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EUROPEAN UNION Paradox

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

By Staff Reporters

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The European Union Paradox is the perceived failure of European countries to translate scientific advances into marketable innovations.

The root of this issue remains debated: is it due to the scientific output being distant from the cutting-edge, or is it because the European innovation system lacks the capacity to harness the potential of groundbreaking research?

And so, this study reveals that, compared to similar European research, the European Research Council has a similar probability of being cited in patents, although it garners a larger number of patent citations. Moreover, patents that do draw upon ERC research are often of superior quality, measured by forward citations.

Compared to similar European research, inventive activities arising from ERC science are predominantly housed within universities and public research organizations. In absolute terms, however, US organizations, especially US companies, still lead in deriving the greatest benefit from ERC science.

Cite: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4635463

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Filed under: "Ask-an-Advisor", Accounting, Funding Basics, Glossary Terms, Investing, LifeStyle | Tagged: books, ERC, European Paradox, European Research Council, European Union, european union paradox, health, Technology | Leave a comment »

METZLER’S Paradox

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

By Staff Reporters

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Metzler’s Paradox is the imposition of a tariff [tax] on imports that may reduce the relative internal price of that good.

It was proposed by Lloyd Metzler PhD in 1949 upon examination of tariffs within the Heckscher-Ohlin Model. The paradox has roughly the same status as immiserizing growth and a transfer that makes the recipient worse off.

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Filed under: Accounting, Funding Basics, Glossary Terms, Health Economics, Taxation | Tagged: economics, export subsidies, good price, Heckscher-Ohlin Model, lloyd metzler paradox, paradox, price, tariff, tax | Leave a comment »

e-BOOKS: For Doctors, Financial Advisors, CPAs, Insurance Agents, Medical Consultants and Health Law Attorneys

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

By Ann Miller RN MHA CMP™

INTRODUCING OUR NEXT GENERATION e-BOOK LIBRARY FROM iMBA, Inc.

An e-book is an electronic or digital book that can be read on a computer or a handheld device.

Our new e-books consists of text, images, and are fixed to a specific spot on the page.

And, our e-books are a data files similar in content and structure to a word-processing document that comes in a PDF format. To use our e-books, you need to purchase and download it to a device that has a .pdf file reader app, such as ADOBE® or similar on a smartphone, tablet or computer. A PDF, also known as a portable document format, is the format most people are familiar with and used in our e-books. PDFs are known for their ease of use and ability to hold custom layouts. They are the most commonly used e-Book formats, especially by professionals and adult-learners.

You can then access the e-book and read it, or highlight pages and even take side notes.

e-Books Save Money

With no manufacturing, printing, binding or shipping costs, e-Books are cheaper than traditional hard or paper back books.The price of each specialized and highly niche focused e-Book [50-100 pages] is only $25, whereas similar paperback printed books of this type generally cost $145, or more!

Payable thru PayPal [3% courtesy surcharge applies].

MORE HERE: https://medicalexecutivepost.com/me-pr-a-new-feature/

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DAILY UPDATE: Winter Solstice & Endo Health Solutions as Stock Markets Rebound

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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The winter solstice, also called the hibernal solstice, occurs when either of Earth’s poles reaches its maximum tilt away from the Sun. This happens twice yearly, once in each hemisphere (North and South). For that hemisphere, the winter solstice is the day with the shortest period of daylight and longest night of the year, and when the Sun is at its lowest daily maximum elevation in the sky. Each polar region experiences continuous darkness or twilight around its winter solstice.

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

Stat: $200 million. That’s how much drug manufacturer Endo Health Solutions paid the federal government for profiting from the opioid crisis and racking up $4 billion in unpaid taxes. (ProPublica)

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

US stocks bounced back Friday as investors digested key inflation data that showed a deceleration in price increases during the month of November.

The tech-heavy NASDAQ Composite (^IXIC) gained 1%. The Dow Jones Industrial Average (^DJI) added 1.2%, while the S&P 500 (^GSPC) rose 1.1%.

But the rebound wasn’t enough to overcome losses earlier in the week. All three major gauges finished the week lower. The NASDAQ gave up 1.8% while the Dow and the S&P both shed around 2%.

CITE: https://tinyurl.com/tj8smmes

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

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BONDS: Revenue

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

DEFINITION

By Staff Reporters

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Revenue bonds are one of the biggest sectors in the municipal debt market.

Unlike a general obligation (GO) bond, revenue bonds are not backed by a municipal issuer’s taxing authority. Instead, interest and principal are secured by the net revenues (tolls, fees, or other charges tied to usage) from the project or facility being financed.

Revenue bonds are issued to finance a variety of capital projects, including construction or refurbishment of utility and waste disposal systems, highways, bridges, tunnels, air and seaport facilities, schools and hospitals.

