The ME-P is Seeking Healthcare “Metaverse” Input

By Ann Miller RN MHA

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Facebook’s latest release, Meta, is said to be the next evolution of social connection. A virtual, 3D network that allows connection and collaboration in ways many of us have never even considered! And while many are buzzing over how Meta will shape everything from education to healthcare – we are eager to get your opinion on our own ME-P ecosystem.

Can patients trust Facebook and others again?

Are you interested in exploring a new platform for connection?

Have you subscribed to the ME-P?

We want to hear all about it! We’re actively collaborating to bring your perspectives to the discussion around the Metaverse and the patient, economics, finance and healthcare community.

If you have insights or experiences to share – just comment and/or let us know.

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THANK YOU

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UPDATE: Oil & Energy Prices

By Staff Reporters

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  • West Texas Intermediate crude for May delivery rose $3.58, or 3.4%, to settle at $107.82 a barrel on the New York Mercantile Exchange after posting a loss of 1.6%.
  • May Brent crude the global benchmark, rose $3.22, or 2.9%, to $113.45 a barrel on ICE Futures Europe, following a 2% loss.
  • May natural gas rose 5.2% to $5.605 per million British thermal units.
  • April gasoline  rose 3.8% to $3.325 a gallon and April heating oil climbed 2.5% to $3.809 a gallon.

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CITE: https://www.r2library.com/Resource/Title/082610254

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PODCAST: Hospital Finance 101

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A basic understanding of hospital finance is crucial as leaders continue to create policy that shapes healthcare financing. This updated 30,000-foot view of hospital finance is intended to shed some light on the complex system.

By The Center for Health Affairs

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CITE: https://www.r2library.com/Resource/Title/082610254

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Happy NATIONAL DOCTOR’s Day 2022

By Staff Reporters

To all our valued physicians readers and subscribers

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You have always been the shield defending and healing patients in our communities. Now more than ever, you have become a guiding light through uncertainty as we navigate toward a brighter future.

This is our chance to thank you for your hard work and incredible impact!

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THANK YOU

Medical Executive-Post

CERTIFIED MEDICAL PLANNER™

http://www.CertifiedMedicalPlanner.org

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PODCAST: How to be a DEBT FREE Direct Primary Care Physician?

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DEFINITION: The DPC model was created to allow for a singular focus upon the Primary Care Physician-2-Patient relationship. To achieve this, DPC removes the hassles and overhead expenses created by insurance and replaces it with a fixed monthly membership fee. This simplified approach frees the physician from meaningless paperwork and allows them to only see 8-10 patients a day. This level of personalized engagement allows them to develop a meaningful and enduring relationship with each patient.

CITE: https://www.r2library.com/Resource/Title/0826102549

By James Hawkes MD

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Dr. James Hawkes grew up in a large family. His father was a U.S. diplomat, which exposed him to different models of healthcare. In addition to exposure, his grandmother encouraged him to become a doctor. He followed her recommendation but to his surprise, the definition of a good doctor wasn’t about improving patients’ quality of life it was about hierarchies, documentation, administrative requirements, and quality measures. 

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Shortly after saying goodbye to the traditional healthcare model, he launched his own direct care practice. Fast forward to today, he is a 100% debt-free direct care physician. He shares his story of how it’s possible to achieve this goal.

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PODCAST: https://healthcareamericana.com/episode/how-to-become-a-debt-free-direct-care-physician/

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The IRS, Taxation and Virtual Currency!

New Reporting Warning Issued

By Staff Reporters

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Virtual currency transactions are taxable by law just like transactions in any other property. Taxpayers transacting in virtual currency may have to report those transactions on their tax returns.

CITE: https://www.r2library.com/Resource/Title/0826102549

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All taxpayers must answer a question about virtual currency on their return.

On March 18th, the IRS issued a new alert warning all taxpayers that they must answer a section about virtual currency on their 2021 tax refund this year, even if they did not deal with any digital transactions. According to the agency, there is a question on the top of all versions of Form 1040 that asks, “At any time during 2021, did you receive, sell, exchange, or otherwise dispose of any financial interest in any virtual currency?”

“All taxpayers filing Form 1040, Form 1040-SR or Form 1040-NR must check one box answering either ‘Yes’ or ‘No’ to the virtual currency question,” the IRS explained. “The question must be answered by all taxpayers, not just taxpayers who engaged in a transaction involving virtual currency in 2021.”

IRS: https://www.irs.gov/businesses/small-businesses-self-employed/virtual-currencies

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EMRs = To Laugh OR Cry?

SAD

[By staff reporters]

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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.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

Product Details

 

UPDATE: The Markets, Treasury Yields, Ukraine & the Week Ahead

By Staff Reporters

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  • Markets: US stocks rose for two straight weeks. Investors appear to be putting more emphasis on strong corporate earnings than all the uncertainty around the war in Ukraine and inflation.
  • Treasury: Yields climbed (in anticipation of higher interest rates), giving a lift to financial stocks.
  • Ukraine: Top Russian military officials signaled a change in approach to the war. They spoke about the “complete liberation” of the Donbas region in eastern Ukraine, which means Russia could potentially be pivoting from its initial goal of taking Ukraine’s biggest cities and toppling its government.
  • EARNING REPORTS THIS WEEK:
  • Monday: Earnings from Dave & Buster’s.
  • Tuesday: US consumer confidence; US Job Openings and Labor Turnover (JOLTS); earnings from Micron, Chewy, Lululemon and RH.
  • Wednesday: US ADP jobs report; US GDP for Q4 (third estimate); weekly crude oil inventories; earnings from BioNTech and Paychex.
  • Thursday: End of first quarter; US personal income and spending; US weekly jobless claims: earnings from Walgreens and Blackberry.
  • Friday: US jobs report; US ISM manufacturing.

