a 2,000 item oeuvre of resources, readings, and nomenclature derivatives? it covers the financial and economics language of every health care industry sector.””
– From the Preface by David Edward Marcinko

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DICTIONARY: Health Economics and Finance

10,000 TERMS, DEFINITIONS, ABBREVIATIONS AND RESOURCES

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PODCAST: Population Health and Patient Economics

HIGH COST MEDICAL CLAIMANTS

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By Eric Bricker MD

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ESSAY: https://medicalexecutivepost.com/2019/08/31/is-health-economics-heterodoxic-or-not/

ESSAY: https://www.modernhealthcare.com/education/ama-adopts-new-policy-training-physicians-healthcare-economics

MORE: https://medicalexecutivepost.com/2019/11/10/ricardian-derived-demand-economics-in-medicine/

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MORE: https://healthcare

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HEALTHCARE POLICY: Blog and Internet Sources of Gravitas

BY DR. DAVID E. MARCINKO MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

REFERENCES

https://mises.org/library/mayo-clinic-and-free-market

http://www.kevinmd.com/blog/2017/08/problem-free-market-health-care.html

http://www.healthsharetv.com/content/dr-zeke-emanuel-history-healthcare-reform-us

https://www.pointnurse.com/blog/do-you-have-a-healthcare-blockchain-strategy/

Not Really Insurance: The Pre-Existing Condition Debate

Learn More about Concierge Medicine

http://www.kevinmd.com/blog/2017/04/health-care-right-privilege-cant-answer.html

http://www.healthissocial.com/

http://www.msn.com/en-us/money/markets/brave-new-world-of-bitcoins-what-they-are-and-how-to-buy-them/ar-AAoWUza?li=BBnbfcN

https://www.pointnurse.com/blog/do-you-have-a-healthcare-blockchain-strategy/

http://www.kevinmd.com/blog/2017/06/golden-era-medicine-never-coming-back.html

http://mdwhistleblower.blogspot.com/2016/02/concierge-medicine-is-it-ethical-or.html

http://www.msn.com/en-us/money/healthcare/americas-health-care-crisis-is-a-gold-mine-for-crowdfunding/ar-BBCxjbU?li=BBnbfcN

http://www.msn.com/en-us/money/companies/the-company-behind-many-surprise-emergency-room-bills/ar-AAoKYCK?li=BBnbfcN

https://studymatescom.wordpress.com/

Is Healthcare a Right? A Privilege? Something Entirely Different?

http://www.kevinmd.com/blog/2017/07/moral-assassination-physicians-must-stop.html

http://www.kevinmd.com/blog/2017/01/emphasize-public-health-medical-education.html

Hobson’s Wrong Answer

Is Health Privacy a Human Right?

http://www.kevinmd.com/blog/2016/12/must-temper-unregulated-free-market-philosophy-health-care.html

http://www.kevinmd.com/blog/2017/06/slow-death-private-practices.html

A Primer For Conservatives: Health Insurance is not Really Insurance

http://www.kevinmd.com/blog/2017/06/doctors-pr-problem.html

http://www.kevinmd.com/blog/2017/06/doctors-cops-can-fight-mistrust-way.html

http://www.msn.com/en-us/health/healthtrending/did-a-1980-letter-help-spark-the-us-opioid-crisis/ar-BBBKkM4?li=BBnb7Kz

http://alertandoriented.com/

http://www.sheknows.com/health-and-wellness/articles/1030383/crowdsourcing-health-care

DIY Textbooks: https://medicalexecutivepost.com/2021/04/29/why-are-certified-medical-planner-textbooks-so-darn-popular/

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MarcinkoAdvisors@msn.com

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DICTIONARY: Health Economics and Finance

By Dr. David Edward Marcinko MBA CMP

CMP logo

COURTESY: http://www.CertifiedMedicalPlanner.org

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FOREWORD

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

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PODCAST: The “Medical Trend”?

