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How many compliance related crimes have you or your colleagues or employees committed today, whether purposefully or, completely inadvertently? Listen to the full story, How Many Felonies Have You Committed Today?


In one fell swoop, CMS pulled the rug out from under hospital control of physician practice, rendering many, if not almost all, hospital outpatient clinics unprofitable. Listen to the full story, CMS Cuts Payments to Hospital Outpatient Clinics By 40% and Boosts Independent Physician Practice and Physician-Owned Facilities.


What is the moral of this story? AKS is a complicated web, be aware of your steps and avoid the situation Dr.Greenspan found himself entrenched in. Listen to Physician Behind Bars For Referrals: Kickbacks, Bribes, and Mail Fraud.


Listen in to the story of the “safety” of PHI at Holland Eye Surgery and Laser Center, which discovered that a hacker began accessing their electronic records in 2016 and, that over time, more than 42,000 patients’ PHI was exposed. Check out Clueless and Dangerous: "Your Medical Records Are Safe Because They're Entered into Our System" on our blog.


I found an old lock in the garage. Now, what's the combination? Listen to The Combination To Joint Ventures


Even Warren Buffet can’t get you this return: 420% over three years. How is that even possible? Find out the full story behind this by listening to $2.6 Billion Collected By Feds From Compliance Cheats. ROI Makes Warren Buffet Look Like An Amateur


The limo driver said that he’d made some bad choices in life. Some things hadn’t worked out as planned, the real question though, is Are You Lying About The Present and Shortchanging Your Future?


You know that I strongly believe that the future of hospitals, isn't hospitals - it's outpatient facilities. Give our latest a listen, Alchemist Can't Turn Outpatients Into Inpatients For Less Then $18.3 Million.


Subtle questions can start you down the primrose path so to speak, are you crafting your responses? How do you use questions in your daily affairs? Check out, Do You Know the Power of Questions?


There’s an expression in carpentry, “measure twice, cut once.” We should have the same expression in terms of healthcare deals...Listen to A Naive Anti-Kickback Question Answered.


This podcast is the second in a series on direct contracting by physicians and medical groups. See Direct Contracting By Physicians and Medical Groups for the first post in the series. Before we get too deep into the subject, let's ask an epistemological question: If you saw one dead raccoon, does that mean that all raccoons are dead? Listen to part two, Direct Contracting – Part 2: Clear Your Mind of The Lies That Bind (Your Thinking).


In healthcare, middlemen abound. Hospital systems are middlemen for their controlled/employed physicians. Insurance companies and even more so (on steroids!) IPAs and risk-bearing medical groups are the middlemen between, largely, employers and their employees' medical care. Check out Direct Contracting By Physicians and Medical Groups.


You can download our most popular strategy podcasts, all compiled for you in one convenient album. Sit back, enjoy and think about your future. Check out Podcast Compilation Greatest Hits - Strategy Edition 1.0!


We often mentally create roadblocks and boogeymen big and small (e.g., the “competition,” “that’s the way it’s done,” “the hospital controls us”) and throw them up in front of us as if they were real, when the truth is that they’re simply self-created, imagined limitations. Listen to This Robot Can Change Your Future.


Should non-taxpaying hospitals, the facilities that prefer to be known by the misnomer “not for profit,” be able to gamble their tax free funds on venture capital investments? Listen to Should Non-Taxpaying Hospitals Be Able to Gamble With Your Funds?


Someone at a conference asked me what’s the biggest mistake medical group leaders make. That’s easy, I told him, it’s not engaging me to represent them. He told me to get serious. I told him that I was. So, he asked me what’s the second biggest mistake. Check out How to Avoid The Second Biggest Mistake Medical Group Leaders Make.


The hospital CFO was hooked on heroin. The heroin of big data. Big data. Gotta have it. Listen to .


Finders keepers, losers weepers.  Except in connection with overpayments by federal health care programs — then it’s a crime. Listen to Hospital Turns $1 Million Of Collections Into $24 Million Of Potential False Claims Act Liability.


As you know, it’s hard to make a decision when you might have to pay a large price for it. It’s much easier to make decisions when there’s only an upside, that is, when there’s an upside if it succeeds and an upside if it fails. Check out What’s The Downside Risk for Hospital Executives?


