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Windows XP and Office 2003 Put your Practice at Risk after Apr 8, 2014

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We would like to provide an update as it relates to the ‘end of life’ of Microsoft Windows XP and Office 2003. There has been a lot of buzz recently and it has been getting a lot of publicity in the news, generating many questions, prompting us to put together this information.

WHAT IS HAPPENING?
Windows XP was released August 2001; before Facebook or Twitter was even introduced to the world. Microsoft will end support officially on April 8, 2014 for Windows XP and Office 2003. Additionally, many Internet Explorer (IE) applications will be moving to and requiring Internet Explorer 9.0 to function; this is also not available with Windows XP. We have all grown to love Windows XP and these technology changes make a large impact to us all and preparations need to start occurring for anyone who has and uses Windows XP in their businesses today.

HOW DOES THIS AFFECT YOU?
First and foremost, with Microsoft ending support and security patches, this will make XP computers more vulnerable to attacks and malware, even if these devices are not connected to the internet and are connected to a private network. Because of the end of security patches, after the end of support date, XP will no longer be an acceptable as part of your practice’s HIPAA compliant solution.
Many software vendors have already released that they will be requiring Internet Explorer 9 in future versions which is an additional reason why XP computers will need to be retired.

WHAT NEEDS TO BE DONE?
Upgrading the operating system OR replacing the XP machines will need to occur to protect the security of your systems and to meet basic HIPAA security compliance. Some computers may have hardware capable to run and upgrade to Windows 7. If the hardware is not powerful enough for the Microsoft upgrades, we recommend to pull, shred the hard drive, and recycle the old PC; replacing it with a new computer running Windows 7 Professional or Windows 8 Professional.

Many computers may have a Windows 7 Professional license running XP and can be upgraded. This can be checked by looking at the top of the computer at the Microsoft certificate of authenticity which will provide the version of the license.

Below are a few links from Microsoft which include so of the above mentioned dates and support.

http://windows.microsoft.com/en-us/windows/products/lifecycle
http://windows.microsoft.com/en-us/internet-explorer/products/ie-9/system-requirements

Lump Sum Distributions vs Pension Plans

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The Markets

If you found holiday songs or Beatles tunes humming through your head last week, it may have been your subconscious processing world and market events.

Over the river and through the woods/To Grandmother’s house we go… Janet Yellen, current Vice Chairman and nominee to be the next Chairman of the Federal Reserve System, testified at her confirmation hearing before the U.S. Senate’s Committee on Banking, Housing, and Urban Affairs on Thursday. Her comments were widely interpreted as indicating that current stimulus measures will remain in place. This made investors happy and helped push global stock markets higher.

In the United States, the Dow Jones, S&P 500, and NASDAQ, all appear to be headed toward milestones. The Dow is nearing 16,000, the S&P is closing in on 1,800, and the NASDAQ is approaching 4,000.

You say you want a revolution/Well you know/We all want to change the world… China’s third plenum of the 18th Central Committee, which also is being referred to as a blueprint for reform, a reform manifesto, and the Decision on Major Issues Concerning Comprehensively Deepening Reforms, is ambiguously phrased, according to The Economist. However, it appears to encourage:

“…Experimentation in everything from trading rural land to the freeing of controls on interest rates. Barriers to migration will be further broken down and the one-child policy relaxed. A widely resented system of extra-judicial detention, known as laojiao (re-education through labor), will be scrapped.”

China’s leaders also promised to elevate the role of markets in the economy. That news helped push Shanghai Composite Index higher last week.

HAVE YOU BEEN OFFERED A LUMP SUM DISTRIBUTION? Not too many employers offer pension plans anymore. You know, pension plans. The kind of retirement plans that employers used to offer; the type where employees generally didn’t contribute and the benefits they received in retirement were determined by their salaries, length of employment, and other factors.

If you’ve ever worked for a company that had one, it’s possible that the offer of a lump sum distribution may be headed your way. If you accept a lump sum distribution, you’re choosing to receive a pile of cash today instead of monthly or annual pension payments in retirement. Basically, you’re agreeing to take responsibility for investing the money and generating a stream of income during retirement so your employer doesn’t have to do those things.

Why are companies offering lump sum distributions? The Pension Protection Act of 2006 (PPA) established new accounting rules. Companies with pension plans must recognize their plans’ funded status on their balance sheets each year. Since balance sheets are scrutinized by analysts and investors, and lots of pension plans are underfunded, companies decided it was time to take action.

How underfunded are these plans? A Wilshire Associates report cited by Reuters found the difference between the amount that S&P 500 companies will owe to retired workers and the amount those companies have set aside to pay retirees is more than $1.5 trillion. How much is that? Well, if you took one trillion one-dollar bills and strung them end-to-end, the chain would stretch further than the distance from the earth to the sun!