By Eric Bricker MD

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MORE: https://medicalexecutivepost.com/2022/01/25/global-medical-trends-healthcare-cost-increases/

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PODCASTS: Health Economics and the AMA

By Professor Jon

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PODCAST: https://www.youtube.com/watch?v=fwYYae_U1OI

PODCAST: https://medicalexecutivepost.com/2022/05/30/ama-to-teach-medical-students-about-health-economics/

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Healthcare A.I. and Financial Outcomes Survey

By Staff Reporters

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17% of Healthcare Execs Said AI Would Affect Financial Outcomes

 •  60% of respondents expect AI to impact clinical outcomes.
 •  17% said AI would affect financial outcomes.
 •  13% said AI would impact their operation outcomes.
 •  9% said AI would impact administrative outcomes.
 •  61% of executives hope to bring about a complete digital transformation in their organizations within three to five years.

Source: Morning Consult via HealthIT Analytics, April 14, 2022

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

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PODCAST: What a Hospital CEO Should Do?

Operational and Financial Changes

BY ERIC BRICKER MD

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OVERVIEW: Healthcare Finance and Insurance Terms & Definitions

Produced FROM Merck Manual

By Roger I. Schreck

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Health care in the US is technologically advanced but expensive, costing about $3.6 trillion in 2018, which was 16.9% of gross domestic product (GDP) (1). This percentage is significantly higher than in any other nation.

According to the Organization for Economic Cooperation and Development (OECD), in 2018 the next highest spending countries were Switzerland (12.2% of GDP) and France, Germany, Sweden, and Japan (each about 11%), while the average of the 35 OECD countries (OECD35) was 8.8% (2).

ASSESSMENT: Of course, the absolute amount and the rate of increase of health care spending in the US are widely regarded as unsustainable. Consequences of increased US spending on health care include the following:

LINK: https://www.merckmanuals.com/professional/special-subjects/health-care-financing/overview-of-health-care-financing

CMS GLOSSARY: https://www.cms.gov/CCIIO/Resources/Files/Downloads/dwnlds/uniform-glossary-final.pdf

GOVERNMENT: https://www.bls.gov/ncs/ebs/sp/healthterms.pdf

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PODCAST: Traditional Medicare Hospital Value Based Payments Explained

THREE CATEGORIES OF VBC

By Eric Bricker MD

Medicare Value-Based Payments (also Called Alternative Payment Models) to Hospitals Fall Into 3 Main Categories:

PODCAST: https://www.youtube.com/watch?v=YEqtpCNwzSg

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PODCAST: The Income and Substitution Effects in Healthcare Finance

Important Economic Concepts to UNDERSTAND

Texas CEO Magazine 2016 Economic Forecast: Dallas - Texas ...

BY ERIC BRICKER MD

One of Their Applications Pertains to the Impact on Time Spent Working Vs. Time Spend on Leisure if a Healthcare Worker’s Pay is Changed.

DEFINITION: The INCOME EFFECT States That If a Worker’s Pay is Decreased, They Will Work More Hours to Maintain the Same Income. Conversely, If a Worker’s Pay is Increased, They Will Work Fewer Hours and Still Maintain the Same Income.

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

A Real-World Example of the Income Effect is When Medicare Decreased Reimbursement for Echocardiograms and as a Result, Decreased Cardiologists’ Pay. Accordingly, Cardiology Practices Increased the Number of Patients They Saw Per Day to Make Up for the Lost Pay and Maintain Their Income.

The SUBSTITUTION EFFECT States That Work and Leisure Time Have OPPORTUNITY COSTS for Each Other.

If a Worker’s Pay Goes Up, then the Opportunity Cost for Leisure (i.e. Not Working) Also Goes Up and the Worker Will Work MORE, Not LESS. Conversely, If a Worker’s Pay Goes Down, then the Opportunity Cost for Leisure Goes Down and the Worker Will Work LESS, Not MORE.

Whether the Income or Substitution Effect Dominates Depends on the Person and the Situation.

THE POINT: In the World of Fee-for-Service Reimbursement, a Decrease in Doctor Pay Per Service May Result in Doctors Providing More Services In Order to Maintain Their Income… Nullifying Any Cost-Savings.

