DAILY UPDATE: Pitch-Book Health Companies, SCOTUS and the Peaking Stock Markets

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SCOTUS: Two technology company cases involving Texas and Florida laws challenging social-media companies’ content moderation were sent to lower courts. SCOTUS thus effectively granted the companies a victory. The Supreme Court isn’t willing to blow up the internet just yet.

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PitchBook released its analysis of digital health venture capital deals done in the first quarter. The first quarter saw downturns in telehealth and digital therapeutics, but opportunities exist in mental health chatbots and care search platforms.


Amedisys, a large home health provider, plans to divest a number of care centers to an affiliate of VitalCaring Group in advance of its planned merger with UnitedHealth Group later this year.


And … ACOs may soon be able to take a breath of fresh air, as CMS shared that it has no intention of punishing them for a $2 billion urinary catheter fraud scandal that rocked the industry.  

What’s up

  • Tesla rose another 10.06% today, continuing its push higher thanks to quarterly car deliveries that beat Wall Street’s expectations. Rivian Automotive rose 6.82% today after beating projections for their own deliveries as well.
  • Paramount Global rose 5.97% on a report from the New York Times that Barry Diller’s IAC may be exploring an acquisition of the embattled entertainment company. IAC fell just 0.26%.
  • Archer Aviation popped 8.92% after the air taxi manufacturer received a $55 million investment from Stellantis.
  • Oliveda International is up 19.81% today after the olive oil company announced massive quarterly revenue growth at a key subsidiary.

What’s down

  • Chewy fell yet another 2.24% as fallout from Roaring Kitty’s stake in the company continues to rattle investors.
  • Pure Storage plunged 4.15% after UBS analysts downgraded the stock to “sell,” citing its high valuation and overhyped AI potential.
  • Home builders took a beating after Citi analysts downgraded Lennar and D.R. Horton from “neutral” to “sell,” noting the housing market will remain soft in the second half of the year. Lennar dropped 1.61%, and D.R. Horton fell 1.35%.

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 33.92 points (0.62%) to 5,509.01; the Dow Jones Industrial Average® ($DJI) climbed 162.33 points (0.41%) to 39,331.85; the NASDAQ Composite® ($COMP) rallied 149.46 points (0.84%) to 18,028.76.
  • The 10-year Treasury note yield (TNX) dipped four basis points to 4.43%.
  • The CBOE Volatility Index® (VIX) dropped to 12.03 after earlier trading at its lowest intraday level since late May.

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SCOTUS: Health policy leaders say patients, providers, and health systems should brace for more uncertainty and less stability in the healthcare system. Even routine government functions such as deciding the rate to pay doctors for treating Medicare beneficiaries could become embroiled in long legal battles that disrupt patient care or strain providers to adapt.

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DAILY UPDATE: Nurses & AI, Private Equity & CPAs, Public Companies and the Hot July Stock Markets

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Private equity gets a big accounting firm yet. The March story about private equity firm New Market Capital buying a $2.8 billion stake in accounting firm Grant Thorton was a big story. Private equity is gobbling up accounting firms, signaling a potential sea change in how accounting firms will operate in the future, with “more than half” of the top 20 accounting firms in talks with private equity.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 14.61 points (0.27%) to 5,475.09; the Dow Jones Industrial Average® ($DJI) climbed 50.66 points (0.13%) to 39,169.52; the NASDAQ Composite® ($COMP) added 146.70 points (0.83%) to 17,879.30.
  • The 10-year Treasury note yield (TNX) rose 12 basis points to 4.47%, the highest level since May 30 and back above its 50-day moving average, a technically important move.
  • The CBOE Volatility Index® (VIX) slipped to 12.19.

Crude oil is up sharply over the last month amid rising Middle East tensions.

What’s up

What’s down

  • Chewy stock popped then dropped 6.63% after Roaring Kitty revealed a 6.6% stake in the pet products company.
  • GameStop shares fell 5.35% after CEO Ryan Cohen posted on Twitter/X for the first time in months to advertise a job opening.
  • Uber fell 2.17% and Lyft fell 0.92% on the news that Massachusetts now requires both companies to pay rideshare drivers $32.50 an hour, plus benefits.
  • Cruise stocks sank on the news that Hurricane Beryl is stronger than expected and will disrupt service throughout the Caribbean. Norwegian Cruise Line fell 5.86%, Carnival fell 5.40%, and Royal Caribbean fell 1.86%.

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The largest nursing union in the US, National Nurses United (NNU), is sounding the alarm about the use of artificial intelligence (AI) in healthcare. In April, the union’s affiliate California Nurses Association (CNA) protested an AI conference helmed by managed care consortium Kaiser Permanente. Like workers in other sectors who are worried about AI encroachment, the nurses fear that the tech is contributing to the devaluation of their skills amid what they say is already a “chronicunderstaffing crisis, nurses reported in an NNU survey of 2,300 registered nurses and members in early 2024.

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DAILY UPDATE: Wall Street Stocks, Dow Dogs, Commodities, Gold, the Fed, Yen and Bitcoin

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If you can believe it, Friday was the final trading day of the first half of 2024. It might be a good time to reflect on your New Year’s resolutions to see how you’re measuring up halfway through the year.

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Dogs of the Dow: The 139-year-old index has never looked more its age, with components Nike, Intel, and Boeing all down more than 30% in 2024. The Dow has gained less than 4% this year.

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But, the S&P 500 gained a sublime 15% in H1, and Nvidia alone was responsible for more than a third of that gain. The maker of AI chips surged ~150% since Jan. 1st to become the most valuable company in the USA at one point.

Going into 2024, investors were expecting the Fed to cut interest rates six times. There hasn’t been a single rate cut yet, but that hasn’t stopped the S&P from notching 31 all-time closing highs, good for the second-best tally of records this century. Stocks have overcome the Fed’s delay thanks to strong earnings, a sturdy economy, and AI fever.

Commodities soar and a currency plummets. Cocoa boomed nearly 85% over shortage concerns. Gold hit a record high last month. The Japanese yen has slumped to a 38-year low against the US dollar.

Bitcoin got a boost from new ETFs, but it’s getting boring.

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DAILY UPDATE: Stock Market Review

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The S&P 500 and NASDAQ shot to record highs last week on a solid PCE reading. But all three indexes spent Friday hovering around flat levels before they all fell into the red by the end of the trading session.

Treasury yields and gold prices alike popped higher on PCE news, with traders hoping that the Fed now has good reason to cut interest rates sooner rather than later. Despite this decline, oil wrapped up a fantastic month, with prices rising for a third straight week on higher demand this summer in the US and higher risks to supply given geopolitical turmoil between Israel and Lebanon.

But, Bitcoin continued to fall, with the crypto inching closer to the all-important $60,000 price point—a line in the sand that traders are desperate not to cross for fear of further declines.

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PODCAST: Shortages in Healthcare

SUPPLY DEMAND CURVE

By Eric Bricker MD

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Are We Over-Optimizing Portfolio Asset Classes?

Too Many Other Asset Classes?

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[By Dr. David Edward Marcinko MBA MEd CMP™]Dr. David E. Marcinko MBA

Some financial analysts believe that the focus on asset classes may have gone too far as physicians and other investors have sought to “over optimize” their portfolios.

In fact, colleague David Loeper, CEO of Wealthcare Capital Management, explained this concept as follows:

“Where things have really got off track has been the insistence on breaking asset classes into sub-classes by style, market capitalization, etc. The unpredictability of all the inputs into our optimizers, even over long periods of time, has been ignored. We have attempted to take efficient portfolios of stocks, bonds and cash and make them even more efficient by breaking the unpredictable asset classes into even less predictable sub-classes. This has all been done into the pursuit of “efficiency” as the proposal was validated by the Brinson & Beebower study, which purports to find that over 90% of the investment return variance is explained by asset allocation. The risk that you produce inefficient portfolios INCREASES if you increase the number of “asset classes” for which you must forecast not only the risk and returns but also each asset class’ correlation to the others.”

Assessment

If true, and I think it is a valid point, the results of the optimizer and your resulting portfolio’s efficiency is based on the accuracy of the inputs and NOT THE NUMBER OF THE INPUTS.

Stock_Market

Or, is this like the TNTC situation in cell cultures and microbiology [Too Numerous To Count].

Conclusion

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DAILY UPDATE: Walgreens, Healthcare Fraud and Opioids as Stock Markets Hurt

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In an interview with the Wall Street Journal, CEO Tim Wentworth said the pharmacy chain Walgreens will shutter a significant share of its 8,600 locations in the US. The closures are part of a broader attempt to boost the ailing company, which also includes reducing its stake in the primary care business VillageMD. Wentworth said the company can reassign most employees instead of conducting layoffs. Shares cratered yesterday after Walgreens whiffed on Wall Street’s earnings projections due to weak consumer spending.

And, read how some counties reduced opioid overdose deaths during the pandemic. (Politico)

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What’s up

  • Oliveda International, which makes beauty products from olive oil, rose 38.33% for no apparent reason. Maybe people just really like the feel of extra virgin olive oil on their skin?
  • Infinera popped 16.38% after Nokia announced it would acquire the telecommunications hardware manufacturer for $2.3 billion.
  • Synchrony Financial rose 6.17% after a Baird analyst initiated coverage of the financial services company with an outperform rating.
  • Regional banking stocks rose on the hopes that a good PCE reading means a better chance of the Fed cutting rates soon. Regions Financial rose 3.83%, while Citizens Financial Group rose 3.16%.

What’s down

A late round of selling in the Treasury market sent yields to fresh highs as the day ended so here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) dipped 22.39 points (0.41%) to 5,460.48; the Dow Jones Industrial Average® ($DJI) fell 45.20 points (0.12%) to 39,118.86; the NASDAQ Composite® ($COMP) lost 126.08 points (0.71%) to 17,732.6.
  • The 10-year Treasury note yield climbed nine basis points to 4.38%.
  • The CBOE Volatility Index® (VIX) moved up slightly to 12.43.

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Nearly 200 people have been charged for their roles in various health care fraud schemes across the U.S. that federal authorities say amounted to over $2.7 billion in intended losses, the Justice Department announced. Attorney General Merrick Garland said charges against 193 people, including 76 doctors, nurse practitioners, and other licensed medical professionals in 32 different federal districts. The defendants were charged over a two-week sweep involving numerous law enforcement agencies nationwide, resulting in the seizure of more than “$231 million in cash, luxury vehicles, gold, and other assets,” according to Garland.

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DAILY UPDATE: Tenet, Rivian, Yen, Public Companies and the Light Stock Markets

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Stat: 40%. That’s how much Tenet Healthcare’s shares jumped in Q1. (Yahoo Finance)

Stat: 12%. This is how much the yen has weakened so far this year against the US dollar, which has people wondering whether the Japanese government will need to intervene. (Bloomberg)

Quote: “We believe the opportunity ahead is significant.”—RJ Scaringe, CEO and co-founder of Rivian, commenting on Volkswagen Group’s plans to invest as much as $5 billion in the EV company. (CNBC)

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What’s up

  • McCormick & Co rose 4.34% after the company posted spicy earnings results, absolutely crushing estimates.
  • Arista Networks rose 3.92% after Citigroup reiterated its buy rating for the cloud company but increased its price target from $330 to $385.
  • BlackBerry is still a company, and rose 10.41% after a berry good first quarter.

What’s down

  • Walgreens Boots Alliance plummeted 22.16% due to a worse-than-expected earnings report that saw the company slash its full-year guidance.
  • Hims & Hers dropped 7.19% after Hunter Growth Capital accused the company of using a shady supplier for its new weight-loss drugs.
  • Levi Strauss crashed 15.27% in a denim downfall for the ages, with second quarter earnings missing expectations after consumers spent less on blue jeans.
  • Micron Technology slid 7.12% despite beating analyst expectations in the third quarter. Unfortunately, management isn’t as bullish as analysts about the rest of the year.
  • Chewy fell 0.03% despite a tweet from Roaring Kitty of a cartoon dog—which is apparently all it takes to move markets these days.

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The U.S. government’s final gross domestic product (GDP) estimate announced early Thursday included a downward revision to quarterly consumer spending.

Treasury yields could move on the data, especially if the report is “hotter” than expected. Yields fell Thursday following mostly soft U.S. economic readings this morning.

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 4.97 points (0.1%) to 5,482.87; the Dow Jones Industrial Average® ($DJI) rose 36.26 points (0.1%) to 39,164.06; the NASDAQ Composite® ($COMP) rose 53.53 points (0.3%) to 17,858.68.
  • The 10-year Treasury note yield lost two basis points to 4.29%.
  • The CBOE Volatility Index® (VIX) fell to 12.29, its lowest close since June 13.

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On Purchasing Individual BONDS!

