More About the End of AMAZON CARE!

By Health Capital Consultants, LLC

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The End of Amazon Care: A Setback in Amazon’s Healthcare Experiment?

On August 24, 2022, Amazon announced its plans to shut down Amazon Care at the end of 2022. The e-commerce giant determined that Amazon Care, a medical care service it uses internally and sells to employer health plans, was not the “right long-term solution for [Amazon’s] enterprise customers” because it is not a “complete enough offering for the large enterprise customers [Amazon has] been targeting.”

This Health Capital Topics article will discuss the history of Amazon Care and what this move may mean for Amazon’s larger healthcare efforts. (Read more…)

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RELATED: https://thehealthcareblog.com/blog/2022/08/29/amazons-coitus-interruptus-in-or-out/

MORE: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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The Branches of “Philosophy”

The Top Four

[By staff reporters]

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Conclusion

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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.

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Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

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

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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Medicare Part C [Advantage Plan] Allegations & Investigations

By Office of Inspector General and the HHS

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READ REPORT: https://oig.hhs.gov/oei/reports/OEI-09-18-00260.asp

OIG: https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf

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HEALTH INSURANCE: 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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On Medication Therapy Management (MTM)

What it is – How it works

By wikipedia

DEM 2

David Edward Marcinko

http://www.HealthDictionarySeries.org

Medication therapy management (MTM) is medical care provided by pharmacists whose aim is to optimize drug therapy and improve therapeutic outcomes for patients.

Eleven national pharmacy organizations adopted this definition in 2004. Medication therapy management includes a broad range of professional activities, including but not limited to performing patient assessment and/or a comprehensive medication review, formulating a medication treatment plan, monitoring efficacy and safety of medication therapy, enhancing medication adherence through patient empowerment and education, and documenting and communicating MTM services to prescribers in order to maintain comprehensive patient care.

Core Elements

Medication therapy management includes five core components: a medication therapy review (MTR), personal medication record (PMR), medication-related action plan (MAP), intervention and/or referral, and documentation and follow-up. A MTR is a systematic process of collecting patient and medication-related information which occurs during the pharmacist-patient encounter.

In addition, the MTR assists in the identification and prioritization of medication-related problems. During the MTM encounter, the pharmacist develops a PMR for use by the patient. The PMR includes all prescription and nonprescription products and requires updating as necessary. After assessing and identifying medication-related problems, the pharmacist develops a patient-specific MAP. The MAP is a list of self-management actions necessary to achieve the patient’s specific health goals.

Moreover, the patient and pharmacist utilize the MAP to record actions and track progress towards health goals. During the MTM session, the pharmacist identifies medication-related problem(s) and determines appropriate intervention(s) for resolution. Often, the pharmacist collaborates with other health care professionals to resolve the identified problem(s). Following the patient encounter and/or intervention, the pharmacist must document his/her encounter and determine appropriate patient follow-up.

Pharmaceutical care  defined 

Hepler and Strand define pharmaceutical care as the provision of drug therapy in order to achieve definite outcomes that improve a patient’s quality of life. Outcomes include cure of a disease, elimination or reduction of a patient’s symptoms, arresting or slowing of a disease process, and preventing a disease or symptom. The process includes pharmacist collaboration with other health care professionals in designing, implementing, and monitoring a therapeutic plan for a patient. Pharmaceutical care focuses on the pharmacist’s role in achieving therapeutic goals to improve the patient’s quality of life.

MMA of 2003 – Part D

The Medicare Modernization Act of 2003, requires Medicare Part D prescription drug plans to include medication therapy management services delivered by a qualified healthcare professional, including pharmacists, beginning in 2006. MTM services target beneficiaries who have multiple chronic conditions (such as diabetes, asthma, hypertension, hyperlipidemia, and congestive heart failure), take multiple medications, or are likely to incur annual costs above a predetermined level.

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Assessment

Medication therapy management is a unique niche for the pharmacy profession, allowing pharmacists to apply their extensive medication knowledge as medication experts with the intent of improving patient outcomes.

Conclusion

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Contact: MarcinkoAdvisors@msn.com

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The Digital Healthcare Market — Ravkoo Health

The digital health market is growing at an unprecedented rate. With advancements in wearable technology, mobile health, and health information technology, more people are leveraging these technologies to improve their lives. The following articles explore the digital healthcare market. Let’s take a closer look at some of the latest innovations in these fields. And, as […]

The Digital Healthcare Market — ravkoo Health

AMAZON’S New Move in Health Care

By Health Capital Consultants, LLC

Amazon, the largest e-commerce company in the world, has made large, strategic moves over the past several years to make a place for themselves in healthcare.

