OPPS: Final Rule Issued by CMS

By Health Capital Consultants, LLC

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On November 1, 2024, CMS released its Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule for calendar year 2025. The rule finalizes payment updates, revises current programs, and establishes new standards to address the ongoing maternal health crisis.

This Health Capital Topics article discusses the key OPPS changes and updates included in the Final Rule. (Read more…)

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DAILY UPDATE: Anthem Health Insurance Cost Cutting as Markets Pause

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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Health insurance companies are under scrutiny for proposed changes to anesthesia billing policies, raising concerns about patient safety and fair compensation for medical professionals. Anthem, a major health insurer, recently announced a controversial policy limiting payments for anesthesia services in Connecticut, Missouri, and New York. The policy would only cover part of the documented anesthesia time during a patient’s surgery, a decision strongly opposed by the American Society of Anesthesiologists (ASA).

Breaking News: Anthem health insurance company is backing off of a controversial plan to limit coverage of anesthesia in at least one state, according to Connecticut’s comptroller.

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WEEKLY UPDATE: SCHEDULE

December 6: November nonfarm payrolls, University of Michigan preliminary December Consumer Sentiment.

December 9: October final wholesale inventories, November consumer inflation expectations, and expected earnings from Toll Brothers (TOL) and MongoDB (MDB).

December 10: Third quarter productivity and unit labor costs and expected earnings from AutoZone (AZO).

December 11: November Consumer Price Index and expected earnings from Adobe (ADBE).

December 12: November Producer Price Index and expected earnings from Broadcom (AVGO), Ciena (CIEN), and Costco (COST).

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  •  The SPX fell 11.38 points (–0.19%) to 6,075.11; the Dow Jones Industrial Average® ($DJI) lost 248.33 points (–0.55%) to 44,765.71; and the NASDAQ Composite® ($COMP) declined 34.85 points (–0.18%) to 19,700.26.
  • The 10-year Treasury note yield was unchanged at 4.18%. 
  • The CBOE Volatility Index® (VIX)inched up to 13.46.

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Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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INSURANCE: Long Term Care Economics

LTC

By Anonymous Insurance Agent

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Some retired people live on a fixed income and many of them live right on the edge of their financial capability.  At some time in their life, they may have to make a choice regarding many purchases.  In this case, we will illustrate “choice” using a couple’s purchase of Long-Term-Care Insurance [LTCI].

Of course, economics is the study of choice; wants, needs and scarcity, etc. In our case, if they decide to make the purchase they commit to a lifetime of premium payments. The financial tradeoff is this; if they make the commitment to purchase LTCI, they must give up something else.

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

Example: In order to maintain a monthly premium of $100 ($1,200per year), an elderly patient, retired layman or couple must essentially relegate about $30,000 of financial assets to generate the $100 necessary to make an average premium payment (assumes a 7% rate of return with 4% withdrawal rate) or [4% X $30,000 = $1,200 year]. Thus, if the monthly premium cost is $500 per month, the elder must give up the use of $150,000 of retirement asset just to generate enough cash flow to pay for the LTC insurance. 

The married elder couple has to make the decision among lifestyle (dinners, vacations, gifts to children, prescription drugs, medical care or food and shelter) versus paying an insurance premium to provide for nursing home coverage for a need, which may be very real, but will not occur until sometime in the ambiguous future. 

And so, when faced with such a tough economics, neither of which delivers peace of mind or a respectable solution; many will simply decide that, in either case, they may already end up impoverished. 

Thus, many will often opt for the better lifestyle now … while they can enjoy it … together. 

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COUNTDOWN: To End of Year BOI Reporting?

Beneficial Ownership Information

By Staff Reporters

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Small business owners face severe penalties if they don’t report to the federal government by year’s end. And, thousands of businesses may not realize they are subject to a new reporting process mandated under the Corporate Transparency Act, which went into effect in January 2024. Even lawyers, doctors, financial advisors and accountants are affected; along with “mom and pop”business owners.

For most eligible businesses, the filing deadline is Jan. 1, 2025, according to the U.S. Chamber of Commerce. “Those who fail to file by this deadline — or fail to update this information if needed — could face up to two years imprisonment and fines up to $10,000, in addition to civil penalties of up to $591 per day,” the U.S. Chamber of Commerce website reads.

Businesses that meet the reporting criteria must submit a Beneficial Ownership Information Report to the U.S. Department of Treasury’s Financial Crimes Enforcement Network (FinCEN), according to the U.S. Chamber of Commerce.