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What are OTC “PINK” Sheets?

LOW PRICED “PENNY STOCKS?

By Dr. David E. Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

Pink sheets are an over-the-counter (OTC) market that connects broker-dealers electronically. There is no trading floor and the quotations are also all done electronically. Since there is no central trading floor or stock exchange like the New York Stock Exchange (NYSE), the pink sheet-listed companies do not have the same criteria to fulfill as the companies listed on national stock exchanges. Many stocks listed on the pink sheets are low-priced penny stocks that trade for under $5 a share.

CITE: https://www.r2library.com/Resource/Title/0826102549

Pink sheets got their name because the original pink sheets listing the stocks were actually printed and distributed on pink pieces of paper. Trading over-the-counter (OTC) refers to the process of how securities listed on the pink sheets are traded through a broker-dealer network.

MORE: https://en.wikipedia.org/wiki/OTC_Markets_Group

Pink Sheets | Explanation | Examples with Advantages and Disadvantages

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DOJ Recoveries for False Claims Act Cases Doubled in 2021

BY HEALTH CAPITAL CONSULTANTS, LLC.

DEFINITION: The False Claims Act, also called the “Lincoln Law”, is an American federal law that imposes liability on persons and companies who defraud governmental programs. It is the federal Government’s primary litigation tool in combating fraud against the Government. The law includes a provision that allows people who are not affiliated with the government, called “relators” under the law, to file actions on behalf of the government. Persons filing under the Act stand to receive a portion of any recovered damages.

CITE: https://www.r2library.com/Resource/Title/0826102549

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DOJ Recoveries for False Claims Act Cases Doubled in 2021

On February 1, 2022, the U.S. Department of Justice (DOJ) announced their recovery of $5.6 billion in settlements and judgments from civil cases involving fraud and false claims for fiscal year (FY) 2021. Over $5 billion was recouped from the healthcare industry for federal losses alone, and included recoveries from drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.

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This figure is more than double the amount of healthcare-related recoveries secured in FY 2020, which totaled $1.8 billion. (Read more…)

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Socially Responsible and ESG Investing!

S.R.I.

[By Rick Kahler CFP®]

The concept of socially responsible investing is far from new; the first SRI fund appeared in 1952. Since then, these funds have used social and ethical screens to exclude companies selling products like tobacco, alcohol, or firearms.

You may not have heard of the next generation of SRI funds, called ESG funds, which means environmental, social and governance funds. Social responsibility is just one-third of the expanded focus of these funds, which also look to include companies that are sensitive to the environment and have more holistic corporate governance.

Updates

In recent years, ESG investing has exploded. According to a July 11, 2018, article in Forbes, The Remarkable Rise of ESG, by Georg Kell, over $20 trillion is invested in ESG funds. This accounts for 25% of all the professionally managed assets in the world. There are currently 275 ESG mutual funds and ETF’s from which to choose.

Yet one facet of investing in ESG funds is widely misunderstood. While ESG investing may help you feel better about yourself, it does not actually impact or hamper the companies you choose not to own.

This may come as a surprise to many ESG investors, who commonly believe that by not owning the shares of an offensive company they are restricting the flow of capital to that company, thereby imperiling its existence. For the most part, that isn’t the case.

The offenders

Listed among the worst offending companies by several ESG organizations are Philip Morris, WalMart, Tyson Foods, Pepsi Corporation, Coca-Cola, and Chevron. No dedicated ESG investors would have these companies in their portfolios. None of these companies would care or be hurt in the least if you didn’t own any of their shares.

Why?

The only time a company benefits from a sale of stock is when the company initially goes public (called an initial public offering, or IPO) or issues additional new shares to raise capital. These are actually fairly rare events.

Most stocks are bought and sold in the “secondary” market through exchanges like the New York Stock Exchange. These platforms facilitate transactions between individuals or institutions wanting to buy or sell shares in a company. The money moves between the buyer and the seller; none of the money goes to the company.

Another way companies receive funding to support their ventures is to borrow money from investors. This is called issuing a bond and is similar to an IPO, only the investor receives a promise from the company to pay them back at some future date and receives interest on the loan in the meantime.

Just like stocks, bonds are only issued by a company once. From then on, buying and selling bonds is done on the open market, and none of the money paid or received goes to the company.

So if you want to punish a company, don’t buy stocks or bonds it issues directly. Otherwise, excluding its shares from your portfolio has no effect on the company’s profits or cash flow.

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Assessment

But if no one bought a company’s shares on the secondary market, wouldn’t that have an impact? Yes, it most certainly would. If the demand for the shares of a company dried up, the company’s stock price would plummet.

The problem is the demand for the shares of these companies isn’t going away as long as they remain profitable. If 25% of investors purchase ESG funds,  that leaves 75% of the market willing to buy these companies. This includes the 20% of stocks owned by passive index funds, which own the entire market.

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.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

The TOP 100 Digital Health Companies

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See the source image

There are a zillion digital health companies on the market, each praising their own solution/product as they can. It is up to the market to decide if these are any good. But how would patients, hospital systems, clinics or even investors decide on their added value? With the help of experts.

It is the 4th time we collect The TOP100 Digital Health Companies. A curated list of the best companies of the thousands we encounter while doing our work at The Medical Futurist. Of them, we chose a hundred that represent the following key values: mindset for innovation, truly disruptive technology, viable business model and a clear dedication to digital health.

Take care,
Berci
Bertalan Meskó, MD
The Medical Futurist

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UPDATE: The SAFE Banking Act

By Staff Reporters

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The SAFE Banking Act: Would allow marijuana [pot] shops to convert from cash transactions to digital exchanges potentially reducing the amount of armed robberies.

