BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on April 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
Essay on the Eight-Hundred Pound Gorilla in the Medical Treatment Room
By Dr. David E. Marcinko MBA MEd CMP
[Editor-in-Chief]
According to economist Austin Frakt PhD, and others, there is a school of thought that says Congress is incapable of controlling costs in the Medicare and Medicaid System [CMS].
And, then there is the reality known by all practicing medical professionals regardless of specialty orientation or degree designation. That is to say, CMS really can control healthcare costs and with great ferocity and efficiency, and to non-public sectors as well …. PARADOXICAL?
On Getting What You Wish For
Blogger Ezra Klein opines that one of the dirty little secrets of the health-care system is that Medicare has done a much better job controlling costs than private health insurers.
Of course, we doctors know that the real problem is that Medicare seemingly [think Seinfeld’s character George Costanza] controls costs all too well; but not really. It is just that CMS pays doctors too little and thus it appears costs are controlled. What really is happening is that physician fees are being reduced carte’ blanche.
Nevertheless, and regardless of semantics, CMS will never control costs much more efficiently than private insurance companies or doctors will simply abandon Medicare for related payment models like direct reimbursement or concierge medicine. This is happening right now. Physicians, osteopaths and podiatrists etc, are opting out of Medicare in increasingly large numbers. In a world where there’s only Medicare and Medicare to control costs, doctors can either take the pay cut or stop seeing patients, and stop being doctors. “Taking what they are given – because they’re working for a livin.”
So sorry that this seems like a forehead-palm moment for Ezra, but not for healthcare practitioners or the ME-P!
Too Much Demand Elsewhere
And, as we see from other countries, many young bright folks want to be doctors, even if being a doctor doesn’t make one particularly wealthy [high demand and high eventual supply produces lower provider costs in the long term?]. Think medical tourism.
Not so much the case anymore in this country [lower demand and lower eventual supply produces higher reimbursement costs to the doctor survivors in the very long term?].
Our Domestic World
But, we are not elsewhere. In fact, in our present domestic healthcare ecosystem, when Medicare decides to control costs, many doctors can simply stop accepting Medicare patients, and the politicians will lose their jobs. One political party then declares that Medicare is rationing and will hurt senior citizens. The other party capitulates and pays MDs more [SGR]. Then, the federal budget looks bad as it does now. The circle is complete when one party asserts that Medicare actually can’t contain costs but the private insurance companies will. It all fails, in an unending circular Boolean-like loop of illogic.
Listen Up!
So, listen up AARP, politicians, CMS and seniors as I admonish you to be careful what you wish for [medical cost controls]. It might just come true. As Ezra rightly says; rinse, repeat – rinse, repeat – ad nausea. You simply can’t have it both ways. You either choose to spend less and offend certain cohorts, or spend more and offend different factions. Either way, you’re going to piss someone off. A good healthcare reimbursement system would try to make that decision rationally [a-politically]. But, at least it would make an economics driven decision; wouldn’t it?
Assessment
Is CMS really the eight hundred pound cost-controlled gorilla in the increasingly large Medicare treatment room? Why or why not? Now, relative to the ACA of 2010, please read: The Case for Public Plan Choice in National Health Reform [Key to Cost Control and Quality Coverage], by Jacob S. Hacker, PhD. Link:Jacob Hacker Public Plan Choice
Conclusion
And so, your thoughts and comments on this ME-P are appreciated. Do we have a Medicare cost control efficiency paradox? Or, are the economists just reveling in the publication banal? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
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The paradox of thrift (saving) states that an increase in autonomous saving leads to a decrease in aggregate demand and thus a decrease in gross output which will in turn lower total saving. The paradox is that total saving may fall because of individuals’ attempts to increase their saving, and, broadly speaking, that increase in saving may be harmful to an economy.
Both the narrow and broad claims are paradoxical within the assumption underlying the fallacy of composition, namely that which is true of the parts must be true of the whole. The narrow claim transparently contradicts this assumption, and the broad one does so by implication, because while individual thrift is generally averred to be good for the economy, the paradox of thrift holds that collective thrift may be bad for the economy.
Posted on April 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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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.
Costco started selling gold bars to its members last August, and Wells Fargo analysts believe that the product is now bringing in between $100 million and $200 million a month. The retailer doesn’t reveal the price of the 1-ounce bullion to nonmembers online, but it’s estimated to be ~2% above the spot price gold trades at, per CNBC—and that price has soared since Costco got into the gold game. The price of gold has gone up 13% this year and reached record highs as investors pile in amid inflation worries.
The big numbers from the Consumer Price Index data released on Thursday
In March, inflation rose 3.5% from the year before, up from 3.2% in February.
The “core” CPI reading, which excludes volatile food and fuel prices, came in even higher, rising 3.8% on an annual basis. That’s the same as in February, but this time it’s serious.
Half of the increases came from rising gas prices and housing.
After seeing inflation fall by 3% over the course of 2023, Fed officials believed that higher inflation readings in January and February 2024 represented a hiccup in an otherwise downward trajectory. However, with the March reading also coming in hotter than anticipated, analysts say this is more than a fluke. That means hopes for a June interest rate cut are dashed. Even the US Postal Service plans to raise the price of “forever” stamps to $0.73 in July. Get yours now. And the Mexican peso is on an absolute tear, leaving the US dollar behind.
The S&P 500® index (SPX) advanced 38.42 points (0.7%) to 5,199.06; the Dow Jones Industrial Average® ($DJI) lost 2.43 points to 38,459.08; the NASDAQ Composite gained 271.84 points (1.7%) to 16,442.20.
The 10-year Treasury note yield (TNX) rose nearly 2 basis points to 4.578%.
The CBOE Volatility Index® (VIX) fell 0.89 to 14.91.