The law was created “to combat illicit activity including tax fraud, money laundering and financing for terrorism by capturing more ownership information for specific U.S. businesses operating in or accessing the country’s market,” the chamber website explained.

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BREAKING NEWS

A federal court has ruled that the beneficial ownership information (BOI) reporting requirements established by the Corporate Transparency Act (CTA) are unconstitutional123. The decision is currently under appeal1.

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MENTALITY: Mob and Herd … and More!

By Staff Reporters

MODERN DAY SOCIAL INFLUENCERS

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Mob Mentality can occur in unfamiliar groups, social cues disappear, and behavior becomes influenced by the crowd. Mob mentality shows how people sometimes act in ways they wouldn’t alone, following the group’s lead. According to colleague Dan Ariely PhD, this effect can create a loss of personal accountability, leading to behavior that may not align with personal values.

Herd mentality is the tendency for people’s behavior or beliefs to conform to those of the group they belong to. The concept of herd mentality has been studied and analyzed from different perspectives, including biology, psychology and sociology. This psychological phenomenon can have profound impacts on human behavior.

QUESTION: What about social media sites and modern influencers today! So-called celebrity endorsements and political elections, too?

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IRS FORM 1099-K: Changes and Implementation?

By Staff Reporters

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2024 LATE YEAR UPDATE

Who sends Form 1099-K?

Payment card companies, payment apps and online marketplaces are required to fill out Form 1099-K and send it to the IRS each year. They must also send a copy to you by January 31st. 2025

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

Who gets Form 1099-K:

You should get Form 1099-K for these situations:

1. If you take direct payment by credit or bank card for selling goods or providing services

If your customers or clients pay you directly by credit, debit or gift card, you’ll get a Form 1099-K from your payment processor or payment settlement entity, no matter how many payments you got or how much they were for.

Find what to do with Form 1099-K.

2. If you used a payment app or online marketplace and received a Form 1099-K

A payment app or online marketplace is required to send you a Form 1099-K if the payments you received for goods or services total over $5,000. However, they can send you a Form 1099-K with lower amounts. Whether or not you receive a Form 1099-K, you must still report any income on your tax return.

This includes payments for any:

  • Goods you sell, including personal items such as clothing or furniture
  • Services you provide
  • Property you rent

The payments can be made through any:

  • Payment app
  • Online community marketplace
  • Craft or maker marketplace
  • Auction site
  • Car sharing or ride-hailing platform
  • Ticket exchange or resale site
  • Crowdfunding platform
  • Freelance marketplace 

If you accept payments on different platforms, you could get more than one Form 1099-K.

Personal payments from family and friends should not be reported on Form 1099-K because they are not payments for goods or services.

Find what to do with Form 1099-K.

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PODIATRY PREP: Pass All Your Board Certification Examinations

Celebrating Your Success!

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Pass ALL the Certification Boards!

By: http://www.PodiatryPrep.org

The Foot and Ankle Research Consortium, Inc. (FARC) is the leading publisher of Podiatric educational software. Since 1992, we have been producing the most effective and innovative method of preparing for ALL the Podiatry Board Examinations.

CURIOUS STUDY: Hallux Valgus Met I

SCARF: scarf osteotomy

This includes: The American Board of Podiatric Surgery, The American Board Of Podiatric Orthopedics and Primary Podiatric Medicine, the American Podiatric Medical Specialties Board, ABLES and the PMLexis. (Now includes the latest information for all Board Re-Certifications).

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RIP: Dr. Kelly Powers MS [Fox News Medical Contributor]

BREAKING NEWS!

“Rest-in-Peace”

Dr. Kelly Powers, a podiatric surgeon and Fox News medical contributor, died Sunday from a remission of brain cancer. She was 45. A a regular commentator on Fox News and Fox Business Network, Powers survived heart failure—symptoms of which she experienced on air while covering that very topic. “It’s crazy–I went into heart failure while doing a report on Fox Business–live–on heart health and talking about the subtle signs that women often miss.

You can’t make this up,” she told Preferred Health Magazine after she had also faced a bout with glioblastoma, which was detected in 2020. After several surgeries, Powers underwent chemotherapy and radiation, and eventually recovered. During that time, she became pregnant and had her now three-year-old son. That cancer returned this year, however. “She was a brave and beautiful soul who could make friends anywhere she went,” an obituary reads. “Kelly had a love for people and she was dedicated to helping others.”

Powers leaves behind her husband, Steven Doll, and son Bennett.

