1.27.2013

Putting your pay raise to work

Now that you finally got that nice little raise, what you will do with it? Treat yourself to a nice dinner? How would you spend it? I am sure the question "how do rich folks spend their money" may have crossed your mind at some point or whenever you had a little bit of money to spare. It is no wonder that the rich are getting richer; the poor are getting poorer while the middle class is getting nowhere. The crux of this wealth accumulation balance lies not in our class but in our perception of how to best allocate our money.

1.26.2013

Making A Case for Surface Pro


The marketing push that Microsoft has garnered clearly suggests that the tech giant is fully geared up for mobile computing. Some say that Microsoft's strategic plans came too little too late, but I think it's perfect timing to see Office 365, Surface RT, Surface Pro, SkyDrive and Windows 8 all coming together at once.

1.15.2013

Health Insurance industry in post reform B2C world


The federally facilitated exchanges and the defined contribution models will shift the business-to-business (b2b) focus towards business-to-consumer (b2c). In the consumer market the brands and the perception they create are the primary influencers in purchase decisions.

1.09.2013

Become a great leader

During the year 1919 a man was fired by his boss from Kansas City Star newspaper. Lack of imagination was cited as the reason for letting go. That man, whose name we now famously know, was Walt Disney. Ironically Disney eventually bought ABC, the parent company that owned the newspaper.

1.04.2013

Rise of the Healthcare Pricing Tools

The notion "you get what you pay for" almost always holds true for general merchandise like clothing and related accessories. The high-end brands are usually expensive because their quality is directly proportional to the price of the product. Comparatively in case of healthcare, the price variances can be a little tricky and are tied to more than just the quality of the procedures.


Healthcare cost differentials

The cost of different kinds of treatments in a given area, city or state can vary substantially because they are dependent on fee schedules, demographics, and physician overhead.

A procedure like Lasik surgery can cost up to $4500 in New York while the exact same procedure runs for about $2800 in Ohio. Both of these treatments are about the same if judged on the scale of quality, procedure implementation, physician experience and time and yet there is a huge difference in cost.

Why the rise of the pricing tools?

Come 2014 the Affordable Care Act (ACA) will require everyone to get insured or face a penalty. This combined with the elimination of the pre-existing condition clause and the defined contribution model will put financial pressure on the whole industry and will create a consumer driven healthcare.

To stay afloat, the insurance companies will underwrite all subscribers as being under the same umbrella which will tie all participants together with an invisible financial thread. This thread will cause all participants to suffer equally for someone else not being able to pay their bills.

To ensure no one defaults on their payments and can afford the care, both the insurance companies and the consumers will demand to know the estimated cost of the treatments before they begin. This demand will give rise to the pricing tools.

Aspects that will matter

Pricing tools will be more than just a mere quoting system. Other facets like hospital versus private facilities, satisfaction ratings, availability and physician experience will equally count.

The consumer driven healthcare model will depend on:
  • How is the reputation of the hospital or a physician's office?
  • What kinds of deals are available inside or outside the plan network?
  • Is the physician willing to offer discount rates to individual customers?
  • What kind of satisfaction ratings did the physician receive?
  • What percentages of outcomes were successful?
  • Is there a price difference between a doctor's facility and a hospital?
  • Are there any payment plans available?

Different types of pricing tools

There are three primary ways of implementing the quoting system: the bluebook approach, the insurance average and the true cost quoting. All of these systems will have an Expedia-like feel with some even offering online shopping through a cart system.

Bluebook approach

Bluebook models already exist in the market but they tend to have a higher chance of deviation from the true estimates. They gather the pricing information from data bank companies like Vitals and then calculate the estimate by taking the averages.

The reason the bluebook approach is not realistic is because it does not take different, more-detailed possibilities into account, remove outliers or have access to different fee schedules. For example: A dental implant surgery can have the possibility of including a bone graft if the jawbone is too small. This is something that bluebook pricing would have trouble representing properly.

Insurance average

In this approach the pricing statistics are created by mining the claims data from different insurance companies. During the calculations the resultant information is further refined for accuracy by removing the outliers from the source costs.

Systems that offer cost information by mining claims data are usually more accurate than their counterparts. The weakness of this system comes from the absence of individual data like copays and deductibles.

