COMPASSION FATIGUE: Be Aware & Beware!

Posted on October 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

AND … BURNOUT

By Staff Reporters

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Compassion fatigue is emotional exhaustion caused by the repeated exposure to others’ suffering. It’s like burning out your empathy circuits. Caregivers, doctors, nurses, healthcare workers and anyone in the helping professions are especially susceptible.

When you’re constantly giving support, it’s easy to feel drained and detached. To combat compassion fatigue, practice self-care and set healthy boundaries.

So, remember, you can’t pour from an empty cup – take care of yourself so you can take care of others.

BURNOUT COACH: https://medicalexecutivepost.com/2024/07/28/medical-coaching-physician-burnout-and-career-change/

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ME-P READERS: You Are a 10/10 Today!

Posted on October 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

Today is the only day of the year we can use the line: “Hey ME-P readers – you’re a 10/10.”

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Markets: Another day, more all-time highs for the S&P 500 and the Dow Jones Industrial Average.

Whether this two-day rally could extend to three will likely depend on this morning’s consumer price index inflation report for September, which will help shape the path of future Federal Reserve interest rate cuts. While most Big Tech stocks gained, Alphabet sank after the Department of Justice said it was considering asking a judge to break it up as we previously reported on this ME-P.

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Be Aware of Your Cognitive Biases!

Posted on October 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Top Fifty [50] to Know

[By staff reporters]

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Assessment: Your thoughts are appreciated.

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UNITEDHEALTHGROUP: Recent Pros and Cons of UNH

Posted on October 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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

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

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

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

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

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DAILY UPDATE: Wegovy, Home Health Medicare, Federal Budget Deficit and Organ Transplants as Stock Markets Set New Highs

Posted on October 10, 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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Kamala Harris announced a plan to broaden Medicare to cover home healthcare for the first time in an effort to help the “sandwich generation” of Americans who are taking care of both their children and their parents.

WeightWatchers said it will offer cheaper copycat versions of Novo Nordisk’s weight loss drug, Wegovy.

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

Stocks up

  • Reddit gained 0.31% thanks to Jefferies analysts, who debuted their coverage of the social media stock with a “buy” rating, praising the company’s AI potential.
  • Biogen climbed 1.90% after the FDA gave its treatment for kidney transplant patients a special Breakthrough Therapy Designation.
  • Cruise stocks sailed higher today, in spite of the oncoming hurricane in the Gulf of Mexico. Norwegian Cruise Line, Carnival, and Royal Caribbean popped 10.91%, 7.05%, and 5.26%, respectively, on upgrades from Citi analysts.
  • Astera Labs jumped 15.60% after it debuted a new family of data center switches built specifically for AI.
  • Helen of Troy soared 17.88% thanks to a stronger-than-expected earnings report from the struggling consumer goods manufacturer.
  • Arcadium Lithium continued to rocket higher today after mining behemoth Rio Tinto announced it’s buying the lithium miner for $5.85 per share. Arcadium shares rose 30.90%.

Stocks down

  • Boeing just can’t catch a break: Talks with striking machinists broke down and the airplane manufacturer withdrew its recent contract offer. Shares sank 3.41% on the news.
  • US-traded shares of German life sciences company Bayer dropped 6.96% after a US court decided it will hear arguments that products from Bayer brand Monsanto allegedly harmed people.
  • Trump Media & Technology Group finally settled down after a wild rally following a wild rally in Pennsylvania featuring Elon Musk, falling 5.64% today.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 40.91 points (0.71%) to 5,792.04, a new record-high close; the Dow Jones Industrial Average® ($DJI) added 431.63 points (1.03%) to 42,512.00, also a new closing high; and the NASDAQ Composite® ($COMP) increased 108.70 points (0.60%) to 18,291.62.
  • The 10-year Treasury note yield (TNX) climbed three basis points to 4.06%, the highest since late July.
  • The CBOE Volatility Index® (VIX) eased to 20.8.

CITE: https://tinyurl.com/tj8smmes

In 2023, about 36% of Hispanic or Latino candidates waiting for a transplant received one, compared to 58% of non-Hispanic white candidates, according to the US Department of Health and Human Services Office of Minority Health.

Stat: $1.8 trillion. That eye-watering number is the federal budget deficit as of September 30th, according to the Congressional Budget Office. Higher interest rates, and increases in Social Security and Medicare, are driving the budget gap. (the Wall Street Journal)

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OPINIONS: Secure Unbiased Financial Planning -or- Economic Practice Management Advice

Posted on October 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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Dr. David Edward Marcinko MBA MEd CMP®

Certified Medical Planner®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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FINANCIAL PLANNING

CAREER DEVELOPMENT

MEDICAL PRACTICE BUY IN / OUT

INVESTMENT ANALYSIS

PORTFOLIO MANAGEMENT

MERGERS AND ACQUISITIONS

PRACTICE APPRAISALS AND VALUATIONS

RETIREMENT PLANNING

FEE-ONLY

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CONTACT: Ann Miller RN MHA CMP®

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NOBEL PRIZE CHEMISTRY: David Baker, Demis Hassabis and John Jumper in 2024

Posted on October 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BREAKING NEWS

By Staff Reporters

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he 2024 Nobel Prize in chemistry has been awarded to a trio of scientists who used artificial intelligence to “crack the code” of almost all known proteins, the “chemical tools of life.”

The Nobel Committee lauded David Baker, a US biochemist, for completing “the almost impossible feat of building entirely new kinds of proteins,” along with Demis Hassabis and John Jumper, who work at Google DeepMind, for developing an AI model to predict proteins’ complex structures – a problem that had been unsolved for 50 years.

“The potential of their discoveries is enormous,” the committee said as the award was just announced in Sweden. The prize, seen as the pinnacle of scientific achievement, carries a cash award of 11 million Swedish kronor ($1 million).

READ: https://www.nobelprize.org

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What is the Cost Per Patient Acquisition [CPA]?

Posted on October 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Neal Baum MD

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There’s a saying by John Wanamaker who pontificated, “Half the money I spend on advertising is wasted; the trouble is, I don’t know which half”.

Today you have opportunities to determine which parts of your marketing efforts are effective and what is wasted. However, you have to measure your marketing results.

This article will discuss marketing metrics and how to use them to get the best bang for your marketing buck.

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The cost per acquisition (CPA)

Not all initial phone callers to a medical practice will convert to paying patients. The 50 patients who made appointments can be plugged into the equation, i.e., campaign costs divided by patients who became paying patients or $2,000 divided by 50 equals $40, representing the patient acquisition cost (PAC).

Now, if each patient who entered the practice spends $800 over the patient’s lifetime, that’s an increase in income of $40,000, not shabby for $2,000 in marketing expenses.

Source: Neil Baum, MD, Physicians Practice [8/26/22]

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MORE: https://pubmed.ncbi.nlm.nih.gov/22834190/

BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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The DUPONT Decomposition Equation for ROI [Collections Rules for Hospitals]

Posted on October 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

D.D.E. FOR HOSPITALS AND HEALTHCARE ORGANIZATIONS

DEM blue

By Dr. David E. Marcinko MBA MEd CMP

[Editor-in-Chief] http://www.CertifiedMedicalPlanner.org

According to the Dupont Decomposition Equation – which involves the conglomeration of net operating income, revenues, expenses and average operating assets – ROI and economic profit is increased in three prioritized ways:

  1. Cost and expense reductions.
  2. Revenue increases [Rev]
  3. Reduced average operating assets [AOO]

Note: ROI = NOI / Rev X Rev / AOO

Cost and expense reductions

Although many hospitals have reduced expenses, postponed projects and put clinical or information technology projects on hold because of the current healthcare conundrum, this may be unwise and quality may suffer. And, mental health care programs are almost always the first cost center to be reduced in tough times.

