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A Due-Diligence ‘Condom’ for Physician Investors

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Using Financial Advisors with Increased Safety

[By Dr. David Edward Marcinko; MBA, CMP™]dr-david-marcinko8

Following the Bernie Madoff investment scheme, and related financial industry scandals, here are seven “red-flags” that should have alerted physician-investors to proceed with extreme caution. Always consider them before making an investment with any financial advisor [FA], registered representative [RR] or financial advisory firm, regardless of reputation, size, referral recommendation or so-called industry certifications and designations. In other words, according to Robert James Cimasi; MHA, AVA, and a Certified Medical Planner™ from Health Capital Consultants LLC, of St. Louis, MO;” trust no one and paddle your own canoe.”

Red Flags of Cautious Investing

As a former insurance agent, financial advisor, registered representative, investment advisor and Certified Financial Planner™ for more than a decade, the existence of any one of the following items may be a “red-flag” of caution to any investor:

  • Acting as its’ own custodian, clearance firm or broker-dealer, etc.
  • Lack of a well-known accounting firm review with regular reporting.
  • Unreliable or sporadic written performance reports.
  • Rates-of-return that don’t seem to track industry benchmarks.
  • Seeming avoidance of regulatory oversight, transparency or review.
  • Lack of recognized written fiduciary accountability in favor of lower brokerage “sales suitability” standards.
  • No Investment Policy Statement [IPS]. 

Assessment

Let a word to the wise be sufficient going forward. But, in hindsight, a healthy dose of skepticism might have prevented this situation in the first place. As is the usual case, fear and greed often seem to rule the day. Just as there is no such thing as safe sex – just safer sex – there is no thing as safe intermediary investing. But, exercising some common sense will surely make investing with any financial advisor much safer. It’s like a condom for your money. 

For more information on the topic of fiduciary standards – which we have championed for the last ten years in our books, texts, white-papers, journal and online educational Certified Medical Planner™ program for FAs – watch out for our exclusive Medical Executive-Post interview with Bennett Aikin AIF®, Communications Coordinator of www.fi360.com coming in March. Ben, an Accredited Investment Fiduciary® did a great job with the tough questions submitted by our own Ann Miller; RN, MHA and Hope Hetico; RN, MHA, CMP™. Don’t miss it!

Disclaimer

I am the Managing Partner for http://www.CertifiedMedicalPlanner.org and I agree with this message.

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

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IBM and Google Health

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[Partners for Online Personal Health Records

By Staff Reporters]

computer-hardwareAccording to MarketWire, February 5, 2009, IBM, Google and the Continua Health Alliance [CHA] announced new software that will enable personal medical devices used for patient monitoring, screening and routine evaluation to automatically stream data results into a patient’s Google Health Account [GHA] or other Personal Health Records [PHR].

PHR Value Extension

This breakthrough extends the value of PHRs to patients and also helps to ensure that such records are current and accurate at all times. Once stored in a PHR, the data can also be shared with physicians and other members of the extended care network at a user’s discretion.

Daschle and e-Health Reform

Of course,Tom Daschle’s recent decision to withdraw his nomination as the Department of Health and Human Services [DHHS] secretary clouds hopes that President Obama will make significant progress on health-care reform in his first 100 days in the White House. But the problems of unaffordable medical bills and millions of uninsured are not going away, and a deepening recession has more Americans feeling worried about their jobs and insecure about their health benefits.

Assessment

The breakthrough of this triumvirate extends the value of PHRs to consumers and also helps to ensure that such records are current and accurate at all times. Once stored in a PHR, the data can also be shared with physicians and other members of the extended care network at a user’s discretion.

Channel Surfing the ME-P

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Conclusion

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

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

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Healthcare Organizations [Financial Management Strategies]

By Hope Rachel Hetico; RN, MHA
Managing Editor
hetico3

This 2-volume, quarterly subscription print publication will reshape the hospital management landscape by following three important principles www.HealthcareFinancials.com

1. World Class Advisory Board

First, we have assembled a world-class editorial advisory board and independent team of contributors and asked them to draw on their experience in economic thought leadership and managerial decision making in the healthcare industrial complex. Like many readers, each struggles mightily with the decreasing revenues, increasing costs, and high consumer expectations in today’s competitive healthcare marketplace.  Yet, their practical experience and applied operating vision is a source of objective information, informed opinion, and crucial information for this manual and its quarterly updates.