True cost quoting

True cost systems are designed to offer more realistic estimates and are geared towards churning out individual estimates. The costs for different treatments are calculated using the same methodology as the insurance average models and then individual deductibles, copays and out-of-pockets are applied. The end result varies from user to user depending on their standing in their plan.

Opportunities and Challenges

The employer contribution model, ACA and consumer driven healthcare will force employers, hospitals, insurance companies and physicians to change their business models. Information and data availability will be at the center of this change.

Hospitals will have to rethink the patient exit surveys, feedback management and the way they charge their patients. Hospitals and doctor offices will be in a state of covert competition which will bring down prices for certain types of treatments.

Price comparison tools are already available in the market but they are not effective enough if they cannot utilize one's copay or deductible in the equation. Insurance companies will have to connect and offer data to their pricing tool vendors so that real-time quote calculations can be made.

Web presence for doctors will not just be "good to have" anymore - consumers will expect doctors to maintain a website. There is a vast opportunity present for software development houses to offer some kind of IT services to doctors because due to the ever increasing costs and overheads as it will be hard for physicians to hire IT staff directly.

Other reasons to maintain a solid web base are so that the physician can contact his/her patients electronically and get their feedback personally. We should not forget that the majority of the consumers leaving feedback on the public pricing tools will be the unhappy campers. Physician websites will allow physicians to showcase their good cases tilting the negative bias towards a positive one from the public areas.

1.03.2013

Landing Promotions and Raises

Money is one of the key rewards for excellence and is a catalyst to increased motivation. However, pay raises are often mistaken to be intertwined with promotions. A promotion is not and should not be the only way to get a healthy raise. 

This is a second post in the work success series. To read the first one, please visit Become Indispensable & Recognized at work.

The case that I tried to make in my first post was that you need to get recognized for being better than average. When you succeed in getting recognized for being better than average, you proceed towards further improving yourself and being extraordinary. When you are extraordinary, you see many options open unto you.

A pay raise is what you employer rewards you with in return for your hard work because your performance level has surpassed your current pay level. Promotions are additional responsibilities that are given to you because you have successfully demonstrated that you have the knowledge and the capacity to lead in a higher role.

Raises and promotions both require hard work and over delivery as pre-requisites. Both are forms of opportunities made possible by the presence of all the slackers. All you have to do is get ahead and avail these opportunities. It is easier than what most people think it is.

Here are some tips and traits that you can develop to score your dreams.

Create an appetite for success

Are you truly ready for your success? How bad do you want it?

I believe that success, wealth and happiness can be achieved by anyone. The probability of our success is directly relational to how bad we want to reach our goal. When it comes to pursuing our dreams, we will need to want them as bad as we want to breathe.

It is certainly true that luck plays a huge role in one’s success. But how do you define luck? In my view, luck is nothing more than one’s preparation meeting the opportunity. It is better to be prepared when opportunity knocks than seeing all kinds of lucky strikes pass you by.

You will need to learn to use your luck! I can give you opportunities all day long, but if you are not ready for them, you cannot avail any of them.

Develop the right attitude

Your attitude is what regulates your energy and the energy that you emit toward others. Four types of attitudes are common among successful people: attitude towards change, correction and advice, teamwork and gratitude.

Attitude towards change

The ability to look for opportunities at the time of change and capitalize on them will open new doors of luck for you. Being resilient towards change will do nothing positive because you cannot stop or avoid change.

Attitude towards correction and advice

One way to show your boss your determination towards being successful is by asking for feedback. However, you can completely destroy the usefulness of that feedback if you cannot listen to your boss without blocking the information or being defensive.

Some of the best advice that helped me with my career came from my bosses. I paid attention to what was being said and how could I improve my shortcomings. If I didn’t understand, I would ask for clarification. The more you understand and act on the feedback, the higher the respect your boss will have for you.

In my career, my mentor Tracy Hall helped me polish my project coordination skills. My manager Jacqui Schmotzer gave me tips on improving my communications skills. Bob Schleichert who was an Associate VP, showed me how to hire, negotiate, plan and budget for large scale undertakings. Kevin Pete, a Senior VP, taught me how to put it all together and be an effective leader.

