BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on January 31, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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For those those senior healthcare professionals that like to get out of town, vacation, or visit the grandchildren, be sure to always ask for discounts from the various travel providers. This is especially true for all travelers age 55 years and over. Here are a few we know about … for you to consider post pandemic:
American Airlines: There are various senior discounts that apply to various trips. Call to find out which are available.
Amtrak: Senior pricing is available for most Amtrak locations. This ranges from 10 to 15 percent off.
Alaska Airlines: Seniors can save a significant amount with discount plane tickets. However, discounts vary from one time frame to the next. Most commonly, seniors can save 10 percent.
Southwest Airlines: Seniors over 65 who are traveling with Southwest Airlines may be eligible for Senior Fares. These are available online and for international and domestic travel. You can also purchase Senior Fares through a customer service representative at the airline or a travel agency. You will need to arrive early at the gate to be able to prove your age in order to be checked in for your flight.
United Airlines: United offers discounted prices for flights for seniors over 65. Seniors need to select the Over 65 category when purchasing tickets online or with a customer service agent. Discounts vary depending on the flight and location.
Posted on January 31, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Ann Miller RN MHACMP®
Executive Director
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The “Medical Executive-Post” is about connecting doctors, health care executives and modern consulting advisors. It’s about free-enterprise, business, practice, policy, personal financial planning and wealth building capitalism.
We have an attitude that’s independent, outspoken, intelligent and so Next-Gen; often edgy, usually controversial.
And, our consultants “got fly”, just like U.
Read it! Write it! Post it! “Medical Executive-Post”.
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Data Platform: Their health provider members care for tens of millions of people and operate thousands of care facilities, providing more than 15% of all care in the United States. Clinical data from this care is de-identified daily and brought together in the Truveta platform to advance patient care and accelerate development of new therapies.
Posted on January 31, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Markets: Stocks just finished a period of high volatility and biotech companies in particular are feeling unsteady. The sector is off to its worst start to a year since 2016 and Moderna is the worst performer in the S&P 500.
Social Media: More than 95,000 people lost a collective $770 million due to fraud on social media last year, a new FTC report found. That represents 25% of all reported losses to fraud in 2021 and a breathtaking 18x increase over social media scam losses in 2017. Driving the surge was bogus cryptocurrencies. In fact, investment-related scams were the most prevalent type of fraud on social media, accounting for 37% of all losses. Romance scams (24%) were No. 2, and online shopping scams (14%) won the bronze medal.
Employment: The January employment rate dropped, but with Omicron forcing so many Americans to call out sick last month, the data may be specious. Economists polled by Dow Jones are estimating the economy added 200,000 jobs last month.
Posted on January 30, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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StocksMarkets: The stock indexes surged higher—and the Dow [DJIA] had its best day of 2022. Just how volatile was the market this week? The S&P swung at least 2.25% every single day…and ended up on Friday afternoon around where it will start today Monday morning.
Economy: New data showed that overall compensation climbed 4% annually last quarter, the biggest jump in two decades. That’s still not enough to keep up with inflation, which is climbing at its fastest pace since 1983.
PANDEMIC: Americans are not OK during the pandemic. According to the General Social Survey, the share of people who said they were “very happy” plunged from 31% in 2018 to 19% in 2021, while the share of people who were “not too happy” surged from 13% to 24%. Over the past few decades, the very happy people had outnumbered the not-too-happies by about three to-one.
Posted on January 29, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Stock Market: US stocks jumped yesterday with the NASDAQ 100 surging more than 3% as a wave of corporate earnings results helped investors overcome fears of a hawkish Federal Reserve.
Federal Reserve: Friday’s action helped the broader stock market indices end the week mostly flat after a series of volatile trading sessions sparked by the Federal Reserve’s Wednesday meeting. The Dow Jones Industrial Average recorded a swing of 1,100 points on Monday alone.
Economy: Americans are the most pessimistic about the economy they’ve been in a decade — with spirits even lower than in the early pandemic lock-downs in spring 2020. The University of Michigan’s Consumer Sentiment Index sank to 67.2 from 70.6 in January, according to data published Friday. Economists surveyed by Bloomberg expected sentiment to slide to 68.7. The final January figure is the lowest since November 2011 and sits 11.8 points below levels seen one year ago.
Cyber-Crime: Lazarus, a known cyber-crime group with ties to the North Korean government, has managed to abuse the MSFT Windows Update Client to distribute malware, cybersecurity researchers from Malwarebytes have found. In a blog post detailing their findings, the researchers said they were investigating a phishing campaign impersonating Lockheed Martin, an American aerospace, arms, defense, information security, and technology corporation.
Posted on January 28, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Markets: Volatility continued on Wall Street, with stocks giving up big gains early in the day to close lower. Netflix avoided the sell-off thanks to billionaire hedge fund manager Bill Ackman, who bought a stake in the company worth nearly $1.1 billion. And, Robinhood stock fell 12% after hours Thursday when it revealed a wider loss than expected.
Supreme Court: Justice Stephen Breyer formally announced his retirement at the White House yesterday, and President Biden affirmed his campaign promise to appoint the first-ever Black woman to the highest court in the land.
FCC: The Federal Communications Commission (FCC) voted unanimously yesterday to require the Comcasts and Verizons of the world to create broadband “nutrition labels” that lay out cost, speed, and data allowances of internet offerings more clearly for consumers as early as November.
Posted on January 28, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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According to reporter Neal Freyman, Tech giant Oracle said it’s paying $28.3 billion to buy electronic medical records company Cerner, because anything that makes paperwork less excruciating seems like a savvy business play.
Oracle is known for being aggressive with acquisitions (it even rallied a group to try and buy TikTok last year), but Cerner is Oracle’s biggest purchase in its history. The deal is further evidence that health care is “on par with banking in terms of the importance to our future,” as cofounder Larry Ellison told analysts earlier this month.
In Cerner, Oracle will get the Klay Thompson of the electronic medical records market—a very influential player, but in second place behind Epic, which owns a 31% market share.
Bottom line: Big tech companies see a golden opportunity in bringing the health care industry to the cloud, given its size (health care spending accounts for almost 20% of US GDP), and its old-school record-keeping process. A Mayo Clinic study cited by Oracle showed that doctors and nurses spend an average of 1–2 hours on desk work for every hour they take to see patients.
Posted on January 27, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Markets: Stocks were in the green yesterday until Fed Chair Jerome Powell explained that the Federal Reserve Open Market Committee was planning to start hiking interest rates in March to combat soaring inflation. Then, they tanked and Treasury yields rose sharply higher. Microsoft still had a solid day after its superb earnings report offered bullish signs for the entire software industry. But, stock markets in Asia tumbled to their lowest in nearly 15 months after America’s central bank chief confirmed widely expected plans to tackle higher inflation with an increase in interest rates this year, beginning in March. And finally, Cryptos got crushed, again!
FOMC: “With inflation well above 2 percent and a strong labor market, the Committee expects it will soon be appropriate to raise the target range for the federal funds rate,” said Chairman Powell.
Posted on January 27, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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IBM has reportedly placed its Watson Health division on the auction block again
Watson is a question-answering computer system capable of answering questions posed in natural language, developed in IBM’s DeepQA project by a research team led by principal investigator David Ferrucci. Watson was named after IBM’s founder and first CEO, industrialist Thomas J. Watson.