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AUSTERITY: Financial Measures

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

By Staff Reporters

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Austerity Financial Measures describe official actions (typically taken under duress) by financially challenged governments (those that are under the threat of otherwise not being able to meet all of their obligations to debt holders and other creditors) to reduce the amount of money they spend, freeing more of it for paying off liabilities.

Austerity measures commonly involve deficit cutting, reduced spending, and cuts in government benefits and services provided. They are considered a “necessary evil,” along with revenue-raising measures, for bringing government budgets back into financial balance.

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FOMC: Cuts Interest Rates

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

BREAKING NEWS!

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By Staff Reporters

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The Federal Reserve cut interest rates by a quarter of a percentage point just now, delivering relief for borrowers at the central bank’s last meeting before President-elect Donald Trump takes office next month. The central bank predicted fewer rate cuts next year than it had previously indicated, however, suggesting concern that inflation may prove more difficult to bring under control than policymakers thought just a few months ago.

The move marked the third consecutive interest rate cut since the Fed opted to start dialing back its fight against inflation in the fall. The FOMC has lowered interest rates by a percentage point in recent months.

However, the Fed’s forecast said it anticipates only a half a percentage point of rate cuts next year and another half-percent cut in 2026.

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CURRENCIES: Carry-Trade Oriented

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

By Staff Reporters

DEFINITION

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Carry-Oriented Currencies are higher-yielding currencies of countries where interest rates are generally higher than those of countries with lower-yielding currencies.

These higher-yielding currencies are targeted for “carry trades,” where investors borrow money in a low-interest rate currency and invest in a higher yielding currency, potentially profiting from the difference in interest rates.

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DAILY UPDATE: PBMs and Healthcare A.I. as All Major Market Indexes Drop

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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

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

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Stat: 97%. That’s how many healthcare leaders think A.I. will become important in healthcare over the next five years.

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Pharmacy benefit managers (PBMs) are once again under pressure from federal leaders. A group of Democratic and Republican congresspeople proposed legislation that would attempt to prevent pharmacies from also owning PBMs. The three largest PBMs—CVS Health’s Caremark, Cigna’s Express Scripts, and UnitedHealth Group’s Optum Rx—currently operate pharmacies and administer more than 80% of the prescriptions in the US, and officials have linked this practice to drug price increases.

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

US stocks fell across the board on Tuesday, with the Dow logging its biggest losing streak in 46 years. The Dow Jones Industrial Average (^DJI) finished the session down roughly 0.6%, registering its ninth straight day of losses. The last 9-day losing streak for the Dow was Feb. 1978. Prior to that, the index suffered an 11-day losing streak in 1974 and another in 1971.

The other major indexes dropped in tandem on Tuesday, with the benchmark S&P 500 (^GSPC) falling around 0.4% and the NASDAQ Composite (^IXIC) losing about 0.3% after the tech-heavy index closed at a record high on Monday.

CITE: https://tinyurl.com/tj8smmes

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

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EXPECTED: Breakeven Inflation Rate

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

Measure of Expected Inflation

By Staff Reporters

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The breakeven inflation rate is the difference between the nominal yield (usually the market yield, which includes an inflation premium) on a fixed-income investment and the real yield (with no inflation premium) on an inflation-linked investment of similar maturity and credit quality.

So, if inflation averages more than the breakeven rate, the inflation-linked investment will outperform the investment with the nominal yield.

Conversely, if inflation averages below the breakeven rate, the investment with the nominal yield will outperform the inflation-linked investment.

Breakeven inflation rates are also considered useful measures of inflation expectations—higher breakeven rates represent higher inflation expectations (and higher relative prices for inflation-linked investments), while lower breakeven rates represent lower inflation expectations (and lower relative prices for inflation-linked investments).

Therefore, ideally, investors want to purchase inflation-linked investments when breakeven rates are relatively low because that’s typically when prices are also relatively low.

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DAILY UPDATE: Anthem BCBS Controversy as Stock Markets End Flat

Posted on December 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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

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

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Stocks ended the session little changed on Friday despite Broadcom’s (AVGO) jump to all-time highs driven by the chipmaker’s bullish AI-fueled sales forecast.

The S&P 500 (^GSPC) closed flat while the tech-heavy NASDAQ Composite (^IXIC) gained 0.1%. The Dow Jones Industrial Average (^DJI) slipped 0.1%

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

The fight between payers and anesthesiologists isn’t over, despite Anthem Blue Cross Blue Shield (BCBS) reversing plans for a policy that would put time limits on commercial claims for anesthesia coverage. The policy would have set a time limit for claims by procedure, with the exception of maternity and pediatric care, in New York, Connecticut, and Missouri starting next year. It called for providers “requiring more time than set or recommended by these standards” to undergo the insurance company’s claim dispute process in order to get paid, according to a statement Anthem provided to FOX61 in November.

