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Max's Back Pocket Volume VIII - Max Out of Pocket
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Max’s Back Pocket Volume VIII


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I’m new to Twitter. I am still trying to figure out if it is worth my time or not. I’m having some fun with it, though. Last week, I ran my first ‘Twitter poll’ to figure out if these weeks are going by fast or slow. I really can’t tell. In some respect, they are flying by. By other measures, they are going at a snail pace. The majority of my massive Twitter following seems to think the weeks are going by fast.

If Twitter is your thing, you can follow me here

As for this last week, I would tend to agree. But I am settling into this slower pace, and I think there is a lot to be learned from it. At the end of this, we will need to decide which new habits we keep. Opening up some capacity for creative thinking has netted my organization some value. Having the time to close out some older finance projects has also resulted in additional money in their pocket. I am learning that I am pretty passionate about helping rural health providers and keeping them financially solvent.

Here we are in the eighth edition of Max’s Back Pocket already and I can hardly believe it. I was once told that we tend to overestimate what we can do in a day but underestimate what we can do in a year. It is hard to believe I started this questionable blogging career over a year ago. I am now running a ridiculous series called “Max’s Back Pocket”. Outside of Mrs. Max OOP, not a soul in my personal network knows about this blogging project. Pretty cool.

When I started this weekly series, I committed to eight weeks. I would then re-evaluate how things were going. Since we are still in the midst of the COVID-19 crisis and I find this structure somewhat therapeutic, I am adding on a 4-week extension. I do think it will eventually turn into an “every two-weeks” thing. So with that, welcome to the 8th edition of Max’s Back Pocket.

Max’s Back Pocket

Over the last several years, I have absorbed a ton of great content from a lot of talented people in and around the internet. Several of those ideas even got implemented into my personal finance strategy. Some of these people are professionals, but a lot of them are just amateurs throwing their weight around in a random niche. I like to think I am pretty good at healthcare and personal finance, but there are plenty of people out there much smarter than me.

Up until now, most of these ideas just landed in my back pocket. There they would sit for my own benefit whenever I needed them. They were rarely shared or exchanged with anyone in my personal network. These days, that is no longer the case. Max will start scouring the entire internet for these ideas in a weekly effort to not only spread but recognize the wealth of knowledge that is out there. This weekly check-in will also give me an excuse to catch up on what’s going on around here more often. What are we calling this idiomatic experiment?

Max’s Back Pocket.

Finally added the Max Out of Pocket symbol

Personal Finance

Here at Max Out of Pocket, I took a break from healthcare this week to touch on some personal finance concepts. One thing everyone needs to decide is how much liquid cash to keep in their portfolio. Since Mrs. Max OOP and I are both still working, I settled at a full year’s worth of living expenses as our liquid cash allocation. This comes out to $51,436 and I keep it in my Vanguard brokerage account.

This cash position is a function of our 2019 expenses. Therefore, I thought it would also be important to check in on our 2020 expenses to make sure everything is in line. It turns out our we are coming in light for the first three months of 2020. So we passed the stress test.

Speaking of that, the folks over at Costa Rica FIRE consider this pandemic a stress test for their FIRE plan. Not only is their consulting business hampered by social distancing and travel restrictions, but their “plan B” of moving to Costa Rica to reduce expenses is also temporarily off the table because the border is closed. Luckily, all of their tenants are paid up through April. Hopefully, they see the same for May.

I thought holding over $50,000 in cash was a bit much, but it is nothing compared to what the folks over at Modern FImily have. They are holding over $200,000 in cash according to their quarterly net worth update. This is over 25% of their portfolio. Their plan is to retire (early) about a year from now. They have plans for their cash, though. $50,000 will go towards the mortgage, $25,000 towards living expenses for the year, and they will end up with $135,000 when they retire. One thing I find interesting is their portfolio crosses over two countries, Canada and the United States. We may find ourselves in that same situation someday.

Healthcare

There is almost too much on the healthcare front to keep track of. I have been trying not to stretch myself too thin by covering every little bill or announcement that comes out. I think I will try to stick to the ones that impact out-of-pocket healthcare costs.

The Centers for Medicare and Medicaid (CMS) started releasing the CARES Act (Public Law 116-136) ‘Provider Relief Fund’ to hospitals and providers around the country over the last few weeks. In total, it’s about 100 billion dollars, and about 50 billion of it is a “general allocation” and hospitals didn’t even need to apply for it.

The money literally just started showing up in bank accounts flagged as “HHSPAYMENT”. The payments are grants, not loans. So the providers of care will not have to pay them back, but there is a catch. The providers have to “attest” not only that they received the payment but that they agree to the lengthy terms and conditions. HHS will assume providers agree to the terms and conditions if they hold the fund for 30 days without responding.

One of the requirements outlined is related to ‘balance billing’ patients. It is long, but I am going to quote it verbatim.

The Secretary has concluded that the COVID-19 public health emergency has caused many healthcare providers to have capacity constraints. As a result, patients that would ordinarily be able to choose to receive all care from in-network healthcare providers may no longer be able to receive such care in-network. Accordingly, for all care for a presumptive or actual case of COVID-19, Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.

Relief Fund Payment from $30 Billion General Distribution – PDF

This is a nice move by the government to put in some protections for COVID-19 (and presumptive) patients seeking care from an out-of-network provider. I like the carrot on the stick approach.

I will tell you, most providers will agree to these terms and conditions. They would be crazy not to. But that doesn’t mean their billing systems have caught up to this agreement yet. So if you happen to go out of network and get a bill that doesn’t seem right, just ask about this.

Life

I am settling into this new slower version of life. Several projects that have been on my list for months are now closed out. I am brushing up on telehealth billing and finance and I will share those concepts here on the blog very soon. I listened to the folks over at ChooseFI again this week; it sounds like they are changing up the format a bit. If you are looking for a podcast to listen to while getting things done around the house, Big ERN is a former economist and even did work for the Federal Reserve Bank. He does a great job explaining why he thinks the stock market has bounced back so quickly. Like Max, Big ERN also has ties to the Big Ten as a graduate from Purdue University and the University of Minnesota.

It should be 60 degrees today. Hopefully, we will get out for a run and a hike. We have still been having indoor fires in our fireplace, but we use May 1 as the cutoff for that. Hopefully, we can move that operation outdoors to our legal firepit soon and enjoy the summer.

How was your week?

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