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DAILY UPDATE: Prior Medical Authorizations Up as Stock Markets Rise to Record Highs!

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

By Staff Reporters

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A new set of rules from the Biden administration seeks to rein in private health insurance companies’ use of prior authorization – a byzantine practice that requires people to seek insurance company permission before obtaining medication or having a procedure. The cost-containment strategy often delays care and forces patients, or their doctors, to navigate opaque and labyrinthine appeals.

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

Here’s where the major benchmarks ended:

The S&P 500 index rose 52.42 points (1.1%) to 4,958.61, up 1.4% for the week; the Dow Jones Industrial Average gained 134.58 points (0.4%) to 38,654.42, up 1.4% for the week; the NASDAQ Composite rallied 267.31 points (1.7%) to 15,628.95, up 1.1% for the week.
The 10-year Treasury note yield (TNX) surged about 16 basis points to 4.024%.
The CBOE Volatility Index^® (VIX) fell 0.04 to 13.84.

The market’s strength continued to be driven by the biggest companies, while smaller names lagged. The small-cap Russell 2000^® Index (RUT) fell 0.6% Friday and posted a drop of 0.8% for the week. In other markets, the U.S. dollar index (DXY) rose 0.8%, reaching its strongest level in nearly two months, amid expectations interest rates will remain elevated, which boosted demand for dollar-denominated assets, such as Treasuries.

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DAILY UPDATE: Tech Industry Sheds Workers as the Stock Markets Rebound

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

By Staff Reporters

LEAP YEAR: This February month is a Leap Year. It’s stuffed with 29 days for 2024. If we didn’t have leap years, then our seasons would completely flip every ~750 years!

GROUND HOG DAY: A tradition observed in the United States and Canada on February 2nd of every year. It derives from the Pennsylvania Dutch superstition that if a ground hog emerges from its burrow on this day and sees its shadow, it will retreat to its den and winter will go on for six more weeks; if it does not see its shadow, spring will arrive early.

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The tech industry has shed tens of thousands of workers over the last year or so, including thousands this month alone across companies including Unity, Twitch, Amazon, Meta, Microsoft, eBay and Google. It also emerged that PayPal is firing around 2,500 people.

Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) rose 60.54 points (1.3%) to 4,906.19; the Dow Jones Industrial Average (DJI) gained 369.54 points (1.0%) to 38,519.84; the NASDAQ Composite^® (COMP) added 197.63 points (1.3%) to 15,361.64.
The 10-year Treasury note fell over 10 basis points to 3.86%.
The CBOE Volatility Index^® (VIX) fell 0.47 to 13.88.

Regional bank shares remained under pressure in the wake of poorly received quarterly results earlier this week from New York Community Bancorp (NYCB), which took over the failed Signature Bank in 2023. The bank’s shares fell another 11% on top of a 38% drop Wednesday while the KBW Regional Banking Index (KRX) sank 2.3% to a two-month low. The bank weakness was offset by strength in several other sectors, including retail and consumer discretionary.

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Cigna Sells Medicare Part C as 23andMe Crashes

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

By Staff Reporters

HCSC will acquire Cigna’s Medicare Advantage, Part D, supplemental benefits and CareAllies businesses, and the parties expect the deal to close in the first quarter of 2025. And, as January exits, we enter the thick of earnings call season. This week executives at AbbVie, Cigna, and Merck—to name a few—will brief healthcare investors on how their companies fared in 2023, and provide insights on what to expect in 2024.

And, Anne Wojcicki’s billions have vanished. 23andMe’s valuation has crashed 98% from its peak and NASDAQ has threatened to delist its sub-$1 stock. Wojcicki reduced staff by a quarter last year through three rounds of layoffs and a subsidiary sale. The company has never made a profit and is burning cash so quickly it could run out by 2025.

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DAILY UPDATE: Microsoft, Google and IMF Up Yesterday, as UPS and the Stock Markets Collapse Today

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

By Staff Reporters

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Microsoft and Google rode the AI wave to huge quarters. Microsoft posted revenues of ~$62 billion in its fiscal Q2 ending Dec. 31, a year over year increase of 17.6% and ahead of analyst’s expectations. That was its best revenue growth in seven quarters, thanks to the release of new AI-enabled Office products. Meanwhile, Google reported strong results, too: Ad revenue at YouTube skyrocketed to $9.2 billion in Q4 of last year, up from below $8 billion the year before. Alphabet CEO Sundar Pichai said YouTube is “already benefiting from our AI investments and innovation.” Alphabet’s total revenue was up 13% year over year to ~$86 billion.

UPS slashed 12k jobs. The shipping giant said it will require employees to return to the office five days a week this year as it changes how it operates amid a slowdown in demand. Revenue declined in Q4, while annual sales fell 9.3% in 2023. Amazon, its biggest customer, accounted for 11.8% of revenue last year, up from the year before, as revenue from other customers declined due to lower demand and more in-store pickups, executives said. UPS is also dealing with higher labor costs due to the deal it made with the Teamsters union to avoid a strike last summer.

The IMF has the US to thank for raising its global forecast. The International Monetary Fund—the UN’s flagship financial agency—said the global economy will grow 3.1% this year, a slight increase from its projection in October. That’s largely due to the strength of the US economy, which has defied economists’ expectations, growing 3.3% in the fourth quarter of 2023. But the improved outlook was also boosted by economic stimulus in China, which has faced deflation and a real estate crisis, among other issues. Other economies, including India, Brazil, and Russia, also performed better than expected, helping to juice the IMF’s forecast.

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Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) fell 79.32 points (1.6%) to 4,845.65; the Dow Jones Industrial Average^® (DJI) lost 317.01 points (0.8%) to 38,150.30; the NASDAQ Composite^® (COMP) dropped 345.89 points (2.2%) to 15,164.01, a two-week low.
The 10-year Treasury note yield (TNX) decreased nearly 9 basis points to 3.969%.
The CBOE Volatility Index^® (VIX) jumped 1.03 to 14.34.

Regional banks led Wednesday’s declines after New York Community Bancorp (NYCB), which took over the failed Signature Bank last year, reported a fourth-quarter loss of $193 million, sending its shares down nearly 38%. The KBW Regional Banking Index (KRX) sank 6%. Communications services shares were also among the weakest performers. Energy companies were also under pressure as WTI Crude Oil futures (/CL) shed nearly 3%.

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Filed under: "Ask-an-Advisor", Accounting, Breaking News, Drugs and Pharma, Ethics, Experts Invited, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, Investing | Tagged: Amazon, CBOE, COMP, crude oil, DJIA, google, IMF, KRX, microsoft, MSFT, NASDAQ, NYCB, S&P 500, SPX, Sundar Pichai, TNX, VIX, WTI, youtube | Leave a comment »

JANUARY: Doctors Beware Divorce Month

Posted on January 31, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

OVERHEARD IN THE ADVISOR’S LOUNGE
[January is Divorce Month]

SPONSOR: http://www.MARCINKOASSOCIATES.com

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January is nick-named the “divorce month” because of an uptick in activity for divorce lawyers after the New Year. Yet, January to April 15th is also a very low period in terms of people inquiring about divorce mediation. The reason is that couples generally want to know where they stand financially before pursuing divorce.

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And, with the economy improving in 2024, people may be less inclined to wait. While anecdotal evidence abounds, hard figures are more elusive. An analysis of national divorce filings between 2008 and 2011 by legal information website FindLaw.com found a spike in January and a gradual rise until a peak in late March.