Posted on January 26, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Maestro Health: Top 5 Ranked Risk Areas
Maestro Health surveyed 600 U.S.-based HR professionals. Survey respondents anticipate their company’s medical costs will increase. The top areas at risk are:
• Decreases in annual physicals/screenings: 62% • Increased pharmaceutical costs: 49% • Unvaccinated employees: 47% • More elective surgeries: 46% • Increased urgent care costs: 45%
Stock Markets: US stocks staged a big afternoon comeback for the second day in a row … but still not big enough to close in the green. American Express was the top performer in both the S&P and the Dow after the company reported its highest billings volume ever in Q4. And, enthusiasm over meme stocks more broadly appears to be dwindling along with cryptos. And, while NASDAQ took a hit, Microsoft reported quarterly sales of more than $50 billion for the first time ever.
Economy: The weight of the financial world is on Jerome Powell’s shoulders today. The Federal Reserve chair will provide an update on the central bank’s views on sky-high inflation and its plan for interest rate hikes this year (though none are expected until March).
Pandemic: Pfizer and BioNTech started clinical trials for an Omicron-specific vaccine yesterday. The results will help the pharma partners decide whether to replace their current jab formula with one that targets the most dominant Covid variant. The new vaccine is being tested both as a three-shot series for un-vaccinated participants and as a booster for the already vaccinated.
The business cycle is also known as the economic cycle and reflects the expansion or contraction in economic activity. Understanding the business cycle and the indicators used to determine its phases may influence investment or economic business decisions and financial or medical planning expectations. Although often depicted as the regular rising and falling of an episodic curve, the business cycle is very irregular in terms of amplitude and duration.
Moreover, many elements move together during the cycle and individual elements seldom carry enough momentum to cause the cycle to move. However, elements may have a domino effect on one another, and this is ultimately drives the cycle. We can also have a large positive cycle, coincident with a smaller but still negative cycle, as seen in the current healthcare climate of today.
First Phase: Trough to Recovery (production driven)
Scenario: A depressed GNP leads to declining industrial production and capacity utilization. Decreased workloads result in improved labor productivity and reduced labor (unit) costs until actual producer (wholesale) prices decline.
Second Phase: Recovery to Expansion (consumer driven)
Scenario: CPI declines (due to reduced wholesale prices) and consumer real income rises, improving consumer sentiment and actual demand for consumer goods.
Third Phase: Expansion to Peak (production driven)
Scenario: GNP rises leading to increased industrial production and capacity utilization. But, labor productivity declines and unit labor costs and producer (wholesale) prices rise.
Fourth Phase: Peak to Contraction (consumer driven)
Scenario: CPI rises making consumer real income and sentiment erode until consumer demand, and ultimately purchases, shrink dramatically. Recessions may occur and economists have an alphabet used to describe them.
For example, with a V, the drop and recovery is quick. For U, the economy moves up more sluggishly from the bottom. A W is what you would expect: repeated recoveries and declines. An L shaper recession describes a prolonged dry economic spell or even depression.
NOTE: Historically, contractions have had a shorter duration than expansions.
Bull and Bear Markets for Medical Professionals
A bull market is generally one of rising stock prices, while a bear market is the opposite. There are usually two bulls for every one bear market over the long term.
More specifically, a bear market is defined as a drop of twenty percent or more in a market index from its high, and can vary in duration and severity. While a bull market has no such threshold requirement to exist, other than they exist between these two periods of sharp decline.
Whither the Bear?
As a doctor, your action plan in a bear market depends on many variables, with perhaps your age being the most important:
In your 30s:
Pay off debts, school or practice loans.
Invest in safe money market mutual funds, cash or CDs.
Start retirement plan or 401-K account.
In your 40s:
Increase your pension plan or 401-K contributions.
Stay weighted more toward equity investments.
Review your goals, risk tolerance and portfolio.
In your 50s:
Position assets for ready cash instruments.
Diversify into stock, bonds and cash.
Retirement:
Maintain 3 years of ready cash living expenses.
Reduce, but still maintain your exposure to equities.
ASSESSMENT: So, where are we right now in the economic business cycle? Your thoughts are appreciated.
Whether you do contract work or have your own small business, tax deductions for the self-employed physician consultant and/or medical executive or nurse consultant, etc., can add up to substantial tax savings.
With self-employment comes freedom, responsibility, and a lot of expense. While most self-employed people celebrate the first two, they cringe at the latter, especially at tax time. They might not be aware of some of the tax write-offs to which they are entitled.
When it comes time to file your returns, don’t hesitate to claim the benefits you get for being the boss. As a self-employed success story, you’ve earned them.
FORM 1099NEC: Form 1099 NEC is one of several IRS tax forms used in the United States to prepare and file an information return to report various types of income other than wages, salaries, and tips. The term information return is used in contrast to the term tax return although the latter term is sometimes used colloquially to describe both kinds of returns.
“Many times an overlooked deduction is educational expenses. If one is taking courses or buying research material to be more effective in their work, this can be deductible.”
Individual Retirement Plans (IRAs)
One of the best tax write-offs for the self-employed physician consultant is a retirement plan. A person with no employees can set up an individual 401 (k). “You can contribute $19,500 in 2021 as a 401(k) deferral, plus 25 percent of net income.”
If you have employees, consider a SIMPLE (Savings Incentive Match Plan for Employees) IRA—an IRA-based plan that gives small employers a simplified method to make contributions to their employees’ retirement. As of 2021, an employee may defer up to $13,500 and employees over 50 may contribute an additional $3,000.
“A third retirement plan is Simplified Employee Pension IRA (SEP IRA).” The employer may contribute the lesser of 25 percent of income or $58,000 in 2021. If the employer has eligible employees, an equal percentage of their income must be contributed.
Recall that retirement plans are “absolutely the No. 1 tax deduction. The government is helping fund retirement.”
Business use of home or dwelling
Now, most self-employed taxpayers’ businesses start as home-based businesses. These people need to know portions of business costs are deductible and so “It is very important that you keep track of expenses relating to your housing costs.”
If your gross income from your business exceeds your total expenses, then you can deduct all of your expenses related to the business use of your home. If your gross income is less than your total expenses, your deduction will be limited to the difference between your gross income and the sum of all business expenses you would pay if the business was not in your home. Those expenses could include telephone lines, the Internet, and other costs to do business.
You must also have a home office that is truly used for work and the Internal Revenue Service may require you to document this.
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Deducting automobile expenses
If you travel for business, even short distances within your own city, you may deduct the dollar value of business miles traveled on your tax return. The taxpayer may file the actual expense s/he incurred, or use the standard mileage rate prescribed by the IRS, which is 56 cents as of 2021. The IRS allowable mileage rates should be checked every year as they can change.
“If you decide to use actual car expenses, be sure to include payments, depreciation, registration, insurance, garage rent, licenses, repairs and maintenance, and parking and toll fees.” AND, “If you decide to use the standard mileage rate, it would be in your best interest to keep a log—daily, weekly or monthly—of miles driven to distinguish personal use from business use.”
Depreciation of property and equipment
Some self-employed people may purchase property and equipment for a business. If they expect that property to last longer than one year, it should be depreciated on the tax return.
Claims regarding property, according to the IRS, must meet the following criteria: You must own the property and it must be used or held to generate income. The property should have an estimated useful life, meaning you should be able to guess how long you can generate income with it. It may not have a useful life of one year or less, and may not be purchased and disposed of in the same year.
