Medicine, Business, Law

• Medical specialists continue to be relatively highly paid.
• Male specialists earn significantly more than do women specialists.
• U.S. Physicians earn considerably more than physicians elsewhere in the developed world.
• Medicine is not the most highly paid profession per year of required education.
• Other professionals can earn more, sooner in a career, and with less training.

“Understanding Healthcare: A Historical Perspective” is a new e-book in which I attempt to address the challenges facing physicians today in part by reviewing the history of healthcare.

• Thirty-one states and the District of Columbia have remained within the ACA.
• Healthcare enrollment in these states is significantly exceeding forecasts.
• Medicaid is the largest line item in most state budgets followed by K-12 education.
• The federal government currently reimburses 100% of the costs for new enrollees through 2016.
• Federal reimbursement will fall to 90% by 2020.
• Federal reimbursement to states for existing enrollees is just 50%.

• Americans pay much for healthcare but get much less in terms of quality and efficiency than Western European nations.
• The training and quality of medical staff is similar in the U.S. and Europe, but for the same experience healthcare providers earn much more in the U.S. than in Europe.
• European patients can access high-quality hospitals with well-trained medical staff, using the same technologies, pharmaceuticals, and devices, for half the price they would pay in the U.S.
• European health systems adopt technologies from the U.S. more quickly than vice versa, due in part to more rapid regulatory approval.
• For the 20 biggest selling pharmaceutical products, prices in the U.S. are much higher than in Europe.

• A mediated divorce is the best way for a divorcing couple to protect the family, determine the future course, and to equitably distribute the assets.
• Divorce is one of the most common and serious threats to financial security in the United States.
• According to statistics from the Centers for Disease Control and Prevention (www.cdc.gov), approximately 43% of all first marriages in the U.S. end in divorce. Second marriages end in divorce about 60% of the time. Nearly 75% of third marriages end in divorce.
• While divorce is frequently an emotionally devastating experience, it can be financially disastrous as well.

• A portion of Medicare recipients could see a significant increase in premiums in 2016.
• Premium increases will affect Medicare Part B.
• Coincidentally, there will be no Social Security cost of living increase in 2016.
• Patients will likely make fewer office visits and will spend less on healthcare.

• Learn more about AMA PCPI, CMS PQRS, HEDIS, and the specific measures that apply to your specialty and position.
• The AMA has created more than 350 individual measures in 47 subject areas.
• The CMS has implemented myriad new PQRS measures.
• The Joint Commission, the NCQA, and the HEDIS measures are also frequently used to evaluate physicians and practices.
• Opportunity remains for healthcare institutions of all sizes to create their own performance metrics. Guidance on this process is widely available.
• Payors want improved outcomes at lower cost, and their willing to pay docs additionally to achieve this.

• The U.S. Department of Health and Human Services (HHS) Paid Nearly $14.5 billion in fraudulent claims in 2014.
• A Texas physician was arrested for defrauding Medicare of more than $375 million, but the collection of smaller crimes cause more damage.
• No Federal agency pays more in false claims than the HHS.
• Under the Affordable Care Act, more than $600 million have been spent to prevent fraud and to recover fraudulent payments.
  
  

• The partners in a reasonably profitable medical practice can more than double the value of the practice by properly structuring the corporation and the books, and by trimming costs.
• There are numerous benefits to running a fiscally simple practice: easier to manage, easier to sell, potentially be more lucrative.
• The basic strategies to follow in order to increase the value of your practice are to a) make more money; b) spend less money; c) run the business more efficiently; d) have strategies in place to increase revenue and profitability.

• The guide emphasizes performance-based healthcare – teaching patients how to get the best outcomes at the lowest costs.
• Consumers are increasingly paying 100% of claims.
• New guide enables patients to comparison shop among treatment providers.
• Consumers will encounter more opportunities to choose care providers.
• Healthcare consumers will face steep learning curve as volume of market information increases.

• Governments call for increased use of naloxone and overdose kits.
• Cost-effective addiction treatment is an essential part of public policy.
• Physicians must make sensible decisions about opioid prescription that weigh both the patient’s right to pain relief and the risk of dependence or addiction.
• According to the World Health Organization, globally an estimated 69,000 people die from opioid overdose each year.
• There are an estimated 15 million people worldwide who suffer from opioid dependence.

• Since 2003, legislators in 33 states have passed workers’ comp laws that reduce benefits or make it more difficult for those with certain injuries and diseases to qualify for them.
• In 37 states, workers can’t pick their own doctor or are restricted to a list provided by their employers.
• For those patients who are able to access workers’ comp benefits, the amounts have been reduced by as much as 65%.

• Financially, a disability is significantly more expensive than a death.
• With a disability, income is reduced or eliminated and expenses increase.
• With a death, expenses disappear and, often, life insurance will pay out a sum.
• Optimal protective strategy is to buy disability insurance as early as possible in your career, when the cost is low.
• If you are age 50 or younger, or if you are older than 50 and have pre-college age children, you should consider the appropriate disability insurance policy to be an absolute necessity.

• A captive insurance company can save taxes for a medical practice on up to $1.2 million of insurance premium per year
• A captive insurance company can go well beyond filling the gaps in existing commercial insurance policies
• Physicians can insure the loss of income from a reduction in reimbursements, loss of a key employee, or loss of a contract with a hospital.
• Practices can also insure expenses associated with a Recovery Audit Contractor (RAC) audit or insurance fraud claim, or delayed reimbursements as a result of ICD-10.