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A Medical Practice business valuation is a set of procedures to estimate the economic value of a physician owner’s interests. Valuation is used to determine the price they are willing to pay or receive to affect a sale of the practice.
The same valuation tools are often used to resolve disputes related to estate and gift taxation, divorce litigation, allocated purchase price among business assets, establish a formula for estimating the value of partners’ ownership interest for buy-sell agreements, and other business and legal purposes.
QUERY: But, what are the most common medical practice valuation blunders to avoid? Written over a decade ago, this white paper highlights the most common mistake still seen today.
Posted on January 9, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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By the numbers:
The unemployment rate dropped to 3.5%, the lowest it’s been in 50 years.
The US added 223,000 non-farm jobs in December. Though job growth slowed from the previous month, the labor market is still going strong.
In 2022, 4.5 million total jobs were added, compared with 6.7 million in 2021.
But the number that really got people talking was the lower-than-expected month over month wage growth, which slowed to .3% in December and 4.6% annually.
While that might not sound like welcome news to anyone who doesn’t live off a fortune inherited from their robber baron granddad, the folks at the Federal Reserve are most certainly pleased. Rapidly growing paychecks are seen as one of the key drivers of inflation, which the Fed has been trying to tame with aggressive interest rate hikes since early last year.
Economists have dubbed the jobs data a “Goldilocks” situation—not too hot, and not too cold. Since both the labor shortage and the strident wage growth it drove seem to be abating, the hope is that inflation will continue to decline. At the same time, a strong labor market (fingers crossed) might just allow the economy to avoid a recession caused by the interest rate increases.
Meanwhile, according to Sam Klebanov of MorningBrew, experts expect slowing wage growth to signal to the Fed that it’s time to chill with the aggressive rate hikes. And it’s not just speculation: Here at the Federal Reserve Bank of Atlanta, President Raphael Bostic said that he’d lean toward just a 25 basis point increase for the next interest rate hike (as opposed to 50 basis points) if the labor market continues to cool.
Finally,Wall Street Legend Burton Malkiel says returns over the next decade will likely be 5 to 6 percent.
Posted on January 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Consumer price data will offer clues about the Federal Reserve’s next policy move, while quarterly results from big banks get fourth quarter earnings season underway.
The stock market rally to kick off 2023 will be put to the test next week when investors face a highly-awaited inflation reading and the start of fourth quarter earnings season, which will be led by big banks.
And, this Thursday morning will bring December’s Consumer Price Index (CPI), a release likely to dictate bets on whether the Federal Reserve raises interest rates by 0.25% or 0.50% at the start of next month.
According to Yahoo Funance, economists expect headline CPI rose 6.6% over the prior year in December, a downshift from the 7.1% increase seen in November, according to data from Bloomberg. On a month-over-month basis, CPI likely stayed flat.
Core CPI, which removes the volatile food and energy components of the report and is closely tracked by the Fed, is also expected to have risen at a slower pace last month, coming in at 5.7% after a 6% increase in November. Over the prior month, core CPI is expected to rise 0.3% after a 0.2% jump in November.
Policymakers monitor “core” inflation more closely due to its nuanced look at key inputs like housing, while the headline CPI figure has moved largely in tandem with volatile energy prices this year.
Most of the thousands of buy and sell orders executed on a typical day on the NYSE are in 100 share or multi-100 share lots. These are called round lots. Some of the inactive stocks traded at post 30, the non-horseshoe shaped post in the northwest corner of the exchange, are traded in 70 share round lots due to their inactivity. So, while a round lot is normally 700 shares, there are cases where it could be 10 shares. Any trade for less than a round lot is known as an odd lot. The execution of odd lot orders is somewhat different than round lots and needs explanation.
When a stock broker receives an odd lot order from one of his doctor customers, the order is processed in the same manner as any other order. However, when it gets to the floor, the commission broker knows that this is an order that will not be part of the regular auction market. He takes the order to the specialist in that stock and leaves the order with the specialist. One of the clerks assisting the specialist records the order and waits for the next auction to occur in that particular stock. As soon as a round lot trade occurs in that particular stock as a result of an auction at the post, which may occur seconds later, minutes later, or maybe not until the next day, the clerk makes a record of the trade price.
Every odd lot order that has been received since the last round lot trade, whether an order to buy or sell, is then executed at the just noted round lot price, the price at which the next round lot traded after receipt of the customer’s odd lot order, plus or minus the specialist’s “cut “. Just like everything else he does, the specialist doesn’t work for nothing. Generally, he will add 1/8 of a point to the price per share of every odd lot buy order and reduce the proceeds of each odd lot sale order by 1/8 per share. This is the compensation he earns for the effort of breaking round lots into odd lots. Remember, odd lots are never auctioned but, there can be no odd lot trade unless a round lot trades after receipt of the odd lot order.
Posted on January 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Practical applications in financial services
Among practical applications provided by the Metaverse, its ability to create virtual environments for people to connect may severely impact the financial industry. The employment of VR and AR during COVID-19 and remote work conditions enabled greater collaboration in teleconferencing where professionals used annotating, chatting and screen-sharing features, allowing them to work efficiently while not in the same physical space.
VR and AR can also be used by financiers in individual capacities, particularly with data visualization, aiding them in analyzing financial risks, providing more precise services to customers. This raises the bar on their expectations, stimulating competition and innovation in the market.
Moreover, virtual environments can be used in consumer-oriented manners. The creation of digital shopping environments in the Metaverse acts as a hub for companies to reach a wider range of consumers without geographical constraints, allowing for greater exposure. Such virtual shopping hubs can employ digital payment means so that transactions take place entirely within the realm of the Metaverse.