This article will review Amazon’s most recent advancements in the industry, including those related to Amazon’s voice-controlled personal assistant, Alexa, and Amazon’s employee healthcare system, Amazon Care, and how this non-healthcare company is changing the industry.

LINK: https://www.healthcapital.com/hcc/newsletter/03_21/HTML/AMAZON/convert_amazon_moves_healthcare_3.25.21.php

RELATED: https://medicalexecutivepost.com/2018/09/07/investors-have-misdiagnosed-amazons-push-into-the-pharmacy-business/

MORE: https://medicalexecutivepost.com/2018/03/07/how-amazon-could-lose-its-health-care-bid/

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Appeals Court Strikes Down Bid to Reinstate OSHA COVID-19 Protection Standard

By Robert King

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The U.S. Court of Appeals for the District of Columbia just ruled that it did not have the power to overturn the Occupational Safety and Health Administration’s (OSHA’s) decision to scrap a temporary protection standard that outlined requirements for hospitals to keep front-line health workers safe from contracting COVID-19. The union National Nurses United decried the decision.

OSHA issued a temporary protection standard for COVID-19 back in June 2021. However, OSHA did not move to make a permanent standard before the temporary one expired last year, as the agency shifted resources toward a vaccine mandate, the appellate opinion said. OSHA had called for health systems to still impose the standard’s requirements voluntarily.

Source: Robert King, Fierce Healthcare [8/30/22]

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PODCAST: Ray Dalio on How the Economy Works in Healthcare

Ray Dalio’s ‘How the Economy Works’ Applied to Healthcare … Credit Cycles and Healthcare Policy

By Eric Bricker MD

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

RELATED: https://www.msn.com/en-us/money/savingandinvesting/ray-dalio-warns-stagflation-will-send-america-back-to-the-1970s/ar-AAVSYgF

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RELATED: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

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On Being a Father [A Labor Day Weekend Thought]

Being A Father

vitaly

By Vataliy Katsenelson, CFA

Conclusion

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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™

How Health Technology Costs Human Jobs [video]

Join Our Mailing List

About a needle-wielding robot [Veebot]

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veebot

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Video: http://www.veebot.com

Assessment

Driving medical, and HR, costs down with new technology. Good for us … bad for phlebotomists.

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Conclusion

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Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

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What are FRACTIONAL [Stock] SHARES?

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According to the SEC

By Staff Reporters

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Fractional Share Investing – Buying a Slice Instead of the Whole Share

The SEC’s Office of Investor Education and Advocacy is issuing this Investor Bulletin to help educate investors about investing in fractional shares.

What are Fractional Shares?

A fractional share is when you own less than one full share of a stock or other security.

Why Invest in Fractional Shares?

Fractional shares are a way to invest when you do not have enough money to purchase a full share of a particular stock. For example, if XYZ stock trades at $1000 per share, but you only have $100 to invest, fractional share investing would allow you to purchase a fraction of the XYZ stock ($1000/$100), or .1 shares.

How does Fractional Share Investing Work?

READ HERE: https://www.sec.gov/oiea/investor-alerts-and-bulletins/fractional-share-investing-buying-slice-instead-whole-share

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CITE: https://www.r2library.com/Resource/Title/082610254
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WEEKEND READING: Labor Day 2022

A Brief History of the Holiday

Labor Day: How it Came About – What it Means

Labor Day, the first Monday in September, is a creation of the labor movement and is dedicated to the social and economic achievements of American workers. It constitutes a yearly national tribute to the contributions workers have made to the strength, prosperity, and well-being of our country.

Founder of Labor Day

More than 100 years after the first Labor Day observance, there is still some doubt as to who first proposed the holiday for workers.

Some records show that Peter J. McGuire, general secretary of the Brotherhood of Carpenters and Joiners and a cofounder of the American Federation of Labor, was first in suggesting a day to honor those “who from rude nature have delved and carved all the grandeur we behold.”

But Peter McGuire’s place in Labor Day history has not gone unchallenged. Many believe that Matthew Maguire, a machinist, not Peter McGuire, founded the holiday. Recent research seems to support the contention that Matthew Maguire, later the secretary of Local 344 of the International Association of Machinists in Paterson, N.J., proposed the holiday in 1882 while serving as secretary of the Central Labor Union in New York. What is clear is that the Central Labor Union adopted a Labor Day proposal and appointed a committee to plan a demonstration and picnic.