Read more at The Daily Beast.

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MPFS Final Rule Cuts Physician Payments [Will it Last?]

By Health Capital Consultants, LLC

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On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released its finalized Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025, aiming “to strengthen primary care, expand access to preventive services, and further access to whole-person care.” While the finalized fee schedule cuts payments to physicians, Congress is considering legislation to override the cut.

This Health Capital Topics article discusses the provisions contained in the MPFS final rule, as well as the proposed “doc fix” legislation. (Read more…)

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DAILY UPDATE: Retail Pharmacies Down as the Stock Market Rally Stall Out

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Rite Aid filed for bankruptcy last October, and CVS and Walgreens reported steep losses over 2024.

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

STOCKS UP

  • AT&T climbed 4.58% thanks to a few big announcements during its investor day, including returning over $40 billion to shareholders via dividends and stock buybacks over the next three years.
  • Palantir popped 6.88% after the US government gave the cybersecurity darling the green light to let its cloud offerings handle classified data. It also helped that Barrons expects the company will be added to the Nasdaq 100 in 2025.
  • Speaking of Palantir, BigBear.ai soared 28.64% after the server company was touted as the next Palantir by the Economic Times.
  • Data center company Credo Technology Group skyrocketed 47.89% thanks to an impressive earnings report and a glowing fiscal forecast.

STOCKS DOWN

  • US Steel dropped 8.01% on President-elect Trump’s declaration that he will block the company’s acquisition by Nippon Steel.
  • Tesla sank 1.59% after a Delaware judge once again blocked Elon Musk’s $56 billion pay package. The case will go back to court yet again, and may eventually reach the Supreme Court.
  • Intel tumbled another 6.10% two days after CEO Pat Gelsinger was fired happily decided to retire.
  • The children aren’t alright: Children’s Place crashed 24.15% after the children’s clothing retailer announced its turnaround isn’t going so well.
  • South Korean stocks took a beating after the country’s president declared martial law. The country’s largest online retailer, Coupang, sank 3.74%, steel manufacturer Posco Holdings dropped 4.32%, and Samsung tumbled 3.71%.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  •  The S&P 500® index (SPX) rose 2.73 points (0.05%) to 6,049.88; the Dow Jones Industrial Average® ($DJI) fell 76.47 points (–0.17%) to 44,705.53; and the NASDAQ Composite® ($COMP) added 76.96 points (0.40%) to 19,480.91.
  • The 10-year Treasury note yield added three basis points to 4.22% after falling below 4.17% at one point.
  • The CBOE Volatility Index® (VIX)held steady at 13.39.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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TRAVEL: Deals on Tuesday

DEFINED

By Staff Reporters

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Travel Tuesday, also known as Travel Deal Tuesday, is a marketing term for e-commerce transactions occurring on the Tuesday after Thanksgiving in the UJSA. It originated in 2017, when Hooper, an online flight marketplace, realized that the Tuesday after Thanksgiving was profitable for consumers to book flights. It is mainly a United States-based phenomenon. However, some overseas companies do recognize the holiday.

History

In 2017, Hopper, an online flight marketplace, created Travel Tuesday after realizing that in the post-Thanksgiving shopping period, the Tuesday after Thanksgiving was the most profitable time for consumers to book flights. Since then, major airline providers such as Orbitz, Travelocity and and Cheap Tickets have recognized the holiday. However, outside the United States, the holiday is rarely celebrated.

Impact

In 2018, Hopper stated that for them, the day offered the highest airfare sales in 2017, also noting that compared to Cyber Monday and Black Friday, fares were somewhat cheaper. In 2022, flight sales because of Travel Tuesday were thrice as much compared to the sales in the rest of the post-Thanksgiving period.

Note: From Wikipedia, the free encyclopedia

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BOND YIELDS: Real and Negative Returns

DEFINITIONS

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Real Bond Yield: For most bonds and other fixed-income securities, real yield is simply the yield you see listed online or in newspapers minus the premium added to help counteract the effects of inflation. Most “nominal” fixed-income yields include an “inflation premium” that is typically priced into the yields to help offset the effects of inflation.

Real yields, such as those for TIPS, don’t have the inflation premium. As a result, TIPS yields and other real yields are typically lower than most nominal yields

Negative Bond Yield: In a normal bond market environment, bond yields are positive, and bond issuers (including governments) make interest payments to investors who lend them money.

In an abnormal, or negative-yield environment, investors essentially pay the bond issuer to hold their money.

