DAILY UPDATE: Semaglutide Drugs, CMS, Emory & UnitedHealthcare as Stock Markets Rise High

Posted on November 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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

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In breaking news, the Biden administration is attempting to cover anti-obesity drugs for weight loss under Medicare and Medicaid. A recent study finds 137 million people are eligible for semaglutide drugs nationwide.

Another insurer can claim victory against CMS after UnitedHealthcare prevailed in its star ratings lawsuit on Friday. The feds will now have to recalculate the scores.

And ... Emory Healthcare is looking to expand value-based care for more than 350,000 patients through a population health partnership with tech company Guidehealth.

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

STOCKS UP

Uncrustables taste almost as good as today’s gains: J.M. Smucker rose 5.70% thanks to a beat-and-raise quarter for the company.

  • Walmart gained 2.02% on a report that Target is losing its high-end customers to the low-price retailer. Target sank 3.03%.
  • Semiconductor stock Semtech rose another 18.10% after announcing stronger-than-expected earnings last night.

STOCKS DOWN

  • Amgen’s new drug did help patients lose up to 20% of their weight in a given year, but that wasn’t enough to impress shareholders, who kicked shares down 4.76%.
  • Kohl’s plummeted 17.01% after the retailer met revenue expectations but missed on earnings last quarter. It definitely doesn’t help that the CEO announced his retirement last night.
  • Abercrombie & Fitch’s turnaround is well underway, and the company beat earnings forecasts last quarter and projected strong holiday sales. But it still fell short of shareholder expectations, and the stock sank 5.10% today.
  • Best Buy rounded out retailer earnings today, dropping 4.89% after missing revenue expectations last quarter and cutting its full-year guidance.
  • Zoom Communications changed its name, but that wasn’t enough to save the company from a 6.31% decline today thanks to its tepid fiscal outlook.

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

Here’s where the major benchmarks ended:

  •  The S&P 500® index (SPX)rose 34.26 points (0.57%) to 6,021.63; the Dow Jones Industrial Average® ($DJI) added 123.74 points (0.28%) to 44,860.31; and the NASDAQ Composite® ($COMP) gained 119.46 points (0.63%) to 19,174.30.
  • The 10-year Treasury note yield climbed four basis points to 4.3% after Trump’s tariff comments, but shorter-term yields fell after the Fed minutes, keeping the yield curve slightly out of inversion.
  • The CBOE Volatility Index® (VIX)dropped to 14.19, near a two-week low.

CITE: https://tinyurl.com/tj8smmes

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

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CONVERSATIONAL “Switch Tracking” Ad Argumentum

Posted on November 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Switch Tracking is the art of changing the focus of an argument or conversation to another topic. It’s like sleight of hand for your words. When the discussion gets uncomfortable, switching tracks can divert attention and defuse tension. Politicians are masters of this, skillfully shifting topics to avoid tough questions.

According to psychologist and colleague Dan Ariely PhD, while it can be a useful tactic, be aware when it’s being used on you. Stay focused on the main issue, and don’t let switch tracking derail your conversation.

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FIXED FINANCIAL SPREADS FOR PHYSICIANS: Duration, Sectors, Widening, Tightening and Other Fixed Income Strategies

Posted on November 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITIONS FOR PHYSICIANS

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Spread duration is a risk measure, expressed in years, that estimates the price sensitivity of a fixed income investment to a 100 basis point change in credit spreads relative to similar-maturity Treasuries.

Spread sectors (aka “spread products,” “spread securities”) in fixed income parlance, are typically non-Treasury securities that usually trade in the fixed income markets at higher yields than same-maturity U.S. Treasury securities. The yield difference between Treasuries and non-Treasuries is called the “spread”), hence the name “spread sectors” for non-Treasuries.

These sectors–such as corporate-issued securities and mortgage-backed securities (MBS–typically trade at higher yields (spreads) than Treasuries because they usually have relatively lower credit quality and more credit / default risk and / or they have more prepayment risk.

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

Spread widening, tightening are changes in spreads that reflect changes in relative value, with “spread widening” usually indicating relative price depreciation and “spread tightening” indicating relative price appreciation.

Spreads (aka “interest-rate spreads”, “maturity spreads,” “yield spreads” or “credit spreads”)

In fixed income parlance, spreads are simply measured differences or gaps that exists between two interest rates or yields that are being compared with each other. Spreads typically exist and are measured between fixed income securities of the same credit quality, but different maturities, or of the same maturity, but different credit quality.

Changes in spreads typically reflect changes in relative value, with “spread widening” usually indicating relative price depreciation of the securities whose yields are increasing most, and “spread tightening” indicating relative price appreciation of the securities whose yields are declining most (or remaining relatively fixed while other yields are rising to meet them). Value-oriented investors typically seek to buy when spreads are relatively wide and sell after spreads tighten.

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


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DAILY UPDATE: Health Insurance Affordability as Stock Markets Broadly Rise

Posted on November 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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“

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The Commonwealth Fund’s 2024 biennial health insurance survey, released November 21, found that though 79% of US adults had continuous health insurance for 12 months, 23% were under insured, meaning they have health insurance and still can’t afford care. About 56% of those surveyed had adequate insurance coverage all year.

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

STOCKS UP

  • Rocket Lab rocketed (sorry) 3.44% to a new record high after launching not one, but two different rockets in two different hemispheres in a single day.
  • Bath & Body Works soared 16.51% on a strong beat-and-raise quarter.
  • Robinhood jumped 3.27% after Morgan Stanley analysts doubled their price target for the investing app.
  • Super Micro Computer surged yet another 15.87%, more than doubling in the last seven days, and shareholders cheered its comeback.
  • Hims & Hers Health climbed 23.77% on the news that the new head of the FDA may be an ally.
  • Flying taxi company Vertical Aerospace popped 45.51% after announcing an additional $50 million in funding from one of its biggest shareholders.

STOCKS DOWN

  • Defense contractor stocks got a double whammy today: Hopes of a ceasefire between Israel and Hezbollah, combined with Elon Musk’s declaration on X that buying manned military aircraft is wasteful. Lockheed Martin fell 3.76%, Northrop Grumman dropped 2.39%, and Raytheon Technologies parent company RTX Corp. fell 1.74%.
  • Speaking of Musk, Tesla sank 3.96% after California announced it may exclude the automaker from incentives that encourage drivers to buy EVs in the state.
  • Pipeline operator Oneok lost 4.72% on the news that it will acquire the remaining portion of EnLink Midstream that it doesn’t already own.
  • After rallying last week thanks to its inclusion in the S&P 500, Texas Pacific Land sank 6.71% today as investors took profits.

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

Here’s where the major benchmarks ended:

  •  The SPX rose 18.03 points (0.30%) to 5,987.37; the $DJI added 440.06 points (0.99%) to 44,736.57; and the NASDAQ Composite® ($COMP) gained 51.18 points (0.27%) to 19,054.84.
  • The 10-year Treasury note yield fell 15 basis points to 4.27%.
  • The CBOE Volatility Index® (VIX)dropped to 14.74, the lowest since November 14.

CITE: https://tinyurl.com/tj8smmes

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

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ILLUSORY: Correlation

Posted on November 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

CORRELATION IS NOT CAUSATION

By Staff Reporters

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According to colleague Dan Ariely PhD, Illusory Correlation is the perception of a relationship between variables when none exists. It’s like thinking that carrying an umbrella causes it to rain. Our brains are pattern-seeking machines, often connecting dots that aren’t actually connected. This bias can lead to superstitions and incorrect beliefs.

The illusory correlation occurs when someone believes that there is a relationship between two people, events, or behaviors, even though there is no logical way to connect them. The illusory correlation fools us into believing stereotypes, superstitions, old wives’ tales, and other silly ideas. Sometimes, the perceived connection between two events is harmless. It’s silly to think that a certain number always brings you luck. But forming these connections is completely normal. To avoid illusory correlations, rely on data and evidence rather than anecdotal observations.