Mediation: https://medicalexecutivepost.com/2023/08/12/a-step-wise-approach-to-the-divorce-mediation-process-for-doctors/

UPDATE 2024: The exclusivity of marriage in the contemporary era has dire, compounding consequences across generations. As researchers Shelly Lundberg, Robert A. Pollak and Jenna Stearns document, in 1960, people with and without college degrees married and formed families in a similar manner, but today, just 11% of childbirths for those with college degrees are non-marital, while 58% of childbirths for those without are. This cleavage makes possible what the Brookings Institution’s Melissa Kearney describes as “two-parent privilege,” an emerging phenomenon through which well-off couples transmit educational and economic advantages to their children. Viewed from this angle, it should not surprise us that many Americans think the rich are galloping ever further ahead.

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DAILY UPDATE: Evergrande and the FanDuel-Flutter as Stocks End Mixed Awaiting the FOMC

Posted on January 31, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Embattled China Evergrande ordered to liquidate by Hong Kong court

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China Evergrande, which owes $300 billion, ordered to liquidate. Yesterday, a Hong Kong court ordered the debt-burdened real estate firm to wind up its business—though it’s not clear if mainland Chinese authorities will enforce it. As one of the largest developers to struggle with debt, the company, which defaulted in 2021, has become a symbol of the real estate bust in China, which has so many homes sitting vacant that an ex-official admitted even its population of 1.4 billion could not fill them. Now, investors around the world will be watching the liquidation process to see how foreign investors fare as a test of how China’s system treats international businesses.

FanDuel parent Flutter lists on New York Stock Exchange. Rob Gronkowski visited the NYSE trading floor yesterday to celebrate the kickoff of the company selling shares in New York, which—for now—is a secondary listing to the European company’s primary London Stock Exchange listing. The move steps up its competition with DraftKings. And with US sports betting booming thanks to legal changes, the FanDuel parent wants to go all in and is proposing making the NYSE its primary trading venue, which would be a blow to the London exchange.

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Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) fell 2.96 points (0.1%) to 4,924.97; the Dow Jones Industrial Average gained 133.86 points (0.4%) to 38,467.31; the NASDAQ Composite^® (COMP) lost 118.15 points (0.8%) to 15,509.90.
The 10-year Treasury note yield (TNX) tumbled about 3 basis points to 4.059%.
The CBOE Volatility Index^® (VIX) dropped 0.29 to 13.31.

Chipmaker shares were among the market’s weakest performers, with the Philadelphia Semiconductor Index (SOX) sinking 1.6%. The small-cap Russell 2000^® Index (RUT) lost 0.8%, giving back part of Monday’s 1.7% gain. Energy and financial companies were among the strongest sectors.

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DAILY UPDATE: Stock Markets Blast Off Again!

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

By Staff Reporters

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Markets: Stocks had a strong start to the week, with the S&P 500 and the Dow once again hitting new records. That’s mostly thanks to a boom in Big Tech as investors anticipate a slew of high-profile earnings (not to mention a Fed meeting) this week. Microsoft, Meta, and Uber all reached all-time highs.

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Here’s where the major benchmarks ended today:

The S&P 500 index rose 36.96 points (0.8%) to 4,927.93; the Dow Jones Industrial Average gained 224.02 points (0.6%) to 38,333.45; the NASDAQ Composite^® (COMP) added 172.68 points (1.1%) to 15,628.04.
The 10-year Treasury note yield (TNX) dropped about 8 basis points to 4.08%.
The CBOE Volatility Index^® (VIX) rose 0.37 to 13.63.

Consumer discretionary and banks were among the market’s strongest sectors Monday, and small caps were also strong. The Russell 2000^® Index (RUT), a small-cap benchmark, outpaced its large-cap counterparts with a gain of 1.7%, ending near a four-week high. Energy shares took pressure after WTI Crude Oil futures (/CL) reversed an initial rally to a two-month high and ended with a loss of more than 1%.

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PODCAST: Hospital Medicare Break-Even Plans

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

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By Eric Bricker MD

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DAILY UPDATE: U.S. GDP and Microsoft

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

By Staff Reporters

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The US GDP grew 3.3% in Q4, per the Commerce Department, annihilating Wall Street’s expectations of 2% growth. For the year, the US economy expanded 2.5% in 2023, up from 1.9% in 2022. That also outpaced Wall Street’s estimates from the beginning of the year. The growth was driven by strong consumer spending made possible by rising wages and a sturdy job market, even as the country dealt with inflation. That, too, improved in Q4: Prices increased 2.7% on an annual basis, down from a 5.9% increase the year prior. The GDP smash adds more fuel to the expectation that the Fed will cut interest rates this year.

The cuts across Xbox and Activision Blizzard account for 8% of Microsoft’s video game division. The tech giant closed on its $69 billion acquisition of Call of Duty-maker Activision Blizzard in October and has since made several leadership changes. CEO Bobby Kotick stepped down in December, and now Blizzard President Mike Ybarra has decided to leave, according to an internal memo obtained by The Verge. An upcoming survival game has also been canceled. The cuts come as several gaming-related companies, including Twitch, Discord, Unity, and Riot Games, have conducted layoffs.

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What is MEDICAL AID [Assistance] in DYING?

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

MAiD

By Staff Reporters

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Medical Assistance in Dying (MAiD) by Pam Dominguez

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Medical Aid in Dying [MAiD] is an end-of-life option for people who are terminally ill. Terminally ill means you have an illness, disease, or health condition that, according to doctors, you will likely die from within 6 months. If you’re eligible for MAiD, you can ask a doctor who participates in MAiD to prescribe life-ending medications. You can take these medications at a time of your choosing.

Medical Aid in Dying (MAID) is legal in eleven jurisdictions in the United States: California, Colorado, District of Columbia, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, and Washington.

But, only patients can make a request for MAiD. Family members, caregivers, and health care agents cannot request MAiD for a patient.

READ: http://tinyurl.com/yes7wbzm

NOTE: If you are struggling with thoughts of suicide or worried about a friend or loved one, call or text the Suicide & Crisis Lifeline at 988 for free, confidential emotional support 24 hours a day, seven days a week.

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DAILY UPDATE: Stocks End Mixed

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

By Staff Reporters

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Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) fell 3.19 points (0.1%) to 4,890.97, up 1.1% for the week; the Dow Jones Industrial Average gained 60.30 points (0.2%) to 38,109.43, up 0.6% for the week; the NASDAQ Composite^® (COMP) dropped 55.13 points (0.4%) to 15,455.36, still up 0.9% for the week.
The 10-year Treasury note yield (TNX) rose about 1 basis point to 4.143%.
The CBOE Volatility Index^® (VIX) fell 0.19 to 13.26.

Energy shares extended a strong week as WTI Crude Oil futures (/CL) rallied further, reaching a two-month high just under $78 per barrel. Regional banks were also among the market’s strongest performers Friday. Small-cap stocks gained modestly to end a firm week with the Russell 2000^® Index (RUT) posting a weekly gain of about 1.8%.

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Filed under: "Ask-an-Advisor", Breaking News, Drugs and Pharma, Ethics, Experts Invited, Financial Planning, Health Economics, Health Insurance, Healthcare Finance, Investing | Tagged: CBOE, COMP, DJIA, Eric Adams, medical debt, New York City, NSDAQ, NYC, RIP Medical Debt, RUT, S&P 500, SPX, TNX, VIX, WTI | Leave a comment »

DAILY UPDATE: Stock Markets Close at Record Highs

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

By Staff Reporters

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Here’s where the major benchmarks ended:

The S&P 500 index rose 25.61 points (0.5%) to 4,894.16, a record high close; the Dow Jones Industrial Average^® (DJI) gained 242.74 points (0.6%) to 38,049.13, also a record high; the NASDAQ Composite rose 28.58 points (0.2%) to 15,510.50.
The 10-year Treasury note yield (TNX) fell about 5 basis points to 4.13%.
The CBOE Volatility Index^® (VIX) rose 0.31 to 13.45.