The plan received backlash from everyone, from anesthesiologists to New York Governor Kathy Hochul.

CITE: https://tinyurl.com/tj8smmes

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

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MERCHANT: Cash Advance Loans

Posted on December 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITION

By Staff Reporters

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A Merchant Cash Advance is a specific type of convoluted financial agreement that lets the issuer bypass laws that limit interest rates on business loans. They are almost always targeted toward companies in dire financial straits that have nowhere else to turn to in order to get loans.

These loans have most often been compared to the business equivalent of a payday lender.

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CMO: Collateralized Mortgage Obligations

Posted on December 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Collateralized Mortgage Obligations (CMOs) are a form of securitized debt derived from mortgage-backed securities. It’s a form of derivative security. Like most MBS pass-through securities, CMOs are typically backed by pools of residential mortgages and their payments. But not all investors want to receive the monthly payments of principal and interest that “plain vanilla” MBS pass-throughs offer–some prefer just the principal, some prefer just the interest, or some want payments with other particular/special characteristics.

For them, the cash flows from MBS can be pooled and structured into many classes of CMOs with different maturities and payment schedules, creating securities with very specific characteristics and behaviors. These characteristics and behaviors can vary widely. Some CMOs can offer less risk than “plain-vanilla” MBS, or can help offset other forms of risk in a diversified portfolio, but others can be much more volatile.

CMOs typically have two or more bond classes, called tranches. Each tranche has its own expected maturity and cash flow pattern. The unique cash flow patterns of each CMO tranche allow investors to tailor their mortgage exposure to meet a range of investment objectives, since different classes can have different risk/return characteristics.

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DEFINED: Public Benefit Corporations

Posted on December 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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What Is a Public Benefit Corporation?

A benefit corporation—also known as a B Corporation—has shareholders who own the company, unlike a non-profit. So making money is the point, just not the whole point.

While non-profits (or not-for-profits) serve a public benefit and don’t make any profits, benefit corporations want to make money while still serving a greater purpose than itself “and a desire for the corporation to help make the world a better place,” according to Rick Bell of Harvard Business Services.

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DAILY UPDATE: Stock Markets Slide

Posted on December 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

FRIDAY 13th = Triskaidekaphobia

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

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The Dow Jones Industrial Average (^DJI) was down and the S&P 500 (^GSPC) were both about 0.5%. The tech-heavy NASDAQ Composite (^IXIC) fell roughly 0.6% while shares of Apple (AAPL) rallied less than 1% to close at a record high.

In bonds, the 10-year Treasury yield (^TNX) added 5 basis points to hit 4.32%, its highest closing level since November 22nd.

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

On a day where President-elect Donald Trump rang the opening bell at the New York Stock Exchange, Wall Street failed to build on a furious rally that has picked up steam after his election win. In focus was fresh inflation data, which helped cast doubt on investor confidence for the path of interest rates ahead.

CITE: https://tinyurl.com/tj8smmes

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

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INCENTIVE BIAS? In Medicine and with Physicians?

Posted on December 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITION

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Incentives: It is broadly accepted that incenting someone to do something is effective, whether it be paying office staff a commissions to sell more healthcare products, or giving bonuses to office employees if they work efficiently to see more HMO patients. Some experts even suggest there are five specific components1 that should be built into an overall physician incentive program:

Appropriate financial incentives.
Managed-care efficiency incentives.
Group citizenship.
Patient satisfaction.
Group profitability.

What is not well understood is that the incentives cause a sub-conscious distortion of decision-making ability in the incented person. This distortion causes the affected person – whether it is yourself or someone else – to truly believe in a certain decision, even if it is the wrong choice when viewed objectively. Service professionals, including financial advisors and lawyers, are affected by this bias, and it causes them to honestly offer recommendations that may be inappropriate, and that they would recognize as being inappropriate if they did not have this bias.

According to colleague Dan Ariely PhD, the existence of this bias makes it important for each one of us to examine our incentive biases and take extra care when advising physician clients, or to make sure we are appropriately considering non-incented alternatives.

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PHYSICIAN CREDIT: Ratings, Scoring, Errors and Repair Services

Posted on December 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

ALMOST ALL ABOUT CREDIT

By Staff Reporters

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Credit Rating and Scoring

The category in which a credit agency classifies you is based upon payment history. Recently, credit reporting agencies have shifted away from ratings to a system known as credit scoring. Your score is determined by proprietary formulas that are based on your credit history, the higher the better. The practical benefits of this scoring system are numerous.

