Dr. William Matzner, Simi Valley, California

William L. Matzner, M.D., PhD, FACP

Dr. William Matzner works in the area of healthcare economics consulting at Healthcare Analytics, LLC, in California, Simi Valley. He graduated Phi Beta Kappa from Stanford University. He received his doctor degree M.D. with Honors from Baylor College of Medicine. In 1988, he was the Solomon Scholar for Resident Research at Cedar Sinai Medical Center. Dr. Matzner subsequently was awarded a PhD in Neuro Economics from Claremont Graduate University. He is board certified in Internal Medicine and Palliative Medicine. He has researched and published extensively on the issue of reproduction and immunology in medical literature. He has been in private practice since 1989, specializing in Reproductive Immunology and Internal medicine.


Website: https://drwilliammatzner.com

Consulting Website: https://healthcareanalytics.biz

LinkedIn: https://www.linkedin.com/in/william-matzner-md-phd-mba-60219730

Blog: https://drwilliammatzner.blogspot.com

News: https://hype.news/dr-william-matzner/

News: https://hippocratesguild.com/dr-william-matzner

News: https://medicogazette.com/dr-william-matzner


William Lee Matzner, MD., is a recognized expert in Healthcare and Neuro Economics

William Lee Matzner, MD., is a recognized expert in Healthcare and Neuro Economics

Cost Effectiveness of Bundled Payments

By William L. Matzner, M.D., PhD, FACP

New Review of Cost Effectiveness of Bundled Payments published by healthcare analyst Dr. William Matzner


The cost of healthcare is a much-discussed and ongoing issue. The new article by William L. Matzner, MD reviews “Bundled Payment for Care Improvement Advanced” 


The cost of healthcare continues to be a topic of intense discussion from kitchen tables, to board rooms, to congressional hearings. Spurred by conversations and allegations, insurance companies and entities such as Medicare and Medicaid have striven to conceive alternate payment approaches besides the traditional fee for service methods on the basis of reducing costs. Dr. William Matzner has published an overview article on this issue. The complete article will be published on the Blog of Dr. Matzner at https://drwilliammatzner.blogspot.com


Capitation (a system in which providers are given a defined sum per patient regardless of how many services are rendered in a defined period of time) has been around for many years and has been fraught with complaints among providers for inconsistencies between responsibility for and authority over patient interactions. The HMO model has also been attempted in various iterations with its focus on preventive care, but most have not survived, Kaiser Permanente being an exception. Medicare has since developed a method falling between that of full capitation and fee for service—the use of bundled payments or put more descriptively, episode-based payments. In this method, reimbursement of healthcare providers (both hospitals and physicians) is based on the expected costs for clinically defined episodes of care. Since 1984, bundling payment methods have been tried and as of 2012 almost one third of medical reimbursement is now from a bundling system.


In 2018, Medicare introduced a variation called Bundled Payment for Care Improvement Advanced (BPCI Advanced). In this model there are 48 episodes, 45 inpatient and three outpatient. Again there are four payment models, with model two being the most common. Several of the medical episodes included in BPCI Advanced include CHF, COPD, Sepsis, Acute MI and Pneumonia. As every physician would know, there is a wide variation in the degree of illness and the course of therapy within these diagnoses, and there is nothing uniform about each case. 


For example, Sepsis includes three DRGs which range from uncomplicated to septic shock. Unlike elective surgery, providers cannot screen these patients to avoid complications, and in fact many of these patients develop complications and/or have significant comorbidities. All of these variables create significant variations of length in stay (LOS) and other costs associated with each hospitalization. In these cases, where there is a wide variation in costs, a need exists to employ a method to better predict these costs. 


That methods exists but seems too seldom used. It is decision tree modeling that offers both the flexibility and complexity of interaction to more accurately predict costs than just a linear model which is commonly used. Since diseases such as sepsis, COPD and CHF can become a complex affair with many possible outcomes that would affect costs, this type of modeling lends itself to such an analysis. Armed with better predictability results, providers are better able to defend both real costs and to negotiate for more fairly applied payment schemes. 


If your objective is to provide the best decision-making for your organization and take a global view of your business, expanding your sights beyond ROI, and educating other decision-makers, Cost Effectiveness Analysis can make your organization more competitive and more profitable.

