Experts Invited | The Leading Business Education Network for Doctors, Financial Advisors and Health Industry Consultants

Socially Responsible and ESG Investing!

Posted on March 27, 2023 by Dr. Marcinko

S.R.I.

[By Rick Kahler CFP®]

The concept of socially responsible investing is far from new; the first SRI fund appeared in 1952. Since then, these funds have used social and ethical screens to exclude companies selling products like tobacco, alcohol, or firearms.

You may not have heard of the next generation of SRI funds, called ESG funds, which means environmental, social and governance funds. Social responsibility is just one-third of the expanded focus of these funds, which also look to include companies that are sensitive to the environment and have more holistic corporate governance.

Updates

In recent years, ESG investing has exploded. According to a July 11, 2018, article in Forbes, The Remarkable Rise of ESG, by Georg Kell, over $20 trillion is invested in ESG funds. This accounts for 25% of all the professionally managed assets in the world. There are currently 275 ESG mutual funds and ETF’s from which to choose.

Yet one facet of investing in ESG funds is widely misunderstood. While ESG investing may help you feel better about yourself, it does not actually impact or hamper the companies you choose not to own.

This may come as a surprise to many ESG investors, who commonly believe that by not owning the shares of an offensive company they are restricting the flow of capital to that company, thereby imperiling its existence. For the most part, that isn’t the case.

The offenders

Listed among the worst offending companies by several ESG organizations are Philip Morris, WalMart, Tyson Foods, Pepsi Corporation, Coca-Cola, and Chevron. No dedicated ESG investors would have these companies in their portfolios. None of these companies would care or be hurt in the least if you didn’t own any of their shares.

Why?

The only time a company benefits from a sale of stock is when the company initially goes public (called an initial public offering, or IPO) or issues additional new shares to raise capital. These are actually fairly rare events.

Most stocks are bought and sold in the “secondary” market through exchanges like the New York Stock Exchange. These platforms facilitate transactions between individuals or institutions wanting to buy or sell shares in a company. The money moves between the buyer and the seller; none of the money goes to the company.

Another way companies receive funding to support their ventures is to borrow money from investors. This is called issuing a bond and is similar to an IPO, only the investor receives a promise from the company to pay them back at some future date and receives interest on the loan in the meantime.

Just like stocks, bonds are only issued by a company once. From then on, buying and selling bonds is done on the open market, and none of the money paid or received goes to the company.

So if you want to punish a company, don’t buy stocks or bonds it issues directly. Otherwise, excluding its shares from your portfolio has no effect on the company’s profits or cash flow.

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Assessment

But if no one bought a company’s shares on the secondary market, wouldn’t that have an impact? Yes, it most certainly would. If the demand for the shares of a company dried up, the company’s stock price would plummet.

The problem is the demand for the shares of these companies isn’t going away as long as they remain profitable. If 25% of investors purchase ESG funds, that leaves 75% of the market willing to buy these companies. This includes the 20% of stocks owned by passive index funds, which own the entire market.

CONCLUSION

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PODCAST: Why Employers Change Insurance Brokers and Benefits Consultants?

Posted on March 27, 2023 by Dr. Marcinko

By Eric Bricker MD

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INVITE: Professor Marcinko to Your Next Seminar or Event

Posted on March 26, 2023 by Dr. Marcinko

See You Soon

SPONSOR: http://www.CertifiedMedicalPlanner.org

Colleagues know that I enjoy personal coaching and public speaking and give as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world. All in a Corona safe environment.

MARCINKO in the METAVERSE

These include lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, end-note lectures at city and statewide financial coalitions, and annual lectures for a variety of internal yearly meetings.

LIVE or PODCAST enabled, as well.

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What to Expect After the Silicon Valley Bank [SVB] Collapse

Posted on March 26, 2023 by Dr. Marcinko

By Vitaliy Katsenelson CFA

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Over the past decade, the Federal Reserve has manipulated asset prices by interfering with free markets by deciding what both short-term and long-term interest rates should be. This resulted in an increase in risk-taking behavior among investors.

CITE: https://www.r2library.com/Resource/Title/08

Risk became a four-letter word uttered only by curmudgeons; the only thing investors feared was being left out. The more risk you took, the more money you made – until you lost it all.

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

READ: Silicon Valley Bank’s Downfall: A Cautionary Tale of What’s to Come

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DAILY UPDATE: Jack Dorsey, Deutsche Bank and the Markets

Posted on March 25, 2023 by Dr. Marcinko

By Staff Reporters

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Jack Dorsey’s wealth tumbled after Hindenburg Research targeted his payments company Block, per Bloomberg. The short seller alleged Block misled investors “with inflated metrics” Block’s share price tumbled as much as 22% on Thursday on Hindenburg’s report.

Short seller Hindenburg Research has hit another billionaire’s fortune with a report. Jack Dorsey, the co-founder of payments company Block and Twitter, saw his net worth tumble by $526 million, or 11%, to $4.4 billion after the US-based research firm led by Nathan Anderson accused Block of misleading investors in a March 23 report, according to Bloomberg. Dorsey isn’t on the list of the world’s 500 richest persons on the Bloomberg Billionaires Index currently. He was previously featured at number 456 with a net worth of $5.41 billion on March 22nd, per Insider’s scan of the Index on Wednesday.

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Investors sparked a furious selloff in Deutsche Bank AG and thrust one of Europe’s most important lenders into the center of concerns about the health of the global financial system. Shares of Germany’s largest lender tumbled as much as 15%, their third consecutive day of losses, though they later regained some ground and were recently down 10%. The cost to insure against its default using credit-default swaps soared to their highest levels since 2020.

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Chairman Jerome Powell was ambiguous this week about future Federal Reserve moves, suggesting “some additional policy firming may be needed.”

Treasury yields dropped near seven-month lows, a seeming indication of escalating recession worries after the Fed raised its benchmark lending rate nine times to a range of 4.75% to 5% over the past year. The release next week of updated data on consumer confidence, inflation, and economic growth will likely be in focus.

Monetary Policy: https://medicalexecutivepost.com/2023/03/17/the-modern-us-monetary-system/

The swings in stock prices this week “were consistent with the unclear outlook for monetary policy, the banking system, and the broader economy,” says Kevin Gordon, senior investment strategist at Charles Schwab. “More time needs to pass before we know the true impact of the expected tightening in credit conditions.”

The S&P 500^® Index was up 22.27 (0.6%) at 3970.99; the Dow Jones industrial average was up 132.28 (0.4%) at 32,237.53; the NASDAQ Composite was up 36.56 (0.3%) at 11,823.96.
The 10-year Treasury yield was little changed at about 3.374%.
CBOE’s Volatility Index was down 0.87 at 21.74.

The real estate sector led the gainers Friday, followed by consumer staples and health care. Financials and consumer discretionary stocks edged lower, and technology stocks were little changed, though the tech-focused NASDAQ Composite still notched its second straight weekly gain. Gold and crude oil futures both declined, while the U.S. dollar strengthened.

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Filed under: "Ask-an-Advisor", Experts Invited, Investing | Tagged: Block, Bloomberg, CBOE, Deutsche Bank, DJIA, DOW, European stocks, Hindenburg, Jack Dorsey, Jerome Powell, Kevin Gordon, monetary policy, moneyary policy, NASDAQ, real estate, S&P 500, Schwab, Treasury yields, twitter | Leave a comment »

DAILY UPDATE: Wood, Moderna and the Domestic Down Markets

Posted on March 23, 2023 by Dr. Marcinko

By Staff Reporters

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Cathie Wood just revealed that her flagship fund ARK Invest lost over $2 billion last year. Her struggles sum up how rising interest rates are affecting markets, according to the CEO of JPMorgan Asset Management. “When the Federal Reserve hits the brakes, something goes through the windshield,” George Gatch said.
Cathie Wood’s Ark Invest also sold $13.5 million worth of Coinbase stock. The famed money manager now holds a 7% stake in the crypto exchange worth $837 million. Shares of Coinbase are up nearly 30% in the past five trading sessions as crypto prices rallied.

