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    Dr. Marcinko is originally from Loyola University MD, Temple University in Philadelphia and the Milton S. Hershey Medical Center in PA; as well as Oglethorpe University and Emory University in Georgia, the Atlanta Hospital & Medical Center; Kellogg-Keller Graduate School of Business and Management in Chicago, and the Aachen City University Hospital, Koln-Germany. He became one of the most innovative global thought leaders in medical business entrepreneurship today by leveraging and adding value with strategies to grow revenues and EBITDA while reducing non-essential expenditures and improving dated operational in-efficiencies.

    Professor David Marcinko was a board certified surgical fellow, hospital medical staff President, public and population health advocate, and Chief Executive & Education Officer with more than 425 published papers; 5,150 op-ed pieces and over 135+ domestic / international presentations to his credit; including the top ten [10] biggest drug, DME and pharmaceutical companies and financial services firms in the nation. He is also a best-selling Amazon author with 30 published academic text books in four languages [National Institute of Health, Library of Congress and Library of Medicine].

    Dr. David E. Marcinko is past Editor-in-Chief of the prestigious “Journal of Health Care Finance”, and a former Certified Financial Planner® who was named “Health Economist of the Year” in 2010. He is a Federal and State court approved expert witness featured in hundreds of peer reviewed medical, business, economics trade journals and publications [AMA, ADA, APMA, AAOS, Physicians Practice, Investment Advisor, Physician’s Money Digest and MD News] etc.

    Later, Dr. Marcinko was a vital and recruited BOD  member of several innovative companies like Physicians Nexus, First Global Financial Advisors and the Physician Services Group Inc; as well as mentor and coach for Deloitte-Touche and other start-up firms in Silicon Valley, CA.

    As a state licensed life, P&C and health insurance agent; and dual SEC registered investment advisor and representative, Marcinko was Founding Dean of the fiduciary and niche focused CERTIFIED MEDICAL PLANNER® chartered professional designation education program; as well as Chief Editor of the three print format HEALTH DICTIONARY SERIES® and online Wiki Project.

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[By Dr. David Edward Marcinko CMP® MBA]

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Given today’s economic and political environment, with its’ increasing competitive pressures, medical practices are focused more-than-ever on patient acquisition and patient retention. Modern medical practices are teaming together to offer comprehensive end-to-end solutions.

If you are partnering with other healthcare organizations to pool in your expertise, offer joint solutions and take up joint medical marketing and patient communications programs, be careful how you execute and about what you agree with your partners on sharing patient databases.

Policy

It is advisable to formulate a simple and clear privacy policy and adhere to that in the partnership agreements. Comply with the policy at all patient touch points. Communicate this very clearly with your partners and patients prominently in all your channels of communication. Inventory your data collection processes and gateways. Select appropriate projects to add security to your data across extended networks and partners.

Note there is no silver bullet to protect the privacy. Privacy compliance is as much a business issue as it is a technical issue, sometimes more so.

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Implications for Patient Strategies

While you are formulating and implementing privacy policies; you need to address the following questions:

  • Do your patients respond to your practice’s privacy strategy? It is not enough to have a privacy policy that is so confidential no one is aware of that. It is imperative for practices, once they implement their privacy strategies, to understand how patients are responding and loop the feedback to fine-tune policies accordingly.
  •  How do you consider the impact on the patient from every privacy decision you make? Every privacy decision made will impact the patient and your practice; but to what extent? How do you determine this impact? Some of them will be patient-facing and some will be in the back–end. This step is essential so that you can make appropriate decisions and make optimum usage of resources.
  • Will your medical practice operations support the privacy initiative? Privacy enablement requires resources and training with perhaps no immediate, apparent short-term value-add to the top-line or bottom-line. Medical practices that take a proactive view of privacy enablement as cost of doing business in the 21st century will benefit. Practices still need to adopt critical processes and technology that agree with their resources and gradually privacy enable in an incremental way.

Role of Technology

There is no technology silver bullet. Privacy enabling a practice is composed of elements of company loyalty towards patients, commitment to build long lasting and profitable patient management by building trust, and engaging cross-functional teams that can pick and deploy suitable data security across the network.

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Steps

Here are some salient steps for secure data management that affect technology choices of any medical practice:

  • Privacy-compliant database development – healthcare organizations have to “listen” and record what patients are saying, and if and how they prefer to be contacted, or not at all. All these details will have to be stored in a secure database, which is regularly refreshed with the outcome of practice communications with patient. This will be the central repository that the office draws upon to design and execute consistent and privacy enabled patient communications.
  • Protect the data across the practice, from group to group, area to area, or from network to network. It is not enough for a medical practice to protect data from external intruders, but also from internal data abusers. It is not enough that patient data is secure during transmission at the patient touch point. It also needs to be safe where it is stored. It is not unusual to have patient data stored or lying around where it is accessible by internal intruders. Therefore it is imperative for medical practices to go beyond traditional firewalls to have multi-layered security at the data level.

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We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants. We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you. Our content creation—including speaking topics, articles and course development—is client-driven.

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1. Consider establishing an employee stock ownership plan (ESOP).

If you own a clinic or medical practice or business and need to diversify your investment portfolio, consider establishing an ESOP. ESOP’s are the most common form of employee ownership in the U.S. and are used by companies for several purposes, among them motivating and rewarding employees and being able to borrow money to acquire new assets in pretax dollars. In addition, a properly funded ESOP provides you with a mechanism for selling your shares with no current tax liability. Consult a specialist in this area to learn about additional benefits.

2. Make sure there is a succession plan in place.

Have you provided for a succession plan for both management and ownership of your medical practice, clinic or business in the event of your death or incapacity? Many business owners or physician-executives wait too long to recognize the benefits of making a succession plan. These benefits include ensuring an orderly transition at the lowest possible tax cost. Waiting too long can be expensive from a financial perspective (covering gift and income taxes, life insurance premiums, appraiser fees, and legal and accounting fees) and a non-financial perspective (intra-family and intra-company squabbles).

3. Consider the limited liability company (LLC) and limited liability partnership (LLP) forms of ownership.

These entity forms should be considered for both tax and non-tax reasons.

4. Avoid nondeductible compensation.

Compensation can only be deducted if it is reasonable. Recent court-decisions have allowed physician executives or business owners to deduct compensation when (1) the corporation’s success was due to the shareholder-employee, (2) the bonus policy was consistent, and (3) the corporation did not provide unusual corporate prerequisites and fringe benefits.

5. Purchase corporate owned life insurance (COLI).

COLI can be a tax-effective tool for funding deferred executive compensation, funding clinic or company redemption of stock as part of a succession plan, and providing many employees with life insurance in a highly leveraged program. Consult your insurance and tax advisers when considering this technique.

6. Consider establishing a SIMPLE retirement plan.

If you have no more than 100 employees and no other qualified plan, you may set up a Savings Incentive Match Plan for Employees (SIMPLE) into which an employee may contribute up to $12,500 per year if you’re under 50 years old and $15,500 a year if you’re over 50 in 2015. As an employer, you are required to make matching contributions. Talk with a benefits specialist to fully understand the rules and advantages and disadvantages of these accounts.

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7. Establish a Keogh retirement plan before December 31st.

If you are self-employed and want to deduct contributions to a new Keogh retirement plan for this tax year, you must establish the plan by December 31st. You don’t actually have to put the money into your Keogh(s) until the due date of your tax return. Consult with a specialist in this area to ensure that you establish the Keogh or Keoghs that maximize your flexibility and your annual contributions.