Energy companies were among the market’s strongest performers Thursday, boosted by a rally in WTI crude oil (/CL) futures, which surged 2.8% and ended near a two-month high above $77 per barrel amid concerns conflict in the Middle East and the Russia-Ukraine war may disrupt global oil supplies.

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DAILY UPDATE: Mobile Payment Fraud Up as Economy Grows and Stock Markets Extend Gains

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

By Staff Reporters

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Alarmed by a surge in fraud draining bank accounts through popular mobile payment apps like Venmo, Cash App and Zelle, Manhattan District Attorney Alvin Bragg, Jr., has sent scathing letters to the CEOs of each company, demanding immediate action to protect consumers.

In the letters, Bragg described the crimes as involving an unauthorized user gaining access to unlocked devices, then stealing significant sums of money from bank accounts by making purchases with the mobile payment apps and using financial information from them to open new accounts.

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And, the U.S. economy expanded at a 3.3% annualized pace in the final quarter of 2023, the Commerce Department said on Thursday.

Why it matters: It’s much stronger growth than economists expected and caps a year of economic resilience as the nation avoided a projected recession.

Here’s where the major benchmarks ended:

The S&P 500 index rose3.95 points (0.1%) to 4,868.55; the Dow Jones Industrial Average^® (DJI) lost 99.06 points (0.3%) to 37,806.39; the NASDAQ Composite gained 55.97 points (0.4%) to 15,481.92.
The 10-year Treasury note yield (TNX) increased about 4 basis points to 4.18%.
The CBOE Volatility Index^® (VIX) rose 0.59 to 13.14.

Tech-related strength helped boost the NASDAQ-100^® (NXD), which includes the NASDAQ’s largest non-financial companies, by 0.6% to a record close. Energy shares were also strong behind continued gains in WTI Crude Oil (/CL) futures, which rose 1.4% and settled near a two-month -high after the Energy Information Administration reported a 7.5% drop in U.S. oil production last week, reflecting disruptions from winter storms. Small-cap shares lagged as the Russell 2000^® Index (RUT) fell 0.7%.

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DAILY UPDATE: R.I.P. Medical Debt as Stock Markets End Mixed

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

By Staff Reporters

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New York City intends to wipe out more than $2 billion in medical debt for up to 500,000 residents, tackling a top cause of personal bankruptcy, Mayor Eric Adams just announced yesterday.

The city is working with RIP Medical Debt, a nonprofit that buys medical debt in bulk from hospitals and debt collectors for pennies on the dollar. The group targets the debt of people with low incomes or financial hardships and then forgives the amounts.

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Here’s where the major benchmarks ended:

The S&P 500 index rose 14.17 points (0.3%) to 4,864.60; the Dow Jones Industrial Average lost 96.36 points (0.3%) to 37,905.45; the NASDAQ Composite^® (COMP) rose 65.66 points (0.4%) to 15,425.94.
The 10-year Treasury note yield (TNX) gained about 4 basis points to 4.138%.
The CBOE Volatility Index^® (VIX) fell 0.64 to 12.55.

Shares of banks and retailers were among the market’s weakest areas Tuesday, while consumer staples were among the upside leaders. Oilfield services companies were also strong, as strong quarterly results from Halliburton (HAL) helped offset a slide in crude oil futures. In other markets, the U.S. dollar index (DXY) hit its strongest level since mid-December, partly reflecting the Bank of Japan’s decision to keep short-term interest rates unchanged.

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FEDERAL HEALTH PROGRAMS: Defined

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

By Staff Reporters

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Theranos founder and ex-CEO Elizabeth Holmes was just banned from US federal health care programs for nine decades, according to the US the health department. Holmes was sentenced in November 2022 to 11 years in prison following a trial that determined she knew her blood-testing startup, which was founded in 2003 and which claimed to be able to test for a range of diseases and risks with one finger prick, produced inaccurate and faulty results. Before government probes, Theranos raised hundreds of millions of dollars, named prominent former U.S. officials to its board, and explored a partnership with the U.S. military to use its tests on the battlefield.

So, just what is a Federal Health Care Program?

Federal Health Care Program means any plan or program that provides health benefits, whether directly, through insurance, or otherwise, which is funded directly, in whole or in part, by the United States Government, including, but not limited to, Medicare, Medicaid/MediCal, managed Medicare/Medicaid/MediCal, TriCare/VA/CHAMPUS, SCHIP, Federal Employees Health Benefit Plan, Indian Health Services, Health Services for Peace Corp Volunteers, Railroad Retirement Benefits Black Lung Program, Services Provided to Federal Prisoners, and Pre- Existing Condition Insurance Plans (PCIPs).

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DOCTORS Getting OUT of Medical Practice!

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

By Staff Reporters

SPONSOR: http://www.MARCINKOASSOCIATES.com

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Why are doctors leaving practice?

For many physicians it’s about demographics. Just like the rest of us, doctors are aging too. Already the average physician age is about 53 years old. The Association of American Medical Colleges reports that about half of doctors are over the age of 55. Over the next decade, an estimated 40% of physicians will be over 65 years old. This means more than two of every five active physicians will reach age 65 within the next 10 years.

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Moreover, compared with their boomer colleagues who were more likely to work past retirement, a robust 60% of younger Generation X doctors are reporting that they plan to retire by age 60.

Doctors cite poor quality of life and stress as reasons for their early departure. The pandemic certainly crushed many providers and has led to burnout. Generation X physicians in their 40s and early 50s were more likely than boomers to report that their current work life was not making the grade. In short, 43% of middle-aged doctors, compared with 31% of doctors over age 55, were reporting lower levels of professional fulfillment. Moreover, 47% of mostly Gen X doctors indicated dissatisfaction with their level of personal fulfillment compared with 36% of practicing boomer physicians.

COACHING: https://marcinkoassociates.com/process-what-we-do/

That dissatisfaction is translating into action and the pandemic is not the only reason for discontent. One survey of physicians in Massachusetts indicated that one in four doctors plans to leave medicine in the next two years and that staffing shortages and related administrative demands, e.g., hospital system metrics, paperwork, eMRs and meeting insurance requirements, were the most cited source of workplace stress.

RISK MANAGEMENT: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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PHYSICIAN: Executive Leadership Thoughts

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

By Dr. David Edward Marcinko MBA

SPONSOR: http://www.MARCINKOASSOCIATES.com

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[Human Nature, Medical and Financial Ethics and Modern Principles]

In any medical blog or investing treatise of gravitas, thoughts on human nature are usually placed at the end of the work, or an afterthought if included at all. However, we elected to prominently place this material as a stand alone feature. Why?

In the end, the success of any financial advisor or physician endeavor ultimately comes down to changing human behavior – helping a doctor/nurse/technician alter whatever s/he was doing toward something that will better allow them to avoid errors and pursue quality care and investing or practice management goals.