2. Writing Style

Second, our writing style allows us to condense a great deal of information into each quarterly issue.  We integrate prose, applications and regulatory perspectives with real-world case models, as well as charts, tables, diagrams, sample contracts, and checklists.  The result is a comprehensive oeuvre of financial management and operation strategies, vital to all healthcare facility administrators, comptrollers, physician-executives, and consulting business advisors.

3. Compelling Content

Third, as editors, we prefer engaged readers who demand compelling content. According to conventional wisdom, printed manuals like this one should be a relic of the past, from an era before instant messaging and high-speed connectivity. Our experience shows just the opposite. Applied healthcare economics and management literature has grown exponentially in the past decade and the plethora of Internet information makes updates that sort through the clutter and provide strategic analysis all the more valuable. Oh, it should provide some personality and wit, too! Don’t forget, beneath the spreadsheets, profit and loss statements, and financial models are patients, colleagues and investors who depend on you.

Assessment

ho-journal1

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 both your print and this e-companion subscription.

Conclusion

Most importantly, we hope to increase your return on investment. If you have any comments or would like to contribute material or suggest topics for a future update, please contact us.

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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At-Home or Nursing-Home for Long Term Care [Part III]

Cost and Duration of Long-Term Care at Home

By Dr. David Edward Marcinko; FACFAS, M.B.A., CPHQ™, CMP™

By Thomas A. Muldowney; M.S.F.S., CLU, ChFC, CFP® CMP™

By Hope Rachel Hetico; R.N., M.H.A., CPHQ™, CMPdr-david-marcinko1

This is the third post, in an exclusive four part series for the ME-P titled: At-Home or Nursing Home Care for Long-Term.”

Average Nursing Home Stays

It is generally agreed that if short, recuperative stays are excluded, the average stay in a nursing home is about 21/2 years. Nursing home studies show that residents experience four types of stay before death: 12 percent remain for less than 90 days; 21 percent stay between 91 and 365 days; 43 percent stay for up to five years; and 24 percent stay longer than five years. It is not possible to know in advance which type of stay you or your family may experience. But, put in another way, two-thirds stay more than one year and one-quarter stay more than five years. Most seniors also have home care services before entering a nursing home.

Custodial Services 

Custodial nursing home services are paid from the elder’s savings or by Medicaid. The current estimated annual cost for a nursing home resident is about $35-40,000. However, the annual cost for a nursing home in metropolitan areas may be at least twice as much.

Assessment

In the past decade, nursing home charges increased 8 percent a year. At a minimum, these costs may be expected to climb at a 5 percent annual rate in the future.

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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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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Launching our ME-P Advertising Initiative

Learning and Growing with your Help

By Medical Executive-Post Staff stk321042rkn

This complimentary and companion blog forum for the 2-volume, 1,200 pages, quarterly print-journal at www.HealthcareFinancials.com provides the very latest news, information, insider reports, rated commentary, white-papers, professional posts and ranked subject matter information on the health care industrial complex. We see it as a “between-the-issues” communications forum, with in-vivo knowledge repository integrated with a ranking utility and professional social network for modernity.

Linking Stakeholders

In other words, we link movers-shakers and promote those in the profession with financial advisors, medical management consultants and health economists. All stakeholders of the healthcare industrial complex are invited to read, vote, submit posts and become involved with us.

Complimentary Resources

In order to make these high-level resources available to you at no cost, we promote our in-house textbooks, dictionaries, white papers, handbooks and print journal; online. www.MedicalBusinessAdvisors.com We also promote our consulting services, seminars, speaking engagements and online education program in heath economics and management for consultants www.CertifiedMedicalPlanner.com  

Soon, we intend to sparsely sell ads to sponsors interested in reaching out to our informed audience.

Privacy Assured

Of course, our sponsors will require some anonymous, aggregate data for reporting purposes

www.HealthDictionarySeries.com But, at no time will personal information or e-mail address be shared with vendors, sponsors or other sites. Please feel free to review our privacy policy.

Assessment

Don’t forget to send in your informed posts, and comments, too! Deep subject matter content is our lifeblood.

Read, rant, rate, rank and rave!

Please be sure to subscribe here for increased functionality.

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Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Will subscribers object to some focused and target-specific advertisements on this blog-site? Or, shall we remain purists? Why or why not?

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

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WorldFocus Interviews Uwe Reinhardt PhD

How We Compare to Canada’s Healthcare System

Staff Reporters56359795

WorldFocus interviewed Uwe Reinhardt PhD on January 28, 2009.