PODCAST: The Income and Substitution Effects Are Important Economic Concepts to Understand in Healthcare Finance.

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BUSINESS & MANAGEMENT TEXTBOOKS OF INTEREST TO SAVVY PHYSICIANS

BUSINESS & MANAGEMENT TEXTBOOKS OF INTEREST TO SAVVY PHYSICIANS
Courtesy: https://lnkd.in/eBf-4vY

Health Economics, Finance, Accounting, Investing, HR and Insurance; etc.
BOOKS: https://lnkd.in/dys_xQz

 


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Percentages of Patients Experiencing Cost-Related Healthcare Access Problems

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An Infographic by Country

By www.MCOL.com

dem

Assessment

Now, compare this to healthcare access difficulties in the USA.

Conclusion

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INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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Top 12 Articles [Health Administration Reading List]

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By Staff Reporters via Austin Frakt PhD

On Health Economics, Finance and Insurance, Quality Care and Organizational Behavior

1. Substantial Health And Economic Returns From Delayed Aging May Warrant A New Focus For Medical Research

By Dana Goldman and others (Health Affairs)

2. Trends Underlying Employer Sponsored Health Insurance Growth For Americans Younger Than Age Sixty-Five

By Carolina-Nicole Herrera and others (Health Affairs)

3. Accountable Care Organization Formation Is Associated With Integrated Systems But Not High Medical Spending

By David Auerbach, Hangsheng Liu, Peter Hussey, Christopher Lau, and Ateev Mehrotra (Health Affairs)

4. The Quality Of Care Delivered To Patients Within The Same Hospital Varies By Insurance Type

By Christine S. Spencer, Darrell J. Gaskin, and Eric T. Roberts  (Health Affairs)

5. Understanding State Variation In Health Insurance Dynamics Can Help Tailor Enrollment Strategies For ACA Expansion

By John Graves and Katherine Swartz (Health Affairs)

6. When Medicare Cuts Hospital Prices, Seniors Use Less Inpatient Care

By Chapin White and Tracy Yee (Health Affairs)

7. More Americans Living Longer With Cardiovascular Disease Will Increase Costs While Lowering Quality Of Life

By Ankur Pandya, Thomas Gaziano, Milton Weinstein, and David Cutler (Health Affairs)

8. Surgical Skill and Complication Rates after Bariatric Surgery

By John Birkmeyer and others (New England Journal of Medicine)

Reading list

9. Who Is in Control? The Determinants of Patient Adherence with Medication Therapy

By Sergei Koulayev, Niels Skipper and Emilia Simeonova (National Bureau of Economic Research)

10. Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception

By Martha Bailey (National Bureau of Economic Research)

11. Identifying the Health Production Function: The Case of Hospitals

By John Romley and Neeraj Sood (National Bureau of Economic Research)

12. ACA Standoff

By Jeffrey Drazen and Gregory Curfman (New England Journal of Medicine)

Assessment

Feel free to send us links to your own hot topic reading list so that we may share.

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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

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

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

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

Physician Advisors: www.CertifiedMedicalPlanner.org

Business%20Optimization

Books for Savvy Doctors and their Financial Advisors and Management Consultants

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Learn and Prosper from the ME-P

By Ann Miller RN MHA

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Assessment

Click on each image for more information.

Feel free to write a review and tell us what you think?

Conclusion

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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 Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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A Five Minute Treatise on Healthcare Economics 101

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An Encore YouTube Video by Joe Flowers

[Staff Reporters]

Why it costs so much, yet we still don’t get what we want and need—better healthcare that is cheaper.

Video link: http://www.youtube.com/watch?v=4Ry1AkbxRQU

Conclusion

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

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

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The ACA and Rising Healthcare Costs?