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Moderna – which received about $10 billion in taxpayer money to produce its COVID-19 vaccine and has since earned billions more in profits selling it – was sued in early 2022 by Genevant Sciences and Arbutus Biopharma Corp., which accused Moderna of using technology they have patented in its vaccine. The two companies have asked a federal court in Delaware to award them damages for the infringement.

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

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Alex Coffey, senior trading strategist at TD Ameritrade, said recent turmoil in the banking industry has effectively tightened credit conditions, possibly making further rate increases by the Fed unnecessary. Still, the Fed had to send a message that it’s not making an abrupt shift in its efforts to bring inflation down. The Fed has been in “cruise control” raising rates, “staying in the fast lane,” Alex says. “Now, it has turned off cruise and maybe changed lanes, but isn’t doing a quick move toward the off ramp. Today’s increase was not a ‘dovish’ hike, but also not the hawkish stance that was feared.”

“We’re near the end of the tightening cycle,” he adds. “But they have to do this slowly.”

The Fed commentary appeared to briefly soothe the market, causing the S&P 500^® Index to rise as much as 1% soon after the central bank’s announcement, but the benchmark changed direction in the last hour of trading. The reversal may have in part been in response to the ambiguity of Powell’s words, as well as continuing concern about a potential recession.

And so, the following is a round-up of today’s domestic market activity:

The S&P 500 Index was down 65.90 (1.7%) at 3936.97; the Dow Jones industrial average was down 530.49 (1.6%%) at 32,030.11; the NASDAQ Composite was down 190.15 (1.6%) at 11,669.96.
The 10-year Treasury yield was down about 17 basis points at 3.44%.
CBOE’s Volatility Index was up 0.88 at 22.26.

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PODCAST: The Healthcare Eco-System Explained?

Posted on March 23, 2023 by Dr. Marcinko

By Eric Bricker MD

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

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PHYSICIANS: “Aging Out”

Posted on March 22, 2023 by Dr. Marcinko

By Staff Reporters

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According to HealthcareBrew, thousands of doctors are expected to reach retirement age in the next three years, and their replacements won’t be physicians. Instead, physician assistants (PAs) and nurse practitioners (NPs) will increasingly provide primary care services, according to a report from consulting firm Mercer.

By 2026, 21% of family medicine, pediatric, and obstetrics and gynecology physicians—or about 32,000 doctors—will be 65 or older, and Mercer anticipates about 23,000 physicians will leave the profession permanently. At the same time, demand for primary care physicians is expected to grow 4%, the report found.

PAs and NPs—also called advanced practice providers (APPs) or physician extenders—are highly trained medical professionals. To become a PA, you have to have both a bachelor’s and a master’s, some clinical work experience, pass the Physician Assistant National Certifying Exam, and then apply to get licensed in your state (you know, easy peasy). It takes seven to nine years to go through that process, compared to 11+ years to become an MD.

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

To become an NP, you must have both a bachelor’s and a master’s in nursing, become a registered nurse, and pass a national NP board certification exam. It takes between six to eight years to become an NP.

Compared to physicians, PAs and NPs are “considerably younger professions with less than half the retirement risk,” the Mercer report stated. Roughly 40,000 PAs and NPs join the workforce annually.

“We’re certainly going to see increasing demand for APPs,” David Mitchell, a partner in Mercer’s career consulting business and a specialist in the healthcare industry, told Healthcare Brew.

While most state licensing boards require a physician to oversee APPs, both PAs and NPs have the authority to do many services primary care physicians do, like seeing and diagnosing patients, ordering lab tests, and writing prescriptions, said Mitchell.

READ HERE: https://www.healthcare-brew.com/stories/2023/03/16/non-mds-will-provide-primary-care?cid=30859907.17846&mid=349b552221c994e2540a304649746d7c&utm_campaign=hcb&utm_medium=newsletter&utm_source=morning_brew

MORE: https://www.aamc.org/data-reports/data/2022-physician-specialty-data-report-executive-summary

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Filed under: "Doctors Only", Career Development, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Retirement and Benefits | Tagged: APPs, David Mitchell, DO, Healthcare Brew, MD, Mercer, NP, NPs, nurse practitioners, PA, PAs, physician assistants | Leave a comment »

Cyber-Risks in Banking

Posted on March 19, 2023 by Dr. Marcinko

By Ibrahim Jaafaru

This is a review of a white paper by Longitude Research that talks about Cyber-Risks in Banking.

It is perfect for Modernity!

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Cyberrisk in Banking

Cyber security is a complex and multifaceted challenge that is growing in importance.

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

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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Digital Health Insurance Tracking Devices

Posted on March 18, 2023 by Dr. Marcinko

By Staff Reporters

Blue Cross Blue Shield has deployed several trackers on its website, according to the web extension Ghostery, a tool that can tell you what kind of technology web pages are using.

Ghostery returned a list of trackers from Twitter, Google, and LinkedIn.

Though we don’t know specifically what kind of data is being transferred, these pixels are usually installed to help marketing departments. Tracking pixels, for the uninitiated, are hidden or embedded graphics that can give a more complete picture of a customer’s journey: what they’ve clicked on, if they’ve searched for something specific, if they’ve put something in a shopping cart, or whether an advertisement drove them to, say, Blue Cross Blue Shield’s homepage. For example, if an insurer wants to show that its ads are working, it can use a pixel to determine that it was their ad that got someone to finally sign up for health insurance, not Susan in HR.

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

Trackers are ubiquitous, but experts and consumers have raised serious questions about the data that’s shared between companies. For example, investigative reporting outlet The Markup found that hospitals shared sensitive information with Facebook through the Meta pixel. And just this month, Indianapolis-based Community Health Network reported that pixels may have affected 1.5 million of its patients.

For more, read Marketing Brew’s interview with sociologist Mary F.E. Ebeling, who wrote a book about the collection of sensitive health data.

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

Posted on March 17, 2023 by Dr. Marcinko

By Free Man Beyond the Wall

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

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

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

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

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

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PODCAST: Behavior Modification and the Science of Change in Healthcare

Posted on March 16, 2023 by Dr. Marcinko

By Eric Bricker MD

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

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DIGITAL HEALTH: 8 Ways to Impress Your Doctor

Posted on March 15, 2023 by Dr. Marcinko

By Bertalan Meskó, MD PhD
The Medical Futurist

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READ HERE: https://tinyurl.com/2hat4fun

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BREAKING NEWS: Oil, Distressed Banks and Banking

Posted on March 13, 2023 by Dr. Marcinko

By Staff Reporters

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Saudi Aramco made what is s probably the “highest net income ever recorded in the corporate world,” Saudi Aramco’s CEO Amin Nasser just said. The state-owned oil giant brought in an astonishing $161.1 billion in net income in 2022, up 46.5% from the previous year. Rising oil prices lifted all energy companies last year, but Aramco raked in almost triple ExxonMobil’s 2022 profits (record for any Western oil company).

So, after getting mixed signals about the economy from Friday’s jobs report, the Fed will take a fine-toothed comb to the consumer price index, which drops tomorrow.

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

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Banks: At the end of an extremely stressful weekend, depositors of collapsed Silicon Valley Bank were told they would be made whole. Yesterday evening, the US government informed anxious SVB depositors that they’d have access to all the money they stashed with the lender today, even if the amount exceeded the $250,000 limit insured by the FDIC. In addition to backstopping depositors, the Fed is offering additional funding to some banks to limit the contagion from spreading across the banking sector.

And, according to MorningBrew, the Fed’s aggressive action shows how the implosion of Silicon Valley Bank on Friday could have quickly turned into a full-blown banking crisis when markets open this morning.

Banking is a confidence game, and if people and businesses felt their uninsured deposits were at risk, they could start pulling money from other banks in a catastrophic bank run.
The government had a hard deadline of 9:30am ET this morning to restore confidence in the banking system, and it beat it.
However, in their announcement, regulators also noted the closure of a second bank, New York-based Signature Bank, over “systemic risk.” All of Signature’s depositors will be made whole, they said.

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ALERT: HSBC Holdings PLC just said that it purchased Silicon Valley Bank UK Ltd., the U.K. arm of the collapsed Silicon Valley Bank, for 1 pound ($1.20). HSBC said the acquisition will help strengthen its franchise in the U.K. As of March 10th, SVBUK had loans of around GBP5.5 billion and deposits of around GBP6.7 billion, while tangible equity is expected to be around GBP1.4 billion. The acquisition was completed immediately.