A Seldom Discussed Investing Topics for Doctors and All Investors Until Now?

By Dr. David Edward Marcinko MBA MEd CMP®

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Now – Trading individual bonds is not like trading stocks. Stocks can be bought at uniform prices and are traded through exchanges. Most bonds trade over the counter, and individual brokers price them.  But, price transparency has gotten better in the last decade. 

For example, in 1999, the bond markets gained clearness from the House of Representatives’ Bond Price Competition Improvement Act of 1999. Responding to this pioneering law, the site http://www.investinginbonds.com was established. This site provides current prices on bonds that have traded more than four times the previous day. With the advent of Investinginbonds.com and real-time reporting of many trades, investors are much better off today.  Many well regarded brokers including Schwab, Ameritrade, and Fidelity Investments now have dedicated websites devoted to bond trading and pricing. 

Fidelity Investments chose to disclose its fee structure for all bonds, making it clear what it will cost you per trade. Fidelity charges $1 per bond trade. Some on-line brokers charge a flat fee as well, ranging from $10.95 at Zions Direct to $45 at TD Ameritrade. Depending on the number of bonds trading, one may be more complimentary than another. The trading fee disclosures, however, do not divulge the spreads between the buy and sell price embedded in the transaction that some dealer is making in the channel. Keep in mind that only by comparison shopping can assist you in finding the best transaction price, after all fees are taken into account. Other sites may not charge any fee, but rather embed the profit in the spread.

Despite the difficulty in pricing and transparency, investing in individual bonds offers several rewards over purchasing bond mutual funds.

First, bond mutual funds never mature.

Second, you know exactly what you will be receiving in interest each year.  You will also know the exact maturity date. 

Furthermore, your individual investment is protected against interest rate risk, at least over the full term to maturity.  Both individual bonds and bond funds share interest-rate risk (the risk of locking up an investment at a given rate, only to see rates rise). This pushes bond prices down.  At least with an individual bond, you can re-invest it at the higher, market rate once the bond matures.

But, the lack of a fixed maturity date on a bond mutual fund causes an open ended problem; there is no promise of the original investment back.  Short of default, an individual bond will return all principal and pay all interest assuming you hold it to maturity.  Bond funds are not likely to default as most funds maintain positions in hundreds of individual bonds.  The force of interest rate risk to individual bond or bond mutual fund prices depends on the maturity of a bond investment: the longer the maturity of a bond or bond fund (average), the more the price will drop due to rising rates. This is known as duration.

Duration is a statistical term that measures the price sensitivity to yield, is the primary measurement of a bond or bond fund’s sensitivity to interest rate changes.  Duration indicates approximately how much the price of a bond or bond fund will adjust in the reverse direction given a rise in interest rates. For instance, an individual bond with an average duration of five years will fall in value approximately 5% if rates rise by 1% and the opposite is accurate as well.

Although stated in years, duration is not simply a gauge of time. Instead, duration signals how much the price of your bond investment is likely to oscillate when there is an up or down movement in interest rates. The higher the duration number, the more susceptible your bond investment will be to changes in interest rates.  If you have money in a bond or bond fund that holds primarily long-term bonds, expect the value of that fund to decline, perhaps significantly, when interest rates rise. The higher a bond’s duration, the greater its sensitivity to interest rates alterations. This means fluctuations in price, whether positive or negative, will be more prominent.

For example, a bond fund with 10-year duration will diminish in value by 10 percent if interest rates increase by one percent. On the other hand, the bond fund will rise in value by 10 percent if interest rates descend by one percent. The important concept to remember is once you recognize a bond’s or bond fund’s duration, you can forecast how it will react to a change in interest rates.

UPDATE:

The yield on the 10-year Treasury note serves as a benchmark for interest rates across the US economy. Since bond prices and yields move in opposite directions, falling yields signal higher demand for Treasuries.

Why it matters: At the most basic level, the 10-year yield is a key indicator of investors’ confidence in future US economic growth. As the Delta variant spreads and threatens to slow the economic recovery, the fall in yields means investors are souring on a mega growth spurt and snapping up safer assets rather than riskier stocks.

What does this mean for inflation? Because investors sell bonds when they think inflation is coming, the runup in bond prices means the worst of Wall Street’s inflation concerns may be over. “It feels like we have moved from thinking inflation will be transitory, to fearing growth will be transitory,” Art Hogan, chief marketing strategist at National Securities, said.

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DAILY UPDATE: MSFT Teams, Deloitte, HealthcCare Cyber Attacks as Markets Lift

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The EU says Microsoft violated its antitrust laws by bundling Teams with Office, potentially setting the stage for a major fine.

And, Deloitte has billions of dollars’ worth of Medicaid contracts, but the consultancy’s eligibility systems are full of errors. (KFF Health News)

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 8.6 points (0.16%) to 5,477.9; the Dow Jones Industrial Average® ($DJI) added 15.64 points (0.04%) to 39,127.8; the NASDAQ Composite® ($COMP) climbed 87.5 points (0.49%) to 17,805.16.
  • The 10-year Treasury note yield rose 8 points to 4.32%.
  • The CBOE Volatility Index® (VIX) eased to 12.5

What’s up

What’s down

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The disastrous ransomware attacks on Change Healthcare and Ascension this year ran up staggering costs and put a spotlight on the healthcare sector’s vulnerability. But healthcare orgs are hardly new to eye-popping bills after a major hack. Analyzing attacks on organizations in 16 countries, IBM/Ponemon Institute has shown healthcare to be the industry with the highest cost per data breach for over a decade, coming in at an average hit of $10.93 million in 2023.

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DAILY UPDATE: Gun Violence, Health & Public Companies as Technology Stocks Rebound

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The U.S. surgeon general just declared gun violence a public health crisis, driven by the fast-growing number of injuries and deaths involving firearms in the country. The advisory issued by Dr. Vivek Murthy, the nation’s top doctor, came as the U.S. grappled with another summer weekend marked by mass shootings that left dozens of people dead or wounded.

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 21.43 points (0.39%) to 5,469.30; the Dow Jones Industrial Average® ($DJI) fell 299.05 points (0.76%) to 39,112.6; the NASDAQ Composite® ($COMP) gained 220.84 points (1.26%) to 17,717.65.
  • The 10-year Treasury note yield (TNX) fell slightly to 4.24%.
  • The CBOE Volatility Index® (VIX) dropped to 12.84. 

What’s up

  • Nvidia rose 6.76% as investors realized they could buy shares of the world’s biggest semiconductor company at a discounted price.
  • Trump Media & Technology Group rose another 8.50% today on the hopes of a cash infusion, as well as hype ahead of Thursday’s presidential debate.
  • Carnival popped 8.85% after it beat analyst expectations for the second quarter, and raised its profit forecast for the rest of the year.
  • Novo Nordisk rose 3.25% after its weight-loss drug Wegovy was approved in China.
  • Enovix soared 35.05% on the news that it signed a major deal to provide VR headset batteries for an as-yet-unnamed California company.

What’s down

  • Pool Corp., maker of…pools, fell 8.04% today after cutting guidance for the year ahead.
  • SolarEdge Technologies dropped 20.60% through no fault of its own—instead, a key customer declared bankruptcy, and will be unable to pay the solar power company the $11.4 million it is owed.
  • Airbus fell 9.41% after the company announced it is cutting financial guidance for the remainder of 2024 thanks to supply chain snarls and higher costs.
  • Auto dealer stocks continue to suffer the effects of a massive cyberattack on CDK, a key supplier of dealership management software. The company says its systems will remain down until June 30, but in the meantime shares of Autonation fell 2.04%, Sonic Automotive dropped 2.56%, and Group 1 Automotive slid 2.49%.

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Digital health company Sharecare has agreed to be acquired by private equity firm Altaris for $1.43 in cash per share, or about $518 million.


Nearly three months after Kaiser Permanente’s Risant Health acquired Geisinger Health, the group has now agreed to terms with Cone Health in North Carolina.


And ... UnitedHealthcare says its Surest unit improves spending and utilization across all age groups and for people with various conditions.

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PHYSICIANS BEWARE: Financial “Advice”

BEWARE THE “DOCTOR EFFECT”

Bread for the advisor – Crumbs for the client

By Dr. David Edward Marcinko MBA CMP

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Several years ago a group of highly trusted and deeply experienced financial services professionals and estate planners noted that far too many of their physician clients, using traditional stock brokers, management consultants and financial advisors, seemed to be less successful than those who went it alone. These Do-it-Yourselfers [DIYs] had setbacks and made mistakes, for sure. But, the ME Inc. doctors seemed to learn from their mistakes and did not incur the high management and service fees demanded from general or retail one-size-fits-all “advisors.

”In fact, an informal inverse relationship was noted, and dubbed the “Doctor Effect.” In others words, the more consultants an individual doctor retained; the less well they did in all disciplines of the financial planning and medical practice management, continuum.

Of course, the reason for this discrepancy eluded many of them as Wall Street brokerages and wire-houses flooded the media with messages, infomercials, print, radio, TV, texts, tweets, and internet ads to the contrary. Rather than self-learn the basics, the prevailing sentiment seemed to purse the holy grail of finding the “perfect financial advisor.” This realization was a confirmation of the industry culture which seemed to be: Bread for the advisor – Crumbs for the client!

And so, at D.E. Marcinko & Associates, our informed cadre’ of technology focused and highly educated doctors, nurses, financial advisors, attorneys, accountants, psychologists and educational visionaries decided there must be a better way for their healthcare colleagues to receive financial planning advice and related management services within a culture of fiduciary responsibility.

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DAILY UPDATE: Dental Staffing, Various Companies & the Stock Markets

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Here’s where the major benchmarks ended:

  • The S&P 500 index lost 16.75 points (0.31%) to 5,447.87; the Dow Jones Industrial Average ($DJI) gained 260.88 points (0.67%) to 39,411.21; the NASDAQ Composite ($COMP) dropped 192.54 points (1.09%) to 17,496.82.
  • The 10-year Treasury note yield (TNX) fell one basis point to 4.25%.
  • The CBOE Volatility Index® (VIX) ended slightly up at 13.47, the highest close since May 30.

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What’s up

What’s down

  • Nvidia dropped 6.68% as the semiconductor stock continues to fall, with the stock entering correction territory earlier today—a sentence we never thought we’d write.
  • Eli Lilly’s weight-loss drug Zepbound can also help people with sleep apnea, cutting into the sleep-aid market, sending shares of ResMed down 11.40% and Inspire Medical Systems down 16.45% on the news.
  • Bitcoin-connected stocks are taking a hit as the crypto selloff continues. Coinbase Global fell 6%, while MicroStrategy fell 7.52%.

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The dental industrylike other parts of healthcare—is facing significant staffing challenges. The US is in need of nearly 10,000 dental professionals and has more than 6,800 health professional shortage areas (HPSAs), which the US Department of Health and Human Services defines as “a geographic area, population, or facility with a shortage of primary care, dental, or mental health providers and services.”

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DAILY UPDATE: Genome Testing, the Stock Markets and Microsoft, Apple & Meta

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Apple and Meta are considering an AI partnership. The two tech giants are discussing integrating Meta’s generative AI model into Apple’s new AI platform, Apple Intelligence, the WSJ reports. Instead of building an in-house AI model, Apple opted for the partnership route and previously announced a deal with OpenAI to bring ChatGPT to iPhones. Apple has also reportedly held talks with AI startups Anthropic and Perplexity to fuse their AI models with Apple Intelligence and get that sweet, sweet distribution Apple provides.

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Genome testing can spot rare disease risks at birth. Newborn babies typically get blood tested for dozens of diseases, but some parents living in North Carolina and New York have recently been able to get their bundles of joy screened for hundreds of potentially life-threatening medical conditions that regular tests can’t catch thanks to a growing field called genomic medicine. Early results from two ongoing studies are very promising, the Washington Post reported, but scaling the new type of testing could be tricky: A full genome read (which covers all of your DNA) costs around $1,000 per patient. Still, research into the cost-benefit of genome sequencing has found that it can ultimately save families money on hospital care.

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Markets: Sweating the upcoming election? Investors aren’t. The S&P 500 is on track for its best first-half performance in an election year going back to 1976, per Dow Jones Market Data. And as trading begins Monday morning, Microsoft is back on the Iron Throne as the US’ most valuable company following Nvidia’s stumbles at the end of last week.