William Matzner, MD. is a recognized expert in Healthcare and Neuro Economics. With a Ph.D. in Economics, MBA and Medical Doctor degree, Dr. William Matzner will provide you with expert analysis on health and wellness programming, populations health management, disease management, new program development, facility development, equipment acquisitions, and other healthcare programs, acquisitions and initiatives. For more information about cost effectiveness analysis and improved financial accountability for your organization, visit Dr. Matzner at http://healthcareanalytics.biz


Dr. Matzner is also available for speaking engagements, retreat presentations and topic specific addresses. 


Website: https://drwilliammatzner.com

Consulting Website: https://healthcareanalytics.biz

LinkedIn: https://www.linkedin.com/in/william-matzner-md-phd-mba-60219730

Blog: https://drwilliammatzner.blogspot.com

News: https://hype.news/dr-william-matzner/

News: https://hippocratesguild.com/dr-william-matzner

News: https://medicogazette.com/dr-william-matzner

William Matzner, MD, practicing medicine since 1989, Internal Medicine and Reproductive Immunology

William Matzner, MD, practicing medicine since 1989, Internal Medicine and Reproductive Immunology

News about WILLIAM MATZNER, MD

The true cost of physician turnover at healthcare facilities

by Dr. William Matzner, MD, PhD

There are many costs involved with recruiting and retaining medical staff. HR experts project a cost factor of 16% to 20% of the physician’s annual salary purely as replacement costs, notes Dr. William Matzner in his analysis.


Just like in any business, it is prudent for a medical clinic to retain physicians over long periods of time. Uncontrolled turnover is costly not just in real dollars, but also in staff morale, patient retention and patient satisfaction. Although medicine may be practiced universally, each clinic and office has its own way of seeing patients, documenting findings, doing and reporting labs and x-rays and after-hours coverage. Those factors are always affected negatively when a “replacement” physician is interjected into the mix.


Dr. William Matzner, MD, based in California, provides his insights in a review article. Dr. Matzner is a recognized expert in Healthcare and Neuro Economics. He has conducted extensive research in and taught Cost Effectiveness Analysis, a methodology he utilizes to evaluate and recommend corporate health and wellness programming predicated on achieving targeted and desired programming and outcomes for organizations.


There are many costs involved with recruiting and retaining medical staff. But focusing just on productivity, it takes time to train the physician in the specific logistics of the practice, and decreases in productivity while the new physician is familiarizing themselves with how the clinic is operated. Generally speaking, HR experts project a cost factor of 16% to 20% of the physician’s annual salary purely as replacement costs. Add to that number recruiter and interviewing costs, and a $200,000 internist can easily cost $65,000 to replace and onboard. 


But this is just what you might consider the direct costs. The indirect costs include, for example, staff upheaval (physicians often create close bonds with staff.) Also, a physician departure, depending on the reasons, may cause other staff to depart as well. Further, depending on the clinic patient structure, you may actually lose patients or at best, have to deal with disgruntled patients. What is the value, the cost, of these issues? More importantly, are you building them in to the cost of replacing a physician?


Moreover, and this is the elephant in the room, do you build them into the cost of retaining a physician? Recruitment and retention run hand-in-hand, but too often cost is based simply on the known directs: recruiter and relocation fees. The perspective I’ve seen too often is that other doctors will take over seeing the departing physician’s patients, so we’re not losing anything, right? Wrong.


When you build a model that measures and values ancillary staff turnover attributable to a physician departure or recruitment, that measures and values lost or unhappy patients, and then add in the recruitment and productivity costs, you will arrive at a very important number – the value of keeping physicians, of reducing turnover and possibly the understanding of the value of adding monies to your retention budget.


In order to retain physicians a clinic may need to offer more time off, less after-hours coverage and shorter hours. A critical analysis may prove these and other retention initiatives are less costly than turnover. Cost effectiveness analysis (CEA) is a unique and clever method for analyzing this problem. Using decision tree models, and assigning not only cost but effectiveness data to the model, it will be possible to make a more informed decision as to how to recruit physicians and what economic and non-economic incentives to offer them in order to create an actual recruitment and retention program rather than just a recruitment program.


If your objective is to provide the best decision-making for your organization and take a global view of your business, expanding your sights beyond ROI, and educating other decision-makers, Cost Effectiveness Analysis can make your organization more competitive and more profitable.