The First Labor Day

The first Labor Day holiday was celebrated on Tuesday, September 5, 1882, in New York City, in accordance with the plans of the Central Labor Union. The Central Labor Union held its second Labor Day holiday just a year later, on September 5, 1883.

In 1884 the first Monday in September was selected as the holiday, as originally proposed, and the Central Labor Union urged similar organizations in other cities to follow the example of New York and celebrate a “workingmen’s holiday” on that date. The idea spread with the growth of labor organizations, and in 1885 Labor Day was celebrated in many industrial centers of the country.

Labor Day Legislation

Through the years the nation gave increasing emphasis to Labor Day. The first governmental recognition came through municipal ordinances passed during 1885 and 1886. From them developed the movement to secure state legislation. The first state bill was introduced into the New York legislature, but the first to become law was passed by Oregon on February 21, 1887. During the year four more states — Colorado, Massachusetts, New Jersey, and New York — created the Labor Day holiday by legislative enactment. By the end of the decade Connecticut, Nebraska, and Pennsylvania had followed suit. By 1894, 23 other states had adopted the holiday in honor of workers, and on June 28 of that year, Congress passed an act making the first Monday in September of each year a legal holiday in the District of Columbia and the territories.

A Nationwide Holiday

The form that the observance and celebration of Labor Day should take were outlined in the first proposal of the holiday — a street parade to exhibit to the public “the strength and esprit de corps of the trade and labor organizations” of the community, followed by a festival for the recreation and amusement of the workers and their families. This became the pattern for the celebrations of Labor Day. Speeches by prominent men and women were introduced later, as more emphasis was placed upon the economic and civic significance of the holiday. Still later, by a resolution of the American Federation of Labor convention of 1909, the Sunday preceding Labor Day was adopted as Labor Sunday and dedicated to the spiritual and educational aspects of the labor movement.

The character of the Labor Day celebration has undergone a change in recent years, especially in large industrial centers where mass displays and huge parades have proved a problem. This change, however, is more a shift in emphasis and medium of expression. Labor Day addresses by leading union officials, industrialists, educators, clerics and government officials are given wide coverage in newspapers, radio, and television.

The vital force of labor added materially to the highest standard of living and the greatest production the world has ever known and has brought us closer to the realization of our traditional ideals of economic and political democracy. It is appropriate, therefore, that the nation pay tribute on Labor Day to the creator of so much of the nation’s strength, freedom, and leadership — the American worker.

Source: http://www.dol.gov/opa/aboutdol/laborday.htm

Conclusion

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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

Product DetailsProduct DetailsProduct Details

  Product DetailsProduct Details

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PODCAST: How Healthcare Policy Sausage is Made

‘America’s Bitter Pill’ by Steven Brill … Contemporary History of Healthcare in America

BY ERIC BRICKER MD

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MANAGED CARE: 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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HOSPITALS: https://www.amazon.com/Hospitals-Healthcare-Organizations-Management-Operational/dp/1439879907/ref=sr_1_4?s=books&ie=UTF8&qid=1334193619&sr=1-4

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What are Fibonacci Extensions?

What they are – How they work

[Courtesy Investopedia and staff members]

UPDATE: https://www.msn.com/en-us/money/topstocks/s-p-500-dips-below-key-fibonacci-chart-level-then-bounces-back-above-it/ar-AA11my5R?cvid=d5ad809a87e04872bb285a86636cae38

Fibonacci extensions are used in Fibonacci retracement to predict spaces of resistance and support in the market. These extensions involve all levels drawn past the basic 100% level; they are frequently used by traders to determine areas that will bring in profits.

One popular extension, the 161.8% level, is used to set a price target on a breakout of an ascending triangle; this target is calculated by multiplying the vertical distance of the triangle by key Fibonacci ratio 61.8%, and then adding the result to the triangle’s upper resistance level.

The Extensions’

A retracement movement of a stock is where the stock “retraces” a section of one of its previous moves. In most cases, a stock performs a retracement at one of three standard Fibonacci levels: 38.2%, 50% and 61.8%. When a stock retraces more than 100% of its prior move, a Fibonacci extension can be calculated. These extensions, used in combination with a variety of other indicators or patterns, are common practice for traders looking to determine one or multiple price targets.