The Bank of England said it took the decision to sell SVBUK to stabilize the business, ensure continuity of banking services, minimize disruption to the country’s technology sector and support confidence in the financial system.

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VALUATION of Internal Medicine Services

Posted on March 11, 2023 by Dr. Marcinko

Valuation of Internal Medicine Services: Reimbursement

BY HEALTH CAPITAL CONSULTANTS, LLC

As noted in the first installment of this five-part series, internal medicine is the largest specialty among physicians and an understanding of the various environments in which these physicians operate is crucial in determining their numerous value drivers.

In particular, healthcare reimbursement, the process by which private health insurers and government agencies pay for the services of healthcare providers (including internists), is perhaps one of the most important environments to understand, as it comprises a provider’s expectation of future return on investment.

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

This installment will discuss the reimbursement of internal medicine services. (Read more…)

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DAILY UPDATE: Lawmaker’s Health Data Breach, BLS Report and the Crashing Bank & Stock Markets!

Posted on March 10, 2023 by Dr. Marcinko

By Staff Reporters

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The online health insurance marketplace for members of Congress and Washington, D.C., residents was subjected to a hack that compromised the personal identifying information of potentially thousands of lawmakers, their spouses, dependents and employees, according to a letter from House leaders informing their colleagues about the breach and a memo from the Senate’s top security official.

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

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

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Today the U.S. Bureau of Labor Statistics (US-BLS) will report the number of jobs the U.S. economy added in February as well as other pertinent information surrounding the labor market. Officials at the Fed and investors have been watching the labor market very carefully, which has been red hot with the unemployment rate in January remaining near historic lows at 3.4%. Fed officials believe the tight labor market is empowering consumers to spend through rising consumer prices, which has made inflation sticky. Fed Chairman Jerome Powell has said previously the Fed would like to see some deterioration in the labor market to know that it’s winning its war with inflation.

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

Bank stocks plunged as investors assessed the potential fallout from the implosions of Silicon Valley Bank and Silvergate Capital.
SVB Financial surprised investors with lowered guidance, a $2.3 billion capital raise, and a massive $1.8 billion loss from its bond portfolio.
“This is sending shock waves through the financials with the regional bank ETF lower by 8%,” NYSE’s Michael Reinking said.

***

U.S. stocks declined to close out a choppy trading session, adding to weekly losses that followed this week’s hawkish Congressional testimony from Fed Chairman Jerome Powell. A larger-than-expected increase in weekly initial jobless claims seemed to offer a modest reprieve from the concerns about how aggressive the Fed may be.

The Financial sector saw pressure, as SVB Financial plummeted after selling securities for a loss, and Silvergate Capital dropped after announcing that it would shut down its bank operations and liquidate. As a result of the turmoil in the sector, the shares of numerous banks declined. In other equity news, Dow member American Express increased its share buyback plan and raised its dividend, while GE rallied as the Street cheered its long-term outlook.

Treasury yields were mostly lower with short-term rates giving back recent gains, and the yield curve steepened somewhat after inverting further on Powell’s testimony.

The U.S. dollar relinquished some of this week’s rally, while crude oil prices were lower, and gold traded to the upside.

Asian stocks finished mixed following some cooler-than-expected Chinese inflation reports, and Europe ended mostly lower, as the global markets continued to react to Fed Chair Powell’s comments.

***

ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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Filed under: "Ask-an-Advisor", Alerts Sign-Up, Experts Invited, Financial Planning, Glossary Terms, Health Economics, Health Insurance, Information Technology, Investing, LifeStyle, Monthly Reports, Portfolio Management, Risk Management | Tagged: Asian stocks, bank stocks, BLS, DJIA, ETFs, European stocks, health insurance marketplace, HIT, IT, Michael Reinking, NASDAQ, NYSE, S&P 500, Treasury yields, US-BLS | Leave a comment »

PODCASTS: The Case Against Value Based Care [VBC]

Posted on March 9, 2023 by Dr. Marcinko

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And Now – The Other Perspective

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BY ERIC BRICKER MD

Your comments are appreciated.

THANK YOU

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

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

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

PODCAST: VBC Financial Risks: https://medicalexecutivepost.com/2021/07/13/podcast-value-based-care-financial-risks/

ENJOY

***

Filed under: Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: Accountable Care Organizations, ACOs, Eric Bricker MD, fee for service, Value-Based care, VBC | Leave a comment »

PODCAST: Hospital Money Challenges in 2023

Posted on March 8, 2023 by Dr. Marcinko

By Eric Bricker MD

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

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

***

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Filed under: "Doctors Only", Career Development, Experts Invited, Health Economics, Health Insurance, Videos, Voting Polls | Tagged: Eric Bricker MD, Financial Planning, funding, Hospital Money Challenges, Investing | Leave a comment »

PODCAST: Health Insurance “Medical Policy” Explained

Posted on March 6, 2023 by Dr. Marcinko

MEDICAL NECESSITY

By Eric Bricker MD

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

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

***

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Filed under: Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Quality Initiatives, Videos | Tagged: Eric Bricker MD, Health Insurance, medical policy, PodCast, video | Leave a comment »

DAILY UPDATE: Silvergate Capital and Tesla Down Amid “Arm” IPO

Posted on March 5, 2023 by Dr. Marcinko

By Staff Reporters

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Shares of cryptocurrency bank Silvergate Capital plummeted 57% last week after the company delayed its annual financial report and warned investors that it may not survive the recent “crypto winter.” In a filing with the Securities and Exchange Commission, Silvergate said it is “analyzing certain regulatory and other inquiries and investigations that are pending.”

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

***

Electric vehicle company Tesla unveiled its latest “master plan” at its highly anticipated analyst and investor meeting but Tesla shares dropped 5.9% amid criticism from analysts that the presentation by CEO Elon Musk lacked clarity and details. Musk reiterated Tesla’s goal of increasing its annual EV production from 1.3 million vehicles in 2022 to 20 million by 2030.

***

Chip designer shuns London to list in NYC: UK-based Arm—a company whose tech is inside almost every smartphone—used to be listed in London before being taken private by Softbank. Yesterday it said it’s planning an IPO in New York. The British government has been trying to woo the company to relist in London, and Arm said it wasn’t ruling out a future London IPO. But it’s a big loss for London for now, and it heightens concerns that the UK market is not competitive internationally. Investment bankers are pegging the company’s valuation between $30 billion and $70 billion, per Bloomberg.

***

ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

***

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Filed under: Investing, "Ask-an-Advisor", Alerts Sign-Up, Experts Invited, LifeStyle | Tagged: Arm, Bloomberg, crypto-winter, elon musk, IPO, New York, NYC, Silvergate Capital, SoftBank, Tesla | Leave a comment »

What is a Stock Market Index IMPLIED OPEN?

Posted on March 4, 2023 by Dr. Marcinko

FINANCIAL TERMS AND DEFINITIONS FOR PHYSICIANS AND ALL INVESTORS

By Dr. David E. Marcinko MBA CMP®

https://certifiedmedicalplannerdotorg1.files.wordpress.com/2012/03/cmp-logo17.jpg

SPONSOR: http://www.CertifiedMedicalPlanner.org

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The stock markets have been near all time highs, lately. Physician colleagues and clients are so excited that they are even checking the overnight status of favorite stocks and/or the domestic/overseas markets.

Some colleagues are even becoming a bit OCD by checking the implied open of various markets the night before. But, what exactly is the Implied Open? How is it calculated?

DEFINITION: The Implied Open attempts to predict the prices at which various stock indexes will open, at 9:30am New York time. It is frequently shown on various cable television channels prior to the start of the next business day.

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

EXAMPLE: Considering the DJIA as an example, the basis of calculating implied open is the price of a “DJX index option futures contract”. This is not the price of the DJIA itself but rather the current ticker price of an option issued by the Chicago Board Options Exchange.

CBOE: The Chicago Board Options Exchange, located at 400 South LaSalle Street in Chicago, is the largest U.S. options exchange with annual trading volume that hovered around 1.27 billion contracts at the end of 2014. CBOE offers options on over 2,200 companies, 22 stock indices, and 140 exchange-traded funds.