Chip maker strength lifted the Philadelphia Semiconductor Index (SOX) more than 2% and extended the benchmark’s year-to-date gain to more than 17%. Communications services and transportation shares were also among the strongest sectors. Financial shares were mixed ahead of expected quarterly results Friday from some major banks including JPMorgan Chase (JPM), Citigroup (C), and Wells Fargo (WFC).
Posted on April 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
Paradox of Prosperity
“A paradox of prosperity is revealed and shown to be stable in the cycles of economic advancement between generations. I would put the matter this way: If one accepts, for example, that Mr. Brokaw’s ‘Greatest Generation’ were characterized by prudence, diligence, and patriotism in deed rather than word, that very generation produced its opposite in the generation that followed it. That is to say, I have found it repeated across the ages and across cultures, that the more diligent a previous generation, as a natural propensity, the more licentious the generation that follows. Invariably therefore, the generation that exhibits the more cogent properties of character for the best sort of citizenship fails to produce a generation of the same or similar characteristics.”
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“Paradox of Prosperity” was applied as a term of analysis in the recent New York Times, Wall Street Journal bestseller Rescue America: Our best America is only one generation away (published October 2011), which Professor Morris co-authored with Chris Salamone. There the inter-generational breakdown is given a fuller exposition. Morris, who has been a careful reader of Thorstein Veblen, particularly Veblen’s masterpiece The Theory of the Leisure Class, says his own advancement of this inter-generational thesis was influenced by Veblen. “I think”, says Morris, “Veblen gave some insight as to what is produced in the generation which follows one such as Tom Brokaw described. The Greatest Generations – if by that we mean a generation characterized by prudence and sacrifice – nearly always produces a generation which can be characterized as a leisure class. They consume without manufacturing. They project feelings over principles. In general terms, they lack a spirit of sacrifice because they abhor the notion of “Objective Values” and so lack the will to re-create or advance the social ethos created by their parent’s generation.” In cultural terms, the generation that followed the “Greatest Generation” were the baby boomers (essentially, the children of the Greatest Generation between 1945–1965). The “Boomers” fit the classic definition of a “leisure class”, which Veblen described as being characterized by Conspicuous Consumption. To quote their description of their leisure class “they move values toward behavior, rather than behavior toward values”.
Posted on April 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST– Today’sNewsletter
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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.
NEW YORK (Reuters) -The U.S. accounting watchdog on Wednesday said it has hit KPMG Netherlands with a $25 million civil penalty, a record for the regulator, in response to “egregious” and widespread exam cheating at the foreign affiliate of the major audit firm.
As millions of Americans approach age 66, they face the inevitable question, is it time to retire? The physician population is aging alongside the general population—more than 40% of physicians in the U.S. will be 65 years or older within the next decade. In the case of surgeons, there is little guidance on how to best ensure their competency throughout their career and at the same time maintain patient safety while preserving mature physician dignity.
It is a scenario playing out nationwide. From Oregon to Pennsylvania, hundreds of communities have in recent years either stopped adding fluoride to their water supplies or voted to prevent its addition. Supporters of such bans argue that people should be given the freedom of choice. The broad availability of over-the-counter dental products containing the mineral makes it no longer necessary to add to public water supplies, they say. The Centers for Disease Control and Prevention says that while store-bought products reduce tooth decay, the greatest protection comes when they are used in combination with water fluoridation.
More health systems are going to be opting out of Medicare Advantage (MA) plans, George Hill, a managing director at Deutsche Bank in Boston, predicted Monday at a “Wall Street Comes to Washington” webinar hosted by the Brookings Institution. “I think you’re going to see more large provider organizations threaten to opt out of networks, particularly as it relates to MA,” Hill said, adding that there are a number of reasons for this. “Prior authorizations are the problem, claims denials are a huge problem, delayed payments and rates are the problem — barriers in access to care in all varieties are the problem.”
The latest budget update from the nonpartisan Congressional Budget Office (CBO) found that the federal government has spent more on paying interest on the national debt than on the military in fiscal year 2024. The CBO’s budget report for March showed that the U.S. has spent $412 billion on military programs at the Department of Defense through the first half of FY-2024, according to preliminary figures from CBO and the Treasury Department.
Consumer price increases remained high last month, boosted by gas, rents, and car insurance, the government said Wednesday in a report that will likely give pause to the Federal Reserve as it weighs when and by how much to cut interest rates this year. Prices outside the volatile food and energy categories rose 0.4% from February to March, the same accelerated pace as in the previous month. Measured from a year earlier, these core prices were up 3.8%, unchanged from the year-over-year rise in February. The Fed closely tracks core prices because they tend to provide a good read of where inflation is headed.
Here’s where the major benchmarks ended:
The S&P 500® index (SPX) dropped 49.27 points (1.0%) to 5,160.64; the Dow Jones Industrial Average lost 422.16 points (1.1%) to 38,461.51; the NASDAQ Composite® ($COMP) fell 136.28 points (0.8%) to 16,170.36.
The 10-year Treasury note yield (TNX) soared more than 18 basis points to 4.548%.
The CBOE Volatility Index® (VIX) jumped 0.82 to 15.80.
Interest-rate-sensitive sectors like banks, real estate, and utilities led Wednesday’s decliners. The KBW Regional Bank Index (KRX) tumbled 5% to its lowest point since late November. The small-cap Russell 2000® Index (RUT) lost 2.5%. Energy shares were among the few gainers as WTI Crude Oil (/CL) futures rebounded after three-straight losing sessions.
In other markets, the U.S. dollar index (DXY) jumped 1% to a five-month high amid expectations interest rates will remain elevated.
Posted on April 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
Medical Ethics – Ever on Guard
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ByAaron Carroll MD, MS
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I’m a doctor. My father is a doctor. My colleagues are doctors, the people I train are doctors, lots and lots of my friends are doctors.