Through digital means, financial advisors can provision for greater convenience, signifying a shift in the industry, and broadening the scope of the services clients can be provided with, such as AR being used to simulate different financial scenarios so that customers can visualize them with ease. With the progression of the Metaverse in finance and banking, the next developments could see the creation of fully-digital bank branches, diminishing or perhaps eliminating the need for physical ones. Such client centric developments can either build upon existing consumer experiences or create entirely new ones.
A main attractive feature of using VR or AR is the ability to superimpose a wider range of information digitally, which mobile devices or computer screens would not accommodate. Thereby, complementing existing mobile banking apparatus, such as apps that showcase customers’ account balances or direct them to the nearest bank branches using AR.
Some people are concerned about whether there is anything for banks to benefit from entering the metaverse. There are a host of new opportunities for banks in the metaverse. So, tet’s look at the most important ones
Firstly, they are working with the idea that being the early adopters by entering the field before others will give them an advantage over latecomers in the future. That is why they are investing in potentially strategic locations in the metaverse.
Secondly, some digital banks imagine that the metaverse has the potential for the banking industry to reinvent transactions for a three-dimensional (3D) world. That is why they are experimenting with it. The primary objective has been to learn new ways of meeting the needs of their customers who are crazy about trending technologies. With metaverse, it could be possible to enable customers to pay bills, check balances, and transfer money using VR or AR channels.
Thirdly, as the younger generations are becoming more attracted to crypto-friendly banks, NFT marketplaces, and other blockchain-based platforms, digital banks are looking for unconventional ways to improve theirbrand image. So, a smart marketing strategy is to create the presence of their brands in the metaverse and win the hearts of their customers through their show of modernity.
Fourthly, the metaverse can offer new ways for banks to engage with their customers. A customer could stay at home and interact with an avatar concerning any business they have with their bank. This technology can be used to deliver personalized financial advice, product recommendations, and even financial planning.
Finally, entering the metaverse is a way for digital banks to poolhighly talented employees. It makes them attractive to professionals such as data scientists, developers, and other IT experts who have been working in this developing field and are looking for job opportunities that can bring out the best in them. For example, the metaverse has the potential for use in on-boarding remote workers and training employees on safety and other aspects of their jobs using simulated environments.
Posted on January 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
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Dry January is a campaign delivered by Alcohol Change UK where people sign up to abstain from alcohol for the month of January. The term “Dry January” is a registered trademark with Alcohol Change UK and was first registered in 2014.
The campaign was first delivered in 2013 by Alcohol Concern (now called Alcohol Change UK) and 2023 marks the 10th anniversary of the campaign. Emily Robinson, founded the campaign after taking a month off alcohol in January 2011 to prepare for a half marathon. After noticing the benefits and people’s interest in her month off alcohol she decided to start the campaign when she joined Alcohol Concern in 2012. Around the same time Nicole Brodeur of The Seattle Times wrote a column on her first Dry January motivated by a friend who had done the same for several years before.
In its first year, 4,000 people signed up for Dry January and it has grown in popularity ever since with over 130,000 people signing up to take part in 2022. Dry January was endorsed by Public Health England in 2015 leading to a large uptake in numbers and steady increase in participants year on year. Research by the University of Sussex published in 2020 found that those signing up to take part in Dry January using Alcohol Change UK’s free Try Dry app and/or coaching emails were twice as likely to have a completely alcohol-free month, compared to those who try to avoid alcohol on their own in January, and have significantly improved well-being and healthier drinking six months later.
Posted on January 7, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
Closer than You Think?
By Staff Reporters
An interactive look at how the health space — from education to therapeutic support — is evolving with virtual reality.
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When Dr. Linda Ciavarelli tried out her 13-year-old son’s new Quest headset for the first time, she saw the future.
Specifically, the podiatry specialist in Wilmington, Delaware saw a new way to make health information accessible — an idea that is now a functioning Horizon Worlds space called HouseCall VR.
Posted on January 7, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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A multi-disciplinary panel of doctors and IT experts from Asia, the United States, and Europe analyzed published articles regarding expert consensus on the Medical Internet of Things, with reference to study results in the field of metaverse technology.
Posted on January 7, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Stocks recorded their first significant rally of 2023 on Friday, as the release of jobs data triggered a relief rally that saw the major U.S. equity averages all rise more than 2%. This marked the biggest one-day percentage gain for the S&P 500 since Nov. 30. The Dow (DJI) ended +2.1%, the S&P 500 (SP500) closed +2.3%, and the NASDAQ Composite (COMP.IND) finished +2.6%.
It seems investors digested December’s key non-farm payroll report and its possible implications on future Fed moves. While job growth remained robust and the unemployment rate fell, indicating a tight job market, wage increases continued to slow. The report came in the wake of other employment data and the Fed’s meeting minutes this week that appeared to solidify expectations of the Fed remaining aggressive in its rate hike campaign.
Meanwhile, domestic services sector activity tumbled into contraction territory for the first time since May 2020 and factory orders fell more than forecasts.
Treasury yields dropped following the data, and the U.S. dollar fell, while crude oil prices nudged higher, and gold gained ground. News on the equity front was in short supply, but Tesla was back in the news after it said it will slash prices in China for a second time, and Bed Bath & Beyond is reportedly near filing for bankruptcy, while Costco reported net sales that were well received.
Stocks in Asia were mixed, and European stocks were noticeably higher, as the markets digested regional economic data and the U.S labor report.
Posted on January 7, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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New medicines launched by US drug makers reached a median price of $222,003 last year, according to Reuters. These astronomical prices were fueled by three very-expensive gene therapies approved by the FDA. In fact, one of them, from Hemgenix, costs $3.5 million, making it the most expensive drug ever.
Congress did cap annual drug price increases via the Inflation Reduction Act, but that doesn’t cover the cost of new medications. Drug-makers, meanwhile, say the cost of their drugs doesn’t reflect what patients pay out-of-pocket for them.