Certain repairs on property used for business may also be deducted.
Educational expenses
Any educational expense is potentially tax-deductible.
“Many times an overlooked deduction is educational expenses. “If one is taking courses or buying research material to be more effective in their work, this can be deductible.”
Think about any books, web courses, local college courses, or other classes or materials that you have purchased to improve your job or business. It’s easy to forget a work-related webinar or business e-book that was purchased online, so remember to save e-receipts.
Also recall that subscriptions to trade or professional publications and donations to business organizations, both of which are frequently necessary for the continuation and growth of your business.
Other areas to explore
Other deductions that can be easily missed are advertising and promotional expenses, banking fees, and air, bus, or train fare. Restaurant meals and other entertainment costs may be written off as long as they are necessary business expenses.
And, consider health insurance premiums, which in most cases represent a credit rather than a tax deduction. “A credit goes directly against one’s taxes, rather than a reduction of income.”
Regardless of which expenses you discover that you may write off, the most important thing is to keep accurate records throughout the year. Save receipts, including e-mail receipts, and file or log them so you have easy access to them at tax time. Not only does keeping receipts, mileage logs, and other expense records make filing taxes easier, but it also facilitates a system that allows you to track changes from year to year.
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Long-term tax-saving strategies
Don’t just look at last-minute write-offs when considering self-employment tax deductions. Think about laying down some long-term strategies for money savings from year to year—particularly if you are a high earner.
“Accountants typically tell you what you have to pay but they don’t always tell you strategies to reduce your payments.”
To reduce your gross taxable income, consider setting up a defined-benefit pension plan. This plan is based on your age and income: The older you are and the higher your earnings, the more you are allowed to contribute. An alternative plan is an age-weighted profit-sharing plan, which is similar and can benefit those who have several employees.
Another strategy for high-earning business owners who own their own building through a limited liability company or similar business structure is to pay themselves rent. This rent is used to pay down the mortgage, but it is also considered a business expense for tax purposes.
Self-employed professionals required to have liability insurance should consider setting up their own insurance company. A captive insurance company is one that insures the risks of the business—or businesses, in the case of a cooperative. Its premiums can be tax-deductible.
But, if money accumulates and claims are minimal, the money taken out is taxable under capital gains. This is not a retirement strategy, but that it can save you money by allowing you to “pay yourself” instead of an insurance company and still deduct the premiums.
Assessment
With any of these more complicated, long-term strategies, consult with a business attorney, CPA/EA or financial planner to ensure you have the best plan possible for your business.
Posted on January 25, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Average Medical Trend in the U.S. is Projected at 7.6% in 2022
The 2022 Global Medical Trends Survey shows variation in healthcare cost increases. Increases across different regions next year are expected to range from:
• 14.2% in Latin America • 10.6% in the Middle East • 10.6% in Africa • 7.6% in Asia Pacific • 6.7% in Europe • 7.6% in the U.S.
Posted on January 25, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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StockMarkets: The major equity indexes staged a thrilling comeback to close solidly in positive territory. At one point, the NASDAQ was down nearly 5% and the S&P entered correction territory.
Mark Cuban: The billionaire owner of the Dallas Mavericks just launched an online pharmacy for generic drugs that looks to cut out middlemen and combat pharmaceutical industry price gouging by offering steep discounts. Set up as CostPlusDrugs.com with 100 generic drugs to treat conditions like diabetes and asthma. Cost Plus will not accept health insurance but claims its prices will still be lower than what people would typically pay at a pharmacy. “All drugs are priced at cost plus 15%!” Cuban tweeted.
Posted on January 25, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
FOR PHYSICIANS AND ALL OF US!
Br. Dr. David E. Marcinko MBA
By Staff Reporters
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It’s been announced that January 24th 2022 is the official start of the tax filing season. This means it’s that time of year again to buy some pricey tax software and prepare your return on your own, hire a tax prep pro, CPA, or take advantage of the Free File Program from the IRS.
A Capital Gain [CG] occurs when you sell something for more than you spent to acquire it. This happens with investments, but it also applies to personal property, such as a car. Every physician and taxpayer should understand these basic facts about capital gains taxes.
Capital gains aren’t just for doctors or rich people
Anyone who sells a capital asset should know that capital gains tax may apply. And as the Internal Revenue Service points out, just about everything you own qualifies as a capital asset. That’s the case whether you bought it as an investment, such as stocks or property, or for personal use, such as a car or a big-screen TV.
If you sell something for more than your “basis” in the item, then the difference is a capital gain, and you’ll need to report that gain on your taxes. Your basis is usually what you paid for the item. It includes not only the price of the item, but any other costs you had to pay to acquire it, including:
Sales taxes, excise taxes and other taxes and fees
Shipping and handling costs
Installation and setup charges
In addition, money spent on improvements that increase the value of the asset—such as a new addition to a building—can be added to your basis. Depreciation of an asset can reduce your basis.
In most cases, your home is exempt
The single biggest asset many people have is their home, and depending on the real estate market, a homeowner might realize a huge capital gain on a sale. The good news is that the tax code allows you to exclude some or all of such a gain from capital gains tax, as long as you meet three conditions:
You owned the home for a total of at least two years in the five-year period before the sale.
You used the home as your primary residence for a total of at least two years in that same five-year period.
You haven’t excluded the gain from another home sale in the two-year period before the sale.
If you meet these conditions, you can exclude up to $250,000 of your gain if you’re single, $500,000 if you’re married filing jointly.
Length of ownership matters
If you sell an asset after owning it for more than a year, any gain you have is a “long-term” capital gain. If you sell an asset you’ve owned for a year or less, though, it’s a “short-term” capital gain. How much your gain is taxed depends on how long you owned the asset before selling.
The tax bite from short-term gains is significantly larger than that from long-term gains – typically 10-20% higher.
This difference in tax treatment is one of the advantages a “buy-and-hold” investment strategy has over a strategy that involves frequent buying and selling, as in day trading.
People in the lowest tax brackets usually don’t have to pay any tax on long-term capital gains. The difference between short and long term, then, can literally be the difference between taxes and no taxes.
Capital losses can offset capital gains
As anyone with much investment experience can tell you, things don’t always go up in value. They go down, too. If you sell something for less than its basis, you have a capital loss. Capital losses from investments—but not from the sale of personal property—can be used to offset capital gains.
If you have $50,000 in long-term gains from the sale of one stock, but $20,000 in long-term losses from the sale of another, then you may only be taxed on $30,000 worth of long-term capital gains.
$50,000 – $20,000 = $30,000 long-term capital gains
If capital losses exceed capital gains, you may be able to use the loss to offset up to $3,000 of other income. If you have more than $3,000 in excess capital losses, the amount over $3,000 can be carried forward to future years to offset capital gains or income in those years.
Business income isn’t a capital gain
If you operate a business that buys and sells items, your gains from such sales will be considered—and taxed as—business income rather than capital gains.
For example, many people buy items at antique stores and garage sales and then resell them in online auctions. Do this in a businesslike manner and with the intention of making a profit, and the IRS will view it as a business.
The money you pay out for items is a business expense.
The money you receive is business revenue.
The difference between them is business income, subject to employment taxes.
Whether you have stock, bonds, ETFs, cryptocurrency, rental property income or other investments, this info is vital to increase your tax knowledge and understanding all while doing your taxes.