8. Section 179 expensing.

Businesses and medical practices may be able to expense up to $25,000 in 2015 for equipment purchases of qualifying property placed in service during the filing year, instead of depreciating the expenditures over a longer time period. The limit is reduced by the amount by which the cost of Section 179 property placed in service during the tax year 2015 exceeds $200,000.

9. Don’t forget deductions for health insurance premiums.

If you are self-employed (or are a partner or a 2-percent S corporation shareholder-employee) you may deduct 100 percent of your medical insurance premiums for yourself and your family as an adjustment to gross income. The adjustment does not reduce net earnings subject to self-employment taxes, and it cannot exceed the earned income from the business under which the plan was established. You may not deduct premiums paid during a calendar month in which you or your spouse is eligible for employer-paid health benefits.

10. Review whether compensation may be subject to self-employment taxes.

If you are a sole proprietor, an active partner in a partnership, or a manager in a limited liability company, the net earned income you receive from the entity may be subject to self-employment taxes.

11. Don’t overlook minimum distributions at age 70½ and rack up a 50 percent penalty.

Minimum distributions from qualified retirement plans and IRAs must begin by April 1 of the year after the year in which you reach age 70½. The amount of the minimum distribution is calculated based on your life expectancy or the joint and last survivor life expectancy of you and your designated beneficiary. If the amount distributed is less than the minimum required amount, an excise tax equal to 50 percent of the amount of the shortfall is imposed.

12. Don’t double up your first minimum distributions and pay unnecessary income and excise taxes.

Minimum distributions are generally required at age seventy and one-half, but you are allowed to delay the first distribution until April 1 of the year following the year you reach age seventy and one-half. In subsequent years, the required distribution must be made by the end of the calendar year. This creates the potential to double up in distributions in the year after you reach age 70½. This double-up may push you into higher tax rates than normal. In many cases, this pitfall can be avoided by simply taking the first distribution in the year in which you reach age 70½.

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13. Don’t forget filing requirements for household employees.

Employers of household employees must withhold and pay social security taxes annually if they paid a domestic employee more than $1,900 a year in 2015 (same as 2014). Federal employment taxes for household employees are reported on your individual income tax return (Form 1040, Schedule H). To avoid underpayment of estimated tax penalties, employers will be required to pay these taxes for domestic employees by increasing their own wage withholding or quarterly estimated tax payments. Although the federal filing is now required annually, many states still have quarterly filing requirements.

14. Consider funding a nondeductible regular or Roth IRA.

Although nondeductible IRAs are not as advantageous as deductible IRAs, you still receive the benefits of tax-deferred income. Note, the income thresholds to qualify for making deductible IRA contributions, even if you or your spouse is an active participant in a employer plan, are increasing.

The $100,000 income test for converting a traditional IRA to a ROTH IRA was permanently eliminated in 2010, allowing anyone to complete the conversion.

You can withdraw all or part of the assets from a traditional IRA and reinvest them (within 60 days) in a Roth IRA. The amount that you withdraw and timely contribute (convert) to the Roth IRA is called a conversion contribution. If properly (and timely) rolled over, the 10 percent additional tax on early distributions will not apply. However, a part or all of the distribution from your traditional IRA may be included in gross income and subjected to ordinary income tax.

Caution: You must roll over into the Roth IRA the same property you received from the traditional IRA. You can roll over part of the withdrawal into a Roth IRA and keep the rest of it. However, the amount you keep will generally be taxable (except for the part that is a return of nondeductible contributions) and may be subject to the 10 percent additional tax on early distributions.

15. Calculate your tax liability as if filing jointly and separately.

In certain situations, filing separately may save money for a married couple. If you or your spouse is in a lower tax bracket or if one of you has large itemized deductions, filing separately may lower your total taxes. Filing separately may also lower the phase out of itemized deductions and personal exemptions, which are based on adjusted gross income. When choosing your filing status, you should also factor in the state tax implications.

16. Avoid the hobby loss rules.

If you choose self-employment over a second job to earn additional income, avoid the hobby loss rules if you incur a loss. The IRS looks at a number of tests, not just the elements of personal pleasure or recreation involved in the activity.

17. Review your will and plan ahead for post-mortem tax strategies.

A number of tax planning strategies can be implemented soon after death. Some of these, such as disclaimers, must be implemented within a certain period of time after death. A number of special elections are also available on a decedent’s final individual income tax return. Also, review your will as the estate tax laws are influx and your will may have been written with differing limits in effect. In 2015, estates of $5,430,000 (up from $5,340,000 in 2014) are exempt from the estate tax with a 40 percent maximum tax rate (made permanent starting in tax year 2013).

18. Check to see if you qualify for the Child Tax Credit.

A $1,000 tax credit is available for each dependent child (including stepchildren and eligible foster children) under the age of 17 at the end of the taxable year. The child credit generally is available only to the extent of a taxpayer’s regular income tax liability. However, for a taxpayer with three or more children, this limitation is increased by the excess of Social Security taxes paid over the sum of other nonrefundable credits and any earned income tax credit allowed to the taxpayer. For 2015 (as in previous years), the income threshold is $3,000.

For more information concerning these financial planning ideas, please call or email us.

More: Enter the CMPs

ABOUT  DR. GARY L. BODE MSA CPA CMP [Hon]

Dr. Gary L. Bode was Chief Executive Officer of Comprehensive Practice Accounting, Inc., a firm specializing in providing tax solutions to medical professionals. Originally, he was a board certified podiatrist and managing partner of a multi-office medical practice for a decade before earning his Master of Science degree in Accounting from the University of North Carolina. He then served as Chief Financial Officer [CFO] for a private mental healthcare facility. Today, Dr. Bode is a nationally known Certified Public Accountant, financial author, educator, and speaker. Areas of expertise include producing customized managerial accounting reports, practice appraisals and valuations, restructurings, and innovative financial accounting as well as proactive tax positioning and tax return preparation for healthcare facilities. He has been quoted in Newsweek.

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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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An Educational Niche Resource Supporting Doctors and their Consulting Advisors

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By Eugene Schmuckler PhD MBA MEd CTS [Academic Provost]

About the Medical Executive-Post

We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants.

We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”

More: Letterhead.iMBA_Inc.

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niche

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Enter the Certified Medical Planners™

There is no certification program, course of study or professional designation for FAs who wish to enter the lucrative financial planning space serving physicians and healthcare professionals.

That’s why the R&D efforts of our governing board of physician-directors, accountants, financial advisors, academics and health economists identified the need for integrated personal financial planning and medical practice management as an effective first step in the survival and wealth building life-cycle for physicians, nurses, healthcare executives, administrators and all medical professionals.

Now – more than ever – desperate doctors of all ages are turning to knowledge able financial advisors and medical management consultants for help. Symbiotically too, generalist advisors are finding that the mutual need for extreme niche synergy is obvious.

But, there was no established curriculum or educational program; no corpus of knowledge or codifying terms-of-art; no academic gravitas or fiduciary accountability; and certainly no identifying professional designation that demonstrated integrated subject matter expertise for the increasingly unique healthcare focused financial advisory niche … Until Now!

Enter the Certified Medical Planner™ charter professional designation. And, CMPs™ are FIDUCIARIES, 24/7.

FAs

Video: http://vimeo.com/84247360

An Interview with Bennett Aikin AIF®

Physician-Investors and the “F” Word

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Let’s Make a Deal!