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DAILY UPDATE: Reverse Aging, Credit Card Competition Act, Nvidia and a Market Re-Cap

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The de-aging biz: Time to pull back the hospital curtain and see who’s behind the booming longevity market. This article, sponsored by Timeline, lays out who’s making $$$ on “reverse aging.*

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  • The S&P 500 and NASDAQ have often outperformed the Dow in recent years thanks to their focus on tech, as well as their market-cap weighting vs the Dow’s price weighting. When tech stocks roar higher, the younger indexes rise above their older peer—but the last few days have seen a sell off of tech stocks led by NVIDIA, bringing the S&P 500 and NASDAQ lower to end the week while the Dow has continued to rise.
  • Bonds remained unchanged for most of the day, ending the trading session flat as investors parse through a week of economic data and prepare for next week’s PCE report.
  • Gold plunged after the dollar rose, making it more expensive for gold bugs to hold the precious metal.
  • As for oil, read on to learn why crude has high hopes today but may not be a smart investment tomorrow.

Nvidia faltered for the second day in a row, falling off the world’s most valuable company perch and shedding $220+ billion in market cap. But the S&P 500 has gone 377 days without a 2.05% sell-off, the longest streak since the 2008 financial crisis, per CNBC.

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The Credit Card Competition Act is proposed legislation in Congress that could fundamentally change credit card systems. If passed, it could devastate the future of cash-back and travel rewards.

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DAILY UPDATE: Amazon Pharmacy, Healthcare Spending Boom, Companies and the Bi-Hybrid Markets

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Amazon Pharmacy announced on June 18 that, effective immediately, its RxPass medication delivery service will be available to more than 50 million Medicare beneficiaries, a move the company says could save up to $2 billion annually for the federal health insurance program.

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Here’s where the major benchmarks ended:

  • The S&P 500 index fell 8.55 points (0.2%) to 5,464.62, up 0.6% for the week; the Dow Jones Industrial Average® ($DJI) gained 15.57 points (0.04%) to 39,150.33, up 1.5% for the week; the NASDAQ Composite® ($COMP) shed 32.23 points (0.2%) to 17,689.36, little changed for the week.
  • The 10-year Treasury note yield (TNX) was little changed at 4.255%.
  • The CBOE Volatility Index® (VIX) dipped 0.06 to 13.22.

What’s up

  • Sarepta Therapeutics soared 30.14% thanks to FDA approval of Elevidys, its new Duchenne muscular dystrophy treatment.
  • Zealand Pharma rose 18.62% after Phase 1b trial results revealed its new weight-loss drug could compete with Ozempic.
  • Asana jumped 14.95% on the news that its board has approved a share repurchase program of up to $150 million of its own stock.
  • CarMax shares rose 0.37% after the company reported first-quarter earnings. The number isn’t big, but the performance is impressive considering the used car company posted a 33% decline in profits.
  • Hertz Global popped 15.95% after the company announced it was raising the size of its bond offering to $1 billion as it looks to update its fleet of rental cars.

What’s down

  • Nvidia fell another 3.22% today as the sell off continued, with investors taking profits after a record run higher.
  • Smith & Wesson Brands dropped 12.87% after the gun maker beat earnings forecasts but announced that next quarter’s sales will be lower than expected.
  • LendingTree slid 2.48% after a Bloomberg report revealed that hackers are auctioning off stolen customer data.
  • Palantir fell 6.78% after the company earned an analyst downgrade for its “gluttonous valuation,” a phrase you never want to hear as an investor.
  • Bitcoin mining stocks took a hit today, selling off after popping higher yesterday after bitcoin prices rallied. Marathon Digital Holdings dropped 7.02%, Riot Platforms fell 8.35%, and CleanSpark sank 9.81%.

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With a record number of people insured and seeking healthcare services post-pandemic, US health spend growth is outpacing GDP growth, and is expected to keep doing so through 2032, according to a June 12 report from actuaries at the Centers for Medicare and Medicaid Services (CMS). By 2032, CMS actuaries project healthcare spending will total $7.7 trillion and make up 19.7% of total US GDP, compared to $4.8 trillion and 17.6% of GDP in 2023.

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DAILY UPDATE: Bilt, Mortgage Rates, Private Equity in Behavioral Health and the Stock Markets

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Wells Fargo is losing $10 million per month on its partnership with Bilt, whose credit card offers users reward points for paying rent, and is looking to renegotiate, the WSJ reports. Apple has stopped offering its buy now, pay later program, Apple Pay Later, after partnering with outside companies, including Affirm.

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Private equity (PE) is all over healthcare, with investment firms owning more than 400 hospitals around the US. But as the country faces a mental health crisis—US Surgeon General Vivek Murthy called it the “the defining public health crisis of our time”—PE has its sights set on one of the fastest-growing areas of the industry: behavioral health care. PE has accounted for over 60% of all behavioral health deal flow since 2018, and firms like Thurston Group and Five Points Capital now own about a quarter of facilities offering behavioral health care in some states, according to a recent cross-sectional study published in JAMA Psychiatry.

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U.S. markets were closed Wednesday for the Juneteenth holiday. Here’s where the major benchmarks ended:

  • The S&P 500 index fell 13.86 points (0.3%) to 5,473.17; the Dow Jones Industrial Average® ($DJI) gained 299.90 points (0.8%) to 39,134.76; the NASDAQ Composite® ($COMP) dropped 140.64 points (0.8%) to 17,721.59.
  • The 10-year Treasury note yield (TNX) climbed about 4 basis points to 4.257%.
  • The CBOE Volatility Index® (VIX) rose 0.80 to 13.28.

What’s up

  • Gilead jumped 8.46% after clinical data revealed that its new twice-a-year shot prevents 100% of HIV cases.
  • Penn Entertainment rose 9.93% on the news that Boyd Gaming has approached its competitor with an acquisition offer.
  • Accenture rose 7.30% after the IT consulting company missed earnings estimates but more than made up for it with bullish bookings data thanks to AI.
  • Darden Restaurants rose 1.53% after a mixed earnings report. Its acquisition of Ruth’s Chris Steak House propped up earnings, while Olive Garden’s same-store sales came in flat, probably because I eat several hundred free breadsticks there every month.

What’s down

  • Trump Media & Technology Group fell 14.56% after the SEC ruled that early shareholders can resell their stock in the company, diluting new shareholders—though providing upward of $247 million in funding for the beleaguered company.
  • Nikola plummeted 31.46% after the company announced a 1-for-30 stock split in a bid to stay listed on the Nasdaq.
  • Kroger fell 3.27% despite beating analyst revenue estimates in its fiscal first quarter as investors digest the chances of the company sealing a deal to buy Albertsons.
  • Tempest Therapeutics dropped 29.47% upon the release of the latest trial data for its liver cancer treatment.
  • Jabil fell 11.45% today after the electronics supplier beat earnings estimates but warned of softer growth in the year ahead.

Mortgage rates fell below 7% last week to their lowest level since March, but this didn’t spur much extra demand.

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Whither the CERTIFIED MEDICAL PLANNER™ Marks?

Wither the CERTIFIED MEDICAL PLANNER™ Professional Certification?

CMP logo

DEAR INVESTMENT ADVISORS, CPAs, FINANCIAL PLANNERS, FINANCIAL ADVISORS & INSURANCE AGENTS

We believe that:

If you do not have a market niche; you are not deeply informed
If you are not deeply informed; you can’t different yourself
If you can’t differentiate yourself; you can’t differentiate price
If you can’t differentiate price; you have no market power
If you have no market power; you have no unique knowledge
If you have no unique knowledge; you have fewer profits

If you have fewer profits; you are not likely a CMP™

CMP

PROGRAM CURRICULUM: Enter the CMPs

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Dean Gene Schmuckler PhD MBA MEd CTS
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DAILY UPDATE: Nvidia, Golden Goose and the Summer Solstice

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HAPPY SUMMER SOLSTICE

Today is the first day of summer in the Northern Hemisphere, aka summer solstice. It’s also the longest day of the year.

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The markets were closed yesterday for Juneteenth, but they’ll be back today to see if they can keep their hot streak going.

But, the company known for selling shoes that look like they’ve been dragged through mud postponed its IPO, putting a pause on what has been a big year for European companies going public. Golden Goose announced Tuesday it wouldn’t go public in Milan on Friday as planned due to fraught market conditions in Europe stemming from parliamentary elections across the Continent.

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Nvidia is now the most valuable company in the world. The chipmaker passed Microsoft to become the world’s most valuable public company, topping $3.3 trillion in market cap. Earlier this month, it reached the $3 trillion mark for the first time, flying past Apple for second place. The AI boom has propelled Nvidia—which owns about 80% of the industry’s data center chip market—to new heights, enriching investors and CEO Jensen Huang along the way. Huang has added nearly $100 billion to his net worth in less than two years, making him the 13th richest person in the world as of June.

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DAILY UPDATE: Wells Fargo, Public Companies as Stock Markets Extend Rally

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Wells Fargo is losing $10 million per month on its partnership with Bilt, whose credit card offers users reward points for paying rent, and is looking to renegotiate, the WSJ reports. Apple has stopped offering its buy now, pay later program, Apple Pay Later, after partnering with outside companies, including Affirm.

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Here’s where the major benchmarks ended:

  • The S&P 500 index gained 13.80 points (0.3%) to 5,487.03; the Dow Jones Industrial Average® ($DJI) added 56.76 points (0.2%) to 38,834.86; the NASDAQ Composite® ($COMP) rose 5.21 points (0.03%) to 17,862.23, a record close for the seventh day in a row.
  • The 10-year Treasury note yield (TNX) dipped more than 6 basis points to 4.215%.
  • The CBOE Volatility Index® (VIX) fell 0.45 to 12.30.

What’s up

What’s down

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And … precision medicine company Tempus AI is going public, raising $410.7 million through its initial public offering.

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DAILY UPDATE: Microsoft & Google Cyber Security Discounts as Stock Markets Rally

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  • Microsoft. According to a same-day announcement on its site, the company will give “nonprofit pricing and discounts for its security products optimized for smaller organizations, providing up to a 75% discount,” along with free cybersecurity training, assessments, and—for at least one year, the company says—Windows 10 security updates.
  • Google. The White House said that Google will “provide endpoint security advice to rural hospitals and nonprofit organizations at no cost,” as well as a pilot program designed to help rural facilities “develop a packaging of security capabilities that fit these hospitals’ unique needs.”

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What’s up

What’s down

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Here’s where the major benchmarks ended:

  • The S&P 500 index gained 41.63 points (0.8%) to 5,473.23; the Dow Jones Industrial Average® ($DJI) added 188.94 points (0.5%) to 38,778.10; the NASDAQ Composite advanced 168.14 points (1.0%) to 17,857.02.
  • The 10-year Treasury note yield (TNX) rose more than 6 basis points to 4.279%.
  • The CBOE Volatility Index® (VIX) increased 0.10 to 12.76.

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Guidelines for Using an Equity Analyst’s Report

Trusting and Testing Fundamental Research

By Dr. David Edward Marcinko; MBA, MEd, CMP™

[Publisher-in-Chief]

It is not unreasonable to doubt the research of some security analysts; as evidenced by Wall Street’s recent upward implosion.

And so, trust but verify with your on research is always a good idea for the physician or lay investor in 2024.

25 Questions to Ask and Answer

Now, as a former financial planner, and professional investment advisor, please allow me to suggest the following before purchasing any equity:

  • How recent is the stock price on the report? If it is not recent, what is the current price? What is the current price relative to the 52-week high and low?
  • What is the P/E on trailing earnings per share? What is the stock’s projected price, based on estimated earnings for the periods shown?
  • What is the cash flow per share and the price-to-cash-flow ratio?
  • What is the book value? Price to book?
  • What is the trading volume relative to the number of shares outstanding?
  • How many shares are outstanding? What is the market capitalization based on current stock price and current shares outstanding? Is it a small, medium, or large-cap company?
  • Is the number of shares on a fully diluted basis shown? Is the fully diluted P/E shown? If there is a significant difference, read the report to find out where the extra shares will come from (convertible stock, a new or re-issue) and what the likelihood is that a conversion or a new issue or re-issue will occur.
  • What is the company’s earnings growth history? Is it a growth company or a cyclical company?
  • Does the company pay a dividend? If so, what is the dividend history and the payout ratio?
  • What is the debt-to-equity ratio? What kind of debt is it (publicly owned bonds, loans, etc.), and when does it have to be paid? What is the annual interest expense?
  • What are the cash ratios? Can the company cover its current liabilities easily? What is the ratio of annual earnings to interest expense?
  • What business is the company in? Are there comparisons to other companies in the same business? Are they similar in size? What is the outlook for the industry?
  • What is the company’s share of the market for its product? Does it have a particular niche? Does it have patents or protected rights on a special product? When do they expire?
  • How do the company’s financial ratios compare to those of other companies in its industry? How do the company’s ratios compare to those of the market as a whole or to narrower industry indexes?
  • Who are the company’s competitors? What advantages does the company have over its competitors?
  • How old is the company? How long has it been public? How long has the current management been running it? Who is the current management, and have there been significant management changes in the recent past?
  • How much of the company’s stock is owned by management? How much is owned by large institutional investors?
  • What kind of labor force does the company rely on? Where is it located?
  • Who are the company’s major customers? Is one customer very important?
  • Who are the company’s major suppliers? Is the company very dependent on one supplier?
  • How is the product distributed? Are there important relationships with distributors? How many different distributors are there?
  • What are the profit margins of the company? Where do they come from (incremental sales over break-even, or are they directly related to sales, no matter what level)?
  • What is the inventory turnover? Is there a lot of old, highly valued (on-the-books) inventory?
  • What is the history of sales revenue growth? What is the history of product mix in sales revenue?
  • Did the company issuing the research report also serve as investment banker?