Posted on January 6, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Here are eight things to keep in mind as you prepare to file your 2022 taxes
1. Income tax brackets shifted somewhat
There are still seven tax rates, but the income ranges (tax brackets) for each rate shifted slightly to account for inflation. For 2022, the following rates and income ranges apply:
Taxable income brackets
Tax rate
Single filers
Married couples filing jointly (and qualifying widows or widowers)
10%
$0 to $10,275
$0 to $20,550
12%
$10,276 to $41,775
$20,551 to $83,550
22%
$41,776 to $89,075
$83,551 to $178,150
24%
$89,076 to $170,050
$178,151 to $340,100
32%
$170,051 to $215,950
$340,101 to $431,900
35%
$215,951 to $539,900
$431,901 to $647,850
37%
$539,901 or more
$647,851 or more
2. The standard deduction increased somewhat
After an inflation adjustment, the 2022 standard deduction increases to $12,950 for single filers and married couples filing separately and to $19,400 for single heads of household, who are generally unmarried with one or more dependents. For married couples filing jointly, the standard deduction rises to $25,900.
3. Itemized deductions remain essentially the same
For most filers, taking the higher standard deduction is more practical and saves the hassle of keeping track of receipts. But if you have enough tax-deductible expenses, you might benefit from itemizing.
State and local taxes: The deduction for state and local income taxes, property taxes, and real estate taxes is capped at $10,000.
Mortgage interest deduction: The mortgage interest deduction is limited to $750,000 of indebtedness. But people who had $1,000,000 of home mortgage debt before December 16, 2017 will still be able to deduct the interest on that loan.
Medical expenses: Only medical expenses that exceed 7.5% of adjusted gross income (AGI) can be deducted in 2022.
Charitable donations: The deductions for charitable donations are not as generous as they were in 2021. In 2022, the annual income tax deduction limits for gifts to public charities1 are 30% of AGI for contributions of non-cash assets—if held for more than one year—and 60% of AGI for contributions of cash.
Miscellaneous deductions: No miscellaneous itemized deductions are allowed.
4. IRA contribution limits remain the same and 401(k) limits are slightly higher
The traditional IRA and Roth contribution limits in 2022 remain the same as the prior year. Individuals can contribute up to $6,000 to an IRA, and those age 50 and older also qualify to make an additional $1,000 catch-up contribution. If you’re able to max out your IRA, consider doing so—you may qualify to deduct some or all of your contribution.
However, the 2022 contribution limits for 401(k) accounts have increased to $20,500. If you’re age 50 or older, you qualify to make an additional $6,500 catch-up contribution for this tax year as well.
5. You can save a bit more in your health savings account (HSA)
For 2022, the maximum you can contribute to an HSA is $3,650 for an individual (up $50 from 2021) and $7,300 for a family (up $100). People age 55 and older can contribute an extra $1,000 catch-up contribution.
To be eligible for an HSA, you must be enrolled in a high-deductible health plan (which usually has lower premiums as well). Learn more about the benefits of an HSA.
6. The Child Tax Credit is lower after a one-year bump
Tax credits, which reduce the tax you owe dollar for dollar, are normally better than deductions, which reduce how much of your income is subject to tax.
In 2021, the American Rescue Plan Act (ARPA) temporarily enlarged the Child Tax Credit. But in 2022, the credit returns to $2,000 per child age sixteen or younger. The credit is also subject to a phase-out starting at $400,000 for joint filers and $200,000 for single filers. For other qualified dependents, you can claim a $500 credit.
7. The alternative minimum tax (AMT) exemption is higher
Until the AMT exemption enacted by the Tax Cuts and Jobs Act expires in 2025, the AMT will continue to affect mostly households with incomes over $500,000. For 2022, the AMT exemptions are $75,900 for single filers and $118,100 for married taxpayers filing jointly. The phase-out thresholds are $1,079,800 for married taxpayers filing a joint return and $539,900 for all other taxpayers. (Once your income for the AMT hits the phase-out threshold, your AMT exemption begins to phase out at 25 cents for every dollar over the threshold.)
8. The estate tax exemption is even higher
The estate and gift tax exemption, which is indexed to inflation, rises to $12.06 million for 2022. But the now-higher exemption is set to expire at the end of 2025, meaning it could be essentially cut in half at that time if Congress doesn’t act.
The annual gift exclusion, which allows you to give money to your loved ones each year without incurring any tax liability or using up any of your lifetime estate and gift tax exemption, increases to $16,000 per recipient (up $1,000 from 2021).
Don’t get caught
Finally, if you’re age 72 or older, make sure you’ve taken your required minimum distribution (RMD) from your retirement accounts before the end of the year or else you face a 50% penalty on any undistributed funds (unless it’s your first RMD, in which case you can wait until April 1, 2023).
Silvergate Capital Corporation reported a sharp drop in fourth-quarter crypto-related deposits on Thursday as investors spooked by the collapse of FTX pulled out more than $8 billion in deposits, sending shares down more than 42%. The crypto-focused bank also said it would cut its workforce by 40%, or about 200 employees, as it tries to rein in costs amid a deepening industry downturn. Its stock was last trading at $12.55.
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U.S. stocks were lower as the markets continued to speculate as to how long the Fed will keep its monetary policy tight. Yesterday’s minutes from the Fed’s December meeting suggested that the Central Bank will remain aggressive. Jobs data pointed to a tight labor market, as the ADP Employment Change Report came in higher than expected, and jobless claims were lower than anticipated, which seemed to be solidifying expectations of further rate hikes. Services sector data also came out, with output being revised higher but continuing to depict contraction.