[By Dr. David Edward Marcinko MBA [Publisher-in-Chief]

[By Prof. Hope R. Hetico RN MHA [Managing Editor]

David and HopeDear ME-P Readers and Subscribers,

Our blogging, reportage and research rely on rapid, electronic access to the brightest minds, thought-leaders and latest publications in all the leading universities, financial advisory firms, consultants, healthcare entities, private practitioners and/or health economists. And, fortunately we are growing … fast.

Unfortunately, for a variety of reasons, we are unable to obtain what we need from all these great contacts and the network we already have in place. All are doing their best, and we appreciate them very much. We are just growing fast and change in the integrated sectors we serve is so unrelenting. In fact, we now have more than fifty [50] topical areas; and more are coming.

Some friends and colleagues have stepped up and filled the gap, for which we are grateful. Thank you very much! But, some of that support system is fading away or is not robust enough.

Frankly, the patchwork of support we’ve stitched together over the past eight years is growing thin.  Can we do better? Let’s see!

If you are a financial advisory firm, BD, RIA, hedge fund or private investor; hospital, university, medical clinic or healthcare organization; e-newspaper, related online professional, educational or social network that can offer us what we need, let’s talk!

We are happy to exchange our top-notch contacts, scholars, content and cognitive resources for something. It could even be just good public relations and expanded visibility in this ecosystem; but make us an offer! The marginal cost to you would be very low.

Assessment

So, let make a deal! A contact form is included, below.

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Financial Planning MDs 2015

On Next-Generation Medical Practice Management Strategies

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Establishing the Way-Forward

[By Dr. David Edward Marcinko MBA CMP™]

dr-david-marcinkoMedical practices today are operating in a new or next-generation practice management environment. There are significant pressures on physicians to increase, or at least maintain revenues and bottom line profits. These pressures are coming from many sources.

First, there is the increase in managed care penetration. As managed care grows, and the ACA implements via ACOs, doctors are forced to sign up with these health plans in order to maintain their patient base. They perform the same services but get paid less for them. Reimbursement is undergoing a paradigm shift, progressing from retail, to a wholesale, mentality. Capitation is changing reimbursement patterns. When capitation becomes the payment system, most doctors lose revenue simply because they do not know how to practice in this type of payment environment.

Second, payers’ have a continuous desire to reduce costs, including federal government programs such as Medicare and Medicaid. Many are bundling services together into single payments. More importantly, many payers are simply reducing what they pay doctors. Government intervention, such as HIPAA and eHRs, is also putting pressures on practice revenues. Increased scrutiny by the Government with regard to fraud and abuse issues, along with the Stark rules and regulations, have both impacted practice revenues. Some practices have found they cannot create the revenues they used to since Stark became law. As a result of government scrutiny, physicians coding practices have become much more conservative, thus impairing revenue.

Finally, these pressures have created a significant increase in competition within the healthcare marketplace. To increase revenues, physicians are becoming more aggressive in the marketplace. Many are spending more money on marketing activities in order to increase patient volume. Others are forming affiliations or alliances to go out and obtain exclusive contracting relationships, which is another way to increase patient volume.

In aggregate, physicians are now forced to take initiatives to increase practice revenues. Practices that do not place emphasis on this strategic strategy find themselves with declining revenues as well as declining profits. This means less money available for physician compensation. However, some practices have been successful in growing their revenues with the following practical strategies, which vary for each practice and each practice locale.

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ImageProxy

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Competing for Managed Care Related Contracts

The objective here is to go out and obtain exclusive contracting arrangements that will add profitability, not necessarily volume, to the practice. This usually means entering into an arrangement with a third party payer. To do this, the practice must do two things. First, it must make sure it is positioned so that a payer will want to award a contract to the practice. In other words, it must have something to sell to the payer. For example, primary care practices are attractive to those payers who want to award global risk contracting arrangements. Second, the practice must market itself to these payers. This means going out and meeting with payer representatives about potential contracting arrangements. The meeting should solicit from the payer what kind of exclusive contracting relationships it is looking for and more importantly, what it thinks about the practice itself. In other words, find out if the payer would even consider awarding a contract to the practice.

Ancillary services

A practice should analyze the services that it is now referring out, so that it can bring them in house to generate revenue. This conflicts with hospital-owned practices since the employed physicians refer most ancillaries to the hospital. In other words, because of government rules, the physicians cannot look to these revenues for additional compensation. However, still look for these opportunities – there might be ancillary services the hospital does not render or does not want to render that could be provided by the practice itself.

Examples of ancillary services that most medical practices could implement include lab, radiology (ie, X-Ray, mammography, echo testing, bone density testing, etc.).

Physician Extenders

As a result of declining reimbursement, physicians are spending less time on patient treatments that do not pay well. In other words, they are not spending time on care that could be rendered by someone else (i.e. by a lower cost provider). Adding a physician extender to a practice can increase revenues simply by freeing up physician time to do other, better paying clinical activities.

For example, an extender could conduct certain post-operative visits, which usually are not paid if treatment is within a designated global surgical period. Extenders could also be used to add patient volume, especially in primary care practices. Many busy practices hire extenders in order to allow patients quick, convenient access to a healthcare provider for simple medical conditions. This way, patients do not have to wait for an appointment. As a result, this leverages the volume of patients a practice can treat on a daily basis.

Added Venue Value

In some service areas, a medical practice can branch out to increase revenue. Practices may be successful adding satellite locations in areas that are either underserved or need a more qualified physician. For example, some practices in urban areas have set up satellite offices in other parts of their county, which are usually geographically outside the urban area itself. Since a significant amount of capital will normally be required to start up the office from scratch, it may be more practical to acquire or merge with an existing practice. The emphasis would then be on increasing the efficiency and profitability of that practice site.

Improving Operations and Productivity

In most cases, revenues can be increased for a medical practice simply by improving operations and physician productivity. For example, many practices have problems with their billing and collection activities, including receivables management. Charges do not get billed on a timely basis, collections at the time of service are inadequate, there is a failure to detect incorrect payer reimbursement, and receivable follow up is unstructured or non-existent. All of this can lead to high receivables and low collections – in other words, lower revenues. The entire billing and collection process should be analyzed and evaluated to see if there are any improvements that can be made that could increase practice revenues.

Next, physicians should look closely at CPT® coding patterns. This is critical for those practices operating in a fixed fee environment because fee schedules cannot be increased to generate additional revenues. First, look at your coding for evaluation and management services. Many doctors under code these services and many do not know how to bill for consultative visits. Look at all other coding issues related to your specific medical specialty. Are modifiers being applied correctly? Are surgical complications identified and billed correctly? Are all available CPT® codes being billed? These are just a few examples.

Make sure the practice fee schedule is maximized. There should not be any billing of a service where the billed charge is approved 100% for payment by the payer. This is especially true for managed care payers. To identify these situations, you must have a system in place to review the Explanation of Benefits (EOBs) that are received from the payers with each reimbursement. Look for those charges that were approved 100% for payment. When identified, the related service fee on the practice charge master should be increased immediately.

Finally, for hospital-owned medical practices, increasing physician productivity can result in an immediate increase in revenues. History has shown that physician productivity often declines after a physician practice is acquired. This is usually because the incentives in the employment contract are misplaced. In these situations, the incentive should be placed on the doctor’s base salary and not any bonus possibilities. A doctor will often maintain productivity if he or she knows that his or her base salary could decline if productivity targets are not met.

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Business Med Practice

***

The Template Textbook for Success

For comprehensive practice management information on how to increase office efficiency, operations, revenue and profit, an excellent textbook is: The Business of Medical Practice, 3rd edition.