Upgrades today, especially with concurrent marketing and advertising promotions, may well be considered a strategic competitive advantage, and at bargain basement prices for those with cash or credit. This cost reduction is easy because it gives the biggest buck-bang in the ROI equation, and is the first line of ROI augmentation by savvy administrators and CEOs. It is also intuitive and wholly “wrung-out” in the marketplace, to date.

Revenue increases

On the other hand, revenues can usually be only incrementally increased by improving services like emergency care, urgent care, wellness, out-patient and/or surgical departments. This is the more difficult part of the equation and yields a positive, but lesser return in the ROI equation.

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

DuPont Formula: Learn More At Accounting Play

Three Modern Collections Rules for Hospitals

The following medical practice procedures will markedly increase upfront office collections:  

  • Train staff to handle exceptions. What is your policy if the patient payment is significant? Will you allow 25% payments—one today and three over the next three months? Communicate your policy to all staff. What will you do if a patient shows up without an insurance card? There will be other exceptions. Train employees to call the appropriate practice-management contact when an exception does not fit in the categories you provide and make sure those managers are responsive.
  • Understand that not everyone will shine in collections. The value of this new front-desk function should be reflected in job descriptions and wages. Track staff performance and hold employees accountable for collection goals. The most successful practices collect in the 90% range.
  • Provide professional signage that states your basic policy. “Payments are due at time of service.” Avoid typewritten, lengthy explanations taped to walls or desks that look like clutter.

Reduced average operating assets

Finally, any delay in updating facilities – while easy and may reduce operating assets – there is little ROI advantage and profit potential. Of course, facility asset upgrades mean borrowing funds through tax-exempt bonds – the main source of debt for most hospitals – and is currently difficult or impossible in this climate. Loans from banks, private investors, angels, venture capitalists or other financial institutions are similarly difficult to obtain. Thus, this part of the equation may often be neglected; as is the case now.

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PODCAST: Is Private Equity Buying Doctors Illegal?

Posted on October 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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DAILY UPDATE: Pfizer Down While Stock Markets Ignite

Posted on October 9, 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.
How May We Serve You?
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Activist investor takes $1 billion stake in Pfizer. The firm Starboard Value has amassed a stake in the pharma giant, which has struggled after reaching new heights during the pandemic, in hopes of turning the company around.

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

What’s up

  • If you can’t beat ‘em, join ‘em: WW International, aka WeightWatchers, soared 46.95% after the company announced it will begin offering GLP-1 weight-loss drugs.
  • Nvidia rose 4.05% after the Foxconn CEO told CNBC that AI demand is still incredibly strong.
  • Trump Technology & Media Group soared 18.54% after Tesla CEO Elon Musk appeared alongside the former president at a rally in Pennsylvania over the weekend.
  • Palantir popped 6.58% after the CTO of the data analytics firm appeared on CNBC and told everyone that his company is making mad money.
  • Welcome to the club: S&P Global announced that DocuSign is replacing MDU Resources Group in the S&P MidCap 400 index, while MDU is moving to the S&P SmallCap 600 index. Docusign rose 6.55% on the news, while MDU gained 2.44%.
  • Humana finally caught a break when a Bernstein analyst upgraded the stock today, writing that the health insurer has been hurt enough. Shares rose 2.92%.

What’s down

  • What goes up must come down: Chinese stocks, which have enjoyed an impressive rally recently, came tumbling back to Earth today after the country’s state planner didn’t announce any new stimulus measures. Bilibili fell 12.93%, JD.com lost 7.52%, Alibaba sold off 6.67%, and Nio dropped 8.10%.
  • Today’s oil selloff pummeled energy stocks: Valero Energy lost 5.31%, while Marathon Petroleum stumbled 7.66%.
  • Sphere Entertainment dropped 2.84% on the news that its CFO is leaving the company.
  • Super Micro Computer gave back 5.01% after its rally yesterday as investors pocketed their profits.

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

Here’s where the major benchmarks ended:

  • The SPX rose 55.19 points (0.97%) to 5,751.15; the Dow Jones Industrial Average® ($DJI) added 126.13 points (0.30%) to 42,080.37; and the NASDAQ Composite® ($COMP) gained 259.01 points (1.45%) to 18,182.92.
  • The 10-year Treasury note yield (TNX) rose one basis point to 4.03%.
  • The CBOE Volatility Index® (VIX) sank to 21.24, still above its long-term average.

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NOBEL PRIZE PHYSICS: John Hopfield and Geoffrey Hinton in 2024

Posted on October 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BREAKING NEWS

By Staff Reporters

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The Nobel Prize in Physics has been awarded to two researchers who helped build the foundations of the artificial intelligence that surrounds us today.

John Hopfield and Geoffrey Hinton both worked on machine learning techniques that would go on to power products such as ChatGPT.

Hopfield’s research is carried out at Princeton University and Hinton works at the University of Toronto.

MORE: https://www.nobelprize.org/

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Dental Managed Care is Substandard Care

Posted on October 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

 Dental Managed Care [DMC] is Substandard Care – count on it!

1-darrellpruittBy D. Kellus Pruitt DDS

Have you noticed most employer-sponsored dental plans boast savings of 30% and more on dental care, without mentioning how unsustainable discounts harms their employees?

Dental Managed Care [DMC] is substandard care: Discount dentistry, like virtually all underfunded handwork, has always been substandard … Or perhaps someone would like to argue that intricate surgery in sensitive mouths of nervous patients is improved when rushed.

Discounts are popular

Those who market obscure, hard to understand managed care plans to clueless, perhaps non-caring employers, do not control the quality of the discounted dentistry they sell.

Think about it: Discount dentistry without quality control. Can you think of a worse idea in healthcare?

What’s more, not one Delta Dental, Humana or Cigna executive can be held accountable for causing harm to equally clueless dental patients through under financed dentistry they sell. Employees who must choose their dentists from preferred provider lists have forfeited freedom of choice, whether they realize it or not. Their underfunded, substandard dentistry is subsidized by tax payers as a special tax-free benefit, benefiting unaccountable third parties most of all.

For example:

  • Want to know what you get with managed care dentistry? Quick prophys. 
  • How many of you get your teeth cleaned in 30 minutes or less? Do they feel clean?

One Hour

l always allowed my hygienists 1 hour to clean patients’ teeth simply because it often takes that long to do the job right – regardless what insurers say hygienists’ time is worth. The economic climate is tough on fee-for-service.

As I am considering signing on as a preferred provider – not because I want to – I notice that the fees allowed by insurers do not cover the hourly rate of most hygienists… unless they can “clean” teeth, take x-rays, take blood pressure, go over patients’ medical history, allow time for the doctor to do a quick exam and turn around the room in less than 30 minutes.

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retro dental exam room

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Assessment 

The motto of my practice is “Dentistry Unhurried.” I don’t want to compete in a race to the bottom which uninformed dental patients always lose.

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

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Stocks, Oil, Gold and Bitcoin

Posted on October 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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  • October continues to be a tough month for stocks, with all three major indexes spending yesterday afternoon in the red. The Dow in particular had a horrible day and dropped over 500 points, while major tech stocks were pushed lower by a series of analyst downgrades.
  • Oil continued its hot streak yesterday, rising above $77 on the back of geopolitical conflict in the Middle East. That helped ensure that, while everything else fell, energy was the only positive sector in the S&P 500.
  • Gold has often found itself rising in tandem with crude, though it broke that habit, with the shiny safe haven dropping a hair as investors digest the idea that the Fed’s next interest rate cut may be smaller than they thought.
  • Bitcoin broke above $64,000 for a moment yesterday only to be yanked back down, as crypto traders ride out the recent volatility.

