CONSUMER CONFIDENCE: Up!

By Staff Reporters

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Consumer confidence rose for the first time in four months

The Consumer Conference Board’s index rose from 99.1 in October to 102 in November thanks to US consumers’ optimism around short-term income, hiring prospects, and the slowdown in inflation. The perceived likelihood of a recession also fell to the lowest level of 2023—though two-thirds of Americans still think one is either “somewhat” or “very likely” to happen in the next year.

The improved economic outlook comes after home prices rose to a new record in September, even as mortgage rates remained elevated.

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DAILY UPDATE: Hospital Ransomware Attack as Stock Markets Mixed Ahead of Inflation Reading

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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A ransomware attack has caused a health care chain, which operates 30 hospitals in six states, to move patients from some of its emergency rooms to other hospitals, while putting certain procedures on pause, the company announced.

According to a statement from Ardent Health Services, the attack happened on November 23rd. The company said as a result of the attack, it took its network offline and suspended user access to its information technology applications, including the software used to document patient care.

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Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500® index was down 4.31 points (0.1%) at 4,550.58; the Dow Jones Industrial Average was up 13.44 points at 35,430.42; the NASDAQ Composite ® was down 23.27 points (0.2%) at 14,258.49.
  • The 10-year Treasury note yield (TNX) was down about 8 basis points at 4.261%.
  • CBOE ® Volatility Index (VIX) was up 0.29 at 12.98.

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

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“BREAKING NEWS” Cigna and Humana to Merge?

By Staff Reporters

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Cigna and Humana are in talks for a combination that would create a new powerhouse in the health-insurance industry. The companies are discussing a stock-and-cash deal that could be finalized by the end of the year, assuming the talks don’t fall apart.

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A combination of the managed-care providers would be huge, given Cigna’s market value Wednesday morning of about $83 billion and Humana’s of roughly $62 billion.

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Cigna and Humana previously explored merging in 2015, but Humana instead struck a deal with another rival, Aetna, that was blocked by a judge on antitrust grounds, leaving Aetna to be scooped up by CVS in 2018. Another deal that would have combined Cigna with Anthem, now known as Elevance Health, also died after an adverse antitrust ruling.

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

Editor’s Note: Medicare Advantage plans are pretty popular with both lawmakers and ordinary Americans — they now enroll about 31 million people, representing just over half of everyone in Medicare, by KFF’s count. Across the country, doctors are grumbling about claim denials and onerous pre-approval requirements by Medicare Advantage plans. Some hospitals and physician practices are so fed up they’re refusing to accept the plans — even big ones like those offered by United Healthcare, Cigna and Humana.

“The insurance companies running the Medicare Advantage plans are pushing physicians and hospitals to the edge,” said Chip Kahn, president and CEO of the Federation of American Hospitals, which represents the for-profit hospital sector.

And, just last week, the industry’s largest lobbying group, the American Hospital Association, fired off a letter to the Centers for Medicare and Medicaid Services warning that some insurers seem intent on circumventing new rules put in place by the Biden administration aimed at reining in some prior authorization and claim denials.

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GM ALERT: Buy-Back as Stock Rises

By Staff Reporters

SPONSOR: http://www.CERTIFIEDMEDICALPLANNER.org

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General Motors plans to sharply increase cash return to shareholders, as Chief Executive Mary Barra seeks to reassure investors about the health of GM’s core car-making business after setbacks in fledgling pursuits such as electric and driver-less vehicles.

The company just announced it will work to offset higher labor expenses from its new contract with the United Auto Workers and unionized employees in Canada. The contracts will add a total of $9.3 billion in costs over about four years, including $1.5 billion next year, higher than analysts had estimated.

Barra is trying to jump-start GM’s flailing shares while also refocusing investors on the underlying strength of its main business: selling gas- and diesel-powered trucks and SUVs. It marks a shift in the message from recent years, during which the CEO sought to recast GM as a tech company poised to transcend the messy world of car manufacturing.

GM said it would log strong profits this year despite a six-week strike that shaved $1.1 billion from its bottom line in the third and fourth quarters. The company expects full-year operating profit of $11.7 billion to $12.7 billion, after withdrawing its guidance last month during the strike

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MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

By Ann Miller RN MHA CMP™

At Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.

The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].

Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

***

But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

***

Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

http://www.DavidEdwardMarcinko.com

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

***

***

DAILY UPDATE: Apple Credit Card, Drug Prices and the Modest Stock Markets

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Apple is pulling the plug on its credit card partnership with Goldman Sachs Group, the Wall Street Journal reported on Tuesday. The tech giant recently sent a proposal to the Wall Street bank to exit the contract in the next 12 to 15 months, the report said, citing people briefed on the matter.

***

Senators Elizabeth Warren (Democrat) and Mike Braun (Republican) sent a letter to the US Department of Health and Human Services last week, asking it to investigate whether large insurance companies are hiking prescription drug prices at pharmacies they own

***

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Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was up 4.46 points (0.1%) at 4,554.89; the Dow Jones Industrial Average was up 83.51 points (0.2%) at 35,416.98; the NASDAQ Composite® (COMP) was up 40.73 points (0.3%) at 14,281.76.
  • The 10-year Treasury yield was down about 6 basis points at 4.33%.
  • The CBOE® Volatility Index (VIX) was little-changed at 12.69.