Treasury yields were mixed, and the U.S. dollar rallied following the data, while crude oil prices rose, and gold dropped.
Equity news offered varying results, as Exxon Mobil offered mixed Q4 guidance, T-Mobile US’ phone customers topped forecasts, Constellation Brands missed earnings estimates and lowered guidance, and Conagra Brands topped quarterly estimates.
Finally, Asian stocks finished mostly higher, and European stocks were mixed following a three-day winning streak, as the markets digested the Fed’s minutes and amid optimism regarding China’s reopening.
Remember, in 2023, do not trigger the US estate and gift tax. Last year’s inflation, the highest in decades, means married couples can now hand their heirs almost $26 million tax-free, $1.7 million more than in 2022 and $2.4 million more than in 2021.
The hike in the lifetime estate-and-gift tax exemption — adjusted for price growth annually by the Internal Revenue Service — is the largest since 2018, when the amount was doubled by Republican-passed legislation signed by former President Donald Trump the prior year. As a result, the individual exemption, which is easily shared between spouses, has rocketed to $12.9 million from $5 million in 2011.
But, richer Americans may be running out of time to pass on this much wealth. The exemption is slated to be cut in half in three years, when provisions of Trump’s tax law are set to expire. While even $26 million is a drop in the bucket for the ultra-rich, the exemption’s size shows why generational wealth transfers — estimated by research firm Cerulli to total almost $73 trillion in the US through 2045 — go largely untouched by the government.
Plus, financial advisors may use loopholes and leverage to multiply the amount of tax-free money available to heirs.
Posted on January 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Ark Invest, the firm led by prominent stock picker Cathie Wood, bought up millions worth of Tesla during the electric vehicle maker’s worst daily dip in more than two years as Wood continues to double down on what initially brought her riches.
U.S. equities finished modestly higher, paring some of the losses that have weighed on the markets to start of 2023.
Treasury yields continued to drop, and the U.S. dollar gave back some of yesterday’s rally, while crude oil prices plunged to extend a recent decline and gold traded to the upside.
Equity news remained sparse, with Dow member Salesforce announcing plans to cut its workforce by about 10%, while Alibaba rallied on signs China may be easing its clampdown on the tech sector.
The economic calendar offered some lackluster data points, as manufacturing activity remained in contraction territory for the second-straight month, and mortgage applications fell for a second-consecutive week as interest rates jumped, while job openings came in above forecasts. Elsewhere, the Fed released the minutes from its December monetary policy meeting, indicating its commitment to continue to raise rates until more progress is made in curbing inflation.
Asia finished mixed, and Europe added to yesterday’s solid start to 2023.
Posted on January 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
Limitless possibilities – Compassionate care
By Staff Reporters
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DEFINITION: GE HealthCare is a subsidiary of American multinational conglomerate General Electric incorporated in New York and headquartered in Chicago, Illinois. As of 2017, it is a manufacturer and distributor of diagnostic imaging agents and radio-pharmaceuticals for imaging modalities used in medical imaging procedures
TUCSON, Ariz., Dec. 06, 2022 (GLOBE NEWSWIRE) — Sheila Page, D.O., a family physician in Aledo, Texas, and president of the Association of American Physicians and Surgeons (AAPS), is featured in the winter issue of the of the Journal of American Physicians and Surgeons. She writes: “Today physicians often feel constrained to pick from among options that are not in the best interest of patients but are ‘covered’ by insurance or approved by officials.”
“An apparently free choice when there is no real alternative is a Hobson’s Choice, and physicians must understand the political structure in which this type of ‘choice’ is embedded,” Dr. Page explains.
“During the COVID pandemic, people often faced a Hobson’s Choice of taking a shot that they believed put their life, health, or fertility at risk, or be barred from their education or career,” she noted.
“Voters generally believe that they have two choices, Republican or Democrat, and that they represent extremes of political ideology. However, when they are in office, politicians behave as if they belong to the same club,” she writes.
“Physicians have accepted the Hobson’s Choice of either abiding by ridiculous regulatory burdens or refusing to treat the senior population,” she explains. They “accept the Hobson’s Choice of either standing against the oppression or keeping their ‘place at the table.'”
“The phrase ‘we need to keep our place at the table to avoid being on the menu’ entirely misses the point,” she states. “The profession is on the table already being carved up. How many times have we been told we must choose the lesser of two evils? Either choice is still evil!”
“We must identify the enemy within,” Dr. Page writes. “The medical profession must grasp the extent to which it has been manipulated by pharmaceutical, insurance, and other systems tied to medicine. We have been burdened with regulations and threats to our licenses by the same people who are selling us the solutions.”
“There is tremendous profit in the existing system, but we must nevertheless offer healing and hope, learn how to fight back effectively, and reject the Hobson’s Choice,” she concludes.
Posted on January 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
A ME-P Reader Opinion Poll
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DEFINITION: NBER defines a recession as “a significant decline in economic activity that is spread across the economy and that lasts more than a few months.” That definition encompasses a range of economic factor but is based on three main criteria: The depth, diffusion and duration of a downturn.
Former Federal Reserve Chair Alan Greenspan recently said a US recession is the “most likely outcome” in 2023 as the central bank tightens monetary policy to curb inflation.
Posted on January 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
SHORT SALE
By Staff Reporters
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DEFINITION: Short selling involves borrowing a security whose price you think is going to fall from your brokerage and selling it on the open market. Your plan is to then buy the same stock back later, hopefully for a lower price than you initially sold it for, and pocket the difference after repaying the initial loan.
Tesla’s stock plummeted more than 12% yesterday for its worst trading session in more than two years. The proximate cause: Though the EV manufacturer sent out a record 405,278 vehicles in the last quarter of 2022, it missed analyst expectations and its own growth goal for the year.