Posted on January 24, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
BY STAFF REPORTERS
Optum recently conducted a survey of 500 senior health care executives. Respondents said they are excited about the potential for AI in improving patient outcomes in multiple ways:
• Virtual patient care (41%) • Diagnosis and predicting outcomes (40%) • Medical image interpretation (36%)
Posted on January 24, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
Stock Markets: The S&P is off to its worst start to a year since 2016. The NASDAQ is in a correction. And the week ahead features a busy earnings slate and a Federal Reserve meeting.
CovisPandemic: Tony Dr. Fauci said he is “confident as you can be” that the Omicron wave in the US will peak by mid-February. In a growing number of states, that peak has already come and gone and cases are plunging in states like New York and Florida. Other states, such as Oklahoma, Idaho, and Wyoming, are still reporting an uptick in new Covid cases.
Crypto-Currency: Crypto investors, meanwhile, wish they got the weekend off like stock traders, because bitcoin, ethereum, and other digital tokens continued to sink.
Federal Reserve: Federal Reserve officials will get together on Tuesday and Wednesday against the backdrop of quaking markets. Investors will want to hear an update on Chair Jerome Powell’s views on inflation. This Fed meeting will likely be the last before an anticipated interest rate hike in March. And, a blizzard of companies will report including nearly half of the Dow’s 30 giants (American Express, 3M, IBM, and more) and tech heavyweights such as Apple, Microsoft, and Tesla.
Tax Season: The income tax filing season opens today and government officials warn it could be bumpy due to a depleted IRS. The Treasury says to file early, file online, and request your refund via direct deposit to avoid the severe headaches.
Posted on January 23, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
Medical education in the U.S. and Canada has changed considerably in the last several decades.
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According to the AMA, the major changes are the following:
Reducing medical school programs leading to the medical degree to three years. Since graduate medical education (i.e., residency) is many years in duration and includes virtually all the information, that would be part of the typical fourth year..
Introducing clinical medicine early in the curriculum.
Including medical information and activities into the basic science component of the curriculum.
De-emphasizing inactive learning by markedly reducing the number of lectures and employing problem-based learning (PBL) which typically takes place in small groups (e.g., 6-8 students led by a single faculty member).
Employing objective structured clinical examinations (OSCE) in which students are asked to solve a problem in which they are faced with a simulated patient and are asked to solve a clinical problem. Students are evaluated as to how well they communicate/interact with patients, take a medical history, arrive at a clinical diagnosis, and come up with a treatment plan. The simulated patients are trained to act as if they were actual patients. The OSCE includes individual students interacting with a single patient, emulating a real patient-doctor interaction. How well the student performs is evaluated by a faculty member observing the activity via video and by the simulated patient who evaluates the student doctor for such activities as his/her communication skills.
Posted on January 23, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
Mark Cuban, not Congress, will give Americans cheaper prescription drugs
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When universal health care fails to pass in Congress, there’s always Mark Cuban to fall back on. The billionaire and Dallas Mavericks owner launched an online pharmacy this week in order to combat the price gouging of prescription drugs by large pharmaceutical companies.
The Mark Cuban Cost Plus Drug Co. (MCCPDC) will offer more than 100 generic drugs that will be purchased directly from the manufacturers and sold online with a 15 percent markup across the board and a small pharmacist fee. For context, pharmaceutical companies generally mark prices up at least 100 percent and up to 1000 percent in some cases.
Posted on January 22, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
ACCOUNTABLE CARE ORGANIZATIONS
By Staff Reporters
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42.7% of physicians in practices that participated in a commercial ACO
An AMA survey of 3,500 physicians finds steady growth of physician participation in accountable care organizations (ACO) and medical homes:
• Nearly one-third of doctors worked in practices participating in medical homes in 2020, up from 23.7% in 2014 • 42.7% of physicians were in practices that participated in a commercial ACO in 2020, up from 31.7% in 2016 • 29.5% of physicians were in practices took part in a Medicaid ACO, up from 20.9% in 2016 • Share of physicians in practices involved in Medicare ACOs has risen from 28.6% in 2014 to 36.7% in 2020 • 32.3% of doctors worked in practices participating in medical homes in 2020, up from 23.7% in 2014
Posted on January 22, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Stock Markets: The S&P and NASDAQ suffered their worst week since the pandemic began, tumbling 5.7% and 7.55%, respectively. But Peloton bounced back after Thursday’s wipe-out when CEO John Foley assured employees that execs “feel good about right-sizing our production.”
Covid Pandemic: A third dose of either Moderna or Pfizer-BioNTech’s Covid vaccine provided significant protection against severe disease in the US, according to three real-world reports that dropped yesterday. One analysis showed that the boosters were 90% effective at preventing hospitalization.
Posted on January 21, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Markets: The S&P 500 closed below 4,500 points for the first time since October after a heavy sell-off in the final hour of the trading day. Netflix stock tumbled in after-hours trading when it revealed slowing subscriber growth for the prior and current quarters.
Economy: The number of people filing jobless claims took an unexpectedly big jump last week after a period of historically low readings. The pop is likely a sign of Omicron disruptions hitting the labor market, and economists expect it to be temporary.
Posted on January 20, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
BY STAFF REPORTERS
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StockMarkets: The NASDAQ made it official, closing in correction territory yesterday (meaning a 10% drop from a recent high). Meanwhile, Microsoft’s massive deal to acquire Activision Blizzard rippled across markets: Gaming company Take-Two Interactive got a bump (perhaps because it, too, could be a takeover target), while Microsoft rival Sony plunged nearly 13% in Tokyo trading.
Economy: President Biden has overseen a historic recovery in the labor market, where the unemployment rate has plunged to 3.9% from a pandemic high of 14.8%. The problem is there is currently too much money chasing too few goods. Inflation hit its highest rate since 1982 in December, while wages haven’t kept up with price growth.
Covid: The pandemic continues to rage despite the availability of vaccines. More people died of Covid in the US in 2021 than in 2020. Getting Americans vaccinated has proven to be a major challenge. President Biden’s vaccine mandate on large employers was blocked by the Supreme Court, and only 63.8% of Americans are fully vaccinated putting it behind virtually all of its wealthy peers.
Posted on January 20, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
WHAT IT IS – HOW IT WORKS – WHY?
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Noteworthy Socks
What it is: A stock is a little sliver or “share” of a company that you can purchase and own. They usually take the form of “common” shares (which have voting rights that can influence some corporate decisions) or “preferred” shares (which don’t have voting rights, but do offer an edge when it comes to receiving dividends, or quarterly payments made to shareholders).
How it works: Companies sell shares on a stock exchange through an initial public offering; an IPO helps raise money to fuel more growth. Companies can also sell extra batches of stock to raise even more money later on and lower share prices; many end up selling millions or billions of shares in total. In the market, share prices usually fluctuate based on supply and demand.
Why it matters: Stocks can move with the broader market, but isolated events from earnings reports to product unveils to C-suite shakeups to Elon Musk tweeting can also affect how investors see a company’s future growth potential, thus sending prices up or down. We’ll occasionally highlight individual stocks and explain what happened to excite or spook investors.
On November 30, 2021, the U.S. Supreme Court heard oral arguments regarding the challenges arising from the cuts made by the Centers of Medicare & Medicaid Services (CMS) to the 340B Drug Pricing Program.