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DAILY UPDATE: Obesity, Three Mile Island and Medical Records as Stocks Crash

Posted on October 8, 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.
How May We Serve You?
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In a public health milestone, the US adult obesity rate stopped its long climb and dropped by roughly two percentage points between 2020 and 2023, according to new data from the National Health and Nutrition Examination Survey.

In 2024, about 62% of clinicians reported that “excessive documentation requirements” is a leading cause of burnout, according to Athenahealth, a health tech and electronic health record (EHR) company. The American Medical Association reported in January that primary care physicians, for example, can spend up to 45.7 minutes on medical record documentation for every 30-minute appointment.

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

What’s up

  • Scholar Rock shares quadrupled (yes, you read that right) 361.99% after its spinal muscular atrophy drug apitegromab provided a dramatic improvement for patients in a late-stage clinical trial.
  • Super Micro Computer surged 15.79% after the semiconductor company announced it shipped over 100,000 GPUs last quarter, highlighting strong data center demand.
  • Generac Holdings makes generators, so it’s no wonder that the stock popped 8.54% thanks to huge demand for back-up power from areas hit by Hurricane Helene and places preparing to deal with Hurricane Milton.
  • Arcadium Lithium skyrocketed 35.39% after it announced that Rio Tinto has approached the lithium miner about an acquisition.
  • Air Products and Chemicals rose 9.53% after CNBC reported that activist investor Mantle Ridge has taken a $1 billion stake in the industrial gas supplier. Activist investors are clearly getting more active these days.

What’s down

  • Netflix sank 2.47% thanks to a downgrade from Barclays analysts worried that the streaming service’s revenues will slow in the coming months. That outweighed an upgrade from Piper Sandler analysts, who think the streamer’s high valuation is warranted.
  • In another big tech downgrade, Wells Fargo analysts downgraded Amazon due to multiple headwinds like competition from Walmart and lower advertising revenue. Shares sank 3.06%.
  • Back-to-back hurricanes hitting the South are pummeling insurance stocks like Universal Insurance (down 19.60%), Allstate (down 4.90%) Travelers Companies (down 4.34%) and Chubb (down 4.61%).
  • Garmin tumbled 4.06% on a downgrade from Morgan Stanley analysts, who think the device-maker’s revenue will decline and margins will shrink in the coming quarters.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 55.13 points (–0.96%) to 5,695.94;the Dow Jones Industrial Average® ($DJI) dropped 398.51 points (–0.94%) to 41,954.24; and the NASDAQ Composite® ($COMP) lost 213.94 points (–1.18%) to 17,923.90.
  • The 10-year Treasury note yield (TNX) rose five basis points to 4.03%, near two-month highs.
  • The CBOE Volatility Index® (VIX) climbed to 22.77, the highest in a month.

CITE: https://tinyurl.com/tj8smmes

Stat: $1.6 billion. That’s the size of the federal loan guarantee that the operators of Three Mile Island are seeking from the Energy Department. Constellation Energy plans to restart the infamous plant to sell electricity to Microsoft data centers (Washington Post)

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NOBEL PRIZE MEDICINE: Victor Ambros and Gary Ruvkun in 2024

Posted on October 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BREAKING NEWS!

By Staff Reporters

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STOCKHOLM (AP) — Two scientists won the Nobel Prize in physiology or medicine on Monday for their discovery of microRNA, tiny bits of genetic material that offer a way for scientists to control what’s happening in our cells and that could lead to new ways of detecting and treating diseases including cancer. The work by Americans Victor Ambros and Gary Ruvkun is “proving to be fundamentally important for how organisms develop and function,” according to a panel that awarded the prize in Stockholm.

NOBEL PRIZE: https://www.nobelprize.org/

Ambros and Ruvkun were initially interested in genes that control the timing of different genetic developments, ensuring that cell types develop at the right time. Their discovery ultimately “revealed a new dimension to gene regulation, essential for all complex life forms,” the panel said.

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USA HIRING: Up Full Force

Posted on October 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters
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Markets: Stocks soared last week despite concerns about geopolitics after new government data showed companies were hiring in full force last month.

Some other highlights:

  • The unemployment rate fell 0.1 percentage point to 4.1%.
  • The underemployment rate (for people working part-time but who want to be working more and so-called “discouraged workers”) also dropped for the first time in about a year.
  • The biggest employment gains last month came from sectors like hospitality and construction, and hourly pay inched up about 0.4%, which if you zoom out, means wages are up 4% compared to a year ago.

Plus, August’s revised jobs report showed the US actually created 159,000 jobs, up from 142,000 initially reported last month.

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But, one stock that didn’t take flight was Spirit Airlines, which sank to a record low.

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DAILY UPDATE: FluMist, Neural Data and the Jobs Report

Posted on October 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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The FDA just approved FluMist from AstraZeneca for self- or caregiver administration for the prevention of influenza virus subtypes A and B.

Plus, August’s revised jobs report showed the US actually created 159,000 jobs, up from 142,000 initially reported last month.

People in CA will have explicit rights to their own “neural data”—covering anything a person thinks or physically/emotionally feels—which is designed to prevent companies from gathering and selling that type of personal info

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TOP 25: Financial Accounting Concepts for Medical Practice Management

Posted on October 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Your Top 25 Most Urgent Questions Answered by iMBA, Inc.

http://www.MarcinkoAssociates.com

By Dr. David Edward Marcinko; MBA, MEd, CMP™

www.CertifiedMedicalPlanner.com

cmp-logoThe modern medical practice is both similar, and unlike, other businesses today. This disparity often adds to confusion for the private practitioner. And so, the experts at iMBA Inc, list the top 25 most urgent questions in practice financial management, asked by clients to date.

Assessment

Since inception in 2000, the Institute of Medical Business Advisors Inc., has become one of North America’s leading professional health consulting and valuation firms; and focused provider of textbooks, CDs, tools, templates, onsite and distance education for the health economics, administration and financial management policy space. As competition and litigation support activities increase and the cognitive demands of the global marketplace change, iMBA Inc is well positioned with offices in five states and Europe, to meet the needs of medical colleagues, related advisory clients and corporate customers today; and into the future.

Link: iMBA Inc Q and As

Website: www.MedicalBusinessAdvisors.com

biz-book1

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TELECOMMUNICATIONS: The Infinite Game

Posted on October 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Vitaliy Katsenelson, CFA

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CABLE COMPANIES
CHTR, just like Comcast, showed only a very slight decline in broadband customers in the last quarter. Most of the decline came from the US government removing subsidies for rural customers. Overall, the business is doing very well.

I want to remind you that broadband is not a secularly challenged business, but an advantaged business that we believe will resume growth soon. 

Cable companies continue to offer a great product on the market, which is actually improving in quality as I type this because they are upgrading their networks to be as fast as fiber. They should be done with their full network upgrade in a year or so.

Also, cable companies have shown that they are very good at attracting wireless customers from wireless carriers. (They have grown their wireless business by 25% in 2024). The more we analyzed this industry. the more bearish we became on AT&T and Verizon.