Semiconductor and transportation shares were among the weakest performers Tuesday, and regional banks were also under pressure. Small cap stocks also lagged. The Russell 2000® Index (RUT) fell about 0.4% for its lowest close in a week.

Retailers and utilities were among the firmest sectors. In other markets, the U.S. Dollar Index (DXY) weakened to its lowest level since mid-August, reflecting expectations that U.S. interest rates have peaked.

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

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GIVING TUESDAY: Radical Generosity

***

By Staff Reporters

Giving uesday is a Movement that Unleashes the Power of Radical Generosity Around the World

Giving Tuesday re-imagines a world built upon shared humanity and generosity.

***

A global network collaborates year-round to inspire generosity around the world, with a common mission to build a world where generosity is part of everyday life.

Whether it’s making someone smile, helping a neighbor or stranger out, showing up for an issue or people we care about, or giving some of what we have to those who need our help, every act of generosity counts, and everyone has something to give.

MORE: https://www.givingtuesday.org/about/

PRO BONO: https://medicalexecutivepost.com/2022/11/29/giving-tuesday-and-pro-bono-medical-care/

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DAILY UPDATE: Interest Rate Cuts, CPA Holidays Spending Watch and the Markets

By Staff Reporters

***

SPONSOR: http://www.MarcinkoAssociates.com

***

Wall Street is gearing up for rate cuts. Yep! Twenty months after the Federal Reserve began a historic campaign against inflation, investors now believe there is a much greater chance that the central bank will cut rates in just four months than raise them again in the foreseeable future.

Interest-rate futures indicated last week a roughly 60% chance the Fed will lower rates by a quarter-of-a-percentage point by its May 2024 policy meeting, up from 29% at the end of October, according to CME Group data. The same data has pointed to four cuts by the end of the year. And, investors, battered by the Fed’s efforts to slow the economy, have reacted by driving the S&P 500 up nearly 9% this month. That is despite the wagers reflecting different possible paths for the economy, not all of them favorable for stocks.

Of course, investors look ahead to the release this week of key US inflation data that could provide a guide for the Federal Reserve’s plans for interest rates going into the new year.

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

***

Read: Can AI save accounting? (the Journal of Accountancy)

***

Here is where the major benchmarks ended:

  • The S&P 500 Index was down 8.91 points (0.2%) at 4,550.43; theDow Jones Industrial Average® (DJI) was down 56.68 points (0.2%) at 35,333.47; the NASDAQ Composite® was down 9.83 points (0.1%) at 14,241.02.
  • The 10-year Treasury note yield (TNX) was down about 10 basis points at 4.387%.
  • CBOE Volatility Index® (VIX) was up 0.23 at 12.69.

Transportation shares were among the weakest performers Monday, and energy was also soft behind a drop in crude oil futures. Weakness in many retail stocks suggested some concern over consumer spending given high interest rates and slower job growth. The S&P Retail Select Index (SPSIRE) fell 0.6% but is still up 8.2% for the month. Consumer discretionary and real estate shares were among the few gainers.

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PHYSICIANS: Seeking Vital [Non-Clinical] Second Opinions?

By Dr. David Edward Marcinko MBA CMP™

EDUCATION: http://www.CERTIFIEDMEDICALPLANNER.org

SPONSOR: http://www.MARCINKOASSOCIATES.com

***

When You May Need a Business, Management or Financial Planning Second Opinion?

The Marcinko & Associates second opinion service is a physician-to-advisor telephone or e-mail portal that connects independent financial and business management professionals and consultants, with doctors or healthcare executives desiring affordable and unbiased financial or business advice on an as-needed, or per-use basis.

***

Medical professionals and healthcare executives can now receive direct access to us in the areas of Practice Enhancement, Investing, Financial Planning, Asset Allocation, Portfolio Management, Insurance, Mortgage and Lending, Practice Management, Information Technology, Human Resources and Employee Benefits. To assist our doctor / healthcare executive members, we can be contracted with per-hour or per-project fees, and contacted by client phone, email or secure instant messaging.

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

This Marcinko & Associates service is designed to fill a growing need for medically focused financial or managerial advice that traditional consultants have not been able to serve.

READ MORE: https://marcinkoassociates.com/opinions-second/

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DAILY UPDATE: Holiday Spending Economics with Mixed Stock Markets

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

***

Shopping data reveals that Q4 isn’t as important as one might expect. For example, the holiday quarter in 2022 accounted for 26.8% of the year’s sales, just a hair over the 25% mark if sales were evenly spread across the year, per the US Census Bureau. Of course, some types of retailers depend on the holiday quarter far more than others. Discretionary retailers (which sell the things you want, but don’t need…aka gifts) rely on Q4 for up to 40% of their yearly sales, according to McKinsey. For department stores, clothing stores, and toy stores, the holiday season really is make-or-break. GameStop, for instance, recorded 37% of its annual revenue last year in the last three months of 2022.

But for other retailers, Q4 isn’t such a big deal. People apparently read throughout the year because book stores only depend on the fourth quarter for 27.4% of sales. People also need to eat food all year long: Q4 accounted for 26.3% of sales for grocery stores.

Meanwhile, gas stations, car dealerships, and building material companies perform worse in the holiday quarter than at other times of the year.