The 340B Drug Pricing Program allows hospitals and clinics that treat low-income, medically underserved patients to purchase certain “specified covered outpatient drugs” at discounted prices (applying a ceiling to what drug manufacturers may charge certain healthcare facilities) – 25% to 50% of what providers would typically pay – and then receive reimbursement pursuant to the rates set forth in the Outpatient Prospective Payment System (OPPS) at the same rate as all other providers. (Read more…)
Posted on January 19, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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StockMarkets: The prospect of higher borrowing costs has pummeled tech companies this year, and that didn’t change even after the market’s day off Monday. The 10-year yield jumped to its highest level in two years yesterday, pushing stocks (especially the tech-heavy NASDAQ) lower.
OilEnergy: Oil prices jumped to a 7-year high after an attack in the UAE raised concerns about a supply squeeze. Goldman Sachs predicts that Brent crude, the international oil benchmark, will top $100 a barrel this year because the pandemic hasn’t hurt demand for fuel as much as expected.
Gaming: An Activision Blizzard takeover would also be the biggest deal in the history of gaming, easily topping Take-Two’s purchase of Zynga for $12.7 billion last week. And, with the help of Activision’s impressive portfolio of titles including Call of Duty,World of Warcraft, Overwatch, Diablo, and Candy Crush, Microsoft will try to galvanize its monthly subscription business, Xbox Game Pass, as the “Netflix for games.”
Pandemic: New Covid cases have peaked in US regions that were hit hardest by the highly contagious variant, like the Northeast. For example, in New York City, the 7-day average of daily new cases has fallen to less than 20,000 from a high of almost 43,000 earlier this month. And, in the capital of Washington, DC, case numbers are down 20% over the last 14 days. Still, because hospitalizations tend to lag case growth by a few weeks, health care facilities are still treating more Covid patients. The average number of Covid hospitalizations has jumped 54% in the last two weeks, to 157,000.
Posted on January 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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75% of Hospitals Seeking Temporary Allied Healthcare Professionals
• 96% have used allied healthcare professionals of various types to fill temporary assignments during the last 12 months. • 75% of hospitals and other healthcare facilities currently are seeking temporary allied health care professionals. • 73% of facilities surveyed, cited a need to fill gaps while permanent workers are being sought. • 71% of facilities surveyed, cited that it is to prevent the burnout of existing staff.
Posted on January 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
WE ARE NOTCONSUMING AND THE MARKETS ARE DOWN
By Staff Reporters
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A Theory of the Consumption Function
One of Milton Friedman’s most popular works, A Theory of the Consumption Function, challenged traditional Keynesian viewpoints about the household. This work was originally published in 1957 by Princeton University Press, and it reanalyzed the relationship displayed “between aggregate consumption or aggregate savings and aggregate income.”
Now, according to Wikipedia, Friedman’s counterpart Keynes believed people would modify their household consumption expenditures to relate to their existing income levels. Friedman’s research introduced the term “permanent income” to the world, which was the average of a household’s expected income over several years, and he also developed the permanent income hypothesis. Friedman thought income consisted of several components, namely transitory and permanent. He established the formula y = y p + y t {\displaystyle y=y_{p}+y_{t}} in order to calculate income, with p representing the permanent component, and t representing the transitory component.
Milton Friedman’s research changed how economists interpreted the consumption function, and his work pushed the idea that current income was not the only factor affecting people’s adjustment household consumption expenditures. Instead, expected income levels also affected how households would change their consumption expenditures. Friedman’s contributions strongly influenced research on consumer behavior, and he further defined how to predict consumption smoothing, which contradicts Keynes’ marginal propensity to consume. Although this work presented many controversial points of view which differed from existing viewpoints established by Keynes, A Theory of the Consumption Function helped Friedman gain respect in the field of economics. His work on the Permanent Income Hypothesis is among the many contributions which were listed as reasons for his Sveriges-Riskbank Prize in Economic Sciences. His work was later expanded on by Christopher D. Carroll, especially in regards to the absence of liquidity constraints.
Posted on January 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Markets: The stock market was closed for Martin Luther King Jr. Day. Maybe a day off is just what the market needs to score its first winning week of 2022. But … For many stocks, 2022 was a real bear of a year. More than 220 US-listed companies with a market cap of $10+ billion are down at least 20% from their peaks. And things are even worse in the tech-heavy NASDAQ, where 39% of companies have dropped at least half from their all-time highs.
Economy: A combo of Omicron disruptions, higher inflation, and shortages of everything has caused forecasters to lower their projections for economic growth this quarter. Analysts surveyed by the WSJ dropped their Q1 forecast to 3% annual growth from 4.2% back in October.
China: World shares were mixed after China reported that its economy expanded at an 8.1% annual pace in 2021, though growth slowed to half that level in the last quarter. And, Paris, Frankfurt, Tokyo and Shanghai advanced while Hong Kong and Seoul declined.
Posted on January 18, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
Telemedicine: Fraud and Abuse During the COVID Pandemic
By Susan Walberg
The COVID-19 pandemic has brought with it huge challenges for people all over the world; not only the obvious health-related concerns but also shutdowns, unemployment, financial difficulties, and a variety of lifestyle changes as a result.
When the COVID pandemic struck, CMS quickly recognized that access to care would be an issue, with healthcare resources strained and many providers or suppliers shutting down their offices or drastically limiting availability. Patients who needed routine care or follow-up visits were at risk for not receiving services during a time when healthcare providers were scrambling to enhance infection control measures and implement other new safety standards to protect patients and healthcare workers.
The Centers for Medicare and Medicaid Services (CMS) has responded by easing restrictions and regulatory burdens in order to allow patients to receive the healthcare services they need without undue access challenges. One key area that has changed is the restrictions related to telehealth services, which were previously only paid by Medicare under certain circumstances, such as patients living in remote areas.
Among the changes and waivers CMS has offered, telemedicine reimbursement is among the more significant. Telemedicine services, which includes office visits and ‘check ins’ are now allowed and reimbursed by Medicare. In addition to reimbursement changes, CMS has also relaxed the HIPAA privacy and information security enforcement standards, paving the way for providers to adopt a new model of providing services electronically.
You can also listen to a professional narration of this article on iTunes, Google & online.
Mr. Market was less than kind to our portfolio over the last few months, and especially the last few weeks. I cannot tell you how little it worries us what Mr. Market thinks about our stocks at any particular point in time. We love* our portfolio even if the Mr. Market doesn’t fancy it today.
Also, before we take Mr. Market seriously, let us tell you about the rationality of Mr. Market lately. The World Health Organization (WHO) names each variant of the Covid virus by going to the next letter of the Greek alphabet. After Delta, which is currently the most predominant variant of the virus ravaging the world, there must have been nine others that were not important enough because we never heard of them. Why nine? Because when the latest variant of concern was found in South Africa, it emerged that the letter Nu was supposed to be applied to it. But Nu sounds a lot like new. WHO didn’t want to confuse people, so it skipped to the next letter in the Greek Alphabet, which is Xi – oops, that’s the Chinese supreme dictator. So, for the sake of global political stability, that letter was skipped, too.
This brings us to Omicron, the name of the latest variant.
This is where this story gets a bit more interesting.
The one disruption that really puzzles me is the labor shortage. There are millions of jobs going unfilled today. I hear stories of Starbucks stores being closed due to a lack of workers. Every service that has a heavy labor component has gotten worse – be it restaurants, ride-sharing, or pharmacies. There happens to be a cryptocurrency, one of thousands, that is also named Omicron. I still cannot grasp the logic behind it, but that cryptocurrency was up 900% on the day the South African variant was christened. There must have been a trading algorithm or a lot of bored investors looking for the next gamble, to drive something seemingly worthless up 900%.