Assessment

Regardless, the keystone of integrated financial planning for all physicians is consistent income. The following practice benchmarking methodology will assist in proactively monitoring this all-important parameter of your financial life, before it is too late.

Conclusion

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Purchase today and Profit in 2014

By Ann Miller RN MHA

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Modern Office Management Skills for Savvy Physicians

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“Learning” about The Business of Medical Practice in Modernity

By Ann Miller RN MHA

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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
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Books for Savvy Doctors and their Financial Advisors and Management Consultants

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Time-Line to Launching a New Medical Practice

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A New Practice Checklist

Dr. David Edward Marcinko MBA CMP™

www.BusinessofMedicalPractice.com

Dr. Marcinko at Emory UniversityIt is important to develop a general checklist that touches some of the most important issues in launching a traditional medical practice; or an extended medical service line.

Link: Chapter 04: Strategic Operations

Once the checklist or “to-do” list is completed, and practically it never will be, a time-line may be developed, accelerated, decelerated or modified depending on circumstances. Just think of it as an overlapping continuum rather than discrete steps using appropriate elements of the checklist below.

Time-Line Milestones to Office Launch

12 Months Out:

  • Determine your strategic competitive advantage
  • Obtain medical license
  • Craft a business plan
  • Secure capital funding and living expenses
  • Secure office location for professional, demographic or lifestyle reasons
  • Retain a practice management consultant, accountant, banker and attorney.

9-11 Months Out:

  • Retain and hire contractor, architect or remodeling firm and build out the office space
  • Obtain certificate of occupancy or appropriate permits
  • Incorporate the business [S Corp, LLC, PC, etc]
  • Obtain state and federal tax ID and EIN, DEA number, NPI, Medicare and Medicaid provider numbers, etc
  • Contact insurance companies for credentialing applications to become a contracted provider
  • Contact local medical professionals, hospitals and ASCs, etc.

7-8 Months Out:

  • Establish a benefit and retirement plan
  • Obtain insurance coverage [life insurance, malpractice insurance, disability and worker’s compensation coverage, etc]
  • Complete Medicare/Medicaid paperwork and from private and commercial insurance companies, hospitals, ASCs, etc.

5-6 Months Out:

  • Complete building out the office
  • Obtain furniture, office equipment, medical and administrative supplies
  • Evaluate and order computerized HIT and eHR systems
  • Begin insurance discussions and obtain policies from agent/broker/counselor

3-4 Months Out:

  • Policy / procedure manuals in place [OSHA, HIPAA, ADA, PA, etc]
  • Interview and start hiring staff, personnel and office manager [FT and PT]
  • Begin marketing and advertising [websites, blogs, yellow pages, TV, radio, etc]
  • Contact drug representatives
  • Retain a CPA, or similar accounting or payroll services professional
  • Secure traditional and electronic “new” yellow page ads
  • Rent a PO box and open a business savings and checking bank account
  • Get a business credit/debt card and unsecured line of credit [LOC], if possible.

1-2 Months Out:

  • Systems check [phone system, answering service, laundry, lawn care, janitorial and cleaning, security, collections, bookkeeping and payroll.
  • Contact clinical laboratory, biopsy, blood analysis, C&S services, etc
  • Contact and set up an account with a medical waste company (unless the landlord includes this in the lease or sub-lease)
  • Secure credit card or similar payment services
  • Prepare for MCO, HMO, CAQH credentialing and walk-thru’s, etc
  • Order office stationary, logos, business cards, etc.
  • Open house parties.

The Road Ahead for New Doctors

Impending Opening

Commence patient care.

Conclusion

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About the Certified Medical Planner™ Program

Certified Medical Planner

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The Virtual Certified Medical Planner™ Program, from iMBA Inc.

Our flagship 500 hour Certified Medical Planner™ professional designation program is designed for fiduciary focused FAs, CFPs®, CPAs, RIAs and other financial services professionals and/or doctors, nurses, health entity CXOs, managers and administrators [medical management consultants] and those in career transition looking to enhance their theoretical knowledge and practical experience in the integrated and expanding fields of medical practice management and personal financial planning.

In all our courses, we cover the full spectrum for any given topic.  Best of all, we utilize real-life case studies from the marketplace, either as a financial advisor or medical management consultant, so students can actively participate in a mock “working financial advisory group” or “medical managerial team”.

And, our unique CMP™ teaching methodology uses “live” dedicated instructors to help [adult-learners] students understand how to fully integrate quantitative and qualitative analysis when advising clients.

We offer 24/7/365 classes designed for working professionals with a heavy workload or travel schedule. In addition, our courses can be taken without ever having to leave your desk, home, office, practice, or even your hotel room.

Our training program is internet based so most of our students take the course virtually. Nevertheless, while our service delivery model is virtual – the educational benefits and notoriety you receive are REAL!

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A Glimpse into Lean Medical Management Tools and Techniques

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A Very Brief Review

By Mark Matthews MD

As most medical and healthcare executives and consultants are aware, there are a few tools and techniques that are unique to the world of Lean process improvement and management.

These  include: Kaizen Events, The 5-S Technique, Standard Work, Visual Controls and Human Factors Engineering.

We will review the first two techniques in this ME-P. Of course, the last three are reviewed in much greater detail in our new book complete with checklists, figures, tables, drawings, graphs and other illustrations.

Kaizen Events

Kaizen is one of the most powerful tools in the Lean methodology. These events involve intense work sessions aimed at making concrete decisions in a short time period without the need for much data collection. Kaizen events are fairly narrow in scope, ideally concentrating on making one or two decisions at the most.

For example, there may be competing improvement ideas that require more exploration. Using a Kaizen event can provide the necessary structure to make the decision needed to move forward with implementation. The steps in a typical Kaizen Event often include:

  • Determine and define the objectives
  • Determine the current state of the process
  • Determine the requirements of the process
  • Create a plan for implementation
  • Implement the improvements
  • Check the effectiveness of the improvements
  • Document and standardize the improved process
  • Continue the cycle

The 5-S Technique

This technique was developed to allow employees to visually control their work area around visual management techniques. The principles involved in visual management include:

  • Improving workspace efficiency and productivity
  • Helping people share workstations by providing standard layouts
  • Reducing the time required to look for needed supplies or tools
  • Improving the work environment

Each “S” in 5S stands for a step in the process:

  • Sort – classify every item in the designated area as either needed or not needed
  • Set (Straighten) – put “everything in its place”
  • Shine (Sweep) – clean all work environments for order and organization
  • Standardize  – document what goes where, who will clean and who will inspect and on what schedule
  • Sustain-design a system for monitoring process, providing feedback, and rewarding good outcomes

Assessment

Prior to conducting a 5S event, a significant amount of planning is vital. It is important to scope the target area as something that is manageable, draw a physical map of the area under consideration [hospital, ED, OR, clinic, office, etc], and assemble a list of current items in that area. This is usually accomplished by taking photographs (both before and after) of the area.

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

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Appreciating the Financial Rewards of a Managerially Efficient Medical Practice

The Real Benefits of Improving Medical Practice Performance

By Dr. Gary L. Bode MSA, CPA, PC

www.BusinessofMedicalPractice.com

Most medical practitioners are not well trained in business.  However, our health care services are provided in an underlying business environment. Let’s consider the financial rewards of a well-run practice, since they are the most tangible. We shall demonstrate the financial benefit of improving practice performance one percent, in three key parameters.