*** William Lee Matzner, MD., is a recognized expert in Healthcare and Neuro Economics. With a Ph.D. in Economics, MBA and Medical Doctor degree, Dr. William L. Matzner will provide you with expert analysis on health and wellness programming, populations health management, disease management, new program development, facility development, equipment acquisitions, and other healthcare programs, acquisitions and initiatives. For more information about cost effectiveness analysis and improved financial accountability for your organization, visit Dr. Matzner at http://healthcareanalytics.biz. Dr. Matzner is also available for speaking engagements, retreat presentations and topic specific addresses.

Consulting Website: https://healthcareanalytics.biz

LinkedIn: https://www.linkedin.com/in/william-matzner-md-phd-mba-60219730

Blog: https://drwilliammatzner.blogspot.com

News: https://hype.news/dr-william-matzner/

News: https://hippocratesguild.com/dr-william-matzner

Website: https://drwilliammatzner.com

William Lee Matzner, MD., is a recognized expert in Healthcare and Neuro Economics

William Lee Matzner, MD., is a recognized expert in Healthcare and Neuro Economics

There comes a time when you should get a Colonoscopy

by Dr. William Matzner, California

The importance of colon health cannot be emphasized enough. A healthy colon and regular bowel movement is not only imperative for the elimination of waste from the body, but the health of the bowel and the digestive tract is a strong indicator of your overall health. 

Despite all of this, however, it’s unfortunate that colon health is neither talked about, nor given the amount of importance that it truly deserves. 


Even in cases when people notice changes with their bowel habits, the possibility of problems of the colon, bowel, or digestive tract are just shot down to prevent tests and screenings. Needless to say, this is an extremely dangerous approach and can be the reason why you’re left in the dark regarding serious colon issues for longer than you should have been. 


Unless you get checked for colon problems, there’s really no way that you’ll be able to find out whether you’re suffering from any problems or issues in your digestive tract until it’s too late. Moreover, since your gut health is related to a number of different aspects of your overall health, getting a colonoscopy done regularly is essential to ensure that you’re in the clear. 


Interested in learning more about colonoscopies, how they work, and when you should start seeing your doctor regularly for colonoscopies? Read on to find out everything you need to know about colonoscopies, the procedure, and how to prepare for your first colonoscopy. 


What is a colonoscopy?


The major reason why most people opt out of getting regular colonoscopies is the fact that they do not know enough about the procedure. While it’s normal to be slightly intimidated if your doctor recommends a colonoscopy, it’s important to note that the procedure itself is far from terrible. In fact, there’s a high chance that you’ll be sedated and won’t even remember the procedure. 


In a colonoscopy, your large intestine will be examined by a doctor to look for any abnormalities or causes of bleeding or pain in the abdomen, or changes in bowel habits. Through a colonoscopy, it will also be possible for your doctor to check for polyps and cancerous masses that can and should be treated before they are given the chance to aggravate. Since colon cancer is a common problem among adults and senior citizens, it is imperative to get a colonoscopy once every few years to ensure that your digestive tract is in perfect health and that there aren’t any problems with you and your organs. 


What do I need to know before a colonoscopy?


While colonoscopies are generally extremely safe procedures, it’s important to note that your medication might have to be adjusted if you already have some conditions, illnesses, or diseases. That’s exactly why you should let your doctor know beforehand if you’re suffering from lung problems or heart conditions, or if you have any allergies. 


Additionally, it is also important for you to let your doctor know if you’re pregnant or have diabetes since the doctor will have to provide you with a different type of medication to prevent blood clotting problems. 


What must I do before a colonoscopy?


It is extremely important for you to have a clean colon before the doctor performs your colonoscopy. That’s why your doctor may ask you to fast from all solid foods at least 24 hours before your colonoscopy. Clear liquids such as broth, water, and sports drinks are generally allowed to prevent dehydration and weakness. 


You might also be provided with a laxative that can help you empty out your bowel completely. You might be requested to consume the laxative the night before your colonoscopy is scheduled to ensure that your bowel is completely empty when the doctor is performing the procedure. In some cases, patients might also be told to consume the laxative on the morning of the procedure or examination. Regardless of the time that your doctor asks you to consume the laxative, it is extremely important for you to follow their instructions to the T to prevent any problems or complications during the actual procedure. 