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But, that doesn’t meant that doctors sometimes aren’t blind to certain issues like their own financial conflicts of interest. Sometimes we have to poke doctors with a stick. That’s how we show our love.
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Conflicts of interest are the topic of this Healthcare Triage video.
Dr. Carroll has published some of the seminal work on various types of health care reform, and continues to be a sought after speaker on cost, quality and access-and the Affordable Care Act and its implications for our future. Considered one of the leading pediatric informaticists in the U.S. he has received millions of dollars in grants to explore the use of information technology in health care. Dr. Carroll was the Primary Investigator on a grant from the Agency for Healthcare Research and Quality to study the true impact of malpractice claims on the practice of medicine.
Conclusion
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, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Posted on April 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
SAFE SOLAR ECLIPSE DAY
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NVIDIA is accelerating the pace of healthcare innovation! Last week they unveiled a suite of AI microservices for developers, launched cutting-edge healthcare AI tools, and deepened their collaborations with giants like Johnson & Johnson. Plus, they’re ramping up investment in clinical trials and drug design.
Do you ever struggle with finding the best sources of information about healthcare AI? Check out my new video, where I share my favorite newsletters, websites, sub-reddits, and a list of must-follow experts. With this toolkit, you won’t miss anything important. Also, I hope you enjoyed a restful and Happy Spring Break – should you celebrate it!
Last week, several Fed officials said they were in no rush to slash interest rates in 2024, which investors have been banking on this year. Meanwhile, oil prices have risen to five-month highs due to concerns about supply shocks in key areas around the world.
And, Wall Street is preparing for a crammed week, with crucial inflation data dropping on Wednesday and big banks (JPMorgan, Wells Fargo, Citigroup) inaugurating earnings season on Friday. The pressure is on companies to post beefy profits to back up their strong stock performance in Q1.
On August 14, 2023, the Centers for Medicare and Medicaid Services (CMS) announced updates to their Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model.
In response to feedback from stakeholders, starting in performance year (PY) 2024, the agency expects to increase the predictability for the model and further advance health equity. Only in its first PY, ACO REACH is a revision and replacement of the Global and Professional Direct Contracting (GPDC) model and the Geographic Direct Contracting (Geo Model) model, a subset of the GPDC model. This Health Capital Topics article will discuss the updates to the ACO REACH model and its implications for existing accountable care organizations (ACOs). (Read more…)
Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find. —LeRoy Howard MA CMPTM,Candidate and Financial Advisor, Fayetteville, North Carolina I taught diagnostic radiology for over a decade. The physician-focused niche information, balanced perspectives, and insider industry transparency in this book may help save your financial life. —Dr. William P. Scherer MS, Barry University, Ft. Lauderdale, Florida This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional. —Parin Khotari MBA,Whitman School of Management, Syracuse University, New York In today’s healthcare environment, in order for providers to survive, they need to understand their current and future market trends, finances, operations, and impact of federal and state regulations. As a healthcare consulting professional for over 30 years supporting both the private and public sector, I recommend that providers understand and utilize the wealth of knowledge that is being conveyed in these chapters. Without this guidance providers will have a hard time navigating the supporting system which may impact their future revenue stream. I strongly endorse the contents of this book.—Carol S. Miller BSN MBA PMP,President, Miller Consulting Group, ACT IAC Executive Committee Vice-Chair at-Large, HIMSS NCA Board Member This is an excellent book on financial planning for physicians and health professionals. It is all inclusive yet very easy to read with much valuable information. And, I have been expanding my business knowledge with all of Dr. Marcinko’s prior books. I highly recommend this one, too. It is a fine educational tool for all doctors.—Dr. David B. Lumsden MD MS MA,Orthopedic Surgeon, Baltimore, Maryland There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them. —Dr. Jason Dyken MD MBA,Dyken Wealth Strategies, Gulf Shores, Alabama I plan to give a copy of this book written ‘by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic. —Alexander Naruska CPA,Orlando, Florida
Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves. —Dr. Thomas M. DeLauro DPM,Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine
Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time! —Dr. Neil Baum MD,Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana
I worked with a Certified Medical Planner™ on several occasions in the past, and will do so again in the future. This book codified the vast body of knowledge that helped in all facets of my financial life and professional medical practice. —Dr. James E. Williams DABPS, Foot and Ankle Surgeon, Conyers, Georgia
This is a constantly changing field for rules, regulations, taxes, insurance, compliance, and investments. This book assists readers, and their financial advisors, in keeping up with what’s going on in the healthcare field that all doctors need to know. —Patricia Raskob CFP® EA ATA, Raskob Kambourian Financial Advisors, Tucson, Arizona I particularly enjoyed reading the specific examples in this book which pointed out the perils of risk … something with which I am too familiar and have learned (the hard way) to avoid like the Black Death. It is a pleasure to come across this kind of wisdom, in print, that other colleagues may learn before it’s too late— many, many years down the road. —Dr. Robert S. Park MD, Robert Park and Associates Insurance, Seattle, Washington
Although this book targets physicians, I was pleased to see that it also addressed the financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable. —Nurse Cecelia T. Perez RN, Hospital Operating Room Manager, Ellicott City, Maryland
Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book. This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™. —Dr. Mark D. Dollard FACFAS, Private Practice, Tyson Corner, Virginia As healthcare professionals, it is our Hippocratic duty to avoid preventable harm by paying attention. On the other hand, some of us are guilty of being reckless with our own financial health—delaying serious consideration of investments, taxation, retirement income, estate planning, and inheritances until the worry keeps one awake at night. So, if you have avoided planning for the future for far too long, perhaps it is time to take that first step toward preparedness. This in-depth textbook is an excellent starting point—not only because of its readability, but because of his team’s expertise and thoroughness in addressing the intricacies of modern investments—and from the point of view of not only gifted financial experts, but as healthcare providers, as well … a rare combination. —Dr. Darrell K. Pruitt DDS, Private Practice Dentist, Fort Worth, Texas This text should be on the bookshelf of all contemporary physicians. The book is physician-focused with unique topics applicable to all medical professionals. But, it also offers helpful insights into the new tax and estate laws, fiduciary accountability for advisors and insurance agents, with investing, asset protection and risk management, and retirement planning strategies with updates for the brave new world of global payments of the Patient Protection and Affordable Care Act. Starting out by encouraging readers to examine their personal ‘money blueprint’ beliefs and habits, the book is divided into four sections offering holistic life cycle financial information and economic education directed to new, mid-career, and mature physicians.