Tesla’s brutal selloff was the continuation of a dramatic downward trend: The most valuable automaker in the world lost 65% of its value in 2022.
And while it may be easy to pin the blame on CEO Elon Musk’s fascination with his shiny new toy, Twitter, the problems go beyond a distracted boss:
Production has slowed down due to Covid shutdowns in China.
Demand has cooled for its vehicles due to lower gas prices, interest rate hikes, and increased competition.
It has suffered from logistical issues that were at least partially to blame for its inability to deliver all of the vehicles that it produced.
Posted on January 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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U.S. equities gave up early gains and finished lower on the first trading session of the year. Today’s movement followed the long holiday weekend, and the end of 2022, which posted the worst yearly decline since 2008. Equity news was light to begin the new year, but Tesla’s shares fell after the company missed on Q4 delivery expectations due to ongoing logistical issues, growing demand concerns, and stiff competition.
Several economic reports were released after the opening bell, as a read on domestic manufacturing activity remained in contraction territory, while construction spending unexpectedly rose in December.
Treasury yields fell and the U.S. dollar rallied, while crude oil prices lost solid ground, and gold was higher.
Finally, Asian stocks finished mixed, and markets in Europe rose, as the international markets digested a host of PMI reports, German inflation data, and the recent rise in China’s COVID cases.
Posted on January 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
There are several types of mental illnesses, but the list below will provide an overview. These categories are also helpful in understanding a person with a particular ailment. Knowing more about these conditions will help you develop more profound empathy for those with the same condition and hope that treatment will be available. The following […]
“Central bank money” refers to money that is a liability of the central bank. In the United States, there are currently two types of central bank money: physical currency issued by the Federal Reserve and digital balances held by commercial banks at the Federal Reserve.
While Americans have long held money predominantly in digital form—for example in bank accounts, payment apps or through online transactions—a CBDC would differ from existing digital money available to the general public because a CBDC would be a liability of the Federal Reserve, not of a commercial bank.
Posted on January 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Stocks are coming off their worst year since 2008 due to investors misjudging how high inflation would soar and the lengths central banks would go to bring it back down.
For example, Global equities lost a record $18 trillion in 2022 amid nearly 300 interest rate hikes from central banks around the world.
But not all stocks were clobbered equally by Jerome Powell and Co.: High-growth tech companies that got a boost from an era of low interest rates got rocked the most in what some are calling the sequel to the bursting of the dot-com bubble in 2000–01. The tech-heavy NASDAQ posted four straight negative quarters for the first time since that crash.
Others survived unscathed. The energy sector soared 59% last year thanks to a boost from surging oil prices. Exxon Mobil finished the year as the eighth-most valuable public company in the US, despite starting 2022 outside the top 25.
The Future?
No one really knows, but analysts generally think stocks will go sideways, weighed down by more rate hikes and a potential recession. The average Bloomberg projection for the S&P at the end of 2023 is 4,009 points (the index closed 2022 at 3,839.50).
Another down year would be extremely rare: The S&P has dropped for two consecutive years in just four instances since 1928.
Stock market holidays are non-weekend business days when the two major U.S. stock exchanges, the New York Stock Exchange (NYSE) and the NASDAQ, are closed for the day. These days often closely follow federal holiday schedules and include major holidays like Independence Day and Thanksgiving.
Regular operating hours for both exchanges are Monday-Friday from 9:30 a.m. – 4 p.m. ET. Markets do not operate during the weekend.
Sometimes, if a holiday falls on a weekend, stock markets will close on the Friday prior to the holiday, as is often the case with Good Friday and Easter. Other times, a holiday will be observed on a Monday after it occurs, like New Year’s Day taking place on Sunday, yesterday, in 2023.
Thus, it is a good time to catch up on you reading:
Posted on January 1, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
The Fed hikes interest rates, sending economy teetering toward a recession?
If everyone was an opinionated virologist in 2020, then 2022 turned us all into macro-economists. In an effort to fight historic inflation, the Fed raised its benchmark interest rate seven times this year, pushing it to a 15-year high. Chair Jerome Powell’s hawkish turn slowed the economy and was a major catalyst for the brutal sell-off in stocks, particularly in the tech sector. This year, Amazon became the first public company to lose $1 trillion in market value.
The U.S. housing market is experiencing its second-biggest home price correction of the post-World War II era. Macro Trends Advisors founding partner Mitch Roschelle attributed the massive correction to Americans’ uncertainty for the markets and their “uneasiness” regarding the economy. He explained on “Varney & Co.” that the “shoe to drop” would be if the nation starts to see a rise in unemployment, which could cause a “leg down” in the housing market.
Finis?
So what’s ahead for 2023? According to MorningBrew, Economists think that a recession is likely, but a few are holding out hope that the Fed can achieve a so-called “soft landing,” where it brings inflation down to normal levels without causing the economy to shrink. Recent months have brought cautiously hopeful news: Annual inflation has cooled from a peak of 9.1% to 7.1%, so rate hikes are expected to be much less aggressive next year.
Posted on December 31, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
NO SANTA CLAUSE RALLY THIS YEAR!
By Staff Reporters
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Tesla CEO Elon Musk’s net worth has shrunk by an astounding $140 billion, slashing his wealth to $130 billion as of 2022, according to the Bloomberg Billionaires Index. The sharp decline reflects the roughly 70% drop in Tesla stock this year, driven by investors swapping technology stocks for safer assets, worrying that running Twitter is a costly distraction for Musk, and fearing a US economic downturn and overseas headwinds will hit the automaker’s growth.
Meanwhile, Amazon founder Jeff Bezos’ wealth has fallen by $86 billion, while Alphabet cofounders Larry Page and Sergey Brin have seen their fortunes shrink by a combined $91 billion. Microsoft cofounder Bill Gates’ net worth has also tumbled by $29 billion, while former CEO Steve Ballmer has taken a $21 billion hit.