CALCULATION: https://www.quora.com/How-do-you-calculate-the-implied-open-from-futures

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NOTE: We would like to remind you that new amendments adopted by the U.S. Securities Exchange Commission (SEC) have gone into effect as of September 28, 2021. These amendments restrict the ability of market makers to publish OTC quotations for those companies that have not made required current financial and company information available to regulators and investors.

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

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***

Filed under: CMP Program, Experts Invited, Glossary Terms, Investing, Touring with Marcinko | Tagged: CBOE, Dictionary of Health Economics and Finance, DJIA, dow futures, implied open, Investing, NASDAQ, stock index implied open | 1 Comment »

VENTURE CAPITAL FUNDING: Slowing Down in Health Care!

Posted on March 4, 2023 by Dr. Marcinko

By Staff Reporters

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Venture capital funding in the digital health space cooled significantly in 2022 following a red-hot 2021; according to Healthcare Brew. Overall, digital health companies raised $15.3 billion last year, down substantially from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to research from Rock Health, a seed fund that supports digital health startups.

Analysts predict investors will still put a good amount of money into digital health in 2023, particularly in alternative care, drug development technology, and software that reduces physician workload. But investors will likely pull dollars away from a few specific sectors this year.

“There is definitely more diligence, a little bit more skepticism in the investments that are made. So you tend to see investments go slower because diligence is taking longer or investors are being a little bit more conservative,” Adriana Krasniansky, head of research at Rock Health, told Healthcare Brew.

Direct-to-consumer products. The first sector in which Krasniansky expects to see funding slow this year is direct-to-consumer (DTC) products. One reason is that with recession fears, “Consumer spend is not as readily available,” Krasniansky said.

But Apple’s new data privacy rules are also partially to blame. As of April 2021, apps sold through Apple’s App Store must ask users for permission to track activity, and users can opt out. That tracking data is crucial for advertisers to create personalized ads.

“Apple’s privacy measures have impacted customer acquisition costs, making the DTC channel more challenging for a lot of startups—and not just digital health startups,” said Krasniansky.

READ: https://www.healthcare-brew.com/stories/2023/02/21/digital-health-hesitancy?cid=30649741.22835&mid=349b552221c994e2540a304649746d7c&utm_campaign=hcb&utm_medium=newsletter&utm_source=morning_brew

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***

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

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Filed under: "Advisors Only", "Doctors Only", Accounting, Career Development, Ethics, Experts Invited, Information Technology, Investing, Taxation | Tagged: Adriana Krasniansky, Healthcare Brew, rock health, VC, VC Healthcare, Venture Capital | Leave a comment »

SECRET: Ways A.I. Companies Might Use Your Personal Data

Posted on March 3, 2023 by Dr. Marcinko

By Bertalan Mesko MD PhD

The Medical Futurist

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Pictures, text prompts, documents and health metrics are just a few examples of data we’re giving away to different AI applications and thus, to different companies/organizations.

What happens to this data? Who owns the various outputs generated by us and/or algorithms? We dig into this topic and were not feeling at ease by the end of the trip.

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***

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

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Filed under: Career Development, Ethics, Experts Invited, Information Technology | Tagged: A.I., artificial intelligence, Artificial Intelligence Medicine, Bertalan Meskó, medical data, personal data | Leave a comment »

PODCAST: Digital Tele-Health Trends 2023

Posted on March 1, 2023 by Dr. Marcinko

Virtual-first, health equity and more

By Bill Siwicki

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A greater focus on care coordination and further embrace of tele-medicine by payers will also be hallmarks this year, says one virtual care expert.

READ: https://www.healthcareitnews.com/news/telehealth-trends-2023-virtual-first-health-equity-and-more

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

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

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***

Filed under: "Doctors Only", Career Development, Experts Invited, Health Economics, LifeStyle, Managed Care, Videos | Tagged: Digital Health, digital health 2023, digital health trands, Siwicki Bill, Tele-Health, tele-medicine | Leave a comment »

What is Stock Brokerage Company “Payment For Order Flow”?

Posted on March 1, 2023 by Dr. Marcinko

By Staff Reporters

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Payment for order flow, or PFOF, is a tactic some brokerages use to rake in piles of cash. Payment for order flow (PFOF) is a form of compensation, usually in terms of fractions of a penny per share, that a brokerage firm receives for directing orders for trade execution to a particular market maker or exchange. Payment for order flow is common in options markets, and is increasingly found in equity (stock market) transactions.

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

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How does it impact everyday investors?

The “P” in PFOF stands for “payment.” That’s because PFOF gets stock brokers paid. It starts when brokers direct trade orders to a particular e-trading firm (like Mountain Securities, for example) instead of routing the trades straight to exchanges. At that point, the e-trading firm may be able to collect the difference between the bid and the ask price, and the brokerages get a cut of that profit. It’s the proverbial “You scratch your broker’s back through their bespoke Ermenegildo Zegna suit, and they’ll scratch yours.”

According to Lillian Stone, some industry experts argue that PFOF is a conflict of interest. (The practice came under scrutiny last year when US brokers made billions on meme stock trading.) You want your broker to get you the best possible prices during a trade, right? Well, if your broker is incentivized to work with one specific e-trading firm, there’s a chance you may not get the sweetest deal—but they’ll line their pockets all the same.

***

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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Filed under: "Ask-an-Advisor", Ethics, Experts Invited, Glossary Terms, Health Economics, Investing | Tagged: brokerage, Lillian Stone, Payment for Order Flow, PFOF, stock, stock brokerage | Leave a comment »

INDEX: Social Frailty of Life?

Posted on February 27, 2023 by Dr. Marcinko

COMPREHENSIVE GERIATRIC ASSESSMENT

How likely are you to die within the next four years?

By Staff Reporters

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A CGA social frailty index showing where you lie on a predicted mortality curve. If you’re under 45, we recommend using 45 as your age when you submit your answers, or the curve widget may not function properly.

You’ll notice a common theme if you take the quiz. This team understood the importance of family, social engagement, community and even fleeting relationships between strangers or acquaintances. It’s a refreshing take.

While many popular studies emphasize diet, lifestyle and self-destructive habits, this approach acknowledges the importance of the connections forming our lives’ foundations.

LINK: https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17446

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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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Filed under: Ethics, Experts Invited, LifeStyle, Risk Management | Tagged: CGA, COMPREHENSIVE GERIATRIC ASSESSMENT, Emma Garofalo, frailty index, Harvard, life span, social frailty | Leave a comment »

PODCAST: What is “SWARM” Learning?

Posted on February 26, 2023 by Dr. Marcinko

By Dr. David E. Marcinko MBA

SWARM INTELLIGENCE IN MEDICINE

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Swarm learning, or swarm intelligence, is how swarms of bees or birds move in response to their environment.

When applied to data there is “more peer-to-peer communications, more peer-to-peer collaboration, more peer-to-peer learning and that’s the reason why swarm learning will become more and more important as … as the center of gravity shifts” from centralized to decentralized data.

Medicine Example:

Consider this example, “A hospital trains their machine learning models on chest X-rays and sees a lot of tuberculosis cases, but very little of lung collapsed cases. So therefore, this neural network model, when trained, will be very sensitive to what’s detecting tuberculosis and less sensitive towards detecting lung collapse.”

“However, we get the converse of it in another hospital. So what you really want is to have these two hospitals combine their data so that the resulting neural network model can predict both situations better. But since you can’t share that data, swarm learning comes in to help reduce that bias of both the hospitals.”

And this means, “each hospital is able to predict outcomes, with accuracy and with reduced bias, as though you have collected all the patient data globally in one place and learned from it.”

Moreover, it’s not just hospital and patient data that must be kept secure. What swarm learning does is to try to avoid or reduce the sharing of data, or totally prevent the sharing of data, to [a model] where you only share the insights, or you share the learnings.

So, that’s why it is fundamentally more secure.

YOUR COMMENTS ARE APPRECIATED.