Assessment

What did we miss – please advise?

Conclusion

And so, your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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DAILY UPDATE: Father’s Day, Medical Debt and USAA

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HAPPY FATHER’S DAY

News 4 in San Antonio Texas organized a video call with several USAA members who lost funds due to fraud — and have been left with little to no recourse. Some of them also belong to the Facebook group, USAA Fraud and Victims, which has 2,900 members. A few USAA members even reported being asked by the institution to cover the negative balances on their accounts after their money was stolen.

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The race to a $3 trillion market cap seemed like it would always be between Apple and Microsoft. But over the last twelve months, Nvidia has come roaring to the front of the pack, neck and neck with the big tech incumbents. In the last two weeks alone it has replaced Apple in the #2 spot, only to be supplanted earlier this week when Apple’s AI plans propelled it back ahead. Now, it’s anybody’s race to the next big benchmark: a $4 trillion market cap.

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In a move that could be good for patients but bad for hospitals, the Consumer Financial Protection Bureau (CFPB) on Tuesday proposed regulation that would wipe medical debt from many consumers’ credit reports. The rule is meant to help the 15 million people in the US who creditors say still have a combined $49 billion of medical debt that negatively affects their credit scores, Rohit Chopra, director of the CFPB, said during a June 11 press briefing. About 100 million people in the US have some amount of medical debt, which totals roughly $220 billion, according to data from the Peterson-KFF Health System Tracker. The proposed regulation comes after three credit-reporting conglomeratesEquifax, Experian, and TransUnion—removed paid-off medical debt and medical debts under $500 from credit reports in 2022 and 2023, respectively.

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Ride Sharing for Elderly Patients

Emerging Transportation Models

By Rick Kahler CFP

For elderly people facing the reality of diminishing capabilities, a service that can help maintain their independence is ridesharing.

Ride – Sharing

Ridesharing is hardly news for most Americans, particularly those in urban areas. After all, it has been around for a decade. In more rural areas of the US, however, ridesharing is just becoming an option. In my home town of Rapid City, South Dakota, for example, Lyft started operations only recently, and Uber  began last September.

Many of us in rural parts of the US, myself included, use ridesharing primarily when we travel. It has changed the way I travel in large cities, and I appreciate it for its convenience, flexibility, and economical cost.

For many others outside of big cities, however, especially senior citizens, ridesharing has the potential to be a game changer for those willing to take advantage of it.

There are a lot of emotional benefits and pitfalls to ridesharing for seniors. The greatest benefit is that, instead of relying on the gratuity and schedules of friends, family, and limited public transportation, they can literally reclaim most of the freedom they once had when they could drive. This alone can be uplifting and empowering. It allows seniors who may be isolated socially to reenter their communities and gives them a renewed sense of independence and autonomy.

However, I find many seniors emotionally resistant and reluctant to embrace the benefits of ridesharing. Many fear the unknown and unfamiliarity of ridesharing. Using the app inherently means owning a smart phone, which many seniors resist. Even those who have smartphones may feel overwhelmed about downloading and learning the app. This is where reaching out to younger family and friends to show you the ropes can be critical.

Another factor that often contributes to reluctance to use the freedom and convenience of ridesharing is a money script of frugality. The assumption may be “I can’t afford it.” While this can be absolutely true for some, many who could easily afford ridesharing also buy into that belief.

Economically, using ridesharing can cost the same as or less than owning a car. This is especially the case if you don’t have a demanding schedule and your need for transportation is moderate for activities like grocery shopping, medical appointments, and occasional social events.

Example:

Let’s assume you average one 10-mile round trip per day, or seven per week.  If you owned a car the gas would cost $50 a month. Insurance could run about $100. Oil, changing tires, servicing, and periodic repairs could average another $50 a month. That’s a total of $200 a month in out-of-pocket costs. The biggest cost is the depreciation on your car. Let’s assume your car is worth $20,000. You could expect it to depreciate 1% per month or around $200. That puts the total cost of owning the car at $400 per month.

Ridesharing costs about $7.00 each way when you are traveling up to 5 miles. That puts the daily average cost at $14.00 per trip, or $420 a month, about the same cost as owning a car—and a cost that could be covered for months through selling your vehicle.

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Assessment

Ridesharing can open up a whole new world of convenience, autonomy, and choices. Its benefits can even be a matter of life and death when seniors reach that difficult time when they can still legally drive but in reality they should not. With physical impairments like deteriorating vision and slower reaction time, driving means putting themselves and others at risk. Having the option of ridesharing can make that tough decision to give up driving just a little easier.

Your thoughts are appreciated.

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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DAILY UPDATE: Sat Healthcare Private Equity, Elder Abuse Awareness Day

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Quote: “​​When private equity gets hold of healthcare systems, it is literally a matter of life and death, so if you drive a hospital like Steward into bankruptcy, putting patients and communities at risk, you should face real consequences.”—Sen. Elizabeth Warren on a proposed federal bill to impose jail time on executives who “loot” health systems, leading to patient harm (Fierce Healthcare)

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Here’s where the major benchmarks ended:

  • The S&P 500 index fell 2.14 points (0.04%) to 5,431.60, up 1.6% for the week; the Dow Jones Industrial Average® ($DJI) lost 57.94 points (0.2%) to 38,589.16, down 0.5% for the week; the NASDAQ Composite gained 21.32 points (0.1%) to 17,688.88, up 3.2% for the week.
  • The 10-year Treasury note yield (TNX) fell more than 2 basis points to 4.215%, after earlier dropping under 4.19%, its lowest since late March.
  • The CBOE Volatility Index® (VIX) rose 0.72 to 12.66.

What’s up

  • Adobe soared 14.51% today after crushing analyst expectations when it announced earnings late yesterday.
  • Shopify rose 4.59% after it received yet another analyst upgrade. JPMorgan analysts gave the stock an overweight rating on June 11, while today Evercore analysts upgraded the company to outperform.
  • Hasbro popped 6% after the toy maker earned an upgrade to “buy” from Bank of America predicated on the company’s digital gaming strategy.

What’s down

  • Cruise stocks took a major blow today after a Bank of America report revealed that there was softer-than-expected pricing across the industry in May. Carnival fell 7.09%, Norwegian Cruise Line dropped 7.43%, and Royal Caribbean fell 4.35%.
  • RH plummeted 17% after the furniture maker reported a larger-than-expected loss in the previous quarter.
  • Stellantis fell 4.08% after the company’s CEO announced it will cut costs to compete with Chinese EV makers.
  • Penn Entertainment sank 8.66% on the news that competitor Boyd Gaming has voted in an M&A expert to its board of directors, which, combined with activist investors pushing Penn to put itself up for sale, could indicate an acquisition ahead.

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June 15th marks an important day on our calendar – Elder Abuse Awareness Day. It is a day for communities worldwide to unite in bringing attention to the challenges and difficulties faced by elders and our collective responsibility to protect and support them.

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DAILY UPDATE: Flag Day, KKR, Wells Fargo and the S&P 500

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HAPPY FLAG DAY

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Wells Fargo found that some of its employees were pretending to work — and sent them packing. More than a dozen employees in the bank’s wealth and investment management divisions were discharged last month “after review of allegations involving simulation of keyboard activity creating impression of active work,” Bloomberg reported citing disclosures filed with the Financial Industry Regulatory Authority (FINRA).

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Here’s where the major benchmarks ended:

  • The S&P 500 index gained 12.71 points (0.2%) to 5,433.74; the Dow Jones Industrial Average lost 65.11 points (0.2%) to 38,647.10; the NASDAQ Composite rose 59.12 points (0.3%) to 17,66756.
  • The 10-year Treasury note yield (TNX) fell about 5 basis points to 4.246%.
  • The CBOE Volatility Index® (VIX) declined 0.10 to 11.94.

What’s up

What’s down

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On Monday, private equity giant KKR jumped 12% after S&P Dow Jones Indices announced the company would be joining the index yesterday, along with CrowdStrike and GoDaddy, which saw their stocks jump 9% and 2%, respectively. The additions will be incorporated June 24.

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DOCTOR: What is Your Investment Philosophy for [Second-Half] 2024?

HERE IS MINE IN BRIEF

DR. DAVID EDWARD MARCINKO MBA MEd CMP

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We have produced Investment Policy Statements of a hundred pages or more for our esteemed physician clients and colleagues. Or, others were just a few pages or a conversation.

ISP: https://medicalexecutivepost.com/2023/03/02/selecting-money-managers/

But, before deciding on any investment direction and philosophy in brief, however, we typically first focus on how much medical clients need to live on. For the income part of a client’s portfolio, that entails locking in rates of at least 4-5%, whether through municipal and corporate bonds, certificates of deposits, Treasury ladders, utilities or conservative dividend producing equities or ETFs, etc.

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Once income requirements are fulfilled, whatever money is left over gets diversified into a portfolio of growth and value stocks—with some alternative investments. We limit making tactical shifts like putting money into cash when markets fell last year, or more recently, buying CDs and Treasuries as rates went up.  But, we do re-direct cash income, rather than sell assets in real time, as our philosophy trends to a “Buy and Hold” strategy.

Currently, we’re sitting on the sidelines with cash, some of which we are getting ready to deploy into the market as we position for any pullbacks later this 2024 year.

So, what is your investing philosophy for today, and or, tomorrow?

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DAILY UPDATE: Moody, CME Fedwatch and Ever Rising Stock Markets

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On Monday, private equity giant KKR jumped 12% after S&P Dow Jones Indices announced the company would be joining the index on Friday, along with CrowdStrike and GoDaddy, which saw their stocks jump 9% and 2%, respectively. The additions will be incorporated June 24.

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Stat: 99.4%. That’s the likelihood that interest rates will stay the same after the Fed’s meeting, according to the CME Fedwatch Tool. So it looks to be more “hurry up and wait” for interest rates to start coming down. 🫤 (Business Insider)

Quote: “It’s hard to think of a time when the US economy has diverged so fundamentally from its peers.”—Mark Zandi, chief economist at Moody’s Analytics, on the strength of the US economy compared to the weakness of other major economies. The US economy is continuing to grow while economies like Germany, Japan, and Canada are falling into recession. (The Atlantic)

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 45.71 points (0.9%) to 5,421.03; the Dow Jones Industrial Average  lost 35.21 points (0.1%) to 38,712.21; the NASDAQ Composite gained 264.89 points (1.5%) to 17,608.44.
  • The 10-year Treasury note yield (TNX) fell more than 7 basis points to 4.326%.
  • The CBOE Volatility Index® (VIX) declined 0.81 to  12.04.

What’s up

What’s down

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DAILY UPDATE: Apple AI, Addus HomeCare, Waystar and the Rising Markets

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 14.53 points (0.3%) to 5,375.32; the Dow Jones Industrial Average® ($DJI) declined 120.62 points (0.3%) to 38,747.42; the NASDAQ Composite gained 151.02 points (0.9%) to 17,343.55.
  • The 10-year Treasury note yield (TNX) fell about 7 basis points to 4.398%.
  • The CBOE Volatility Index® (VIX) rose 0.13 to 12.87.

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What’s up

  • Apple shares rose 7.26%, hitting a new all-time high on hopes that the company’s AI innovations can make up for lost ground. Today’s surge reaffirmed its position as the second-largest publicly traded company in the US, retaking the #2 spot from Nvidia.
  • Affirm popped 11.04% as Apple’s newest partner, with its buy-now-pay-later loans to be embedded in Apple Pay.
  • FMC Corp rose 4% on the news that its president and CEO has stepped down. It can’t feel good when your company’s stock rises after you announce you’re leaving.
  • Calavo Growers was up 8.24% after the avocado producer announced strong second quarter results thanks to high avocado prices. Those darn millennials eating their avocado toast strike again!

What’s down

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The “A” in AI stands for Apple, the techies attending Apple’s annual Worldwide Developers Conference (WWDC) were told yesterday. CEO Tim Cook and Co. unveiled Apple Intelligence, a host of AI-powered features that will debut on iPhones, iPads, and Macs this fall.

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Addus HomeCare is making a major move to expand its business with plans to buy Gentiva’s personal care business for $350 million.