Yet, there is still remarkably little education or training for financial planners or medical professionals focused directly on motivation or change theory, in any related area except psychiatry/psychology or perhaps professional liability. Instead, doctors and advisors/planners are increasingly turning to professional consultants to learn best practices on how to help them actually make the behavioral changes necessary to achieve their medical quality improvement and client acquisition goals; as we attempt to answer these questions:

Are you and your medical practice, or financial advisory practice, ready for change?
How to transition from [traditional] solo practitioner B-models to modern forms?
What are leadership, management and governance?
In group practices, how is leadership shared?
What issues need be considered when hiring a financial planner or practice administrator or clinic CEO?
What is medical ethics and financial munificence? Why is it needed? How does it work?
What are the types of risk?
How are risks managed in the medical practice space or financial advisory eco-system?

In addition, medical and financial planning practitioners need to strive to avoid what Zenger and Folkman describe as the 10 most common leadership shortcomings based on a survey of 11,000 leaders. They include:

Lacks energy and enthusiasm
Accepts mediocre self performance
Lacks clear vision and direction
Poor judgment
Not collaboration
Not following standards
Resistant to new ideas
Doesn’t learn from mistakes
Lacks interpersonal skills
Fails to develop others.

Source: Zenger and Folkman: The Daily Stat: The 10 Most Common Failures of Business Leaders, Harvard Business Publishing, June 4, 2009.

Leadership V. Management: https://medicalexecutivepost.com/2023/04/14/healthcare-leadership-vs-management/

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DAILY UPDATE: Drug Makers Rise, Reddit to IPO and Stock Markets Surge

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

By Staff Reporters

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Top 1000 Pharma Companies in 2020 - Pharma Excipients

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Drugmakers kicked off 2024 by raising the list prices for Ozempic, Mounjaro and dozens of other widely used medicines. Companies including Novo Nordisk, the maker of Ozempic, and Eli Lilly, which sells Mounjaro, raised list prices on 775 brand-name drugs during the first half of January 2024, according to an analysis for The Wall Street Journal by 46brooklyn Research, a nonprofit drug-pricing analytics group.

The drugmakers raised prices of their medicines by a median 4.5%, though the prices of some drugs rose by around 10% or higher, according to the research group. The median increase is higher than the rate of inflation, which ticked up to 3.4% in December.

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Reddit’s IPO is reportedly due in March. According to Reuters, the social media platform’s long-awaited initial public offering will launch by the end of March after it makes its public filing in late February. It’ll be the first big social media IPO since 2019, when Pinterest went public. All eyes will fall on Reddit’s own users, who are known to fuel meme stock rallies—namely AMC and GameStop—and could help prop up the company’s debut on the stock market. Valued at about $10 billion as of 2021, Reddit reportedly will sell 10% of its shares as it competes with TikTok and Facebook for attention and ad dollars.

Here’s where the major benchmarks ended:

The S&P 500 index rose 58.87 points (1.2%) to 4,839.81, up 1.2% for the week; the Dow Jones Industrial Average gained 395.19 points (1.1%) to 37,863.80, up 0.7% for the week; the NASDAQ Composite^® (COMP) increased 255.32 points (1.7%) to a two-year high of 15,310.97, up 2.3% for the week.
The 10-year Treasury note yield (TNX) fell about 1 basis point to 4.132%.
The CBOE Volatility Index^® (VIX) fell 0.83 to 13.30.

Strength in Nvidia and other chipmakers like Advance Micro Devices (AMD), which surged 6%, lifted the Philadelphia Semiconductor Index (SOX) 4% to a record high close. Regional banks were also among the market’s strongest performers, as the KBW Regional Banking Index (KRX) added nearly 2%. Food and beverage companies and utilities were among the weakest performers.

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ADVERSE: Medical Events

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

By Dr. David Edward Marcinko MBA

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Aggregated experience from the Doctors Company and other malpractice insurers has shown that adverse medical events tend to fall into three categories:

A. Medical and/or System Error
Error is defined by the National Quality Forum Consensus report titled Standardizing a Patient Safety Taxonomy as “the failure to perform a task satisfactorily against customary standards and the failure cannot be attributed to causes beyond the patient or provider.” When the investigation (including a sentinel event root cause analysis) is complete and the cause is determined to be medical and/or system error, a disclosure meeting should take place with the patient or family.

B. Known Risk/Complication or Unforeseeable Event
The key factor in this category is pre-ventability. Disclosure communications following unpreventable complications or unforeseeable events need to be forthright, open, and compassionate, though they differ qualitatively from apologies after preventable errors.

Review the known facts surrounding the adverse outcome.
Determine if the event was preventable.
Review your process of informed consent to determine if the known risk or complication was discussed.
Proceed to the disclosure meeting with the patient or family. Focus on discussing the cause(s) of the known risk or complication. Review the informed consent if appropriate.

C. Unexplained Change in Patient Status or New Diagnosis of Late-Stage Disease

The main challenge in communicating after a Category C event is the avoidance of a premature conclusion that a severe and surprising outcome must be due to a negligent error. It is especially important in these circumstances to limit the information conveyed to the confirmed details and to provide ongoing updates as new information becomes available. These cases are particularly vulnerable to retraction and correction cycles that render all subsequent communications with the patient and family questionable.
Conduct an internal review of the medical records to determine exactly what happened and to determine if the status change was preventable or if the new diagnosis could have or should have been made earlier.
If appropriate, initiate an external expert review. Peer reviews of the medical care with the outcome blinded can lend unique insight into these events.
If a sentinel event occurred, a root cause analysis is appropriate.
Proceed to the disclosure meeting. Review the findings of your medical record review and investigation. Explain the implications of the change in the patient’s health status and how this will affect his or her subsequent disease management. Discuss the prognosis and management of the newly diagnosed late-stage disease.

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Disruptive Behavior and Bullies in Medicine

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

“Micro-Aggressors” in Healthcare

[By staff reporters] http://www.CertifiedMedicalPlanner.org

Every workplace has “micro-aggressors” or/or bullies that exhibit disruptive behavior.

But, when the workplace is a hospital, it’s not just an employee problem.

Definition

Microaggression is a term coined by psychiatrist and Harvard University professor Chester M. Pierce in 1970 to describe insults and dismissals he said he had regularly witnessed non-black Americans inflict on African Americans.

In 1973, MIT economist Mary Rowe extended the term to include similar aggression directed at women; eventually, the term came to encompass the casual degradation of any socially marginalized group, such as the poor and the disabled.

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Case Report

In one reported case, the worker, felt threatened: His superior came at him “with clenched fists, piercing eyes, beet-red face, popping veins, and screaming and swearing.” He thought he was about to be hit. Instead, his angry co-worker stormed out of the room.

But, it wasn’t just any room: It was in a hospital, adjacent to a surgical area. The screamer was a cardiac surgeon, and the threatened employee was a perfusionist, a person who operates a heart/lung machine during open heart surgery. In 2008, the Indiana Supreme Court ruling in Raess v. Doescherupheld a $325,000 settlement for the perfusionist, who said he was traumatized.

PHYSICIAN COACH: https://marcinkoassociates.com/process-what-we-do/

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

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

Foreword by: J. WESLEY BOYD MD PhD MA

Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

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PODCAST: Hospitals Post Laboratory Test Prices on EMRs

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

By Eric Bricker MD

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The Emerging Role of Chief Diversity Officer [CDO] 2.0

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

By Dr. David Edward Marcinko MBA MEd

http://www.CertifiedMedicalPlanner.org

My history

I came of age on the mean inner city streets of Baltimore, Maryland and developed a special interest in diversity, inclusion and urban renewal at a young age.