So always remember: correlation does not imply causation, no matter how convincing it seems.

More: https://medicalexecutivepost.com/2024/06/05/correlation-is-not-causation/

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Valuation of Hospitals [Technological Environment]

Posted on November 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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Technological advancements have accelerated the shift of healthcare services from inpatient to outpatient settings, creating both opportunities and challenges for hospitals. For instance, minimally invasive procedures often serve as alternatives to traditional, more invasive surgeries. Additionally, the integration of telehealth and artificial intelligence (AI) has the potential to enhance access to and quality of care while reducing expenditures and administrative burdens.

This final installment of a five-part series on the valuation of hospitals examines the technological advancements transforming the industry. (Read more…) 

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DAILY UPDATE: Morningstar, Amazon Anthropic and Private Equity Banks

Posted on November 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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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Amazon invests $4 billion more in Anthropic. The deal marks the second time in a year that Amazon has earmarked $4 billion for Anthropic as it seeks to keep pace with its main rival, OpenAI, which raised $6.6 billion in October.

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

Morningstar Inc. has announced a change to the methodology for its Morningstar Medalist Rating system that it says provides a more precise assessment of investment alpha. The change, which will take effect on October 29th, will alter the medalist ratings of about 20% of the 200,000 funds Morningstar has rated, with most of those changes downgrades. For example, Morningstar expects around 40% of funds currently assigned Bronze ratings globally will be assigned Neutral ratings after the change.

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

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SOCIAL COMPARISON THEORY: Downward and Upward

Posted on November 24, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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According to some studies, as much as 10 percent of our thoughts involve comparisons of some kind. Social comparison theory is the idea that individuals determine their own social and personal worth based on how they stack up against others. The theory was developed in 1954 by psychologist Leon Festinger. Later research has shown that people who regularly compare themselves to others may find motivation to improve, but may also experience feelings of deep dissatisfaction, guilt or remorse, and engage in destructive behaviors like lying or disordered eating.

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Downward Comparison is the act of comparing oneself to others who are worse off to feel better about one’s situation. It’s like looking at someone else’s messy desk to feel better about your clutter.

On the other hand, Upward Comparison is the act of comparing oneself to others who are better off to feel bad about one’s situation. It’s like looking at someone else’s neat desk and feel worse about your own clutter.

Finally, according to Dan Ariely PhD, these coping mechanisms boosts self-esteem or depress us with a sense of relief or dread. While helpful in moderation, relying too much on upward or downward comparisons can help hinder personal growth and/or depress growth or empathy; etc.

So, them sparingly and remember: upward comparisons can inspire you to improve and strive for better; while downward comparisons have the opposite effects.

MORE: https://www.verywellmind.com/what-is-the-social-comparison-process-2795872

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CONTRAST EFFECT: Cognitive Bias

Posted on November 24, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

FOR FINANCIAL ADVISORS

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Sensation, emotion and cognition work by Contrast Effect [cognitive bias]. 

Now, such perception is not only on an absolute scale, it also functions relative to prior stimuli.  This is why room temperature water feels hot when experienced after being exposed to the cold.  It is also why the cessation of negative emotions “feels” so good. 

Cognitive bias functioning also works on this principle.  So one’s ability to analyze information and draw conclusions is very much related to the context with in which the analysis takes place, and to what information was originally available.  This is why it is so important to manage one’s own expectations as well as those of a financial advisor’s or stock broker’s clients. 

For example, a client is much more likely to be satisfied with a 10% portfolio return if they were expecting 7% than if they were hoping for 15%.

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BID/ASK SPREAD: Basis Points with Formulas

Posted on November 24, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

DEFINITIONS

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Basis Points are used in financial literature to express values that are carried out to two decimal places (hundredths of a percentage point), particularly ratios, such as yields, fees, and returns. Basis points describe values that are typically on the right side of the decimal point–one basis point equals one one-hundredth of a percentage point (0.01%). So 25 basis points equals 0.25%, and 50 basis points equals 0.50%.

Only when basis points equal or exceed 100 does the value move to the left of the decimal point–100 basis points equals 1.00%, 500 basis points equals 5.00%, etc.

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

Bid/Ask Spread (also known as bid/offer spread) is the difference between the National Best Bid and the National Best Offer, which represents the implied cost to trade a security.

As compensation for the risk taken, the market maker (or dealer) earns the bid/offer spread in exchange for facilitating the trade. Wider spreads generally indicate higher costs associated with trading the underlying assets in the ETF, hedging costs, inventory management costs, and general market risk.

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

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PHYSICIAN FINANCIAL FEAR: Money Anxiety & Chrometophobia

Posted on November 24, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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If you’ve found yourself worrying about the stock market or money lately, you definitely have company. Money anxiety, also called financial anxiety, has become more common than ever after the presidential election of November 2024.

In fact, the American Psychological Association’s 2022 Stress in America Survey, 87 percent of people who responded listed inflation as a source of significant stress. The rise in prices for everything from fuel to food has people from all backgrounds worried, today. The researchers say, in fact, that no other issue has caused this much stress since the survey began in 2007.

When money and financial concerns cause ongoing stress in your life, you could eventually begin to experience some feelings of anxiety as a result. This anxiety can, in turn, have a negative impact on your quality of life.

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Chrometophobia, commonly known as fear of money, is a psychological condition characterized by overwhelming anxiety and avoidance of currency; according to colleague Dan Ariely PhD.

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

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Physician Financial Fear is probably the most common emotion among physicians. The fear of being wrong – as well as the fear of being correct! It can be debilitating, as in the corollary expression on fear: the paralysis of analysis.

According to Paul Karasik, there are four common investor and physician fears, which can be addressed by financial advisors and psychologists in the following manner:

  • Fear of making the wrong decision: ameliorated by being a teacher and educator.
  • Fear of change: ameliorated by providing an agenda, outline and/or plan.
  • Fear of giving up control: ameliorated by asking for permission and agreement.
  • Fear of losing self-esteem: ameliorated by serving the client first and communicating that sentiment in a positive manner.

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Some Retirement Statistics and Questions for Physicians

Posted on November 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Transitioning to the End of Your Medical Career

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 BY DR. DAVID EDWARD MARCINKO MBA MEd CMP®

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With the PP-ACA, increased compliance regulations and higher tax rates impending from the Biden administration – not to mention the corona pandemic, venture capital based healthcare corporations and telehealth – physicians are more concerned about their retirement and retirement planning than ever before; and with good reason. After payroll taxes, dividend taxes, limited itemized deductions, the new 3.8% surtax on net investment income and an extra 0.9% Medicare tax, for every dollar earned by a high earning physician, almost 50 cents can go to taxes!

Introduction

Retirement planning is not about cherry picking the best stocks, ETFs or mutual funds or how to beat the short term fluctuations in the market. It’s a disciplined long term strategy based on scientific evidence and a prudent process. You increase the probability of success by following this process and monitoring on a regular basis to make sure you are on track.

General Surveys

According to a survey from the Employee Benefit Research Institute [EBRI] and Greenwald & Associates; nearly half of workers without a retirement plan were not at all confident in their financial security, compared to 11 percent for those who participated in a plan, according to the 2014 Retirement Confidence Survey (RCS).

In addition, 35 percent of workers have not saved any money for retirement, while only 57 percent are actively saving for retirement. Thirty-six percent of workers said the total value of their savings and investments—not including the value of their home and defined benefit plan—was less than $1,000, up from 29 percent in the 2013 survey. But, when adjusted for those without a formal retirement plan, 73 percent have saved less than $1,000.

Debt is also a concern, with 20 percent of workers saying they have a major problem with debt. Thirty-eight percent indicate they have a minor problem with debt. And, only 44 percent of workers said they or their spouse have tried to calculate how much money they’ll need to save for retirement. But, those who have done the calculation tend to save more.

The biggest shift in the 24 years has been the number of workers who plan to work later in life. In 1991, 84 percent of workers indicated they plan to retire by age 65, versus only 9 percent who planned to work until at least age 70. In 2014, 50 percent plan on retiring by age 65; with 22 percent planning to work until they reach 70.