LINK: https://www.congress.gov/bill/117th-congress/house-bill/1996

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PENSION PLANS: Defined Benefit V. Defined Contribution Types

KNOW THE DIFFERENCE

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Defined Benefit Pension Plan

A defined benefit (DB) pension plan is a type of pension plan in which an employer/sponsor promises a specified pension payment, lump-sum or combination thereof on retirement that is predetermined by a formula based on the employee’s earnings history, tenure of service and age, rather than depending directly on individual investment returns. Traditionally, many governmental and public entities, as well as a large number of corporations, provide defined benefit plans, sometimes as a means of compensating workers in lieu of increased pay.

Defined Contribution Pension Plan

A defined contribution (DC) plan is a type of retirement plan in which the employer, employee or both make contributions on a regular basis. Individual accounts are set up for participants and benefits are based on the amounts credited to these accounts (through employee contributions and, if applicable, employer contributions) plus any investment earnings on the money in the account. In defined contribution plans, future benefits fluctuate on the basis of investment earnings. The most common type of defined contribution plan is a savings and thrift plan. Under this type of plan, the employee contributes a predetermined portion of his or her earnings (usually pretax) to an individual account, all or part of which is matched by the employer.

CITE: Wilipedia

CITE: https://www.r2library.com/Resource/Title/0826102549

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UPDATE: Bitcoin, Retail Sales, ONS and Consumer Confidence

By Staff Reporters

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Bitcoin: Rallied 2% after Russia said it would begin accepting it as payment for oil and natural gas.

Retail Sales: Fell and consumer confidence is at its lowest level in 16 months amid the recent surge in living costs.

Office for National Statistics: Reported an unexpected 0.3% decline in retail sales volumes for February, although some of this weakness reflected a drop in food sales as more people went out to pubs and restaurants.

Consumer Confidence: Continues to deteriorate after GfK reported the worst reading since November 2020 as households face up to 30-year-high levels of inflation, record fuel and food prices and a recent interest rate hike.

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What is an “Inverse” ETF?

WHAT IT IS – HOW IT WORKS

Traditional ETFs: https://medicalexecutivepost.com/2008/01/07/exchange-traded-funds-etfs/

Tax and ETFs: https://medicalexecutivepost.com/2008/01/11/etfs-and-tax-efficiency/

INVERSE DEFINITION:

An inverse exchange-traded fund is an exchange-traded fund, traded on a public stock market, which is designed to perform as the inverse of whatever index or benchmark it is designed to track. These funds work by using short selling, trading derivatives such as futures contracts, and other leveraged investment techniques.

Citation: https://www.r2library.com/Resource/Title/0826102549

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How Inverse ETFs Can Help And Hurt You

READ: https://smartasset.com/investing/inverse-etf

RELATED: https://smartasset.com/investing/what-is-a-leveraged-etf

ASSESSMENT: Your comments and thoughts are appreciated.

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PODCAST: The Successful Quest Diagnostics Employee Health Plan Cost Reduction Case-Report

By Eric Bricker MD

Their 8 Point Strategy Included: 1) CDHP, 2) Centers-of-Excellence, 3) Narrow Network, 4) Rx Formulary Changes, 5) Spousal Surcharge, 6) COBRA Members to the Exchange, 7) 2nd Opinion Program … AND 8) Moved Health Plan Control from HR to a Chief Medical Officer AND Kept a Short Leash on their ASO Carrier.

CITE: https://www.r2library.com/Resource/Title/082610254

Special Thanks to Dr. Steven Goldberg for Publishing His Company’s Experience in an Academic Journal.

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The Hemline Stock Market Index

What’s Up?

[By staff reporters]

According to Wikipedia, the hemline index is a theory presented by economist George Taylor in 1926. The theory suggests that hemlines on women’s dresses rise along with stock prices.

In good economies, we get such results as miniskirts (as seen in the 1920s and the 1960s), or in poor economic times, as shown by the 1929 Wall Street Crash, hems can drop almost overnight.

Non-peer-reviewed research in 2010 supported the correlation, suggesting that “the economic cycle leads the hemline with about three years”.

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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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Primary Care Physician Estimated Career Turn-Over Per Year

By Staff Reporters

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 •  General internal medicine: 4370 (4% of this workforce)
 •  Family medicine: 3624 (3% of this workforce)
 •  General pediatrics: 1320 (2% of this workforce)
 •  Obstetrics/gynecology: 1563 (4% of this workforce)
 •  Geriatrics: 149 (3% of this workforce)
 •  Preventive medicine: 93 (2% of this workforce)

Source: Mayo Clinic Proceedings, “Health Care Expenditures Attributable to Primary Care Physician Overall and Burnout-Related Turnover: A Cross-sectional Analysis,” February 25, 2022

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Are Target Date Mutual Funds a Good Choice?

An Easy Answer to Retirement Planning -or- MisStep?

By David Wallace [Search and social media marketer from Anthem, Arizona]

Investing in a target date mutual fund seems like the easy answer to retirement planning.

But, how can a single fund be appropriate for thousands of investors, doctors and medical professionals?

Assessment

Check out the above infographic to see the limitations of target date funds.

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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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

Product DetailsProduct DetailsProduct Details

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PODCAST: Primary Medical Care: US versus Other Countries

By Eric Bricker MD

The Commonwealth Fund Released a Study in March 2022 Comparing Primary Care in the United States to Other Industrialized Countries.

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ETFs and Tax Efficiency

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A Better Financial Product than Mutual Funds?

[By JD Steinhilber]

Exchange-traded funds are inherently more tax efficient than actively managed mutual funds, which have been rightly criticized for their tax-inefficiency. Tax-efficiency is a critical issue for financial advisors and physician-investors because delaying the taxation of appreciating assets normally enhances after-tax returns over time.