Today, I resonate with the identity of human capital educational leadership; small classes or teams; engaged students and stakeholders; parents and teachers; research and development; and a motivated staff inculcating life-long learning initiatives and critical thinking skills.

Career

Yet, I am not a career opportunist seeking incremental advancement through the halls of academia. Rather, I am a culturally sensitive and bi-racial physician-executive who senses there are deep, but often untapped, human resources embedded within many universities. If true; they are best released by an externally recruited champion of diversity and inclusion.

A Chief Diversity Officer [CDO]; if you will.

This includes a respect for values that celebrate the unique attributes, characteristics and perspectives that make each person who they are; ethnicity; gender; gender identity; language differences; nationality; parental status; physical, mental and developmental abilities; race; religion; sexual orientation; skin color; socio-economic status; work and behavioral styles; the perspectives of each individual DNA shaped by their nation, experiences and culture—and more.

Even when people appear the same on the outside, they are different.

Importantly, such inclusion includes a strategy to leverage diversity.

Diversity always exists in social systems.
Inclusion, on the other hand, must be created.

In order to leverage diversity, an environment must be created where people feel supported, listened to and able to do their personal best; for example:

The BAKKE DECISION

Historically, and for me, an important ruling on affirmative action by the Supreme Court in 1978 was the BAKKE Case. Allan Bakke, a white man, was denied admission to a medical school that had admitted black candidates with weaker academic credentials. Bakke contended that he was a victim of racial discrimination. The Court ruled Bakke had been illegally denied admission to the medical school, but also that medical schools were entitled to consider race as an admission factor.

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My story

As Department Chair and Residency Director at a local hospital, I was credited with accepting the first women residents and African Americans into our post-graduate education and surgical training program.

So, at this level of blended pedagogy, andragogy and heutagogy, my mission is to be a modern guide on the side; not bombastic sage on the stage. Moreover, this CDO 2.0 position holds special gravitas in order to set the tone for the future growth of inclusion and diversity thru example; in words and deeds.

Assessment

Frankly, I don’t see the CDO role as a mere “job”. It is a calling that requires a “hands-on” ambassador — helping to advise and lead in all related matters. As the sage once opined:

There is no limit to what you can accomplish if you don’t care who gets the credit!

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
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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DAILY UPDATE: Canadian Drugs, ACA and the Mixed Stock Markets

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

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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States that have long pushed the FDA to allow drug importation from Canada touted the move as a major step forward in their efforts to lower prescription drug spending and rein in healthcare costs. But while the idea of importing drugs from Canada is new for states, some businesses have been using existing drug import pathways to help consumers save money on certain high-cost medications.

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More than 20 million US residents—a record number, according to the Biden administration—have signed up for health insurance through the Affordable Care Act’s marketplaces. (the New York Times)

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Here’s where the major benchmarks ended:

Stocks were a mixed bag yesterday as investors pored over the first big earnings reports and new data showing that wholesale prices surprisingly went down in December. Airlines took a hit after Delta beat earning expectations but lowered its profit forecast.

The S&P 500 index rose 3.59 points (0.1%) to 4,783.83, up 1.8% for the week; the Dow Jones Industrial Average^® (DJI) fell 118.04 points (0.3%) to 37,592.98, up 0.3% for the week; the NASDAQ Composite rose 2.57 points to 14,972.76, up 3.1% for the week.
The 10-year Treasury note yield (TNX) fell about 3 basis points to 3.943%.
The CBOE^® Volatility Index (VIX) rose 0.26 to 12.70.

Retailers and consumer discretionary shares were among the market’s weakest performers Friday, and regional banks were also under pressure. The KBW Regional Banking Index (KRX) fell 2% for the week and ended at a one-month low. Energy shares led gainers behind strength in crude oil futures. The small-cap-focused Russell 2000^® Index (RUT) ended little-changed for the week but is still down 3.8% so far this year.

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

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DOWN: Digital Health Care Funding

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

By Dr. David Edward Marciniko MBA CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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DEFINITION: According to the Food and Drug Administration [FDA], the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, tele-health and tele-medicine, and personalized medicine. From mobile medical apps and software that support the clinical decisions doctors make every day to artificial intelligence and machine learning, digital technology has been driving a revolution in health care. Digital health tools have the vast potential to improve our ability to accurately diagnose and treat disease and to enhance the delivery of health care for the individual. Digital health technologies use computing platforms, connectivity, software, and sensors for health care and related uses. These technologies span a wide range of uses, from applications in general wellness to applications as a medical device. They include technologies intended for use as a medical product, in a medical product, as companion diagnostics, or as an adjunct to other medical products (devices, drugs, and biologics). They may also be used to develop or study medical products.

Cite: http://tinyurl.com/2jbafuc7

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As many investors predicted, digital health funding took a dive in 2023, according to Rock Health’s year-end funding report. Startups got creative to stay afloat but many digital health founders will have to “face the music” in 2024, the VC firm’s analysts say.

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

Editor’s Note: I am on the Advisory Board of Medblob™a start-up based in Boston, MA. The digital mission of Medblob™ is to improve community and national health by allowing patients to better manage their health, providers to better treat their patients, and researchers to have the best information to discover cures to the most prevalent and pernicious diseases.

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PRIVATE HOSPITAL EQUITY: Adverse Events Rise?

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

By Staff Reporters

DEFINITION: Adverse events are medical errors that healthcare facilities could and should have avoided. The National Quality Forum (NQF) defines these errors, which are also called serious reportable events. There are 29 adverse events listed as reportable errors. The events may result in patient death or serious disability. The department manages aggregate data on adverse events and posts quarterly reports on this website.

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

NEVER EVENTS: https://medicalexecutivepost.com/2007/12/20/new-never-events-policy/

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A hospital’s acquisition by a private equity firm is linked to a rise in adverse events despite the pool of lower-risk patients they tend to admit, according to a Medicare Part A claims analysis just published in the Journal of the American Medical Association [JAMA], and according to Dave Muoio of Fierce Healthcare.

JAMA: https://jamanetwork.com/journals/jama/article-abstract/2813379

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HELPING DOCTORS ACHIEVE: New Year Resolutions

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

COACHING AND MENTORING

Physician Goal Setting [Business V. Personal Approach] in 2024

By Marcinko Associates, Inc.

SPONSOR: http://www.MarcinkoAssociates.com
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CORPORATE APPROACH

The year-end physician, nurse and/or medical employee reviews in general aren’t very effective at motivating employees in ACOs, and VBC organizations, etc.

And, according to a Gallup [non-medical worker] poll, only 14% of employees “strongly agreed” that a performance review inspired them to improve. But in recent years, some workplaces have changed how they conduct performance reviews—or abandoned them altogether especially in technology.

A decade ago, Microsoft disbanded its version of stack ranking, the practice pioneered by General Electric CEO Jack Welch in the 1980s in which the company would rank every employee. Experts say it hurts morale and can create a toxic work culture.
Netflix has around 10,000 employees but has eschewed the year-end review for informal conversations during the year.
Google revamped its system last May by reducing performance reviews from twice to once a year.
Apple dropped performance reviews completely.

Healthcare business and corporate employees want feedback, even physicians, but it has to be useful.

PERSONAL APPROACH

Now that you’ve set your personal goals on your landmark date (New Year 2024), how you pursue it will go a long way toward whether you achieve it. There are generally two ways to tackle the goals you’ve set for yourself—and one yields more success than the other.

Avoidance goals: While this works well when it comes to your ex-medical partner or spouse, it’s not how you want to attack resolutions. Avoidance goals include “stop eating sweets” or “watch less TV.”
Approach goals: Instead of avoiding a behavior, you create a new one. Your goals would be “eating more vegetables” or “reading more books” to replace the habits you want to shake.