DR. GOH PODCAST: https://www.technologyreview.com/2021/08/16/1031738/a-new-age-of-data-means-embracing-the-edge/?mc_cid=30af99395f&mc_eid=72aee829ad

Thank You

***

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

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Filed under: Career Development, Experts Invited, Glossary Terms, Information Technology, LifeStyle, Touring with Marcinko, Videos | Tagged: AI, Dr. Goh, swarm intelligence, swarm learning | 2 Comments »

DAILY UPDATE: Larry Summers Speaks About Domestic Economic Activity as the Markets Collapse

Posted on February 25, 2023 by Dr. Marcinko

By Staff Reporters

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According to Bloomberg, former Treasury Secretary Lawrence Summers said worrying signals of a potential sharp drop-off in activity combined with strength in other indicators point toward an uncertain economic outlook.

Here is Why:

Inventories “look to be building up relative to sales.”Companies are “reporting concerns about their order books.”The business sector appears to have a high payroll head-count relative to “the level of output they’re producing.”“Consumer savings are being depleted, with a low savings rate.” And, “there is stuff when you look down the road a bit that has to be substantially concerning about the Wile E. Coyote kind of moment,” reiterating his reference to the cartoon character that falls off a cliff.

Federal Reserve policymakers will need to “stay nimble and flexible” given the uncertainty, Summers said. The central bank should “resist the pressure to be giving strong signals about what it’s going to do next.”

Finally, the former Treasury chief also reiterated the lack of past examples in which the US managed to avoid a recession when the unemployment rate dropped below 4% and inflation went above 4%. “That’s a powerful historical truth and I think it’s one that’s relevant to our current situation.”

The latest unemployment-rate reading was 3.4%, while the consumer price index climbed 6.4% in January on a year-on-year basis.

***

Stocks Fell Following Hot Inflation Report and U.S. equities ended the day and week lower as the markets reacted to a Fed-favored gauge of inflation that came in hotter-than-expected. PCE and Core PCE Price Indexes rose more than anticipated, while personal income increased less than expected, and spending jumped. The moves came as equities have shown some volatility amid festering uncertainty regarding the ultimate economic impact of aggressive global central bank tightening as a result of persistent inflation. In other economic news, new home sales rose, and consumer sentiment was surprisingly revised the upside.

Treasury yields were higher, and the U.S. dollar gained ground, while crude oil prices increased, and gold traded to the downside. Q4 earnings season rounded a corner this week with some second-tier results hitting the tape, as Autodesk disappointed with its guidance and Intuit bested expectations, while Warner Bros. Discovery fell well short of forecasts.

In other equity news, shares of Boeing declined after the company paused delivery of its 787 Dreamliner planes. Asian stocks finished mixed, and markets in Europe fell, with economic data in the respective regions keeping the anxiety over future global monetary policy elevated.

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

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

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Filed under: Breaking News, Experts Invited, Investing, LifeStyle | Tagged: Bloomberg, Domestic Markets collapse, economic activity, economics, Federal Reserve, FOMC, inflation, Larry Summers, PCE, Treasury Secretary, un-employment rate | Leave a comment »

F.A. HAYEK versus J.M. KEYNES

Posted on February 25, 2023 by Dr. Marcinko

Keynes VERSUS Hayek

By staff reporters

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ORDER: https://www.routledge.com/Comprehensive-Financial-Planning-Strategies-for-Doctors-and-Advisors-Best/Marcinko-Hetico/p/book/9781482240283

THANK YOU

***

Filed under: Experts Invited, Health Economics, Health Law & Policy, Investing | Tagged: FA Hayek, Hayek, John Maynard Keynes | 1 Comment »

Appreciating the [Physician] Entrepreneur’s Personality

Posted on February 24, 2023 by Dr. Marcinko

13 Vital Questions for all Entrepreneurs to Consider

By Dr. David Edward Marcinko MBA, CMP™

[Editor-in-Chief]

http://www.CertifiedMedicalPlanner.org

There is no way to eliminate all the risks associated with starting a medical practice, or launching any innovative concept in the health 2.0 ecosystem. However, entrepreneurial focused doctors can improve their chance of success with good planning and preparation. So, prior to starting your practice, merging, franchising or purchasing an existing one, ask yourself the following sobering questions. Hopefully, such reflection will enhance success, or at least prevent an unmitigated catastrophe. (www.sba.gov)

The Questions to Consider

1. Is medical practice ownership and physician entrepreneurship right for you?

It will be up to you, and your consultants; not someone else telling you to develop projects, organize your time or follow through on details. Your must be self motivated.

2. Do you like people and get along with different personality types?

Practice owners need to develop working relationships with a variety of people including patients, customers, vendors, staff, other physicians, and professionals like lawyers, accountants, consultants and bankers. Can you deal with a demanding patient, an unreliable vendor or cranky staff person in the best interest of your practice?

3. Can you make decisions and leave with ambiguity?

Practice owners are required to make independent decisions constantly; often quickly, under pressure and without all the facts. Ambiguity is a constant.

4. Do you have the physical and emotional stamina?

Practice ownership can be challenging, fun and exciting. But it’s also a lot of work. As a physician-owner, can you face twelve hour work days? As a doctor, can you offer advice, service, care and moral support 24/7?

5. How long can you live on your current savings?

Most small medical practice startups induce a declining bank balance in the early going. So, it’s wise to look at your expenses and determine how long you can live on your savings, and what personal costs you can temporarily eliminate. Emotionally, it’s easier to tighten expenses when you’re contemplating a new practice, than it is to cut back after you’ve started. Financial consultants and accountants that perform consolidated financial statement preparation and analysis are vital in this regard. A two to five year margin of safety is not unusual and may be needed

6. How deeply in debt can you go?

Medical practice business debt can be good. It can fund expansion, improve profit ratios and cash flow. For physician entrepreneurs, business debt is often personal debt. Many start a practice by deferring payments for their own labor. Although lenders may make loans to a practice, the physician-owner will often be required to personally guarantee the loan. So, although the debt is on the business’s books, is ultimately the doctors’ debt should the practice fail.

7. What about health insurance?

If your current residency, fellowship or job offers health insurance, and is subject to the Consolidated Omnibus Budget Reconciliation Act (COBRA), you might be able to keep your coverage by paying the premiums, plus another 2% for administrative costs. You may keep your coverage under COBRA for up to 18 months and is a useful stopgap. For example, pay the premiums for six months or until another health insurance plan is obtained. Others suggestions are working spouse coverage with family benefits, or an HMO; or Medical or Health Savings Account (HSA/MSA).

8. Can you line up credit in advance?

Some new practice owners may set up a home equity line of credit that will let them borrow money at 1-2 percentage points over the prime rate or less. Lenders are more willing to make loans to someone who has a steady paycheck than to a new practice entrepreneur. If you have an excellent credit rating, you can probably get a home equity or other secured loan, but with more paperwork than in the recent past. Once you’re a self-employed practice owner, you’ll probably have to provide your most recent tax returns before getting approval. But, today, the biggest obstacle to a practice loan is a home mortgage. Domestic credit has been very tight since 2007, even for physicians.

9. What if you can’t manage the practice?

Disability insurance, unlike health insurance, usually cannot be transferred to an individual policy when you leave your job to start a new venture. So, get your own disability policy while you are still employed. Once you have the policy established and are paying the premiums, you should be able to keep the policy when you go out on your own. Remember, benefits received on a policy paid by you are free of federal income tax. Benefits on a policy paid for by a previous employer were taxable.

10. How well do you plan and organize?

Research indicates that many medical practice failures could have been avoided through better planning. Good organization of financials, inventory, schedules, information technology, medical services and human resources can help avoid many pitfalls.

11. Is your determination and drive strong enough to maintain your motivation?

Running a practice can wear you down. Some doctor-owners feel burned out by having to carry all the responsibility on their shoulders. Strong motivation can make the practice succeed and will help you survive slowdowns as well as periods of burnout.

12. How will the practice affect your family?

The first few years of practice startup can be hard on family life. The strain of an unsupportive spouse may be hard to balance against the demands of starting a medical business. There also may be financial difficulties until the business becomes profitable, which could take years. You may have to adjust to a lower standard of living or put family assets at risk.