Physician Statistics

Now, compare and contrast the above to these statistics according to a 2018 survey of physicians on financial preparedness by American Medical Association [AMA] Insurance. The statistics are still alarming:

  • The top personal financial concern for all physicians is having enough money to retire.
  • Only 6% of physicians consider themselves ahead of schedule in retirement preparedness.
  • Nearly half feel they were behind
  • 41% of physicians average less than $500,000 in retirement savings.
  • Nearly 70% of physicians don’t have a long term care plan.
  • Only half of US physicians have a completed estate plan including an updated will and Medical directives.

Retired MD Doctor Retirement Gift Idea Retiring - Doctor ...

Thoughts to Ponder

And so, to help make your golden years comfortable and worry free, here are ten important retirement questions for all physicians to consider:

  1. How much money do you need to retire?
  2. What is your retirement cash flow?
  3. What is your retirement vision?
  4. How to stay on retirement track?
  5. How to maximize retirement plan contributions such as 401(k) or 403(b)?
  6. How to maximize retirement income from retirement plans?
  7. What are some other retirement plan savings options?
  8. What is your retirement plan and investing style?
  9. What is the role of social security in retirement planning?
  10. How to integrate retirement with estate planning?

The opinion of a competent Certified Medical Planner® can assist.

ASSESSMENT: Your thoughts, comments and input are appreciated.

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

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BONDS: Tobacco

Posted on November 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Tobacco bonds are a form of municipal debt securities and securitized debt whose payment obligations are tied to a master medical lawsuit settlement agreement between 46 states and several major U.S. tobacco companies.

In exchange for the states settling their lawsuits against the tobacco industry for recovery of tobacco-related health care costs and exempting the tobacco companies from private tort liability regarding harm caused by tobacco use, the companies agreed to curtail or cease certain tobacco marketing practices and to pay, in perpetuity, various annual payments to the states to compensate for the medical costs of tobacco-related illnesses.

These tobacco industry payments have been securitized into municipal bonds. One underlying risk, among others, is that if certain conditions are met, the tobacco companies may reduce or suspend part of their payments.

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MEDICAL ECONOMICS: Healthcare Inflation

Posted on November 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Inflation has hit record levels this year as demand for goods and services far outpaced supply, and many companies are still trying to bounce back from the shutdowns of early 2020. Health systems, which have razor-thin operating margins even in the best of times, aren’t an exception.

“In the past, we’ve always said that healthcare was kind of recession-proof because demand for healthcare keeps going, regardless of what’s happening in the economy,” said Tina Wheeler, leader of consulting firm Deloitte’s US healthcare practice.

But in the last year, inflation hovered around 8% for much of the year, while medical-care prices increased by only 4.8%, according to Wheeler. Since medical costs are negotiated between hospitals and payers years in advance, hospitals can’t just raise their prices now to keep up with the pace of inflation, said Gerard Brogan Jr., senior vice president and chief revenue officer at Northwell Health.

READ: https://medicalexecutivepost.com/2022/11/10/the-cpi-and-stock-markets/

Here’s how badly hospitals could be hurting:

  • Inflation could cause an additional $370 billion more in healthcare spending than the expected baseline increase by 2027, according to McKinsey.
  • The national health expenditure could grow at a rate of 7.1% over the next five years, compared to the expected economic growth rate of 4.7%, according to McKinsey.
  • By the end of 2021, total hospital expenses per adjusted discharge were up 20.1% compared to 2019, according to the trade group American Hospital Association.

Rising interest rates also hurt hospitals since their main access to capital is through issuing tax-exempt bonds, Wheeler said. The rising cost of capital limits hospitals’ ability to fund projects, like opening a new oncology center to treat patients, for example. Keep reading here

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About iMBA Inc Expertise in Healthcare Valuation

Posted on November 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

iMBA Inc., and the ME-P Team

By Ann Miller RN MHA CMP™

SPONSOR: http://www.MarcinkoAssociates.com

The www.MedicalBusinessAdvisors.com is focused solely on appraising medical practices, surgery centers [ASCs], medicine, podiatry, optometry and allied healthcare businesses.

Working with our affiliated partners, like the ME-P and others, we are also available for behemoth multi-specialty medical practices, major clinics, hospitals, related healthcare organizations and networks, and PHOs, etc.

We are backed by the expertise of dedicated appraisers and valuation analysts who are trained by the foremost organizations in our industry www.CertifiedMedicalPlanner.org

Practice owners, attorneys and accountants retain us for projects including, but not limited to the following:.

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.

Assessment

Our methods and approaches adhere to accepted standards of healthcare practice appraisal and utilize direct market data to reach justifiable conclusions.  These are documented in a comprehensive report which is tailored to meet the need of the specific engagement.

BLUNDERS TO AVOID: Medical Practice Valuation Blunders[1]

SAMPLE ENGAGEMENTS: See partial engagement list below.

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:

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DAILY UPDATE: Bitcoin, MicroStrategy and Credit Card Competition as the DJIA Hits a Record

Posted on November 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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

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

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Bitcoin jumped about 130% this year, but MicroStrategy has skyrocketed almost 500%.

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

The proposed Credit Card Competition Act (CCCA) could devastate credit card rewards at the national level if passed. Now, states are getting involved too Read on.

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

STOCKS UP

Ross Stores rose 2.19% after beating earnings estimates but missing sales forecasts last quarter, with shoppers spending less thanks to inflation.

  • MicroStrategy tumbled big time yesterday after a short seller report highlighted the risk inherent in betting it all on bitcoin, but the stock recovered 6.19% today.
  • Super Micro Computer continues to recover from the brink of defeat, rising another 11.62% as investors beg the tech company’s forgiveness for ever doubting it.
  • Data analytics company Elastic sprang 14.77% higher today on a strong earnings report highlighted by rising demand from customers building AI applications.

STOCKS DOWN

Tax-filing company Intuit sank 5.68% after reporting strong earnings last quarter but forecasting weaker results this quarter.

  • Reddit dropped 7.18% after a one-two punch from shareholders: Tencent Holdings sold a chunk of its stake in the social media company, while Advance Magazine Publishers is selling its stake but, through some financial trickery, is keeping control of the shares.
  • Palo Alto Networks may have beaten earnings expectations yesterday afternoon, but the cybersecurity stock fell 3.61% after shareholders weren’t impressed by its full-year guidance.

CITE: https://tinyurl.com/tj8smmes

Here’s where the major benchmarks ended:

  •  The S&P 500® index (SPX) rose 20.63 points (0.35%) to 5,969.34 to end the week up 1.68%; the $DJI gained 426.16 points (0.97%) to 44,296.51 to end the week up 1.96%; and the NASDAQ Composite® ($COMP) added 31.23 points (0.16%) to 19,003.65 to end the week up 1.73%.
  • The 10-year Treasury note yield fell two basis points to 4.41% and is down two basis points for the week, while the 2-year note yield rose seven basis points this week as rate cut odds fell.
  • The CBOE Volatility Index® (VIX)fell sharply to 15.31 and finished slightly lower for the week.

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MORTGAGE BACKED SECURITIES: Prepayment Risk

Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITION

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Prepayment risk is typically used in reference to mortgage-backed securities. It refers to the risk that mortgage refinancing activity might increase when market interest rates decline, which is generally not favorable for MBS investors.

For example, when homeowners refinance their mortgages, MBS investors are “prepaid,” shortening the life of their investments and forcing investors to reinvest the proceeds under lower interest rate conditions than what were most likely prevailing at the time of the original MBS investment.

Price adjustments for prepayment risk are one factor that helps explain why MBS, despite their generally high credit quality, have higher yields than comparable-maturity Treasury securities.

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AMA: Bye-Bye Medicare Billing Codes?

Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Robert F Kennedy Jr, who was selected by Donald Trump to run the U.S. health and human services department, is working on plans to rid the American Medical Association from its role in drawing up Medicare’s billing codes, which sets doctors’ fees for more than 10,000 procedures, Oliver Barnes of The Financial Times reports.