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Effects of Affordable Care Act on Private Health Care Costs Remain to be Seen
[By Staff Reporters]
###
The latest data on economic growth shows the American economy spent the last quarter growing at a rate equal to 2.5 percent a year. That’s neither recession-level bad nor full employment recovery-level good, but it’s worth diving into the numbers to see exactly what’s driving this slow expansion.
###
A significant part of the growth came from personal spending on health care as insurance premiums continue to rise, meaning a lot of that growth wasn’t very productive. That health care costs are rising—and rising faster than most other expenses—is a problem that businesses and policymakers have struggled with for years: It’s the major cause of federal budget deficits and the reason behind the health care law passed in 2010. While the effects of the Affordable Care Act on private health care costs remain to be seen—many of its provisions will not go into affect for another two years—health care economists like Harvard’s David Cutler say it draws on nearly every idea that exists to lower costs.
###
But, Cutler adds that while we wait for pilot programs to succeed and scale or fail, more changes to the system—including a public insurance option and further incentives for health providers to reform delivery—should be on the table.While policymakers in Washington and state capitals wait on politics and legal challenges to the 2010 law, consumers can take action themselves to lower costs. Innovative health care companies are coming up with new ways to make cost savings easier to find.

infographic, healthcare, politics, business, cost, transparency, GOOD

Source: Simplee

Conclusion

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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 Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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“Journal of Financial Management Strategies” for Healthcare Organizations

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Hospitals and Healthcare Organizations

[A Textbook of Financial Management Strategies]

Buy from Amazon

 

Update on How Physicians Get Paid in 2010-11 [A slide show]

Part 2: [A Visual .ppt Presentation]

By Dr. David Edward Marcinko; MBA

[Editor-in-Chief]

From prior posts and comments on this ME-P, we know that most patients don’t have a clue about how doctors get paid in the real world of health insurance reimbursement.

A Popular Topic

We know this because prior posts on the topic have consistently been among the most popular on this platform. For example:

Part 1: https://healthcarefinancials.wordpress.com/2008/09/12/how-doctors-get-paid

Assessment

And so, we have taken the liberty of drilling down the topic, to a more granular level, in this attached .ppt presentation.

Link: How Doctors Get Paid in 2010 

Conclusion

And so, your thoughts and comments on this ME-P special presentation are appreciated. Tell us what you think?

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 Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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

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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[Health] Plan Management Navigator

January 2011

By Douglas B. Sherlock, CFA
Senior Health Care Analyst

Dear ME-P Readers and Subscribers,

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At the risk of appearing overwhelmed with New Year’s enthusiasm, we think this edition of Plan Management Navigator is especially interesting:

1. We report on the cost decisions made by low cost Blue Cross Blue Shield plans. Low cost plans make decisions that differ from their higher cost peers. Hallmarks of these decisions include levels and distributions of expenses between functions, the levels and distribution of staff between functions, the levels of compensation and its distribution between functions and the distribution between functions, and levels of, non-labor expenses. Overall, low cost Blue Cross Blue Shield Plans have “tactical” administrative expenses that are $5.75 PMPM, or 30%, lower than their higher cost counterparts. These tactical expenses are all administrative expenses excluding medical management and sales and marketing.

Last month we published a similar study of the choices of low cost Independent / Provider-Sponsored Plans. Low cost health plans had tactical costs that were 36% lower than their peers, or by $6.39.

A more detailed version of either of these analyses is available to licensed users of each of our benchmarks. Please call us for further information if you have an interest.

2. We introduce a new service on our website that will enable you to determine how a health plan is doing relative to the 2010 benchmarks. You can select your universe and then determine whether you are high or low and, if so, by how much.

3. We invite you to participate in the 2011 benchmarking study. We are now forming universes. We think that, under pending MLR rules, participation is very timely.

Link: Navigator January 2011

Thank you for your continued interest in our research.

Assessment

sherlock@sherlockco.com
Ph:  215-628-2289
Fax: 215-542-0690

Conclusion

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

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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Our Other Print Books and Related Information Sources:

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

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

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Hospitals and Healthcare Organizations [2 New Print Books]

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Healthcare Organization and Hospital Financial Management Strategies

All hospitals and healthcare organizations, both emerging and mature, face a daunting financial scenario in today’s volatile healthcare re-imbursement environment.