That is the drunken Mr. Market that is pricing our stocks today.
I am going to repeat what you will find me saying several times in the letter: We own businesses that are priced, not valued, by Mr. Market thousands of times a day. We have done a lot of work on each company in the portfolio, and through diligent research we have reached the conclusion that each is worth more than the price it is changing hands at today. Are we going to be right about each and every stock? Of course not. This is a numbers game. But we use a time-tested methodology centered on common sense and the cash flows these businesses generate. Also, this is not our first rodeo. We’ll go on making small tweaks, taking advantage of Mr. Market’s manic-depressive moods, at least when it comes to anything that generates cash flows.
Of course, we could change our investment process and load up on the cryptocurrency called Pi Coin, which happens to take its name from the letter in the Greek alphabet that follows Omicron. But I think we all agree we should stick to our knitting, buying high-quality businesses that are significantly undervalued. (Anyway we already loaded up on pie during Thanksgiving.)
Our advice – enjoy this holiday season. Spend time with your loved ones; don’t look at your portfolio. Let us worry about it – after all, we own the same stocks you do.
A future is a financial derivative that represents the purchase of a particular investment at a predetermined date. Futures are traded on a wide range of investments (e.g., baskets of stocks, interest rates, currencies and commodities) and are useful tools for controlling the risk of cash flow timing for those that wish to lock in a particular price for a security.
Futures versus Options
Likewise, they also provide some insight as to the expected future price in the market of the security.
The key difference between futures and options is that futures obligate both parties to make the agreed upon transaction, whereas options give the option holder the right, but not the requirement, to make the transaction.
Trades
Futures are typically traded on an organized exchange, such as the Chicago Board of Trade (e.g., interest rate and stock index futures) or the Chicago Mercantile Exchange (e.g., foreign exchange and stock futures). The design of the contract traded on an exchange typically includes a pre-defined contract size and delivery month.
Margin Maintenance
Also, futures transactions generally require maintaining a margin deposit (i.e., a fraction of the trade value held in reserve to help ensure the final settlement at the contract settlement date) and the recognition of gains and losses on a daily basis with movements in contract prices.
Assessment
The pricing of a futures contract is based upon the price of the underlying security (e.g., the S&P 500 Index price), the opportunity cost of cash (e.g., current borrowing rates) and any distributions expected from the security over the period (e.g., dividends).
Timothy J. McIntosh is Chief Investment Officer and founder of SIPCO. As chairman of the firm’s investment committee, he oversees all aspects of major client accounts and serves as lead portfolio manager for the firm’s equity and bond portfolios. Mr. McIntosh was a Professor of Finance at Eckerd College from 1998 to 2008. He is the author of The Bear Market Survival Guideand the The Sector Strategist.
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
Posted on January 17, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
WHO KNEW?
By Staff Reporters
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According to Wikipedia, in economics, inflation refers to a general progressive increase in prices of goods and services in an economy.[1] When the general price level rises, each unit of currency buys fewer goods and services; consequently, inflation corresponds to a reduction in the purchasing power of money.[2][3] The opposite of inflation is deflation, a sustained decrease in the general price level of goods and services. The common measure of inflation is the inflation rate, the annualised percentage change in a general price index.[4]
Healthcare Not a Part of the US Inflation Surge: Who Knew?
However, according to Jeff Goldsmith, overall health spending has only risen by 4.4% since January of 2020, and the percentage of GDP devoted to health has fallen by more than half a percent, from 18.1% pre-pandemic to 17.5% in October. This is despite four surges of COVID hospitalizations, overflowing ICUs and ERs, labor shortages, and other COVID-related stresses. Health system staffing levels are still nearly a half-million lower than they were pre-pandemic. Had the federal government not stepped in through the CARES Act, FEMA funding, and temporary suspensions of Medicare rate cuts, the nations’ hospitals would have been seriously damaged by COVID-related financial stresses, which are far from being over.
Posted on January 17, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Blue Monday is considered to be the most depressing day of the year, but some people may be confused whether this label is real or just pseudoscience.
There are claims around this time of year that this specific day commonly coincides with the arrival of some of the year’s toughest psychological challenges.
Issues can include a combination of particularly bleak winter weather, the post-Christmas comedown and being wracked with guilt over yet more failed New Year’s resolutions.
And, additionally, people have over the past two years witnessed the trauma of dealing with the concerns about COVID-19’s effects on physical and mental health.
As with every year, Blue Monday rolls around every year on the first month’s third Monday, meaning in 2022 it is said to arrive today, on January 17th.
QUESTION: However, is this specific time of the year something people should really note?
The modes of persuasion, modes of appeal or rhetorical appeals (Greek: pisteis) are strategies of rhetoric that classify a speaker’s or writer’s appeal to their audience. These include ethos, pathos, and logos.
Rhetorical appeal with persuasion elements are often key attributes for doctors, medical professionals, lawyers, CPAs, and all sorts of financial advisors and medical management consultants, etc.
Posted on January 16, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
The 2-Ps [80/20] Rule
[By staff reporters]
Pareto’s law is either of the following closely related ideas: Pareto principle or law of the vital few, stating that 80% of the effects come from 20% of the causes Pareto distribution
Pareto distribution
The Pareto distribution, named after the Italian civil engineer, economist, and sociologist Vilfredo Pareto, is a power law probability distribution that is used in description of social, scientific, geophysical, actuarial, and many other types of observable phenomena. en.wikipedia.org
Posted on January 16, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
Mitigations for the Digital Health Era
By Shahid N. Shah MS
There has been a tremendous explosion of information technology (IT) in healthcare caused by billions of dollars of government incentives for usage of digital healthcare tools. But, IT systems face threats with significant adverse impacts on institutional assets, patients, and partners if sensitive data is ever compromised. Every health enterprise is required to confidentiality, integrity and availability of its information assets (this is called “information assurance” or IA). Confidentiality means private or confidential information must not be disclosed to unauthorized persons. Integrity means that the information can be changed only in an authorized manner so as to maintain the correctness of the information. Availability defines the characteristic that information systems work as intended and all services are available to its users whenever necessary.
It is well known that healthcare organizations face and have been mitigating many risks such as investment risk, budgetary risk, program management risk, safety risk, and inventory risk for many years. What’s new in the last decade or so is that organizations must now manage risks related to information systems because operating systems [OSs] are also at risk. IT is now just as a critical an asset as most other infrastructure managed by health systems. It is important that information security risks are given the same or more importance and priority as given to other organizational risks.
As health records move from paper native to digital native, it’s vital that organizations have information risk management programs and security procedures that woven into the culture of the organization. For this to happen, basic requirements of information security must be defined and implemented as part of both the operational and management processes. A framework that provides guidance on how to perform these activities, and the co-ordination required between these activities is needed.
INTRODUCTION
The Risk Management Framework (RMF), supported by the National Institute of Standards and Technology (NIST) provides this framework. The NIST 800 series publications provide a structured approach to achieve risk management. It provides broad guidance and not necessarily all the prescriptions, which means it can be tailored to meet the organization’s specific needs and providing the flexibility needed for the different organizations. Using the NIST RMF helps organizations with risk management not only in a repeatable manner, but also with greater efficiency and effectiveness. Healthcare information assurance is complex and without a framework that takes into account a broad risk management approach, it is difficult to consider all the intricacies involved.