In this extended interview, Dr. Reinhardt, a leading adviser on health care economics and professor of political economy at Princeton University, compares the Canadian and American health care systems.

Reinhardt criticizes the US health care culture and expresses his optimism about the new Obama administration.

Video: http://worldfocus.org/blog/2009/01/28/how-the-us-measures-up-to-canadas-health-care-system/3783/#comments

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Decide for yourself; is Uwe correct; or not? Why, or why not? Despite Democratic control, is healthcare reform even likely?

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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Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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At-Home or Nursing-Home for Long Term Care [Part I]

Cost and Duration of Long-Term Care at Home

By Dr. David Edward Marcinko; FACFAS, M.B.A., CPHQ™, CMP™

By Thomas A. Muldowney; M.S.F.S., CLU, ChFC, CFP® CMP™

By Hope Rachel Hetico; R.N., M.H.A., CPHQ™, CMPdr-david-marcinko

This is the first post in an exclusive four part series for the ME-P titled: At-Home or Nursing Home Care for Long-Term Care.”

Remaining at Home

It is not surprisingly, eighty-five percent of married elders prefer to remain at home instead of moving to a nursing home or some other senior care facility. Staying at home is easier, more comfortable, and less traumatic. Home care statistics are limited, but three years is the estimated average number of years that elders will require custodial care services. This estimate also may combine home care followed by nursing home care. And, the anecdotal healthcare experience of two authors [DEM and HRH] confirms this period length.

Incremental LT Cost Approach

Quantifying the annual incremental costs of LTC home custodial services is difficult. Today, a high percentage of home care services are provided by unpaid family members, friends, or volunteer organizations. In the future, however, there will be fewer available unpaid caregivers, and more elders will have to pay for home custodial care.

Because of this potential shortage of caregivers, new business opportunities are springing up and, as usual, let the buyer beware. Many of these new businesses, for a fee, contract with a family that needs home LTC for a family member.  Upon contract, the new LTC business owner begins a search for a candidate caregiver who will live in your house and care for your parent or spouse. Often the in-home caregivers have difficulty speaking the language or may not be familiar with local customs.

Furthermore, many of them wish to be paid in cash rather than by check. As you might imagine, background checks, tax compliance and other legal considerations are of utmost importance.  Career education and career experience are also very important. Be sure that if you look for such a caregiver, you must exercise thorough due diligence so that your loved one will be cared for properly.

LTC Costs Vary Widely

LTC home care cost estimates vary widely by location and type of service. At present, the average annual cost for a live-in, full-time aide in the United States (especially if part-time help to relieve a full-time aide is added) is estimated at $40,000, the same as the estimated cost of staying at a nursing home for a year. If living expenses are added to costs for custodial aides, LTC home care costs can be more expensive than nursing home costs.

For three shifts of paid LTC custodial services, home care costs may exceed $100,000 annually; more than triple the current estimated cost for nursing home care. These numbers should not be surprising.  In a nursing home environment, one caregiver may be able to provide care for multiple patient/residents. This reduces the cost per patient. In your private home, your personal caregiver can give only care to a single patient.

Custodial Aide Costs

Costs for custodial aides in the fragmented, rapidly expanding, competitive home care industry may increase at a faster rate than the Consumer Price Index [CPI]. Employed aides will replace family caregivers. The Bureau of Labor Statistics [BLS] indicates that jobs for home health aides, human service workers, and personal and home care aides are expected to grow faster than any other industry in terms of total jobs.

In the next decade, there will be more than 2 million home care jobs, and they will become a larger component of total gross domestic product expenditures. Using an estimated three-year home care requirement and current estimated costs, and allowing for 15 years of inflation at 5 percent, $225,000 per person is a reasonable estimate to use for financial planning purposes.

Assessment

However, in some metropolitan or suburban areas, such as New York City, the cost should be increased by at least 100 percent. Of course, three years of required care is an estimate. About one-third of the people who require nursing home care will need it for more than three years. Presumably, nursing home care will be preceded by home care. Moreover, only one full-time aide was assumed. Some elders also will require additional part-time help.

And so, your thoughts and comments on this Medical Executive-Post, which represents the first in a series of four parts on: At Home or Nursing Home Care for Long Term Care, are appreciated. Comments from physicians and LTC insurance agents are especially valued.