13. How do you feel about the Patient Protection and Affordable Care Act of 2010?

Most provisions of the PPACA take effect over the next four to eight years, including expanding Medicaid eligibility, subsidizing insurance premiums, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage/claims based on pre-existing conditions, establishing health insurance exchanges, and support for medical research. The expense of these provisions are offset by a variety of taxes, fees, and cost-saving measures, such as new Medicare taxes for high-income brackets, cuts to the Medicare Advantage program in favor of traditional Medicare, and fees on medical devices and pharmaceutical companies. There is also a tax penalty for citizens who do not obtain health insurance. Decreased physician reimbursement is a component, as well.

Assessment

More info: www.BusinessofMedicalPractice.com

Are you a medical innovator or healthcare entrepreneur? I am available for queries – thanks again for your interest.

Channel Surfing the ME-P

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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

Filed under: "Doctors Only", Career Development, Experts Invited, Practice Management, Recommended Books, Research & Development | Tagged: david marcinko, Physician-Entrepreneur | 4 Comments »

DRUGS: Use and Abuse Epidemiology Information

Posted on February 24, 2023 by Dr. Marcinko

By Staff Reporters

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“The staggering increase in methamphetamine-related deaths in the United States is largely now driven by the co-involvement of street opioids.”—Rachel Hoopsick, an assistant professor of epidemiology at the University of Illinois at Urbana-Champaign and lead researcher on a 20-year study (US News and World Report)

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How 3 companies came to dominate the PBM market

MORE: https://medicalexecutivepost.com/2022/09/21/podcast-pbm-money-flow-explained/

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More docs than ever use health IT for opioid prescribing

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

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Drug Econometrics

LINK: https://medicalexecutivepost.com/2016/11/06/are-soaring-health-care-costs-hurting-the-u-s-economy/

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“ENTERPRISE METAVERSE” Innovation and Entrepreneurship

Posted on February 24, 2023 by Dr. Marcinko

WHAT IS IT?

On an earnings call last year Microsoft CEO Satya Nadella said the term “enterprise metaverse.”

By [Avatar] Dr. David Edward Marcinko MBA

DEFINITION: The Metaverse is a collective virtual shared space, created by the convergence of virtually enhanced physical reality and physically persistent virtual space, including the sum of all virtual worlds, augmented reality, and the Internet.

The word “metaverse” is made up of the prefix “meta” (meaning beyond) and the stem “verse” (a back formation from “universe“); the term is typically used to describe the concept of a future iteration of the internet, made up of persistent, shared, 3D virtual spaces linked into a perceived virtual universe.

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DAILY UPDATE: The “Bond King” PODCAST as Stocks Move Up

Posted on February 24, 2023 by Dr. Marcinko

By Staff Reporters

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Jeffrey Gundlach has raised the alarm on an impending US recession, warning investors they need to prepare for it regardless of how severe it ends up being. Gundlach — whose nickname is the “Bond King” — is a billionaire investor and the boss of DoubleLine Capital. He warned stocks may come under pressure, loan defaults might surge, and inflation could prove stubborn in a recent Yahoo Finance interview. Moreover, he cautioned that attempting to forestall an economic slump can result in a far more devastating downturn in the future.

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U.S. equities ended higher in a choppy trading session as uncertainty remained regarding the ultimate economic impact of aggressive global central bank tightening. The volatile session followed yesterday’s release of the minutes from the Fed’s February monetary policy meeting, which suggested that the Central Bank may need to continue its rate hike campaign to try to tame inflation. In economic news, jobless claims came in below expectations, and Q4 GDP growth was unexpectedly revised lower and the inflation components came in well above estimates.

Treasury yields were mostly lower in choppy trading, and the U.S. dollar was mostly unchanged, while crude oil prices increased after a string of losses, and gold moved to the downside. Q4 earnings season continued down the home stretch, as Nvidia Corporation rallied after topping estimates and offering upbeat Q1 revenue guidance. Elsewhere, eBay matched earnings forecasts but its outlook garnered scrutiny, and Domino’s Pizza fell after missing revenue forecasts and adjusting its guidance lower.

Asian stocks finished mostly lower, though Japan was closed for a holiday, and markets in Europe were mixed as investors around the globe grappled with the outlook for monetary policies.

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PODCAST: Direct Primary Care Entrepreneurship and Innovation

Posted on February 24, 2023 by Dr. Marcinko

By Free Market Medical Association

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DEFINITION: Direct Primary Care (DPC) is an innovative alternative payment model improving access to high functioning healthcare with a simple, flat, affordable membership fee. No fee-for-service payments. No third party billing. The defining element of DPC is an enduring and trusting relationship between a patient and his or her primary care provider. Patients have extraordinary access to a physician of their choice, often for as little as $70 per month, and physicians are accountable first and foremost their patients. DPC is embraced by health policymakers on the left and right and creates happy patients and happy doctors all over the country!

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

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MEDICAL DEBT: Remains a Household Strain

Posted on February 24, 2023 by Dr. Marcinko

Report underscores ongoing concerns about accuracy of collections data, particularly with respect to medical debt

By Staff Reporters

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According to Gabriella Cruz-Martinez, tens of millions of debt collections disappeared from Americans’ credit reports during the pandemic, a new government watchdog report found, but overdue medical bills remain a big strain on many households nationwide. The total number of debt collections on credit reports dropped by 33% from 261 million in 2018 to 175 million in 2022, according to the Consumer Financial Protection Bureau, while the share of consumers with a debt collection on their credit report shrunk by 20%.

Medical debt collections also dropped by 17.9% during that time, but still made up 57% of all collection accounts on credit reports, far more than other types of debt combined — including credit cards, utilities, and rent accounts. Despite the reduction in collections, the CFPB noted that the results underscore ongoing concerns that current medical billing and collection practices can lack transparency, often hurting the credit scores and financial health of those most vulnerable.

“Our analysis of credit reports provides yet another indicator that, due to a strong labor market and emergency programs during the pandemic, household financial distress reduced over the last two years,” Rohit Chopra, CFPB director said in a statement. “However, false and inaccurate medical debt on credit reports continues to drag on household financial health.”

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Essay on Capitalism Weeding

Posted on February 23, 2023 by Dr. Marcinko

What it Is – How it Works?

By Rick Kahler MS CFP® ChFC CCIM www.KahlerFinancial.com

What is capitalism? How does it work? For some time now I’ve been meaning to write a column on that topic, but it has seemed to be a daunting task more fit for an economist than a financial planner.

Then I remembered this story from my childhood. But, it is an allegory for doctors, too!

The Story

One summer, we were visiting my grandparents. I was about ten and my brother was seven. Our grandfather hired us to weed his garden, paying us a dime apiece.

That seems like a paltry sum, but it wasn’t such a bad wage for a couple of kids at the time. After all, a bottle of soda only cost a nickel.

We started off to work. The day was hot. The garden seemed huge. I kept thinking about getting a bottle of soda and sitting in the shade. Pulling all those weeds seemed like a huge price to pay for that reward.

Then I had a brilliant idea. “Dave,” I said, “How would you like to earn an extra nickel?”

My brother was interested. I offered him the opportunity to weed my half of the garden for half of my dime. It seemed like a good idea to him, and we made a deal.

David weeded the entire garden. I bought a bottle of Coke with my nickel, sat in the shade, and watched him work. When the weeding was finished, he was tired and hot but had fifteen cents to show for his labors. I was broke, but I had enjoyed relaxing with my soda instead of having to work in the hot sun.

It seemed like a win-win situation to me. My grandfather didn’t see it the same way. In his view, I had taken advantage of my innocent younger brother by coercing or manipulating him into doing my work for me. I’m not sure Granddad ever forgave me for what I did that day.

A Willing Seller and a Willing Buyer

I suppose there may have been a tiny grain of truth in his perspective. After all, I was three years older than my brother. However, I don’t remember any bullying or manipulation being involved. I simply offered him a deal, and he took it. The transaction involved One thing of value—his work—was exchanged for another thing of value—my nickel. He benefitted from receiving more money, and I benefitted from not having to perform manual labor.

Thinking about it all these years later, it occurred to me that what I did was exactly the same thing my grandfather did. Each of us paid someone else to do a task we didn’t want to do. And each of us got the job done at the lowest cost to ourselves.