The plan would result in an upheaval of a system that has been in place for decades. Publicly traded companies in the healthcare space include CVS Health (CVS), Centene (CNC), Cigna (CI), Elevance Health (ELV), Humana (HUM), Molina Healthcare (MOH) and UnitedHealth (UNH).

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The TIPPING POINT: Meanings Vary

Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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A “Tipping point” has slightly varied meanings depending upon the field of study, but is frequently defined as a series of small changes in an evolutionary process that ultimately lead to a significant change or point beyond which new circumstances and conditions obtain.

For example, the point at which emerging economies go from being a long-time source of deflation to a source of inflation can be said to be an inflationary tipping point.

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The Tipping Point: How Little Things Can Make a Big Difference is the debut book by Malcolm Gladwell, first published by Litttle, Brown in 2000. Gladwell defines a tipping point as “the moment of critical mass, the threshold, the boiling point.” The book seeks to explain and describe the “mysterious” sociological changes that mark everyday life. As Gladwell stated: “Ideas and products and messages and behaviors spread like viruses do.”

Examples of such changes in his book include the rise in popularity and sales of Hush Puppies shoes in the mid-1990s and the steep drop in New York City‘s crime rate after 1990.

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DAILY UPDATE: Google and Ford Motor as Stock Markets Rise and Broaden

Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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.

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The DOJ asked a judge to force Google to sell its Chrome browser, following his ruling that Google maintained an illegal monopoly in search.
Ford said it is cutting 4,000 jobs in Europe, about 14% of its workforce on the continent, citing weak demand for EVs and competition from Chinese cars.

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

STOCKS UP

  • Data analytics firm Snowflake soared 32.71% after posting impressive earnings, including a 28% increase in revenue last quarter.
  • BJ’s Wholesale Club has had an okay year, but its latest earnings report gave shareholders plenty to cheer. The big news: BJ’s is increasing its membership fee for the first time in seven years. Shares rose 8.24%.
  • Despite the fact that the world’s largest farming equipment manufacturer sees a big slowdown ahead, Deere beat earnings estimates last quarter, which was enough to help shares climb 8.12%.

STOCKS DOWN

It took a second, but it’s finally registering that Alphabet may be forced by the Department of Justice to divest its popular Chrome browser. Shares fell 4.74% as investors digest this stark reality.

  • Speaking of search engines, Baidu sank 5.90% after the Chinese tech stock missed analyst estimates on both earnings and revenue last quarter.
  • Speaking of Chinese companies, PDD Holdings, parent company of online retailer Temu, reported higher earnings and revenue last quarter—but it still fell short of analyst forecasts. Shares dropped 10.64%.
  • Speaking of struggling retailers, Beyond Inc., the company that owns Bed, Bath & Beyond and Overstock.com, was supposed to invest $40 million into struggling retailer The Container Store. Unfortunately for both, the deal fell through. Shares of Beyond sank 2.87%, while The Container Store dropped 9.79%.

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

Here’s where the major benchmarks ended:

  • The SPX buoyed 31.60 points (0.53%) to 5,948.71; the Dow Jones Industrial Average® ($DJI) rose 461.88 points (1.06%) to 43,870.35; and the NASDAQ Composite® ($COMP) stayed relatively flat, up 6.28 points (0.03%) to 18,972.42.
  • The 10-year Treasury note yield added two basis points to 4.42%, staying rangebound.
  • The CBOE Volatility Index® (VIX) slipped to 16.87, still above last week’s levels.

CITE: https://tinyurl.com/tj8smmes

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

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INVESTMENT: Management Strategies

Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Active investment management strategies are the opposite of passive investment strategies. Active portfolio managers regularly take investment positions that clearly differ from those of the portfolio’s performance benchmark, with the objective of outperforming the benchmark over time.

Passive: https://medicalexecutivepost.com/2024/06/09/active-or-passive-investing-pursuits/

In addition to the upside potential of outperforming the benchmark, there’s also the downside possibility of under performing the benchmark. In an efficient market, there should be roughly the same magnitude of out performers and under performers for any given benchmark. But, markets are not always efficient.

Active non-transparent investment management strategies are Exchange Traded Funds that are actively managed by a portfolio manager or team of managers without daily disclosure of portfolio holdings. Active transparent strategies are daily disclosures of portfolio holdings as an attribute of traditional index-based Exchange Traded Funds (ETFs). Active transparent exchange traded funds are actively managed by a portfolio manager or team of managers. As with index-based ETFs, their portfolio holdings are disclosed daily.

Di-Worsification: https://medicalexecutivepost.com/2024/04/09/what-is-financial-portfolio-di-worsification-2/

NOTE: Absolute return as an investment vehicle seeks to make positive returns by employing investment management techniques that differ from traditional mutual funds. Absolute return investment techniques include using short selling, futures, options, derivatives, arbitrage, leverage and unconventional assets.

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

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ABSURDISM versus NIHILISM

Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Absurdism is the philosophical idea that life is inherently meaningless, but we should embrace the absurdity and create our own meaning. Think of it as existentialism’s quirky cousin. It’s like laughing at the cosmic joke instead of crying over spilled milk. Absurdism encourages us to find joy in the randomness and chaos of life.

So, according to colleague Dan Arily PhD, the next time you’re feeling overwhelmed by the lack of purpose, channel your inner absurdist and find humor in the absurdity of it all.

Nihilism, on the other hand, is the belief that all values are baseless and that nothing can be known or communicated. It is often associated with extreme pessimism and a radical skepticism that condemns existence. A true nihilist would believe in nothing, have no loyalties, and no purpose other than, perhaps, an impulse to destroy. While few philosophers would claim to be nihilists, nihilism is most often associated with Friedrich Nietzsche who argued that its corrosive effects would eventually destroy all moral, religious, and metaphysical convictions and precipitate the greatest crisis in human history.

In the 20th century, nihilistic themes–epistemological failure, value destruction, and cosmic purposelessness–have preoccupied artists, social critics and philosophers, alike. Mid-century, for example, the existentialists helped popularize tenets of nihilism in their attempts to blunt its destructive potential. By the end of the century, existential despair as a response to nihilism gave way to an attitude of indifference, often associated with anti-foundationalism.

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GROSSMAN-STIGLITZ: Financial Information Paradox

Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The Grossman-Stiglitz Paradox was introduced by Sanford J. Grossman and Joseph Stiglitz in a joint publication in American Economic Review in 1980 that argues perfectly informationally efficient markets are an impossibility since, if prices perfectly reflected available information, there is no profit to gathering information, in which case there would be little reason to trade and markets would eventually collapse.

IOW: According to colleague Eugene Schmuckler PhD MBA CTS, the Grossman-Stiglitz paradox is the inability to recoup the cost of obtaining market information and thus implies that efficient markets cannot exist.

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DAILY UPDATE: GoodRx as Stocks End Flat

Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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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Daily Update Provided By Staff Reporters Since 2007.
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It’s not all good news for GoodRx.

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STOCKS UP

Williams-Sonoma soared 27.50% to a record high after the home goods store beat top and bottom line earnings expectations. Its operating profit margin jumped to 17.8% from 17% last year, and the company said its board greenlit a $1 billion stock buyback plan.

  • Wix jumped 14.31% on a solid beat for its third quarter. Profit for the software firm reached $0.46 per share, compared to the $0.12 per share it reported last year.
  • Lemonade rose 16.04% after Morgan Stanley upgraded the insurance company from “underweight” to “equal-weight.” At its investor day, Lemonade unveiled a plan to juice its premiums from $1 billion to $10 billion over the next several years.

STOCKS DOWN

  • Ford said it was cutting 4,000 jobs in Europe, about 14% of its workforce on the continent, citing weak demand for EVs and competition from Chinese cars. Shares fell 2.90%.
  • Qualcomm dropped 6.34% after its first Investor Day in three years disappointed. On Tuesday, the chipmaker revealed its big plans to expand from its bread-and-butter smartphone business into making chips for cars and PCs.
  • Elf sank 2.23% after short seller Carson Block, the founder of Muddy Waters Research, accused the beauty company of inflating revenue.