What does partnership mean in a medical group? What does it mean to you? What does it mean for your group? What does it mean if you are setting up a medical group? Listen to 


The Wall Street Journal portrays it as causing panic in the streets.  I’m taking about the pending acquisition of Aetna by CVS Healthcare. It’s stoking fear of the combination of a ubiquitous retail delivery platform, CVS, with the health insurance, managed care, and huge patient database of Aetna. Listen to .


Corporations exist to make a profit. There’s nothing wrong with that. It’s a fact of life. Listen to .


Sure, compensation plans are about money, but they’re certainly not only about money. Listen to .


How many times and for how long do you think a Broadway actor prepares for his first performance, or even for subsequent performances? Listen to 


If I can make you a dollar by cutting your costs, can I keep 50 cents? That, in a nutshell, is what's described as "gainsharing" in the context of arrangements between medical groups and hospitals. Listen to What Have You Got to Gain? A Lot!


What are you doing to get attention for your practice or business? Attention from your referral sources, from your patients, from hospitals? Check out Do You Know Your "One Weird Trick To Losing Belly Fat?"

The right question regarding the uncertain future, is to ask is what underlies your profession, your specialty, or its role. What’s the motivating desire or overriding function? Listen to Are You Asking the Wrong Question About Your Future?


Have you imposed an expiration date on your career, on your business? Listen to Why You Must Reset Your Time Horizon.


Could you smell it in Cleveland, Carson City or Cape Cod? The stench filled the air in Paris, as taxi drivers burned tires to protest Uber. Listen to Why Hospitals Are Like Taxis Fighting the Uber of Healthcare. 


The medical group that I was going to see was under pressure. One of its former members had jumped ship and aligned with a competitor. The hospital issued an RFP. The competitor became the golden haired group. Listen to What If They Had Begun to Think About Their Future When It Was Still in Their Past?


“Psst! Send me some referrals. I can’t pay you directly, so I’ll pay your spouse.” Listen to Kickback Disguise Schemes: Oh, What A Tangled Web We Weave.


From down the street I could see the fortune teller’s shop. Listen to The Fortune Teller.


Many say that the world is a tough place. Maybe it is, because it’s not just dog-eat-dog. It’s flea-kills-dog as well. Check out What You Need To Know About the Flea That (Metaphorically) Killed the Medical Center CEO.


All medical groups have a culture, whether or not it’s been purposefully created. It exists. Listen to The Mismatch of Story and Culture Within Medical Groups.


You might skip over indemnification provisions when negotiating a contract. You understand what they are. They’re just boilerplate, right? Wrong. Check out Putting A Limit On Your Obligation To Indemnify.


I’m going to share a secret with you today. There’s no such thing as value. At least not in the fixed sense. In fact, value is as malleable as clay. Listen to Why You Must Know How Framing Changes Value.


Disruptive physicians. But what if the physician isn’t actually disruptive, but simply nonconformist or challenging? Listen to Disruptive Physician or Nonconformist Medical Group Asset?


Criminal and, at least, serious civil, liability lurks in many neat neighborhoods. Create your own neighborhood watch to make sure that it’s not lurking behind your medical group’s otherwise metaphorical neat lawn. Listen to .


Sure, unlike immigration love, less than heartfelt medical group merger isn’t a federal crime. Listen to .


Modern office machines, from copiers to printers to maybe even label makers have memory devices, and those devices may be chock full of protected health information. Listen to 


Leaders must lead. They cannot bog themselves down in the morass of consensus building. Listen to .


The federal Anti-Kickback statute makes it illegal to receive anything of value for the referral of federal health care program patients. How are you managing this potential pitfall? Check out .


Behold! We have the incredible shrinking hospital. Check out 


Once again, this case demonstrates that simple, facial reliance on safe harbors under the Federal Anti-Kickback Statute and Stark do not guaranty safety for either hospitals or their physician employees and subcontractors. Listen to .


In your negotiations, are you letting the other side think that they won? Listen to .


Across the county in nearly every industry, large companies are laying off full time workers and are turning to staffing companies which, in turn hire what amount to temps, many on a part time basis. Listen to Wal-Mart And Why Hospitals May Be Liable For Medical Group Obligations.


