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CIRCA – 20290
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THANK YOU
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Filed under: Health Insurance, Health Law & Policy | Tagged: ACA, ACA Silver Plan Premiums, PP-ACA | Leave a comment »
Election Impacts ACA, Medicaid Expansion and Marijuana
Posted on November 15, 2018 by Editor-in-Chief
Healthcare Triage News: Election Results Impact the ACA, Medicaid Expansion, and Marijuana
via Aaron Carroll
The recent election results of last week have a lot of impact on health care in the United States.
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The new Democratic House of Representatives and the ACA, expansion of Medicaid in red states, and medical and recreational marijuana are all affected by recent returns.
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MORE: What The Midterm Election Results Mean for Health Care?
Assessment
Your thoughts are appreciated.
MORE FOR DOCTORS:
“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8
“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d
“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5
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Filed under: iMBA, Inc. | Tagged: ACA, marijuana, medicaid expansion, pot, PP-ACA | 5 Comments »
PP-ACA Silver Plan Premium Costs
Posted on June 15, 2017 by Editor-in-Chief
Changes for 2017
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Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Filed under: Health Insurance | Tagged: ACA, ACA Silver Plan Premiums, Affordable Care Act., PP-ACA, Silver Plan | 3 Comments »
Racial Disparities in UnInsured Rates
Posted on November 20, 2016 by Editor-in-Chief
On Health Insurance [PP- ACA]
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Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Filed under: Health Insurance, Health Law & Policy | Tagged: ACA, Health Insurance, PP-ACA, Racial Disparities in UnInsured Rates | 1 Comment »
Presidential Politics & Wall Street
Posted on October 13, 2016 by Editor-in-Chief
and ….. Doctors!
By Rick Kahler MS CFP®
Recently, I reported on a survey that found most investment advisors are expecting the presidential election to result in rough seas for both their businesses and their client’s long-term retirement portfolios.
As it turns out, I am in the minority of advisors that disagree with that belief.
Presidential Power?
This is why. Even though the U.S. President is often called the most powerful person in the world, our presidents don’t run the economy any more than they run the Congress or the Supreme Court. While they may have some influence over all three, that influence goes only so far.
Certainly the president, as head of the executive branch, has authority over enforcing or not enforcing the laws passed by Congress. We’ve witnessed this most notably with President Bush, who didn’t enforce some environmental laws, and President Obama, who has vigorously enforced them. This gives the president a lot of influence on enforcing regulations which impact business and consumers.
Enforcing or not enforcing regulations dealing with commerce and Wall Street can have some influence on the economy.
Executive Branch Powers
Still, Executive Branch powers include foreign affairs, ordering military actions, and making appointments to the courts. Congress enacts all laws and controls the spending. The Supreme Court decides if both the Executive Branch and the Congress comply with the Constitution. Presidents can certainly influence Congress, but they remain one cog of many cogs in the wheel of government.
While the president has an influence on the economy, it isn’t the major influence that the media or either political party make it out to be. People think a president has great power to fix an economy. Even presidential candidates believe their own rhetoric around what they can accomplish until they take up residence in the Oval Office and discover there are a plethora of constraints that mute their power. This is how the founding fathers designed our government, which is actually a good thing, especially in this election cycle.
Long Term Portfolios
That is why, viewed in the context of your long-term retirement portfolio, you need not worry about who becomes president. Could there be some short-term swings in the stock market? Certainly.
Will who is elected president in November make a difference in the long run … No?
Of More Concern
Of slightly more concern, and potentially more economically impactful, is if one party gains control of both the Executive Branch and Congress. The last time we saw that was in 2008-2010 when the Democrats controlled both houses of Congress and the Presidency. One of the biggest outcomes of that two-year run was the passing of the Affordable Health Care Act, which certainly had a large economic impact. Whether that impact was positive or negative depended on your economic status. For many of the uninsured working poor, it was a godsend. For anyone not qualifying for a subsidy on the exchanges, it was a massive increase in health premiums.
That said, I won’t be doing anything differently with my investments even if we have a Democratic or Republican sweep of the Congress and Presidency. If you have a globally diversified portfolio of many different asset classes, you have no need to make any adjustments.
And now … Doctors and Political Parties
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Your Surgeon Is Probably a Republican, Your Psychiatrist …
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Assessment
While I am neutral as to the impact of the presidential election on my investment portfolio, that certainly does not mean I don’t care about the election or the person who represents our country in its highest office. I am going to vote, because elections do matter. The choices we make as voters, not only for president, but for Congress and state and local officials, do have an impact on the direction of our country.
MORE: President Trump vs. President Clinton: The impact on physicians
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Filed under: "Doctors Only", Investing | Tagged: Clinton, PP-ACA, Presidential elections and Wall Street, Rick Kahler CFP®, Trump | Leave a comment »
Sherlock Health Administration Expense Benchmarks Invitation
Posted on April 1, 2016 by Editor-in-Chief
Sherlock Benchmarks – Participation and Licensing
By Douglas B. Sherlock CFA
Hello All ME-P Readers and Subscribers:
This email invites your participation and/or licensing of the Sherlock Benchmarks.
A central effect of the Affordable Care Act is to sharply increase the incentive for health plans to minimize their administrative expenses. The Sherlock Benchmarks can be a catalyst to respond to these incentives since they identify and prioritize cost variances.
Use of the Sherlock Benchmarks reflects this:
• At least 40 health plans serving at least 40 million people with health insurance are so far committed as participants in this year’s Sherlock Benchmarking study.