Example:

Our hypothetical example uses a practice with $500,000 per year of gross fees, a 20% aggregate contractual write off rate, 3% of bad debt and 70% of overhead.  The money available for pre tax practitioner salary is $116,400 as calculated below:

1) 80% (100% minus the 20% of contractual write off) of 500,000 in gross fees is $400,000.

2) 97% (100% minus the 3% of bad debt) of 400,000 is $388,000.

3) 30% (100% minus the 70% of overhead) of 388,000 is $116,400.

Leverage

The financial leverage inherent in a practice makes even small improvements in performance yield dramatic bottom-line or “in pocket” results. Cutting overhead 1% nets the practitioner an extra annual $3,880 of potential salary.  Likewise, decreasing bad debt 1% yields $1200.  A simultaneous 1% improvement in both parameters yields $5,120, all for the same amount of patient care with no additional malpractice liability.

Assessment

Notice that increasing gross fees, the area most practitioners think of when discussing practice management, has the least financial impact of the three key parameters.  While outside the scope of this essay, good services marketing can improve any practice’s gross fees, even in today’s environment.  The key to this is superb patient service, of which the clinical result is only a component.  Making the patient’s total perceptions exceed their prior expectations insures a full appointment book.

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

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

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ME-P Recommends the “Health Dictionary Series”

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About Our Newest Practice Management Book

MEDICAL PRACTICE MANAGEMENT EDUCATION:
The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors]

www.BusinessofMedicalPractice.com

Front Matter BoMP – 3

David E. Marcinko; Hope Rachel Hetico
December 2010 – 750 pp Hardcover (C) 2011
ISBN: 9780826105752  – Price: $95.00 

Reach the Executive Decision-Makers!

If you want the opportunity to reach a personalized weekly audience of health care industry insiders, innovators and watchers, the Medical Executive-Post and its educational forums may be right for you?

https://medicalexecutivepost.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

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

Autumn 2010 Update from the ME-P Editors

What We Are Up To – Now

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

By Prof. Hope R. Hetico; RN, MHA, CMP™

[Managing Editor]

To All ME-P Readers and Subscribers

Gosh, it’s been an incredibly busy summer and last few weeks.

So much for a fall-break!

Our Latest Textbook Release

For example, the Institute of Medical Business Advisors team www.MedicalBusinessAdvisors.com, and our related author-partners, have been fully occupied finishing up the third edition our newest book The Business of Medical Practice [Transformational Health 2.0 Skills for Doctors] www.BusinessofMedicalPractice.com 

Frontmatter: Front Matter BoMP – 3

After a decade since first release, some are even calling it a “classic”. And, it will be most useful for our personalized and unique www.CertifiedMedicalPlanner.com online educational program for all financial advisors interested in the “red-hot” healthcare consulting space. 

Of course, we’ve also been helping existing clients realize the benefits of our financial advice, practice management experience, and crowd-sourced knowledge.

Back to Basics

One of the fascinating things about enabling financial advisors, medical management consultants and their physician-clients to harness the power of health 2.0 modernity is how rapidly it, and we, have become as an essential tool and powerful ecosystem affecting so much of what they do – and how they do it – from “office to hospital and home” and from “practice inception to succession and retirement planning”.  

This is an exciting and satisfying time for us all – sort of like letting the textbook and consulting genie out of the bottle – but with every one winning – not just the person who gets to make the wish!

Assessment

And, to all those who are passionate about integrating personal financial planning for physicians – with medical practice management – you will be delighted by our renewed focus on our individual and institutional clients; both old and new.  This shift is long overdue and – and if done properly – will benefit every single ME-P user, iMBA Inc client, and all those empowered by same [doctor-patients and FA-clients].

Conclusion

So, give us a “shout-out” the next time we meet and look for us on the speaking circuit in 2011. Exciting times, indeed!

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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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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Useful Managed Care Patterns and Procedural Utilization Trends

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Part One of Two

By Dr. David Edward Marcinko MBA

[Publisher-in-Chief]

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

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

Link: Front Matter BoMP – 3

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

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

Reimbursement Contract Negotiations

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

www.managedcaredigest.com

hos

Procedural Utilization Trends

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

Assessment

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

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

Conclusion

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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How the ME-P Views Client Engagements and Consultations

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

By Ann Miller RN, MHA

[Executive Director]

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

[picapp align=”none” wrap=”false” link=”term=financial+advisor&iid=5289604″ src=”5/0/3/9/Group_of_people_333f.jpg?adImageId=12975963&imageId=5289604″ width=”337″ height=”506″ /]

Typical Clients

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

  • Evaluate current performance, identify improvement areas and drive progress over time
  • Uncover opportunities to capture market share and grow volumes
  • Anticipate future demand using our proprietary forecasting model
  • Adopt innovative care delivery processes and structures to meet clinical, financial and service goals
  • Develop informed, effective leadership teams to drive organizational change and growth
  • Launch seminars, lectureships, collaborative workshops and speaking engagements.

The ME-P Difference

Along with the ME-P website, here is how we are different: www.CertifiedMedicalPlanner.com

ME-P is future-focused

We have a track record of predicting trends that keep you ahead of the competition. We continuously scan the horizon to anticipate changes that will transform practices, clinics, hospitals, the financial services industry, RIAs and medical practices.

ME-P is expert-led

Our experts collaborate with you to form powerful relationships, support critical decision making, address challenges and uncover opportunities. We bring a unique understanding of your challenges—many of our experts are former financial services colleagues, physicians, CXOs, insurance agents, executives and nurses, etc.

ME-P is data-driven and action-oriented

Our solutions are grounded in proprietary analytical tools and data. By combining expert insight and data intelligence, we develop recommendations that may empower you to grow top-line and bottom-line performance today and in the future.

ME-P is core to health entity and business process

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

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Conclusion

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

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

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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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 Dictionary Series: http://0ga191.web.officelive.com/default.aspx

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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2010 Physician Sentiment Index™

Taking the Pulse of the Physician Community

By Ann Miller RN, MHA

[Executive Director]

From time to time, our readers send in e-books, files or e-chapters, pamphlets or other material they have created for client, educational or marketing use. Some of it may be worthwhile; some not so. Nevertheless, these publications are often a good place to start the conversation, or thought-process on related topics.

They will be occasionally offered as a complimentary membership feature of the Medical Executive-Post.

[picapp align=”none” wrap=”false” link=”term=doctors&iid=279612″ src=”0276/0e9a3c11-109e-45f7-8862-39f6ee6676a3.jpg?adImageId=13062844&imageId=279612″ width=”319″ height=”480″ /]

February 2010 Physician Sentiment Index

By athenahealth

By Sermo

Link: Sermo

Disclaimer

No advice is offered. We make no copyright claim to these works. Veracity should be checked and information should be considered time sensitive. Please contact a professional for your situation.

Assessment

Feel free to send in your own material for the benefit of all Medical Executive-Post readers and subscribers.

Conclusion

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

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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.

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Letter from the Editor-in-Chief

Help Support the ME-P

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

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

Our History

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

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

The Pioneers

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

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

Participatory Power

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

Our Request

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

Assessment

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

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

Support Independent Journalism – Donate

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

Conclusion

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

Contact: MarcinkoAdvisors@msn.com 

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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

Seeking your Medical Practice Management [Horror] Story

Help us Find a Case Report Learning Experience

By Ann Miller; RN, MHA

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

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

Difficult Doctor Clients

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

Assessment

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

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

Call to Action

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

Submissions

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

Related: www.CertifiedMedicalPlanner.com

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

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

Sponsors Welcomed

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

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

Financial Accounting Concepts for Medical Practice Management

Your Top 25 Most Urgent Questions Answered by iMBA, Inc.

