Practice Management

With 90 days left until the deadline for state submission of Exchange applications, Congress is pushing CMS for more information.  There is a lack of clarity regarding Medicaid, Medicare, and the general area of commercial insurance.

Health and Human Services Secretary Kathleen Sebelius has not been widely quoted on this issue since March, 2012.  “Near silence” rules on critical issues related to the eutopian concept of a cloud-based free market of commercial benefits and new expansive state Medicaid capacities.  Face it, PDA constituents, we are 100 days from something.  As usual, ObamaCare has given us no clear way to make informed decisions.

This uncertainty in Texas is causing significant concern for providers and insurance agents.  Small business owners, the backbone of the U.S. economy, are very confused.  To many, the vague promise of an Exchange  is an excuse to drop commercial insurance.  They are cutting benefits and telling the employees to go “Exchange shopping” on their own.

This all comes down to the need for medical practice managers to stay on top of their revenue mix and margins from services.  A provider’s capacity and demographic mix are important determiners of earnings.  PDA can help.  Referral to an experienced and successful practice manager is just a phone call away.

Open Invitation #2


As Medicare ratchets down and managed care muddles on, everyone knows that some physicians are branching into aesthetics, plastic surgery, cosmetics, wellness, anti-aging, etc. to re-capture shrinking profit margins. This message is a new invitation to physicians and non-physicians to make more money, stay free of bureaucracy, and not work any harder.  In that spirit, here is an out-of the-box presentation that could add $25,000 to $100,000+ of new annual income. Please read closely.

If a magic wand could be waved, the Miers Group would have ten physician benefits agents in training and the company would have twenty five on-line physician-agents. Each could be earning commissions for simply making referrals.  This idea is different to physicians because it smacks of “selling”.  But in the insurance world, this practice is “earning your commission”, and you need a license to do it.

Every business owner, manager, or person of importance that seeks medical care is a hot lead for insurance benefits.  With the patient’s permission, simply acting as a licensed referral source allows the physician to participate in the commission.  As medical reimbursement dwindles, there must be new practitioner-controlled income options.  Naysayers and critics will argue that independent physicians should accept their fate and trudge into economic obscurity. No Way!!!

With the Miers Group agency assistance and a license that you could secure in two weeks of evening study, the big opportunity is before you.

If you decide to go even further, the Miers Group will train you to become a successful benefits counselor/broker. The Texas Department of Insurance license provides you a legitimate basis to generate revenues, deduct expenses, and consider making appropriate, depreciable capital expenditures. Our benefits consulting firm and general brokerage entity will support your revenue production and make sure you operate between the white lines of reputable performance and avoidance of conflict of interest.

Today, there are three veteran, business-trained physicians that lead the agent cadre.  Three prestigious physicians have earned various counseling, benefits, and property & casualty licenses. Through appointment, they can represent the vast majority of insurance companies. They have the ability to earn commissions and/or fees from consulting assignments. Daniel S. Karin M.D., for example, holds three licenses. He could write your medical malpractice coverage or provide a benefits strategy for your office staff, introduce better medical malpractice coverage, and sit at the planning table with corporate America. These three forward thinking physicians are creating real change and are about to make big waves in the market.  They have melded the agent/counselor role into a parallel but separate strategy with their medical practices and managerial roles.

This is a time for genuine opportunity.  Please consider this pathway to new earnings and self-protection in the world of ObamaCare!  Call today and ask for James Martin!

The ObamaCare Insurance Exchanges

Part of the “You will have to pass it to read it” healthcare reform bill is intended to provide coverage to 25 million previously uninsured people. The gateway to this new healthcare is the “Exchange”.  These are new on-line purchasing portals that allow small businesses and individuals to shop for their coverage.  The exchanges are portrayed to function like travel agencies, and the government is quietly working fast at building the system.  Open enrollment is scheduled to start on October 1, 2013 with actual coverage locking in by January 1, 2014.

This is a big deal.  First of all, it has the potential to convert insurance brokers to “exchange navigators”, the insurance equivalent of travel agents.  For a fee, the navigator would be available to guide the prospective buyer through the maze of benefit decisions.  The fee part is really interesting as the purchaser may be able to demand transparency regarding the fee and elect what to pay for the service.  Currently, agents and brokers are appointed by insurance companies and paid a contractual commission.  One has to wonder how many persons understand who represents what?  Add in the government’s new requirement that 80-85% of insurance premiums must be allocated to direct healthcare expenses, and there is little mirth in the benefits sales office.

Several GOP governors have not accepted federal funds for development of exchanges.  Well, Justice Roberts’ recent court decision resulted in leaving in place both state exchanges and an option to create federal exchanges.  In simple terms, Governor Rick Perry and the state of Texas have not accepted funding for exchanges, but it could still happen just the way ObamaCare drew it up.

Now, the Feds could do an end run and set up a new federal exchange for Texas.  There are national press reports that federal exchanges are being developed at break-neck speed. Exchanges are a top administration priority, even though sources estimate the cost of exchanges to be beyond $850 million.  Legal complexities and possible shut downs exist, but the possibility of a new government bureaucratic impasse looms large.  This is a tough one to predict and the federal option could develop for half the states.

PDA will keep tabs on this situation.