Here is where the major benchmarks ended:

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

The S&P 500 Index was 2.72 up points (0.1%) at 4,559.34, up 1% for the week; the Dow Jones Industrial Average®(DJI) was up 117.12 points (0.3%) at 35,390.15, up 1.3% for the week; the NASDAQ Composite was down 15.00 points (0.1%) at 14,250.85, up 0.9% for the week.

  • The 10-year Treasury note yield (TNX) was up about 5 basis points at 4.47%.
  • CBOE Volatility Index (VIX) was down 0.34 at 12.46.

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NURSING: Emerging Trends and Innovation

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MORTGAGE RATES: Elevated on Black Friday!

By Staff Reporters

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Elevated mortgage rates are set to keep sellers of previously owned homes out of the market heading into next year, but sales will “bottom out” in early 2024, Fannie Mae said this week, before a rebound the following year.

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

Mortgage rates hovered near 8 percent as recently as October, the highest level it has hit since the turn of the millennium, which has scared used homeowners from selling their homes as many prefer to stay in lower rates secured in years past. This “lock in effect,” as Fannie Mae analysts describe it, has added to a depleted supply of homes available for buyers and helped push up prices.

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DAILY UPDATE: Profiting From Black Friday “Reverse Logistics”

By Staff Reporters

***

Black Friday, one of the biggest shopping days of the year, is a half day for the stock market. Both stock exchanges close at 1:00 p.m. ET, with eligible options trading until 1:15 p.m. Normal trading hours resume on the Monday after Thanksgiving, also known as Cyber Monday, when many online retailers host major sales.

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SPONSOR: http://www.MarcinkoAssociates.com

***

DEFINITION: Reverse logistics—or the supply-chain processes of returns—is a little-known but rapidly growing sector of the economy that’s booming alongside the rise in online shopping that started during the pandemic.

Now, as retailers crack down on returns to avoid hearing another “it was broken when I got it” excuse, some companies are counting on you to send your holiday gifts back. A “reverse logistics” industry has sprung up in recent years to take advantage of the more than $300 billion in returns Americans make every holiday season.

  • Venture capital firms pumped nearly $200 million into reverse logistics startups last year—over 2.5x as much as in 2021, according to Bloomberg.
  • Loop Returns, which sells software to companies looking to streamline the return process on the customer side, raised $115 million at the end of 2022.

Established companies see potential in reverse logistics as well. Last month, Uber launched a feature enabling drivers to pick up your packages and bring them to a returns center. Meanwhile, UPS, whose returns business has grown 25% since 2020, recently acquired the startup Happy Returns.

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The HEALTH DICTIONARY SERIES

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HEALTH DICTIONARY SERIES

VISIT: https://healthdictionaryseries.wordpress.com/

By Ann Miller RN MHA

[An Internet WIKI CROWD-SOURCED Curation Project]*

To keep up with the ever-changing healthcare industrial complex, we must learn new definitions and re-learn old terminology in order to correctly apply it to practice. By aggregating the most up-to-date abbreviations, acronyms, definitions and terms, the Health Dictionary Series offers a wealth of information to help understand the ever-changing terms-of-art in healthcare today.

Each 10,000 item handbook is essential for doctors, nurses, benefits managers and insurance agents, CPAs, and administrators; as well as graduate and under graduate students and professors. Our goal to for each dictionary to be designated as a Doody’s Core Title. 

Dictionary of Health Insurance and Managed Care

With more than 8,000 definitions, 4,000 abbreviations and acronyms, and a 3,000 item oeuvre of resources, readings, and nomenclature derivatives, this dictionary covers the Medicare, managed care and Medicaid, private insurance, Veteran’s Administration and PP-ACA language of the entire health and long-term care insurance sector.

Product DetailsProduct DetailsProduct Details

Dictionary of Health Economics and Finance

Health economics and finance is an integral component of the health care industrial complex. Its language is a diverse and broad-based concept covering many other industries: accounting, mathematics, the actuarial sciences, stochastics and statistics, salary reimbursements, physician payments, compensation and forecasting are all commingled arenas.

Product DetailsProduct DetailsProduct Detailsm

 Dictionary of Health Information Technology Security

There is a myth that all healthcare stakeholders understand the meaning of information technology jargon. In truth, the vernacular of contemporary systems is unique, and often misused or misunderstood. Moreover, emerging Heath Information Technology (HIT) thru the HITECG initiatives; in the guise of terms, definitions, acronyms, abbreviations and standards; often puts the non-expert in a position of maximum uncertainty and minimum productivity.

Product DetailsProduct DetailsProduct Details

 *NOTE: A wiki website allows users to add or update content using their browser thru a hosted server created by the collaborative effort of site visitors. The Hawaiian term “wiki wiki” means “super fast.”

HDS

****

A THANKSGIVING DONATION: In “Name” Only?

DONOR ADVISED FUNDS

By Staff Reporters

***

Proponents of DAFs say that their structure encourages giving: The tax deduction encourages wealthy patrons to dedicate money for charity even before they’ve decided which cause to support. “Donors may have good reasons to postpone grants,” a Stanford Law School article says..

In one hypothetical, a tech founder who “sells a startup for millions of dollars” may want to donate her takings but is too busy to immediately decide how to direct the funds; a DAF is a good choice for this person, the law article notes.

However, while DAFs could in theory grow the charitable pie, in practice, they too often allow the donor the illusion of charity while letting them keep control of their funds, critics say. 