Similarly, Oracle cofounder and Tesla investor Larry Ellison has suffered a $17 billion blow to his fortune, while Warren Buffett’s wealth has only dropped by $3 billion. The eight Americans, along with LVMH’s Bernard Arnault, Adani Group’s Gautam Adani, and Reliance Industries’ Mukesh Ambani, hold the top 11 spots in Bloomberg’s global wealth rankings.
Posted on December 31, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Tesla stock is on pace for its worst year on record as trading in 2022 comes to a close. Shares have lost about 65% from the start of the year. CEO Elon Musk has faced pressure from investors over his preoccupation with Twitter.
The S&P 500 closes out dismal year with worst loss since 2008
And, the U.S. dollar surrendered its status as the world’s premier safe haven in Q4. Central banks in Europe and — more recently — Japan applied a more aggressive monetary policy, signaling that they intend to close the gap with higher U.S. yields created by the Federal Reserve. This helped to drive their currencies higher. At the same time, investors in the U.S. were betting that the Fed’s campaign of interest rate rises was drawing nearer to its end. This resulted in the euro rising roughly 8.8% against the dollar, its biggest quarterly gain since 2010, according to Dow Jones Market Data.
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Finally, U.S. equities closed out 2022 in the red, and all three major indexes registered solid losses on a yearly basis. The stock market posted its worst yearly decline since 2008. Trading remained subdued in the final days of the year as volumes continued to be on the lighter side. Equity news remained in short supply, but Southwest Airlines continued to be in the headlines after saying its latest troubles will affect Q4 results.
The economic calendar was also relatively quiet, with today’s lone report showing a surprising rebound in manufacturing activity in the Chicago region.
Treasury yields gained ground, and the U.S. dollar declined, while crude oil prices rose, and gold was slightly higher.
Asian stocks finished out the year mixed in thin trading, and markets in Europe saw widespread losses, with the region posting the worst year since 2018.
Posted on December 31, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Centene Corporation showers politicians with millions as it courts contracts and settles over-billing allegationsby Samantha Young, Andy Miller, and Rebecca Grapevine (Kaiser Health News)
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Somehow KHN made Medicaid over-billing sound sexy.
This deep dive into Centene, “the nation’s largest private managed-care provider for Medicaid,” shows how the company has maintained good relationships with politicians as it looked to keep its market share and settle over-billing allegations.
Posted on December 30, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Ann Miller RN MHA CMP®
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About the Institute of Medical Business Advisors, Inc
The Institute of Medical Business Advisors, Inc provides a team of experienced, senior level consultants led by iMBA Chief Executive Officer Dr. David Edward Marcinko MBA CMP™ MBBS [Hon] and Ann Miller RN MHA CMP™ to provide ongoing contact with our clients throughout all phases of each project, with most of the communications between iMBA and the key client participants flowing through this Senior Team. iMBA Inc., and its skilled staff of certified professionals have many years of significant experience, enjoy a national reputation in the healthcare consulting field, and are supported by an unsurpassed research and support staff of CPAs, MBAs, MPHs, PhDs, CMPs™, CFPs® and JDs to maintain a thorough and extensive knowledge of the healthcare environment. The iMBA team approach emphasizes providing superior service in a timely, cost-effective manner to our clients by working together to focus on identifying and presenting solutions for our clients’ unique, individual needs.
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The iMBA Inc project team’s exclusive focus on the healthcare industry provides a unique advantage for our clients. Over the years, our industry specialization has allowed iMBA to maintain instantaneous access to a comprehensive collection of healthcare industry-focused data comprised of both historically-significant resources as well as the most recent information available. iMBA Inc’s specific, in-depth knowledge and understanding of the “value drivers” in various healthcare markets, in addition to the transaction marketplace for healthcare entities, will provide you with a level of confidence unsurpassed in the public health, health economics, management, administration, and financial planning and consulting fields. iMBA Inc’s information resources and network of healthcare industry textbook resources enhanced by our professional consultants and research staff, ensure that the iMBA project team will maintain the highest level of knowledge regarding the current and future trends of the specific specialty market related to the project, as well as the healthcare industry overall, which serves as the “foundation” for each of our client engagements.
Considered for years to be a “duopoly” over the advertising industry, they are on track to account for only 48.4% of US ad revenues this year. It’s the first time their market share has fallen below 50% since 2014, per Insider Intelligence.
Posted on December 30, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Initial claims for state unemployment benefits rose 9,000 to a seasonally adjusted 225,000 for the week ending December 24th, the Labor Department reported, in line with the median estimate among economists polled by Reuters. Meanwhile, the number of people receiving benefits after an initial week of aid rose 41,000 to 1.710 million in the week ending December, 17th, 2022.
Meanwhile, Amazon stock closed the December 22 trading session at $83.79, which represents a 49.7% drop compared to December 31, 2021. This is the lowest closing level for the Amazon stock since March 12, 2019. Basically, the group, founded by Jeff Bezos, has completely erased all the gains during the two years when strict restrictions were put in place to limit the spread of COVID-19. It closed today at $84.18.
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Finally, U.S. stocks rose sharply, ending a two-session losing streak, though trading volumes remain subdued in the final days of the year. The heavyweight Information Technology sector led the rally, rebounding from a recent drop that has weighed on the markets this week. The equity front continued to offer little in terms of headlines, though shares of Cal-Maine Foods fell after the company missed earnings estimates.
The economic calendar introduced labor data, as jobless claims ticked slightly higher compared to the prior week.
Treasury yields were mixed, the U.S. dollar dropped, crude oil prices were lower, and gold traded higher.