By Dr. David Edward Marcinko; MBA, CMP

By Hope Rachel Hetico; RN, MHA, CMP

www.CertifiedMedicalPlanner.com

cmp-logoThe modern medical practice is both similar, and unlike, other businesses today. This disparity often adds to confusion for the private practitioner. And so, the experts at iMBA Inc, list the top 25 most urgent questions in practice financial management, asked by clients to date.

Assessment

Since inception in 2000, the Institute of Medical Business Advisors Inc., has become one of North America’s leading professional health consulting and valuation firms; and focused provider of textbooks, CDs, tools, templates, onsite and distance education for the health economics, administration and financial management policy space. As competition and litigation support activities increase and the cognitive demands of the global marketplace change, iMBA Inc is well positioned with offices in five states and Europe, to meet the needs of medical colleagues, related advisory clients and corporate customers today; and into the future.

Link: iMBA Inc Q and As

Website: www.MedicalBusinessAdvisors.com

biz-book1

Conclusion

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

 

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

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

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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.

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

Sponsors Welcomed

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

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

Understanding the Need for Onsite Practice Management Visits

Interview Information also Important

By Dr. David E. Marcinko and Staff Reporters

www.healthcareFinancials.comHO-JFMS-CD-ROM

According to Robert James Cimasi MHA, ASA, AVA, CMP™ of Health Capital Consultants, LLC, in St. Louis, MO, the following types of information specific to medical practices should be gathered by the financial executive, financial advisor or healthcare consultant when performing a practice enhancement engagement, or especially, an economic valuation and appraisal. This information may be obtained through an interview, questionnaire, or preferably a site visit:

  • Background Information: Include such information as the number of years the entity has operated at its current location and in the community, as well as the office hours.
  • Building Description: Include the location (urban/suburban), proximity to hospitals and other medical facilities, and its size, construction, electrical and computer wiring, age, access to parking, and so on.
  • Office Description: Approximate acquisition details and price, as well as ownership or lease details should be included.  The square footage and number of rooms, and a description of different office areas should be outlined, including, where applicable: medical equipment, including all diagnostic imaging and major medical equipment; pharmacy, laboratory, examination rooms, waiting rooms, and other areas.
  • Management Information Systems: Document types of hardware and software and the cost, age, and suitability of all components, including their management functions, reporting capabilities, and integration between programs.
  • History of the Entity: Give the date founded and by whom, the number of full-time equivalent (FTE) physicians in practice by year, the physicians who have joined and left the entity, the dates they practiced at the entity, and their relationship and practice arrangement with the entity.
  • Staff Description: Include the number and types of non-physician positions as well as the tenure and salary of all current employees.
  • Competitive Analysis: Include details of hospital programs impacting practice, growth or decline in the volume of business and the reasons, association with other physicians, competitive strengths and threats, the number and volume of procedures performed, any change in the number and volume, and the corresponding fees.
  • Patient Base Information: Encompass income distribution and percentages from different payors, the number of new patients and total patients seen per week, the age mix of patients, the number of hours spent in patient care per week, and the number of surgeries performed.
  • Managed Care Environment: Details the terms and conditions of all managed care contracts including discounts and withholds, the impact on referral patterns and revenues, willingness to participate in risk sharing contracts and capitation, and the entity’s managed care reporting capabilities.
  • Hospital Privileges and Facilities: List all hospital privileges held by physician members of the medical practice and the requirements for acquiring privileges at the different local hospitals.
  • Credit Policy and Collections: Include practice policies for billing and payment, use of collection agencies, acceptance of assignments, other sources of revenues, and an aged breakdown of accounts receivable.
  • Financial Management: Include cash management procedures and protections, credit lines and interest, controls to improve payment of accounts payable, late payment frequency, formal or informal financial planning methods, and budgeting processes.
  • Operational Assessment: Include governance structure for the entity, detailing responsibilities and procedures for performance, conflicts, recruitment, outcomes measures, case management, reimbursement; income, continuing medical education (CME), credentialing, and utilization review.

Assessment

www.CertifiedMedicalPlanner.comBecome a CMP

The financial advisor must also allow for discussion of overall relationships with physicians in the community, practice concerns, and needs.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Have you ever had such an onsite visit? Was it by a fiduciary financial advisor or medical management consultant; or other? What was the outcome? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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

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 

Get our Widget: Get this widget!

Our Other Print Books and Related Information Sources:

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

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

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

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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

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

Sponsors Welcomed

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

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

Physician [Fee] Schedule Augmentation

Organizing and Analyzing Financial Data

[By Christy Clodwick; MHA]

biz-book1After all medical practice management data has been gathered, organize it onto a spreadsheet or chart.  This analysis report will help to determine the codes and/or health plans that should be targeted for process improvement.

Focus … Focus … Focus

The focus should be on the highest volume and dollar value codes. Does this mean patients with unusual conditions or low dollar value codes are not treated? Hopefully it will not; but it will push this process forward and the practice will see the greatest benefit from these categories. When you review the report and find that a fee is being paid at a much lower rate, this would be indicative of a necessary negotiation with the payer for an increase for that procedure. Most health plans are committed to preventing disease. Maybe, but they are still actually aimed at treating diseases; not preventing them. If this is true of many payers then they should be willing to provide the incentives for those services to be carried out. You will find that some payers’ fee schedules are very much out of line with a percentage of Medicare payments, therefore the practice administrator should focus on those payers and bring evidence of the inadequacies to their attention.

The Specialists

Specialists are, for the most part, paid at a higher rate than primary care physicians not usually for the same service! And, with GPs as gatekeepers, the specialty doc incomes may have actually decreased in some instances, while the GPs may have increased. There was a time when Medicare had two conversion factors, and this was the result. This inequity could also be used as a tool for better reimbursement rates.

Finalizing the Fee and Revenue Analysis

When the final preparations of the fee analysis have been completed, it is time to react to the results of the findings. There are several options to choose from when it has been determined that a health plans fee schedule is not in tune with the practice’s financial growth. The practice should act on these results as soon as they are discovered, to avoid the loss of any more revenue.

No longer Accepting Health Plans

During the analysis phase, you may determine that a health plan’s payment levels are extremely low. You will have to determine whether the plan is worth negotiating or the practice administrator should consider dropping out of the plan altogether at the end of the contract period. It will have to be carefully determined by the local market. If the practice is in a highly competitive market, this process should not be considered as first choice. However, if the market is very slim, the health care purchaser will be responsible for complaining to the health insurance plan provider that there is simply not enough physician coverage for their employees for the area. This could be a very effective way to force a negotiation with the health care company. If this were the case, the area would have less managed care and more MC/MD.

Not Accepting New Patients from Low Paying Health Plans

One option would be to not accept any more patients from the health plan that is reimbursing the practice with low rates. Although this may initially lower your patient count, over time the practice will benefit from new patients with health plans that have a better reimbursement policy. Include snapshot of what the final analysis or report should look like and the details of what it should include. This can be used in any specialty to assist in putting together the individual practice analysis to achieve the same results. But is it noble or ethical? What about any willing provider laws?

dhimc-book1The Future for Health Care Reimbursement

The health care purchasers who pay most of the bills, such as employers and the government, will soon be challenging the annual increase and the overall cost of health care. The cost increases of the hospital and pharmacy sectors of healthcare are far higher than that of the physician. However, the pressure for cost containment is being felt across the board. This will eventually depress future reimbursement for all healthcare providers.  In the future it will be hard for practices to keep up with the demands of labor, malpractice and supply cost increase. All medical providers need to plan for this future paradigm. To offset this trend, physicians will need to get the most out of the work that they are doing today as well as look to new revenue generating procedures for their practice that will be cheaper and more convenient to the patient.