Practical Use

It is best, and most practical, to calculate Fibonacci extensions when stocks are at new highs or new lows, and when there are no clear levels of resistance or support on the chart. If, for example, a trader is long on a stock and the stock begins to generate new highs, the trader can calculate Fibonacci extension levels to get a basic idea of where the stock is likely to fall and is more likely to make profits. The same is true for a trader who is short. Fibonacci extension levels can be calculated to give the trader a general idea of where the stock may begin to rally. The trader then has the option to decide if he wishes to cover his position at that level.

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Caution

Keeping practicality, and basic common sense, in mind, decisions to buy and sell stocks should never be made based solely on Fibonacci extensions. It is wise for traders to wait and watch for candlestick patterns, such as price action, to become evident to confirm whether a stock is likely to reverse at the traders’ target price.

Assessment

Fibonacci extensions are applicable to any timeframe, such as monthly charts to one-minute charts, and are tools best used on price waves so projections of future price waves can be generated. It is also wise for traders to note that clusters of Fibonacci levels are indicative of a price area that will inevitably be significant.

Conclusion

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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. https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Contact: MarcinkoAdvisors@msn.com

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Valuation of Remote Therapeutic Monitoring [Reimbursement Environment]

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By Health Capital Consultants, LLC

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VALUATIONS

Valuation of Remote Therapeutic Monitoring: Reimbursement Environment

The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and has a strong influence on physician reimbursement. In 2020, Medicare and Medicaid accounted for an estimated $829.5 billion and $671.2 billion in healthcare spending, respectively.

The prevalence of these public payors in the healthcare marketplace often results in their acting as a price setter, and being used as a benchmark for private reimbursement rates. (Read more…) 

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MORE: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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PODCAST: Social Determinants of Health [Impact on Medical Training and Healthcare Costs]

By Eric Bricker MD

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As a result of SDOH problems, Johns Hopkins Hospital Trains Doctors That Have a Ton of Exposure to Diseases That Result from These Social Determinants of Health: 1) Endocarditis, 2) Hepatitis C, 3) HIV, 4) Pancreatitis, 5) Liver Cirrhosis, 6) Diabetes, 7) Heart Attack, 8) Stroke, 9) Infections, 10) Cancer, 11) Spinal Injuries, 12) Dialysis, 13) Diabetic Ketoacidosis and 14) Hypertensive Emergencies.

Johns Hopkins Hospital Also Loses Money When Treating These Diseases Caused by Social Determinants of Health.

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

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MORE: PODCAST: Social Determinants of Health

Mental: Social Determinants of Mental Health

Related: “Social Determinants of Health”

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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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HEALTH INSURANCE: 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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Mark Cuban Launches Generic Drug Company

COST PLUS Drug Company

[By Staff Reporters]

The company’s first drug is antiparasitic drug albendazole but plans to offer over 100 additional drugs by the end of 2021 and now in 2022.

LINK: https://costplusdrugs.com/

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FTC Discourages Healthcare COPA Laws

By Health Capital Consultants, LLC

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FTC Discourages Certificates of Public Advantage Laws

On August 15, 2022, the Federal Trade Commission (FTC) published a policy paper and fact sheet regarding the use of Certificates of Public Advantage laws (COPAs) by states in regulating healthcare mergers. Specifically, the FTC asserts that COPAs can negatively impact healthcare costs, quality of care, and hospital staff wages.

This Health Capital Topics article will discuss the policy paper and how this publication appears to fit in with the FTC’s recent moves to increase competition in healthcare.(Read more…) 

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UPDATE: Deflation with August Stock Round-Up?

By Staff Reporters

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Inflation is starting to “drop like a rock” rather than a feather, leading to outright deflation in some areas of the economy, Fundstrat’s Tom Lee said in a note. A slowdown in rising inflation would be welcome news to investors given that the stock market has sold off 5% since Fed Chair Jerome Powell’s hawkish speech at Jackson Hole last week. Powell reiterated the Fed’s resolve to tame inflation by being aggressive with interest rate hikes and a reduction to its $9 trillion balance sheet. The market currently expects another outsized 75 basis point rate hike from the Fed at its FOMC meeting in late September. If inflation cools and is less “sticky” than most expect, it could change the Fed’s current interest rate hike trajectory, ultimately leading to a faster pivot towards a pause in rate hikes. That would be a boon for risk assets, which have been stymied in recent months by fast rising interest rates.