For example, it is estimated that between 1994 and 1999, investors in diversified U.S. stock mutual funds lost, on average, 15% of their annual gains to taxes. The tax inefficiency of mutual funds is the result of portfolio turnover at the fund level caused by two factors: the trading activity of the portfolio manager and the activity of other shareholders in the fund.       

The Mutual Fund Performance / Redemption Problem

Due to fund manager efforts to outperform benchmarks, actively managed mutual funds almost invariably experience more “manager-driven” portfolio turnover than ETFs, where trading is generally driven by change in the composition of the underlying indexes being replicated. Mutual fund portfolio turnover can also be caused by the actions of shareholders in the fund. 

In a mutual fund structure, redemption requests by shareholders can force the fund to sell securities to raise cash. These sales may give rise to gains that, by law, must be distributed and will be taxed to all shareholders in the fund.

Unique Architectural Structure

ETFs, in contrast, are structured in such a way that the actions of one shareholder do not result in tax consequences to another shareholder.  ETFs accomplish this through the innovative architecture in which ETF “units” (which are subdivided into individual ETF shares) are created and redeemed to accommodate the fluctuating demand for the shares of a particular ETF.

ETF units are created and redeemed by institutional investors though non-taxable, “in-kind” transactions, which means that only securities – not cash – change hands in the creation and redemption process. 

An example of this process would be an institution exchanging a portfolio of stocks constituting the S&P 500 index for an S&P 500 ETF “creation unit”. And, once created, the S&P 500 ETF can be subdivided into individual shares that are tradable by investors on the exchange.   

Assessment

As a result of the above – physicians may be insulated from a tax standpoint by the actions of other investors – because taxable transactions don’t take place at the fund level.  Instead, ETF shares are traded between retail investors in transactions on the exchanges, so the tax accounting becomes very similar to that associated with individual stocks.    

Have you used ETFs in your own portfolio, and what is your tax efficiency experience with them; truth or hype? 

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Product Details

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

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General Obligation and Revenue Bonds

Understanding GOs and RBs

[By Staff Writers]fp-book2

General obligation bonds are secured by the taxing authority and are therefore considered safer than other municipals. The full faith and credit of the municipality ensures prompt payment of principal and interest.

Further more, most municipal bonds, including city, county, and school district issues, are secured by a pledge of unlimited property taxes (known as ad-valorem taxes), which further secures the bonds. If taxes are not paid, the property may be sold at a tax sale, at which the bondholder has a superior position.

Revenue bonds

Revenue bonds are payable from the earnings of a revenue-generating facility, such as water, sewers, or utility systems, toll bridges, or airports. The risk, however, is that the facility will not generate income sufficient to pay the interest, and therefore the yield is somewhat higher than for a general-obligation bond.

Revenue bonds are supported only by the revenue earned, so if the project does not produce revenues sufficient to pay the interest on the bonds, then the bonds go into default. Therefore, it is important to properly evaluate the municipality’s ability to tax and/or the assumptions used to project the facility’s revenue.

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.

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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:

LEXICONS: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com

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Understanding Municipal Bond Underwriting

A Primer for Physician Investors

By Dr. David Edward Marcinko MBA CMP™

[Publisher-in-Chief]

While the underwriting procedures for corporate bonds are almost identical to corporate stock, there are significant differences in the underwriting of municipal securities. Municipal securities – hospitals for example – are exempt from the registration filing requirements or the Securities Act of 1933. A state or local government, in the issuance of municipal securities, is not required to register the offering with the SEC, so there is no filing of a registration statement and there is no prospectus which would otherwise have to be given to investors.

Municipal Underwriting

There are two main methods of financing when it comes to municipal securities. One method is known as negotiated. In the case of a negotiated sale, the municipality looking to borrow money would approach an investment bank and negotiate the terms of the offering directly with the firm. This is really not very different from the equity process.

Competitive Bidding

The other type of municipal underwriting is known as competitive bidding. Under the terms of competitive bidding, an issuer announces that it wishes to borrow money and is looking for syndicates to submit competitive bids. The issue will then be sold to the syndicate which submits the best bid, resulting in the municipality having the lowest net interest cost (lowest expense to the issuer).

If the issue is to be done by a competitive bid, the municipality will use a Notice of Sale to announce that fact. The notice of sale will generally include most or all of the following information.

  • Date, time, and place. This does not mean when the bonds will be sold to the public, but when the issue will be awarded (sold) to the syndicate issuing the bid.
  • Description of the issue and the manner in which the bid is to be made (sealed bid or oral).
  • Type of bond (general obligation, revenue, etc.)
  • Semi-annual interest payment dates and the denominations in which the bonds will be printed.
  • Amount of good faith deposit required, if any.
  • Name of the law firm providing the legal opinion and where to acquire a bid form.
  • The basis upon which the bid will be awarded, generally the lowest net interest cost.

The Bond Attorney

Since municipal securities are not registered with the SEC, the municipality must hire a law firm in order to make sure that they are issuing the securities in compliance with all state, local and federal laws. This is known as the bond attorney, or independent bond counsel. Some functions are included below:

  1. Establishes the exemption from federal income tax by verifying requirements for the exemption.
  2. Determines proper authority for the bond issuance.
  3. Identifies and monitors proper issuance procedures.
  4. Examines the physical bond certificates to make sure that they are proper
  5. Issues the debt and a legal opinion, since municipal bonds are the only securities that require an opinion.
  6. Does not prepare the official statement.

When medical or other investors purchase new issue municipal securities from syndicate or selling group members, there is no prospectus to be delivered to investors, but there is a document which is provided to purchasers very similar in nature to a prospectus. It is known as an Official Statement. The Official Statement contains all of the information an investor needs to make a prudent decision regarding a proposed municipal bond purchase.