This structure permits one to dip into the book based on personal need to find relief, rather than to overwhelm. Given the complexity of modern domestic healthcare, and the daunting challenges faced by physicians who try to stay abreast of clinical medicine and the ever-evolving laws of personal finance, this textbook could not have come at a better time. —Dr. Philippa Kennealy MD MPH, The Entrepreneurial MD, Los Angeles, California Physicians have economic concerns unmatched by any other profession, arriving ten years late to the start of their earning years. This textbook goes to the core of how to level the playing field quickly, and efficaciously, by a new breed of dedicated Certified Medical Planners™. With physician-focused financial advice, each chapter is a building block to your financial fortress. —Thomas McKeon, MBA, Pharmaceutical Representative, Philadelphia, Pennsylvania An excellent resource … this textbook is written in a manner that provides physician practice owners with a comprehensive guide to financial planning and related topics for their professional practice in a way that is easily comprehended. The style in which it breaks down the intricacies of the current physician practice landscape makes it a ‘must-read’ for those physicians (and their advisors) practicing in the volatile era of healthcare reform. —Robert James Cimasi, MHA ASA FRICS MCBA CVA CM&AA CMP™, CEO-Health Capital Consultants, LLC, St. Louis, Missouri Rarely can one find a full compendium of information within a single source or text, but this book communicates the new financial realities we are forced to confront; it is full of opportunities for minimizing tax liability and maximizing income potential. We’re recommending it to all our medical practice management clients across the entire healthcare spectrum. —Alan Guinn, The Guinn Consultancy Group, Inc., Cookeville, Tennessee Dr. David Edward Marcinko MBA CMP™ and his team take a seemingly endless stream of disparate concepts and integrate them into a simple, straightforward, and understandable path to success. And, he codifies them all into a step-by-step algorithm to more efficient investing, risk management, taxation, and enhanced retirement planning for doctors and nurses. His text is a vital read—and must execute—book for all healthcare professionals and physician-focused financial advisors. —Dr. O. Kent Mercado, JD, Private Practitioner and Attorney, Naperville, Illinois
Kudos. The editors and contributing authors have compiled the most comprehensive reference book for the medical community that has ever been attempted. As you review the chapters of interest and hone in on the most important concerns you may have, realize that the best minds have been harvested for you to plan well… Live well. —Martha J. Schilling; AAMS® CRPC® ETSC CSA, Shilling Group Advisors, LLC, Philadelphia, Pennsylvania I recommend this book to any physician or medical professional that desires an honest no-sales approach to understanding the financial planning and investing world. It is worthwhile to any financial advisor interested in this space, as well. —David K. Luke, MIM MS-PFP CMP™, Net Worth Advisory Group, Sandy, Utah Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisor. I highly recommend it and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done. —Ken Yeung MBA CMP™, Tseung Kwan O Hospital, Hong Kong I’ve seen many ghost-written handbooks, paperbacks, and vanity-published manuals on this topic throughout my career in mental healthcare. Most were poorly written, opinionated, and cheaply produced self-aggrandizing marketing drivel for those agents selling commission-based financial products and expensive advisory services. So, I was pleasantly surprised with this comprehensive peer-reviewed academic textbook, complete with citations, case examples, and real-life integrated strategies by and for medical professionals. Although a bit late for my career, I recommend it highly to all my younger colleagues … It’s credibility and specificity stand alone. —Dr. Clarice Montgomery PhD MA,Retired Clinical Psychologist In an industry known for one-size-fits-all templates and massively customized books, products, advice, and services, the extreme healthcare specificity of this text is both refreshing and comprehensive. —Dr. James Joseph Bartley, Columbus, Georgia
My brother was my office administrator and accountant. We both feel this is the most comprehensive textbook available on financial planning for healthcare providers. —Dr. Anthony Robert Naruska DC,Winter Park, Florida
Posted on April 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Here’s where the major benchmarks ended:
Markets: Stocks pulled it out for a Friday win after the government dropped encouraging economic data. But all three major indexes were still down for the week, with the Dow enduring its worst of 2024.
Stock spotlight:Tesla took a wild ride, plunging after Reuters reported it had scrapped plans to produce its long-awaited Model 2 affordable EV only to regain some ground after Elon Musk denied it. The company then jumped after hours because Musk said it’ll debut a robotaxi on August 8.
The S&P 500 index gained 57.13 points (1.1%) to 5,204.34, down 1.0% for the week; the Dow Jones Industrial Average added 307.06 points (0.8%) to 38,904.04, down 2.3% for the week; the NASDAQ Composite® ($COMP) rose 199.44 points (1.2%) to 16,248.52, down 0.8% for the week.
The 10-year Treasury note yield (TNX) rose more than 8 basis points to 4.392%.
The CBOE Volatility Index® (VIX) fell 0.32 to 16.03.
Meta Platforms (META) and Netflix (NFLX), two members of the “Magnificent Seven” mega-cap group, both jumped around 3% Friday, helping lift the S&P 500 Communication Services Index ($SP500#50) 1.6% to lead top-performing sectors. Meta shares closed at a record above $527, up 49% for the year.