Since you will be sedated for the colonoscopy, it is also recommended that you bring someone along who can drive you back home since the effects of the sedative are bound to last for up to 8 hours after the examination. 


How are colonoscopies performed?


Your doctor or medical professional will ask you to lie down on your left side and provide you with IV sedatives. Once you are unconscious, the doctor will insert a long device called a colonoscope into your rectum. Colonoscopes have a light and camera attached to allow the doctor or medical professional to get a clear view of the colon to assess whether or not everything is normal. 


The doctor might also inflate your colon to help get a better view of the colon in its entirety. 

Should the doctor find any polyps or irregular masses, a snare in the colonoscope can also be used to remove them efficiently and effectively during the colonoscopy procedure. The entire colonoscopy should not last more than half an hour should everything be normal. 


When should I start getting colonoscopies? 


While it is important for both males and females to get colonoscopies once every few years starting at age 50, there are certain factors that might want you to start investing in colonoscopies even earlier than that. In case you have one or multiple relatives who have suffered from colon problems or colon cancer, it is important to start getting colonoscopies once every 5 to 10 years starting at age 40 to ensure that you don’t have any undetected problems down the road. 


Moreover, if any relative of yours has experienced problems with their colon at an early age, you should preferably start getting tested around the age when your relative was diagnosed to prevent problems. Since a colonoscopy can help you get a clear picture of your colon health, it is not necessary for you to get the procedure done more than once every 5 to 10 years. 

  

About William L. Matzner, M.D., PhD, FACP


Dr. William Matzner works in the area of healthcare economics consulting at Healthcare Analytics, LLC, in California. He graduated Phi Beta Kappa from Stanford University. He received his M.D. with Honors from Baylor College of Medicine. In 1988, he was the Solomon Scholar for Resident Research at Cedar Sinai Medical Center. Dr. Matzner subsequently was awarded a PhD in Neuro Economics from Claremont Graduate University. He is board certified in Internal Medicine and Palliative Medicine. He has researched and published extensively on the issue of reproduction and immunology in medical literature. He has been in private practice since 1989, specializing in Reproductive Immunology and Internal medicine.


Website: https://drwilliammatzner.com

Consulting Website: https://healthcareanalytics.biz

LinkedIn: https://www.linkedin.com/in/william-matzner-md-phd-mba-60219730

Blog: https://drwilliammatzner.blogspot.com

News: https://hype.news/dr-william-matzner/

News: https://hippocratesguild.com/dr-william-matzner

News: https://medicogazette.com/dr-william-matzner

Dr. William Matzner, healthcare economics consulting at Healthcare Analytics, LLC, in California

Dr. William Matzner, healthcare economics consulting at Healthcare Analytics, LLC, in California

Dr. William Matzner, healthcare economics consulting at Healthcare Analytics, LLC, in California

Blog of Dr. William Matzner

Additional Information

William Matzner, MD starts Blog with information and insights on effective health care management 


Experienced doctor’s blog will address medical practice management issues that affect the delivery of cost-effective health care.


Doctor William Matzner, with decades of experience practicing medicine and a business education, started a Blog to provide on practice management, available at  https://drwilliammatzner.blogspot.com 


In this era of increasing competitiveness and innovation, measuring the effectiveness of health and wellness programs using Cost Effectiveness Analysis is of crucial importance in the health care sector. In his Blog, Dr. Matzner review the significant forces that in the last several years have been changing the way healthcare has and will continue to be delivered. The emergence of more unique ways to deliver care such as clinics incorporated into businesses and factories, the increased use of mid-level providers (nurse practitioners & physician assistants), the increase integration of technologies such as telemedicine and robotics and the shift from interventional reimbursement to outcomes reimbursement are just a few examples.


Compounding these are the ever-increasing costs of healthcare, the strain of funding Medicare on the U.S. economy, and the complications of insurance and healthcare payments under the affordable care act, ACA.


This has led to changes in how businesses intend to interface with the healthcare system going forward. CVS's acquisition of Aetna will try to leverage healthcare delivery through their pharmacy structure. United Healthcare's acquisition of DaVita hopes to leverage cost containment and resource control by directly controlling physicians. And the recently announced collaboration among Berkshire Hathaway, Amazon and J.P. Morgan Chase presents a yet unknown structure whose stated goals is improved quality and less cost. How they will implement their strategy is yet to emerge.