Conclusion

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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About Health CEOs for Healthcare Reform

A Coalition from the New America Foundation

Staff Reporters

stk312038rkn

Many pundits posit that real health reform will entail quality, affordable coverage for all Americans and a restructured health care delivery system. And, a growing number of health industry leaders understand they must reorganize their business models to realize these goals.

Health CEOs for Reform

Recognizing that business as usual is no longer a sustainable model in health care, a diverse coalition of six CEOs from across the health care sector have come together to form Health CEOs for Health Reform [HC4HR]. The coalition, facilitated by the New America Foundation, brings together health industry leaders with a unique willingness to transform their business models to create a more sustainable health system.

Guiding Principles

According the its website, the group’s members are committed to moving past broad policy concepts toward detailed blueprints that reconcile the legislative goals and principles of lawmakers with the operational realities of our health care system. The coalition is built on the following three principles:

 

  1. Health reform is an urgent priority for our nation and should not be postponed.
  2. Meaningful health reform entails quality, affordable health coverage for all and delivery system reform. This will require all stakeholders to move away from “business as usual.”
  3. A more sustainable health system will require all health care stakeholders to offer and accept changes to their business models as part of a catalytic package that will better serve everyone.

Assessment

The CEOs announced the formation of HC4HR in an event at the National Press Club. Senator Sheldon Whitehouse [D-RI] provided a Congressional keynote for the event, stressing the importance of health reform in our national agenda and applauding the leadership shown by HC4HR.

Link: http://www.newamerica.net/events/2008/ceos_health_reform

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Do we really need another group to discuss healthcare reform? We all know the problems of divergent stakeholder interest. Is this the time for solutions, or another group reframing the problem?

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

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Myths and Solutions for Healthcare Reform

Enter the Primary Care Docs, NPs, PAs and DNPs

Staff Reportersidea

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Would more family practitioners, and professional medical care extenders, help or hinder true healthcare reform?  

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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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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America’s Safest Hospitals

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[Behind the Numbers]

[By Staff Reporters]56382989

Did you know that at Missouri Baptist Medical Center in St. Louis, it only takes 90 seconds to save a life? While all hospitals keep staff on-call for emergencies, Missouri Baptist has implemented a rapid response program through which anyone, even family members, can call a team of clinicians to the bedside of a distressed patient within 90 seconds.

An Idea from Down-Under

As seen in Forbes, January 27, 2009, Missouri Baptist imported the idea from Australia, with an overall emphasis on safety that is evident not only in its innovative programs, but also in its numbers.

The Internal Data

According to reported internal data, only 48% of patients die as would be expected given their diagnoses. With outcomes like these, it’s no surprise that Missouri Baptist was designated by HealthGrades, a private hospital rating company in Golden, Colo., as one of the safest in the country. In its seventh annual study of “quality and clinical excellence”, known as Behind the Numbers, HealthGrades identified 270 hospitals out of 5,000 that collectively had a 28% lower mortality rate and 8% lower complication rate than the national average. The list reflects the top 5% of hospitals nationwide.

About HealthGrades

The HealthGrades [NASDAQ: HGRD] site promotes the firm as a leading healthcare ratings organization, providing ranking and profiles of hospitals, nursing homes and physicians to consumers, corporations, health plans and other hospitals. Millions of consumers and hundreds of the nation’s largest employers, health plans and hospitals rely on HealthGrades’ independent ratings, consulting and products to make healthcare decisions based on the quality of care. Founded in 1999, the firm has over 160 employees www.HealthGrades.com

Assessment

Now, what ever happened to governmental reporting, the Joint Commission, etc? Of course, after the IOM Report on Crossing the Quality Chasm in 2001, this type of service may be more important than ever.

Link: quality-chasm3

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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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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About Hiperwall.com

Cool New Video Wall Creations – for Medicine?

Staff Reporters56371220

Hiperwall software enables anyone to build a scalable, high performance video wall from ordinary computers, monitors and an ethernet network.