Posted on April 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Ulta and other major beauty companies that thrived during the past few years of economic instability provided good fodder for the “lipstick index”—a duct-tape economic measure that assumes people still buy small indulgences (like lipstick) during tough times, keeping the beauty industry recession-proof.
However…it’s not. Ulta’s full-year sales growth target is just 4% to 5%, which falls below Wall Street’s estimates, and Estée Lauder announced in February it was laying off 3% to 5% of its workforce after some difficult months.
And, other consumer goods powerhouses are bracing for a slowdown, too. The parent company of Calvin Klein and Tommy Hilfiger said this week that it’s preparing for a 6% to 7% revenue drop this year.
The S&P 500 index dropped 64.28 points (1.2%) to 5,147.21; the Dow Jones Industrial Average® ($DJI) tumbled 530.16 points (1.4%) to 38,596.98; the NASDAQ Composite® ($COMP) sank 228.38 points (1.4%) to 16,049.08.
The 10-year Treasury note yield (TNX) fell more than 5 basis points to 4.303.%.
The CBOE Volatility Index® (VIX) surged 2.07 to 16.39.
Semiconductors were among Thursday’s weakest performers as a drop of more than 8% in Advanced Micro Devices (AMD) helped send the Philadelphia Semiconductor Index (SOX) down 3% to a two-week low. Retail shares were also soft. WTI Crude Oil futures rose for the sixth consecutive day and topped $87 per barrel, marking a gain of 4.3% so far this week. Volatility based on the VIX ended at its highest level since early November. Brent Crude Oil (/BZ) futures, the global benchmark, topped $90 for the first time since October.
Posted on April 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Ulta Beauty plunged after its CEO revealed that, despite the resilience of the beauty category, sales have slowed.
And, Walt Disney’s current rulers will continue to oversee the kingdom. The company’s board, helmed by CEO Bob Iger,defeated activist investors and Nelson Peltz who had hoped to replace current board members and steer the company in a new direction.
Here’s where the major benchmarks ended:
The S&P 500 index rose 5.68 points (0.1%) to 5,211.49; the Dow Jones Industrial Average lost 43.10 points (0.1%) to 39,127.14; the NASDAQ Composite® ($COMP) added 37.01 points (0.2%) to 16,277.46.
The 10-year Treasury note yield fell more than 1 basis point to 4.351%.
The CBOE Volatility Index® (VIX) declined 0.28 to 14.33.
Energy shares remained one of the market’s strongest performers behind strength in WTI Crude Oil (/CL) futures, which rose a fifth consecutive day and ended above $85 per barrel, the highest since October. The Philadelphia Oil Service Index (OSX) jumped1.6%, extending its year-to-date gain to almost 14%.
Posted on April 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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DEFINITION: A safety net hospital is a type of medical center in the United States that by legal obligation or mission provides healthcare for individuals regardless of their insurance status or ability to pay. This legal mandate forces safety net hospitals to serve all populations. Such hospitals typically serve a proportionately higher number of uninsured, Medicaid, Medicare, Children’s Health Insurance Program, low-income, and other vulnerable individuals than their “non-safety net hospital” counterpart.
But, some Safety net hospitals will soon learn how the government plans to reimburse them for nearly $10 billion resulting from underpayments from the federal drug discount program. The question is whether it will come at the expense of other hospitals. The Centers for Medicare and Medicaid Services [CMS] is poised to reveal a repayment plan to facilities in the 340B program, after the Supreme Court found the agency made illegal program cuts from 2018 to September 2022.
Posted on April 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Medicare Part C papers, glasses and stethoscope.
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Humana and other managed-care stocks were down sharply in trading Tuesday after the Centers for Medicare and Medicaid Services announced an average 3.7% increase in revenue for Medicare Advantage plans in 2025. That amount is the same as the proposed increase the government had announced in January, but it came as a shock to investors who were hoping for a slight bump.
Humana (HUM) shares fell sharply in early Tuesday trading, while rivals UnitedHealth UNH and CVS Health (CVS) traded firmly in the red, as the health insurance industry received yet another blow to its 2024 profit forecasts. All three major health insurance groups have trailed the broader market this year, with Humana down nearly 25%, amid concern that profit margins will be hit by a surge in medical costs tied to a rise in elective procedures. Those procedures had been delayed by the Covid pandemic.
The S&P 500 index fell 37.96 points (0.7%) to 5,205.81; the Dow Jones Industrial Average lost 396.61 points (1.0%) to 39,170.24; the NASDAQ Composite slipped 156.38 points (1.0%) to 16,240.45.
The 10-year Treasury note yield was up almost 3 basis points to 4.357%.
The CBOE Volatility Index® (VIX) rose 0.96 to 14.61.
Retailer, biotechnology, and regional bank shares were among the weakest performers Tuesday, leading a broad market slump in which declining stocks outnumber advancers by a greater than three-to-one ratio. The small-cap Russell 2000® Index (RUT) lost 1.8% and settled at a two-week low.
Energy companies, by contrast, extended recent strength behind an ongoing climb in WTI Crude Oil (/CL) futures, which surpassed $85 per barrel for the first time since late October. The Philadelphia Oil Service Index (OSX) advanced 2.1% and ended at a 5-½-month high. Oil prices have surged this year due to OPEC production cuts and concern over supply disruptions stemming from the Middle East conflict.
Posted on April 2, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Federal health officials said they would offer emergency funding to physicians, physical therapists, and other professionals that provide outpatient healthcare, following a cyberattack that crippled the nation’s largest processor of medical claims and left many organizations in financial distress. The Centers for Medicare and Medicaid Services also announced that it would make advance payments available to suppliers that bill through Medicare Part B, which serves a wide array of healthcare organizations.