Healthcare payment software maker Waystar debuted on the public market Friday, raising $967.5 million, and marking the biggest health tech IPO since 2022. The company plans on paying off existing debt.

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DAILY UPDATE: Tele-Health, Fortune 500, Companies and the Stocks Markets

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The end has come for the Covid-19-era federal Affordable Connectivity Program, which some critics say will make telehealth access challenging for millions in rural and tribal areas. (NPR/KFF Health News)

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Here’s where the major benchmarks ended yesterday:

  • The S&P 500 index rose 13.80 points (0.3%) to 5,360.79; the Dow Jones Industrial Average® ($DJI) gained 69.05 points (0.2%) to 38,868.04; the NASDAQ Composite added 59.40 points (0.4%) to 17,192.53.
  • The 10-year Treasury note yield (TNX) rose almost 4 basis points to 4.467%.
  • The CBOE Volatility Index® (VIX) rose 0.52 to 12.74.

What’s up

  • Diamond Offshore Drilling rose 10.91% after fellow offshore drilling company Noble Corp. announced it would acquire Diamond in a cash and stock deal worth $1.6 billion total. Noble shares rose 6.08% on the news as well.
  • Crowdstrike, GoDaddy, and KKR will be added to the S&P 500 when the index rebalances at the end of the quarter. Crowdstrike rose 7.29%, GoDaddy rose 1.94%, and KKR was up 11.22% on the news.
  • Texas Pacific Land Corporation shares also rose 24.57% on the news that the company will be inducted into the S&P MidCap 400.

What’s down

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Stat: 42. That’s how many healthcare industry companies were named on the latest Fortune 500, which lists the largest corporations in the US based on revenue for fiscal year 2023. (Advisory Board)

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DAILY UPDATE: Markets, Cue Health Down, Blue Kansas Part C and the FOMC

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Markets: Stocks dropped ever so slightly to end last week as investors tried to make sense of the big jobs report. Lots of jobs = good, but lots of jobs also = interest rates likely staying the same for awhile longer (more below). AMC had a rough day, tumbling 15% as the latest meme stock craze started to fizzle.

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Blue Kansas City Exiting MA Market by 2025 Due to ‘Regulatory Demands’

Blue Cross and Blue Shield of Kansas City (Blue KC) is leaving the Medicare Advantage (MA) market at the end of 2024, the insurer announced recently. The company blamed “heightened regulatory demands and rising market and financial pressures” for the decision but said it is still focused on employer-sponsored health plans, and Medicare supplement and Affordable Care Act plans in the state.

“We explored every alternative path for our MA members and are disappointed we must exit this line of business,” said Erin Stucky, Blue KC President and CEO, in a statement. “We value our MA members and are committed to providing uninterrupted, quality service to our current MA membership through the end of 2024.”

Source: Noah Tong, Fierce Healthcare [6/3/24]

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Cue Health, founded in 2010, started with great hopes as it promised a way to accurately test for Covid-19 without needing a lab. “We designed and developed a new molecular testing platform bringing lab complexity to an easy-to-use, portable device. Now you can get the best of lab molecular testing — speed, accuracy, and versatility – at home, the office, or on the go,” the company shared on its website. The company went public (with the ticker  (HLTH) ) in 2021 at $16 and rose to $20.55 and carried that massive $2.3 billion valuation. Through 2023 and into this year, Cue unsuccessfully tried to shore up operations, get new products to market, and find new capital.

In May, however, the FDA advised customers not to use two of its products at all because they did not deliver accurate results. Finally, its board and executives threw in the towel. On May 28th, the company announced it was ceasing operations and filed for bankruptcy in Delaware’s U.S. Bankruptcy Court. The company’s assets will be sold off at an undetermined date, and the proceeds will be distributed to creditors.       

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Inflation data from the Fed meeting on Wednesday: Inflation data for May arrives in the morning, and it’s expected to show price growth held steady at 3.4% annually. In the afternoon, the FOMC will wrap up its meeting with a Jerome Powell press conference. The Fed is pretty much a lock to hold interest rates at their current level.

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DAILY UPDATE: Payroll Jobs and Longevity Up

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People whose job it is to watch the economy are shocked at how many jobs the economy added last month: Payrolls added 272,000 more jobs in May, according to employer stats the government dropped yesterday, vastly exceeding the 190,000 increase that analysts predicted.

  • The biggest job gains were in healthcare (68k jobs), government (43k), and hospitality (42k).
  • The average hourly pay increased by 0.4% from the previous month and 4.1% over the year, also exceeding analysts’ predictions.

The surprisingly strong employment gains are prompting some head-scratching since they come amid slowing economic growth as consumers pull back on spending. The job market’s resilience has dashed hopes among investors and anyone planning to take out a loan that the Fed will lower interest rates soon. For example:

  • The unemployment rate ticked up to 4% from 3.9% in April, breaking its historic streak of 27 months under 4%.
  • A survey of households revealed that the number of Americans working dropped by 408,000 from April to May.

Some economists claim the household survey fails to properly account for immigrant workers, who have been the main driver of working population growth in recent years. But others say it checks out given the general cool-down vibes in the labor market: Job openings were at a three-year low in April, and many recent college grads have struggled to find work.

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While some companies would be thrilled if everyone started living to 120, it could spell trouble for the rest of us. Experts believe that centenarians becoming anything more than an anomaly would put the world in an economic pickle and require a societal overhaul to adapt. Even without futuristic tech that enables ultra-longevity, many developed countries are already in an economic bind due to aging populations and declining birth rates. The US Census Bureau projects that people older than 64 will reach 23% of the population by 2060 (compared to 17% in 2020), which means higher retirement and healthcare costs with fewer workers to offset them.

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DAILY UPDATE: Companies and Stocks Dip as Job Growth Rises

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Bank of America analysts recently looked back at the last 100 years of stock market data, searching for asset bubbles and what indicated their approach. The nine historical bubbles they found all had one thing in common ahead of their bursting: rising volatility. But, right now the Volatility Index, or VIX, is nowhere near the highs seen before the dot-com bubble burst, which should soothe investor concerns.

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What’s up

  • Jazz Pharmaceuticals rose 5.39% today thanks to RBC Capital reiterating its outperform rating of the stock, highlighting the potential of the company’s forthcoming essential tremor treatment.
  • CarGurus popped 4.05% after receiving a shiny new outperform rating from JMP Securities, which likes the company’s online marketplace business model.
  • Las Vegas Sands rose 3.11% today on no particular news, as did Cedar Fair, which rose 3.27%. Both are beneficiaries of the vacation season, and likely enjoyed a boost today due to nothing more than the fact that it was a sunny summer Friday.

What’s down

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Here’s where the major benchmarks ended:

  • The S&P 500 index declined 5.97 points (0.1%) to 5,346.99, up 1.3% for the week; the Dow Jones Industrial Average® ($DJI) lost 87.18 points (0.2%) to 38,798.99, up 0.3% for the week; the NASDAQ Composite® ($COMP) shed 39.99 points (0.2%) to 17,133.13, up 2.4% for the week.
  • The 10-year Treasury note yield (TNX) jumped about 15 basis points to 4.432%.
  • The CBOE Volatility Index® (VIX) fell 0.36 to 12.22.

Interest-rate-sensitive sectors including banking, real estate, and utilities were among this week’s poorest performers amid expectations the Fed is unlikely to lower rates from historically high levels. The Dow Jones Utility Average ($DJU) dropped 2.8% this week. Retailers also posted a down week. Semiconductors still clocked a firm week despite declines the past two days. The PHLX Semiconductor Index (SOX) advanced 3.2% for the week. 

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Walking Doctors Through a Stock Exchange Trade

Understanding the Traditional Process

By Dr. David Edward Marcinko MBA MEd CMP

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To see how the transactions are actually handled on the floor of an exchange, let us assume that an order to buy 100 shares of General Electric has been given by a doctor customer to the registered representative (stock broker), of a member firm in Atlanta. The order is a market order (an order to buy at the lowest possible price at the time the order reaches the floor of the exchange). This order is telephoned by direct wire, or computer, to the New York office of the member firm, which in turn telephones its order to its clerk on the floor of the exchange.

Each member firm has at least one member of the exchange representing them making trades on the floor. Each one of these members is assigned a number for identification. When the floor clerk receives the order to purchase the General Electric, he causes his member’s call number to appear on 3 large boards situated so that one is always in view. These boards are constantly watched brokers so that they will know when wanted at the phone, since there’s too much noise on the floor to use a paging system. Seeing his number on the board, the broker hurries to his telephone station or cell phone and receives the order to buy 100 shares of G.E. “at the market”. Acting as a commission broker, he immediately goes to the post where G.E. is traded and asks “how’s G.E”, of the specialist?

Order and Position Types

At this point, it is important to understand the different types of orders and positions that can be used to buy and sell securities from the specialist.

Market Order:

A market order is an order to be executed at the best possible price at the time the order reaches the floor. Market orders are the most common of all orders. The greatest advantage of the market order is speed. The doctor specifies no price in this type of order, he merely orders his broker to sell or buy at the best possible price, regardless of what it may be. The best possible price on a buy is the lowest possible price. The best possible price on a sell is the highest possible price. In other words, if a medical professional customer is buying, he logically wants to pay as little as possible, but he is not going to quibble over price. He wants the stock now, whatever it takes to get it. If he’s a seller, the doctor client wants to receive as much as possible, but will not quibble, he wants out, and will take what he can get, right now. No other type of order can be executed so rapidly. Some market orders are executed in less than one minute from the time the broker phones in the order. Because the investor has specified no price, a market order will always be executed. The doctor is literally saying, “I will pay whatever it takes, or accept whatever is offered”.

Limit Order:

The chief characteristic of a limit order is that the doctor decides in advance on a price at which he decides to trade. He believes that his price is one that will be reached in the market in reasonable time. He is willing to wait to do business until he has obtained his price even at the risk his order may not be executed either in the near future or at all. In the execution of a limit order, the broker is to execute it at the limit price or better. Better, means that a limit order to buy is executed at the customer’s price limit or lower, in a limit order to sell, at price limit or higher. If the broker can obtain a more favorable price for his doctor customer than the one specified, he is required to do so.

Order Length:

Now, even though the doctor has given his price limit, we need to know the length of effectiveness of the order. Is the order good for today only? If so, it is a day order, it automatically expires at the end of the day.  Alternatively, the doctor may enter an open or, “good until canceled” order. This type of order is used when the doctor believes that the fluctuations in the market price of the stock in which he’s interested will be large enough in the future that they will cause the market price to either fall to, or rise to, his desired price, i.e. his limit price. He is reasonably sure of his judgment and is in no hurry to have/his order executed. He knows what he wants to pay or receive and is willing to wait for an indefinite period.

Years ago, such orders were carried for long periods of time without being reconfirmed. This was very unsatisfactory for all parties concerned.  A doctor would frequently forget his order existed and, if the price ever reached his limit and the order was executed, the resulting trade might not be one he wished to make. To avoid the problem, open (GTC) orders must be reconfirmed by the doctor customer each six months. Does that mean six months after the order is entered? … No! The exchange has appointed the last business day of April and the last business day of October as the two dates per year when all open orders must be reconfirmed.

Example: Dr. Smith wants to buy 100 shares of XYZ. The price has been fluctuating between 50 and 55. He places a limit order to buy at 51, although the current market price is 54. Limit orders to buy (buy limit orders) are always placed below the current market. To do otherwise makes no sense. It is possible that, within a reasonable time, the price will drop to 51 and his broker can purchase the stock for him at that price. If the broker can purchase the stock at less that 51, that would certainly be fine with the doctor customer since he wants to pay no more than 51. A sell limit order works in reverse and is always placed above the current market price.

Example: Dr. Smith wants to sell 100 shares of XYZ stock. The order is 54. A sell limit order is place at 56. Sell limit orders are always placed above the market price. As soon as the pride rises to 56, if it ever does, the broker will execute it at 56 or higher. In no case will it be executed at less than 56.

The advantage of the limit order is that the doctor has a chance to buy at less or to sell at more than the current market price prevailing when he placed the order. He assumes that the market price will become more favorable in the future than it is at the time the order is placed. The word” chance ” is important. There is also the “chance” that the order will not be executed at all. The doctor just mentioned, who wanted to buy at 51, may never get his order filled since the price may not fall that low.  If he wanted to sell at 56, the order may also not ever be executed since it might not rise that high during the time period the order is in effect.

Stop Orders:

A very important type of order is the stop order, frequently called a stop-loss order. There are two distinct types of stop orders. One is the stop order to sell, called a sell stop, and the other is a stop order to buy, called a buy stop. Either type might be thought of as a suspended market order; it goes into effect only if the stock reaches or passes through a certain price.