Underwriting Syndicate

The formation of a municipal underwriting syndicate is very similar to that for a corporate issue. When there is a negotiated underwriting, an Agreement Among Underwriters (AAU) is used. When the issue is competitive bid, the agreement is known as a Syndicate Letter. In the syndicate letter, the managing underwriter details all of the underwriting agreements among members of the syndicate. Eastern (undivided) and Western (divided) accounts are also used, but there are several different types of orders in a municipal underwriting.

Order Types

The traditional types of orders, in priority order, are:

  • Pre-Sale Order: Made before the syndicate actually offers the bonds. They have first priority over any other order turned in.
  • Syndicate (group net) Order: Made once the offering is under way at the public offering price. The purchase is credited to each syndicate member in proportion to its allotment. An institutional buyer will frequently purchase” group net”, since many of the firms in the syndicate may consider this buyer to be their client and he wishes to please all of them.
  • Designated Order: Sales to medical investors (usually healthcare institutions) at the public offering price where the investor designates which member or members of the syndicate are to be given credit.
  • Member Orders: Purchased by members of the syndicate at the take-down price (spread). The syndicate member keeps the full take-down if the bonds are sold to investors, or earns the take-down less the concession if the sale is made to a member of the selling group. Should the offering be over-subscribed, and the demand for the new bonds exceeds the supply, the first orders to be filled are the pre-sale orders. Those are followed by the syndicate (sometimes called group net) orders, the designated orders, and the last orders filled are the member’s.

Assessment

Finally, be aware that the term bond scale is a listing of coupon rates, maturity dates, and yield or price at which the syndicate is re-offering the bonds to the public. The scale is usually found in the center of a tombstone ad and on the front cover of the official statement. One of the reasons why the word “scale” is used – is that like the scale on a piano – it normally goes up. A regular or positive scale is one in which the yield to maturity is lowest on the near term maturities and highest on the long term maturities. This is also known as a positive yield curve, since the longer the maturity, the higher the yield. In times of very tight money, such as in 1980-81, one might find a bond offering with a negative scale. A negative (sometimes called inverted) scale is just the opposite of a positive one, with, yields on the short term maturities are higher than those on the long term maturities.

http://www.amazon.com/Financial-Planning-Handbook-Physicians-Advisors/dp/0763745790/ref=sr_1_1?ie=UTF8&s=books&qid=1276795609&sr=1-1 

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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PODCAST: The Healthcare Price versus Quality Disconnect

By Dr. Eric Bricker MD

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CITATION: https://www.r2library.com/Resource/Title/0826102549

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MENTAL ACCOUNTING: What is it?

By Dr. David E. Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanning.org

DEFINITION: Mental accounting attempts to describe the process whereby people code, categorize and evaluate economic outcomes. The concept was first named by Richard Thaler. Mental accounting deals with the budgeting and categorization of expenditures. People budget money into mental accounts for expenses or expense categories

CITE: https://www.r2library.com/Resource/Title/0826102549

Mental Accounting is the act of bucketizing investments and then reviewing the performance of the individual buckets separately (e.g. investing at low savings rate while paying high credit card interest rates).

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Mental Accounting • Money is

Examples of mental accounting are: (1) matching costs to benefits (wanting to pay for vacation before taking it and getting paid for work after it was done, even though from perspective of time value of money the opposite should be preferred0, (2) aversion to debt (don’t like long-term debt for short-term benefit), (3) sunk-cost effect (illogically considering non-recoverable costs when making forward-going decisions).

In investing, treating buckets separately and ignoring interaction (correlations) induces people not to sell losers (even though they get tax benefits), prevent them from investing in the stock market because it is too risky in isolation (however much less so when looked at as part of the complete portfolio including other asset classes and labor income and occupied real estate), thus they “do not maximize the return for a given level of risk taken).

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CORRELATION in Modern Portfolio Theory Investing

“Correlation” has been used over the past twenty years by institutions, [physician] investors and financial advisors to assemble portfolios of moderate INVESTMENT risk

By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Modern Portfolio Theory approaches investing by examining the complete market and the full economy. MPT places a great emphasis on the correlation between investments. 

DEFINITION: Correlation is a measure of how frequently one event tends to happen when another event happens. High positive correlation means two events usually happen together – high SAT scores and getting through college for instance. High negative correlation means two events tend not to happen together – high SATs and a poor grade record. No correlation means the two events are independent of one another.

CITATION: https://www.r2library.com/Resource/Title/0826102549

CORRELATION: https://medicalexecutivepost.com/2021/02/05/correlation-is-not-causation/

In statistical terms two events that are perfectly correlated have a “correlation coefficient” of 1; two events that are perfectly negatively correlated have a correlation coefficient of -1; and two events that have zero correlation have a coefficient of 0.

In calculating correlation, a statistician would examine the possibility of two events happening together, namely:

  • If the probability of A happening is 1/X;
  • And the probability of B happening is 1/Y; then
  • The probability of A and B happening together is (1/X) times (1/Y), or 1/(X times Y).

There are several laws of correlation including;

  1. Combining assets with a perfect positive correlation offers no reduction in portfolio risk.  These two assets will simply move in tandem with each other.
  2. Combining assets with zero correlation (statistically independent) reduces the risk of the portfolio.  If more assets with uncorrelated returns are added to the portfolio, significant risk reduction can be achieved.
  3. Combing assets with a perfect negative correlation could eliminate risk entirely.   This is the principle with “hedging strategies”.  These strategies are discussed later in the book.