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

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CYBER SALES WEEK [Is is a Real Thing?]

By Staff Reporters

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Cyber Week Defined

As first reported in the Forbes “Entrepreneurs” column on December 3rd, 2013: “Cyber Monday, the online counterpart to Black Friday, has been gaining unprecedented popularity – to the point where Cyber Sales are continuing on throughout the week.”

In fact, Peter Greenberg, Travel Editor for CBS News, further advises: “If you want a real deal on Black Friday, stay away from the mall. Black Friday and Cyber Monday are all part of Cyber Sales Week 

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

And so, Cyber Monday isn’t over yet for this year 2024: It’s morphed into Cyber Week, the actual final iteration of sales during the Black Friday-Cyber Monday discount season of 2024. A substantial number of retailers are maintaining their Black Friday-level discounts through today and some through tomorrow and the entire week.

Yes-Cyber Week is a real thing, so got for it. Buy it! Charge it!

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DAILY UPDATE: Intel CEO Out, Stellantis CEO Down and Mega Caps Up!

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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The CEO Intel has been forced out after failing to return the American microchip company to the cutting edge, despite promises of billions from Joe Biden’s administration. Pat Gelsinger, who joined the Silicon Valley icon 45 years ago, said he had retired with immediate effect, three years after returning to the company with a pledge to resurrect US leadership in microchip technology.

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

STOCKS UP

  • Super Micro Computer has been declared innocent of financial wrongdoing by…Super Micro Computer. Shares popped 26.86% on news that the company’s internal investigation revealed nothing wrong with its finances.
  • Gap continues its hot streak, rising 6.45% today thanks to an upgrade from JPMorgan analysts who think the retailer could gain another 20% from here.
  • Dana isn’t just the name of your favorite dental hygiene technician—it’s also an auto parts manufacturer that received an upgrade from Barclays analysts today. Shares gained 13.30%.
  • XPeng announced record car deliveries last month. Shares of the Chinese automaker jumped 5.31%.

STOCKS DOWN

  • Archer Aviation is a company that makes flying taxis. If that doesn’t sound like a good investment, a lot of investors would agree: Short interest is mounting, pushing shares down 23.72% today. Competitor Joby Aviation dropped 9.39% as well.
  • Upstart Holdings sank 14.47% after the AI-powered lending company received a downgrade from JPMorgan analysts. LendingClub was downgraded as well, and fell 4.93%.
  • Not all Chinese automakers had a great Monday: Li Auto fell 3.72% after announcing car deliveries dropped 5.25% month over month.

CITE: https://tinyurl.com/2h47urt5

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 14.77 points (0.24%) to 6,047.15; the Dow Jones Industrial Average® ($DJI) fell 128.65 points (–0.29%) to 44,782.00; and the NASDAQ Composite® ($COMP) added 185.78 points (0.97%) to 19,403.95.
  • The 10-year Treasury note yield added two basis points to 4.20%. 
  • The CBOE Volatility Index® (VIX)eased to 13.44.

CITE: https://tinyurl.com/tj8smmes

Chrysler-parent Stellantis said CEO Carlos Tavares is stepping down, effective immediately, after the automaker’s sales and profit sharply declined this year. Shares dropped about 7% in Monday trading. Stellantis’s shares have fallen more than 40% this year. The company said Sunday that it wasn’t changing the financial guidance that it gave in October.

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“FREE STUFF”: Powerfully Irrational

BEWARE THE PSYCHOLOGY OF HOLIDAY SHOPPING!

[Online -OR- Onground]

By Staff Reporters

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Power of Free

Who doesn’t love free stuff? The word “free” is like a magic spell that makes our rational minds go on vacation.

According to colleague Dan Ariely PhD, the power of free compels us to grab things we don’t need and make questionable choices. Why buy one and get one free when you can get two for the price of one? It’s the same deal, but free feels better.

IOW: Like other heuristics, the Power of Free is a mental shortcut that allows us to bypass rational thought and save effort to make quick decisions. Studies of the Power of Free have shown it to be closely linked to the Affect Heuristic. Specifically, it is linked to emotional and social thinking rather than transactional thinking. People become influenced by emotion and obligated to socially acceptable behaviors.

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

For example, say, a yoga studio charges extra to use their mats. This leads more people to pay the fee and use their mats for convenience. Then, say, the same yoga studio removed the extra fee more people would bring their mats from home instead of feeling guilty about borrowing one for class.