First, medical professionals do not need to be experts at deciphering credit reports since the same scoring system is used by many different companies.

Correcting Credit Report Errors

A credit bureau is not the place to get an item to be fixed on your credit report. Rather, you must take it up directly with the credit issuer. In any case, a late payment noted on a credit report by a durable medical equipment vendor, for example, has to be addressed directly with that merchant. The DME merchant then has 30 days to acknowledge your complaint and respond to you. In the meantime, you do not have to pay for the disputed items. Most credit errors cannot be reported or kept on your credit report for more than seven years.

For legitimate late payments you should contact the credit grantor and negotiate to take one of the following steps. Be tenacious, and either remove the late payment or write a letter explaining that the problem has been resolved and you now are a good credit risk again. This letter is a powerful tool and should be saved with other permanent financial records. The industry term for it is a letter of correction.

Credit Repair Services

Credit repair services are oversold and their claims tend to be exaggerated. They do not have an inside track to the consumer reporting agencies. Good credit repair services are experienced in communicating with creditors and can help with legitimate repairs. They cannot restore your credit rating or your good name.

However, realize that with some time and effort you can accomplish the same results yourself.

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

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Filed under: "Ask-an-Advisor", Accounting, Ethics, Financial Planning, Funding Basics, Glossary Terms, Investing, Risk Management, Taxation | Tagged: credit, credit cards, credit errors, credit ratings, credit repair, credit repair services, credit reporting, credit score, credit scoring, finance, personal-finance | Leave a comment »

MYOPIA: Prime Financial Earning Years

Posted on December 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

COGNITIVE BIAS

SPONSOR: http://www.MarcinkoAssociates.com

By Staff Reporters

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Myopia makes it hard for us to imagine what our lives might be like in the future.

For example, because we are young, healthy, and in our prime earning years now, it may be hard for us to picture what life will be like when our health depletes and we know longer have the earnings necessary to support our standard of living.

According to colleague Dan Ariely PhD, this short sighted cognitivebias makes it hard to save adequately when we are young, when saving does the most good.

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MEDIA HEADLINES: Financial Security Risk Management

Posted on December 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Headline risk refers to the risk that a negative news media headline about one security issuer, incident or sector could affect the demand for and pricing of a much wider swath of securities, including those that have no direct relation to the securities headlined and whose fundamentals (defined above) remain intact.

Financial analyst Meredith Whitney’s appearance on “Sixty Minutes” in December 2010 was a classic example of the potential impact of headline risk, when her prediction of “a spate of municipal bond defaults” helped trigger a massive municipal bond market selloff, even though most municipal bonds actually faced no immediate default threat at that time, and the number of municipal defaults actually declined in the subsequent 12 months.

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MARCINKO ASSOCIATES: Physician Wealth Advisors and Practice Management Consultants

Posted on December 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

FIDUCIARY MEDICAL COLLEAGUES – FEE ONLY – NO PRODUCT OR SALES COMMISSIONS

SPONSOR: http://www.MarcinkoAssociates.com

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DEAR MEDICAL COLLEAGUES

Achieving your financial, wealth and medical practice management goals is important, but handling everything on your own can be overwhelming. That’s where we come in. At D. E. Marcinko & Associates, our team of dual degree experienced physician advisors and medical consultants is here to guide you every step of the way. We believe in providing unbiased, high-quality financial and business advice.

For example, we offer a one-time written financial plan with oral evaluation for a flat fee with no ongoing sales or assets under management fees or commissions. Together, we can create a personalized financial plan tailored to your unique goals, empowering you to make confident, informed decisions as you navigate your financial future.

Other Services Include:

Estate Planning We have a network of qualified legal professionals that we can refer you to for state specific estate planning needs.
Tax Strategy We can work alongside your CPA for tax planning purposes. If needed, we can refer you to a qualified tax professional.
Investment Analysis If you have investments, we review your accounts to make sure they are aligned with your long-term goals.
401-k Allocations We evaluate your 401(k) allocations and provide recommendations that align with your goals.
Education Savings We help you explore the various ways to plan and save for education expenses.
Insurance & Risk Management We assess your insurance coverage to ensure it adequately protects you against potential risks; as well as evaluate and provide expert litigation witnesses, as needed.
Medical Practice Management We evaluate your current or potential medical practice to determine value and/or private equity offers or physician practice management formats [PPMC] for new, mid-career or retiring physicians, nurses and dentists.

D. E. Marcinko & Associates is unique and fully committed to all phases of a medical professionals personal and business life cycle. We are at your service 24/7: Email MarcinkoAdvisors@outlook.com

ANN MILLER RN MHA CMP™

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USA: Contact

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DAILY UPDATE: Walgreens to PE as CPI Upticks and Markets Blast Off this Morning

Posted on December 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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

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

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?