While a gift to a DAF is treated the same as an outright gift to the Red Cross or United Way, in practice, it “effectively allows the donor to retain ongoing control over the charitable disposition and investment of the donated assets,” tax scholars Roger Colinvaux and Ray Madoff wrote in 2019. What’s more, “donors are under no obligation, and have no incentive, ever to release their advisory privileges to make the funds available for charitable use.”

And ultra wealthy donors get a substantially larger tax break than a middle-class worker. As much as 74 cents of every dollar given to charity comes back to the donor in the form of tax breaks, according to calculations by Colinvaux and Madoff, with the highest-earning donors getting the biggest benefits A person in the top tax bracket would save 37% of their federal income tax for every dollar they contribute with a charitable donation; a similar amount of state income tax; and, depending on what they donate and when, they can also avoid capital gains tax and estate tax. (By contrast, a typical worker who makes about $60,000 and doesn’t own stocks would save 22% from their cash contribution, in addition to any state tax savings.) 

What’s more, because there’s no way to track donations from particular DAF accounts, they act as a form of “dark money,” allowing donors to give vast sums, essentially anonymously, to a range of potentially unsavory organizations, including nonprofits that advocate for specific political causes or organizations classified as hate groups, IPS says. 

“This allows DAFs to be used to hide transfers — similar to the way the ultra-wealthy use multiple shell companies to hide the movement of money among offshore accounts,” IPS writes. 

All of these strategies are completely legal, the IPS notes, as are other potentially questionable tactics used by family foundations—such as paying family members to serve as foundation trustees or act as executives of foundations, sometimes at salaries in the hundreds of thousands of dollars a year. However, the IPS argues, they erode public trust in charities and the tax system overall.

“The fact that billionaires opt out of paying taxes, have these closely held family foundations and get to play God about where the money goes, that’s private power — unaccountable private power,” Collins said. 

“At this point philanthropy is at risk of becoming taxpayer-subsidized private power.”

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PHYSICIANS ONLY: Career Coaching and Development

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

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CONTACT US: https://marcinkoassociates.com/process-what-we-do/

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DAILY UPDATE: Thanksgiving Travel Gas Prices Down – Narrow Traffic Lanes Safer – Walgreens Pharmacies Closed as the Stock Markets Roar

***

Thanksgiving is a trading holiday. Both the New York Stock Exchange and the Nasdaq are closed. Black Friday, one of the biggest shopping days of the year, is a half day for the stock market. Both stock exchanges close at 1:00 p.m. ET, with eligible options trading until 1:15 p.m. Normal trading hours resume on the Monday after Thanksgiving, also known as Cyber Monday, when many online retailers host major sales.

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Thanks to plummeting prices at the pump, US drivers will save a collective $1.2 billion this Thanksgiving travel period, and day, compared to last year, according to GasBuddy. The average price per gallon is down nearly 46 cents from a year ago, and more than 50,000 stations now show gas prices at $2.99/gallon or less.

***

Narrow traffic lanes are safer than wide ones. Researchers at Johns Hopkins analyzed more than 1,000 streets in seven major cities across the US and found that narrower roads mitigated traffic collisions in certain conditions. The study did not find a significant difference between roads 9-feet wide and those 10- or 11-feet wide, but it did conclude that traffic accidents increase 1.5x when a road widens from 9 feet to 12 feet. Traffic fatalities are the leading cause of death for Americans aged 1–54.

***

Walgreens will close most of its pharmacies and stores on Thanksgiving Day for the first time in the company’s history, executives said last Thursday. The move to close more than 8,700 stores for the federal holiday comes as some Walgreens workers staged a three-day walkout this fall to push for improved working conditions and increased staffing numbers, Reuters reported.

***

***

Here is where the major benchmarks ended on Wednesday:

  • The S&P 500 Index was up 18.43 points (0.4%) at 4,556.62, near a four-month high close; the Dow Jones Industrial Average®(DJI) was up 184.74 points (0.5%) at 35,273.03; the NASDAQ Composite was up 65.88 points (0.5%) at 14,265.86.
  • The 10-year Treasury note yield (TNX) was down about 1 basis point at 4.41%, after earlier dropping to a two-month low under 4.37%.
  • CBOE Volatility Index (VIX) was down 0.50 at 12.85.

Communications services and technology were among the strongest performers Wednesday. Food and beverage companies were also firm. Energy shares were among the weakest performers Wednesday behind a drop of over 1% in WTI Crude Oil futures (/CL). ), which fell following reports OPEC delayed a weekend meeting until November 30th, a possible reflection of cartel members struggling to reach consensus over production cuts. WTI crude ended just under $77 a barrel, down 19% from a 2023 high above $95 in late October.

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NVIDIA UPDATE: Smashes Revenue Expectations!

By Staff Reporters

***

***

The good times keep rolling for the chip maker. Q3 revenue increased 206% year over year to $18.1 million, topping Wall Street’s estimates of about $16.2 billion. The company’s stock has more than tripled amid the AI boom this year, accounting for a big part of the S&P 500’s tech-fueled rise.

And yet, shares ticked down from record highs in after-hours trading on Tuesday after Nvidia tempered expectations for Q4 due to new restrictions on chip exports to China.