Though owning cable stocks has not been rewarding (I’m being very gentle to myself), the more research we’ve done into the industry, the more convinced we’ve become that once the dust settles, their market share will not decrease but likely increase. Fixed wireless has taken all the share it will take and will start donating share to cable companies as customers get frustrated with intermittency of the service and usage caps. 

The industry is moving towards the bundle – one bill for broadband and wireless (and maybe TV service, though that has been marginalized by streamers). It’s a lot easier for cable companies to add wireless customers than for wireless companies to add wired broadband customers. 

This point is paramount! 

It costs very little for a cable company to add a wireless subscriber, as 80-90% of a subscriber’s data is traveling on Wi-Fi (i.e., the cable network is already there). 

Meanwhile, the cost of building out broadband is pushing into uneconomical territory, for several reasons. First of all, all the low-hanging fruit has already been picked. It costs, let’s say, $50-100 thousand dollars to lay a mile of fiber, whether that covers one or a thousand homes. High-density areas already have cable or fiber service. With the latest upgrades the cable industry is doing, both their upload and download speeds are on par with fiber. Second, labor costs have gone up significantly over the last few years.

Verizon just announced buying Frontier Communications for $20 billion. Frontier has 2.2 million fiber subscribers. With this purchase, Verizon is paying $9,000 per fiber subscriber.

Let’s examine the economics of this transaction:

Frontier gets about $800 a year of revenues from these broadband customers (on a par with Charter and Comcast). Let’s say they achieve a 23% margin (Frontier is barely a profitable business, so I’m using Charter’s margins). Thus, each customer will generate $184 of profit for them. So Verizon is paying $9,000 for $184 of profit, and it will take Verizon 49 years to break even on this transaction. 

As you can see, these economics make no sense. Verizon and AT&T are horrible at capital allocation, and this deal is a sign of supreme desperation. The market has been slow to see what we see in Charter and Comcast, and this is always our goal – we want the market to agree with us, later. 

Our very conservative estimate of Charter’s 2028 free cash flow per share is $48-60. In this estimate we are assuming no customer growth in broadband and 2% price increases a year. At 13-15 times free cash flows, we get a price of around $630-900 in 2028. Charter is trading at about $320 as I write this. 

We really like Charter’s management. We heard an anecdote about Charter CEO Chris Winfrey that warmed our soul. A week after he became CEO, Charter announced a huge, multibillion-dollar upgrade for its broadband network. This news sent the stock down 15%. (I wrote about it; we thought it was a great idea.) Anyway, someone met Chris at a party and told him, “That’s the right move, but very gutsy.” Chris said, “We build the company for our grandchildren.” This is what we want to see from our CEOs. They’re willing to sacrifice short-term profitability to improve the business’s moat.

Often, the idea of “creating shareholder value” is misunderstood. Paying employees poorly, abusing suppliers, and trying to rip off your customers is not going to create long-term (key term) shareholder value. It may bring short-term profits and boost the stock price, but it shortens the company’s growth runway and erodes its moat.

I don’t want to get off topic, but I’ve been thinking a lot about this. We’ve spent a lot of time studying the aircraft industry; our focus was Airbus, and thus we spent a lot of time looking at Boeing.

Boeing, under previous management, focused on “shareholder value creation.” It cut costs, laid off a lot of workers, including many quality control folks. Its “shareholder value creation” didn’t stop there; it willingly lied to regulators and took shortcuts in safety. Specifically, Boeing made critical design changes to its 737 MAX aircraft without fully informing regulators or pilots, and pushed for reduced pilot training requirements to save costs. These decisions directly contributed to two fatal crashes in 2018 and 2019, resulting in 346 deaths and the worldwide grounding of the 737 MAX for nearly two years.

Did its management actions maximize shareholder value? Well, it depends on the time frame. It boosted short-term earnings and drove the stock price higher. It may have made its CEO rich beyond belief.

But.

Over a longer time frame, these decisions have destroyed shareholder value. People used to say, “If it’s not Boeing, I’m not going.” Today, I become slightly more religious when I board a Boeing plane. The company has incurred over $20 billion in direct costs related to the 737 MAX crisis, including compensation to airlines and families of crash victims, and increased production costs. 

This doesn’t account for the incalculable damage to Boeing’s reputation and loss of market share. It gave Airbus an opening to produce more planes and take market share, with Airbus surpassing Boeing in deliveries and orders in recent years, particularly in the crucial narrow-body market.

We want to own companies that aim to maximize long-term shareholder value by treating all their stakeholders fairly. We want our companies to play the infinite game. What does “fairly” mean in this context? I’ll borrow from US Supreme Court Justice Potter Stewart, who famously dodged defining pornography by saying, “I know it when I see it.”

Update: After I wrote the above, Charter proposed to buy Liberty through a merger. We don’t own Charter directly, but rather through Liberty Broadband, which holds a 25% stake in Charter. Liberty was trading at a significant discount (around 30%) to the value of its Charter shares. Liberty agreed, but at a higher price. Our estimate of Liberty’s net asset value is about $88. The shares are trading at $75 as of this writing (up from $60). If the deal goes through we’ll end up owning shares of Charter at a significant discount.

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The “WOOZLE EFFECT” is Not a GOOZLE!

Posted on October 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Evidence by Citation

By Dr. David E. Marcinko MBA

Courtesy: www.CertifiedMedicalPlanner.org

“A reliable way to make people believe in falsehoods is frequent repetition, because familiarity is not easily distinguished from truth.” – Daniel Kahneman

As I was watching with interest more [fake] news such as stories surrounding evidence by citations of Russian involvement in US elections and fake prices leading to some violent market gyrations as in Bitcoin and the Corona Virus Pandemic, and societal musings around the thematic of hoaxes … we decided to offer this theme.

Enter the WOOZLE

And so, the Woozle effect, also known as evidence by citation, or a woozle, occurs when frequent citation of previous publications that lack evidence misleads individuals, groups and the public into thinking or believing there is evidence, and non-facts become urban myths and factoids.

Not a GOOZLE: https://www.daredictionary.com/view/dare/ID_00024696

H INDEX: https://medicalexecutivepost.com/2014/11/07/understanding-the-scientific-publication-h-index/

GOOGLE SCHOLAR INDEX: Google Scholar Search

LINK: https://en.wikipedia.org/wiki/Woozle_effect

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SMART PHONES: Not for All Financial Advisors or Doctors

Posted on October 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DUMB PHONES ANYONE?

By Anonymous Reporter[s]

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Allow us [me] to suggest the use of Android and iOS shortcuts that disable bio-metric unlocking on your cell phone.  

“If you use a bio-metric phone sensor [eye scan or fingerprint], you can be compelled to decrypt your device for law enforcement because a bio-metric is something you are,” lawyer Riana Pfefferkorn said in a 2019 talk at the Defcon security conference.

But, “If you use a pass-code to decrypt, typically, you can’t be compelled to unlock, because a pass-code is something that you know.” Her talk did not cover how claiming to have forgotten a pass-code would affect those issues. 

In either case, if your cell phone becomes in possession of federal investigators, you may faces the risk of them determining the unlock code through other means, like using such third-party tools as Cellebrite’s unlocking kits to defeat the phone’s security.

Stay Legal! Or simply invoked your Fifth Amendment right against self-incrimination; if needed. 

In conclusion: I [we] advise the awareness of cell phone privacy risks involved in having so much of your life stored on personal smart cell phone devices that you take almost everywhere. Stay Safe!

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DAILY UPDATE: PayPal, IRS, Flood Insurance and the US Hiring Pace as Stocks Roar Ahead

Posted on October 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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PayPal completed its first transaction using its proprietary stablecoin to pay an invoice to Ernst & Young. It’s a milestone for the payments company’s advance into cryptocurrency.