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

Here’s where the major benchmarks ended:

  •  The S&P 500® index (SPX) stayed mostly flat, up 0.13 points (0.0%) to 5,917.11; the Dow Jones Industrial Average® ($DJI) rose 139.53 points (0.32%) to 43,408.47; and the NASDAQ Composite® ($COMP) fell 21.32 points (0.11%) to 18,966.14. 
  • The 10-year Treasury note yield added four basis points to 4.41%.
  • The CBOE Volatility Index® (VIX) climbed to 17.26, near recent highs.

CITE: https://tinyurl.com/tj8smmes

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

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PSYCHOLOGY: Retrospective Framing

Posted on November 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Ever notice how memories change over time? That’s retrospective framing.

According to Dan Ariely PhD, our brains are like movie editors, constantly tweaking the past to fit our current narrative. Recall that terrible vacation where everything went wrong? Fast forward and now it’s a hilarious adventure. This mental editing helps us make sense of our lives and learn from our experiences.

So, just remember, the past is a story we keep rewriting, and sometimes those edits can be more fiction than fact

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Stocks, Treasuries, Gold and Bitcoin

Posted on November 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
SPONSOR: http://www.MarcinkoAssociates.com

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  • Stocks sank yesterday on news that Russian President Vladimir Putin lowered the threshold for using nuclear weapons, retaliation against the US for allowing Ukraine to use American-made long-range missiles. The NASDAQ and S&P 500 managed to recover, but the DJIA stayed all day in the red.
  • Treasury yields dropped as bonds rose.
  • Gold popped as traders sought safety, as the commodity benefited from the US dollar pulling back from a recent one-year high.
  • Bitcoin continued to climb slowly but surely, reaching another new all-time high.

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CHARGE MASTER: Medical Bills Paradox

Posted on November 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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CHARGE MASTER MEDICAL BILLS

Classic Definition: A comprehensive review of a physician, clinic, facility, medical provider or hospital’s charges to ensure Medicare billing compliance through complete and accurate HCPCS/CPT and UB-92 revenue code assignments for all items including supplies and pharmaceuticals. The charge master captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges

Modern Circumstance: A charge master quizlet (charge description master [CDM]) document that contains a computer-generated list of procedures, services, and supplies with charges for each. Charge master rates are essentially the health care market equivalent of Manufacturer’s Suggested Retail Price (MSRP) in the car buying market. Poor charge master maintenance can lead to overpayments or underpayments. It can also lead to claim rejections from insurance companies, poor patient experience, or compliance violations.

Paradox Examples:

  • Superbills: An encounter form that is the financial record source document used by healthcare providers and other personnel to record treated diagnoses and services rendered to the patient during the current encounter. It is also called a superbill.
  • Payment rates: Almost no one actually pays the publicized charge master rates. The vast majority of health care consumers are represented by a payer of some kind, such as a commercial health insurance company, Medicaid, or Medicare. Commercial insurers negotiate the actual prices they pay during the process of contracting with providers. Medicare and Medicaid establish their own payment levels independent of hospitals’ charge master lists – Medicare through the federal government and Medicaid through state governments.
  • Cash pay: The sad irony of the charge master is that the uninsured are the most likely to be billed charge master rates because they are not represented by a third-party payer.
  • Problematic features: Other items also impede the ability of payers to have a comprehensive and accurate understanding of hospitals’ financial positions. For example, nonprofit hospitals are required to report charity care, bad debt expenses, community benefit initiatives, and uncompensated care. When these expenses are reported at the charge master level, expenses can be paradoxically overstated, potentially making a hospital’s financial position look worse than it actually is.

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DAILY UPDATE: Dermatology and Oura Rings as NASDAQ Rises

Posted on November 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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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Daily Update Provided By Staff Reporters Since 2007.
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How dermatology became the hottest field in medicine.

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STOCKS UP

  • Talk about cutting it close: Super Micro Computer filed a much-delayed financial plan at the 11th hour, avoiding a delisting from the Nasdaq. Shares soared 31.24%.
  • AI-enabled robotics company Symbotic surged 27.68% after announcing an impressive beat-and-raise quarter.
  • MicroStrategy climbed another 11.89% after yesterday’s huge surge. The crypto company announced it will continue to purchase more bitcoin in the weeks ahead.

STOCKS DOWN

  • More Trump Trade 2.0 developments: The newly formed Department of Government Efficiency is considering creating an app that allows Americans to file their taxes on a phone for free. Intuit sank 5.10%, and H&R Block dropped 8.31% on the news.
  • Speaking of Trump, platform Bakkt popped then dropped 0.67% following yesterday’s news that Trump Media & Technology Group may acquire the company. Trump Media shares fell 8.88%.
  • Kraft Heinz fell 1.58% on a Piper Sandler downgrade due to the company’s slow retail sales and the threat of new government regulations from the Health Department.
  • Lowe’s may have beaten top and bottom line expectations last quarter, but the home improvement retailer’s forecast of slower sales next year sent the stock falling 4.62%.
  • Incyte tumbled 8.33% after the pharma company announced it was pausing the Phase 2 trial of its new spontaneous hives treatment.

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

Here’s where the major benchmarks ended:

  •  The S&P 500® index (SPX) was up 23.36 points (0.4%) to 5916.98; the Dow Jones Industrial Average® ($DJI) dipped 120.66 points (0.28%) to 43,268.94; and the NASDAQ Composite® ($COMP) rose 195.66 points (1.04%) to 18,987.49.
  • The 10-year Treasury note yield fell four basis points to 4.38%.
  • The CBOE Volatility Index® (VIX) eased to 16.04 after an earlier pop above 17.

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Oura rings will soon be integrated with glucose biosensors after a $75 million series D funding round with medical device maker Dexcom.

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

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CBOE: Chicago Board Options Exchange [Volatility Indexes]

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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RELATED DEFINITIONS

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Volatility indexes are forward-looking measures of the market’s expectations of volatility (or how much a stock index’s price moves). The CBOE manages and publishes three of the most widely used volatility indexes based on three major stock indexes:

The VIX Index tracks the expected 30-day future volatility of the S&P 500 Index.

The VXN Index tracks the expected 30-day future volatility of the NASDAQ-100 Index.

The VXD Index tracks the expected 30-day future volatility of the Dow Jones Industrial Average Index.

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SECURITY ORDERS: Stop-Loss and Stop-Limit

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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A Stop order, also known as a “stop-loss order,” a stop order is an order placed with a bank or brokerage firm to either buy or sell a security after it reaches a specified price. Once the price is reached, the stop order becomes a market order, meaning there is no guarantee that an order will be completely filled at the specified stop price.

MORE: https://medicalexecutivepost.com/2024/08/30/stock-orders-positions-doctors-should-know/

A Stop-limit order is order placed with a bank or brokerage firm to buy or sell a fixed amount of an investment after it reaches a specified or better price, combining the features of a stop order and a limit order.

MORE: https://medicalexecutivepost.com/2024/08/07/about-securities-order-and-position-types/

A stop-limit order requires investors to set two price points: the first initiates the stop (the order to buy or sell) and the second sets the limit, or price beyond which the investor would not like to buy or sell. The investor also sets a time frame for which the order is valid before being cancelled. If the investor’s price cannot be met during the specified time frame, the order will be cancelled.

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WHAT TRUMP’S ELECTION WIN COULD MEAN FOR HEALTH CARE

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. Bertalan Meskó, MD PhD

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Regarding AI, the emphasis will shift away from the regulatory environment towards technology companies making their own decisions. Trump also promised to repeal Biden’s executive order on AI because it “hinders AI Innovation”.