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DAILY UPDATE: Nvidia Up, Zhao of Binance is Out and the Stock Index Win Streak Ends

By Staff Reporters

***

How to Close Binance Account - Cryptalker

SPONSOR: http://www.MarcinkoAssociates.com

***

Nvidia reported another quarter of record sales and gave a strong revenue outlook, pointing to red-hot demand for chips that underpin the artificial-intelligence boom. Huge investments in AI by tech giants from Microsoft to Amazon.com and by other large corporations have helped propel Nvidia’s sales to unprecedented levels in recent quarters.

***

The chief executive of Binance, the largest global cryptocurrency exchange, plans to step down and plead guilty to violating criminal U.S. anti-money-laundering requirements, in a deal that may preserve the company’s ability to continue operating, according to people familiar with the matter. And, the U.S. Department of Justice has just brought criminal charges against Binance and its billionaire founder and CEO, Changpeng Zhao.

Here is where the major benchmarks ended:

The S&P 500 Index was down 9.19 points (0.2%) at 4,538.19; the Dow Jones Industrial Average® (DJI) was down 62.75 points (0.2%) at 35,088.29; the NASDAQ Composite was down 84.55 points (0.6%) at 14,199.98.

  • The 10-year Treasury note yield (TNX) was down about 2 basis points at 4.404%.
  • The CBOE Volatility Index® (VIX) was down 0.06 at 13.35.

Financial and technology shares were among the weakest sectors Tuesday, with the KBW Regional Banking Index (KRX) dropping 2.1%. Small-cap stocks also gave back some of a recent rally, as the Russell 2000® Index(RUT) fell 1.3% after touching a two-month high Monday. Health care, materials and utilities were among the few sectors to post gains.

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MARCINKO & Associates, Inc.

WHAT WE DO AND HOW WE ASSIST MEDICAL COLLEAGUES

Hard Business – Financial Advice AND Personal Lifestyle Coaching

http://www.MARCINKOASSOCIATES.com

***

By Ann Miller RN MHA CMP™

At Marcinko & Associates our clients traditionally include physicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.

The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].

Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.

***

But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.

***

Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.

***

***

CONTACT US TODAYTHRIVE TOMORROW!

Suite #5901 Wilbanks Drive

Norcross, Georgia USA 30092-1141

email: MarcinkoAdvisors@msn.com

***

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THANKSGIVING TURKEY: How Long to Cook the Bird?

By Staff Reporters

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ORDER: 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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FAIR MARKET VALUATION DETERMINATION: Medical Practices or Clinics

MEDICAL PRACTICE OR AMBULATORY SURGERY CENTER

MARCINKO ASSOCIATES, Inc.

http://www.MARCINKOASSOCIATES.com

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FAIR MARKET VALUATION DETERMINATION

There are a Myriad of Reasons for Obtaining a Medical Practice Valuation and Appraisal Engagement:

  • Outright selling-buying
  • Partnership and Associate buy-in / buy-out
  • Mergers and Acquisitions
  • Organic growth tracking
  • Hospital integrations
  • Private and public reporting
  • Financing and Venture Capital
  • Estate and tax planning

Our Capability

We have the ability to provide extensive analysis of value components in healthcare practices and provide appraisals based on business, economic, and market conditions. This involves detailed examination of financials and clinical data in the context of numerous factors including medical specialty, physician supply and demand, payer mix, regulatory environment, regional dynamics, and risk premium.

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

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READ MORE: https://marcinkoassociates.com/welcome-medical-colleagues/

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DAILY UPDATE: Inflation Down but Old Navy and the Gap are Up as Altman Goes to Microsoft

By Staff Reporters

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News last week that inflation eased more than expected in October solidified the view that the Federal Reserve is done with its most aggressive rate-hike campaign in four decades. And that could be a boon for the stock market and your 401(k).

Over the last 10 rate hike cycles dating to 1974, the S&P 500 index rose an average 14.3% in the 12 months following the Fed’s final rate increase, according to an analysis by Ryan Detrick, chief market strategist at Carson Group.

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Stocks climbed to reach their third positive week in a row for the first time since summer, boosted by data showing inflation is on its way down. And, the Gap soared as the retailer reported strong sales last quarter at both Old Navy and its namesake stores.

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AMA: Calls Out Skinny Health Insurance Networks!

By Staff Reporters

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Patients aren’t the only ones voicing concerns over the state of the US health insurance industry. The American Medical Association’s (AMA) policy making arm just called for new oversight and standards that ensure health plans don’t improperly limit patient access to in-network care.

The AMA House of Delegates voted to establish and enforce health insurance network adequacy standards as it met in National Harbor, Maryland, this week. The body adopted the proposal—along with several others—as part of the AMA’s continued efforts to ensure health plans meet patient needs and are held accountable for narrow networks.

The association said inadequate networks can create difficulties for patients in need of new or continued care. They can further limit patient choice when it comes to who is able to treat them and where they can be treated.

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DAILY UPDATE: OpenAI’s Sam Altman Out – Maybe Not?

By Staff Reporters

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In a shocking move, the OpenAI’s board of directors pushed out CEO Sam Altman, one of the world’s most prominent tech executives. The company said that Altman “was not consistently candid in his communications with the board,” and thus the board lost its confidence in Altman’s ability to lead.