Many Content Types

Hiperwall allows viewing in any combination of content types:

 

  • Ordinary graphic images
  • Extremely large graphic images, up to 1 gigabyte or larger
  • Digital movies, including standard and HDTV format
  • Streaming content from cameras and other live sources
  • Live “sender” feeds that let a room full of people view the constantly changing screen displays of one or more computers

Hiperwall has the ability to resize and relocate each content object anywhere on the video wall, within a single monitor or across multiple monitors. It is as easy as moving and resizing windows on the desktop of your personal computer. Hiperwall also provides advanced capabilities like zoom, rotation, shading and transparency, enabling users to examine content with increased flexibility and effectiveness. It is based on technology originally developed by researchers from the University of California at Irvine, and is now available for use by anyone www.Hiperwall.com

Assessment

Now, what does this all have to do with healthcare? Well, think digital radiology, cardiology, PET, CT and MRI scans, and others graphically intensive specialties? For example, an early client was Stanford University Medical School and Samsung Electronics. Still, with few other clients and only a hand-full of employees, consider overall costs, viability and follow-up support. Nevertheless, on January 24, 2009 – Information Week named the company as the “Startup-of-the-Week.”

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated; especially from you daring early-adopters, out there! Think PACS [picture archiving and communication systems].

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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Troubles Brewing for Physician Owned Hospitals

Financial Problems Predicted

Staff Reporterscrazy-house

According to the Wall Street Journal, January 22, 2009, a bill making its way through Congress to provide more low-income children with health-insurance coverage might mean financial trouble for scores of physician owned hospitals.  

 

Emergence and Growth

The very existence of doctor-owned hospitals is controversial. But, their numbers have tripled to about 200 since 1990.

The Supporters

Supporters say these hospitals, which usually focus on several lucrative services, such as cardiac care or orthopedics, are highly efficient, saving expenses for both patients and insurance programs, including Medicare.

More: www.HealthcareFinancials.com

The Critics

Critics say physicians who refer patients to hospitals with an ownership stake drive up costs, because they order more tests or perform unnecessary surgery. They argue that such hospitals also cherry pick healthy patients hurting surrounding non-profits hospitals.

Assessment

According to Pete Stark, chairman of the House Ways and Means health subcommittee, the proposed legislation would prohibit “the unethical kickbacks that physicians receive from ownership hospitals, most of which are of questionable safety and quality.”

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Do you agree, or disagree with the thesis; why or why not? Does this mean that not-for-profit hospitals, for-profit entities, or those hospitals with training programs don’t order un-needed tests? Are these hospitals and physician-investors, “crazy” or colorful and sane? 

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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Hospital Revenue Cycle Management

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Augmentation thru Technology Adoption

[By Karen White PhD, and Staff ]

Several major hospitals, or healthcare systems, have filed bankruptcy this fiscal quarter. These include a two-hospital system in Honolulu; one in Pontiac, MI; Trinity Hospital in Erin, Tennessee; Century City Doctors Hospital in Beverly Hills, and four hospital system Hospital Partners of America, in Charlotte. 

And so, since cash flow is the life blood of any healthcare revenue cycle management initiative, it is important for physician executives and healthcare administrators to appreciate the impact of modern health information technology systems on this vital function.

Functional Area Targets

Technology plays a key role across all health entity revenue cycle operations. By functional area, the following are key targets:

Patient Access

This is the front-end of a hospital’s revenue cycle. It is made up of all the pre-registration, registration, scheduling, pre-admitting, and admitting functions. Enhancing revenue cycles in this area requires the following:

  • a call center environment with auto dialing, faxing, and Internet connectivity to quickly ensure and verify all pertinent information that is key to correct and timely payment for services rendered;
  • Master Person Index software to eliminate duplicate medical record numbers and assist with achieving of a unique identifier for all patients;
  • registration and admission software that scripts the admission process to assist employees in obtaining required elements and check that insurer-required referrals are documented;
  • denial management definition, including focus on how to obtain all the correct patient information up front while the patient is in-house; and
  • imaging of data up front.

Health Information Management

This is the middle process of a hospital revenue cycle and is often still referred to as “Medical Records.” This area is made up of chart processing, coding, transcription, correspondence, and chart completion. Better control of revenue cycles requires the following recommended technology:

  • chart-tracking software to eliminate manual outguides and decrease the number of lost charts;
  • encoding and grouping software to improve coding accuracy and speed and improve reimbursement;
  • auto printing and faxing capabilities;
  • Internet connectivity for release of information and related document management tasks; and,
  • electronic management of documents.

Patient Financial Services

This is the back-end process of a hospital revenue cycle. The operations include all business office functions of billing, collecting, and follow-up post-patient care. Recommended technology to optimize these functions includes the following:

  • automated biller queues to improve and track the productivity of each biller;
  • claims scrubbing software to ensure that necessary data is included on the claim prior to submission; and
  • electronic claims and reimbursement processing to expedite the payment cycle.