NIST Risk Management Framework
The NIST Risk Management Framework consists of a six step process designed to guide organizations in managing the risks in their information systems. The various steps as defined in the NIST specifications are the following:
Categorize the information system and the information processed, stored, and transmitted by that system based on an impact analysis.
Select an initial set of baseline security controls for the information system based on the security categorization; tailoring and supplementing the security control baseline as needed based on an organizational assessment of risk and local conditions
Implement the security controls and describe how the controls are employed within the information system and its environment of operation.
Assess the security controls using appropriate assessment procedures to determine the extent to which the controls are implemented correctly, operating as intended, and producing the desired outcome with respect to meeting the security requirements for the system.
Authorize information system operation based on a determination of the risk to organizational operations and assets, individuals, other organizations, and the Nation resulting from the operation of the information system and the decision that this risk is acceptable.
Monitor the security controls in the information system on an ongoing basis including assessing control effectiveness, documenting changes to the system or its environment of operation, conducting security impact analyses of the associated changes, and reporting the security state of the system to designated organizational officials.
All information systems process, store and transmit information. What is the possible impact if a worst case scenario occurs that causes endangers this information? A structured way to find out the potential impact on the confidentiality, integrity and availability of information can be done through the first step of NIST RMP, the categorization of information systems. The NIST SP 800-60 provides such guidance. The potential impact is assigned qualitative values – low, moderate, or high. Based on these impact levels for each of the information type contained in the system, the high water mark level is calculated, that helps in selecting the appropriate controls in the subsequent steps.
Organizations need to mitigate risks adequately by selecting an appropriate set of controls that would work effectively. In the selection of security controls step, the set of controls are chosen based on the categorization of the information system, the high water mark and the goals of the organizations. These baseline controls are selected from NIST SP 800-53 specification, one of three sets of baseline controls, corresponding to low, moderate, high impact rating of the information system. These baseline controls can be modified to meet specific business needs and organization goals. These tailored controls can be supplemented with additional controls, if needed, to meet unique organizational policies and environment factors and its security requirements and its risk appetite. The minimum assurance requirements need to be specified here.
All the activities necessary for having the selected controls in place, is done in the implementation of security controls step. The implementation of the selected security controls will have an impact on the organization risks and its effects. NIST SP 800-70 can be used as guidance for the implementation. An implementation strategy has to be planned and the actions have to be defined and the implementation plan needs to be reviewed and approved, before the implementation is done.
Once the controls are implemented, then the assessment of security controls is done to find out whether the controls have been correctly implemented, working as intended, and giving the desired output with respect to the security requirements. In short, whether the applied security controls are indeed the right ones, done in the right way, giving the right outcome. NIST SP 800-53,, NIST 800-53A, NIST 800-115 can provide the necessary guidance, here.
IS authorization
The authorization of information systems is an official management decision, authorizing that the information system can be made operational, with the identified risks mitigated and the residual risks accepted, and is accountable for any adverse impacts on the confidentiality, integrity and availability of information systems. If the authorizing personnel find that the risks are not mitigated and hence can compromise the sensitive information, they can deny authorizing the information system. NIST SP 800-37 provides guidance on authorization. The authorizing personnel are to be involved actively throughout the risk management process.
Risk management is not one-time process, that once it is done, it is forgotten. It is a continuous process, to be integrated with day-to-day activities. One of the key aspects of any risk management is the monitoring of security controls to check whether the controls are performing as intended. The main focus of monitoring security controls is to know whether the controls are still effective over a period time, given the changes that occur in the information systems — the changes in hardware, software and firmware, the changes in environment factors, operating conditions etc. NIST SP 800-37 provides guidance about this. And if the security controls are found to be ineffective, the cycle starts again, with either re-categorization or selecting another set of baseline controls, or assessing the effectiveness of the controls once more etc.
And, in all the steps in risk management framework, one of the important aspects is communication. Appropriate documents needed to be generated in all the steps, reviewed and kept up-to-date.
Assessment
Organizational risk management provides great benefits to the organization because it helps to prioritize the resources, increase interoperability, and reduce costs incurred due to the adverse effects. It helps to prevent unauthorized access to personally identifiable information which will lead to security breaches.
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Just like real estate, butter has been around for thousands of years. Sometime in the 1800’s someone decided that there was a need for something that looked like butter, tasted similar to butter, but wasn’t butter. Along came margarine. Real estate investment trusts (REITs) are the margarine of the real estate investing world.
NAREIT, the National Association of Real Estate Investment Trusts, answers the question
“What is a REIT?” in the following way:
“A REIT, or Real Estate Investment Trust, is a type of real estate company modeled after mutual funds. REITs were created by Congress in 1960 to give all Americans – not just the affluent – the opportunity to invest in income producing real estate in a manner similar to how many Americans invest in stocks and bonds through mutual funds. Income-producing real estate refers to land and the improvements on it – such as apartments, offices or hotels. REITs may invest in the properties themselves, generating income through the collection of rent or they may invest in mortgages or mortgage securities tied to the properties, helping to finance the properties and generating interest income.”
While REITs typically own real estate, investors in REITs do not. REITs are paper assets that represent interest in a company that owns and operates income producing properties. In essence they are real estate flavored stock. As such, REITs are generally highly correlated with the stock market.
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TERMINOLOGY
When discussing REITs, you encounter the following terminology – public, private, traded, and non-traded. Public REITs can be designated as non-traded or traded depending on whether or not they are traded on a stock exchange.
Since traded REITs are traded on the stock exchange, they enjoy a high degree of liquidity just like any other stock. Unfortunately, traded REITs tend to follow the economic cycles and can closely correlate with the stock market. This can lead to a higher degree of volatility than what is usually seen with physical real estate. Additionally, they do not afford the investor the tax-advantages that come with investments in physical real estate.
Private REITs and non-traded public REITs are not traded on an exchange. These are usually offered to accredited investors through broker-dealer networks. These REITs are illiquid and generally have high fees. They have been plagued with transparency issues as well as conflicts of interest. Valuation of this stock is difficult and can be misleading to the investor. Due diligence is very important as the quality of non-traded REITs can vary widely.
Posted on January 14, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
Markets: The NASDAQs 3-day rally fizzled as everything from Big Tech (Microsoft) to Smaller Tech (Snap) sold off.
On the other hand, Ford, one of the best performing companies in the S&P last year, notched a market cap of $100 billion for the first time in its 118-year history.
TODAY: Big banks will kick off Q4 earnings season.
Here are eight things to keep in mind as you prepare to file your 2021 taxes.
1. Income tax brackets have shifted a bit
There are still seven tax rates, but the income ranges (tax brackets) for each rate have shifted slightly to account for inflation. For 2021, the following rates and income ranges apply:
Tax rate
Taxable income brackets:Single filers
Taxable income brackets:Married couples filing jointly (and qualifying widows or widowers)
10%
$0 to $9,950
$0 to $19,900
12%
$9,951 to $40,525
$19,901 to $81,050
22%
$40,526 to $86,375
$81,051 to $172,750
24%
$86,376 to $164,925
$172,751 to $329,850
32%
$164,926 to $209,425
$329,851 to $418,850
35%
$209,426 to $523,600
$418,851 to $628,300
37%
$523,601 or more
$628,301 or more
Source: Internal Revenue Service
2. The standard deduction has increased slightly
After an inflation adjustment, the 2021 standard deduction has increased slightly to $12,550 for single filers and married couples filing separately and $18,800 for single heads of household, who are generally unmarried with one or more dependents. For married couples filing jointly, the standard deduction has risen to $25,100.