Asian stocks finished mostly lower after yesterday’s downturn in the U.S., while markets in Europe were higher despite uncertainty regarding the ultimate global impact of aggressive monetary policy tightening across the world.
On December 6, 2022, the Centers for Medicare & Medicaid Services (CMS) proposed a modernization of the prior authorization process for health insurance. The proposed rule seeks to require certain insurers to implement electronic prior authorization, shorten decision timeframes, and make the process more transparent and efficient.
The rule includes “five key provisions and five Requests for Information,” aiming to “improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.” This Health Capital Topics article will review those provisions and requests for information, as well as stakeholder responses to the proposals. (Read more…)
Posted on December 29, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Popular money manager Cathie Wood of Ark Investment Management has seen her young-technology-stock funds hit the skids this year amid weak earnings. Her Ark Innovation ETF (ARKK) – Get Free Report has lost 68% in 2022 and is down 81% from its February 2021 peak. The Ark chief executive has defended her strategy by noting that she has a five-year investment horizon. But the five-year annualized return of Ark Innovation totaled a negative 2.66% through Dec. 26, against the S&P 500’s positive return of 9.38%. The fund’s performance also doesn’t come close to Wood’s goal for annualized returns of 15% over five-year periods.
U.S. equities finished lower, adding recent losses with the markets approaching year-end. The moves came amid lighter volume in the waning days of a dismal 2022, with the equity front offering little in terms of news. However, Southwest Airlines continues to be troubled by mass flight cancellations.
The economic calendar delivered another drop in pending home sales, while Richmond manufacturing activity unexpectedly moved into expansion territory.
Treasury yields were mixed after yesterday’s solid gains, and the U.S. dollar was slightly higher. Crude oil prices fell, and gold pulled back from Tuesday’s rise.
Asia finished mixed and Europe also diverged as the global markets wrestled with China’s reopening and uncertainty regarding the ultimate impact of aggressive monetary policy tightening across the globe.
Posted on December 28, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
SUSPICIOUS AFFINITY MARKETING?
By Staff Reporters
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DEFINITION: Affinity marketing is a concept that consists of a partnership between a company and an organization that gathers persons sharing the same interests to bring a greater consumer base to their service, product or opinion. This partnership is known as an affinity group.
So, after the collapse of Sam Bankman-Fried’s crypto exchange FTX, a number of celebs who had acted as ambassadors for the company were named as defendants in a class-action suit against it.
Comedian and Seinfeld creator Larry David, Tampa Bay Buccaneers quarterback Tom Brady, and basketball stars Shaquille O’Neal and Stephen Curry were likely trading lawyer recommendations in the A-lister group chat.
Posted on December 28, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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U.S. equities were mixed on the first trading session of the week following the long holiday weekend. The markets reacted to a host of economic data that was released, as home prices decreased on a seasonally adjusted basis, the trade deficit narrowed much more than expected, wholesale inventories increased, and manufacturing activity in the Dallas region contracted more than predicted.
Equity news was light, but shares of Southwest Airlines declined after the U.S. Department of Transportation said that it would examine the mass flight cancellations and delays. Additionally, Tesla’s shares fell after the company announced that it plans on running a reduced production schedule at its Shanghai factory.
Treasury yields continued to rise, and the U.S. dollar dipped, while crude oil prices were little changed, and gold was solidly higher.
Asian equities increased, led by mainland Chinese stocks, after the Chinese government announced that it would put an end to quarantine restrictions for inbound travelers effective early January.
Markets in Europe were mixed amid improved sentiment in the wake of the news.
Posted on December 28, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By SMART ASSET
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If shrinking your tax liability is high on your list of priorities, a few states stand out. The winners in the list below either have no state income tax, no tax on retirement income, or a substantial discount on the taxes levied on retirement income. But that’s just the start.
While several additional states have no state income tax, the states that made our list also have favorable sales, property, inheritance, and estate taxes.
Alaska
Florida
Georgia
Mississippi
Nevada
South Dakota
Wyoming
If those seven locations aren’t ideal, consider the next tier of tax-friendly states. Tax benefits aren’t quite as high as those above, but they do stand out in one specific category: no taxes on social security income.
That’s not to say they don’t make up for it in other areas, however. Washington State, for example, has no state income tax, but does have a 6.5% state sales tax. Still, it’s always beneficial to avoid income tax when possible.
Posted on December 27, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Value of a $1,000 investment in Microsoft’s IPO today
Microsoft completed its initial public offering (IPO) on March 13, 1986, at a price of $21 per share. Since then, the company has grown so valuable, and its stock price has soared so high, that management opted to conduct nine stock splits over time to ensure its shares remained accessible to small investors.
Had you invested $1,000 in Microsoft at its IPO, you would have acquired 47 shares at $21 per share. Adjusting for the stock splits, you’d actually have 13,536 shares today with a cost basis of $0.0729 per share.
Given Microsoft now trades at $238.73 per share, that translates to a return of 327,401%.
In dollar terms, that $1,000 investment in 1986 would be worth a whopping $3.23 million today. But it gets better, because Microsoft has paid a dividend since 2003 — and assuming you never sold a single share along the way, you’d have also received $341,513 in dividends.
Given Microsoft continues to pay a quarterly dividend of $0.68 per share, you would still be collecting a cool $36,817 each year, or 36 times your initial $1,000 outlay. That’s the power of long-term investing.
On December 20, 2022, the U.S. Congress announced its deal to fund the federal government through 2023, averting an imminent government shutdown. The 4,155-page, $1.7 trillion spending bill spans a vast array of funding initiatives and other bipartisan measures, including a number of noteworthy healthcare provisions.