And, a recent study found that approach goals are more likely to be accomplished (59%) than avoidance goals (47%) across a wide range of potential resolutions. Good luck with that!

WE CAN HELP.

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DAILY UPDATE: S&P 500 is High as McKinsey Settles Opioid Claims

Posted on December 31, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

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The S&P 500 has climbed about 24% in 2023, hovering right around its all-time high. And, the NASDAQ Composite is up 44%, although the tech-heavy index still has some ground to cover before it starts carving out new all-time highs of its own.

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By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Consulting firm McKinsey and Co. has agreed to pay $78 million to settle claims from insurers and health care funds that its work with drug companies helped fuel an opioid addiction crisis. The agreement was revealed late Friday in documents filed in federal court in San Francisco. The settlement must still be approved by a judge.

Under the agreement, McKinsey would establish a fund to reimburse insurers, private benefit plans and others for some or all of their prescription opioid costs. The insurers argued that McKinsey worked with Purdue Pharma – the maker of OxyContin – to create and employ aggressive marketing and sales tactics to overcome doctors’ reservations about the highly addictive drugs. Insurers said that forced them to pay for prescription opioids rather than safer, non-addictive and lower-cost drugs, including over-the-counter pain medication. They also had to pay for the opioid addiction treatment that followed.

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

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HEALTHCARE: Spending Grew in 2022

Posted on December 26, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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On December 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released its annual report on healthcare spending in the U.S., highlighting the growth in private insurance and Medicaid spending in 2022, which was offset by the declines in supplemental federal funding as a result of the COVID-19 pandemic.

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

This Health Capital Topics article reviews the notable healthcare spending findings in CMS’s report. (Read more…)

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MERRY CHRISTMAS

Posted on December 25, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

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A Financial Early “Christmas Eve Carol” [Parts 1 and 2]

Posted on December 23, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Rick Kahler MS CFP®

http://www.KahlerFinancial.com

For me, the Christmas season doesn’t seem complete without Charles Dickens’s A Christmas Carol. I’ve long been captivated by the transformation of the cold-hearted and calculating Mr. Scrooge, the seemingly inherent goodness of Bob Cratchit, and the haunting visits of the Ghosts of Christmas.

As a student of Dickens’s fable, I’ve been amazed at the wisdom and universal truths contained in that seemingly simple story. I have discovered that Mr. Scrooge isn’t merely the villain he’s often made out to be, nor is Cratchit the straightforward hero.

It’s not uncommon for the average American to have a stressful, even adversarial relationship with money, especially since half of Americans have no savings or investments and live month to month. Stress over money is especially exacerbated during the Christmas season each year. Many Americans borrow heavily on credit cards for gifts and end up stressing for months afterward trying to pay the bill.

Financial Transformations

How ironic that what Dickens unveils in the short A Christmas Carol is a powerful process for financial transformation (or any desired transformation). Dickens gives us a four-step process that anyone can employ to change destructive financial behaviors.

A few years ago I co-authored a book, The Financial Wisdom of Ebenezer Scrooge that highlights the subtle wisdom of Dickens’s story as it pertains to transforming one’s behavior around finances. The story became the heart of a successful model employed by financial planners and therapists to help transform a person’s relationship with money.

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The Story

The first big event in the story is the visit to Scrooge by the ghost of his old business partner, Jacob Marley. Scrooge takes to heart Marley’s warning to change his ways, thereby becoming willing to consider changing. Psychologists would call this an intervention.

The first and most important step toward transformation needs to be a personal realization that something is amiss with your behavior and it’s you who wants to contemplate changing, as opposed to someone else insisting you ought to or should change. Meaningful and sustainable change comes only from within, not without. Blaming personal financial problems on family, employers, the wealthy, or the government just keeps a person stuck in delusion.

What is the key to developing an internal desire to change? Addiction recovery programs call this “hitting bottom.” I describe it as reaching a state of openness to accept the facts and circumstances as they are, not as you wish they were. It is becoming convinced that change is crucial and that you are passionately ready to take action to change.

On that Christmas Eve, inexplicably, Scrooge was finally ready consider the message his old friend Marley had tried to deliver to him on many Christmas Eves previously.

In the book Changing for Good, psychologist James O. Prochaska and his co-authors describe this as moving from the stage of pre-contemplation to contemplation. Scrooge was willing to consider that his firmly entrenched world view might be skewed and to consider seeing the facts for what they were, not as he assumed they were.

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We may not be misers like Scrooge, but when it comes to our beliefs around money, we have as many delusions as he did. A few of the more popular of these beliefs, or money scripts, are: “More money is the answer,” “The stock market is a gamble,” “I work hard so I deserve to spend money,” and, “If I work hard I will make money.”

Assessment

Becoming willing to consider change is half the battle to free ourselves from destructive financial behavior based on these delusions. But it is only half. Next time we will look at three additional steps to transformation.

Part 2: A Financial “Christmas Carol” [Part 2]

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Conclusion

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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DAILY UPDATE: Happy “Festivus” with Drug Delays as the Stock Market Win Streak Continues

Posted on December 23, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Festivus is a secular holiday on December 23rd as an alternative to the pressures and commercialism of the Christmas Season. Originally created by author Daniel O’Keefe, Festivus entered popular culture after it was made the focus of the 1997 Seinfeld episode which O’Keefe’s son, Dan,co-wrote.

The non-commercial holiday’s celebration includes a Festivus dinner, an unadorned aluminum Festivus pole, practices such as the “airing of grievances” and “feats of strength”, and the labeling of easily explainable events as “Festivus miracles”. The TV episode refers to it as “a Festivus for the rest of us”.

It has been described both as a parody holiday festival and as a form of playful consumer resistance. Journalist Allen Salkin describes it as “the perfect secular theme for an all-inclusive December gathering”.

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(Bloomberg) — Drug-makers are slow-walking products to market to get around President Joe Biden’s plan to lower medication prices.

Companies from Roche Holding AG to biotech Alnylam Pharmaceuticals Inc. are among those delaying or evaluating therapies in light of the government’s new ability to negotiate for lower prices. Firms that normally try to sell drugs as soon as possible are suspending clinical trials and shifting timelines, while patient groups are demanding change.

Here is where the major benchmarks ended:

Here’s where the major benchmarks ended:

The S&P 500 index was up 7.88 points (0.2%) at 4,754.63, up 0.8% for the week; the Dow Jones Industrial Average was down 18.38 points at 37,385.97, up 0.2% for the week; the NASDAQ Composite^® (COMP) was up 29.11 points (0.2%) at 14,992.97, up 1.2% for the week.
The 10-year Treasury note yield (TNX) was up about 1 basis point at 3.901%.
The CBOEe^® Volatility Index (VIX) was down 0.62 at 13.03.

Small-cap stocks continued a strong finish to the year. The Russell 2000^® Index (RUT) rose 0.8% Friday to end at its highest level since April 2022 and rose 2.5% for the week, the small-cap benchmark’s sixth consecutive weekly gain. Regional banks and utilities were also among the strongest performers. In other markets, the U.S. Dollar Index (DXY) extended its recent slide and dropped to its weakest level since late July, reflecting ideas an outlook for lower interest rates may prompt investors to seek higher returns elsewhere.