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Officials had previously announced a similar program to make emergency payments available for hospitals that had been ensnared by the February 21st hack of Change Healthcare, a unit of UnitedHealth Group, and have struggled to get paid for more than two weeks. The emergency funds represent upfront payments made to healthcare providers and suppliers based on their expected future claims.
Posted on April 1, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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On March 9th, 2024, President Biden signed into law a $460 billion spending package to continue funding the federal government for the remainder of the 2024 fiscal year. Contained within the spending package was legislation to cut in half the 2024 Medicare physician payment update of approximately -3.4%.
This Health Capital Topics article discusses the payment update, other healthcare provisions contained in the bipartisan spending bills, and responses from stakeholders. (Read more…)
Posted on March 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
NOBEL PRIZE WINNER AND FATHER OF BEHAVIORAL ECONOMICS
By Staff Reporters
DEFINITION: According to Wikipedia, behavioral economics is the study of the psychological, cognitive, emotional, cultural and social factors involved in the decisions of individuals or institutions, and how these decisions deviate from those implied by classical economic theory.
Behavioral economics is primarily concerned with the bounds of rationality of economic agents. Behavioral models typically integrate insights from psychology, neuroscience and microeconomic theory. The study of behavioral economics includes how market decisions are made and the mechanisms that drive public opinion.
Behavioral economics began as a distinct field of study in the 1970s and ’80s, but can be traced back to 18th-century economists, such as Adam Smith, who deliberated how the economic behavior of individuals could be influenced by their desires.
The status of behavioral economics as a subfield of economics is a fairly recent development; the breakthroughs that laid the foundation for it were published through the last three decades of the 20th century. Behavioral economics is still growing as a field, being used increasingly in research and in teaching.
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Daniel Kahneman PhD, the father of behavioral economics, died yesterday at age 90 years old. He’s best known for applying psychology to economics and uncovering biases and mental shortcuts that make people act irrationally, as he chronicled in his best-selling book Thinking, Fast and Slow.
Kahneman, along with his long-time collaborator and friend Amos Tversky PhD, developed “prospect theory,” or loss-aversion theory, which earned him the Nobel Prize in Economics in 2002 (which he shared with fellow economist Vernon Smith). The idea is that people value losses and gains differently, so we feel more bad about losing $100 than we feel good about making the same amount. He applied this theory to investors, who had previously been considered rational decision-makers. It shows up elsewhere, too—for example, golfers putt better when they’re facing the loss of a stroke than when they might gain one.
Two other biases he identified include:
The “peak-end rule” that people remember an experience primarily based on how they felt at its most intense moment and the final part of it. It’s why you consider a whole vacation good if the last day was good—or the opposite.
The conjunction fallacy where people erroneously think the probability of two things being true is more likely than just one thing, which the famous “Linda the Bank Teller” problem illustrates.
Posted on March 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Independent pharmacies have struggled in recent years to stay open—and new financial constraints may mean a record number of pharmacy closures in 2024. And, nearly a third of independent pharmacies are at risk of going out of business due in part to a new rule from the Centers for Medicare and Medicaid Services (CMS) that results in lower prescription reimbursements, according to the National Community Pharmacists Association (NCPA), a trade group that represents more than 19,400 US pharmacies.
“This is an emergency,” NCPA CEO B. Douglas Hoey said in a statement. “If Congress fails to act again, thousands of local pharmacies could be closed within months and millions of patients could be stranded without a pharmacy.” The CMS rule, which went into effect on January 1st, requires payers and pharmacy benefit managers (PBMs) to apply what’s called direct and indirect remuneration (DIR) fees at the time a patient picks up a prescription.
The S&P 500 index added 44.91 points (0.9%) to 5,248.49; the Dow Jones Industrial Average climbed 477.75 points (1.2%) to 39,760.08; the NASDAQ Composite added 83.82 points (0.5%) to 16,399.52.
The 10-year Treasury note yield fell four basis points to just under 4.2%.
The CBOE Volatility Index® (VIX) dropped 0.48 to 12.76.
In addition to utility stocks, real estate, industrials, and materials were the strongest sectors. Information technology and communications were the weakest but found late-day strength to finish higher.
Managerial and medical cost accounting is not governed by generally accepted accounting principles (GAAP) as promoted by the Financial Accounting Standards Board (FASB) for CPAs. Rather, a healthcare organization costing expert may be a Certified Cost Accountant (CCA) or Certified Managerial Accountant (CMA) designated by the Cost Accounting Standards Board (CASB), an independent board within the Office of Management and Budget’s (OMB) Office of Federal Procurement Policy (OFPP).
The Cost Accounting Standards Board
CASB consists of five members, including the OFPP Administrator who serves as chairman and four members with experience in government contract cost accounting (two from the federal government, one from industry, and one from the accounting profession). The Board has the exclusive authority to make, promulgate, and amend cost accounting standards and interpretations designed to achieve uniformity and consistency in the cost accounting practices governing the measurement, assignment, and allocation of costs to contracts with the United States.
Codified at 48 CFR
CASB’s regulations are codified at 48 CFR, Chapter 99. The standards are mandatory for use by all executive agencies and by contractors and subcontractors in estimating, accumulating, and reporting costs in connection with pricing and administration of, and settlement of disputes concerning, all negotiated prime contract and subcontract procurement with the United States in excess of $500,000. The rules and regulations of the CASB appear in the federal acquisition regulations.
North American Industry Classification System (NAICS) codes are used to categorize data for the federal government. In acquisition they are particularly critical for size standards. The NAICS codes are revised every five years by the Census Bureau. As of October 1, 2007, the federal acquisition community began using the 2007 version of the NAICS codes at www.census.gov/epcd/www/naics.html
Cost Accounting Standards
Healthcare organizations and consultants are obligated to comply with the following cost accounting standards (CAS) promulgated by federal agencies:
CAS 501 requires consistency in estimating, accumulating, and reporting costs.