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According to reporting from the Wall Street Journal, the pharmacy chain Walgreen’s is discussing selling to private equity (PE) firm Sycamore Partners, a deal that could close early next year. This comes following a tumultuous year for the company, which announced it would close 1,200 stores in October and laid off more than 250 employees in November. The PE firm is allegedly considering selling off pieces of the business or working with partners, sources told the Journal. Following the news, Walgreens’s stock jumped 28%, its biggest single-day increase since 1980, according to Yahoo Finance.

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

Inflation rose 2.7% on an annual basis in November, according to the latest government report on the Consumer Price Index, or CPI. Last month’s CPI was forecast to come in at 2.7%, according to economists surveyed by financial data firm FactSet. The Consumer Price Index, a basket of goods and services typically bought by consumers, tracks the change in those prices over time.

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

US stocks opened higher on Wednesday as investors digested another month of sticky inflation data that met economists’ expectations and likely pointed to a Federal Reserve interest rate cut next week. The Dow Jones Industrial Average (^DJI) increased about 0.2%, while the S&P 500 (^GSPC) jumped nearly 0.5%. The tech-heavy NASDAQ Composite (^IXIC) also added to across-the-board gains, rising roughly 0.8%.

CITE: https://tinyurl.com/tj8smmes

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

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RICHARD EASTERLIN: Happiness Paradox

Posted on December 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Richard Easterlin PhD, Paradox: For countries with income sufficient to meet basic needs, the reported level of happiness does not correlate with national income per person.

According to colleague Dan Ariely PhD, one explanation is that my happiness depends on a comparison between my income and my perceptions of the average standard of living. If everyone’s income increases, my increased income gives a short boost to my happiness, since I do not realize that the average standard of living has gone up. Some time later, I realize that the average standard of living has also gone up, so the happiness boost produced by my increased income disappears. It is the contradiction between the point-of-time and time series findings that is the root of the paradox: while there is a correlation at a fixed point, there is no trend over multiple points.

That is, in the short run, everyone perceives increases in income to be correlated with happiness and tries to increase their incomes. However, in the long run, this proves to be an illusion, since everyone’s efforts to raise standards of living lead to increasing averages, leaving everyone in the same place in terms of relative income.

Various theories have been advanced to explain the paradox, but the paradox itself is solely an empirical generalization. The existence of the paradox has been strongly disputed by other researchers.

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ENTITLEMENT PROGRAMS: Criteria and Integration

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

DEFINITIONS

By Staff Reporters

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Entitlement programs: From an economic overview or government budgeting perspective, entitlement programs are types of government programs that provide individuals with personal financial benefits (or sometimes special government-provided goods or services) to which an indefinite (but usually large) number of potential beneficiaries have a legal right when they meet specified eligibility requirements. The beneficiaries are normally individuals, but can also be organizations. The most important examples at the federal level in the U.S. include Social Security, Medicare, and Medicaid.

Environmental, Social, Governance (ESG) Criteria: The risk and/or opportunity to a company’s market valuation resulting from environmental, social and governance (ESG) factors. Depending on the sector, environmental and social factors include, but are not limited to, 1) climate change, 2) water stress, 3) product safety and quality (supply chain and manufacturing), 4) cybersecurity and data privacy, and 5) human capital management. Regardless of the sector, governance factors include: 1) business (mis)conduct, 2) board composition, independence and entrenchment, 3) accounting practices, 4) ownership structure, and 5) executive pay-for-sustainability performance alignment.

Environmental, Social, Governance (ESG) Integration: The structural incorporation of financially-relevant information on Environmental, Social and Governance (ESG) factors into the investment decision-making process.

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SYNTHETIC EQUITY: Deferred Compensation for Financial Advisors

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

DEFINED FOR FINANCIAL ADVISORS

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Think of synthetic equity as a communal garden. You don’t own the plot, and you don’t necessarily have a say in what’s planted, but you’re guaranteed a share of the crops that are harvested.

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

Synthetic equity is a form of deferred compensation that mirrors some of the benefits of real stock ownership without granting actual shares. It’s a contractual agreement between you and your employer that entitles you to a payout upon certain events—such as an IPO, acquisition, or surpassing earnings milestones.

Companies use synthetic equity plans to motivate their personnel through growth-related incentives. In other words, it grants employees a sense of ownership without issuing shares or altering the business’s ownership structure. As the company succeeds and appreciates in value, so does your potential payout. Although you don’t own actual shares of company stock, you are compensated as if you did.

READ: https://tinyurl.com/mr3upbn6

According to Carla McCabe, synthetic equity programs also have a significant tax advantage to both business owners and the key employees.