Finally, with just four trading days left in 2023, the S&P 500 and other major equity benchmarks are poised to turn in a strong year that may more than make up for 2022’s losses. Through Friday, the S&P 500 was up nearly 24% for the year, after tumbling 19.4% in 2022. The Dow Jones Industrial Average and the NASDAQ Composite were up 13% and 43%, respectively, after losing 8.8% and 33% in 2022.

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

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BEWARE: Holiday Healthcare Telephone Scams.

Posted on December 23, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

OPEN ENROLLMENT

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According to new data released by Hiya, a company that tracks phone fraud and spam, calls offering phony health plans and fraudulent Medicare support skyrocketed between October and November this year, coinciding with the start of the marketplace open-enrollment period that runs from November 1st through January 16th, 2024.

Whether the automated message purports to be from Dale at Elite Medicare Options or Ashley from the Health Enrollment Center (both real examples that Hiya has documented), the fraud-protection platform found that most scammers will try to get their target to interact with a button- or voice-activated menu.

The menu might be disguised as a survey of Medicare coverage or an option to opt out of receiving future calls, according to Hiya, but either way, the person who responds to the automated call could be in trouble.

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HOLIDAY: Tip Etiquette 2023?

Posted on December 21, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

GRATUITIES

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EtG – The Rosie Ruiz of Bent Science and Bad Medicine

Posted on December 21, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

BAD Medicine … and that is NOT “Good”

[By Michael Lawrence Langan MD]

The original pitch to the medical boards for Etg was done by ex-felon Greg Skipper who is one of the Federation of State Physician Health Program (FSPHP) “impaired physician” architect…

EtG: https://www.verywellmind.com/widely-used-etg-test-for-alcohol-unreliable-80212

Conclusion

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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PODCAST: FFS MedicalPayment As a Public Health Threat?

Posted on December 21, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

FEE FOR SERVICE

By Eric Bricker MD

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DOL: Proposes “Best Interest” Retirement Investment Advice

Posted on December 20, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MARCINKOASSOCIATES.com

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The Department of Labor’s proposal aims to close governance loopholes and require financial advisers to give retirement advice in the best interests of savers rather than chase the highest payday.

“Bad financial advice by unscrupulous financial advisers driven by their own self-interest can cost a retiree up to 1.2% per year in lost investment,” President Biden said. “That doesn’t sound like much but if you’re living long, it’s a lot of money.

MORE: https://medicalexecutivepost.com/2023/03/11/recast-an-interview-with-fiduciary-bennett-aikin-aif-2/

“Over a lifetime, it can add up to 20% less money when they retire. For a middle-class household, that can amount to tens of thousands of dollars over time.”

MORE: https://marcinkoassociates.com/financial-planning/

FIDUCIARY OATH: https://medicalexecutivepost.com/2023/02/19/the-fiduciary-oath/

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PODCAST: US Primary Medical Care V. Other Industrialized Nations

Posted on December 18, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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SECTION 179 DEDUCTIONS: Physicians Avoiding IRS Tax Mistakes

Posted on December 17, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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DEFINITION: Section 179 of the U.S. IRS code is an immediate expense deduction that business owners can take for purchases of depreciating business equipment instead of capitalizing and depreciating the asset over a period of time. The Section 179 deduction can be taken if the piece of equipment is purchased or financed and the full amount of the purchase price is eligible for the deduction.

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

Not understanding parameters – Eligible property and annual limits

Medical practices may make mistakes by not fully understanding which types of property qualify for a Section 179 deduction. Section 179 is applicable only to assets used for business purposes. Failing to allocate assets properly can lead to improper deductions.

Eligible property for Section 179 may include:

Equipment, X-Ray, computers, fax machines, telephones, and other business property
Furniture and fixtures
Off-the-shelf-software that is used for business operations
Improvements to real-estate such as roofs, heating, ventilation, and air-conditioning.

Section 179 limits are updated annually, so it is important for doctors and practice owners to be aware of these limits and to plan accordingly.

Source: Natalie Westfall, Physicians Practice [12/4/23]

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DAILY UPDATE: Healthcare Artificial Intelligence Safety as the DJIA Sets Record

Posted on December 15, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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Twenty-eight healthcare companies, including CVS Health , are signing U.S. President Joe Biden’s voluntary commitments aimed at ensuring the safe development of artificial intelligence (AI), a White House official said yesterday. The commitments by healthcare providers and payers follow those of 15 leading AI companies, including Google, OpenAI and OpenAI partner Microsoft to develop AI healthcare models responsibly.

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Health insurance company Humana is being accused of allegedly wrongfully denying care to elderly patients, who are enrolled in Medicare Advantage Plans, using an augmented intelligence model “to override” physicians’ orders on “necessary care patients require,” according to a new lawsuit.

The lawsuit, filed by two Humana Medicare Advantage Plan customers on December th 12 in Kentucky, claims that Humana uses an AI model called nH Predict, and it allegedly has a high error rate. And allegedly, despite knowing that it’s inaccurate, the company still uses it.

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Here is where the major benchmarks ended:

The S&P 500 index was up 12.46 points (0.3%) at 4,719.55; the Dow Jones Industrial Average was up 158.11 points (0.4%) at 37,248.35; the NASDAQ Composite^® (COMP) was up 27.59 points (0.2%) at 14,761.56.

The 10-year Treasury note yield (TNX) was down about 11 basis points at 3.923%, falling under 4% for the first time since early August.
The CBOE® Volatility Index (VIX) was up 0.25 at 12.44.

Financial shares remained among the market’s strongest post-FOMC gainers, reflecting ideas that lower interest rates will boost profit margins for banks. Goldman Sachs (GS) rallied nearly 6%, the second-best gain among Dow companies, and hit a 23-month high. The KBW Bank Index (BKX), which includes major companies like Bank of America (BAC) and Citigroup (C) as well as several regional lenders, surged 5% to a nine-month high.

Also, the small-cap Russell 2000^® Index (RUT) continued to outgain large-cap counterparts, rising 2.7% to a 4 ½-month high.

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

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DEAR COLLEAGUES: Are You a Financial Advisor’s “Customer” or “Client”?

Posted on December 15, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA CMP™

SPONSOR: http://www.MarcinkoAssociates.com

First – a little “insider expert” background on the confusion. It exists largely because of the influence that large financial institutions (who earn revenue through the sale of financial products) have on legislators.

The Investment Advisors Act of 1940 requires that anyone giving investment advice must be acting in a fiduciary capacity. The intent was to separate the financial salespeople, who had significant conflicts of interest, from the investment advisors, who had few to none. If you know very little about financial products, would you rather be educated as the customer of a commissioned salesperson or the client of a fee-for-service advisor? Hands down, you’d want the fee-for-service advisor.

Of course, the financial institutions selling products understood this. They were able to influence the drafting of the 1940 Investment Advisors Act, to exclude “any broker or dealer whose performance of such [advisory] services is solely incidental to the conduct of his business as a broker or dealer.” So if salespeople just happen to give some financial advice that is “incidental” to the sale of a product, they and their companies are not held to the fiduciary standard. Our U.S. Congress allows financial companies to advertise as if they are fiduciaries while their sales forces are not held to a fiduciary standard.

Now, according to Rick Kahler CFP®, the same conflict arises in some professional designations, like the Certified Financial Planner® designation conferred by the CFP® Board. The designation initially certified the completion of training in financial planning. In 2008 the Board added a fiduciary requirement to the designation.

However, CFP®’s are only held to a fiduciary requirement when they are doing what the CFP® Board defines as financial planning. If a CFP® professional is giving advice to a client, the fiduciary standard applies. Yet the same professional can sell the same client an annuity with high fees and high commissions, even if the product may not be in the client’s best interest, as long as no “financial planning” is part of the transaction. The result is significant confusion for consumers.