Automation

Automation can lead to decreased paperwork, process standardization, increased productivity, and cleaner claims. In 2004, Hospital & Health Network’s “Most Wired Survey” found that the 100 most wired hospitals — including three out of the four AA+ hospitals in the country — had better control of expenses, higher productivity, and efficient utilization management. Today, these top hospitals tend to be larger and have better access to capital in these times of credit tightening.

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Assessment

The positive return on investment in technology increases allocation of funding to technology. This correlation is important because it begins to link the investment in information technology with positive financial returns in all areas of a hospital’s business, including the revenue cycle.

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Physician Malpractice Liability Immunity

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Free Charity Medical Care?

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Sen. Mike Enzi [R-Wyoming], the senior Republican on the Senate Health, Education, Labor and Pensions Committee [HELP], recently introduced legislation that would allow physicians and other medical professionals to volunteer their services at charity clinics and community health centers free from medical liability concerns.

Query

What is your opinion on this idea, given that there are more than 42 million uninsured Americans, in need? Please comment and explain? We are especially interested in hearing from doctors, lawyers, actuaries and health economists.

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On Physician Peer Review

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New Era Risks

By Dr. David Edward Marcinko; MBA, CMP™

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The Center for Peer Review Justice is a group of physicians, podiatrists, dentists and osteopaths who have witnessed the perversion of medical peer review by malice and bad faith.

Raison D’etre

Like the American Association of Neurological Surgeons [AANS], they have seen the statutory immunity, which is provided to “peers” for the purposes of quality assurance and credentialing, used as cover to allow those “peers” to ruin careers and reputations to further their own, usually monetary agenda of destroying the competition.

Cause and Goals

Therefore, the group is dedicated to the exposure, conviction, and sanction of doctors, and affiliated hospitals, HMOs, medical boards, and other such institutions, that would use peer review as a weapon to unfairly destroy other professionals.

Assessment

www.PeerReview.org is a rallying point and resource center for any medical professional that finds himself in the midst of an unfair and bad faith attack by unethical, malicious “peers”.

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New Health Insurance Compliance Issues

Implications of US Patriot and Bank Secrecy Acts on Hospitals

By Dr. David E. Marcinko; MBA, CMP™

By Hope R. Hetico; RN, MHA, CMP™  dave-and-hope4

With the recent popularity and growth of personal health insurance plans (PHIPs), health savings accounts (HSAs) and / or medical savings accounts (MSAs), compliance with the USA PATRIOT Act has become an important issue for these new health insurance products.  

These insurance plans place financial services organizations into relationships with shared information institutions like hospitals, healthcare organizations, medical clinics and patient clients.

The Online Connection 

This happens because many, perhaps even the majority of health insurance plans are opened online as patients and insurance company clients use Internet search engines to find the “best” policy type to meet their needs.  

Appropriately, banks, healthcare entities, and hospitals are working with insurance companies, trust companies, banks and broker-dealers to offer identity-compliant and integrated insurance plan products. 

Verifications that these clients are who they say they are, is as paramount as monitoring their activity. 

Example:  

Section 314(b) of the US Patriot Act permits financial institutions and health insurance companies – upon providing notice to the United States Department of the Treasury – to share patient and related information with one another in order to identify and report to the federal government activities that may involve money laundering or terrorist activity.  

The US Patriot Act 

The US Patriot Act aims to partially accomplish this through three critical goals:  

  1. First, it gives investigators familiar tools to use against a new threat.
  2. Second, it breaks down a wall that has prevented information sharing between agencies.
  3. Third, it updates U.S. laws to respond to the current Internet environment.  

Bank Secrecy Act, PHIPs, MSAs and HSAs 

For additional compliance security, The USA Patriot Act also amended the Bank Secrecy Act [BSA] to give the federal government enhanced authority to identify, deter and punish money laundering and related terrorist financing activities.  

Assessment 

Whatever the financial outlays required for insurance/financial organizational compliance, it may result in very large savings later if affected hospital assets and patient health insurance information is safeguarded against attacks of virtual or real assets. 

Conclusion 

And so, what is your opinion on the above health law and policy? 

Institutional information: www.HealthcareFinancials.com 

Terminology: www.HealthDictionarySeries.com 

Related reference: Marc B. Royo and David B. Nash.Sarbanes-Oxley and Not-for-Profit Hospitals: Current Issues and Future Prospects.” American Journal of Medical Quality: Vol. 23, No. 1, 70-72, February 2008.

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AN UPDATE TO 2016

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