So, you see, there is one thing common among all of the bosses I had, they all gave me feedback and opportunities, and left it to me whether I avail them or not. This also means that a true leader will play a key role in your success; hence make sure the one you are working for has those qualities!

Attitude towards teamwork

Your willingness towards helping your coworkers is a reflection of your leadership. Being able to jump in when needed and help others with their problems will earn you extra points.

Attitude towards gratitude

Your chances of success are slim if you cannot think of anything to be grateful for from your employer. Not to say that there are bad employers out there, but the majority of the time it is us who needs to change our perception.

You can improve your perception by a simple exercise. Take a piece of paper and write down everything you can think of that you like at your place of work. Do this over and over again until your sheet is full. This will affect your behavior and your employer will clearly be able to see your gratitude through your behavior.

Don’t be afraid to lose

Don’t let the fear of losing keep you away from accomplishing your dreams. The real loss we suffer in our life is when we cease to try something out of the fear that we will end up making fools out of ourselves.

I used to have a great deal of fear of public speaking. Having known this weakness, I still volunteered to speak about our experience at the graduation ceremony of Aultman Exploring Leaders. Mind you that this graduation event was attended by many high level executives at my company.

My speaking endeavor ended up anything but a Cinderella story; I panicked so bad that I forgot what I was going to say next. After subjecting my audience to a painful 30 seconds of silence, I managed to say some last words and ended my speech. Needless to say, I was furious, embarrassed and angry at myself.

I used those emotions of embarrassment and anger to improve myself by practicing hard. My next chance came three months later in form of an IT presentation. I practiced my speech in front of a mirror, friends, family and my pet cat. Finally the big day arrived and I sailed through my speech like a seasoned presenter. I tell you that the joy and the euphoria I felt after the speech was inexplicable and tastefully addictive.

Earn the flexibility

We all know that family and personal life is very important; however, in order to have a fair balance between work and personal life, you will have to work harder. Your boss will show flexibility around your family needs if your work is on time, is of high quality and you are there when your boss needs you. The secret to earning flexibility is to over deliver!

Bottom line

You should see an equitable increase in your pay if you truly are extraordinary and an over-achiever. However, if being a leader is your cup of tea and you want to go further down the rabbit hole, please stay tune for my next post in this series: Become an effective leader.

1.01.2013

No real Medicare solution in 2013 Fiscal Cliff deal

I was hoping, or to put it more accurately, dreaming, that the senate and the house will give sequestration and SGR a reasonable thought during the fiscal cliff discussions. Looking at the outcome I fear a gradual drop in the number of physicians dealing with the Medicare.

The fiscal cliff bill (HR 8) passed by the Senate delayed the Medicare payment cuts by one year. Current rates will continue until December 31, 2013, and at that time this patch will require more action.

Hospitals will pay for the delay

Besides not enacting a permanent fix, the other disturbing part is the cost of delaying is offset by requiring hospitals to fill the bill. Republicans did propose to pay for the bill through cuts to ACA and its beneficiaries, which the Obama administration overwhelmingly rejected.

Medicare cuts has no positive outcome

Hospitals will suffer because they will see reduced payments due to Medicare payment cuts and Disproportionate Share Hospitals plan. Physicians will suffer because they will either have to eat their losses or mitigate them by limiting their involvement in the Medicare program. Insurance companies will suffer because a reduction in Medicare physicians will affect their Advantage Plan’s provider network.

Doctors will leave Medicare

Many patients are questioning the old belief that doctors were supposed to join medical field to help people. Money should not be the primary factor. Some have gone so far as to say that professional honor is replaced by the goal of running a profitable venture, and I could not disagree more with this theory.

Doctors still join the medical field to help people, because many of these talented men and women could have gone onto other professions with more money, less hours and less hassle. But considering the large sum of medical school debt they accrue and the overhead of running their facility, the actual salary they are paid is like a rain drop in a desert.

Bottom line

Sequestration is a very serious problem which is not created by doctors in general. Instead of enforcing the existing laws, rules and regulations, the Government is further punishing care givers by adding more rules while leaving them hanging and guessing for the final outcome for another year. This will bring no positive change but force doctors to opt out of these programs.