The bottom line is this: when you look for financial advice or financial products, don’t assume the advisor is looking out for you. It’s your responsibility to find out whether any financial professional owes you a fiduciary duty.

So, I suggest you ask directly, “Am I a customer or a client?” The answer is almost always “a client,” as most financial services salespeople honestly don’t know the difference. After you explain that difference, ask them to verify their fiduciary duty in writing. That five-minute solution may have a lasting impact on your financial well-being.

Better yet, consider speaking to your fiduciary focused and fee-only Certified Medical Planner® professional colleagues at D.E. Marcinko & Associates.

“By Doctors – For Doctors”

CMP: http://www.CertifiedMedicalPlanner.org***

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HUMAN FRAGILITY: Standardized for Financial Advisors and Medical Professionals

Posted on December 13, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA

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DEFINITION: A general review of research on frailty defined it more specifically as “a state characterized by reduced physiological reserve and loss of resistance to stressors caused by accumulated age-related deficits.”

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

Between 10 and 15% of older adults are considered frail. But how do doctors measure frailty? One tool is called the Frailty Index for Elders (FIFE) and consists of 10 items that are scored zero to 10, with zero indicating no frailty, one to three indicating that there is a risk of frailty, and four or above indicating that the individual is considered frail in that item.

Another frailty index, used by Dalhousie University in Canada, requires 30 variables to be measured and is regarded more as a comprehensive measure of one’s overall health.

It’s important to understand that maintaining good health and fitness is not just about avoiding illness and injury, reaching overhead for that jar of peanut butter on the top shelf, and walking the dog farther than just around the block. It’s also about recovering more quickly when you get sick or injured, which everyone does eventually.

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ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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The UK Questions Microsoft & OpenAI as Aetna Medicaid Aids Hungry Homeless

Posted on December 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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SPONSOR: http://www.MarcinkoAssociates.com

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United Kingdom Regulators Looking into Microsoft’s Partnership with OpenAI

A British watchdog is asking for feedback on whether Microsoft’s $13 billion, 49% stake in the ChatGPT-maker’s for-profit division constitutes a merger, the WSJ just eported. So, if the agency decides to launch a formal investigation into whether the partnership creates an unfair advantage in the artificial intelligence industry, it could eventually force the companies to change how they operate.

And, following OpenAI’s dramatic firing and rehiring of CEO Sam Altman last month, Microsoft was given a “nonvoting observer” seat on the OpenAI board.

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

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Aetna Better Health of Georgia has invested $510,000 in 17 local organizations that offer services for individuals experiencing food insecurity and homelessness across the state of Georgia.

“A holistic approach to health care starts with ensuring each individual has stable and consistent access to healthy, nutritious foods, as well as a safe place to live,” said Sonya Nelson, division president at Aetna Medicaid. “By partnering with local organizations committed to improving the quality of life for all Georgians, we can help ensure people’s most basic needs are fulfilled and they’re able to prioritize care for themselves and their families.”

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TELE-HEALTH: The “Smile Direct Club” Frowns

Posted on December 11, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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SmileDirectClub is the latest casualty of what some have dubbed a startup Mass Extinction Event.

The telehealth company that attempted to revolutionize traditional orthodontics just announced that it was winding down operations less than three months after it filed for Chapter 11 bankruptcy. At its peak, SmileDirectClub was valued at $8.9 billion and had raised $427 million as a private company before going public in 2019.

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

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PODCAST: Physician Performance Reviews

Posted on December 11, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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CAREER: Physician Coaching and Development in 2024

Posted on December 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

MARCINKO ASSOCIATES, Inc.

SPONSOR: http://www.MarcinkoAssociates.com

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Did you Know?

Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.

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

Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.

CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].

NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686971/

THANK YOU

COACH: https://marcinkoassociates.com/process-what-we-do/

CONTACT US: https://marcinkoassociates.com/process-what-we-do/

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CVS PHARMACY: Rx Drug Price Overhaul

Posted on December 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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CVS is overhauling how it prices prescription drugs

In a recent announcement, the company CVS promised that its new model would be more transparent than the current setup, which prices drugs based on complex reimbursement formulas that can make the costs of prescriptions confusing for consumers.

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

The new model, called CVS CostVantage, is based on a simple equation: Drugs will cost what CVS paid for them, plus a limited markup and a flat fee to cover the services of fulfilling the prescriptions. That’s similar to a plan proposed by billionaire Mark Cuban, founder of Cost Plus Drugs, to bring accountability to drug pricing in the US.

MORE: https://medicalexecutivepost.com/2022/06/23/mark-cubans-cost-plus-drugs-com/

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PODCAST: “Open Enrollment” Best Practices

Posted on December 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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MEDICARE [dis] ADVANTAGE Plans?

Posted on December 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Leading hospital trade groups are accusing some Medicare Advantage plans, including giant UnitedHealthcare, of flaunting coverage requirements recently codified by CMS. The American Hospital Association is now petitioning the Biden administration to crack down.

However … the Medicare Advantage market is booming but investment in cancer care continues to lag.

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HEALTHCARE Innovation and Practice Management on the Move

Posted on December 1, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Online therapy company Talkspace will provide free virtual mental health services to more than 400,000 adolescents and teens in New York City after inking a deal with the city. The new program, dubbed TeenSpace, will connect teens to a licensed therapist through phone, video and text.

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The Patient-Centered Outcomes Research Institute (PCORI) has announced funding awards of $80.5 million to support four new studies focused on disparities in maternal health. They will take into account clinical and social factors that contribute to inequities and will compare interventions in various settings.

And … Ayble Health, a digital health platform for patients with chronic gastrointestinal conditions, is working with the Mayo Clinic Complex Care Program to offer a hybrid care model that matches patients with the appropriate virtual and in-person care based on acuity and need.

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“BREAKING NEWS” Cigna and Humana to Merge?

Posted on November 30, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Cigna and Humana are in talks for a combination that would create a new powerhouse in the health-insurance industry. The companies are discussing a stock-and-cash deal that could be finalized by the end of the year, assuming the talks don’t fall apart.

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A combination of the managed-care providers would be huge, given Cigna’s market value Wednesday morning of about $83 billion and Humana’s of roughly $62 billion.

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Cigna and Humana previously explored merging in 2015, but Humana instead struck a deal with another rival, Aetna, that was blocked by a judge on antitrust grounds, leaving Aetna to be scooped up by CVS in 2018. Another deal that would have combined Cigna with Anthem, now known as Elevance Health, also died after an adverse antitrust ruling.

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

Editor’s Note: Medicare Advantage plans are pretty popular with both lawmakers and ordinary Americans — they now enroll about 31 million people, representing just over half of everyone in Medicare, by KFF’s count. Across the country, doctors are grumbling about claim denials and onerous pre-approval requirements by Medicare Advantage plans. Some hospitals and physician practices are so fed up they’re refusing to accept the plans — even big ones like those offered by United Healthcare, Cigna and Humana.

“The insurance companies running the Medicare Advantage plans are pushing physicians and hospitals to the edge,” said Chip Kahn, president and CEO of the Federation of American Hospitals, which represents the for-profit hospital sector.

And, just last week, the industry’s largest lobbying group, the American Hospital Association, fired off a letter to the Centers for Medicare and Medicaid Services warning that some insurers seem intent on circumventing new rules put in place by the Biden administration aimed at reining in some prior authorization and claim denials.

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