3. Itemized deductions remain the same
For most filers, taking the higher standard deduction is more practical and saves the hassle of keeping track of receipts. But if you have enough tax-deductible expenses, you might benefit from itemizing.
The following rules for itemized deductions haven’t changed much for 2021, but they’re still worth pointing out.
State and local taxes: The deduction for state and local income taxes, property taxes, and real estate taxes is capped at $10,000.
Mortgage interest deduction: The mortgage interest deduction is limited to $750,000 of indebtedness. But people who had $1,000,000 of home mortgage debt before December 16, 2017, will still be able to deduct the interest on that loan.
Medical expenses: Only medical expenses that exceed 7.5% of adjusted gross income (AGI) can be deducted in 2021.
Charitable donations: The cash donation limit of 100% of AGI remains in place for 2021, if donations were made to operating charities.1
Miscellaneous deductions: No miscellaneous itemized deductions are allowed.
4. IRA and 401(k) contribution limits remain the same
The traditional IRA and Roth contribution limits in 2021 remain the same as in 2020. Individuals can contribute up to $6,000 to an IRA, and those age 50 and older also qualify to make an additional $1,000 catch-up contribution. If you’re able to max out your IRA, consider doing so—you may qualify to deduct some or all of your contribution.
The 2021 contribution limit for 401(k) accounts also stays at $19,500. If you’re age 50 or older, you qualify to make an additional $6,500 catch-up contribution as well.
5. You can save a bit more in your health savings account (HSA)
For 2021, the max you can contribute into an HSA is $3,600 for an individual (up $50 from 2020) and $7,200 for a family (up $100). People age 55 and older can contribute an extra $1,000 catch-up contribution.
To be eligible for an HSA, you must be enrolled in a high-deductible health plan (which usually has lower premiums as well). Learn more about the benefits of an HSA.
6. The Child Tax Credit has been expanded
For 2021, the American Rescue Plan Act (ARPA) has temporarily modified the Child Tax Credit requirements and amounts for household incomes below $75,000 for single filers and $150,000 for married filing jointly.
First, the ARPA has raised the age limit for dependents from 16 to 17. In addition, the child tax credit has increased from $2,000 to $3,000 for children age 6 through 17 and up to $3,600 for children under 6. If your income exceeded the above limits but was below $200,000 for single filers or $400,000 for joint filers, you’ll receive the standard child tax credit of $2,000 per child.
The IRS began sending monthly advance Child Tax Credit payments to eligible families in July and sent its last advance in December. If your dependent didn’t qualify for the child tax credit, you may still qualify for up to $500 of tax credits under the “credit for other dependents” (see IRS Publication 972 for more details). Tax credits, which reduce the tax you owe dollar for dollar, are generally better than deductions, which reduce your taxable income.
7. The alternative minimum tax (AMT) exemption has gone up
Until the AMT exemption enacted by the Tax Cuts and Jobs Act expires in 2025, the AMT will continue to affect mostly households with incomes over $500,000. Still, the AMT has investment implications for some high earners.
For 2021, the AMT exemptions are $73,600 for single filers and $114,600 for married taxpayers filing jointly. The phase-out thresholds are $1,047,200 for married taxpayers filing a joint return and $523,600 for all other taxpayers.
8. The estate tax exemption is even higher
The estate and gift tax exemption, which is indexed to inflation, has risen to $11.7 million for 2021. But the now-higher exemption is set to expire at the end of 2025, meaning it could be essentially cut in half at that time if Congress doesn’t act.
The annual gift exclusion, which allows you to give money to your loved ones each year without incurring any tax liability or using up any of your lifetime estate and gift tax exemption, stays at $15,000 per recipient.
Don’t get caught off guard
As you prepare to file your taxes for 2021, here are a few additional items to consider.
If you’re not retired, the 10% early withdrawal penalty that was waived for retirement account distributions in 2020 has been reinstated for 2021.
If you’re age 72 or older, make sure you’ve taken your required minimum distribution (RMD) from your retirement accounts or else you face a 50% penalty on any undistributed funds (unless it’s your first RMD, in which case, you can wait until April 1, 2022).
If you haven’t contributed to your retirement accounts already, now is the time. Review your earnings for the year and take advantage of any deductions that can lower your tax bill. Also, keep an eye on Washington for any last-minute tax changes that could affect your return before you file. Tax season will be here before you know it, and it’s never too early to start preparing.
1Operating charities, or qualifying public charities, are defined by Internal Revenue Code section 170(b)(1)(A). You can use the Tax Exempt Organization Search tool on IRS.gov to check an organization’s eligibility.
Posted on January 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Spike in Hospitals Suing Patients for Unpaid Medical Bills
• Lawsuits over unpaid bills for hospitals rose by 37% in Wisconsin from 2001 to 18. • Wage garnishments from the lawsuits rose 27% in that time period. • 5% of hospitals account for 25% of lawsuits. Nonprofit hospitals and critical access hospitals are more likely to sue patients, according to the study. • There were 1.86 lawsuits per 1,000 Black residents in 2018, compared to 1.32 per 1,000 white residents.
Posted on January 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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COVID-19 Prevention and Treatment
The majority of COVID-19 patients being treated in hospitals are unvaccinated or have not received a booster dose of the vaccine. These hospitalizations show how vaccines work and highlight the importance of continued vaccination efforts. President Biden has emphasized that vaccines, boosters, and therapeutic drugs have lessened the danger of COVID-19 for vaccinated people.
Vaccine Recommendations: A new recommendation from the CDC says that people who were initially immunized with the Pfizer vaccine should now receive their booster dose after five months, down from six. Some people with weakened immune systems will soon be eligible for a fourth dose of the COVID-19 vaccine and an Omicron specific vaccine could be ready by March.
Vaccine Mandates:The Supreme Court is weighing the Biden administration’s requirement that workers get vaccinated or be tested regularly for COVID-19. Many states and cities have created their own vaccine rules and employers are left confused about what to do next during the legal battles and the current rise in cases.
At-Home Testing Shortage: There is a shortage of COVID-19 at-home test kits and kit prices are rising as are reports of price gouging. The White House announced a policy to make at-home tests freely available to Americans. Learn more about at-home tests and their accuracy here.
Antiviral Pills:Doctors express concern that the limited supply of antiviral drugs is unlikely to ameliorate the strain hospitals are experiencing. The U.S. doubled its order for Pfizer’s COVID pill so there’s enough for 20 million people.
Posted on January 13, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
BY STAFF REPORTERS
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Stock Markets: An inflation report couldn’t stop stocks from pushing higher yesterday, likely because it wasn’t worse than expected. Biogen shares tumbled after Medicare said it would limit coverage of its controversial $28,000 Alzheimer’s drug, Aduhelm; as the ME-P has noted.
Covid Pandemic: The current Omicron wave is projected to peak by January 19th in the US, according to an influential model from the University of Washington. Then, cases are expected to plummet “simply because everybody who could be infected will be infected,” Washington professor Ali Mokdad told the AP. Cases appear to have already peaked in Britain.
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