You must be extremely careful when entering into any physician compensation arrangement, whether you are the payor or the recipient in order to steer clear of possible AKS violations. Listen to OIG Issues Fraud Alert On Physician Compensation.


Has your medical group put themselves in a position where they can be easily taken over legally and cheaply? Check out Sam Walton’s Failure Is A Lesson For Medical Groups.


What if you’re sued for an event that one of your own members didn’t cause? To your dismay, you find out that you’re not covered for that. Listen to Get Sure 

That You’re Insured. 


Running a hospital based group as “service” for the hospital, functioning as a sort of clearinghouse for income and expenses, severely limits your group’s future. Listen to You Are Not A Service.


You keep your medical skills up. It’s time that you focus on your sales skills as well. Listen to Why You’re Actually In Sales.


Learn to protect negotiating positions and to use “informal” communication with administration proactively. Check out Negotiation Rules: Hallway Chat = Boardroom Meeting.


Medical group leaders are busy focusing on day to day activities: Most are deeply involved in direct patient care. Some, yes, some, also devote some time to working on their business. But there’s a pressing need to engage in strategy. And you have to address the tough issues, like governance, succession planning, compliance, expansion of your business, and many more. Listen to It’s Never The Right Time.


Many medical group leaders bemoan their group’s circumstances: caught in the hard place between increasing commoditization, what they believe to be the limitations of independent structure, and the pressure of national group competition. Listen to How to Cure Paralysis Over Your Future.


“I can’t put it in the agreement, but trust me on this. You have my word.”  Those are famous words from a hospital CEO. And, maybe you can trust him. But can you trust his successor? Check out Why You Must Understand How Sky-High Hospital CEO Turnover Impacts Your Practice.


Opportunity is a funny thing because it’s always there but isn’t usually seen. That’s because it’s hiding in the camouflage of everyday problems. Listen to Will the Lightbulb Go On For You?

Will today’s physicians soon be referred to as “human physicians” or “carbon-based docs” as opposed to the silicon-based kind? Paging Dr. Robot? Listen to The Rise of the Machines: Dr. Watson, Al and the Future of Your Medical Group.

Robert Collier, one of the fathers of direct mail advertising, famously advised copywriters to enter the conversation already going on within the customer’s mind. Listen to What A Long Dead Copywriter Knew About Medical Group Success.

A magic show is about misdirection: that which is seen and that which isn’t seen. Listen to Bastiat, A Teenage Magician and Medical Group Decision Making.

Compliance – it’s the multi-zillion dollar reason why your medical group’s or healthcare business venture’s efforts must constantly be tested, reviewed, and retuned. Listen to Extrapolation: How the Government Turns One Alleged Bad Claim Into Thousands of Violations.

Are your contract in line to be held hostage through collective bargaining? Check out How to Avoid a Black Friday for Your Medical Group.

RFPs can wear many faces, is it an organic, fictitious or fulcrum RFP? Find out which type you’re facing, and strategize your responseListen to Weaponized RFPs – A Podcast.

Are you planning for your ideal future reality, or focusing on slight incremental improvements? Check out Mediocre Advancement or Transformational Improvement?

Contracts exist so all the information can be located in one convenient place.Listen to Contracts Needn’t Always Be Contracted.

July 4th, Independence Day in the United States, celebrates the original 13 colonies’ declaration, in 1776, of their independence from Great Britain. Listen to Your Independence Day.

Seemingly discreet events in the life of running a medical group, are actually all related. Listen to It’s All Related.

It’s Friday night. After leaving the restaurant you turn onto the sidewalk and walk down the street. Ah, an art gallery! You wander inside. Listen to Artists, Patient Satisfaction, And The Creation Of Something Out Of Nothing.

“When you have time to gripe, you have time to wipe. When you have time to lean, you have time to clean.” Listen to When You Have Time To Gripe.

I recently read an article about a physician who had sold his practice to a hospital. The physician was quoted as having stated that he had grown disenchanted with running the business end of his own practice, thus his agreement to “have my practice managed by” the hospital. Check out This Isn’t Medical Practice It’s Employment.

Legend has it that it was a bottomless basket. As much tribute to the master as could be piled into it, the basket took more and more and more. Listen to Beware Of The Open End.