Regarding health care, Trump said he would let Robert F. Kennedy “go wild” on health. Being a vaccine doubter and having made many unscientific claims about health, this could be a huge risk to digital health and the FDA’s job on regulating technologies. READ MORE

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DAILY UPDATE: All About the Stock Markets

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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  • Stocks ended the day mixed, with the Dow sinking into the red while the S&P 500 and NASDAQ kicked off the week on a positive note thanks to gains from tech stocks.
  • Oil popped on a double-whammy of news: Long-range, US-made ballistic missiles launched from Ukraine into Russia might disrupt oil supply, while the shutdown of Norway’s Johan Sverdrup oil field due to a power outage will definitely disrupt oil supply.
  • Crypto continued its hot streak today: Bitcoin popped back above $90,000, giving other cryptocurrencies a boost.
  • Bitcoin’s boom has certainly helped MicroStrategy, which announced today that it purchased 51,780 bitcoins for approximately $4.6 billion in cash, or roughly $88,627 per bitcoin, in the last week alone.

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

STOCKS UP

The new Trump Trade continues: The president-elect’s selection of Liberty Energy CEO Chris Wright to lead the Department of Energy gave Liberty a 4.85% boost today. Wright is also on the board of nuclear company Oklo, which popped 14.83%.

  • Speaking of Trump, Trump Media & Technology Group soared 16.65% on the news that it may purchase crypto trading firm Bakkt.
  • Netflix disappointed viewers with its glitchy showing of Jake Paul vs. Mike Tyson, but shareholders forgave the company after it announced record viewership of the fight. Shares climbed 2.80%.
  • CVS Health gained 5.41% on news that it struck a deal with activist investor Glenview Capital Management to add four new seats to its board.
  • Robinhood jumped 8.29% to a new all-time high thanks to an upgrade from Needham analysts giving the investing app a “buy” rating due to its crypto offerings under a pro-crypto Trump presidency.
  • Warner Bros. Discovery rose 2.71% on a Wall Street Journal report that it has settled its legal dispute with the NBA, guaranteeing broadcast rights for the next decade.

STOCKS DOWN

  • Nvidia isn’t often in this section of the newsletter, but the semiconductor leader sank 1.29% today on a report from The Information that its new Blackwell chips are prone to overheating.
  • Palantir popped after moving over to the Nasdaq last week, but the red-hot software stock dropped 6.86% as investors collected profits.
  • Redfin may help you buy a house, but the online real estate brokerage is a “sell,” according to Goldman Sachs. The Wall Street firm cited low home sales, low affordability, and low chances of success in a competitive market. Shares fell 4.42%.
  • Uber dropped 5.35% to a new 52-week low on the threat of Tesla’s robotaxis ruling the road thanks to a Trump administration that seems keen on cutting self-driving regulations.

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Here’s where the major benchmarks ended:

  •  The SPX was up 23.00 points (0.4%) to 5893.62; the Dow Jones Industrial Average® ($DJI) fell 55.39 points (0.1%) to 43,389.6; and the NASDAQ Composite® ($COMP) was up 111.69 points (0.6%) to 18,791.81.
  • The 10-year Treasury note yield fell one basis point to 4.41%.
  • The CBOE Volatility Index® (VIX) eased to 15.57.

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

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The Decline Bias [Declinism]

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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You may have heard the complaint that the internet, blogs, vlogs and social media will be the downfall of information dissemination; but, Socrates reportedly said the same thing about the written word.

Declinism refers to a bias in favor of the past over and above “how things are going.” Similarly, you might know a member of an older generation who prefaces grievances with, “Well, back in my day” before following up with how things are supposedly getting worse.

The decline bias may result from something before — we just don’t like change. People like their worlds to make sense, they like things wrapped up in nice, neat little packages.

Our world is easier to engage in when things make sense to us. When things change, so must the way in which we think about them; and because we are cognitively lazy (Kahenman, 2011; Simon, 1957), we try our best to avoid changing our thought processes.

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GAMIFICATION: Motivation and Achievement

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Gamification is the application of game-design elements in non-game contexts to motivate and engage people. It’s like turning life into a video game with points, badges, and leader boards. This approach leverages our love for games and competition, making mundane tasks more enjoyable.

According to Dan Ariely PhD, whether it’s a fitness app tracking your steps or a learning platform rewarding your progress, gamification taps into our natural desire for achievement and recognition.

So, the next time you find yourself hooked on a task, thank the power of gamification for making it fun.

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DAILY UPDATE: Spirit Airlines in Chapter 11 as Nvidia Rises and Target, Lowes & Walmart Highlight Stock Earnings Week

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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“

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Spirit Airlines said Monday it has filed for Chapter 11 bankruptcy protection after struggling with losses, growing debt and a failed merger during the post-pandemic travel lull. The company said in a stock market statement that it had secured a prearranged deal with bondholders that includes £300 million in financing to keep it afloat, with the business planning to end its bankruptcy in the first quarter of 2025.

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Analysts are expecting Nvidia, the world’s largest publicly traded company, to show quarterly sales of ~$33 billion, up 10% from the previous quarter and 83% year over year, but they also warn the mind-blowing growth of the chip maker could begin to slow.

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And, reports this week from Walmart, Target, Lowe’s, and other retailers will offer a peek at consumer health.

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STOCK POSITION SIZING: How to Construct Investment Portfolios That Protect You

Posted on November 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Vitaliy Katsenelson CFA
For a while in the value investing community the number of positions you held was akin to bragging on your manhood– the fewer positions you owned the more macho an investor you were. 

I remember meeting two investors at a value conference. At the time they had both had “walk on water” streaks of returns. One had a seven-stock portfolio, the other held three stocks. Sadly, the financial crisis humbled both – the three-stock guy suffered irreparable losses and went out of business (losing most of his clients’ money). The other, after living through a few incredibly difficult years and an investor exodus, is running a more diversified portfolio today.

Under-diversification is dangerous, because a few mistakes or a visit from Bad Luck may prove to be fatal to the portfolio.

On the other extreme, you have a mutual fund industry where it is common to see portfolios with hundreds of stocks (I am generalizing). There are many reasons for that. Mutual funds have an army of analysts who need to be kept busy; their voices need to be heard; and thus their stock picks need to find their way into the portfolio (there are a lot of internal politics in this portfolio). 

These portfolios are run against benchmarks; thus their construction starts to resemble Noah’s Ark, bringing on board a few animals (stocks) from each industry. Also, the size of the fund may limit its ability to buy large positions in small companies.

There are several problems with this approach. First, and this is the important one, it breeds indifference: If a 0.5% position doubles or gets halved, it will have little impact on the portfolio. The second problem is that it is difficult to maintain research on all these positions. Yes, a mutual fund will have an army of analysts following each industry, but the portfolio manager is the one making the final buy and sell decisions. Third, the 75th idea is probably not as good as the 30th, especially in an overvalued market where good ideas are scarce.

Then you have index funds. On the surface they are over-diversified, but they don’t suffer from the over-diversification headaches of managed funds. In fact, index funds are both over-diversified and under-diversified. Let’s take the S&P 500 – the most popular of the bunch. It owns the 500 largest companies in the US. You’d think it was a diversified portfolio, right? Well, kind of. The top eight companies account for more than 25% of the index. Also, the construction of the index favors stocks that are usually more expensive or that have recently appreciated (it is market-cap-weighted); thus you are “diversified” across a lot of overvalued stocks.

If you own hundreds of securities that are exposed to the same idiosyncratic risk, then are you really diversified?

Our portfolio construction process is built from a first-principles perspective. If a Martian visited Earth and decided to try his hand at value investing, knowing nothing about common (usually academic) conventions, how would he construct a portfolio?

We want to have a portfolio where we own not too many stocks, so that every decision we make matters – we have both skin and soul in the game in each decision. But we don’t want to own so few that a small number of stocks slipping on a banana will send us into financial ruin.

In our portfolio construction, we are trying to maximize both our IQ and our EQ (emotional quotient). Too few stocks will decapitate our EQ – we won’t be able to sleep well at night, as the relatively large impact of a low-probability risk could have a devastating impact on the portfolio. I wrote about the importance of good sleep before (link here). It’s something we take seriously at IMA.