• Of the 36 U.S. – based Blue Cross Blue Shield primary licensees, one-half are participating in this year’s Sherlock Benchmarking Study, either as an enterprise or through a subsidiary.
• Of the 13 members of the Alliance of Community Health Plans that are not focused on public programs or are staff-model plans, 11 are participating in this year’s Sherlock Benchmarking Study for Independent / Provider – Sponsored Health Plans.
• Most of the largest members of the Health Plan Alliance that are not focused on public programs are participating in this year’s Sherlock Benchmarking Study for Independent / Provider – Sponsored Health Plans.
• Health plans serving at least one-half of all insured Americans are licensed users of Sherlock Benchmarks since January 1, 2015.
Licensing and participation is available to all health plans
We have recently launched the Independent / Provider – Sponsored and Blue Cross Blue Shield surveys. There is still time, but the financial metrics survey form must be returned to us by the end of April.
So please contact me immediately if you wish to join these robust panels.
Our universes of Medicaid and Medicare plans will launch in a few months to avoid conflict with your Medicare bid process. If a plurality of your members are in either Medicare or Medicaid, please contact us about participation. Note that all costs are segmented by product as well as by function to assure an apples-to-apples comparison between the plans.
Licensing is available without participation. Licensing costs more but it entails less effort. The 2016 Sherlock Benchmarks for Blue Cross Blue Shield Plans and Independent / Provider – Sponsored plans will be available beginning in July. The 2016 Sherlock Benchmarks for Medicare plans and Medicaid plans will be available beginning in September.
Assessment
We look forward to working with you.
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]
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Filed under: Health Economics, Health Insurance, Healthcare Finance | Tagged: ACA, Alliance of Community Health Plans, Blue Cross Blue Shield, Douglas B. Sherlock CFA, invitation, Medicaid, medicare, PP-ACA, Sherlock Benchmarks | Leave a comment »
Health Insurance Costs [circa 2016]
Posted on January 15, 2016 by Editor-in-Chief
The most devious tax increases in modern history?
By Rick Kahler MS CFP®
http://www.KahlerFinancuial.com
A few months ago I scoffed when my wife told me about a report from CNN that the average individual, unsubsidized health insurance premium was going up over 60%.
After receiving my 2016 premium notice from Wellmark Blue Cross and Blue Shield, I’m no longer scoffing. My monthly premium for family coverage went from $1,400 to $2,140, an increase of $740, or 53%. According to healthcare.gov, the average Wellmark increase in South Dakota is 43%.
I immediately started looking for ways to decrease my premiums. This has become an annual ritual ever since Obamacare was pushed through Congress in 2010. Back then, my family health insurance policy (now considered a Platinum plan) had a low deductible with a maximum out-of-pocket of $3,500 and cost $660 a month.
Despite the President’s promise that “If you like your plan you can keep your plan,” I can’t even purchase that same plan today. If I could, I estimate it would cost over $3,500 a month. In order to keep health insurance affordable, each year I’ve reduced my coverage, increased my deductibles, and paid a higher premium than the year before.
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I set out to analyze my options for 2016. After spending six hours crunching numbers and pouring over online calculators, I admitted defeat. There is no simple way to analyze plans to determine whether, based on your personal health care expenditures, you are better served to go with a copay or a deductible plan, a Bronze or a Silver plan, or if a Health Savings Account is preferable to a plan with coinsurance. All the online calculators I found were limited in scope and woefully generic. My health insurance agent didn’t know of any better ones, either.
Adding to my angst, while Wellmark makes policyholders’ year-to-date healthcare expenses available on its website, it doesn’t provide any breakdown of costs. You must figure out for yourself how many drug or doctor co-pays you had, the average cost of a copay visit, the average total costs of those visits, and any other information you need for any type of analysis.
This task was daunting for me, a financial planner and numbers guy. How are average consumers supposed to navigate it? The need for this information is so obvious, one wonders what the insurance companies are hiding by not providing it.
Ultimately, I selected a Bronze plan with no copays and an out-of-pocket cap of $11,900 on in-network providers and $18,500 on out-of-network providers. Based on my family’s average health care costs for the last three years, my out-of-pocket spending for premiums, covered drugs, and approved in-network medical providers will be $2,612 per month, or $31,344, in 2016. It was $11,420 in 2010. That’s an increase of 273%, or 18.3% a year.
By comparison, during the same time period medical costs only increased 16.0%, or 2.7% a year. The increase in premiums is clearly not about increasing health costs.
The $1,660 extra per month I had available to spend on consumer goods and services in 2010 is now going to insurance companies to subsidize the health care of others. This is a clear-cut example of a massive transfer of wealth.
Based on my family’s needs, if I earned $97,000 a year I would qualify for a subsidy of $912 a month. But since I earn over $98,000, I pay the full premium.
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Assessment
Clearly, the only people who find the Affordable Care Act affordable are those who receive a subsidy or who have preexisting conditions. For them, Obamacare was a godsend. For the rest of us, it turned out to be one of the most devious tax increases in modern history.
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
- PRACTICES: www.BusinessofMedicalPractice.com
- HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
- CLINICS: http://www.crcpress.com/product/isbn/9781439879900
- ADVISORS: www.CertifiedMedicalPlanner.org
- FINANCE: Financial Planning for Physicians and Advisors
- INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
- Dictionary of Health Economics and Finance
- Dictionary of Health Information Technology and Security
- Dictionary of Health Insurance and Managed Care
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Filed under: Health Insurance | Tagged: ACA, Health Insurance, ObamaCare, PP-ACA, Rick Kahler CFP® | 5 Comments »