Decreasing revenues, increasing costs, and high consumer expectations present a complex challenge for CEOs, CFOs, physicians and nurse executives, administrators, financial advisors and department managers who must not only lead in today’s climate, but also position their organizations for tomorrow’s financial tumult and potential political changes of the Obama Administration and ACA, etc.

A National Team of Contributors

Produced by  economists, administrators – accountants, business leaders, MDs and IT consultants, among others; Hospitals and Healthcare Organizations [Financial Management Strategies] looks at ways to manage assets, costs, human resources and healthcare claims.  Everything – from inventory management to hybrid and activity based cost analysis in order to accelerate the cash conversion cycle – is scrutinized.  And, modern health economic themes like competitive strategy, workplace violence and financial benchmarks, for both public and private entities, are included.

Contemporaneous Health 2.0 Topics

We also examine contemporaneous topics such as the lessons learned from the corporate healthcare market competition and the PPMC imbroglio of the early 2000’s, and the domestic financial meltdown of 2009. This includes current methods for achieving hospital objectives, negotiating and analyzing cost-volume-profit contracts, and understanding the financial impact of regulatory requirements under HIPAA, STARK I-III, OSHA, the US Patriot Acts, the Deficit Reduction Act [DRA], the often contentious Sarbanes-Oxley Act, ARRA and HITECH Acts, and the Fair and Accurate Credit Transactions [FACT] Act. In addition, information technology issues like electronic medical records (eMRs), RFID controls, RSS feeds and blogs, Health 2.0 initiatives and computerized physician order entry (CPOE) systems are examined in detail. Virtually no operational, strategic business, health economics, or financial management topic is omitted.

Assessment

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Hospitals and Health Care Organizations [Financial Management Strategies] is dedicated to meeting the administrative needs of our nation’s healthcare organizations in order to help them maintain a competitive edge in the markets they serve; and to take advantage of emerging business opportunities. We therefore invite you to be the first health economics cynosure in your hospital, facility, or healthcare system to join us for the journey.

Channel Surfing the ME-P

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

Conclusion

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

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

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A Funny [Poignant] Video about Health Insurance

What Exactly Do Patients Know and Understand?

By Staff Reporters

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This video illustrates the current state-of-the-art regarding patient understanding of health insurance reimbursement and physician income. But, should it be played in all doctors offices’ and waiting rooms?

Title

It is titled: “What the public does not know about doctors and insurance.”

Link: http://www.youtube.com/watch?v=Y00kxCn7m0s

Assessment

The movie was made and uploaded with Xtranormal’s State. To make your own movie just visit: http://xtranormal.com

Source: Dr. Jon Purdy

Conclusion

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

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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Our Other Print Books and Related Information Sources:

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

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

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About HealthCareTownHall.com

Informed Healthcare Reform Dialogue

By Staff Reporters

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Milliman is the host of this blog to encourage an informed dialogue about healthcare reform.

Complications

Healthcare is complicated, and there is no single, silver-bullet answer to the question of “How do we best improve the current system?”  

Assessment

But, thoughtful discussions will help move reform in the right direction and mend the fractured system; especially in terms of entitlements, costs and spending, etc.

  Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Visit www.HealthCareTownHall.com and tell us what you think? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

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

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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

Top Hospital Administration and Healthcare Business Blogs

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The Top 50 List for 2009

[By Staff Reporters]

According to some experts, one of the best things you can do for your career in health care is to read a variety of blogs to help you get some insight into how things work from an administrative standpoint. This can be very helpful as you learn about different aspects of hospital administration and the business of health care.

Assessment

From IT, economics and finance, to healthcare policy and law, to management leadership and being a hospital CEO or private medical practice physician, there is a great deal of information out there.