Process Improvement

The biggest benefits will come from continually improving the process of the daily operations of the practice, as well as ensuring accurate diagnostic coding. This will enable a practice to keep up with charge capturing through the explanation of benefits (EOB) when the charge has been processed and paid by the health insurance provider. When this process identifies that there is room for negotiation, the provider should proceed for a better reimbursement rate. If the provider is in a dominant market, the payers will be more likely to issue sweeping fee increases and so can you give me an example of this ever happening? By completing a Practice Fee Analysis, any practice should be able to use this tool to demonstrate the inequities and negotiate a better reimbursement rate for the practice.

Assessment

The first step in the negotiation process would be to contact a representative of the health insurance company that is in question. If you can produce compelling evidence to the representative, the negotiation process should be the next meeting. These folks may be fired if they do what you suggest, too frequently. Continually updating the practice fee schedule will help the practice stay on top of the contracts that it practices under. Practices that present a well-documented argument may (almost never) be rewarded with positive payer response. Again, proper planning will make for great future performance in any health care practice.

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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The Business of Medical Practice [3rd Edition]

By Hope Rachel Hetico RN, MHA, CMP™

[Managing Editor]biz-book7

Dear Colleagues,

As you may know, we are commencing work on the third edition of our best selling book: The Business of Medical Practice

TOC 1st: http://www.amazon.com/Business-Medical-Practice-Maximizing-Doctors/dp/0826113117/ref=sr_1_8?ie=UTF8&s=books&qid=1231111232&sr=1-8

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Invitation to Contribute

Accordingly, we would be honored for you to consider contributing a new or revised chapter, in your area of expertise, for a low-effort but high-yield contribution. Our goal is to help physician colleagues and management executives benefit from nationally known experts, as an essential platform for their success in the healthcare 2.0 business industry. Many topics are still available: [health accounting and costing; law, policy and administration; Medicare fraud and abuse; coding and insurance; HIT, grid and cloud computing; finance and economics, competitive models, collaboration and leadership, etc].

Support Always Available

Editorial support is available, and you would enjoy increasing subject-matter notoriety, exposure and public relations in an erudite and credible fashion. As a reader, or preferably a subscriber to the ME-P, your synergy in this space may be ideal. Time line for submission of a 5,000-7,500 word chapter is ample, and in a prose writing style that is “wide, not deep.” 

A Health 2.0 Initiative

And, be sure to address health 2.0 modernity. Update chapters from the second edition are also available. 

Definition: https://healthcarefinancials.wordpress.com/2008/09/12/emerging-healthcare-20-initiatives

Assessment

Please contact me for more details, if interested. A best selling-book is rare; while a third-edition volume even more so. Join us in this project. Regardless, we trust you will remain apostles of our core ME-P vision, “uniting medical mission and financial profit margin”, promoting it whenever possible.

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Conclusion

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About: Healthcare Organizations [Financial Management Strategies]

Our Print Mission Statement

[By Dr. David Edward Marcinko; MBA, CMP™]

Publisher-in-Chief

dem25As Editor-in-Chief of a two volume – 1,200 pages – premium quarterly print journal, I am often asked about our mission statement; or the journal’s raison d’etra.

A Two-Volume Guide

As so, Healthcare Organizations: [Financial Management Strategies], with its quarterly updates, will promote and integrate academic and applied research, and serve as a multi-disciplined communications forum for the dissemination of financial, managerial, business and related economic information to decision makers in hospitals, outpatient centers, clinics, medical practices and all mature and emerging healthcare organizations. 

Target Market and Ideal Reader

Healthcare Organizations [Financial Management Strategies] and its quarterly updates should be in the hands of all:

* CFOs, CEOs, COOs, CTOs, VPs and CIOs from every type of hospital and healthcare organization including: public, federal, state, Veteran’s Administration and Indian Health Services hospitals; district, rural, long-term care and community hospitals; specialty, children’s and rehabilitation hospitals; diagnostic imaging centers and laboratories; private, religious-sponsored, and psychiatric institutions.

*  Physician Hospital Organizations, Management Services Organizations (MSOs), Independent Practice Associations (IPAs), Group Practices Without Walls (GPWWs), Integrated Delivery Systems (IDSs) and their administrators, comptrollers, cost accountants, budget directors, cash managers, auditors, healthcare attorneys and consultants,  and actuaries, and all endowment fund directors, executives, consultants and strategic financial managers.

*  Ambulatory care centers, hospices, and outpatient clinics; skilled nursing facilities, integrated networks and group practices; academic medical centers, nurses and physician executives; business school and health administration students, and all economic decision-makers and directors of allopathic, dental, podiatric and osteopathic healthcare organizations.

Assessment

After publication, my suggestion is to read, study and act upon the guide in this way:

1. First, browse through the entire text.

2. Next, slowly read those chapters and sections that are of specific interest to your professional efforts.

3. Then, extrapolate portions that can be implemented in specific strategies helpful to your healthcare setting.

4. Finally, use its’ ME-P updates as a reference manual to return to time and time again; and enjoy!

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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Developing a Financial – Management – Advisory Practice for Doctors

Deep Knowledge and Personalized Marketing Brings in New Clients

By Dr. David Edward Marcinko; MBA, CMP™

BY Professor Hope Rachel Hetico; RN, MHA, CMP™

[ME-P Publisher and Managing Editordave-and-hope]

In any marketing situation, the more you know about your target audience, the more successful you will be. Accordingly, all of the old rules still hold true, such as “do your homework.” Unfortunately, for some financial advisors and management consultants, homework means researching broad (i.e., vague) demographic information such as zip codes, income, and age. This broadband approach to marketing is insufficient and unlikely to succeed. For example, SWOT analysis is best done in-house, while related medical marketing information can be obtained from the Institute of Medical Business Advisors, Inc.

www.MedicalBusinessAdvisors.com

Focus like a Laser Beam

An absolute of communication is to focus on the person receiving your message. If you don’t know anything about the person, you can’t focus on what is important to him or her, and you end up placing too much emphasis on yourself. Your message then carries less weight and has less impact.

Defining Your Niche

Instead of approaching all people in a certain neighborhood or age group, look for people within professional subcategories—people who use their talents in a specific way. Primary care physicians, dentists, podiatrists and optometrists apply their talents differently than surgeons or pediatricians. And, private management consultants and entrepreneurs use their talents differently than large corporate managers.

Develop a Profile

Let’s look at the medical entrepreneur niche space. Perhaps you regularly work with such entrepreneurs who manufacture or deal in medical gadgets, Durable Medical Equipment [DME], healthcare IT devices, instruments etc., and would like to increase the number of clients you serve in this niche.biz-book

The Process

First, you need to develop a profile that gives you specific information about those who manufacture said medical widgets in your area (i.e., more than just their zip codes), bearing in mind of course, that the profile is a point of departure. The general profile is then divided into several subsets based upon their specialty sales-type, devices, locations, market size, gender, etc. Concentrate on developing niches in which you have existing clients. Next, consider the attitudes, values, and mental processes common to all of your clients within a given niche. Knowing (or at least being able to project) what those qualities are will make your marketing efforts more successful because you already are familiar with who they are, their values, and how they want to receive information.