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

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U.S. stocks ended the month with their fourth straight daily decline cementing the weakest August performance in seven years as worries about aggressive interest rate hikes from the Federal Reserve persist. Adding to pressure were declines in the technology sector, and more specifically chip-makers, after soft forecasts from Seagate and HP Inc. The three main indexes suffered their biggest monthly percentage declines in August since 2015. After hitting a four-month high in mid-August, the S&P 500 has stumbled in recent weeks, dropping more than 7% through the close and falling through several closely watched technical support levels.

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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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PODCAST: Primary Care Innovation at Scale [ChenMed]

By Eric Bricker MD

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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

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VIDEO: What is the “Baltimore Nod”?

Dope Fiends

By Anonymous DEA Agent

DOPE FIEND: A habitual user of a narcotic; slang term.

NOD: To lower and/or raise one’s head slightly and briefly, especially in greeting, assent, or understanding, or to give someone a signal.

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Single Nod

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Group Nod

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Street Nod

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MORE: https://medicalexecutivepost.com/2012/06/01/video-of-the-new-drug-krokodil-aka-crocodile/

Assessment:

An anonymous DEA agent sent us these pictures. The videas are all over YouTube. So, just say “NO” and don’t do drugs.

NOTE: The nod is not to be confused with TD. Tardive dyskinesia is a disorder that results in involuntary, repetitive body movements. This may include grimacing, sticking out the tongue, or smacking the lips. Additionally there may be rapid jerking movements or slow writhing movements. In about 20% of people, decreased functioning results. Tardive dyskinesia occurs in some people as a result of long-term use of neuroleptic medications. These medications are usually used for mental illness, etc.

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Product DetailsProduct DetailsProduct Details

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Invite Dr. Marcinko

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PODCAST: Excessive Out of Pocket Healthcare Costs

By Eric Bricker MD

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RELATED: https://medicalexecutivepost.com/2022/08/22/dictionary-health-economics-and-finance-2/

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DICTIONARY: Health Economics and Finance

10,000 TERMS, DEFINITIONS, ABBREVIATIONS AND RESOURCES

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

SECOND OPINIONS: https://medicalexecutivepost.com/schedule-a-consultation/

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

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PODCAST: Healthcare Service and Sacrifice [Economics 101]

Understand Diminishing Returns and Opportunity Costs

By Eric Bricker MD

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

Diminishing Returns: https://medicalexecutivepost.com/2010/10/26/higher-spending-on-healthcare-doesnt-always-deliver-quality/

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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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PODCAST: Law Firm Fairmark Partners Suing Large Hospital Systems for Antitrust Violations

Using Court System to Change Healthcare

By Eric Bricker MD

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HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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U.S. Hospitals Feeling the Pain of Physician Burnout

U.S. Hospitals Feeling the Pain of Physician Burnout [REPRINT]

Source: Reuters Health News via MDLinx [11/22/17]

neurotic

Hospitals are just beginning to recognize the toll of burnout on their operations

Experts estimate, for example, that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt, a former Mayo Clinic researcher who became Stanford Medicine’s first chief physician wellness officer in September said Stanford, Harvard Business School, Mayo Clinic, and the American Medical Association (AMA) are working on that. They have put together a comprehensive estimate of the costs of burnout at the organizational and societal level, which has been submitted to a journal for review.

Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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 Hospitals can ill afford these added expenses in an era of tight margins, costly nursing shortages, and uncertainty over the fate of the Affordable Care Act, which has put capital projects and payment reform efforts on hold.

COACH

For a graphic, click here.

http://fingfx.thomsonreuters.com/gfx/rngs/TRAVIS%20HARTMAN/010051RR403/index.html

Sound familiar?

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Graphic-for-2-4-2019-pdf

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The “HEMLINE STOCK INDEX”

Hemline Index

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The hemline index is a theory presented by economist George Taylor in 1926.
The theory suggests that hemlines on women’s dresses rise along with stock prices. In good economies, we get such results as miniskirts (as seen in the 1920s and the 1960s), or in poor economic times, as shown by the 1929 Wall Street Crash, hems can drop almost overnight.
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Non-peer-reviewed research in 2010 supported the correlation, suggesting that “the economic cycle leads the hemline with about three years”.
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Assessment: Your thoughts are appreciated
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The “Deeper Dive” Costs of College Debt

Unintended Consequences?

[By Rick Kahler MSFS CFP]  [Dr. David Marcinko MBA]

Not only is a college education a door to higher wages, but providing that education is an important segment of our economy and a huge source of good paying jobs.