The free IRS tax filing software, which was piloted in 12 states for the 2024 tax season, will be available in 24 states for 2025.

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

Stocks Up

  • Your loss is our gain: Shares of airline stocks popped on the news of Spirit’s problems. Delta Air Lines ascended 3.84%, United Airlines climbed 6.47%, and Frontier Group Holdings soared 16.43%.
  • Albemarle popped 8.25% on the rumor that mining behemoth Rio Tinto may try to make an acquisition of the lithium miner. Other potential takeover targets rose as well, including Arcadium (up 10%) and SQM (up 3%).
  • Abercrombie & Fitch rose 9.10% thanks to an upgrade from JP Morgan analysts, who are bullish about the fashion retailer’s recent momentum.
  • Ubisoft Entertainment skyrocketed 29.87% on the news that the video game maker’s parent company and founders are considering a buyout.

Stocks down

  • Rivian Automotive tumbled 3.15% after the EV startup cut its 2024 production forecast and missed on Q3 deliveries.
  • Homebuilder stocks sank on today’s strong jobs report, which propelled treasury yields higher, which means that mortgage rates aren’t getting any lower. D.R. Horton dropped 2.91%, Lennar fell 2.52%, and Toll Brothers lost 2.57%.
  • Transportation stocks fell thanks to an agreement between port owners and longshoremen to put the recent strike on pause. Moller-Maersk lost 5.37%, while Zim Integrated Shipping Services stumbled 12.55%.

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

Here’s where the major stock benchmarks ended:

  • The S&P 500® index (SPX) climbed 51.13 points (0.9%) to 5,751.07 up 0.22% for the week;the Dow Jones Industrial Average® ($DJI) added 341.16 points (0.81%) to 42,352.75, up 0.09% for the week; and the NASDAQ Composite® ($COMP) rose 219.37 points (1.22%) to 18,137.85, up 0.1% for the week. 
  • The 10-year Treasury note yield (TNX) soared 13 basis points to 3.98%, finishing the week up 23 basis points. The 2-year yield rose 37 basis points this week.
  • The CBOE Volatility Index® (VIX)fell to 18.58 but remains elevated from last month’s lows, likely on geopolitical concerns.

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Only 2% of the homes hit by Hurricane Helene in Georgia, North Carolina, and South Carolina had a policy protecting them against catastrophic flooding, according to an analysis by Politico and E&E News.

The US Hiring Pace picked up strongly in September and the unemployment rate ticked down to 4.1%, signs the U.S. economy had continued momentum in a month the Federal Reserve delivered its first interest-rate cut in four years. U.S. employers added 254,000 jobs last month, the Labor Department said Friday.

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About the Phillips Curve

Posted on October 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

[By staff reporters]

An important concept in macroeconomics

When Federal Reserve officials meet to decide whether to raise interest rates again, one question will be front and center according to Neil Irwin?

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[Rate of Change of Wages against Unemployment

United Kingdom 1913–1948 from Phillips (1958)]

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Question: How much faith should be placed in a line on a graph first drawn by a New Zealand economist nearly six decades ago, based on data on wages and employment in Britain dating to the 1860s?

The 57-Year-Old Chart That Is Dividing the Fed

More:

Assessment

So, if you believe in the traditional Phillips curve, as some at the Fed do, inflation should be taking off any day now?

Conclusion

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J CURVE: The Economics Paradox

Posted on October 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

IN PRIVATE EQUITY AND MEDICINE

By Staff Reporters

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PRIVATE EQUITY

In private equity, the J curve is used to illustrate the historical tendency of private equity funds to deliver negative returns in early years and investment gains in the outlying years as the portfolios of companies mature.

And, according to Wikipedia, in the early years of the fund, a number of factors contribute to negative returns including management fees, investment costs and under-performing investments that are identified early and written down. Over time the fund will begin to experience unrealized gains followed eventually by events in which gains are realized (e.g., IPOs, mergers and acquisitions, leveraged recapitalizations).

Historically, the J curve effect has been more pronounced in the US, where private equity firms tend to carry their investments at the lower of market value or investment cost and have been more aggressive in writing down investments than in writing up investments. As a result, the carrying value of any investment that is under performing will be written down but the carrying value of investments that are performing well tend to be recognized only when there is some kind of event that forces the PE to mark up the investment.

The steeper the positive part of the J curve, the quicker cash is returned to investors. A private equity firm that can make quick returns to investors provides investors with the opportunity to reinvest that cash elsewhere. Of course, with a tightening of credit markets, private equity firms have found it harder to sell businesses they previously invested in. Proceeds to investors have reduced. J curves have flattened dramatically. This leaves investors with less cash flow to invest elsewhere, such as in other private equity firms. The implications for private equity could well be severe. Being unable to sell businesses to generate proceeds and fees means some in the industry have predicted consolidation among private equity firms.

MEDICINE

In medicine, the “J curve” refers to a graph in which the x-axis measures either of two treatable symptoms (blood pressure or blood cholesterol level) while the y-axis measures the chance that a patient will develop cardiovascular disease (CVD). It is well known that high blood pressure or high cholesterol levels increase a patient’s risk.

Paradoxically, what is less well known is that plots of large populations against CVD mortality often take the shape of a J curve which indicates that patients with very low blood pressure and/or low cholesterol levels are also at increased risk.

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PODCAST: The Economic “KUZNETS” Curve

Posted on October 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

The “KUZNETS” Curve

Courtesy: www.CertifiedMedicalPlanner.org

In economics, a Kuznets curve (/ˈkʌznɛts/) graphs the hypothesis that as an economy develops, market forces first increase and then decrease economic inequality.

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

The hypothesis was first advanced by economist Simon Kuznets in the 1950s and 1960s.

PODCAST: https://www.bing.com/videos/search?q=Kuznets+Curve&view=detail&mid=A5D7EFB417EC37F3CDFEA5D7EFB417EC37F3CDFE&FORM=VIRE

Assessment: Your thoughts are appreciated.

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DAILY UPDATE: Costco Gold, US Dock Workers & OpenAI Funding as Stocks Close Lower

Posted on October 4, 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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Costco, which found success selling gold bars, will now sell platinum ones, too.

US dock workers agreed to return to work after port operators sweetened their contract offer, ending a three-day strike that threatened to disrupt the American economy. The breakthrough Thursday came after port employers offered a 62% increase in wages over six years, according to people familiar with the matter.

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

Stocks up

  • Nvidia gained 3.32% after CEO Jensen Huang said in an interview that demand for the company’s new Blackwell chips is “insane.”
  • EVgo soared 60.81% after the EV charging company received both a $1.05 billion loan from the Department of Energy and an upgrade from JP Morgan analysts.
  • Utility stocks soared in the third quarter thanks to higher electricity demand for AI, and it isn’t stopping anytime soon. Both Vistra Corp. and Constellation Energy surged 5.62% and 4.52%, respectively, on comments from Google CEO Sundar Pichai that the tech titan may utilize nuclear energy in the coming years.