The fact that the market price reaches or goes through the specified stop price does not mean the broker will obtain execution at the exact stop price. It merely means that the order becomes a market order and will be executed at the best possible price thereafter. The price specified on a stop order bears a relationship to the current market price exactly opposite to that on a limit order. Whereas a sell limit is placed at a price above the current market, a sell stop is placed at a price below the current market. Similarly, while a buy limit is placed at a price below the current market, a buy stop is placed at a price above the current market. Why would a doctor investor use a stop order?

There are two established uses for stop orders. One of them might be called protective; the other might be called preventive.

Protective: This order protects a doctors’ existing profit on a stock currently owned.

For example, a doctor purchases a stock at 60. It rises to 70. He has made a paper profit of $10 per share. He realizes that the market may reverse itself. He therefore gives his broker a stop order to sell at 67. If the reversal does occur and the price drops to 67 or less, the order immediately becomes a market order. The stock is disposed of at the best possible price. This may be exactly 67, or it may be slightly above or below that figure. Why? …Because what happened at 67 was that his order became a market order; the price he actually received was dependent upon the next activity in the market. Let us suppose that the sale was made at 66 1/2. The doctor customer made a gross profit of 6 1/2 points per share on his original purchase. Without the stop order, the stock may have dropped considerably below that before the customer could have placed a market order and his profit might have been less or, in fact, he might have even sold at a loss.

Preventive:

A doctor purchases 100 shares of a stock at 30. He obviously anticipates that the price of the stock will rise in the near future (why else would he buy?). However, he realizes that his judgment may be faulty. He therefore, at the time of purchase, places a sell stop order at a price somewhat below his purchase price, for example, at 28. As yet, he has made neither profit nor loss; he’s merely acting to prevent a loss that might follow if he made the wrong bet and the stock does fall in price. If the stock does drop, the doctor knows that once it gets as low as 28, a market order will be turned in for him and, therefore, he will lose only 2 points or thereabout. It might have been much more had he not used the sell stop.

Miscellaneous Orders and Positions

Beside market, limit and stop orders, there are some other miscellaneous orders to know.

A stop limit order is a stop order that, once triggered or activated, becomes a limit order. Realize that it is possible for a stop limit to be triggered and not executed, as the limit price specified by the doctor may not be available.

In addition, there are all or none and fill or kill orders, and even though both require the entire order to be filled, there are distinct differences. An all or none (AON) is an order in which the broker is directed to fill the entire order or none of it. A fill or kill (FOK) is an order either to buy or to sell a security in which the broker is directed to attempt to fill the entire”‘ amount of the order immediately and in full, or that it be canceled.

The difference between an all or none and a fill or kill order is that with an all or none order, immediate execution is not required, while immediate execution is a critical component of the fill or kill. Be cause of the immediacy requirement, FOK orders are never found on the specialist’s book. Another difference is that AON orders are only permitted for bonds, not stocks, while FOK orders may be used for either.

Also, there exists an immediate or cancel order (IOC), which is an order to buy or sell a security in which the broker is directed to attempt to fill immediately as much of the order as possible and cancel any part remaining. This type of order differs from a fill or kill order which requires the entire order to be filled. An IOC order will permit a partial fill. Because of the immediacy requirement, IOC and FOK orders are never found on the specialist’s book.

Long and Short Positions

A long buy position means that shares are for sale from a market makers inventory, or owned by the medical investor, outright. Market makers take long positions when customers and other firms wish to sell, and they take short positions when customers and other firms want to buy in quantities larger than the market maker’s inventory. By always being ready, willing, and able to handle orders in this way, market makers assure the investing public of a ready market in the securities in which they are interested. When a security can be bought and sold at firm prices very quickly and easily, the security is said to have a high degree of liquidity, also known as marketability.

A short position investor seeks to make a profit by participating in the decline in the market price of a security.

Now, let’s see how these terms, long and short, apply to transactions by medical investors, rather than market makers, in the securities markets.

When a doctor buys any security, he is said to be taking a long position in that security. This means the investor is an owner of the security. Why does a doctor take a long position in a security? Besides – receiving dividend income, to make a profit from an increase in the market price. Once the security has risen sufficiently in price to satisfy the investor’s profit needs, the investor will liquidate his long position, or sell his stock. This would officially be known as a long sale of stock, though few people in the securities business use the label “long sale”. This is the manner in which the above investor had made a profit is the traditional method used; buy low, sell high.

Let’s look at an actual investment in General Motors to investigate this principle further. A medical investor has taken a long position in 100 shares of General Motors stock at a price of $70 per share. This means that the manner in which he can do that is by placing a market order which will be executed at the best “available market price at the time, or by the / placing of a buy limit order with a limit price of $70 per share. The investor firmly believes, on the basis of reports that he has read about the automobile industry and General Motors specifically, that at $70 a share, General Motors is a real bargain. He believes that based on its current level of performance, it should be selling for a price of between $80 and $85 per share. But, the doctor investor has a dilemma. He feels certain that the price is going to rise but he cannot watch his computer, or call his broker, every hour of every day. The reason he can’t watch is because patients have to be seen in the office. The only people who watch a computer screen all day are those in the offices of brokerage firms (stock broker registered representatives), and doctor day traders, among others.

In the above example, with a sell limit order, if the doctor investor was willing to settle for a profit of $12 per share, what order would he place at this time? If you said, “sell at $82 good ’til canceled”, you are correct. Why GTC rather than a day order? Because our doctor investor knows that General Motors is probably not going to rise from $70 to $82 in one day. If he had placed an order to sell at $82 without the GTC qualification, his order would have been canceled at the end of this trading day. He would have had to re-enter the order each morning until he got an execution at 82. Marking the order GTC (or open) relieves him of any need to replace the order every morning. Several weeks later, when General Motors has reached $82 per share in the market, his order to sell at 82 is executed. The medical investor has bought at 70 and sold at 82 and realized a $12 per share profit for his efforts.

Let’s suppose that the medical investor, who has just established a $12 per share profit, has evaluated the performance of General Motors common stock by looking at the market performance over a period of many years. Let’s further assume that the investor has found by evaluating the market price statistics of General Motors is that the pattern of movement of General Motors is cyclical. By cyclical, we mean that it moves up and down according to a regular pattern of behavior. Let’s say the investor has observed that in the past, General Motors had repeated a pattern of moving from prices in the $60 per share range as a low, to a high of approximately $90 per share. Further, our investor has observed that this pattern of performance takes approximately 10 to l2 months to do a full cycle; that is, it moves from about 60 to about 90 and back to about 60 within a period of roughly l2 months. If this pattern repeats itself continually, the investor would be well advised to buy the stock at prices in the low to mid 60’s hold onto it until it moves well into the 80’s, and then sell his long position at a profit. However, what this means is that our investor is going to be invested in General Motors only 6 months of each year. That is, he will invest when the price is low and, usually within half a year, it will reach its high before turning around and going back to its low again. How can the doctor investor make a profit not only on the rise in price of General Motors in the first 6 months of the cycle, but on the fall in price of General Motors in the second half of the cycle? One technique that is available is the use of the short sale.

The Short Sale

If a doctor investor feels that GM is at its peak of $ 90 per share, he may borrow 100 shares from his brokerage firm and sell the 100 shares of borrowed GM at $ 90. This is selling stock that is not owned and is known as a short sale. The transaction ends when the doctor returns the borrowed securities at a lower price and pockets the difference as a profit. In this case, the doctor investor has sold high, and bought low.

Odd Lots

Most of the thousands of buy and sell orders executed on a typical day on the NYSE are in 100 share or multi-100 share lots. These are called round lots. Some of the inactive stocks traded at post 30, the non-horseshoe shaped post in the northwest corner of the exchange, are traded in 70 share round lots due to their inactivity. So, while a round lot is normally 700 shares, there are cases where it could be 10 shares. Any trade for less than a round lot is known as an odd lot. The execution of odd lot orders is somewhat different than round lots and needs explanation.

When a stock broker receives an odd lot order from one of his doctor customers, the order is processed in the same manner as any other order. However, when it gets to the floor, the commission broker knows that this is an order that will not be part of the regular auction market. He takes the order to the specialist in that stock and leaves the order with the specialist. One of the clerks assisting the specialist records the order and waits for the next auction to occur in that particular stock. As soon as a round lot trade occurs in that particular stock as a result of an auction at the post, which may occur seconds later, minutes later, or maybe not until the next day, the clerk makes a record of the trade price.

Every odd lot order that has been received since the last round lot trade, whether an order to buy or sell, is then executed at the just noted round lot price, the price at which the next round lot traded after receipt of the customer’s odd lot order, plus or minus the specialist’s “cut “.  Just like everything else he does, the specialist doesn’t work for nothing. Generally, he will add 1/8 of a point to the price per share of every odd lot buy order and reduce the proceeds of each odd lot sale order by 1/8 per share. This is the compensation he earns for the effort of breaking round lots into odd lots. Remember, odd lots are never auctioned but, there can be no odd lot trade unless a round lot trades after receipt of the odd lot order.

Conclusion

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Hurdle Rates V. Highwater Marks V. Claw Back Provisions

More on Hedge Funds and Fees

dem-2By Dr. David Edward Marcinko MBA MEd CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

Many physicians and other investors — even those that meet net worth guidelines — are surprised to learn that there exists a $500 – 999 billion, or more, alternative investment industry that is not generally marketed to the public. Such alternative investments have also been known as hedge funds or private investment funds.

Unlike mutual funds, these alternative investments can be structured in a wide variety of ways. Because of the very same regulations discussed above, these funds cannot be advertised, but they are far from illegal or illicit.

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History

In fact, physicians were among the most significant early investors in one of the last century’s most successful hedge funds. Mr. Warren Buffett, Chairman of Berkshire Hathaway, Inc. and a legendary investor got his start in 1957 running the Buffett Partnership, an alternative investment fund not open to the general public. Mr. Buffett’s first public appearance as a money manager was before a group of physicians in Omaha, Nebraska. Eleven decided to put some money with him. A few of these original investors followed him into Berkshire Hathaway, now among the most highly valued companies in the world.

The alternative investment, or hedge, funds of today are similar to the original Buffett Partnership in many ways. So, we will discuss several unique terms which potential investors should be aware.

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Hurdle Rate

Hedge funds may feature a hurdle rate as part of the calculation of the fund manager’s performance incentive compensation. Also known as a “benchmark,” the hurdle rate is the amount, expressed in percentage points, an investor’s capital account must appreciate before the account becomes subject to a performance incentive fee. Potential medical investors should view the hurdle rate as a form of protection in context with other features of the fee arrangement.

The hurdle rate, which benchmarks a single year’s performance, may be considered mutually exclusive of any other year, or the hurdle rate may compound each year. The former case is more common. In the latter case, a portfolio manager failing to attain a hurdle rate in the first year will find the effective hurdle rate considerably higher during the second year.

Once a fund manager attains the hurdle rate for an investor, the medical investor’s capital account may be charged a performance incentive fee only on the performance above and beyond the hurdle rate. Alternatively, the account may be charged a performance fee for the entire level of performance, including the performance required to attain the hurdle rate. Other variations on the use of the hurdle rate exist, and are limited only by the contract signed between the fund manager and the investor. The hurdle rate is not generally a negotiating point, however.

Example:

A fund charges a performance fee with a 6 percent hurdle rate, calculated in mutually exclusive manner. Dr. Lanouettea, a radiologist investor places $100,000 with the fund. The first year’s performance is 5 percent. The investor therefore owes no performance fee during the first year because the portfolio manager did not attain the hurdle rate. During year two, the portfolio manager guides the fund to a 7 percent return. Because the hurdle rate is mutually exclusive of any other year, the portfolio manager has attained the 6 percent hurdle rate and is entitled to a performance fee.

Highwater Mark

Some funds feature a highwater mark provision, also known as a ”loss-carryforward” provision. As with the hurdle rate, potential investors should consider the highwater mark a form of protection. A high water mark is an amount equal to the greatest value of an investor’s capital account, adjusted for contributions and withdrawals. The high water mark ensures that the hedge fund manager charges a performance incentive fee only on the amount of appreciation over and above the highwater mark set at the time the performance fee was last charged. The current trend is for newer funds to feature this highwater mark, while older, larger funds may not feature it.

Example:

A fund charges a 20 percent performance fee with a highwater mark but no hurdle rate. Dr. Butalak, a dentist investor contributes $100,000 to the fund. During the first year, the hedge fund manager grows that capital account to $110,000 and charges a 20 percent performance fee, or $2,000. The ending capital account balance and highwater mark is therefore $108,000. During year two, the account falls back to $100,000, but the highwater mark remains $108,000. During year three, in order for the manager to charge a performance fee, the manager must grow the capital account to a level above $108,000.