Anyway, having an underfunded plan became a corporate finance headache. Two-thirds of companies that have pension plans are trying to limit the effect of those plans on their financial statements (69 percent) and cash flows (58 percent), as well as reduce the overall cost of their plans (41 percent), according to a recent Towers Watson survey. CFO Research in collaboration with Mercer said employers plan to do this by:

  • Adopting more conservative investment strategies
  • Transferring pension obligations to insurance companies by purchasing annuities
  • Offering lump-sum payouts to retired and current employees

In many cases, accepting a lump sum payout rather than having income from a pension may have a significant impact on your retirement.

Think About It

“The average 401(k) account balance fell 34.8 percent in 2008, then rose from 2009 to 2011. Overall, the average account balance increased at a compound annual average growth rate of 5.4 percent over the 2007-2011 period, to $94,482 at year-end 2011… The median 401(k) account balance (half above, half below) increased at a compound annual average growth rate of 11.5 percent over the period, to $42,082 at year-end 2011.”

— Employee Benefit Research Institute, June 2013 [12]

How Do You Know if You Need to Restore Your Pluck?

Categories: Articles

If you are full, well-rested and financially strained, you survived yet another Thanksgiving holiday. As we begin December and look ahead to January, we shift our focus to 2014 planning.

Keith Finger, a B2B marketer and NicheLabs partner, shared his thoughts with us, which we would like to share with you. In his post, Keith highlighted the importance of tapping customers and prospects to for valuable insights into both what we are doing well and what elements of our marketing approaches need tweaking.

How do you obtain reliable, external input? NicheLabs welcomes you to share your thoughts on this topic one-on-one, as well.

Is Your Marketing Plan a Turkey?
It’s November and hopefully you’ve done some planning for 2014. I’ve found that companies frequently make strategic decisions based on their unique view of reality, and without any external input. Of course, the way we look at our own businesses is vastly different from how prospects and even customers view us.
So how do you get reliable input? Here are some thoughts:
1. Do NOT talk exclusively with customers. They know you and may not give you the candid input you’d receive from non-customer. While customer feedback is important, don’t rely on it exclusively for planning purposes.
2. Do NOT rely on focus groups. It’s all too easy in a focus group for a few outspoken people to dominate the discussion and cause others to stay quiet or change their opinions, even with a good moderator. They’re also expensive.
3. DO talk with companies who are not your customers. This is the best way to get info on unmet needs, perceptions of the marketplace, competitors, etc.
4. Do NOT gather info from prospects you’re also selling to. It’ll make the sales process awkward.
5. DO gather info using one-to-one interviews, conducted by an inquisitive marketer. Find people to interview using LinkedIn and association websites. Send an email asking for their input for research and be sure to state the length of the call and assure them it is not a sales call in disguise.
6. DO interview at least 10 people. Twenty is even better. You need enough info to allow you to see patterns and make some judgments on actions to take. If you get an especially insightful response from one person towards the end of your calling, contact previous respondents to get feedback and confirmation.
7. DO prepare a basic list of questions but don’t read them off like a bad telemarketer. Be conversational. Also, it’s okay to veer off-course and probe particularly insightful responses.
7.5 One more point: hire a facilitator to run planning meetings. You’ll end up with better results if everyone participates and someone doesn’t also have to also run the meeting and log comments.

Comments? Questions? Click reply or drop Keith a note at keith@keithfinger.com or contact Hal at NicheLabs hschlenger@nichelabs.com or 888-978-9254

You are not Planning to Move but don’t Overlook Your Renewal

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By Stan Sharp

With new regulations coming from seemingly every direction, the looming implementation of ICD10 and the far reaching effects of the Affordable Care Act practices often overlook a significant source of bottom line savings, their lease renewal. When your practice has a lease which is a year from expiration you should begin the process of planning for a successful renegotiation.
That process involves many of the same elements you consider in looking for new space. You must first examine the clinical needs of your practice at that location in terms of your current needs but more importantly in terms of your needs over the renewal term. Based on that evaluation you must determine if your current space is able to meet those needs. If your current space does not meet those needs you must determine what changes are needed and the cost and practicality of those changes. You will be signing a long term high dollar commitment which will have a significant impact on your practice’s bottom line. Many practices fail to start the renewal process early enough and they fail to consider the renewal as an opportunity to plan for the efficient operation of that location into the future. The renewal gives your practice the chance to consider how changes in healthcare will change the requirements for that particular location in terms of the amount of space needed and in the layout of the space.

To examine your current and future needs you need to begin asking questions.

  • Do you plan to add or reduce the number of providers at that location during the term of the renewal?
  • If you plan an increase or a decrease in the number of providers how will what effect the number of exam rooms, restrooms, and doctors offices needed?
  • What changes should or could be made to the support areas based on the changes to the clinical areas which would necessitate either an increase or a decrease in the space needed?
  • Will changes in your practice change the number of staff needed (either by addition or subtraction) throughout that office?
  • Have equipment changes either in the front office or elsewhere caused the need for a redesign of the effected area?
  • Has the patient base either current or projected changed in such a way as to necessitate the need to re-examine the geographical location of that office?