Stocks down

  • Levi Strauss sank 7.69% after releasing subpar earnings, cutting its full-year sales forecast , and announcing it may sell its Dockers brand.
  • Tesla fell 3.35% after announcing a recall of over 27,000 Cybertrucks due to issues with their rearview camera.
  • Hims & Hers Health dropped 9.60% on the announcement that Eli Lilly’s weight-loss drugs are no longer on the FDA’s shortage list.
  • Joby Aviation tumbled 8.63%, giving up a portion of yesterday’s gains after the aviation startup received $500 million in additional funding from Toyota.
  • Stellantis, makers of Jeep, Dodge, and Chrysler vehicles, sank 4.11% to a new 52-week low today as a combination of terrible sales forecasts and a downgrade from Barclays analysts kicked the automaker while it’s already down.
  • Constellation Brands had strong beer sales but terrible wine and spirits sales last quarter, leading to a mixed earnings report that has shareholders worried about what the future holds. Shares sank 4.70%.

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

Here’s where the major stock benchmarks ended:

  • The S&P 500® index (SPX)fell 10 points (–0.17%) to 5,699.96; the Dow Jones Industrial Average ($DJI) dropped 185 points (–0.44%) to 42,011.59; the  NASDAQ Composite® ($COMP) shed 7 points (–0.04%) to 17,918.48.
  • The 10-year Treasury note yield (TNX) added 7 basis points to 3.85%. 
  • The CBOE Volatility Index® (VIX) rose 1.7 points to 20.59.

CITE: https://tinyurl.com/tj8smmes

Microsoft, NVIDIA, and Apple were rumored to be among the investors to participate in OpenAI’s latest funding round, pushing its market cap well beyond $150 billion. However, Apple dropped out of the exercise at the eleventh hour for unclear reasons as OpenAI was about to close the funding round.

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What is a “Kinked” Demand Curve?

Posted on October 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Modified Supply-Demand

[By staff reporters]

The Kinked-Demand curve theory is an economic theory regarding oligopoly and monopolistic competition.

When it was created, the idea fundamentally challenged classical economic tenets such as efficient markets and rapidly changing prices, ideas that underlie basic supply and demand models.

Kinked demand was an initial attempt to explain sticky prices.

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™
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ECONOMICS: Price Gouging VS. Supply & Demand

Posted on October 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

NEBULOUS DEFINITIONS

By Staff Reporters

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The simplest model of a market involves two things, supply and demand, and the price and quantity of the goods sold in the market are a function of both. When a natural disaster hits like Hurricane Helene, the immediate effect can be two-fold. In such situations, it is not unusual that the demand for certain products may increase. For example, if everyone is trying to leave the area, demand for gas may rise. The other effect is that supply for certain products may decrease. And, it may be more costly to transport gas in areas affected by a natural disaster, thus decreasing the supply of gas and in turn, increasing the price.

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

When supply decreases, the price of the good increases. And when demand increases, again the price of the good increases. So we would predict that the market price of gas, for example, would increase in areas recently affected by a hurricane. And in fact we do see this.

Price-gouging occurs when companies raise prices to unfair levels. There is no rule for what qualifies as price-gouging, but it is not an uncommon occurrence. For example in medicine, EpiPen costs is a current example of price increases that have been labeled unfair. 

Note: An epinephrine auto-injector (or adrenaline auto-injector, also known by the trade mark EpiPen) is a medical device for injecting a measured dose or doses of epinephrine (adrenaline) by means of auto-injector technology. It is most often used for the treatment of anaphylaxis. The first epinephrine auto-injector was brought to market in 1983.

Cite: https://tinyurl.com/55kmum86


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About the Laffer Curve

Posted on October 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

What it is – How it works
By staff reporters

DEFINITION:

In economics, the Laffer curve is a representation of the relationship between rates of taxation and the resulting levels of government revenue.

The Laffer curve claims to illustrate the concept of taxable income elasticity—i.e., taxable income will change in response to changes in the rate of taxation.

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

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HISTORY:

The Laffer Curve is a theory developed by supply-side economist Arthur Laffer to show the relationship between tax rates and the amount of tax revenue collected by governments.

The curve is used to illustrate Laffer’s main premise that the more an activity such as production is taxed, the less of it is generated. Likewise, the less an activity is taxed, the more of it is generated.

MORE: https://www.investopedia.com/terms/l/laffercurve.asp

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DAILY UPDATE: MSFT, J&J and CVS as Stock Markets Lag

Posted on October 3, 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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Rosh Hashanah, the Jewish New Year, begins tonight and ends on Friday. Shana Tova to those celebrating.

Microsoft overhauled its Copilot AI assistant, adding voice and vision capabilities to make it more personalized.

A new report from Deloitte reveals improving health equity could increase the country’s GDP by $2.8 trillion by 2040 and increase U.S.-based corporate profits by $763 billion.

And … Johnson & Johnson’s is not moving forward with implementation of its proposed rebate model after HRSA push-back.  

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

What’s up stocks

  • Caesars Entertainment popped 5.27% after it announced it will buy back $500 million in common shares while also offering $1 billion in senior notes to raise money.
  • Joby Aviation surged 27.92% on the news that Toyota will invest another $500 million in the aviation startup as it attempts to build a flying electric taxi.
  • Lamb Weston Holdings rose 2.62% thanks to a strong earnings report and a comprehensive restructuring plan for the french fry titan.
  • Novavax soared 19.16% following a glowing report from Jefferies analysts citing the pharma company’s strong vaccine sales.

What’s down stocks

  • Tesla sank 3.49% after revealing that auto deliveries for the third quarter came in lower than analysts expected.
  • Ford fell 2.51% for pretty much the same reason, reporting disappointing sales growth in the third quarter.
  • It’s never a good thing when a company pulls its guidance, and that was certainly true for Nike today. Shares dropped 6.77% after the company postponed its investor day and reported a 10% year over year decline in sales.
  • Nike’s report was so bad that shares of Foot Locker and Dick’s Sporting Goods fell 2.97% and 0.23%, respectively.
  • Humana plummeted 11.79% on the news that membership in its 4 star-rated Medicare Advantage plans plunged 94%.
  • Conagra Brands dropped 8.07% after the packaged food giant missed on both sales and earnings estimates last quarter.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX)was little changed at 5,709.54; the Dow Jones Industrial Average ($DJI) rose 39.55 points (0.09%) to 42,196.52; the NASDAQ Composite® ($COMP) gained 14.76 points (0.08%) to 17,925.12.
  • The 10-year Treasury note yield (TNX) added 5 basis points to 3.78%. 
  • The CBOE Volatility Index® (VIX) edged 0.4 points lower to 18.86.

CITE: https://tinyurl.com/tj8smmes

CVS is laying off nearly 3,000. The healthcare giant is conducting a strategic review as its stock has fallen more than 20% this year, the Wall Street Journal reported

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What is the “S” Logistics Chart Curve?

Posted on October 2, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

SIGMOID CURVE

By Staff Reporters

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DEFINITION

The S curve refers to a chart that is used to describe, visualize, and predict the performance of a project or business overtime. More specifically, it is a logistic curve that plots the progress of a variable by relating it to another variable over time. 

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

The term S curve was developed as a result of the shape that the data takes. Projects on the S curve often experience a slow growth at the beginning, rapid growth in the middle, and slow growth and at the end. The maximum point of acceleration is called the point of inflexion. It is at this point that the project or business returns to the initial slow growth it started from. 

MATH PROOF: https://mathworld.wolfram.com/SigmoidFunction.html

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ORDER: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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PODCAST: Health Insurance Company Subsidies

Posted on October 2, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4
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California Passes Bill Regulating Private Equity Deals

Posted on October 1, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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On August 31, 2024, the California legislature passed a bill that may curb private equity (PE) healthcare transactions in the state. The legislation is now on Governor Gavin Newsom’s desk for signature, who must sign or veto the bill by September 30, 2024. If signed into law, California will have the strictest regulation of PE deals of any state in the country.