So, here are some of the top 50 hospital administration and health business blogs available:

List: http://mastersinhealthcareonline.com/2009/top-50-hospital-administration-business-blogs/

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Secure e-mail Delivery with a Widget for your Website

By Ann Miller; RN, MHA

[Executive-Director]

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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

Around the Healthcare Financial Blog-O-Sphere

News and Economics Updates in Thirty Minutes or Less 

By Staff Reporters

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1. Unions pressure Democrats on health insurance tax
Associated Press via Google, December 10, 2009

2. Is there a doctor in the corporation? Maybe soon
Reuters, December 9, 2009

3. Sebelius Statement on Benefits of Health Insurance Reform for Businesses
HHS Press Release, December 3, 2009

4. Majority of employers would reduce health benefits to avoid proposed excise tax
Mercer Press Release, December 3, 2009

5. U.S. unemployed face higher healthcare premiums
Reuters, December 2, 2009

6. Public support for health-care reform is high, but some CFOs take a different view
CFO.com, December 1, 2009

7. Survey: Growing worker stress seen in benefits use
Associated Press via Google, November 30, 2009

8. Employers Play Dr. Mom to Limit Swine Flu Impact
Associated Press via Google, November 30, 2009

9. Health Care Savings Could Start in the Cafeteria
The New York Times, November 28, 2009

10. Ford, GM Face $2.5 Billion First VEBA Bill
Workforce Management, November 24, 2009

11. Plan credits healthy habits – Employer cuts costs by allowing workers to ‘earn’ lower rates
Business Insurance, November 23, 2009

12. Health Care: GE Gets Radical
Business Week, November 19, 2009

Conclusion

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Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Sponsors Welcomed

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Get the New ME-P Widget

Spreading ME-P Content and Informaton with our Gift to You

By Ann Miller; RN, MHA

[Executive Director]Our Gift

As someone who reads far too many medical, healthcare finance, political and health economics blogs on a daily basis, I decided to compile our ME-P blog RSS feeds into a nice, clean widget which you can quickly cut and paste into your own blog, wike or website.

Why Would you Want this Widget?

  • Easily keep up with latest ME-P posts and comments on more than 50 topical channels.
  • Spread goodwill throughout the blogo-sphere when you send visitors to other blogs.

Assessment

If you’re not tech savvy, we’ve done the hard work – just cut and paste and you’re done. Please e-mail me if you have any questions.

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Channel Surfing

Get more from www.BlogSurfer.US  Be sure to visit our other topic channels too! Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. 

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Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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Sponsors Welcomed

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

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

Sherlock Expense Evaluation Report [SEER]

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Plan Management Navigator

By Marco Georeno

Ph:  215-628-228956372274      

Please find attached the April 2009 edition of Plan Management Navigator. In it we provide an update on the timing of the Blue Cross Blue Shield universe and the Independent / Provider-Sponsored editions of the Sherlock Expense Evaluation Report (SEER). In addition, we expect to circulate the benchmarking surveys for the Medicaid and Medicare universes on or about June 1st, for completion by July 20th, 2009.

Benchmarking Studies

If you are interested in participating in our benchmarking studies please contact us as soon as possible. Additional information about SEER is available at www.sherlockco.com/seer.shtml or by contacting Doug Sherlock (sherlock@sherlockco.com).

Best Practices for the Healthcare Enterprise

We also endeavor to provide an enterprise view of best practice. Best practice is typically considered to be the most efficient way of achieving a desired outcome. We believe that the best way of determining the best practice in its most practical application is to start with an overall objective and weigh all particular practices in light of how they contribute to that overall objective.

In that vein, over the next several months, Sherlock Company will be offering web conferences focused on best practices. The first conference will address activities within Customer Services, as well as activities or effects in other functional areas. This web conference will be held on Wednesday May 20th at 2:30 PM, Eastern Time. The costs will be $225. Participation is free of charge to health plans participating in our 2009 benchmarking studies. If you are interested in participating, please email Erin Sawchuk (erinsawchuk@sherlockco.com) or call at 215-628-2289.

Assessment

This edition of Navigator also discusses the latest private health plan Dashboard results for the trailing three months ended January 31, 2009.

Link: navigator

Sincerely,
Sherlock Company

Marco Georeno – Analyst
mgeoreno@sherlockco.com

Fax: 215-542-0690

Conclusion

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

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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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Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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About Medlytix.com

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On Patient Payment Behavior Scoring

[By Staff Reporters]56371606

Medlytix is a healthcare consulting and technology firm specializing in the field of predictive payment analytics. Utilizing sophisticated data mining and scoring strategies, the company reports enhanced hospital revenue cycles and collections for healthcare providers across the country.