Perhaps most significantly, Congress intervened in the impending cuts to the Medicare Physician Fee Schedule (MPFS), overriding some, but not all, of the payment reductions. This Health Capital Topics article will discuss the congressional measures to ameliorate the payment cuts to physicians in 2023, as well as the other healthcare provisions included in the omnibus spending bill. (Read more…)
Posted on December 27, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Since Christmas Day [Sunday], the U.S. stock markets were closed on Monday, December, 26th, 2022.
OPENTODAY!
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Nevertheless, nearly 125,000 employees lost their jobs this year as more than 120 large U.S. tech companies, banks and manufacturers implemented massive rounds of layoffs, according to the Forbeslayoff tracker, which documented major cuts (over 100) beginning in June when recession fears began to surge.
That’s a troubling figure for what had been one of the economy’s strongest growth sectors, but economists don’t expect it to spell doom for other industries. Even as tech companies downsized, the broader labor market remained strong throughout the year, with the unemployment rate ticking up slightly, to just 3.7% as of November.
The bargain-hunting value style is looking for shares that are under priced in relation to the company’s future potential. A value investor will invest in a company in the expectation that its shares will increase in value over time. Value investing is based essentially on quantitative criteria; asset values, cash flow, and discounted future earnings. The key properties of value shares are low Price/Earnings, Price/Sales ratios, and normally higher dividend yields.
So, on observing a company’s earnings growth, a value manager will decide whether to buy shares based on the company’s consistency or recovery prospects. The key research questions are: 1) Does the current P/E ratio warrant an investment in a slow growth company or, 2) Is the company a higher growth candidate that has dropped in price due to a temporary problem. If this is the case, will the company’s earnings growth recover, and if so, when? The key to value investing is to find bargain shares (priced low historically or for temporary and/or irrational reasons), avoiding shares that are merely cheap (priced low because the company is failing).
The buying opportunity is identified when a company undergoing some immediate problems is perceived to have good chances of recovery in the medium to long term. If there is a loss in market confidence in the company, the share price may fall, and the value investor can step in. Once the share price has achieved a suitable value, reflecting the predicted turnaround in company performance, the shareholding is sold, realizing a capital gain. A potential risk in value investing is that the company may not turn around, in which case the share price may stay static or fall.
Tax-loss harvesting is a strategy to lower investment taxes that involves selling securities at a loss to offset capital gains. BofA said investors in the past week also pulled out $10 billion from bonds.
Amazon.com Inc. has erased more shareholder wealth than any other publicly traded company in 2022. In total, investors in Amazon have lost $804.6 billion this year. The stock is down 48% in 2022.
Apple Inc. and Microsoft Corp. have also suffered larger market-cap declines than Tesla, by virtue of their sheer size.
Posted on December 25, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The House passed, and President Biden later signed, a $1.7 trillion spending bill that will fund the federal government through FY 2023 and do a lot more—like send $45 billion to Ukraine and NATO allies and offer $40 billion in US disaster relief.
Happy Holidays from the Institute of Medical Business Advisors, Inc
At this special time of year, we give thanks for our clients and our employees, as well as all essential workers in hospitals, health centers and medical practices across the country.
May the holiday spirit be with you and your family throughout the season and everyday We look forward to serving you in 2024.
Posted on December 24, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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he emerging Omicron subvariant XBB contributes to an increasingly high number of COVID-19 cases in the U.S., rivaling the sister strains BQ.1.1 and BQ.1, according to the latest estimates from the Centers for Disease Control and Prevention (CDC).
Recent studies have indicated that the updated bivalent COVID-19 booster performed poorly against BQ.1.1, with even a weaker antibody response against XBB.
In late November, citing its poor neutralization effect on BQ.1 and BQ.1.1., the FDA pulled the emergency use authorization granted for bebtelovimab, a COVID-19 antibody therapy developed by Eli Lilly (LLY) and AbCellera Biologics (ABCL).
The CDC estimates for the week ending Dec. 24 show that XBB has made up ~18% of COVID cases in the U.S. compared to ~11% a week ago. Meanwhile, BQ.1.1 has led to ~36% of cases unchanged from a week ago, and BQ.1 caused ~27% of cases, a decline from ~29% last week.
Posted on December 24, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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You don’t have to sign all the forms to be treated
Part of being a patient is signing stacks of forms, most of which you barely read much less understood. This is a mistake, Charlotte O’Leary says. Look for any “blank check” clauses on intake forms—it’s the part that reads, “I will be responsible for all costs not covered by insurance.”
Instead, Charlotte Hilton Andersen, MS recommends crossing it out and writing, “I will be responsible for all costs that are medically necessary, that are not the responsibility of my insurer, are competitively priced, and that I am made aware of prior to treatment if they are not part of standard operating procedures.”
Posted on December 24, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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IRS pauses rule requiring people to report PayPal, Venmo transactions over $600. To avert taxpayer confusion in the upcoming tax season, the IRS is delaying a rule that would have required e-commerce sites and payment platforms like eBay Etsy and PayPal to send out tax paperwork to a much wider swath of people in 2023.
And, U.S. equities ended the day higher and the week mixed. The S&P 500 and NASDAQ posted a third-straight week of losses, while the Dow was able to buck the trend by posting a weekly gain. The moves came amid a day full of economic reports that offered varying results. Personal income rose slightly, and the Fed-favored inflation gauge showed continued moderation, new home sales surprisingly rose, and consumer sentiment was revised higher.
However, durable goods orders fell noticeably, and personal spending came in softer than expected. Treasury yields were higher, and the U.S. dollar was lower, while crude oil and gold prices traded to the upside. News on the equity front was in short supply, but Meta Platforms garnered attention after it agreed to settle a class action lawsuit for $725 million.
Finally, Asian stocks finished lower amid some disappointing data out of Japan, while markets in Europe diverged heading into the long holiday weekend.
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