For Granddad to accuse me of using my position as the oldest to take advantage of my brother wasn’t quite fair. After all, one could say he used his position as a grandfather to get cheap labor out of a couple of little kids. I suppose one of his aims was to teach us about the value of hard work and the satisfaction of being paid for our efforts. The lesson I learned wasn’t exactly the one he had intended to teach.

Micro-Capitalism

The whole process, though, was a small example of capitalism at work. It was a lesson I took to heart.

Assessment

My brother must have done the same. He’s still a hard worker, and he’s certainly been a very successful capitalist. And when his son was a teenager and I hired him to do my yard work, I had to pay him a lot more than a nickel.

Conclusion

How does this story relate to ACOs, pre-paid healthcare, managed care, the PP-ACA, MC/MD or the direct pay model of medicine? If, at all?

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

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PODCAST: History Applied to Health Economics

Posted on February 22, 2023 by Dr. Marcinko

Divining the Future?

By Eric Bricker MD

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

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PODCAST: Out-Patient Hospital Pricing Explained

Posted on February 22, 2023 by Dr. Marcinko

By Eric Bricker MD

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DAILY UPDATE: Meta C-Suite Executives Exit & ARK Reduces Nvidia Holdings as Markets Collapse

Posted on February 22, 2023 by Dr. Marcinko

By Staff Reporters

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Meta confirmed chief business officer Marne Levine is stepping down after 13 years with the company in order to “recharge and prioritize some quality time with family” before beginning her “next professional chapter.” She’s the third female C-suite leader to leave Meta in recent years, following chief operating officer Sheryl Sandberg’s exit in 2022 and global ad chief Carolyn Everson’s in 2021.

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Cathie Wood has steadily reduced ARK Invest’s position in Nvidia (NASDAQ: NVDA) over the last four months. Between November 2022 and January 2023, her flagship ARK Innovation ETF (NYSEMKT: ARKK) completely exited its stake in the microchip stock. So far in February, Wood has also significantly trimmed the positions of Nvidia held by two other ARK Invest ETFs. ARK Fintech Innovation ETF (NYSEMKT: ARKF) still owns 48,272 shares of the stock. ARK Next Generation Internet ETF (NYSEMKT: ARKW) still owns 81,054 shares. After the sales, Nvidia ranks as the 22nd- or 23rd-largest holding in both of these ETFs. Wood’s activity isn’t because Nvidia isn’t performing well. Actually, the stock has soared close to 50% so far in 2023. Several stocks that she has bought this year haven’t delivered comparably impressive gains. So, she is likely just taking gains.

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U.S. equities kicked off the holiday-shortened week by posting sharp losses. Uncertainty regarding the Fed’s future rate hike decisions appeared to pressure market sentiment, as investors grapple with recent hot inflation data and Fedspeak. Retail companies headlined the earnings calendar, as Dow member Walmart bested profit projections and raised its annual dividend, while Dow component Home Depot beat estimates and increased its quarterly dividend, but issued some disappointing guidance. And, Amazon corporate employees will be paid up to 50% less in 2023 due to its falling share price, the WSJ reported. Amazon’s pay packets rely heavily on stock awards, making them vulnerable to price fluctuations. The tech giant is laying off 18,000 employees, its largest ever job cuts, amid weakening economic conditions.

The economic calendar showed manufacturing activity increased but continued to contract, while services activity rose more than expected into expansion territory. Additionally, existing home sales declined in January as the median existing home price continued to rise.

Treasury yields were noticeably higher, and the U.S. dollar gained ground, while crude oil prices were slightly lower, and gold fell. Asia finished mixed, and Europe was mostly lower, as international investors digested some mixed global manufacturing and services sector reports.

Finally, SoftBank Group Corp. founder Masayoshi Son increased the amount of stock pledged as collateral to financial institutions to 175.25 million shares, or about 35% of his total stake in the Japanese conglomerate.

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SECOND OPINIONS: Physician Financial Planning, Investing, Medical Practice Management and Business Valuations; etc!

Posted on February 21, 2023 by Dr. Marcinko

BY DR. DAVID EDWARD MARCINKO MBA CMP

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Financial Planning for Medical Professionals

HERE: https://medicalexecutivepost.com/schedule-a-consultation/

CONTACT: Ann Miller RN MHA

770-448-0769

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HOSPITAL RANSOMWARE ATTACKS: A Delivery and Patient Outcomes Analysis

Posted on February 21, 2023 by Dr. Marcinko

NIHCM GRANTS

By Hannah Neprash

By Sayeh Sander Nikpay

By Claire McGlave

UNIVERSITY OF MINNESOTA

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Despite increased occurrences, the lack of data on ransomware attacks has impeded research.

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

This research team will use a newly developed database to analyze how hospital ransomware attacks affect health care delivery and patient outcomes. The findings will provide new evidence for ongoing debates and legislative proposals about improving the cybersecurity of critical US infrastructure – including hospitals.

The Effect of Hospital Ransomware Attacks on Health Care Delivery and Patient Outcomes

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SUBSCRIPTION SERVICE “Meta Verified”

Posted on February 20, 2023 by Dr. Marcinko

By Staff Reporters

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According to Alexandra Bruell at alexandra.bruell@wsj.com the aim of Meta Verified is to increase security and authenticity across the company’s services, Chief Executive Mark Zuckerberg said Sunday in social-media posts. It is also meant to “help up-and-coming creators grow their presence and build community faster,” according to a Meta spokesperson.

The service will cost $11.99 a month for Facebook and Instagram accounts that sign up from a web browser, or $14.99 a month for subscriptions through devices running Android and Apple Inc.’s iOS system, according to Meta. Tests of the service will begin in Australia and New Zealand this week.

In the coming months, the company expects it to roll out in the U.S. and eventually other markets, according to the spokesperson.

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HOSPITAL PARTNERSHIPS: CBOs and SDOH

Posted on February 19, 2023 by Dr. Marcinko

COMMUNITY BASED ORGANIZATIONS

SOCIAL DETERMINANTS OF HEALTH

NIHCM GRANTS

By Yunyu Xiao Weil of Cornell Medicine

By Timothy Brown of UC Berkley Medicine

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This study will determine the causal effects of hospital-CBO partnerships on hospital re-admissions and mortality for the leading mental health and injury-related causes of death (suicidal ideation or suicide) and the leading physical cause of death (heart attack).

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

Findings may inform how, where, and for whom targeted hospital partnerships with CBOs can reduce hospital readmission and mortality.

Do Hospital Partnerships with Community-Based Organizations (CBOs) that Address Social Determinants of Health Reduce Hospital Readmission and Mortality?

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The “NO LANDING ECONOMY” – Defined?

Posted on February 18, 2023 by Dr. Marcinko

By Staff Reporters

FINANCIAL JARGON

The notion of a “no landing” scenario for the U.S. economy — as opposed to a hard or soft landing — is the latest topic to dominate discussions among economists and strategists.

DEFINITION?

According to Michael B. Kelley Editorial Director of Yahoo Finance, says that a “no landing” scenario involves the economy continuing to grow despite the Federal Reserve’s best efforts to tamp down inflation with interest rate hikes. And, what does that does it mean? “It’s all about inflation,” Bianco Research President Jim Bianco told Yahoo Finance Live.

“What they want or what they’re hoping for, both at the Fed and on the Street, is that the inflation rate is going to hit 2%,” he explained. “Well, the only way that it’s going to do that — at least the belief is — the economy has to slow. And if it doesn’t slow, then the inflation rate stays up. And if the inflation rate stays up, the Fed keeps hiking.”

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

Breaking down the 'no landing' buzz: What it means for investors

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LINK: https://flo.uri.sh/visualisation/6180194/embed?auto=1

Given the implication the Fed will continue raising rates until inflation subsides — and, in turn, the economy cools off — some observers argue that there’s no such thing as a “no landing” scenario.

“Because we’re in this highly volatile environment, and because there is so much uncertainty, we’ve now seen a number of different ways to interpret or call what we’re seeing in the economy,” EY Parthenon Chief Economist Gregory Daco told Yahoo Finance this week.

“No landing does not make any sense, because it essentially means the economy continues to expand, and it’s part of an ongoing business cycle and it’s not an event — it’s just ongoing growth,” Daco added. “Doesn’t that entail that the Fed will have to raise rates more, and doesn’t that increase the risk of a hard landing?”