For example, when a key employee receives shares under the firm’s synthetic equity program, the IRS does not recognize that receipt as taxable income to the employee until he or she actually receives the money. This usually occurs when the firm is sold or when the employee retires and is cashed out (assuming the employee’s synthetic shares are vested). This is very attractive considering that regular shares are taxed as ordinary income and the employee basically has to pay the associated tax even though he or she didn’t receive any cash.

Of course, all this begs the question: Why would a company offer synthetic equity instead of actual equity?

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VALUATION OF HOSPITALS: Reimbursement Environment

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

By Health Capital Consultants, LLC

The U.S. government is the largest payor of medical costs, through Medicare and Medicaid, and has a strong influence on reimbursement to hospitals. In 2022, Medicare and Medicaid accounted for an estimated $944.3 billion and $805.7 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.

This third installment of the series discusses the reimbursement environment in which hospitals operate. (Read more…)

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OPPS: Final Rule Issued by CMS

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

By Health Capital Consultants, LLC

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

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

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INSURANCE: Long Term Care Economics

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

LTC

By Anonymous Insurance Agent

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

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

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

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

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

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

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

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COUNTDOWN: To End of Year BOI Reporting?

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

Beneficial Ownership Information

By Staff Reporters

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

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

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

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

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BREAKING NEWS

A federal court has ruled that the beneficial ownership information (BOI) reporting requirements established by the Corporate Transparency Act (CTA) are unconstitutional¹ ² ³. The decision is currently under appeal¹.

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IRS FORM 1099-K: Changes and Implementation?

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

By Staff Reporters

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2024 LATE YEAR UPDATE

Who sends Form 1099-K?

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

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

Who gets Form 1099-K:

You should get Form 1099-K for these situations:

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

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

Find what to do with Form 1099-K.

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

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

This includes payments for any:

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

The payments can be made through any:

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

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

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

Find what to do with Form 1099-K.

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

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

By Health Capital Consultants, LLC

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

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

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BOND YIELDS: Real and Negative Returns

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

DEFINITIONS

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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

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

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

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

AUSTRIAN SCHOOL OF ECONOMICS

By Staff Reporters

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

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

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

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

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

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

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

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

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Record-Breaking Savings for ACOs in 2023

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

ACCOUNTABLE CARE ORGANIZATIONS

By Health Capital Consultants, LLC

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

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

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AMA: 41 Senators Sign Letter to Stop Medicare Cuts

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

By Staff Reporters

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In a sign of legislative momentum, 41 senators are supporting efforts to prevent a pending 2.8 percent cut in Medicare physician payments that will go into effect January 1st. The bipartisan letter led by Sens. John Boozman, R-Ark., and Peter Welch, D-Vt., to Senate leaders says the cuts would interfere with the ability of physicians to provide high-quality care. “These continued payment cuts undermine the ability of independent clinical practices – especially in rural and under served areas – to care for their communities,” the letter said.

The Senate letter follows one from the American Medical Association (AMA) and 127 other state medical associations and national medical societies asking Congress to use these last few congressional days to prevent the scheduled cuts. The letter to congressional leaders also urges Congress to provide a positive payment update for 2025. All 50 state medical societies – and DC— as well as 77 national medical societies signed.

Source: AMA

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

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BLACK FRIDAY 2024: The Physician Micro-Economy

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

Is it Good for Retailers … but Bad for Doctors and Consumers?

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If Black Friday 2024 is anything like 2023, retailers may not be swimming in cash while shoppers bathe in savings. Black Friday deals drew 212 million shoppers to stores in fabulous 2010 and collectively spent $39 billion on products and services.

And, the average amount spent by a Black Friday shopper in 2010 was a whopping $365.34.

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Assessment

We predict Black Friday 2024 sales surpass 2023 with a slight increase over 20222 because of fewer shopping days; and the COVID pandemic explosion..

QUESTION: But, is Black Friday good for the [healthcare] economics sector post [thu] the pandemic? Do patients go shopping rather than to the doctor? What about inflation?

Channel Surfing the ME-P

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register. It is fast, free and secure.

Conclusion

Your thoughts and comments on this ME-P are appreciated.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

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THANKSGIVING: Donor Advised Funds

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

DONATION: In “Name” Only?

Staff Reporters

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Proponents of DAFs say that their structure encourages giving: The tax deduction encourages wealthy patrons to dedicate money for charity even before they’ve decided which cause to support. “Donors may have good reasons to postpone grants,” a Stanford Law School article says..

In one hypothetical, a tech founder who “sells a startup for millions of dollars” may want to donate her takings but is too busy to immediately decide how to direct the funds; a DAF is a good choice for this person, the law article notes.

However, while DAFs could in theory grow the charitable pie, in practice, they too often allow the donor the illusion of charity while letting them keep control of their funds, critics say.