In 2017 the average salary for the country’s 624,822 full-time college instructors was $82,240, according to an annual study from the Department of Education’s National Center of Education Statistics.

The old days

In the days before college loans were as easy to get as the common cold, college costs were due in cash. Students and parents had to save money or pay tuition out of their earnings. Many students worked their way through college. Those without savings, the ability or desire for college jobs, or high enough grades for scholarships didn’t go to college.

Since colleges competed for students, market forces controlled the tuition rates. Raising tuition too much resulted in fewer students and smaller revenues. The two forces of supply (college capacity) and demand (the ability to pay tuition) kept college costs in check.

Understandably, borrowing to pay for college tuition was difficult. What sane bank or investor would loan money to an unemployed teenager with no collateral to speak of? If you could find someone willing to make such a risky loan, the interest rate was high.

Politics

Well-intended politicians decided it wasn’t fair that those without the means to pay tuition were denied college educations. Their solution was to require taxpayers to underwrite college loans, sometimes at interest rates lower than those available to the most creditworthy.

With tuition money easy to obtain through low-cost, government backed loans, demand for a college education increased. With the increased demand came higher tuition costs. This easy money is the primary reason that college tuition costs have far outpaced inflation and have gone up twice as fast as medical costs since 1985.

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Consequences

Unfortunately, one consequence of loaning money to those deemed poor risks is that a high percentage of those borrowers are unable to repay the debt.  It should come as no surprise that 10.7% of all student loans are currently 90 days or more in default. Conversely, the composite default rate on mortgages, credit cards, and auto loans is 0.82% as of October 2018.

Today, taxpayers are on the hook for over 92% of the $1.5 trillion in outstanding student loans made to over 44 million borrowers, according to a June 13, 2018, Forbes article by Zack Friedman, “Student Loan Debt Statistics in 2018.” Only home mortgages exceed student loan debt.

And the appetite for loans continues to rise. The average student from the Class of 2016 graduated with over $37,000 of college debt. It isn’t uncommon for a medical student to amass over $200,000 of student loan debt. This year we will add another $120 billion in college debt to the books.

The more college debt that graduates take into the workplace, the less they have to spend for vehicles, rent, and consumer goods. The damage to the credit ratings of the 10.7% who are in default will also hinder their purchasing power for years to come.

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Assessment

If taxpayers ever decide to quit footing the bill, my hunch is that many colleges’ tuition rates will fall as hard as housing prices did in Florida, Arizona, and California in 2009. Lower tuition costs would create a financial hardship for most colleges and the some 4,000,000 people employed in higher education.

Politically, I don’t expect that to happen. Colleges are big business with a lot of money and influence in Congress. Further, a college education is becoming viewed as a right that should be free. In the meantime, savvy students will do whatever they can to minimize their college tuition and graduate debt-free.

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COACH

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Conclusion

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By Eric Bricker MD

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New Medical Practice Entrepreneurial Business Rules for Young Physicians [circa 2022]

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Go “Out-of-Box” – OR – Go Employee

By Dr. David Edward Marcinko MBA CMP™ www.CertifiedMedicalPlanner.org

There are more than 950,000 physicians in the United States. Yet, the brutal supply and demand, and demographic calculus of the matter is that there are just too many aging patients chasing too few doctors. Compensation and reimbursement is plummeting as Uncle Sam becomes the payer-of-choice for more than 52% of us. More so, going forward with the PP-ACA OR, perhaps not so much after the Trump election.

Furthermore, many large health care corporations, hospitals, and clinical and medical practices have not been market responsive to this change. Some physicians with top-down business models did not recognize the changing health care ecosystem or participatory medicine climate. Change is not inherent in the DNA of traditionalists. These entities and practitioners represented a rigid or “used-to-be” mentality, not a flexible or “want-to-be” mindset.

Yet today’s physicians and emerging Health 2.0 initiatives must possess a market nimbleness that cannot be recreated in a command-controlled or collectivist environment. Going forward, it is not difficult to imagine the following rules for the new virtual medical culture, and young physicians of the modern era.

A. Rule 1

Forget about large office suites, surgery centers, fancy equipment, larger hospitals, and the bricks and mortar that comprised traditional medical practices. One doctor with a great idea, good bedside manners, or competitive advantage can outfox a slew of insurance companies, Certified Public Accountants, or the Associate Management Accountant, while still serving patients and making money. It is now a unit-of-one economy where “ME Inc.,” is the standard. Physicians must maneuver for advantages that boost their standing and credibility among patients, peers, and payers.