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USA HEALTHCARE QUALITY: Confidence Down

Posted on February 17, 2023 by Dr. Marcinko

Confidence in the caliber of the American health system has never been lower

A GALLUP POLL

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ANNUAL GALLUP HEALTHCARE QUALITY REPORT

More than one in five adults (21%) living in the US now rate the country’s healthcare as “poor” quality—a record high, according to Gallup’s annual health and healthcare poll.

Less than half of all respondents (48%) surveyed in 2022 said they’d rank the quality of healthcare in the US as “excellent/good”—a new low since Gallup began tracking the issue in 2001. (That’s down from 50% in 2021 and a record high of 62% in 2010 and 2012.) About a third (31%), meanwhile, said they’d rate the quality of US healthcare as “only fair,” a slight drop from 35% in 2021.

Gallup partially attributed the drop in perceived quality to politics, noting that “Republicans’ positive ratings have been subdued since President Donald Trump left office.” Other likely factors, the organization offered, could be “changes to healthcare that have taken place amid the Covid-19 pandemic or curtailed access to abortion since the Supreme Court’s Dobbs decision.”

Survey Reports:

Respondents reported a rosier take on the care they personally receive. Over 70% rated it as “excellent/good” compared to 6% who rated it as “poor.” But that high “excellent/good” mark is still down from 76% in 2021 and 82% in 2020.
Costs remained a point of contention in 2022. Less than a quarter (24%) of respondents said they were “satisfied” with the total cost of healthcare in the US, and this proportion is on par with rates from the past two decades. But only 56% of those surveyed reported being satisfied with the total cost they pay for care—the lowest level since 2016.
One in five respondents think the US healthcare system is in a “state of crisis” (20%) or has “major problems” (48%).

EDITOR’S NOTE: As a former CPHQ [Certified Physician in Healthcare Quality], I find this report alarming and confusing – David EdwardMarcinko MBA CMP

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

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What Is Health 2.0?

Posted on February 16, 2023 by Dr. Marcinko

New-Wave Operative Definitions

By Jennifer Tomasik MS

Health 2.0 is participatory health care.

Enabled by information, software, and community that we collect or create, we the patients can be effective partners in our own health care, and we the people can participate in reshaping the health system itself.

— Dr. Ted Eytan, Director, Permanente Federation, LLC

Potential

Health 2.0’s potential lies in enabling, catalyzing, and sustaining changes in the practice of healthcare.

Dr. Ted Eytan, a nationally recognized proponent of digitally-enhanced patient care with a particular interest in preventive care, has blogged the above “declaration of health care independence,” which we will use as our own working definition of Health 2.0.

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

A Human Space Defined by Engagement

We see Health 2.0 as a human space defined by engagement, aided by technology, in which information and accountability can flow between individuals and their care teams and between individuals and their social networks.

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

Assessment

The “practice” of healthcare can be understood as a set of “behaviors” that becomes embedded in daily life, plus the “supports” that provide the appropriate resources to achieve the desired outcomes.

Thus, changing a current practice (in pursuit of a different outcome) requires enabling the behavior you want to encourage by providing the necessary supports to make it happen. Health 2.0 has made new supports available for people to embed health-seeking behaviors and sustain practices that increase their involvement in their own health.

NOTES:

[i] Eytan T. “The Health2.0 Definition: Not just the Latest, The Greatest!,” Ted Eytan, MD (Blog).Online 13 Jun 2008. Accessed 1 Nov 2012. <http://www.tedeytan.com/2008/06/13/1089>

[ii] Hawn C. “Take Two Aspirin and Tweet Me in the Morning: How Twitter, Facebook, and Other Social Media Are Reshaping Health Care.” Health Affairs 2009;28(2):361-8.

[iii] Moussa M, Tomasik JL. “Doctor-Patient Relationships in the Modern Era: Can We Talk—A Collaborative Shift in Bedside Manner.” Ch. 15 in Marcinko D.E. and Hope R. Hetico. The Business of Medical Practice: Transformational Health 2.0 Skills for Doctors. New York: Springer Pub. Co., 2011.

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

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PODCAST: Health Insurance Denials Contradict DEI, ESG and Fairness Initiatives

Posted on February 16, 2023 by Dr. Marcinko

By Eric Bricker MD

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

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Filed under: "Doctors Only", Career Development, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Videos | Tagged: DEI, diversity, equity, Eric Bricker MD, ESG, ESG and Fairness Initiatives, Health Insurance, Health Insurance Denials, inclusion | Leave a comment »

Musings on a Famous Portfolio Asset Allocation Study

Posted on February 14, 2023 by Dr. Marcinko

Some Critics Claim Brinson, Hood, and Beebower Conclusions Wrong

[By Dr. David Edward Marcinko MBA CMP™]

http://www.CertifiedMedicalPlanner.org

[Publisher-in-Chief]

Frequently, we hear the axiom that asset allocation is the most important investment decision, explaining 93.6% of portfolio returns. The presumption has been that once the risk tolerance and time horizon have been established, investing is simply a matter of implementing a fixed mix of stocks, bonds, and cash using mutual funds selected for this purpose. This axiom is based on a famous study by Brinson, Hood, and Beebower (BHB) published in the Financial Analysts Journal in July/August 1986. It is the stuff of most modern business school and graduate students in economics and finance.

Enter the Critics

One critic claims that BHB’s conclusions and the interpretation of their conclusions are wrong, stating that because of several methodological problems, BHB needed to make certain assumptions for their analysis to go forward. They assumed that the average asset-class weights for the 10-year period studied are the same as the actual normal policy weights; that investments in foreign stocks, real estate, private placements, and venture capital can be proxied by a mix of stocks, bonds, and cash; and that the benchmarks for stocks, bonds, and cash against which fund performance was measured are appropriate. The author believes that each of these assumptions can lead to a faulty measurement of success or failure at market timing and stock selection.

The Jahnke Study

William Jahnke claims that BHB erred in their focus on explaining the variation of quarterly portfolio returns rather than portfolio returns over the 10-year period studied. According to the study, asset allocation policy explains only a small fraction of the range of 10-year portfolio returns earned by the pension funds reported in the study. The author concluded that this discrepancy is caused by the effect of compounding returns. He adds that BHB were wrong to use variance of quarterly returns rather than the standard deviation. Use of standard deviation would reduce the often cited 93.6% to about 79%. Moreover, BHB did not consider the cost of investing, such as operating expenses, management fees, brokerage commissions, and other trading costs, which are more significant for individual investors than for the pension plans studied. Jahnke claims that excessive costs can reduce wealth accumulation by 50%.

Note: (“The Asset Allocation Hoax,” William W. Jahnke, Journal of Financial Planning, February 1997, Institute of Certified Financial Planners [303] 759-4900).

Assessment

Finally, the author takes issue with establishing long-term fixed asset class weights. Asset allocation should be a dynamic process. Higher equity return expectations should in turn produce larger equity allocations, other things being equal.

Conclusion

Are doctors different than the average investor noted in this essay?

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Filed under: CMP Program, Experts Invited, Investing, Op-Editorials, Portfolio Management, Touring with Marcinko | Tagged: asset allocation, Brinson, CMP, david marcinko, Hood Beebower, The Asset Allocation Hoax, William Jahnke, www.certifiedmedicalplanner.com | 1 Comment »

PODCAST: Medical Utilization Management and Review Explained

Posted on February 13, 2023 by Dr. Marcinko

By Eric Bricker MD

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

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Filed under: "Doctors Only", Career Development, Experts Invited, iMBA, Inc., Managed Care, Practice Management, Videos | Tagged: Eric Bricker MD, medical UM, medical UR, UM, UR, utilization management, utilization review | Leave a comment »

SECOND OPINIONS: Physician Financial Planning, Investing, Medical Practice Management and Business Valuations; etc!

Posted on February 12, 2023 by Dr. Marcinko

BY DR. DAVID EDWARD MARCINKO MBA CMP

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HERE: https://medicalexecutivepost.com/schedule-a-consultation/

CONTACT: Ann Miller RN MHA

770-448-0769

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