OpenAI, and Altman, became household names this year after the company’s ChatGPT chatbot sparked a frenzy around the field of generative artificial intelligence. OpenAI, which has received $13 billion in investment from Microsoft, is reportedly valued at $86 billion. CTO Mira Murati will keep the CEO seat warm for now.

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

Back In? https://arstechnica.com/information-technology/2023/11/breaking-sam-altman-reportedly-in-talks-for-potential-return-as-openai-ceo/

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HEALTH FRAUD: Abuse Control Program Annual Report

By Staff Reporters

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Healthcare Fraud and Abuse Control Program Annual Report Released

In Fiscal Year (FY) 2022, the Department of Justice (DOJ) opened more than 809 new criminal healthcare fraud investigations. Federal prosecutors filed criminal charges in over 419 cases involving at least 680 defendants. More than 477 defendants were convicted of healthcare fraud related crimes during the year. Also, in FY 2022, DOJ opened more than 774 new civil healthcare fraud investigations and had over 1,288 civil healthcare fraud matters pending at the end of the fiscal year. 

Federal Bureau of Investigation (FBI) investigative efforts resulted in over 499 operational disruptions of criminal fraud organizations and the dismantlement of the criminal hierarchy of more than 132 healthcare fraud criminal enterprises. In FY 2022, investigations conducted by HHS’s Office of Inspector General (HHS-OIG) resulted in 661 criminal actions against individuals or entities that engaged in crimes related to Medicare and Medicaid, and 726 civil actions, which include false claims, unjust-enrichment lawsuits filed in Federal district court, and civil monetary penalty (CMP) settlements. HHS-OIG excluded 2,332 individuals and entities from participation in Medicare, Medicaid, and other Federal healthcare programs.

Source: U.S. Department of Health and Human Services and U.S. Department of Justice

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What is the Stock Market DEATH CROSS?

Is A Market Downside Ahead?

By Staff Reporters

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What Is a Death Cross?

The death cross is a technical chart pattern indicating the potential for a major sell-off. The death cross appears on a chart when a stock’s short-term moving average crosses below its long-term moving average. Typically, the most common moving averages used in this pattern are the 50-day and 200-day moving averages.

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LINK: https://medicalexecutivepost.com/2022/02/09/what-is-a-bear-market-relief-rally/

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

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Summary:

  • The death cross is a bearish signal that’s issued when the short term moving average penetrates the falling long term moving average from above.
  • The most common settings for the averages are 50 and 200.
  • The death cross is a lagging indicator, which should be taken into consideration before relying on it for your own investments.

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DAILY UPDATE: The U.S. Stock Markets

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Here is where the major benchmarks ended on Friday:

  • The S&P 500 Index (SPX) was up 5.78 points (0.1%) at 4,514.02, up 2.2% for the week; the Dow Jones Industrial Average (DJI) was up 1.81 points at 34,947.28, up 1.9% for the week; the NASDAQ Composite was up 11.81 points (0.1%) at 14,125.48, up 2.4% for the week.
  • The 10-year Treasury note yield was down about 1 basis point at 4.439%.
  • CBOE’s Volatility Index (VIX) was down 0.54 at 13.78.

Retail shares were among Friday’s strongest sectors, helped by a nearly 30% surge by Gap (GPS) after the apparel company stronger-than-expected quarterly results. Energy companies were also higher thanks to a nearly 4% rise in WTI Crude Oil futures (/CL). Oil prices are still down 20% from a 2023 peak of more than $95 posted in late September.

In other markets, the U.S. dollar index dropped 1.8% for the week to touch its weakest level since September 1st, reflecting stepped-up expectations that interest rates have peaked.

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UNITEDHEALTHGROUP: Recent Pros and Cons of UNH

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

A class action lawsuit has been filed in Minnesota against UnitedHealth Group (NYSE:UNH) over allegations that the health insurer and its subsidiary, NaviHealth, used a faulty algorithm to deny rehabilitation care for Medicare Advantage beneficiaries. California-based Clarkson Law Firm filed the lawsuit in the U.S. District Court of Minnesota on Tuesday following an investigative report published by the health-focused news site Stat.

It alleges that UnitedHealth and its subsidiary, NaviHealth, used the computer algorithm named nH Predict to “systematically deny claims” of patients recovering from debilitating illnesses in nursing homes. According to the lawsuit, despite its 90% error rate, the company used the algorithm to deny claims, knowing that only 0.2% would appeal its decision. According to Stat, Humana (HUM), the nation’s second-largest player in the Medicare Advantage market behind UnitedHealth (UNH), also uses nH Predict. UnitedHealth (UNH) denied it used the NaviHealth predict tool to arrive at coverage decisions.

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Ironically, UnitedHealth’s (NYSE:UNH) Optum Rx unit announced Thursday plans to move eight insulin products to “preferred” status on formularies to further expand the number of patients benefiting from $35 or less monthly out-of-pocket costs for the lifesaving therapy.

Optum Rx, UNH’s pharmacy benefit manager (PBM), said that effective January 1, 2024, all short- and rapid-acting insulins will move to Tier 1 in commercial formularies, a list of drugs the company maintains to indicate coverage for insured patients.

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

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DAILY UPDATE: Mixed U.S. Stock Markets

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Over the course of the last few weeks, Cathie Wood of ARKK has been offloading the firm’s holdings in Roku, Inc. (NASDAQ:ROKU). Across all of her firm’s funds, Wood has sold stock in the streaming company totaling over $56 million. The move comes after Roku released its financials for q3. 