Examples include patient satisfaction surveys, outcomes research analysis, evidence-based-medicine, direct reimbursement compensation, physician economic credentialing, and true patient-centric medicine. Physicians should realize the power of networking, vertical integration, and the establishment of virtual offices that come together to treat a patient and then disband when a successful outcome is achieved. Job security is earned with more successful outcomes; not a magnificent office suite or onsite presence.

B. Rule 2

Challenge conventional wisdom, think outside the traditional box, recapture your dreams and ambitions, disregard conventional gurus, and work harder than you have ever worked before. Remember the old saying, “if everyone is thinking alike, then nobody is thinking.” Do traditionalists or collective health care reform advocates react rationally or irrationally?

For example, some health care competition and career thought-leaders, such as Shirley Svorny, PhD, a professor of economics and chair of the Department of Economics at California State University, Northridge, wonder if a medical degree is a barrier—rather than enabler—of affordable health care. An expert on the regulation of health care professionals, including medical professional licensing, she has participated in health policy summits organized by Cato and the Texas Public Policy Foundation. She argues that licensure not only fails to protect consumers from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible.

Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today.

C. Rule 3

Differentiate yourself among your health care peers. Do or learn something new and unknown by your competitors. Market your accomplishments and let the world know. Be a non-conformist. Conformity is an operational standard and a straitjacket on creativity. Doctors must create and innovate, not blindly follow entrenched medical societies into oblivion.

For example, the establishment of virtual medical schools and hospitals, where students, nurses, and doctors learn and practice their art on cyber entities that look and feel like real patients, can be generated electronically through the wonders of virtual reality units.

D. Rule 4

Realize that the present situation is not necessarily the future. Attempt to see the future and discern your place in it. Master the art of quick change with fast, but informed decision making. Do what you love, disregard what you do not, and let the fates have their way with you.

Assessment

I receive a couple of phone calls each month from young doctors on this topic. I ask them to decide if they are of the philosophical ilk to adhere to the above rules; or become another conformist and go along … to get along? In other words, get fly!

Or, become an employed, or government doctor.  Just remember … the entity that gives you a job, can also take it away.

Sample fly: http://crossoverhealth.com/

MORE: Marriage Business

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What President Biden’s Student Loan Forgiveness Means for Doctors

By Joe Hannan

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Key Takeaways

President Biden’s student loan forgiveness plan may offer some relief to residents, but many attending physicians will not be eligible.

  • Residents may see $10,000 to $20,000 in debt cancellation, plus a reduction in their monthly payments if they are on an income-driven repayment plan.
  • Clinicians should review the requirements to see if they are eligible. They should also keep tabs on developments with the Public Service Loan Forgiveness (PSLF) program, which could also help eliminate their debt.

Source: Joe Hannan, MD Linx [8/26/22] 

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

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PODCAST: Hospitals Block Guiding Patients

By Eric Bricker MD

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PODCASTS: The “Long Fix” for America’s Healthcare Crisis

By Vivian Lee MD PhD MBA

Politics and Prose

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ERIC BRICKER MD PODCAST: https://www.youtube.com/watch?v=fbXM44YSBfs

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Inflation and Crypto-Currency

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By Staff Reporters

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The inflation-proof nature of cryptocurrency works in the same way as stocks– inflation will cause prices to increase so companies can charge more for their goods which means people are willing to pay.

However, since cryptocurrencies are fairly new and not backed by anything at this point it’s better if they make up a small portion of your portfolio instead of trying to go all in with one coin unless you have enough money lying around where losing some won’t hurt too much.

A lot of corporate investment portfolios have started to include crypto because let’s face it, inflation matters.

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Only 7 % of mHealth apps have more than 50,000 monthly active users

Best mHealth user retention concepts
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By Stela Nikolova
Research2Guidance
phone: +49  176 819 26976
email: stela.nikolova@research2guidance.com
www.research2guidance.com

Dear David,

Please find below Research2Guidance’s latest digital health article: “Only 7 % of mHealth apps have more than 50,000 monthly active users – Best mHealth user retention concepts“.

User retention for digital healthcare solutions is still a major issue. Only 7% of mHealth app portfolios count more than 50,000 active users. mHealth publishers know that to become a daily companion, mobile health apps must be individualized, easy to work with and offer real value to their users. Having a good share of active users offers them more business opportunities.