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

This Health Capital Topics article discusses the new law and reviews the status of both state and federal regulation of PE. (Read more...)

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PODCAST: The Opioid Crisis Exposed By Mises Senior Fellow Dr. Mark Thornton

Posted on October 1, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Free Man Beyond the Wall

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We welcomes Senior Mises Institute Fellow Dr. Mark Thornton to the show. Dr. Thornton recently gave a talk at the Mises Institute Supporters Summit on the opioid crisis that is plaguing the United States. Dr. Thornton lays out a short history of this tragic epidemic that is taking lives every day.

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

He addresses how doctors prescribe these drugs, how government regulates them and explains what happens when people are forced into the “black market” to sustain their addiction.

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

PODCAST HERE: https://freemanbeyondthewall.libsyn.com/episode-169-the-opioid-crisis

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DAILY UPDATE: Health Plan Costs Up and Stock Markets Upbeat

Posted on October 1, 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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http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Despite inflation cooling down, employer health plan costs are heating up, according to a September analysis from consulting firm consulting firm Mercer.

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

STOCKS UP

STOCKS DOWN

Stellantis, the European company behind Chrysler, Dodge, and Jeep sank 12.49% after it warned that sales in the second half of its fiscal year will come in lower than expected. The bad news pulled down shares of competitors Aston Martin (which fell 24.51%), Ford (a 2% drop), and GM (3.53% lower today).

  • Carnival beat top and bottom line estimates last quarter, and posted record revenue for the third quarter. But shares stumbled 0.32% on management’s forecast that earnings in the fourth quarter will disappoint. Rival cruise companies all dropped in sympathy: Royal Caribbean fell 0.10%, while Norwegian Cruise Line Holdings tumbled 2.10%.
  • Crypto stocks took a beating today after bitcoin’s latest rally fizzled out. Coinbase fell 6.83%, while MicroStrategy lost 4.32%.

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

Here’s where the major stock market benchmarks ended:

  • The SPX gained 24.26 points (0.42%) to 5,762.48; the Dow Jones Industrial Average® ($DJI) rose 17.15 points (0.04%) to 42,330.15; the NASDAQ Composite® ($COMP) added 69.58 points (0.38%) to 18,189.17.
  • The 10-year Treasury note yield (TNX) climbed five basis points to 3.8%, near the high of its recent range.
  • The CBOE Volatility Index® (VIX) eased to 16.66 after climbing above 17 earlier today but remains up from a week ago.

CITE: https://tinyurl.com/tj8smmes

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Big Data and Health Economics: S.W.O.Ts.

Posted on September 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Brendan Collins

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Read Here: https://medicalexecutivepost.com/wp-content/uploads/2019/01/big-data.pdf

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

HIT: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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MOOCs & MOODLES – Are You a Teaching and Educational Futurist?

Posted on September 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

On Massive Open Online Courses

By Dr. David Edward Marcinko MBA M.Ed

Courtesy: www.CertifiedMedicalPlanner.org

Today, colleges and universities are beginning to identify students who are adept at learning online and reward top achievers and professors. Employers, graduate and business schools are beginning to troll MOOCs [massive open online courses] seeking viable job, and academic, candidates.

Definition

A massive open online course ( MOOC / m uː k / ) is an online course aimed at unlimited participation and open access via the web.  In addition to traditional course materials such as filmed lectures, readings, and problem sets , many MOOCs provide interactive courses with user forums to support community interactions among students, professors, and teaching assistants (TAs) as well as immediate feedback to quick quizzes and assignments.

Dictionary: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

Update

In fact, when I last checked, the nation’s graduate, B-school and MBA students were enrolled in more than 118 online MBA/MPH/MSH healthcare administration programs. MOOCs offer greater access for a larger number of students, at significantly lower costs than on-site programs.

By the same token, technology like Blackboard®, Cengage, eXplorance, BANNER and Kalture must be used to full potential. Smart phones, PCs and tablets, videos, interactive games, A.I. simulators and apps with Skype®-like virtual classrooms and cloud storage are obvious embellishments to online initiatives.

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Definition

A Moodle is a free and open-source learning management system written in PHP and distributed under the GNU General Public License. Developed on pedagogical principles, Moodle is used for blended learning, distance education, flipped classroom and other e-learning projects in schools, universities, workplaces and other sectors.

Note: PHP is a popular general-purpose scripting language that is especially suited to web development. Fast, flexible and pragmatic, PHP powers everything from your blog to the most popular websites in the world.

Dictionary: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

ASSESSMENT: Your thoughts are appreciated. Are you a didactic educational futurist? MOOCs or MOODLES anyone?

MORE BUSINESS, EDUCATION AND FINANCE FOR DOCTORS:

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

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

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

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DAILY UPDATE: The Stock Markets and Meta

Posted on September 30, 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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  • Markets: It’s been a September to remember for the stock market after the S&P 500 and Dow Jones hit fresh highs last week. Thursday was the 42nd record-high close for the S&P 500 this year, and on Friday, the Dow notched its 32nd record-high close, per CNN Business. Recent data indicates that all the ingredients are coming together for a “soft landing”: The economy is staying strong while inflation has continued to fall. And more rate cuts are on their way.

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

Stock spotlight: Meta’s rally this year has been fruitful for its CEO’s bank account. The net worth of Mark Zuckerberg, who owns a 13% stake in his company, climbed above $200 billion for the first time, per Bloomberg. He’s now the fourth-richest person in the world.

CITE: https://tinyurl.com/tj8smmes

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Hospital Operations Finally Rebound Post-COVID

Posted on September 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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For the first time since the COVID-19 pandemic, hospitals are finally reporting sustained, improved financial and operational performance. To date in 2024, hospitals have seen better margins, increased patient utilization, and a more stabilized workforce. Another result of this improved performance has been an increase in hospital transactional activity.

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

This Health Capital Topics article reviews the hospital sector performance to date, factors driving this improvement, and the impact on hospital transactional activity. (Read more...) 

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BENEFICIARIES: Assigned to MSSP Accountable Care Organizations [ACOs]

Posted on September 29, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Number of Beneficiaries Assigned to MSSP ACOs, 2012-2013 to 2022

By Charlene Ice

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  1. 2012/2013: 3.2 million
  2. 2014: 4.9 million
  3. 2015: 7.3 million
  4. 2016: 7.7 million
  5. 2017: 9 million
  6. 2018: 10.5 million
  7. 2019: 10.4 million
  8. 2020: 11.2 million
  9. 2021: 10.7 million
  10. 2022: 11 million

Notes: “MSSP” denotes the Medicare Shared Savings Program
Source: Statista, June 20, 2022
Source URL: https://www.statista.com/statistics/1278948/number-of-benefi…

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

Posted on September 29, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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  • Markets: Wall Street life was looking good last week as all the major indexes clinched their third consecutive winning week. Stocks were a mixed bag for Friday, but the Dow Jones scored another record close. Bristol Myers Squibb rose after the FDA approved its schizophrenia drug as the first new treatment for the condition in decades.
  • Economy: The FOMC’s favorite inflation gauge came in lower than expected for last month, likely clearing the way for Jerome Powell and the Federal Reserve to keep cutting interest rates.

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

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When Medical Doctors are Entrepreneurs

Posted on September 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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By Michael Accad MD

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In this article, I wish to introduce the reader to the theory of entrepreneurship advanced by Frank Knight (1885–1972), and show that the common, everyday work of the physician could be considered a form of entrepreneurial activity in the Knightian sense.