While a gift to a DAF is treated the same as an outright gift to the Red Cross or United Way, in practice, it “effectively allows the donor to retain ongoing control over the charitable disposition and investment of the donated assets,” tax scholars Roger Colinvaux and Ray Madoff wrote in 2019. What’s more, “donors are under no obligation, and have no incentive, ever to release their advisory privileges to make the funds available for charitable use.”

And ultra wealthy donors get a substantially larger tax break than a middle-class worker. As much as 74 cents of every dollar given to charity comes back to the donor in the form of tax breaks, according to calculations by Colinvaux and Madoff, with the highest-earning donors getting the biggest benefits A person in the top tax bracket would save 37% of their federal income tax for every dollar they contribute with a charitable donation; a similar amount of state income tax; and, depending on what they donate and when, they can also avoid capital gains tax and estate tax. (By contrast, a typical worker who makes about $60,000 and doesn’t own stocks would save 22% from their cash contribution, in addition to any state tax savings.)

What’s more, because there’s no way to track donations from particular DAF accounts, they act as a form of “dark money,” allowing donors to give vast sums, essentially anonymously, to a range of potentially unsavory organizations, including nonprofits that advocate for specific political causes or organizations classified as hate groups, IPS says.

“This allows DAFs to be used to hide transfers — similar to the way the ultra-wealthy use multiple shell companies to hide the movement of money among offshore accounts,” IPS writes.

All of these strategies are completely legal, the IPS notes, as are other potentially questionable tactics used by family foundations—such as paying family members to serve as foundation trustees or act as executives of foundations, sometimes at salaries in the hundreds of thousands of dollars a year. However, the IPS argues, they erode public trust in charities and the tax system overall.

“The fact that billionaires opt out of paying taxes, have these closely held family foundations and get to play God about where the money goes, that’s private power — unaccountable private power,” Collins said.

“At this point philanthropy is at risk of becoming taxpayer-subsidized private power.”

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Valuation of Hospitals [Technological Environment]

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

By Health Capital Consultants, LLC

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

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

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PHYSICIAN FINANCIAL FEAR: Money Anxiety & Chrometophobia

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

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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

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

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

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

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BONDS: Tobacco

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

By Staff Reporters

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

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

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

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MORTGAGE BACKED SECURITIES: Prepayment Risk

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

DEFINITION

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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AMA: Bye-Bye Medicare Billing Codes?

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

By Staff Reporters

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

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

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Stocks, Treasuries, Gold and Bitcoin

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

SPONSOR: http://www.MarcinkoAssociates.com

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

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CHARGE MASTER: Medical Bills Paradox

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

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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CHARGE MASTER MEDICAL BILLS

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

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

Paradox Examples:

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

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DAILY UPDATE: All About the Stock Markets

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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

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

STOCKS UP

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

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

STOCKS DOWN

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

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

Here’s where the major benchmarks ended:

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

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

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DEDICATED: Short Stock Bias Strategies

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

By Staff Reporters

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

From Shorting to a Short Bias

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

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

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BIAS: Of “Social Proof” and Influencers

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

INVESTING DEFINITION

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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

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

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

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

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FINANCIAL YIELDS: All About Fixed Income Securities

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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Yield: For bonds and other fixed-income securities, yield is a rate of return on those securities. There are several types of yields and yield calculations. “Yield to maturity” is a common calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity.

Yield curve: A line graph showing the yields of fixed income securities from a single sector (such as Treasuries or municipals), but from a range of different maturities (typically three months to 30 years), at a single point in time (often at month-, quarter- or year-end). Maturities are plotted on the x-axis of the graph, and yields are plotted on the y-axis. The resulting line is a key bond market benchmark and a leading economic indicator.

Yield to maturity [real yield to maturity]: Yield to maturity is a common performance calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity. Real yield to maturity is simply yield to maturity minus any “inflation premium” that had been added/priced in. (See Real yield.)

Yield ratio: A ratio of one yield divided by another. Most often used as a relative value measurement.

Yield spread: A “spread,” in fixed income parlance, is simply a difference. Yield spreads measure yield differences, typically between debt securities with high credit ratings (which typically have lower yields) and those with lower ratings (which typically have higher yields). Yield spreads can also be measured between debt securities with different maturities (shorter-maturity securities typically have lower yields and longer-maturity securities typically have higher yields).

Yield trap: An investment that can lure investors with an attractive yield that may not be fundamentally sustainable, or that may lead to undesired price volatility. Yield traps can lurk in both the equity and fixed income markets. They have a tendency to prey on those who can least afford them, including retirement investors looking for increased relative income and stability, who may have been too focused on their income goals and not enough on stability.