CAS 502 requires consistency in allocating costs incurred for the same purpose.
CAS 505 requires proper treatment of unallowable costs.
CAS 506 requires consistency in the periods used for cost accounting.
The requirements of these standards are different from those of traditional financial accounting, which are concerned with providing static historical information to creditors, shareholders, and those outside the public or private healthcare organization.
Assessment
Functionally, most healthcare organizations also contain cost centers, which have no revenue budgets or mission to earn revenues for the organization. Examples include human resources, administration, housekeeping, nursing, and the like. These are known as responsibility centers with budgeting constraints but no earnings. Furthermore, shadow cost centers include certain non-cash or cash expenses, such as amortization, depreciation and utilities, and rent. These non-centralized shadow centers are cost allocated for budgeting purposes and must be treated as costs http://www.CertifiedMedicalPlanner.org
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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
Posted on March 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The European Union isinvestigating Meta, Apple, and Alphabet for potential violations of its Digital Markets Act. And its regulators have started looking into Amazon as well.
The Digital Markets Act is the EU’s law to make the markets in the digital sector fairer and more contestable. In order to do so, the Digital Markets Act (“DMA”) establishes a set of clearly defined objective criteria to identify “gatekeepers”.
And, stocks were headed for a great Tuesday before investors sent stock indexes back down and leaving the Dow largely unchanged. Meanwhile, Donald Trump’s social media company, Truth Social, surged 16% in its first day of trading, just as the former president must pay $175 million as part of his civil fraud trial.
Here’s where the major benchmarks ended:
The S&P 500 index lost 14.61 points (0.3%) to 5,203.58; the Dow Jones Industrial Average dropped 31.31 points (0.1%) to 39,282.33; the NASDAQ Composite tumbled 68.76 points (0.4%) to 16,315.70.
The 10-year Treasury note yield (TNX) fell two basis points to 4.23%.
The CBOE Volatility Index edged up 0.05 to 13.24.
In terms of sector performance, utilities, information technology, and energy were the weakest. Health care and financials saw relative strength.
Dr. Michel Accad is a practicing cardiologist who blogs for a medical audience at alertandoriented.com
Conclusion
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, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
The fact that every physician in private medical practice, without a business education, leaves approximately a million dollars on the table and is unaware of it is well known to business experts who work with medical doctors experiencing financial difficulties.
Business experts such as Dan S. Kennedy, Peter Drucker, Michael Gerber, Maxwell Maltz, Neil Baum, William Hanson,Huss and Coleman, Steven Hacker, Thomas Stanley, Chris Hurn, Napoleon Hill, and Dave Ramsey, among others, understand the financial problems faced by medical practices and how to solve them.
Posted on March 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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About 1,300 nurses at Staten Island University Hospital (SIUH) will strike on April 2nd if contract negotiations fail, the New York State Nurses Association (NYSNA) announced Thursday. The union, which represents about 42,000 nurses across the state, is looking for higher wages and improved nurse-to-patient ratios for their members—sticking points for Northwell Health, according to NYSNA.
The S&P 500 index sank 15.99 points (0.3%) to 5,218.19; the Dow Jones Industrial Average dropped 162.26 points (0.4%) to 39,313.64; the NASDAQ Composite lost 44.35 points (0.3%) to 16,384.47.
The 10-year Treasury note yield (TNX) rose three basis points to 4.25% after a four-day retreat.
The CBOE Volatility Index® (VIX) edged up 0.14 to 13.20.
The energy sector followed crude oil prices and was the strongest sector Monday. Utilities and materials also saw strength. Weakest sectors included industrials, information technology, and real estate.
The more expensive something is – the less likely you are to use it. This relationship between price and product utility is graphed as an “inverted U.”
Posted on March 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Investors hope this week on Wall Street will be as enjoyable as the last, when stocks raced higher after Fed Chair Jerome Powell previewed a series of rate cuts. Wingstop stock has surged more than 380% in the last five years.
Here’s where the major benchmarks ended last week:
The S&P 500 index sank 7.35 points (0.1%) to 5,234.18, up 2.3% for the week; the Dow Jones Industrial Average dropped 305.47 points (0.8%) to 39,475.90, up 2% for the week; the NASDAQ Composite rose 26.98 points (0.2%) to 16,428.82, up 2.9% for the week.
The 10-year Treasury note yield dipped five basis points to 4.22%, down nearly nine basis points for the week.
The CBOE Volatility Index edged up 0.14 to 13.06, falling 1.34 points for the week.
Posted on March 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Colin Hung
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Small- and medium-sized medical practices are struggling. The uncertain economic environment, staffing challenges, and the increasing complexity of providing care is putting practice owners under tremendous stress. EverHealth, providers of end-to-end solutions for healthcare providers, believes that these practices need support from partners that can take on some of the administrative, operational, and financial tasks so they can continue to deliver care to patients.
Healthcare IT Today sat down with Adam Laskey, General Manager of EverHealth at EverCommerce, to find out more about the company’s work, their vision for medical practices, and how the acquisitions of DrChrono and Updox is progressing.
Posted on March 24, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Financial hardship has led dozens of operators of senior facilities to file for bankruptcy over the past three years, with 13 companies filing petitions in 2021, 12 debtors filing in 2022 and 15 more in 2023, according to Gibbins Advisors.
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Notable Chapter 11 filings over the past year have included Evangelical Retirement Homes of Greater Chicago, which filed Chapter 11 in the U.S. Bankruptcy Court for the Northern District of Illinois in June 2023 to sell its assets at auction. Also, Windsor Terrace Health, an operator of 32 nursing homes in California and three in Arizona, filed its petition in the U.S. Bankruptcy Court for the Central District of California in August 2023 listing $1 million to $10 million in assets and liabilities and unable to pay its debts.