Which user retention concepts work best for mHealth apps?

Thank you for your time.
Conclusion

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The DENTAL Witness Stand

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By Darrell Pruitt DDS

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Today I was on the witness stand in a Dallas County courthouse for 2 hours testifying as an expert witness in an injury case involving a dentist who failed to pay attention to a patient’s safety. The three year old girl was brought into the dental operatory while hugging her mom, face-to-face. The mom and child were in that same position when they were seated in the dental chair – with the child’s legs straddling her mom’s waist, and extending a few inches beyond the back of the chair.

The dentist entered the operatory and reclined the chair by pushing a button on the control module. The hinge mechanism severely pinched the child’s right foot, breaking all 5 metatarsals. She will have problems with her foot the rest of her life.

The lesson, Doc: Never ever recline a dental chair unless all limbs are visibly clear of pinch points.

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PODCAST: Orthopedic Surgery Payment Changes in Total Knee and Hip Replacements

By Eric Bricker MD

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Of Doctors, Bull and Bear Markets

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Of Bull and Bear Markets

By Dr. David Edward Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A bull market is generally one of rising stock prices, while a bear market is the opposite. There are usually two bulls for every one bear market over the long term.

More specifically, a bear market is defined as a drop of twenty percent or more in a market index from its high, and can vary in duration and severity. While a bull market has no such threshold requirement to exist, other than they exist between these two periods of sharp decline.

Whither the Bear? 

As a doctor, your action plan in a bear market depends on many variables, with perhaps your age being the most important: 

In your 30s:

  • Pay off debts, school or practice loans.
  • Invest in safe money market mutual funds, cash or CDs.
  • Start retirement plan or 401-K account. 

In your 40s:

  • Increase your pension plan or 401-K contributions.
  • Stay weighted more toward equity investments.
  • Review your goals, risk tolerance and portfolio. 

In your 50s:

  • Position assets for ready cash instruments.
  • Diversify into stock, bonds and cash. 

Retirement:

  • Maintain 3 years of ready cash living expenses.
  • Reduce, but still maintain your exposure to equities.

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Bear + A Falling Stock Chart

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Assessment

Conclusion

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[PHYSICIAN FOCUSED FINANCIAL PLANNING AND RISK MANAGEMENT COMPANION TEXTBOOK SET]

  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™           Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

[Dr. Cappiello PhD MBA] *** [Foreword Dr. Krieger MD MBA]

Front Matter with Foreword by Jason Dyken MD MBA

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TWO SKILLS: Physician Programmers Need to Know

By Joel Comm

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Machine Learning

The global machine learning market was valued at $15.44 billion in 2021, and it is expected to grow to $209 billion by 2029. Machine Learning is a technology that has grown in popularity over the past years, especially driven by the success of companies like Google in the field of AI.

This success is also in big part due to the technology becoming more accessible to the masses. Take OpenAI’s AI image generator, DALL-E, as an example: Since DALL-E Mini went public, it has been given uses ranging from making memes to artwork worth the attention of The New Yorker.

Gone are the days in which machine learning was only accessible to researchers in top-notch institutions. Today, machine learning can be mastered all around the globe in official institutions, online education platforms, and even via comics.

Web3 / Blockchain Development

Whether you are invested in crypto and NFTs or not, the Metaverse is being built, and it promises to turn centralized, corporate-controlled Web2 on its head. The world of computer users–that’s pretty much all of us–has, for years, grown increasingly frustrated by having to operate under the oversight of a few monoliths.

The promise of Web3 is community–not corporation–first.

Innovators in the space like Proof of Learn are developing easily accessible educational platforms where Web2 pros and the tech-interested can learn to code in Web3, in a learn and earn model. The company’s first project is a lore-rich online academy called Metacrafters.io, drawing in gamers and developers, and attracting some serious backing from leading VCs and crypto investors. Fellow industry leaders, such as Solana, Flow, Avalanche, and Polygon Foundations, recently gave $4.5 million in grant funding to support Metacrafters’ mission of upskilling Web2 developers. This grant helps fund their learn and earn protocol, so you get to take courses in a game world and get paid for it.

Metacrafters.io might be one with this learn and earn model teaching coding skills, but it is in line to inspire more of its kind. Look around at the landscape of Web3 education and get cracking, because the Metaverse will be here sooner than expected, and developers will be the major players in it.

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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