Here is where the major benchmarks ended:

  • The S&P 500 Index was up 5.36 points (0.1%) at 4,508.24; the Dow Jones Industrial Average was down 45.74 points (0.1%) at 34,945.47; the NASDAQ Composite was up 9.84 points (0.1%) at 14,113.67.
  • The 10-year Treasury note yield (TNX) was uabout 9 basis points at 4.445%.
  • Cboe’s Volatility Index (VIX) was up 0.14 at 14.32.

Walmart’s commentary weighed on the retail sector. Energy was also a laggard, as crude oil futures fell 5% to a four-month low of less than $73 a barrel, in part because record U.S. crude production has boosted supply.

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

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SEASONAL AFFECTIVE DISORDER: Doctors, FAs and the Winter Blues

SEASONAL AFFECTIVE DISORDER

Out … Like a Light!

DST: Daylight saving time, also known as daylight savings time or daylight time, and summer time, is the practice of advancing clocks during warmer months so that darkness falls at a later clock time.

BUT – Do you have trouble fitting daylight into your winter lifestyle? Or, have difficulty seeing medical patients, making hospital rounds, or serving consulting or financial advisory clients? Maybe it’s SAD?

But, how do you cope with the long dark, days of December and January?

To raise awareness of SAD, First Choice has brought together statistics from sources such as SADA, SAD.org.uk, Bupa and the Mood Disorders Society of Canada to create this new infographic.

In it you can find out how much daylight office workers receive year-round, as well as a collection of facts that can help you recognize and treat SAD. With December and the winter solstice drawing in we are certainly in for some short days in the coming weeks.

Conclusion           

And so, your thoughts and comments on this ME-P are appreciated. Regardless of occupation, how do you cope with SAD?

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

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DAILY UPDATE: Government Shutdown Averted as US Markets Extend their Gains

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Senate leaders voted Wednesday night in favor of the short-term government funding bill the House passed Tuesday night ahead of Friday’s shutdown deadline. House Speaker Mike Johnson pitched a two-step plan that he described as a “laddered CR” — or continuing resolution — that will keep the government funded at 2023 levels. The bill extends government funding until January 19th for the Veterans Affairs, Transportation, Housing and Urban Development and Energy departments, as well as for military construction. The rest of the government is funded until February 2nd, 2024.

Here is where the major benchmarks ended:

  • The S&P 500® Index (SPX) was up 7.18 points (0.2%) at 4,502.88; the Dow Jones Industrial Average was up 163.51 points (0.5%) at 34,991.21; the NASDAQ Composite was up 9.45 points (0.1%) at 14,103.84.
  • The 10-year Treasury note yield (TNX) was up about 10 basis points at 4.541%.
  • CBOE’s Volatility Index (VIX) was up 0.02 at 14.18.

Retail and financial shares were among Wednesday’s strongest performers. The KBW Regional Banking Index (KRX) rose 1.3% to a 2½-month high. Transportation and consumer staples were also higher. Energy shares were one of the few laggards as crude oil futures sank more than 2% after the Energy Department reported a larger-than-expected increase in U.S. crude inventories.

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

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NATIONAL: Nurse Practitioner Week

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Nurse Practitioner Week takes place annually in the second week of November to recognize these incredible healthcare providers and raise awareness of the powerful role they play in ensuring general health and well-being.

Can you believe that the nurse practitioner profession has been in existence for 56 years now? Nurse practitioners are highly educated and trained medical professionals who are almost like doctors. In addition to their fundamental roles as registered nurses, they can provide primary care, counseling, diagnosis, offer health education, and write prescriptions.

Want to become a nurse? Here are some nursing scholarships to help you.

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DAILY UPDATE: US Economic Prognostications as Stock Markets Surge

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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US Economic leaders are looking to the past for some inspiration on how to deal with the present—the only issue is, no one seems to be able to agree which past era they should be studying. But, predictions diverge, for example.

  1. Deutsche Bank believes the U.S. economy closely resembles the turbulent times of the 1970s, an outlook prompted by the war in Israel, oil shocks, and rampant inflation.
  2. Meanwhile economists at the White House say the inflationary period after World War II acts as a better guide because pent-up demand from the pandemic will eventually fade away.
  3. UBS disagrees with both, saying the 1990s more closely resembles the economic climate world leaders are currently attempting to navigate. A note from the UBS Chief Investment Office, led by Jason Draho, questioned whether the 2020s would act as “another roaring 20s” seen a century before. During this period, technological advances led to a rapid increase in productivity, while major industries like automotive, film and chemicals took off. The data suggests today’s economy has officially entered a new regime, UBS outlined: “A regime is defined by its growth, inflation, and rate attributes. These are all at their highest levels since prior to the global financial crisis (GFC).”

Here is where the major benchmarks ended:

  • The S&P 500 Index was up 84.15 points (1.9%) at 4,495.70; the Dow Jones Industrial Average (DJI) was up 489.83 points (1.4%) at 34,827.70; the NASDAQ Composite (COMP) was up 326.64 points (2.4%) at 14,094.38.
  • The 10-year Treasury note yield (TNX) was down about 18 basis points at 4.453%.
  • CBOE’s Volatility Index (VIX) was down 0.60 at 14.16.