Clawback Provision

Rarely, a fund may provide investors with a clawback provision. This term, borrowed from the venture capital fund world, such provisions result in a refund to the investor of all or part of a previously charged performance fee if a certain level of performance is not attained in subsequent years. Such refunds in the face of poor or inadequate performance may not be legal in some states or under certain authorities.

Conclusion

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DAILY UPDATE: +/- Stocks and Dull Market Reviews

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

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What’s up

What’s down

  • Victoria’s Secret shares dropped 6.37% even though the company met both earnings and revenue estimates this quarter. It’s still mid-turnaround, however, and high debt remains a concern for investors.
  • Big Lots shares tanked 18.32% after the company announced abysmal earnings thanks to core customers cutting back their spending.
  • Canopy Growth shares dropped 8.45% after the marijuana producer announced plans to sell more shares in order to keep the company afloat.
  • Five Below shares fell 10.60% after announcing unimpressive earnings as low-income customers get squeezed by inflation.
  • Nio shares dropped 6.92% after the EV maker announced slower earnings than anticipated thanks to the ongoing decline in EV sales.

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Here’s where the major benchmarks ended:

  • The S&P 500 index fell 1.07 points (0.02%) to 5,352.96; the Dow Jones Industrial Average® ($DJI) gained 78.84 points (0.2%) to 38,886.17; the NASDAQ Composite eased 14.78 points (0.1%) to 17,173.12.
  • The 10-year Treasury note yield (TNX) fell slightly to 4.285%.
  • The CBOE Volatility Index® (VIX) declined 0.05 to  12.58.

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DAILY UPDATE: D-Day, Digital Health, Stock Companies as Markets Zoom Up!

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Today is the 80th anniversary of D-Day: More than 60 World War II veterans flew to Paris over the weekend to take part in what organizers believe could be the final major WWII commemoration involving living veterans. American veterans will be joined by President Joe Biden and other heads of state in Normandy.

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The digital health market has had a tough year, with no IPOs in all of 2023. Comparatively, the industry saw roughly 20 public exits in 2021. The recent slowdown in the broader IPO market is linked to several trends, including high interest rates and some high-profile bankruptcies, according to Adriana Krasniansky, head of research at digital health strategy group and venture fund Rock Health’s advisory arm.

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 62.69 points (1.2%) to 5,354.03; the Dow Jones Industrial Average® ($DJI) gained 96.04 points (0.3%) to 38,807.33; the NASDAQ Composite rallied 330.86 points (2.0%) to 17,187.90.
  • The 10-year Treasury note yield (TNX) fell more than 5 basis points to 4.283%, its lowest level since April 1.
  • The CBOE Volatility Index® (VIX) declined 0.53 to 12.63.

What’s up

  • Nvidia only rose 5.16% today, but it was enough to surpass Apple’s market cap, making the high-flying semiconductor stock the second most valuable public company in the US.
  • Crowdstrike rose 11.98% today after reporting better than expected fiscal first quarter earnings yesterday afternoon.
  • Guidewire Software rose 17.63% today after its beat & raise quarterly report late yesterday.
  • Stitch Fix rose 29.40% after a red-hot earnings report, completely turning around the stock’s slow slide downward this year.
  • SweetGreen popped 12.76% this afternoon after revealing that its new automated kitchens can actually save on costs and cut time for orders in the long run.

What’s down

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In case you needed more proof that we’re living in the strangest timeline: Morgan Stanley, which owns E*Trade, is contemplating kicking stock influencer Roaring Kitty off the platform. It’s concerned he manipulated GameStop stocks by…posting a meme on X. (the Wall Street Journal)

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DAILY UPDATE: The Peso, Health Company News with Firmer Stock Markets

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Sword Health, a virtual provider of musculoskeletal care, banked a financing round of $130 million after nearly tripling its revenue in the past year.


Blue Cross and Blue Shield of Kansas City is leaving the Medicare Advantage market, citing increased regulatory demands and a relatively small MA membership.


And … Cigna laid off 261 employees from its Evernorth Care Group division in Arizona. Keep up to date with all workforce updates with Fierce Healthcare’s ongoing layoff tracker.

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On Monday, the largest U.S.-traded, Mexico-focused fund — the iShares MSCI Mexico ETF which has more than $2 billion under management — slid 10.7% to book its largest daily percentage decrease since March 16th, 2020. Meanwhile, the Franklin FTSE Mexico ETF was off 10%, also logging its worst day in over four years, according to Dow Jones Market Data. The two funds, which traded at $57.93 and $28.78, respectively, on Monday afternoon, closed at their lowest levels since early November, according to Dow Jones Market Data. 

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June got off to a rough start on Monday when a glitch at the NYSE incorrectly made it appear that some stocks suffered steep plunges—including a 99% dip in Berkshire Hathaway. Trading in the affected stocks was quickly halted and the errors were fixed.

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What’s up

What’s down

  • Stanley Black & Decker fell 3.69% after it was downgraded at Barclays. A slowdown in consumer spending plus a slow housing market means not many people are buying fancy drills at the moment.
  • Bath & Body Works fell 12.60% after beating analyst expectations this quarter but announcing that next quarter will bring lower lower earnings.
  • Designer Brands fell 20.27% after it beat revenue expectations but missed on earnings as its turnaround continues.

Here’s where the major benchmarks ended:

  • The S&P 500 index gained 7.94 points (0.2%) to 5,291.34; the Dow Jones Industrial Average® ($DJI) added 140.26 points (0.4%) to 38,711.29; the NASDAQ Composite® ($COMP) rose 28.38 points (0.2%) to 16,857.05.
  • The 10-year Treasury note yield (TNX) fell more than 7 basis points to 4.328%.
  • The CBOE Volatility Index® (VIX) rose 0.05 to 13.16.

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PHYSICIANS: Is $2.5 Million “Really” Enough to Retire at Age 65?

By Staff Reporters

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Is $2.5 Million Really Enough to Retire?

A retirement nest egg of $2.5 million can likely produce an annual income of $100,000 for as long as you are likely to live. This is using the 4% withdrawal rate many financial advisors consider standard. After starting with the first withdrawal of 4% of the total, the annual withdrawal will adjust for inflation. For example, if inflation runs at the target 2% rate of federal policymakers, during retirement the retiree will withdraw:

$100,000

in the first year

$102,000

in the second year

$104,040

in the third year and so on …

According to this model and conventional wisdom, a 4% withdrawal rate will allow a portfolio to last for at least 30 years. This would permit a 65-year-old retiree to maintain consistent purchasing power until age 95 and beyond.

For most retirees, this will likely be adequate to maintain a satisfying standard of living. Only about 3% of 2,000 retirees surveyed by the Employee Benefit Research Institute in 2022 spent $7,000 or more per month, equivalent to $84,000 in annual spending.

This model does not include a number of other factors. For instance, nearly all retirees are eligible for Social Security. For 2023, the maximum monthly Social Security benefit for people who claim benefits at full retirement age is $3,627. That’s equal to more than half the spending of the top 3% of retirees surveyed by EBRI. And, like the standard withdrawal rate, Social Security benefits are indexed to inflation.

5 Variables for Retiring With $2.5 Million at Age 65

While $2.5 million could seem like enough to retire at 65, many factors could change the outlook.

1. Unexpected Healthcare Costs

The Fidelity Retiree Health Care Cost Estimate suggests an average 65-year-old couple could need (approximate, after taxes):Unexpected Healthcare Costs

This assumes both spouses are enrolled in traditional Medicare, which between Medicare Part A and Part B covers expenses such as hospital stays, doctor visits and services, physical therapy, lab tests and more, and in Medicare Part D, which covers prescription drugs.

This figure does not include long-term care (“custodial care”), most dental care, eye exams and more, so your estimated healthcare costs in retirement could be considerably more.

2. Inflation

Inflation can powerfully influence retirees’ financial well-being. When inflation occurs, it reduces the purchasing power of money withdrawn from your retirement account. You can increase withdrawals to maintain purchasing power, but this risks more quickly depleting your savings.

3. Market Downturns

Inflation isn’t the only cause of market downturns. Business cycles and financial crises can exaggerate normal fluctuations in stock market valuations. If you’re selling investments to generate income for living expenses, you may want to sell more if valuations are down.

4. Longevity

While living a long life is positive, you could outlive the money you’ve saved for retirement. Many financial planners use life expectancy to age 95 or 100 when developing plans for funding retirement.

The Social Security Administration says an average 65-year-old male can live to age 83, while the average woman can live to age 86. However, people in their 80s and 90s also generally reduce their spending, with the exception of healthcare costs.

5. Estate Planning

Retiring at 65 with $2.5 million likely involved generating high income and savings, so there’s a chance you could have assets to pass on. With estate planning, adding members of your family as beneficiaries for homes you paid off with a mortgage may have long-term positives.

You may also want to think about any additional income streams. For example, if you own a medical practice or business, you may want to add your family as a beneficiary so they can decide to keep the business running or sell it.

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SUNK COSTS: The Fallacy

By Staff Reporters

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A common term in business, the sunk cost fallacy applies to our choices and activities made daily.

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A sunk cost fallacy is a simple logical fallacy that means sticking with a losing or failed venture or activity because you have already invested considerable time, energy, money, or other things you can’t get back. It’s the idea that because you already have incurred costs, you stick with it to  “get your money’s worth.”

The sunk cost fallacy differs from other logical fallacies because it’s not a rhetorical fallacy. You may also experience a discussion with a “red herring” or “straw man” fallacy with someone. But the sunk cost fallacy is an illogical choice as a way to justify to yourself why you keep doing something.

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DAILY UPDATE: Cyber Health Hacks, DocGo, Public Companies and Mixed Stock Markets

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Dollar General has ended a pilot program with mobile care provider DocGo, becoming the latest retailer to wind down primary care operations, spokespeople from both companies confirmed to Healthcare Brew on May 31st. The retail giant—the largest in the US by number of stores—began the healthcare partnership in 2023 after announcing ambitions to establish itself as a “health destination” two years prior. DocGo and Dollar General offered mobile health clinics with basic, preventive, and urgent care services at three stores in Tennessee. Dollar General executives previously said in a June 2023 press release that they would expand the DocGo pilot program to more stores.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 5.89 points (0.1%) to 5,283.40; the Dow Jones Industrial Average® ($DJI) lost 115.29 points (0.3%) to 38,571.03; the NASDAQ Composite® ($COMP) advanced 93.65 points (0.6%) to 16,828.67.
  • The 10-year Treasury note yield (TNX) declined more than 11 basis points to 4.40%, near a two-week low.
  • The CBOE Volatility Index® (VIX) rose 0.19 to 13.11.

🟢 What’s up?

What’s down?

  • GSK dropped 8.65% on the news that a Delaware court will allow scientific evidence to be heard in a series of lawsuits regarding the discontinued heartburn drug Zantac.
  • Boston Beer fell 3.25% after shareholders decided to take their winnings and run following Friday’s big pop after news of its apparent acquisition by Suntory.
  • Tractor Supply shares toppled 6.21%, likely on poor manufacturing news from the ISM Index, while Halliburton shares fell 5.34%, likely on poor oil news from OPEC+.
  • Dozens of Mexican stocks and ETFs tumbled today on the election of a new president. The steepest decline was seen by Grupo Financiero Banorte, SAB, which fell 11.38%.

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Cyberattacks around the country are wreaking havoc on the ground at targeted hospitals, but a new study shows that security breaches hurt surrounding providers, too. The research published in JAMA on May 29 found that cyberattacks led to a decrease in emergency department (ED) visits at attacked hospitals and an increase in ED patients at nearby hospitals.

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DAILY UPDATE: Jobs, Chips, Banks and Tax Refunds

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Stat: 4.6%. That’s how much the average income tax refund increased YoY, from $2,878 in April 2023 to $3,011 as of April 5th. (Axios)

Quote: “Wall Street has never been known for high character and high values. Is there a willingness to support Trump if it looks like he’s on the right track? Yes. I’m not proud of that, and I’m not part of that either.”—Dan Lufkin, co-founder of investment bank Donaldson, Lufkin & Jenrette (Bloomberg)

Read: Bank of America’s CEO sees an overall cautiousness on display in the current spending choices of consumers and businesses. (CNBC)

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The May jobs report will drop on Friday: Little change is expected from April, when the unemployment rate ticked up to 3.9% and fewer jobs were added than expected (175,000). This jobs report will be one of the final pieces of economic data to drop before the Fed meets on June 11th and 12th. The central bank is unlikely to announce an interest rate cut.

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Software is no longer eating the world. For the first time, chip stocks now account for the heaviest weighting in the S&P 500, taking the top spot away from software companies last week. Salesforce and other enterprise software giants are getting crushed as companies prioritize generative AI investments (chips and servers) over SaaS products.