The Business of Healthcare

It is a fact that consumers treat medical bills differently than other financial obligations. So, Medlytix customizes revenue-enhancement strategies to target each provider’s individual market.

Suite of Services

All stakeholders benefit from a more efficient operation – from provider to patient. Medlytix offers expertise and technology to enhance the cash conversion and revenue cycle by eliminating inefficiencies while maximizing collections. A customized strategy that’s based on specific needs is crafted. Three offerings include: 1.Medilyzer, 2. Predyx, and 3. Consulting services to improve the bottom line.

Non-Profits Hospitals

Non-profit hospitals exist to serve their communities with quality healthcare accessible to all. By helping hospitals pinpoint charity-care patients who are truly in need, the focus is on the patient.

Assessment 

The mission of Medlytix is to build a healthier bottom line for hospitals. As fiscal strength improves, better hospitals provide better service to patients.

Medlytix

Conclusion

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

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

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Evaluate our 2-Volume Institutional Print Guide

Healthcare Organizations [Financial Management Strategies]

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www.HealthcareFinancials.com

Our 1,200 pages, 2-volume, quarterly institutional print guide Healthcare Organizations [Financial Management Strategies] is available on a 30-day, risk-free trial.

You may contact http://www.STPub.com at (604) 983-3434, fax (604) 983-3445, or e-mail at custinfo@stpub.com to place an order, or ask questions regarding pricing and/or availability.

All shipments arrive within 5 to 10 days. Prepayment is required for all international shipments and a small courier charge will be added to the subscription price.

After hours, we suggest you review the STP website FAQs section for answer to your inquiry: www.stpub.com/pubs/custinfo.htm

Assessment

Rest assured, Healthcare Organizations: [Financial Management Strategies] will become an important peer-reviewed vehicle for the advancement of working knowledge and the dissemination of research information and best practices in our field. In the years ahead, we trust these principles will enhance utility and add value to your subscription. Most importantly, we hope to increase your return on investment [ROI] by some small increment.

Review and Ordering Information:

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orders@stpub.com

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Note: The guide is sponsored by www.MedicalBusinessAdvisors.com with contributions from www.CertifiedMedicalPlanner.com and is edited by ME-P’s Dr. David E. Marcinko and Professor Hope R. Hetico; RN, MHA. Definitions and terms supplied by www.HealthDictionarySeries.com

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Reviews from current journal-guide subscribers are encouraged and appreciated.

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

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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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Consulting for the ME-P

Talk to Us

By Ann Miller; RN, MHA

[Executive Director]solo-consultant

We would like to better understand who is visiting the Medical Executive-Post, and what you like, or do not like, about our blog site, print journal and/or communications forum. Most of all, we wish to know who is just visiting versus who is posting, commenting and subscribing; and why?

Assessment

Your responses are confidential, and will only be used for internal use to improve the website blog. We will not sell your information to anyone, ever!

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Please send in your considered responses to me at: MarcinkoAdvisors.@msn.com

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

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NEW: Health Industry Indignation Index

Foibles of Industry Movers-Shakers

New Beta Feature

By Staff Reporterssubmission-frenzy3

What it is – How it works

The Industry Indignation Index [III] is an occasional survey feature of the Medical Executive-Post. Our goal is to chronicle the dubious, ironic or humiliating behavior that we humans in the healthcare industrial, financial and health economics complex are prone to do or say. Related sectors are fertile topics, as well.

Our Industry Indignation Score Card

The mathematical scores measured on a scale of 1 [just smelly and cheesy] – to 100 [utterly indignant and totally shameless] are subjective and not-statistically significant. They are non-representative samples however, of the obnoxious behavior of some in the news and their public foibles. 

User Generated Content

Feel free to send in your items, stories or political gossip for consideration.  We will rate-em, rank-em, post-em, and do the rest for you!

Conclusion

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

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

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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