In the real world, negative correlations are very rare.  Most assets maintain a positive correlation with each other.  The goal of a prudent investor is to assemble a portfolio that contains uncorrelated assets.  When a portfolio contains assets that possess low correlations, the upward movement of one asset class will help offset the downward movement of another.  This is especially important when economic and market conditions change.

As a result, including assets in your portfolio that are not highly correlated will reduce the overall volatility (as measured by standard deviation) and may also increase long-term investment returns. This is the primary argument for including dissimilar asset classes in your portfolio. Keep in mind that this type of diversification does not guarantee you will avoid a loss.  It simply minimizes the chance of loss. 

In this table provided by Ibbotson, the average correlation between the five major asset classes is displayed. The lowest correlation is between the U.S. Treasury Bonds and the EAFE (international stocks).  The highest correlation is between the S&P 500 and the EAFE; 0.77 or 77 percent. This signifies a prominent level of correlation that has grown even larger during this decade.   Low correlations within the table appear most with U.S. Treasury Bills.

Historical Correlation of Asset Classes

Benchmark                             1          2          3         4         5         6            

1 U.S. Treasury Bill                  1.00    

2 U.S. Bonds                          0.73     1.00    

3 S&P 500                               0.03     0.34     1.00    

4 Commodities                         0.15     0.04     0.08      1.00      

5 International Stocks              -0.13    -0.31    0.77      0.14    1.00       

6 Real Estate                           0.11      0.43    0.81     -0.02    0.66     1.00

Table Source: Ibbotson 1980-2012

ASSESSMENT: Your thoughts are appreciated.

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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PODCAST: Will Your Health Care Directives Protect You?

By Rick Kahler CFP

PODCAST: https://kahlerfinancial.com/financial-awakenings/estate-planning/will-your-health-care-directives-protect-you

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MORE: https://www.nia.nih.gov/health/advance-care-planning-health-care-directives

CITE: https://www.r2library.com/Resource/Title/0826102549

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Risk Management: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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On All Things “Fiduciary”

My Journey From Financial Advisor to Journalist to Fiduciary Ambassador

By Kathleen M. McBride, AIFA® [Founder, Fiduciarypath, LLC]

EDITOR’S NOTE: Kathleen M. McBride, AIFA®, Founder, Fiduciarypath, LLC and CEFEX-certified analyst, talks about her journey from advisor to journalist to fiduciary ambassador.

Dr. David E. Marcinko MBA

[Editor-in-Chief]

Image result for fiduciary

LINK: https://www.fi360.com/blog/post/all-things-fiduciary

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Welcome ARPA-H [health]

By Dr. David Edward Marcinko MBA CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Recent advances in biomedical and health sciences—from immunotherapy to treat cancer, to the highly effective COVID-19 vaccines—demonstrate the strengths and successes of the U.S. biomedical enterprise. Such advances present an opportunity to revolutionize how to prevent, treat, and even cure a range of diseases including cancer, infectious diseases, Alzheimer’s disease, and many others that together affect a significant number of Americans.

NIH: https://www.nih.gov/arpa-h

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To improve the U.S. government’s capabilities to speed research that can improve the health of all Americans, President Biden is proposing the establishment of the Advanced Research Projects Agency for Health (ARPA-H). Included in the President’s FY2022 budget as a component of the National Institutes of Health (NIH) with a requested funding level of $6.5B available for three years, ARPA-H will be tasked with building high-risk, high-reward capabilities (or platforms) to drive biomedical breakthroughs—ranging from molecular to societal—that would provide transformative solutions for all patients.

MORE: https://thehealthcareblog.com/blog/2022/03/22/arpha-h-needs-to-think-bigger/

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An Interest Rate Review for Physician-Executives

Managerial Accounting

By Dr. David E. Marcinko MBA

Recently, several major banking institutions have addressed the problem of escalating debt upon graduating physicians, mid-life practitioners and even seasoned healthcare providers; despite historically low rates for prime customers.

Unfortunately, one may still wonder how many clinicians truly appreciate the risks associated with usurious interest rates for homes, cars, medical equipment and other consumer items; as we offer the following review to reduce this peril.

WHITE-PAPER: IRs

Assessment: Your thoughts are appreciated.

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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PSYCHOLOGICAL “TRAPS” of Investing

MIND TRAPS PHYSICIAN INVESTORS MUST REDUCE AND AVOID AT ALL COSTS

See the source image

By Dr. David E. Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

As human beings, our brains are booby-trapped with psychological barriers that stand between making smart financial decisions and making dumb ones. The good news is that once you realize your own mental weaknesses, it’s not impossible to overcome them.

CITE: https://www.r2library.com/Resource/Title/0826102549

In fact, Mandi Woodruff, a financial reporter whose work has appeared in Yahoo! Finance, Daily Finance, The Wall Street Journal, The Fiscal Times and the Financial Times among others; related the following mind-traps in a September 2013 essay for the finance vertical Business Insider; as these impediments are now entering the lay-public zeitgeist.

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8 Psychological Traps All Stock Investors Should Avoid - YouTube

 Anchoring happens when we place too much emphasis on the first piece of information we receive regarding a given subject. For instance, when shopping for a wedding ring a salesman might tell us to spend three months’ salary. After hearing this, we may feel like we are doing something wrong if we stray from this advice, even though the guideline provided may cause us to spend more than we can afford.

 Myopia makes it hard for us to imagine what our lives might be like in the future. For example, because we are young, healthy, and in our prime earning years now, it may be hard for us to picture what life will be like when our health depletes and we know longer have the earnings necessary to support our standard of living. This short-sightedness makes it hard to save adequately when we are young, when saving does the most good.

 Gambler’s fallacy occurs when we subconsciously believe we can use past events to predict the future. It is common for the hottest sector during one calendar year to attract the most investors the following year. Of course, just because an investment did well last year doesn’t mean it will continue to do well this year. In fact, it is more likely to lag the market.