Removing a dollar value increases its inherent value and makes it more desirable. The type of product matters too. People are more likely to opt for a free product that is fun rather than functional. This is because emotion is more powerful than rational thinking under the influence of the Power of Free.

In another example, people are more likely to say “yes” to a free piece of cake or sample size of perfume than furniture polish or a bag of white flour.

So, next time you find yourself going to a free financial planning or retirement seminar with free dinner, or a free medical screening test, or free stock market portfolio review, just blame it on the irresistible and irrational power of free.

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PRESIDENT: Pardons Son Robert Hunter Biden

BREAKING NEWS!

By Staff Reporters

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President Joe Biden has just pardoned his son, Hunter Biden, who was convicted on federal gun charges and was due for sentencing in December, 2023.

Despite the White House’s assurances last month that the president had no intentions of pardoning his son, the announcement came through on Sunday evening that he had pardoned him.

READ: https://tinyurl.com/2hdpwrzj

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DAILY UPDATE: S&P 500, Gold, Treasury Yields and Bitcoin

By Staff Reporters

BREAKING NEWS: President Joe Biden just pardoned his son,Hunter Biden, sparing the younger Biden a possible prison sentence for federal felony gun and tax convictions and reversing his past promises not to use the extraordinary powers of the presidency for the benefit of his family members.

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  • The short trading session didn’t stop the S&P 500 from hitting another new record today, and the S&P 500 and the Dow each wrapped up their best month of 2024 on a high note.
  • Meanwhile, November was the worst month for gold in over a year. Safe-haven investors sold the commodity while the US dollar soared following the election.
  • 10-year Treasury yields dropped to their lowest level in a month today as bond buyers bought in bulk.
  • Finally, bitcoin had one heck of a month. The crypto rose yet again today, and has climbed nearly 40% in November—though it has yet to break above $100,000.

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GOAL GRADIENTS: Motivational Theories

By Staff Reporters

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The Goal Gradient effect is the phenomenon where people accelerate their efforts as they approach a goal. It’s like a runner sprinting to the finish line.

According to colleague Dan Ariely PhD, our motivation peaks when we see the goal within reach, driving us to work harder and faster. Marketers use this by showing progress bars and loyalty rewards. Knowing about the goal gradient can help us set milestones and maintain motivation throughout our tasks.

So, break your big goals into smaller ones and watch your productivity soar as you get closer to each milestone.

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ECONOMIC PARADOXES: Prosperity, Thrift, Toil, Value and Productivity

AUSTRIAN SCHOOL OF ECONOMICS

By Staff Reporters

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A Paradox is a logical self-contradictory statement or a statement that runs contrary to one’s expectation. It is a statement that, despite apparently valid reasoning from true or apparently true premises, leads to a seemingly self-contradictory or a logically unacceptable conclusion. A paradox usually involves contradictory-yet-interrelated elements that exist simultaneously and persist over time. They result in “persistent contradiction between interdependent elements” leading to a lasting “unity of opposites”.

Here are five economic paradoxes from the Austrian School of Economics.

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Prosperity: Why do generations that significantly improve the economic climate seem to generally rear a successor generation that consumes rather than produces?

Thrift: If everyone saves more money during times of recession, then aggregate demand will fall and will in turn lower total savings in the population.

Toil: If everyone tries to work during times of recession, lower wages will reduce prices, leading to more deflationary expectations, leading to further thrift, reducing demand and thereby reducing employment.

Value: [also known as Diamond-Water Paradox]: Water is more useful than diamonds, yet is a lot cheaper.

Productivity: [also known as Solow Computer Paradox]: Worker productivity may go down, despite technological improvements.

Note: The Austrian School of Economics promotes an economic and social thinking that is not trapped in unrealistic, mostly mathematical models. It does not see the economy as an object of state political regulation and central, almost engineering-like control. Rather, its analysis focuses on autonomous entrepreneurial action and the free interaction of individuals in the marketplace, which eludes both the logic of differential equations, and centrally planned political control.

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Record-Breaking Savings for ACOs in 2023

ACCOUNTABLE CARE ORGANIZATIONS

By Health Capital Consultants, LLC

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On October 29, 2024, CMS announced Performance Year (PY) 2023 results for accountable care organizations (ACOs) participating its Medicare Shared Savings Program (MSSP). Notably, MSSP ACOs garnered the largest net savings in MSSP’s history – more than $2.1 billion.

This Health Capital Topics article discusses MSSP performance in 2023 and how this may inform value-based care going forward. (Read more…) 

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