The big question then with these new ventures are how do organizations know what works financially and how do they track performance. In other words, how does one you track, measure and value the relationships between cost and outcomes? How can the analyst measure which methods(s) may generate better or best outcomes?


While there are no perfect answers, Dr. Matzner will offer his experience and insight on his blog. For example: A simple return on investment, ROI, calculation will not provide needed nor valid insights. However, the use of cost-effectiveness analysis (CEA) would provide quite useful, valid and actionable information. CEA uses decision tree models to compare not only cost outcomes but effectiveness outcomes of various treatments on patient health and even on future healthcare usage based on various current actions. It can further be used to determine how effective a set amount of money spent on a particular treatment or method will impact outcomes (i.e. willingness to pay calculation). CEA models are flexible and can incorporate a wide variety of scenarios. As opposed to Big Data, CEA makes use of Broad Data so that comparisons of treatment modalities can be evaluated using real life outcomes. It can compare effects on a discrete problem such as a cancer tumor, or on chronic ongoing diseases such as COPD or CHF.


As the delivery of effective yet profitable, or at least cost effective, healthcare becomes more challenging, methods for evaluating treatments and programs become more necessary if not essential. Methods must be implemented to evaluate these new treatments and programs once they are in place so adjustments can be made. CEA enable organizations to both initially evaluate and subsequently monitor new methods and programs in a meaningful way.

Dr. Matzner’s blog is available at available at  https://drwilliammatzner.blogspot.com 


About William L. Matzner, M.D., PhD, FACP


Dr. Matzner graduated Phi Beta Kapa from Stanford University. He received his M.D. with Honors from Baylor College of Medicine. In 1988, he was the Soloman Scholar for Resident Research at Cedar Sinai Medical Center. Dr. Matzner subsequently was awarded a PhD in Neuro Economics from Claremont Graduate University. He is board certified in Internal Medicine and Palliative Medicine. He has researched and published extensively on the issue of reproduction and immunology in medical literature. He has been in private practice since 1989, specializing in Reproductive Immunology and Internal medicine.

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Health and Wellness Programs & Cost Effectiveness Analysis

WILLIAM L. MATZNER, MD, PHD, MBA FACHE, FACP

Overview 


Health and Wellness programs that appeared in the corporate world two tot three decades ago were considered more an employee perk than a focused effort to change behaviors and influence health and performance factors. However, various emerging trends and solid research data have led corporations over the last several years to look at employee health and wellness an investment in worker productivity, staff retention and an opportunity to directly impact utilization and cost of a growing healthcare cost liability. It seems intuitive that a workforce which does not smoke, is not overweight, participates in exercise programs, and eats healthy will perform more efficiently and cost the corporation less in term of fewer sick days and lower healthcare costs . But how does a corporation go from a generally good idea to implementing a program which has real costs, but conversely has the potential to foster even more significantly real cost benefits.


Current Situation


Measuring real cost and value has presented considerable challenges to health and wellness professionals and consultants in the industry. Some programs have attempted to use Return on Investment calculations (ROI) to help in decision making. ROI by definition is Net Profit/Investment (gain from investment-cost of investment)/cost of investment. While at first this calculation seems simple and straightforward, there are many pitfalls in using this calculation, which was really designed for investment in property, manufacturing equipment, and other capital acquisitions or expenditures.


Opportunity


The use of Cost Effectiveness analysis, a branch of decision analysis, can likely be used to produce more useful and actionable data and information. In this analysis, one sets up a decision tree model to determine a treatment choice, or in this case a wellness program choice, and directly chart how its costs and benefits affect the decision. In this technique, we investigate and quantify the costs of certain interventions and their outcomes. One can also include opportunity costs (the cost of not doing something) in the model. The benefit is typically measured in terms of Quality Adjusted Life Years which is not only the benefit of living one year longer, but living it in a quality and enjoyable manner. Techniques have been developed to quantify this, and from a corporate perspective, it may be correlated directly to cost associated with various employee outcomes or actions, such as productivity, absenteeism, turnover, or other such factors as the organization may measure or choose to measure in the future


One can evaluate the effectiveness of a standard treatment for a tumor versus a new treatment. The costs are in the numerator (dollars), and the effectiveness in the denominator (usually representing quality adjusted life years). The best choice is the branch with the lowest ratio (cost/effectiveness)—here the Standard Treatment arm that Eradicates the Tumor. Likewise, we could use the cost of a particular Health and Wellness Program and model how changes in health will affect the costs and benefits to the workforce at the organization. The model can be as simple or as complex as one wishes to model it. It can directly visualize how much an organization may wish to invest in a wellness program in order to get desired benefits. Although my example is a model of different treatments for diseases, the analogy is that a particular intervention in a corporate health and wellness program is a type of treatment that can actually impact health for the employees.