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DAILY UPDATE: Bitcoin Fog as Chegg the DJIA and NASDAQ Drop

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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The operator of the longest-running money laundering machine in dark web history, Bitcoin Fog, has been sentenced to 12 years and six months in US prison. Roman Sterlingov, 36, a Russian-Swedish national, was also ordered to repay more than half a billion dollars accrued from the cryptocurrency mixing service that he ran for a decade between 2011 and 2021.

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Stocks Up

r Elliott Investment Management is at it again, this time with a $5 billion stake in industrial conglomerate Honeywell. Shares gained 3.87% on the news.
Shopify announced its ninth consecutive quarter of beating analyst revenue expectations, pushing shares up 21.04%.
Bad news is good news: 40% of the workforce at 23andMe is getting laid off to cut costs. Shareholders cheered, and shares climbed 2.17%.
Where’s the beef? Tyson Foods popped 6.55% after announcing strong earnings thanks to higher beef and chicken prices last quarter.
Sentinel One climbed 2.01% after Deutsche Bank analysts upgraded the cybersecurity stock from “hold” to “buy,” noting it should profit from CrowdStrike’s outage earlier this year.

Stocks Down

Novavax fell 6.10% after cutting its financial guidance due to poor sales of its Covid-19 vaccine.
Holding company IAC is considering a spinoff of home improvement services platform Angi (formerly Angie’s List). Nobody liked that: Shares of IAC fell 12.56%, and Angi plummeted 26.34%.
Payments processor Shift4 Payments sank 5.69% after crushing revenue expectations but missing on earnings.
Mosaic dropped 7.74% thanks to Hurricane Milton, which disrupted the fertilizer company’s business across the board.
TreeHouse Foods plunged 14.36% to a new 52-week low after the food processor missed on both top- and bottom-line earnings expectations.

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

Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) fell 17.36 points (–0.29%) to 5,983.99; the Dow Jones Industrial Average^® ($DJI) lost 382.15 points (–0.86%) to 43,910.98; and the NASDAQ Composite^® ($COMP) decreased 17.36 points (–0.09%) to 19,281.40.
The 10-year Treasury note yield added 12 basis points to 4.43%.
The CBOE Volatility Index^® (VIX) fell to 14.81, unusual on a day when stocks lost ground.

CITE: https://tinyurl.com/tj8smmes

Chegg is on the verge of collapse. Its stock is down 99% since 2021, the Wall Street Journal reported, wiping out nearly $15 billion in market value.

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

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PHYSICIAN: Pay Cuts in 2025

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Doctors, Facing Another Pay Cut, Call for Permanent Medicare Payment Reform

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. CMS has finalized the calendar year 2025 Medicare Physician Fee Schedule rule that sets payment rates for next year and also outlines new policies focused on primary care, preserved telehealth flexibilities, and a strengthened Medicare Shared Savings Program (MSSP).

But, provider groups were quick to condemn CMS’ decision to go ahead with the pay cut, which was proposed in the draft rule released in July. In a statement, Bruce Scott, MD, president of the American Medical Association (AMA), pointed out that that while physicians are receiving a 2.8% payment cut next year, medical practice costs for physicians will increase by 3.5% in 2025. After adjusted for inflation, Medicare reimbursement to physicians has decreased 29% since 2001, the AMA says.

Source: Heather Landi, Fierce Healthcare [11/2/24]

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KENNETH ARROW: Information Paradox

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

To sell information you need to give it away before the sale

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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THE FATHER OF HEALTH ECONOMICS

According to Wikipedia, a fundamental tenet of the paradox is that the customer, i.e. the potential purchaser of the information describing a technology (or other information having some value, such as facts), wants to know the technology and what it does in sufficient detail as to understand its capabilities or have information about the facts or products to decide whether or not to buy it. Once the customer has this detailed knowledge, however, the seller has in effect transferred the technology to the customer without any compensation. This has been argued to show the need for patent protection [HIPPA].

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

If the buyer trusts the seller or is protected via contract, then they only need to know the results that the technology will provide, along with any caveats for its usage in a given context. A problem is that sellers lie, they may be mistaken, one or both sides overlook side consequences for usage in a given context, or some unknown-unknown affects the actual outcome.

MORE :https://www.nobelprize.org/prizes/economic-sciences/1972/arrow/facts/

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e-Books Save Money

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

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What Is a Public Benefit Corporation?

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Credit Rating and Scoring

Correcting Credit Report Errors

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

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By Health Capital Consultants, LLC

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Who sends Form 1099-K?

Who gets Form 1099-K:

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

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

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Is it Good for Retailers … but Bad for Doctors and Consumers?

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SPONSOR: http://www.MarcinkoAssociates.com

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STOCKS UP

STOCKS DOWN

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

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