FRANK KNIGHT PhD: https://medicalexecutivepost.com/2019/06/12/what-is-knightian-uncertainty-in-economics/

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READ: https://mises.org/library/when-medical-doctors-are-entrepreneurs

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ADVICE: Financial, Investment or Medical Practice Management Second Fiduciary Opinions

Posted on September 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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MARCINKO & ASSOCIATES, Inc.

SPONSOR: http://www.MARCINKOASSOCIATES.com

Dr. David Edward Marcinko MBA MEd CMP®

Certified Medical Planner®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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FINANCIAL PLANNING

CAREER DEVELOPMENT

MEDICAL PRACTICE BUY IN / OUT

INVESTMENT ANALYSIS

PORTFOLIO MANAGEMENT

MERGERS AND ACQUISITIONS

PRACTICE APPRAISALS AND VALUATIONS

RETIREMENT PLANNING

FEE-ONLY

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On DISPOSABLE and Other “Next-Gen” Credit Cards

Posted on September 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Touring with Marcinko | The Leading Business Education ...

BY DR. DAVID EDWARD MARCINKO MBA CMP®

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‘Chip & Pin’ Technology

Disposable credit cards are the newest innovation to help reduce fraud and assumed identity scams on e-commerce based websites. As with traditional credit cards, these cards are numbered, but used only once. Then, electronically they are erased so that there is nothing left in the merchant’s database for hackers to steal.

But, in 2014, Congress began looking at new ways to keep personal credit card information safe after several high-profile security breaches at some of America’s top retailers.

WHY? Current credit cards use easy to hack magnetic strip technology from the 1960s. Many consumers want more secure “pin & chip” cards which have been in use in Europe for years. Even though micro-chip technology costs billions to implement, merchants are moving in that direction as they issue new cards to consumers. Most modern polls show nearly half of all people surveyed are extremely concerned about the safety of their personal credit card information.

Burner Cards: Similar to a burner phone or “throwaway” social media account, burner credit cards are temporary, virtual credit cards that are not your “main” credit card. The bank or burner card app will give you a temporary number that links back to your main credit card which you can use for online purchases.

An ANonymous Credit Card provides an extreme degree of privacy and prevents the tracking of your expenses by a spouse, people with bad intentions or government monitoring agencies. It is important to realize that there are plenty of legitimate reasons for wanting to buy something discreetly through an Anonymous Credit Card.

Credit Card Mistakes to Avoid

No number has as far-reaching an impact on your money as your credit scores.

Here are some obstacles, physicians and all of us, should dodge on the road to financial security:

  • Don’t pay for a credit card repair service.
  • Don’t miss a payment.
  • Don’t max out your card.
  • Don’t take a cash-advance.
  • Don’t skip using your cards.
  • Don’t chase interest rates.
  • Don’t apply for several credit cards all at once.
  • Don’t co-sign a loan.
  • Don’t spread our car or mortgage payments.

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

Denied Credit

If you are denied a credit card, you have the right to obtain a credit report free from the agency which denied you. Your request must be made in writing and within thirty-sixty days. Consumer credit is governed by the Fair Credit Reporting Act (FCRA).  The regulations are issued by and enforced by the Federal Trade Commission. Certain states offer consumers additional rights.  Credit reporting agencies are referred to as a “consumer reporting agency”.

ASSESSMENT: Your thoughts are appreciated.

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

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DAILY UPDATE: MyChart, Meta, Zelle and Acadia as the DJIA Rises

Posted on September 28, 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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Stat: 150. That’s how many health systems use AI to help draft replies on MyChart, sometimes without disclosing this to patients. (the New York Times)

Contained in a roughly 200-page quarterly filing from JPMorgan Chase last month were eight words that underscore how contentious the bank’s relationship with the government has become. The lender disclosed that the Consumer Financial Protection Bureau could punish JPMorgan for its role in Zelle, the giant peer-to-peer digital payments network. The bank is accused of failing to kick criminal accounts off its platform and failing to compensate some scam victims.

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

Stocks Up

Bristol-Myers Squibb rose 1.56% after the FDA approved its new drug for schizophrenia, the first new treatment of its kind in decades. Some analysts expect the drug, Cobenfy, to bring in $6 billion in peak annual revenue.

  • Trump Media gained 5.58% despite a co-founder of its Truth Social platform cashing out nearly all of his shares—worth about $100 million at current prices.
  • Chinese EV maker Nio added another 12.80% to bring its weekly gains to nearly 25%. It’s benefiting from the overall euphoria around Chinese stocks and anticipation over its quarterly delivery numbers due next week.
  • Speaking of the Chinese government’s stimulus measures, investors are wagering that the Macau locations of Las Vegas Sands Corp. (up 5.59%) and Wynn Resorts (up 7.24%) will see more visitors.
  • IonQ, a quantum computing company based in College Park, MD (go Terps), shot up 20.47% after inking a contract with the US Air Force Research Lab.

Stocks down

  • Nvidia dropped 2.17%. Bloomberg reported that the Chinese government is ramping up the pressure on local tech companies to move away from using Nvidia AI chips and lean more on domestic suppliers.
  • WeightWatchers, whose shares are down more than 90% this year, booted its CEO Sima Sistani, who pivoted the company to weight-loss drugs. Investors aren’t betting a change at the top will lead to a turnaround, sending shares 2.11% lower on the day.
  • Globe Life sank 4.74% after the US Equal Employment Opportunity Commission found that the life insurance company tolerated a “pervasive pattern of harassing conduct” at one of its top sales agencies, per Business Insider.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) lost 7.20 points (–0.13%) to 5,738.17 to end the week up 0.62%; the Dow Jones Industrial Average® ($DJI) added 137.89 points (0.33%) to 42,313.00 to end the week up 0.59%; the NASDAQ Composite® ($COMP) fell 70.70 points (–0.39%) to 18,119.59 to end the week up 0.95%.
  • The 10-year Treasury note yield (TNX) fell four basis points to 3.75%, up two basis points for the week.
  • The CBOE Volatility Index® (VIX) jumped to 16.64.

CITE: https://tinyurl.com/tj8smmes

Meta is facing a fine of $102 million for storing some users’ passwords in “plaintext”. The social media giant has admitted to poor password management.

Acadia and the Department of Justice just reached a ~$20M agreement to settle accusations that the company billed Medicare, Medicaid, and TRICARE for medically unnecessary inpatient mental health services. Acadia found itself under pressure after a New York Times investigation published earlier in September allegedly found that the company kept patients in facilities against their will to maximize insurance payments.

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CMS: A New Primary Care Medicine Model

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

“MAKING CARE PRIMARY”

By Health Capital Consultants, LLC

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CMS Announces New Primary Care Model

On June 8, 2023, the Centers for Medicare and Medicaid Services (CMS) announced the establishment of Making Care Primary (MCP) Model, a voluntary primary care model that will be tested in Colorado, Massachusetts, Minnesota, New Mexico, North Carolina, New York, New Jersey, and Washington.

Launched on July 1, 2024, the 10 ½ year model will seek to improve the coordination and management of care, enable primary care clinicians to form relationships with healthcare specialists, and form community-based connections to address the health needs of patients, as well as health-related social needs such as nutrition and housing.
CITE: https://www.r2library.com/Resource

This Health Capital Topics article will discuss the new MCP Model and its implications for the healthcare industry. (Read more...)

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Filed under: "Advisors Only", "Doctors Only", Career Development, Drugs and Pharma, Ethics, Events-Planner, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Managed Care, Op-Editorials, Quality Initiatives, Taxation | Tagged: , , , , , , , | Leave a comment »

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