Once you have asked sufficient questions and obtained sufficient answers you can determine whether your current space can accommodate your future needs both in terms of square footage and layout. This information can then be used to make design changes to your current office and to select alternatives to your current space which meet your current and future needs. The alternatives you select serve a dual purpose. At the end of the analysis one of them may provide a better alternative than your current space and they will provide valuable leverage which you can use in negotiations with your current landlord.

Once you have picked realistic alternatives you should work thru the process just as you would if you were looking for a new space in a new area. You request proposals from your current space and the initial alternatives you selected. Based on a comparison of the responses you will choose one or two of the alternatives as finalists. These finalists are then asked to prepare preliminary floorplans and construction pricing so that each of the finalists can provide an updated proposal which reflects the lease cost and the construction cost for that alternative. Using these proposals and the updated proposal you received from your current landlord, which reflects any proposed tenant improvements, you will negotiate between options to achieve the best possible offers from each. Remember that negotiation is a process not a one time request for terms. After you feel you have negotiated the best terms obtainable from each of the options, including your current space, you compare the options and select a winner. Once chosen you negotiate a final lease document with the winner.

The process of negotiating between your current space and the alternatives provides critical leverage to make sure that whether you choose to remain in your current space or choose an alternative you have a space that will meet the changing needs of your practice over the renewal term and you have negotiated the most cost effective terms. Too many practices skip this process and as a result leave significant money on the table but with prior planning you can make a positive difference in the outcome of your next renewal.

Stan Sharp is founder of HealthOne Realty Advisors. He can be reached at 770-578-4996 .

Uncertainty Requires Building Energy Reduction

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INTRODUCTION
In the United States, buildings use one-third of our total energy, so therefore building owners need to know and understand the energy consumption of their building due to the high cost of energy and the uncertainty of future energy costs.

This knowledge will also be a benefit to the building ownership in regard to value of the building when steps are taken during design and construction to reduce energy consumption.

The U.S. Green Building Council has developed the LEED (Leadership in Energy and Environmental Design) rating system where a building is designed and built to meet the criteria for the four levels of certification. Those four levels are Certified, Silver, Gold, and Platinum. These rating levels can only be achieved when a LEED’s certified professional is involved with the design and construction of the building. LEED certification takes into account all of the aspects of the building process from site selection, material delivery distances, distance to public transportation, and many other environmental impacts. Should a building owner select not to have his building LEED certified due to the strict requirements and cost impact, he should direct his building design team to incorporate energy saving systems to increase his building value.

The following are some to be considered:

BUILDING LIGHTING
Artificial lighting needs to be selected to reduce heat load of the light fixture. Light fixtures typically produce heat when operating which requires more air conditioning. Reducing the heat load of the light fixture will reduce the air conditioning requirements of the building. Also many of the light fixtures on the market which
produce low heat load are more efficient to operate and have a long lifespan.
New advancements are being made in LED (Light-Emitting Diode) lighting where these systems can be used to reduce energy. In the future LED light bulbs will replace other low efficiency lighting helping reduce energy cost, reduce maintenance, and disposal costs.

ROOF AND WALL INSULATION
Increasing the thickness of roof and wall insulation help to reduce heat or cooling lost through the largest exposed areas of the building. Special attention should be given to the roof area due to the direct exposure to the sun. Also thought should be given to the roofing material selection to increase the reflectivity of the sun’s rays. Thin solar panels are now being developed to be placed on building exteriors to produce electrical currents to help power the building systems. These systems should be ready for building use in the next three (3) to five (5) years.

GLASS SYSTEMS
The exterior glass systems of the building should include an insulated glass panel with reflective coating and a thermal break in the framing system. The reflective glass helps control the heat gain of the building, helping reduce the energy requirements for conditioned air. Thermal breaks in the framing system eliminate the thermal conductivity between the inner air condition of the building and outer building conditions. Another consideration to the glass system design is using reflectors or diffusers to help add natural light but not direct heat gain caused by the sun’s rays. Not too far in the future, we will have “intelligent” glass systems which increase glass reflectivity as the solar gain increase similar to eye glass lens which change from clear to darker as lighting increases.

RAINWATER RECLAMATION
Another system which should be considered when building a building in the Atlanta area is rainwater reclamation or rainwater harvesting, due to the small drainage basin which servesthe metro Atlanta area. In simple terms, a rainwater harvesting system collects and stores rainwater which falls on the building site for future use. If the building is designed properly, this water can be used in the building for non-potable use such as toilet flushing, cleaning, and landscape irrigation. If stored rainwater is used in this manner, use of city or county water can be reduced by up to 60%. Sunbelt Structures – Use of Efficient Lighting Achieving Medical Practice Profitability

CONCLUSION
This article only mentions a few of many energy saving systems which should be considered when building a new facility or renovating an existing facility to increase the over-all project value. Should the owner have interest in energy savings and a concern for the environment, he should select a competent architect and general contractor to aid him with the selection of energy saving systems and the cost impact and pay back of those energy saving systems.

by Eric A. Schoppman – Schoppman Company

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