Letting each partner write his or her terms of partnership is not a long term strategy for success. Check out I’m a Partner in The Group, So Leave Me Alone.

Don’t worry, we’ll have your blog back up by 1:00 p.m. Pacific time on the 28th. Yet, as I’m writing this post on the morning of January 30, 2017, our blog is still down. Somehow, someplace within Network Solutions, which provides our webhosting, they disconnected our blog from the rest of our website. Oh, I mean from the entire internet. Listen to Do What You Say You're Going To Do.

I recently heard of a consumer survey done at a hotel in which it was found that the guests’ impressions of every factor tested for, the quality of the service, the attractiveness of the rooms, the cleanliness of the common areas, etc., depended upon their satisfaction with the hotel check-in experience. Listen to Yes, I Agree.

There was a time warp in the box from the garage. Listen to What The Time Warp Reveals About Healthcare Employment.

Let’s listen in to a series of calls from a potential deal partner to the office of the Smith and Jones Medical Group. Listen to The Fast And The Dead. 

Don’t get your medical group or healthcare business lost in big data. Listen to Speak Truth To Numbers. 

If yours is an average group, you’re doing more work for less pay. Listen to The (Not So) Obvious Alternative to Cutbacks. 

Hospitals that use RFPs and others fool’s tools in respect of physician relationships will surely suffer as fools in the end. Listen to RFP For Physician Services: Really Foolish Proposition.

Office-based specialists, from ENT’s to urologists, often enter into suite sharing arrangements. No problem! That is, until they make it one. Listen to Office Sharing: Turning Share Mates Into Cell Mates.

Most medical groups have a two-level physician engagement/compensation structure: owners and non-owners. Listen to An Alternative Structure For Medical Group Compensation. 

If, as I’ve written before and as we’re now beginning to see, a hospital need not have beds, then what’s the difference between a hospital (which physicians can’t develop as a Medicare facility) and an ASC? Listen to Bedless Hospitals And Physician Opportunities. 

Would you rather have one marshmallow now, or two tomorrow? Listen What A Marshmallow Says About Your Medical Group's Future.

It’s morning in a mall outside of a metro station in Washington, D.C. Josh, dressed in jeans, T-shirt and baseball hat, picks up his violin and begins to play. Classical music, some of the most complex and beautiful ever written for the instrument, floods the air. Listen to Why You Must Control The Context To Influence The Outcome.

Tom Peters popularized the style of business management in which the manager cruises the workplace observing and interacting. He referred to it as “management by wandering around.” Listen to Management By Wandering Around (Someone Else's Business). 

Want to make a deal?Sure you do. Perhaps it’s the renewal of an exclusive contract. Perhaps it’s an extension of your office lease. Perhaps it’s a rate increase in a payor agreement. Listen to Do They Have The Power To Say Yes? 

To paraphrase J.P. Morgan, we always have two reasons for doing anything: a good reason and the real reason. Listen to A Good Reason And The Real Reason To Avoid Physician Owned Hospitals. 

Medical groups,especially first generation medical groups, often suffer from a common management error: Their leaders or board members manage from the perspective of their individual personal success, not from the perspective of the group’s, that is, the business’, success and of its long-term future. Listen to Medical Group Management Error: Managing For Your Personal Gain. 

Compounding pharmaceuticals, specific drugs for specific patients, offers tremendous benefit. The problems arise when the benefit is for the prescribing physician. Then, we’re dealing with analyses under the federal Anti-Kickback Statute (AKS), the Stark Law, and their state law counterparts. Listen to Compounding The Kickback Problem. 

Many medical groups (actually, many of all sorts of businesses) shortchange their future as a result of their past. Listen to Why Your Past Doesn't Count. 

They say that beauty is in the eyes of the beholder. Listen to Why Document The Value Of A Group Member's Interest? 

A friend told me about his old boss, a guy who thought he was sending a message of his own importance by showing up late to meetings with his clients. Listen to Showing Up On Time and Negotiation.

I’m no enemy of fast food. I just don’t want to eat it. I don’t care if you do. I wouldn’t make it illegal. But some mayors would. Listen to Opting Out To Opt In For Yourself. 

Measurement of “care” will soon count for more than care itself. Listen to Bean Counters 1, Patients 0.  