 Avoidance is simply procrastination. Even though you may only have the opportunity to adjust your health care plan through your employer once per year, researching alternative health plans is too much work and too boring for us to get around to it. Consequently, we stick with a plan that may not be best for us.

 Loss aversion affected many investors during the stock market crash of 2008. During the crash, many people decided they couldn’t afford to lose more and sold their investments. Of course, this caused the investors to sell at market troughs and miss the quick, dramatic recovery.

 Overconfident investing happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. Data convincingly shows that people who trade most often underperform the market by a significant margin over time.

 Mental accounting takes place when we assign different values to money depending on where we get it from. For instance, even though we may have an aggressive saving goal for the year, it is likely easier for us to save money that we worked for than money that was given to us as a gift.

MORE: https://medicalexecutivepost.com/2021/09/04/more-on-money-psychology/

RELATED: https://medicalexecutivepost.com/2014/12/15/on-internet-investing-psychology/

 Herd mentality makes it very hard for humans to not take action when everyone around us does. For example, we may hear stories of people making significant profits buying, fixing up, and flipping homes and have the desire to get in on the action, even though we have no experience in real estate.

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RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors : Best Practices from Leading Consultants and Certified Medical Planners™ book cover

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PODCAST: Healthcare “Certificate of Need” Laws Explained

By Eric Bricker MD

C.O.N. Legislation is Not New!

Certificate of need laws are state-level regulations that require healthcare institutions to obtain approval from state officials before moving forward on large capital expenditure projects, such as the construction of a new facility or the purchase of expensive new equipment.

CITE: https://www.r2library.com/Resource/Title/082610254

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INVESTING: “Direct Indexing” Definition

WHAT IT IS – HOW IT WORKS?

Citation: https://www.r2library.com/Resource/Title/0826102549

Direct Indexing at Vanguard - FiPhysician

READ: https://smartasset.com/investing/direct-indexing#:~:text=Advantages%20of%20Direct%20Indexing%201%20Tax%20Efficiency.%20Direct,Social%20Criteria%20Customization.%20…%204%20Lower%20Costs.%20

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The Millennial Spend on COVID-19 Tests?

By Dr. David E. Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Millennials Spent the most on COVID-19 tests ($142)

A recent ValuePenguin survey found out-of-pocket costs for COVID-19 tests on average varied by age groups as follows:

 •  Gen Zers (ages 18-25): $125
 •  Millennials (ages 26-41): $142
 •  Gen Xers (ages 42-56): $101
 •  Baby boomers (ages 57-76): $59

Source: ValuePenguin, “COVID-19 Testing Survey: Americans Talk Out-of-Pocket Charges, Bill Negotiations, Barriers,” February 14, 2022

CITE: https://www.r2library.com/Resource/Title/082610254

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UPDATE: The Housing and Single Family Rental Markets

By Staff Reporters

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HOMES: Last year was a really good time to own a home—like, historically good. For the first time on record, homeowners earned more from the increase in home values than income from their jobs, according to Zillow. The numbers: The typical US home increased $52,667 in value, while the median full-time worker earned about $50,000 before taxes.

Rentals: Single-family rental prices jumped 12.6% from a year earlier, according to the latest CoreLogic Single-Family Rent Index. All major metropolitan areas saw increases, but the Sun Belt experienced by far the biggest gains, with Miami’s asking rents up almost 39%.

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My Investing “Sell” Principle

The Renaissance of Pipelines

Vitaliy N. Katsenelson, CFA - YouTube

By Vitaliy N. Katsenelson, CFA

A client recently asked me whether there is a difference in our sell discipline between high and low growth companies.

Selling is one of the hardest parts of investing. I wrote a lot on the subject in the past, but let’s zoom in on how our selling practice differs between high-growth companies with long runways for compounding and slow-growth companies.

LINK: https://contrarianedge.com/our-sell-discipline/

AUDIO: https://investor.fm/the-renaissance-of-pipelines-and-our-sell-discipline-ep-113

Your thoughts are appreciated.

EDITOR’S NOTE: It has been a few years since I spoke with my colleague Vitaliy. But, I read his newsletters and blog regularly and suggest all ME-P readers do the same.

Dr. David E. Marcinko; MBA

[Editor-in-Chief]

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

BOOK: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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ACCOUNTABLE CARE: Competitive Market for Talent is Biggest Challenge in Recruiting

By Staff Reporters

DEFINITION: An accountable care organization (ACO) is a group of doctors, hospitals, and other health care providers that work together on your care. Their goal is to give you — and other people on Medicare — better, more coordinated treatment. The largest effort in payment innovation in Medicare is a portfolio of accountable care organization (ACO) programs that include the Medicare Shared Savings Program (MSSP), the Next Generation model, and Comprehensive End Stage Renal Disease model. But drawbacks include limited choice as some patients will have trouble finding doctors outside of a specific group. The shortage of options could lead to higher patient costs. And, referral restrictions as ACOs provide doctors incentives to refer to specialists within the group.

CITE: https://www.r2library.com/Resource/Title/082610254

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In a recent survey from AKASA healthcare finance leaders ranked the biggest challenges in recruiting and retention within the revenue cycle as healthcare organizations navigate significant staffing gaps across the board.

Great Resignation: https://medicalexecutivepost.com/2022/03/08/healthcare-industry-hit-with-the-great-resignation-retirement/

 •  #1: Competitive market for talent (71%)
 •  #2: Vaccine mandates (42%)
 •  #3: Employee burnout (41%)
 •  #4: Rapid employee turnover (40%)
 •  #5: Limitations to offer remote work (23%)

Source: AKASA via PR Newswire, February 23, 2022

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SELLING: Financial Advice!