Client Values

How do you find out what someone’s values are? Just watch the person work. Ask questions. What do you want? Why do you do that? What’s important to you? To what words and phrases do you relate? What words and phrases do you resent? What does your desk look like? How do you prefer to receive information? Do you prefer a structured or a more relaxed environment?

The Value of Profiles

Developing profiles of specific groups within any given niche helps you establish rapport with people who are not yet clients. Many marketers make their initial contact through a letter. That’s dangerous, unless you are able to establish rapport in the letter. If not, you have diminished your reputation and accomplished little.

Mirroring

If you understand the concept of mirroring, you know it is important to mimic the other person’s breathing, vocal tonality and body language. That works amazingly well in meetings or even during telephone conversations.

Beware Letters

However, you can’t mimic in a letter, so you have to mirror the other person’s mentality. You have to match his or her attitudes, values, and mental processes in your marketing. Again, to consider sending a marketing letter – without first developing a profile – may be a foolish gamble.

Assessment

In short, relationship niche marketing can work to increase your practice without diminishing your reputation.

fp-book

Enter the Certified Medical Planner™

For those fiduciaries interested in the medical management and the healthcare financial advisory deep-space, for doctors and medical professionals, please visit www.CertifiedMedicalPlanner.com for more information.

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated? Despite the CFP imbroglio, how do you niche market, or attract physicians or other “high-value” clients, to your advisory practice? Do you possess any special deep-knowledge or “gravitational pull?” 

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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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Evaluate “Healthcare Organizations” [Financial Management Strategies] AND Order Now!

By Dr. David Edward Marcinko; MBA

By Professor Hope Rachel Hetico; RN, MHA

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As healthcare continues to evolve, leaders and executives have the formidable and immediate challenge of creating both short-term and long-term financial strategies. Given that today’s knowledge-base is different from that of even six-months ago, and the need is for solutions to tomorrow’s economic problems, success seems always just beyond your grasp!

Why Subscribe?

But fortunately, you can be ready; Healthcare Organizations: [Financial Management Strategies] is your blueprint for success. To ensure your organization’s competitive edge and perhaps even its survival, you must quickly gain the financial management tools and techniques necessary to lead in the 21st century. What you learn and implement using this Guide enables you to respond proactively to the rapidly changing healthcare environment. Your subscription to Healthcare Organizations: [Financial Management Strategies] not only helps you lead, it brings together healthcare executives and visionary thought leaders to help you develop essential models and successful financial management strategies, going forward.

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Testimonials

“This well-organized financial management guide is easy to use and perfect for the healthcare organization, hospital or clinic manager; CFO, CEO, administrator or comptroller; CNO, CMO or physician-executive  who is tasked with developing, implementing and extending a comprehensive (and integrated) financial, accounting, health economics and enterprise-wide business management program.”

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Assessment 

For today … for tomorrow … for all healthcare organizations … for you! Remember, the Guide 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 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

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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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Evaluate our 2-Volume Institutional Print Guide

Healthcare Organizations [Financial Management Strategies]

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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.

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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.

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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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Understanding the Successful Practice Management Consulting Engagement

Characteristics of an Integrated Financial Review

By Dr. David Edward Marcinko; MBA, CMP™

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

Generally, although the presentation and style may vary, a well thought out and comprehensive medical practice management review should contain at least the following 10 elements. This should be obtained by completing a confidential business financial or data gathering questionnaire, or by personal interview.

At our firm, the Institute of Medical Business Advisors, Inc www.MedicalBusinessAdvisors.com, we believe in the adage, garbage in = garbage out, and feel that any consulting engagement will only be as good as the information used to perform it.

1. Goals and Objectives with Practice Data:

This means your business data and a prioritization of your goals, with estimated time line, and economic benchmarks for achieving them. For example, you may not expect to jump-start your practice over night, but it is not unreasonable to improve its efficiency and profitability over time. Or, you may be able to decrease variable costs now, and slowly reduce fixed costs, in the long run.

2. Special Issues:

May include illness, practice continuation or, buy/sell agreements.  Especially noteworthy, according to Dr. Rex Huber, MBA, a professional practice management consultant in Minneapolis, MN:

“Are the myriad new concerns involving practice mergers, acquisitions, anti-trust, IPA, or regional network contracting issues”.

3. Business Economic Assumptions:

Will change over time but usually include such items as medical specialty focus, payer and inflation factors and real rates of return, personal and corporate risk assumptions, geographic location and demographics, reimbursement rates, inflation, economic indicators, training, age and sex, as well as personal risk tolerance or aversion.

4. Consolidated Financial Statements:

Should include at least the last three – or four – annual corporate financial statements (balance sheet, net income statement, retained earnings, and statement of cash flows) with tax returns. According to Dr. William P. Scherer, MS, a HIT guru in Ft. Lauderdale:

“Initially, financial software such as Quicken® made the creation of consolidated financial statements a pleasure – rather than a chore. But now, there are many ASPs (application service providers) to outsource this function.”

5. Net-Worth Statement:

Net worth on the balance sheet represents practice equity levels obtained by subtracting short and/or long term, liabilities from assets, at a particular point in time; as well as future estimates and projections. Practice net worth however, is not income and professional expenses are paid out of cash flows, and not net worth. Nevertheless, more is usually better, except when assets are overstated, or liabilities under reported. Physician practices are increasingly particularly prone to have high gross incomes but low profit margins and net worth because of this problem

6. Income Taxation:

Should include, but may not be limited to: a review of corporate and personal income tax statements for all relevant years, deductions, credits, tax liability and rates, especially EGTRRA 2001, and the Tax Act of 2003 with “sun-set” considerations for 2010-11.

7. Insurance and Risk Management: 

This minimally should include an analysis of your personal and corporate financial exposure, relative to malpractice liability, morbidity, property-casualty, health, life, annuity, long-term care, buy-sell and key-person agreements, and disability insurance. It should also include an analysis of corporate buy/sell agreements and a review of all polices in force.

8. Benefits and Retirement Planning:

Contains an evaluation of all traditional and Roth IRAs, SEPs, 401-Ks, 403-Bs, annuities, social security projected benefits, personal pension and profit sharing plans, of both the defined contribution and defined benefit types. A comparison should also be made of the taxable, and tax-exempt rates of returns for these investment vehicles.

9. Operational Audits:

Should generally include a review of most of the following: processes, patient flow and controls; accounts receivable and cash management; fee schedule review with CPT and ICD-9 coding and compliance; IT and security; cost expense analysis; practice financial ratio creation and analysis, marketing and advertising plans, and stationary; profit maximization and reimbursement issues; human resource issues and workplace violence; insurance and third-party payer processing and controls: personnel polices, administration, job structure, benefits and productivity reviews; as well as any special concerns of the practice.  

10. Recommendations, Implementation and Follow-up:

Oral and written communication between you and your consultant is important in order to understand, execute and achieve your management goals and the costs associated with them, as well as the risks and benefits of each.

Assessment

A prioritized schedule and action list is used to implement or reject recommendations, as described in all of the above In short; the practice management planning process denotes the method of how individual doctors can meet their business goals through proper management of resources. It is a broad based approach that distinguishes the exceptional management consultant from other professions or non-integrated advisors who typically focus on only a single area of the management picture. ho-journal10

And, for larger practices, ASCs, clinics, hospitals and healthcare institutions, we suggest the 2-volume, quarterly print journal guide, Healthcare Organizations [Financial Management Strategies] www.HealthcareFinancials.com, for starters.

 

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. What do you reasonably expect from your consulting engagements? Have you been pleased or disappointed, in same?

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

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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