The small-cap focused Russell 2000 Index (RUT), which has lagged large-cap benchmarks for most of the year, jumped more than 5% Tuesday. Small-caps are often seen as being more exposed to the economic cycle and had suffered because of concerns that high interest rates could push the economy into recession.

Other interest rate-sensitive sectors, such as real estate, materials, and utilities, also saw outsize gains.

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CASH AMERICANS: Stock Markets Up as We Spend Dollars

By Staff Reporters

SPONSOR: http://www.MARCINKOASSOCIATES.com

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The S&P 500 Index was up 84.15 points (1.9%) at 4,495.70; the Dow Jones Industrial Average (DJI) was up 489.83 points (1.4%) at 34,827.70; the NASDAQ Composite (COMP) was up 326.64 points (2.4%) at 14,094.38.

And, new data shows Americans have more cash sitting in the bank than they did before the COVID pandemic.

  • Americans have ~10%–15% more in their bank accounts than they did in 2019,  according to a JPMorgan Chase analysis of 9 million Chase customers’ checking and savings accounts.
  • Meanwhile, after lagging behind inflation for two years, wages are finally rising faster than prices. Last month, hourly wages were up 4%, while prices for consumer goods only climbed 3%.

Though Americans have more funds than they did before they had an opinion on the best brand of hand sanitizer, median account balances have dipped more than 41% from their peak in April 2021, when people collected stimulus checks with nowhere to go spend them, the Chase analysis shows. And people still want to shop—consumer sentiment spiked to an almost two-year high this month.

It helps explain why the recession that Wall Street kept warning us about hasn’t materialized, according to the Washington Post.

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PODCAST: How PBMs Work -OR- Don’t Work?

PRIOR AUTHORIZATION

By Eric Bricker MD

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DAILY UPDATE: McLaren Health Care and Mr Cooper Bank Experience Security Breach as Stocks are Mixed Ahead of Inflation Data

By Staff Reporters

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Michigan-based healthcare nonprofit McLaren Health Care notified more than 2 million people about a data breach exposing personal information on Thursday, according to a data breach notification report. Unauthorized access to McLaren systems began on July 28th and lasted through August 23rd before the company noticed it a week later on August 31st, according to a notice on the McLaren website.

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And, top US mortgage lender Mr Cooper has confirmed that “certain customer data” may have been exposed following a recent cyberattack. Precisely which data could have been exposed remains unconfirmed as the company continues to investigate “around the clock,” but affected customers are being promised complimentary credit monitoring services in due course.

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And so, here is where the major benchmarks ended today:

  • The S&P 500® Index (SPX) was down 3.69 points (0.1%) at 4,411.55; the Dow Jones Industrial Average was up 54.77 points (0.2%) at 34,337.87; the NASDAQ Composite (COMP) was down 30.36 points (0.2%) at 13,767.74.
  • The 10-year Treasury note yield was up about 1 basis point at 4.636%.
  • CBOE’s Volatility Index (VIX) was up 0.59 at 14.76.

Energy shares were among the strongest performers Monday, with an assist from stronger crude oil futures, which jumped for a second straight day but remain near 3½-month lows touched last week. Health care and consumer staples were also higher. Utilities led decliners, with the Dow Jones Utility Index (DJU) falling to its lowest level in over a week.

From a technical standpoint, chart patterns “remain in the bulls’ favor,” Nathan says, with the S&P 500 closing above 4,400 and its 100-day moving average (currently just above 4,402) for the second day in a row. He pegs key near-term resistance at roughly 4,500. That’s about where the index encountered resistance in late August and early September, with 4,600 a key intermediate hurdle for the bulls.

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CAREER: Executive Physician Coaching

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

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DAILY UPDATE: World Kindness Day 2023

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World Kindness Day, an international holiday that was formed in 1998, to promote kindness throughout the world and is observed annually on November 13th as part of the World Kindness Movement. It is observed in many countries including the United States, Canada, Japan, Australia and the U.A.E. World Kindness Day presents us with the opportunity to reflect upon one of the most important and unifying human principles. On a day devoted to the positive potential of both large and small acts of kindness, try to promote and diffuse this crucial quality that brings people of every kind together. 

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And, stocks markets are on a roll with almost too many trophies to hand out. The NASDAQ had its best day since May on Friday, while the S&P 500 has gained for nine of the last 10 sessions, rising 7.2% in that period. Falling bond yields have investors thinking the market is poised for a rally to close out 2023.

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What is Financial CARRIED INTEREST?

A TAX LOOPHOLE?

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Carried interest, or carry, in finance, is a share of the profits of an investment paid to the investment manager in excess of the amount that the manager contributes to the partnership, specifically in alternative investments (private equity and hedge funds).

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

In small businesses that are not blind pools, such as single property real estate, the investment manager often funds the business prior to the formation of the partnership. It is a performance fee, rewarding the manager for enhancing performance. The structure also takes advantage of favorable tax treatment in the United States.

However, critics of carried interest want it to be reclassified as ordinary income – not capital gains – to be taxed at the ordinary income tax rate. Private equity advocates argue that the increased tax will subdue the incentive to take the kind of risk that is necessary to invest in and manage companies to profitability.

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What is the carried interest tax loophole?

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TAXATION: https://www.taxpolicycenter.org/briefing-book/what-carried-interest-and-how-it-taxed

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