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It is All About Sales

Rick Kahler MS CFP

By Rick Kahler MS CFP®

Steve Forbes, editor of the well-respected financial publication Forbes Magazine, once said,

“You make more selling advice than following it. It’s one of the things we count on in the magazine business, along with the short memory of our readers.”

Scores of publications sell advice on their proprietary investing secrets. In addition, hundreds of thousands of active money managers claim they can “beat the market” and give you above average returns. Usually, “the market” this advice refers to is the Standard & Poor’s 500 Index.

Investing in the S&P 500 Index simply means owning a fraction of every one of the largest 500 companies in the US. No skill is involved at all; a third grader can do this.

Accepting average market returns through an index fund is termed “passive” investing, while trying to beat the market is called “active” investing. Enticing as the latter may seem, very few active investors manage to do it.

Dimensional Fund Advisors

A recent study cited by Dimensional Fund Advisors found that only 17% of money managers beat the S&P 500 Index over 15 years. A similar study done by Dalbar, Inc. found that over 20 years, just 3% of money managers beat the S&P 500 Index. In other words, 97% of all money managers didn’t do as well as a third grader who invested in the S&P 500 Index.

In addition, active investors generally pay around 1.35% a year in fees, compared to around 0.20% a year for passive investors. According to the Dalbar study, the average active investor earns 3% to 4% less annually than the average passive investor. That’s a really big deal.

With all the research to the contrary, why does active investing flourish?

There are three reasons:

First, people are confused. Few investors understand that Wall Street has every financial incentive to keep you confused. So does much of the financial press, because passive investing doesn’t sell papers or magazines. We don’t see headlines reading, “What You Need To Do With Your Portfolio Now: NOTHING!”

Second, people tend to be extremely overconfident. Most of what people mistake for outperformance in a money manager is actually just dumb luck. According to Ken French, professor of finance at Dartmouth, it takes 64 years of data to sort through all the random probabilities to assess whether a manager’s short-term beating the market is due to skill rather than chance.

To emphasize this, try an experiment that can make you a stock-picking genius. Select 64 people, preferably not friends. Tell 32 of them the price of a share of Apple will be higher at the end of the month; tell the other 32 it will be lower. Of course, your “prediction” will be true for one group or the other. At the end of the month take the “true” group, divide it into two groups of 16, and repeat the exercise. At the end of the second month, divide the “true” group in half and repeat. Continue the pattern with the remaining 8, then 4, and the last 2. After six months you will have correctly predicted the movement of Apple stock to one person—who will think you are a financial genius.

The third reason active investing flourishes is the superior skill of the top 3%—the Bill Millers and Jim Simons. Such investment gurus provide encouragement that you, too, can beat the market. Yet actually, the fact they exist is exactly the reason why you shouldn’t try. Why?

Assessment

In order for them to do better than the market, they need lots of others to do worse. As Ken French reminds us, trying to beat the market is a zero sum game. 

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investing

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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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

 Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™   Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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The “Fair Health” Study of Private Healthcare Claims

By Staff Reporters

Three [3] Key Findings

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 •  Among patients aged 19-35, mental health conditions were the most common diagnosis associated with emergency ground ambulance in the period 2016-2020.
 •  Throughout the period 2016-2020, advanced-life-support (ALS) accounted for a larger percentage of emergency ground ambulance claim lines than basic-life-support (BLS) services. For example, in 2020, 51.5% of emergency ground ambulance claim lines were associated with ALS compared to 48.5% associated with BLS.
 •  Individuals 65 years and older were consistently the largest age group associated with emergency ground ambulance services, though their share of the distribution decreased from 37.7% in 2016 to 34% in 2020.

Source: Fair Health Via PR Newswire, “Ground Ambulance Services in the United States,” February 23, 2022

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UPDATE: Medical Debt, Credit Reports & Spring

By Staff Reporters

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Medical Debt. The top three credit reporting agencies—Equifax, Experian, and TransUnion—said recently that they’ll remove most medical debt from consumers’ credit reports beginning this summer. This move will wipe out almost 70% of medical debts that can sometimes stick around for up to seven years on Americans’ credit reports and make it harder for them to buy a house, car, or take out other loans.

Spring: Today is the first day of Spring [aka the vernal equinox or one of two moments of the year when the Sun is exactly above the Equator].

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HAPPY SPRING 2022

Editor-in-Chef: Dr. David Edward Marcinko MBA CMP™

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PODCAST: How Prescription Drug Coverage Really Works

By Eric Bricker MD

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DICTIONARY HEALTH INSURANCE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4


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The [HISTORICAL] Trouble with Banks?

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“I don’t trust banks and neither should you”

eric

   By Erik Kobayashi-Solomon

 [intelligent option investor]

More On Banks

I don’t trust banks and neither should you if you care at all about understanding the company in which you are investing.  While financial statements for all companies contain estimates, virtually every line item on a bank’s financial statement are estimates – to the extent that, taken as a whole, the statements become little more than complex, arcane works of fiction.

The Trouble with Banks

Conclusion

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Hospital Employment Declining

ARE WE SURPRISED?

By Staff Reporters

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Hospital Employment Declined 2.5% in 2020-Q2

 •  Health care employment levels declined from 22.2 million in 2019 to 21.1 million in 2020
 •  Health care employment levels rebounded to 21.8 million in 2021-Q2
 •  Dentist offices employment declined 10% in 2020-Q2
 •  Skilled nursing facility employment declined 8.4% in 2020-Q2
 •  Hospital employment declined 2.5% in 2020-Q2

Source: JAMA Health Forum, “US Health Care Workforce Changes During the First and Second Years of the COVID-19 Pandemic,” February 25, 2022

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