They looked for a 16 cent phone charge.I know someone who runs an efficient business. Or so he tells me. Listen to Do You Measure Up Or Measure Down? Efficiency vs. Efficacy. 

How do you become a millionaire? Make a billion dollars and then buy an airline.” — Warren BuffettAmerican Airlines emerged from bankruptcy and merged with, well, actually into, US Airways. Listen to How To Become A Millionaire. 

You’ve heard that old expression to the effect that it’s better to do and then ask for forgiveness than it is to ask for permission in the first place.I’m not sure if that’s always right in a social setting, but in business it often works out in your favor. Listen to Why Taking Control Is A Smart Contracting Tactic. 

Here’s something you can absolutely plan on: most planning done by medical groups, especially that common variety, the “strategic planning retreat,” is a complete waste of time. Listen to Why You Shouldn't Waste Your Money Planning A "Strategic Planing" Retreat.  

Socialism is alive and well, and I’m not simply talking about the socialistic charade of Hugo Chavez. Listen to Socialism Is Alive And Well Within Medical Groups. 

It was 9:00 p.m. The restaurant was clearing out. I was eating alone after returning to the hotel following a meeting. Listen to Physician Talks Out Of His (not)Mouth - Brags Of Kickbacks.

1. Look before you leap. CHECK.2. Measure twice, cut once.  CHECK.3. Document your deal with your partners before commencing joint practice. WHAT? Listen to Look Before You Leap: Document Your Deal.

Anita Roddick, the late founder of the highly successful natural cosmetics chain, The Body Shop, which she sold to the cosmetic giant L’Oréal for $1.1 billion, was a tremendously driven entrepreneur and an extreme social and political activist. Listen to Department Of The Future. 

It’s hard enough to watch what you say when you’re speaking, but at least you’ve got inflection on your side. Listen to Do You Make This Mistake In English? 

My dog stood body frozen stiff yet ready to lunge. His eyes fixed on the only object in his world, the squirrel eating seeds off the ground 14 feet away. Listen to The Odds Of Medical Group Survival. 

It’s about 1 pm on Sunday and I’m thinking of getting a cheeseburger for lunch. But if I don’t, it won’t make any difference to me. Listen to Why Not Wanting The Deal Is The Way To Get It (Or, If Not, Who Cares!)

Why Not Wanting The Deal Is The Way To Get It (Or, If Not, Who Cares!)
July 4th, Independence Day in the United States, celebrates the original 13 colonies’ declaration, in 1776, of their independence from Great Britain. Listen to Your Independence Day. 

In 1919, New York hotelier Raymond Orteig announced the Orteig Prize: $25,000 to the first aviation team to fly nonstop between New York and Paris. Listen to It's Human Nature: Incentivizing Performance.

The first time that I saw a computer there were two in the room. One of them took up most of the south side of a floor of the Computer Science Building and the other took up most of the north side. Listen to Beware The Government-Hospital Complex.

Earlier this year, a Santa Clara County, California jury awarded the insurer Aetna a $37,452,199.00 judgment in a lawsuit against Bay Area Surgical Management, LLC, a surgery center management company, a number of its managed ASCs, and three of Bay Area’s executives. Listen to Aetna Obtains $37-plus Million Judgement Against ASC Manager.
Some leaders of hospital-based groups, and I use the term “leader” broadly, believe that their groups are a function of the hospital. If the hospital no longer wants to contract with them, then that would be it, they’d simply pull the plug on the group. Listen to Who Is Really In Charge Of Your Medical Group. 

You probably already know that it is my firm belief that hospitals, at least as we know them, are basically dead. They just don’t know it yet. What I mean is that the majority of surgery cases are going to be shifting out of hospitals. Listen to Thoughts On Surgery Center Development And Operations. 

Major League Baseball has an antitrust exemption. It also has a level playing field. The players, as employees, can collectively bargain. Listen to An Antitrust Exemption For Physicians. 

When my kids were small, they used to talk about their super powers. They were convinced that they were real. Listen to How Not To Destroy Your Medical Group's Ability To Compete.
 
Yes. Sure. Of course. How many times each day do you say one of those words? Listen to No, But Thank You

I see too many deals that are hatched from the evil twins of self-inflicted human nature: fear and hope. Listen to Why Hope And Fear Drive (Stupid) Deals.