Holding too many stocks will result in both a low EQ and low IQ. It is very difficult to follow and understand the drivers of the business of hundreds of stocks, therefore a low IQ about individual positions will eventually lead to lower portfolio EQ. When things turn bad, a constant in investing, you won’t intimately know your portfolio – you’ll be surrounded by a lot of (tiny-position) strangers.

Portfolio construction is a very intimate process. It is unique to one’s EQ and IQ. Our typical portfolios have 20–30 stocks. Our “focused” portfolios have 12–15 stocks (they are designed for clients where we represent only a small part of their total wealth). There is nothing magical about these numbers – they are just the Goldilocks levels for us, for our team and our clients. They allow room for bad luck, but at the same time every decision we make matters.

Now let’s discuss position sizing. We determine position sizing through a well-defined quantitative process. The goals of this process are to achieve the following: Shift the portfolio towards higher-quality companies with higher returns. Take emotion out of the portfolio construction process. And finally, insure healthy diversification.

Our research process is very qualitative: We read annual reports, talk to competitors and ex-employees, build financial models, and debate stocks among ourselves and our research network. In our valuation analysis we try to kill the business – come up with worst-case fair value (where a company slips on multiple bananas) and reasonable fair value. 

We also assign a quality rating to each company in the portfolio. Quality is absolute for us – we don’t allow low-quality companies in, no matter how attractive the valuation is (though that doesn’t mean we don’t occasionally misjudge a company’s quality).

The same company, at different stock prices, will merit a higher or lower position size. In other words, if company A is worth (fair value) $100, at $60 it will be a 3% position and at $40 it will be a 5% position. Company B, of a lower quality than A but also worth $100, will be a 2% position at $60 and a 4% position at $40 (I just made up these numbers for illustration purposes). 

In other words, if there are two companies that have similar expected returns, but one is of higher quality than the other, our system will automatically allocate a larger percentage of the portfolio to the higher-quality company. If you repeat this exercise on a large number of stocks, you cannot but help to shift your portfolio to higher-quality, higher-return stocks. It’s a system of meritocracy where we marry quality and return.

Let’s talk about diversification. We don’t go out of our way to diversify the portfolio. At least, not in a traditional sense. We are not going to allocate 7% to mining stocks because that is the allocation in the index or they are negatively correlated to soft drink companies. (We don’t own either and are not sure if the above statement is even true, but you get the point.) 

We try to assemble a portfolio of high-quality companies that are attractively priced, whose businesses march to different drummers and are not impacted by the same risks. Just as bank robbers rob banks because that is where the money is, value investors gravitate towards sectors where the value is. To keep our excitement (our emotions) in check, and to make sure we are not overexposed to a single industry, we set hard limits of industry exposure. These limits range from 10%–20%. We also set limits of country exposure, ranging from 7%–30% (ex-US).

In portfolio construction, our goal is not to limit the volatility of the portfolio but to reduce true risk – the permanent loss of capital. We are constantly thinking about the types of risks we are taking. Do we have too much exposure to a weaker or stronger dollar? To higher or lower interest rates? Do we have too much exposure to federal government spending? I know, risk is a four-letter word that has lost its meaning. But not to us. Low interest rates may have time-shifted risk into the future, but they haven’t cured it.

READ: Position Sizing: How to Construct Portfolios That Protect You

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NOVEMBER: National Alzheimer’s Awareness Month

Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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The number of people living with Alzheimer’s disease is growing. The ripple effect is straining families, communities, and the healthcare system, yet talking about the disease on a personal level can be difficult.

November is Alzheimer’s Awareness Month because it can happen in any family, and because it’s worth talking about the challenges of living with or caring for someone with this disease.

You may notice splashes of teal and purple sprouting up this November, as both colors are associated with Alzheimer’s awareness. Teal is the color of the Alzheimer’s Foundation of America, chosen for its calming effect. Purple is the signature color of the Alzheimer’s Foundation, which stands for strength in the fight against Alzheimer’s disease.

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BOOLEAN: Logic & Search Engine

Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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George Boole, an English mathematician from the 19th century, developed an algebraic method that he first described in his 1847 book, The Mathematical Analysis of Logic and expounded upon in his An Investigation of the Laws of Thought (1854).

Boolean algebra is fundamental to modern computing, and all major programming languages include it. It also figures heavily in statistical methods and set theory.

Today’s database searches are largely based on Boolean logic, which allows us to specify parameters in detail — for example, combining terms to include while excluding others. A Boolean search, in the context of a search engine, is a type of search where you can use special words or symbols to limit, widen, or define your search.

This is possible through Boolean operators such as AND, OR, and NOT, plus symbols like + (add) and – (subtract).

When you include an operator in a Boolean search, you’re either introducing flexibility to get a wider range of results, or you’re defining limitations to reduce the number of unrelated results.

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DEDICATED: Short Stock Bias Strategies

Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Dedicated short bias strategies short stocks expected to depreciate as a result of company-specific catalysts or falling markets. These strategies maintain a net short exposure to the equity market, seeking to reduce equity portfolio volatility and offer the potential to earn returns in falling equity markets. Of course, they may be challenged in periods of rising equity markets.

From Shorting to a Short Bias

Prior to the long-term bull market for U.S. equities that took place in the 1980s and 1990s, many hedge funds used a dedicated short strategy, rather than a dedicated short bias strategy.

The dedicated short strategy was one that exclusively took short positions. The dedicated short funds were virtually destroyed during the bull market, so the dedicated short bias fund emerged and took a more balanced approach. The long holdings are enough to keep losses manageable, although funds can still run into problems with leverage and capital flight if losses continue for too long.

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VARIETY: Insensitivity

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Variety Insensitivity is the tendency to under appreciate the value of variety in choices.

According to Dan Ariely PhD, it’s like always ordering the same dish at your favorite restaurant and forgetting how exciting new flavors can be. Our brains love routine, but this can lead to boredom and missed opportunities. Embracing variety can enhance experiences and satisfaction.

So, next time you’re stuck in a rut, shake things up and try something different. Your brain will thank you for the new stimulation.

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IRMAA: Income Related Monthly Adjustment Amount

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The income-related monthly adjustment amount (IRMAA) is a fee you pay on top of your Medicare Part B and Part D premiums if you make a yearly income above the annual thresholds.

READ: https://secure.ssa.gov/poms.nsf/lnx/0601101020

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CURSE of the “Stereotype”

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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The Stereotype Curse is the negative impact of stereotypes on an individual’s performance or behavior. It’s like a self-fulfilling prophecy where being aware of a stereotype makes you more likely to conform to it.

For example, if you’re told you’re bad at math because of your gender, that stress can affect your performance. Breaking free from stereotypes requires awareness and effort.

So, next time you feel boxed in by a stereotype, remind yourself: you’re more than a cliché.

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PATTERNICITY: Apophenia vs. Pareidolia

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Patternicity is our brain’s tendency to find patterns in random data. It’s why we see faces in clouds or think the stock market follows our horoscope. According to colleague Dan Ariely PhD, this quirk helped our ancestors survive by recognizing predator shapes in the bushes, but in modern times, it can lead us astray. Our brains love making connections, sometimes too much, seeing patterns where none exist.

So, when you’re convinced that your lucky socks influence your team’s performance, remind yourself: it’s just your brain’s patternicity at work.

Apophenia vs. Pareidolia

Now, “Apophenia is the general term for the human tendency to see patterns in meaningless data that may involve visual, auditory, or other senses,” according to Dr. Harold Hong, a psychiatrist from Raleigh, North Carolina. He points out that pareidolia is a specific form of apophenia that refers to seeing visual patterns in random or ambiguous visual stimuli, such as seeing a face in the clouds.

Apophenia and pareidolia are common occurrences, says Hong, and challenges often only present when someone becomes fixated on specific patterns or details that others perceive as random. “While both phenomena are natural human tendencies, they can become concerning if someone starts to fixate on specific patterns excessively,” he says, noting that apophenia may be prevalent in certain mental health conditions, such as obsessive-compulsive disorder (OCD).