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Financial “Planning” versus Financial “Preparing”

Understanding the Difference

By Rick Kahler CFP®

Retirement planning is one of the issues that commonly lead clients to consult financial advisers.

One of its essential aspects is creating a plan to save and invest in order to provide a comfortable retirement income. Ideally, this starts many years ahead of retirement, even as early as your first paycheck.

As retirement comes closer, planning for it expands to take in a host of other considerations, such as deciding when to retire, where to live, and what kind of lifestyle you hope to have. When retirement becomes a reality, the focus shifts to carrying out the plan.

Preparing

All of this planning is crucial. Yet, for both financial advisers and clients, it’s good to keep in mind that planning has its limits. In the post-retirement years, it may be helpful to think in terms of preparing for old age rather than planning for it.

The older we get, the more important this distinction between planning and preparing becomes. Too many life-changing things can happen without regard to our best-laid plans. Often they occur unexpectedly, resulting in emergency situations where urgent decisions have to be made. A stroke or a fall, a diagnosis of terminal illness, a broken hip that leaves someone unable to go back to independent living—and suddenly, right now, the family needs to find an assisted living facility, arrange for live-in help, or sell a home.

What are some of the ways to prepare for these contingencies?

  1. Explore housing options well ahead of time. Find out what assisted living, home care, and nursing home services and facilities are available where you live and whether they have waiting lists. Have family conversations about possibilities like relocating or sharing households:
  2. Research the financial side of these options. Investigate the cost of hiring help at home, assisted living facilities, and nursing care centers. Find out what is and is not covered by Medicare and long-term care insurance. For example, people are sometimes surprised to learn that Medicare does not pay for nursing home care other than short-term medical stays.
  3. Designate someone to take over decision-making, and do the paperwork. Execute documents like a living will, medical power of attorney, and contingent power of attorney. Update them as necessary, and give copies to your doctors, your financial planner, and appropriate family members.
  4. Start relatively early to downsize. Well before you’re ready to let go of possessions or move into smaller housing, start considering what to do with your “stuff.” Focus on the decisions rather than the distribution. There’s no need to get rid of possessions prematurely, but decide what you want to do with them—and put in writing. Do this while it’s still your choice, rather than something your family members do while you’re in the hospital or nursing home
  5. Do your best to practice flexibility and acceptance. No matter how strongly you want to live in your own home until the end of your life, for example, it may not be possible. The physical limitations of aging can limit our choices, and even the best options available may not be what we would like them to be. It is a profound gift to yourself and your family members to accept these realities with as much grace as you can muster.

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Assessment

Finally, please don’t underestimate the importance of planning financially for retirement. Because the bottom line is that you can’t plan for all the things that might happen as you age, but you can prepare to deal with them. One of the most useful tools to cope with those contingencies is having enough money.

Conclusion

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OFTEN NEEDED: A Business, Medical Management or Financial SECOND Opinion?

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When You May Need a Business, Management or Financial Second Opinion?

The Marcinko & Associates second opinion service is a physician-to-advisor telephone or e-mail portal that connects independent financial and business management professionals and consultants, with doctors or healthcare executives desiring affordable and unbiased financial or business advice on an as-needed, pay-per-use basis.

Medical professionals and healthcare executives can now receive direct access to us in the areas of Practice Enhancement, Investing, Financial Planning, Asset Allocation, Portfolio Management, Insurance, Mortgage and Lending, Practice Management, Information Technology, Human Resources and Employee Benefits.

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DAILY UPDATE: Mixed Stock Markets with DJIA Up

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Here’s where the major benchmarks ended:

  • The S&P 500 index added 42.03 points (0.8%) to 5,277.51, down 0.5% for the week; the Dow Jones Industrial Average® ($DJI) gained 574.84 points (1.5%) to 38,686.32, down 1.0% for the week; the NASDAQ Composite® ($COMP) declined 2.06 points (0.01%) to 16,735.02, down 1.1% for the week. 
  • The 10-year Treasury note yield (TNX) fell more than 6 basis points to 4.491%.
  • The CBOE Volatility Index® (VIX) declined 1.55 to 12.92.

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🟢 What’s up

  • Gap popped 27% after the retail conglomerate raised its guidance for the year and sales for all four of its brands beat earnings expectations.
  • Caesars jumped 12% because of the Carl Icahn effect: The investor reportedly acquired a “sizeable stake” in the casino company, per Bloomberg.
  • The Boston Beer Company shares gained 21% on reports that the company may sell itself to Suntory.
  • Ambarella leapt 20% after better-than-expected earnings for the semiconductor company.
  • PENN Entertainment jumped 20% today after an activist investor called for a sale of the company.

What’s down

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Private equity and consolidation are leading to a rise in hospital costs for patients. (the Wall Street Journal)

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The Hemline Stock Market Index

What’s Up?

[By staff reporters]

According to Wikipedia, the hemline index is a theory presented by economist George Taylor in 1926. The theory suggests that hemlines on women’s dresses rise along with stock prices.

In good economies, we get such results as miniskirts (as seen in the 1920s and the 1960s), or in poor economic times, as shown by the 1929 Wall Street Crash, hems can drop almost overnight.

Non-peer-reviewed research in 2010 supported the correlation, suggesting that “the economic cycle leads the hemline with about three years”.

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Conclusion

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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DAILY UPDATE: Hospital Charges, Cannabis and Stocks as Markets Slump

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The prices hospitals charge for their services have long been opaque, but thanks to a 2021 hospital price transparency law, the picture is starting to come slightly into focus. And it turns out, there are some huge disparities in the prices hospitals charge that can’t be attributed to quality of care, according to a recent study from research institute Rand Corporation.

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🟢 What’s up

What’s down

  • Salesforce is down 19.73% after the cloud computing company missed revenue estimates for the first time since 2006 and projected slower sales in the coming quarter. Turns out not even commercials featuring hunky Matthew McConaughey could save the company’s quarter.
  • UIPath shares plummeted 34.06% after announcing disappointing results and lower forward guidance, and to add insult to injury got hit with an analyst downgrade from Bank of America.
  • Build-A-Bear Workshop got the stuffing knocked out of it, dropping 13.92% after it missed estimates on both the top and bottom lines.
  • Hormel sank 9.69% after missing earnings thanks to slower retail sales offsetting higher meat prices, leaving shareholders stuck eating bologna sandwiches for lunch.
  • Kohl’s dropped 22.88% in its worst day ever after the company announced a terrible quarter and forecast more issues ahead due to customers contending with inflation.

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 31.47 points (0.6%) to 5,235.48; the Dow Jones Industrial Averagedropped 330.06 points (0.9%) to 38,111.48; the NASDAQ Composite® ($COMP) declined 183.50 points (1.1%) to 16,737.08.
  • The 10-year Treasury note yield (TNX) lost more than 7 basis points to 4.548%.
  • The CBOE Volatility Index® (VIX) rose 0.19 to 14.47.

Interest-rate-sensitive sectors including banks and utilities were among the stronger performers Thursday, boosted by a pullback in Treasury yields from four-week highs posted earlier in the week. Stocks are still heading for a down week, with the S&P 500 on track for its first weekly decline out of the past six.

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

Legal cannabis is a booming industry: An estimated $38.4 billion in medical and recreational cannabis was sold in the US in 2023, and that figure is projected to rise to $56.9 billion by 2028. The industry has grown an average of 29.1% per year between 2018 and 2023, according to IBISWorld.

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OMAHA: Breakfast Meeting 2024

By Vitaliy Kensenelson CFA

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Breakfast in Omaha Meeting 2024 – Session One
While I was in Omaha attending the BRK annual meeting, I hosted Q&A sessions for my readers. Due to high reader interest, what started out as a simple breakfast get-together turned into two breakfast sessions and an afternoon session. We had so much interest that we were still unable to accommodate all of our readers – we had 200 folks on the waiting list.

I was exhausted, but I really enjoyed answering questions and meeting readers. The upside of this is that we have three video recordings.

Over the next three weeks, I will share the videos from each session. For those who prefer to read, I will also include a lightly edited full transcript.

For those who don’t have the time to read 15 pages or watch an hour-long video, I’ll include my favorite excerpts from each session.

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DAILY UPDATE: Physician Salary, Consumer Confidence, Company Stocks and Slumping Markets

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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

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

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

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Daily Update Provided By Staff Reporters Since 2007.
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Doctors Saw a 6% Boost in Pay in 2023

After several years of modest or declining growth, the average pay for doctors jumped 5.9% in 2023, rebounding from a decline of 2.4% in 2022. Most medical specialties experienced positive growth in 2023, with the top 10 seeing annual growth rates exceeding 7%, according to the 2024 Physician Compensation Report from professional medical network Doximity.

However, inflationary pressures continue to impact physicians’ real income. According to the American Medical Association, when adjusted for inflation, Medicare physician payment has dropped 26% since 2001. Doximity’s compensation data draw from nearly 150,000 survey responses over five years, including responses from more than 33,000 U.S. physicians in 2023 alone.

Source: Heather Landi, Fierce Healthcare [5/23/24]

Economic Summary

  • The S&P 500 has risen 23 of the last 30 weeks, according to Deutsche Bank, and rose slightly today as well. Meanwhile, the NASDAQ closed at a record high yesterday after tech companies across the board rose, while the Dow dropped over 200 points.
  • Treasury prices fell and yields rose after two weaker-than-expected auctions saw soft sales of 2-year and 5-year bonds.
  • Gold prices slipped 5% last week after falling four days in a row, but the key commodity kicked off this week with a win. With key PCE data coming out on Friday that could send the market soaring or tanking, investors are hedging their bets with the shiny yellow metal.
  • Bitcoin fell as Mt. Gox made good with its creditors a decade after being hacked, while ethereum sank as traders continued to lock in gains from the SEC’s dramatic ruling last week.
  • The S&P 500® index (SPX) fell 39.09 points (0.7%) to 5,266.95; the Dow Jones Industrial Average lost 411.32 points (1.1%) to 38,441.54; the NASDAQ Composite® ($COMP) shed 99.30 points (0.6%) to 16,920.58.
  • The 10-year Treasury note yield climbed more than 7 basis points to 4.614%.
  • The CBOE Volatility Index® (VIX) rose 1.38 to 14.30.

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

Consumer confidence rose for the first time in four months

Americans are unexpectedly feeling better about the economy this month: Per the Conference Board’s monthly index, US consumer sentiment rose from 97.5 in April to 102 in May, smashing economists’ estimates. Meanwhile, the expectations index, which measures the short-term outlook for income and other labor market conditions, increased the most since July. However, the report showed that Americans remain worried about inflation and interest rates. Despite their mixed feelings about the economy, Americans continue to spend vigorously on travel. The TSA set a record for most travelers screened in a single day last Friday.

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

STOCKS UP:

Dick’s Sporting Goods rose 15.86% to a new all-time high today after the company reported impressive earnings and a strong outlook.

STOCKS DOWN:

American Airlines shares fell 13.54% after the company cut its guidance for the second quarter. Southwest Airlines fell 3.83%, and Delta Air Lines fell 0.74%.

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DAILY UPDATE: Citigroup, CBO, CFPB, Spiked Treasury Yields and the Mixed Stock Markets

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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

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

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

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

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Stat: $78 million. That’s the fine levied against Citigroup for an accidental, “fat finger” trade that momentarily erased $322 billion in market value in the European stock markets. (Business Insider)

Quote: “The CFPB wants to make sure that these new competitive offerings are not gaining an advantage by sidestepping the rights and responsibilities enshrined under the law.”Rohit Chopra, director of the Consumer Financial Protection Bureau, on the CFPB’s decision to treat “buy now, pay later” apps as credit cards.

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

Here’s where the major benchmarks ended yesterday:

  • The S&P 500® index (SPX) rose 1.32 points (0.02%) to 5,306.04; the Dow Jones Industrial Average® ($DJI) lost 216.73 points (0.6%) to 38,852.86; the NASDAQ Composite gained 99.09 points (0.6%) to 17,019.88.
  • The 10-year Treasury note yield jumped almost 7 basis points to 4.54%.
  • The CBOE Volatility Index® (VIX) rose 0.55 to 12.91.

Financial shares were among Tuesday’s weakest performers, reflecting ideas elevated interest rates could burden bank margins. The KBW Regional Bank Index (KRX) sank 1% to its lowest close since April 30. Biotechnology and health care sectors were also under pressure.

In other markets, WTI Crude Oil (/CL) futures jumped more than 3% and ended at a four-week high above $80 per barrel ahead of next weekend’s OPEC meeting, which is expected to end with no change to the cartel’s production levels.

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

House Committee Chair Jodey Arrington (R-Texas) said that site-neutral payment policy is the “most obvious” solution amid supportive testimonies from partisan think-tanks, the Congressional Budget Office and a practicing independent physician. 

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