The benefit of this type of analysis lies in its flexibility. Although general programs for corporate health and wellness exist in many organizations, the specific programs are dictated by a combination of the desire of the employee population and the desires and needs of the corporation. Benefits can include healthier employees who can work more efficiently and effectively while at work, and have less time off for illness. It can also give the employee a sense of belonging to the organization, which can have secondary beneficial effects for the organization. Such benefits can be incorporated into the model in the denominator as a form of quality in the Quality Adjusted Life Year (QALY) measurement. A survey could be conducted of the employees in a specific organization to determine what is most important to them and even quantify just how important each benefit could be.


From the perspective of the organization itself, there are numerous potential benefits to the corporation. Healthier employee populations can work for longer periods of time and more efficiently. Furthermore, they would have less sick days off which are in effect an opportunity cost (cost of not having someone at work). This can further correlate to lower health insurance premiums if statistically fewer employees are making claims. 


This is a definite direct cost savings for corporations participating in health and wellness programs. A model could be constructed to incorporate the premium costs to the organizations in two scenarios: one with a particular wellness program and one without. The difference in cost savings can guide the organization in how much they could spend on a program and still be ahead from a cost/benefit perspective.


Another issue arises as to the time horizon for both investment and at what point the organization can see beneficial effects from their investment in a particular wellness program. One problem that employers have a difficult time visualizing when considering a wellness program is the length of time it will take to see a difference. In general, most corporate wellness programs will say that it will take 2-3 years to see a difference. Using CE analysis, one can actually track the benefits over specific time periods. 


Furthermore, there are advanced modeling techniques that can simulate the course of chronic debilitating diseases over time. These models will incorporate the probability that something will happen as a percentage of certainty per year, and then it iterates the probability over X number of years to give one an accurate idea of the cumulative effect of a disease outcome over time. This capability is not at all possible using ROI or VOI calculations.  Since many common health problems that can affect the corporation fall into this category (heart disease, lung disease such as COPD, smoking, obesity), cost effectiveness analysis is the only accurate way to model the outcome of such diseases and the benefits of intervening through corporate health and wellness programs.


Conclusion


In assessing the costs and benefits of corporate health and wellness programming and strategies, an organization may begin with a record review of healthcare expenditures to gather a picture of current healthcare utilization and the determination of interventional points of opportunity. A second step would be to survey the workforce based both on demographics and behaviors, as determined important by the corporate health and wellness director. This process will develop data points that may be used to then create the type of analysis presented here. 


As a result, this type of analysis can guide the corporate health and wellness director in deciding which of the many programs that are presented would be worth implementing. And it provides the executive team with highly quantifiable data from which to make effective economically sound employee benefit decisions. 


About William L. Matzner, M.D., PhD, FACP


Dr. William Matzner works in the area of healthcare economics consulting at Healthcare Analytics, LLC, in California. He graduated Phi Beta Kappa from Stanford University. He received his M.D. with Honors from Baylor College of Medicine. In 1988, he was the Solomon Scholar for Resident Research at Cedar Sinai Medical Center. Dr. Matzner subsequently was awarded a PhD in Neuro Economics from Claremont Graduate University. He is board certified in Internal Medicine and Palliative Medicine. He has researched and published extensively on the issue of reproduction and immunology in medical literature. He has been in private practice since 1989, specializing in Reproductive Immunology and Internal medicine.


Website: https://drwilliammatzner.com

Consulting Website: https://healthcareanalytics.biz

LinkedIn: https://www.linkedin.com/in/william-matzner-md-phd-mba-60219730

Blog: https://drwilliammatzner.blogspot.com

News: https://hype.news/dr-william-matzner/

News: https://hippocratesguild.com/dr-william-matzner

Dr. William Matzner, healthcare economics consulting at Healthcare Analytics, LLC, in California

Dr. William Matzner, healthcare economics consulting at Healthcare Analytics, LLC, in California