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DAILY UPDATE: 401[k] and Wamco as Stock Markets Crash!

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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“

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The Internal Revenue Service (IRS) ruled that employees at an unnamed company can designate a portion of their employer match to student debt repayments or health reimbursement accounts, in addition to their traditional 401(k).

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STOCKS UP

  • Warren Buffett’s Midas touch gave a boost to Domino’s Pizza and Pool Corp. after Berkshire Hathaway announced it has bought shares of both companies. Domino’s popped to start the day but dropped 1.27%, while Pool climbed just 0.54%.
  • Palantir is jumping ship, moving from the NYSE to the Nasdaq. Shareholders liked the move, pushing the stock up 11.14%.
  • Bloom Energy…bloomed 59.19% on the news that the renewable energy company reached an agreement to provide utility company American Electric Power with 1 gigawatt worth of fuel cells.

STOCKS DOWN

  • What Buffett giveth, Buffett taketh away: Apple sank on the news that Berkshire Hathaway has sold shares of the company, and almost completely eliminated its position in Ulta Beauty. Apple fell 1.41%, while Ulta Beauty dropped 4.60%.
  • Shareholders were expecting the worst from Chinese online retailer Alibaba, and although the company actually beat earnings forecasts, it wasn’t enough—shares still sank 2.20%.
  • Applied Materials tumbled 9.20% after beating both top and bottom line expectations, but shareholders balked at the slowdown in several key businesses.
  • AST SpaceMobile plummeted 9.59% after reporting bigger losses and smaller sales than Wall Street wanted to see.

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

Here’s where the major stock market benchmarks ended:

  • The SPX fell 78.55 points (–1.32%) to 5,870.62 to end the week down 2.08%; the Dow Jones Industrial Average® ($DJI) lost 305.87 points (–0.70%) to 43,444.99 to end the week down 1.24%; and the NASDAQ Composite® ($COMP) decreased 427.52 points (–2.24%) to 18,680.12 to end the week down 3.15%.
  • The 10-year Treasury note yield rose one basis point to 4.43% but added 12 basis points for the week. Shorter-term yields rose less.
  • The CBOE Volatility Index® (VIX) climbed sharply to 16.11 as stocks fell.

CITE: https://tinyurl.com/tj8smmes

The problems at storied bond manager Western Asset Management keep growing. Clients have pulled about $55 billion from Wamco, as the division is known, since mid-August, representing about 15% of its assets. Franklin Templeton, its 77-year-old parent company and one of the largest asset managers in the U.S., recently reported its steepest quarterly outflows on record.

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

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RESPONSE: Flight -OR- Fight?

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The Fight or Flight Response is our built-in alarm system, ready to spring into action at the first sign of danger. Whether it’s a charging lion or an impending deadline, our bodies react the same way – heart racing, adrenaline pumping, ready to fight or flee. This ancient survival mechanism is great for escaping predators but less helpful when dealing with modern stressors.

So, the next time you feel your heart racing over a tough email or stock market loss, remember: it’s just your caveman brain doing its thing.

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BIAS: Of “Social Proof” and Influencers

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

INVESTING DEFINITION

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Social Proof is a subtle but powerful reality that having others agree with a decision one makes, gives that person more conviction in the decision, and having others disagree decreases one’s confidence in that decision. 

This bias is even more exaggerated when the other parties providing the validating/questioning opinions are perceived to be experts in a relevant field, or are authority figures, like doctors, attorneys, financial advisors, teachers and/or people on television.  In many ways, the short term moves in the stock market are the ultimate expression of social proof – the price of a stock one owns going up is proof that a lot of other people agree with the decision to buy, and a dropping stock price means a stock should be sold. 

According to colleague Dan Ariely PhD, when these stressors become extreme, it is of paramount importance that all participants in the financial planning and investing process have a clear understanding of what the long-term goals are, and what processes are in place to monitor the progress towards these goals. 

Without these mechanisms it is very hard to resist the enormous pressure to follow the crowd; think social media and related influences.

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FATAL: Narcissism

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA MEd

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Imagine if Narcissus had a social media account. Fatal narcissism is what happens when self-love goes off the rails. It’s not just about admiring your reflection; it’s an all-consuming need for admiration and validation. Think endless selfies and humblebrags.

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While a bit of narcissism is normal, fatal narcissism is like a black hole – it sucks in all attention and gives nothing back.

So, if my Instagram looks like a shrine to my own greatness, you might be witnessing fatal narcissism in action.

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Convertible Securities, Bonds and Corporate Securities

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Convertible securities are those that can be converted at the investor’s choice into other investments, normally into shares of the issuer’s underlying common stock. Convertibles are typically issued as bonds or preferred stock.

Convertible bonds, which provide an ongoing stream of income, can be converted into a preset number of shares of the company’s common stock and have a maturity date. Unlike common stock, which pays a variable dividend depending on a corporation’s earnings, convertible preferred stock pays a fixed quarterly dividend. It can be converted into common stock at any time, but often are perpetual.

Corporate securities (corporate bonds and notes) are debt instruments issued by corporations, as distinct from those issued by governments, government agencies, or municipalities.

Corporate securities typically have the following features: 1) they are taxable, 2) they tend to have more credit (default) risk than government or municipal securities, so they tend to have higher yields than comparable-maturity securities in those sectors; and 3) they are traded on major exchanges, with prices published in newspapers.

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

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DAILY UPDATE: Healthcare Private Equity Prominent as Stocks Go Down

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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.

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Daily Update Provided By Staff Reporters Since 2007.
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Private equity (PE) dollars have become prominent in the US healthcare industry in recent decades, with PE firms now owning roughly 8% of all private hospitals in the country, according to nonprofit Private Equity Stakeholder Project. But studies have illustrated the financial model’s potential adverse effects, such one published in JAMA in December 2023 that found PE-owned hospitals are 25.4% more likely to report patient complications. Others have found that PE-owned healthcare companies represented more than one-fifth of healthcare company bankruptcies in 2023 and that PE-owned hospitals see their assets drop an average of 24% following an acquisition.

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

STOCKS UP

Tapestry, parent company of luxury brands like Coach and Kate Spade, and Capri, parent company of luxury brands like Versace and Jimmy Choo, have announced they will mutually terminate their planned merger. Tapestry popped 12.80%, while Capri rose 4.43%.

  • Speaking of luxury brands, Burberry soared 18.04% after its CEO announced a turnaround plan designed to halt the company’s recent decline.
  • Semiconductor maker ASML plummeted last month on a profit warning, but rose 2.90% today on reassurances that it’s still on track to meet its 2030 revenue forecasts.

STOCKS DOWN

  • Super Micro Computer fell yet another 11.41% as it nears the November 16 deadline to report fiscal year earnings or be delisted from the Nasdaq.
  • Trump Media & Technology Group dropped 6.71% as investors digested news that company insiders are shedding shares, as well as in reaction to a number of President-elect Trump’s cabinet appointments.
  • Hims & Hers Health tumbled 24.46% on the news that Amazon is getting into the telehealth game, offering Prime members fixed prices on treatments for hair loss and erectile dysfunction.
  • Ibotta is a cashback rewards company, but its shareholders may want their cash back. The company beat on top and bottom line estimates last quarter, but the win wasn’t good enough, and shares sank 12.55%.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 36.21 points (–0.60%) to 5,949.17; the Dow Jones Industrial Average® ($DJI) lost 207.33 points (–0.47%) to 43,750.86; and the NASDAQ Composite® ($COMP) dropped 123.07 points (–0.64%) to 19,107.65. 
  • The 10-year Treasury note yield fell three basis points to 4.42%.
  • The CBOE Volatility Index® (VIX) edged up to 14.17.

CITE: https://tinyurl.com/tj8smmes

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

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PLEASE SUBSCRIBE: MarcinkoAdvisors@msn.com

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