More recently, Magnolia Senior Living, an operator of four facilities in Georgia, filed for Chapter 11 protection on March. 19 in the U.S. Bankruptcy Court for the Northern District of Georgia.
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The Great Recession of 2008 had a lot of downsides: People lost homes, jobs, and retirement savings, had their careers derailed, and were forced to learn what the heck synthetic collateralized debt obligations are. But according to recent research, it also made people in the US live longer.
Venture capital funding in the digital health space cooled a bit in 2022 following a red-hot 2021. Overall, digital health companies raised $15.3 billion last year, down from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to Rock Health a seed fund that supports digital health startups.
Nevertheless, analysts predict VC investors and bankers will still put a good amount of money into digital health in 2024 and 2025, especially in alternative care, drug development, health information technology technology, EMRs and software that reduces physician workload.
Of course. an essential first part of attracting VC interest and money is the crafting and presentation of your formal business plan [“elevator pitch”]; as well as the needed technical and managerial experience. This is crucial for success and exactly where we can assist.
(“Informed Voice of a New Generation of Fiduciary Advisors for Healthcare”)
For most lay folks, personal financial planning typically involves creating a personal budget, planning for taxes, setting up a savings account and developing a debt management, retirement and insurance recovery plan. Medicare, Social Security and Required Minimal Distribution [RMD] analysis is typical for lay retirement. Of course, we can assist in all of these activities, but lay individuals can also create and establish their own financial plan to reach short and long-term savings and investment goals.
But, as fellow doctors, we understand better than most the more complex financial challenges doctors can face when it comes to their financial planning. Of course, most physicians ultimately make a good income, but it is the saving, asset and risk management tolerance and investing part that many of our colleagues’ struggle with. Far too often physicians receive terrible guidance, have no time to properly manage their own investments and set goals for that day when they no longer wish to practice medicine.
For the average doctor or healthcare professional, the feelings of pride and achievement at finally graduating are typically paired with the heavy burden of hundreds of thousands of dollars in student loan debt.
You dedicated countless hours to learning, studying, and training in your field. You missed birthdays and holidays, time with your families, and sacrificed vacations to provide compassionate and excellent care for your patients. Amidst all of that, there was no time to give your finances even a second thought.
Between undergraduate, medical school, and then internship and residency, most young physicians do not begin saving for retirement until late into their 20s, if not their 30s. You’ve missed an entire decade or more of allowing your money and investments to compound and work for you. When it comes to addressing your financial health and security, there’s no time to waste.
Posted on March 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
CHERRY BLOSSOM FESTIVAL, DC.
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KROGER, the supermarket chain said it expects to close the sale of its specialty pharmacy business during the second half of 2024. Kroger said it is planning to sell its speciality pharmacy business to pharmacy benefit manager CarelonRx, a subsidiary of Elevance Health, the company just reported.
Nvidia continues its bid for world domination with the announcement of its new B200 “Blackwell” chip. The Blackwell is 2.5 times more powerful than the “Hopper” chip which helped it become a $2 trillion company. (Bloomberg)
Here’s where the major benchmarks ended:
The S&P 500 index added 46.11 points (0.9%) to 5,224.62; the Dow Jones Industrial Average gained 401.37 points (1%) to 39,512.13; the NASDAQ Composite rose 202.62 points (1.3%) to 16,369.41.
The 10-year Treasury note yield slid two basis points to 4.27%.
The CBOE Volatility Index®(VIX) fell 0.77 to 13.06.
Health care was the biggest loser among the S&P 500 sectors. Energy was also lower after crude oil prices sank on the heels of weekly inventory data. Brent Crude Oil (/BZ) futures, the global benchmark, dropped 1.6% on the heels of five days of gains.
The producer price index (PPI) rose 0.6% for the month, according to the Bureau of Labor Statistics—double the Dow Jones estimate, CNBC reported. February’s larger-than-expected PPI uptick follows a more modest 0.3% increase in January and a 0.1% decline in December. On an annual basis, the PPI increased 1.6%, “the largest rise since moving up 1.8% for the 12 months ended September 2023,” according to the BLS.
The market had a good Tuesday, with stocks climbing as investors await word from the Fed meeting today on any changes to interest rates. The bank is expected to keep rates the same for now, but could signal when (or how often) it’ll lower them later in the year. Meanwhile, Nordstrom shares surged following a report that the retailer’s founding family wants to take it private.
The S&P 500 index added 29.09 points (0.6%) to 5,178.51; the Dow Jones Industrial Average® ($DJI) gained 320.33 points (0.8%) to 39,110.76; the NASDAQ Composite® ($COMP) rose 63.34 points (0.40%) to 16,166.79.
The 10-year Treasury note yield (TNX) eased four basis points to just under 4.3%.
The CBOE Volatility Index® (VIX) lost 0.50 to 13.83.
The energy sector was the top performer after crude oil prices notched multi-month highs ahead of weekly inventory data from the American Petroleum Institute. After a 2% rally to start the trading week, Brent Crude Oil (/BZ) futures, the global benchmark, added another 0.6% Tuesday.
Industrials, consumer discretionary, and utilities were among the other strong sectors. Communications, real estate, and materials finished modestly lower.
Posted on March 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Stocks started the week off strong yesterday as tech companies rose. Chipotle, Progressive, and more hit all-time highs. Tesla got a boost after announcing higher prices for its Model Y in the US and parts of Europe.
Here’s where major benchmarks ended yesterday:
The S&P 500 index rose 32 points (0.6%) to 5,149.42; the Dow Jones Industrial Average ($DJI) gained 75.66 points (0.2%) to 38,790.43; the NASDAQ Composite jumped 130.27 points (0.8%) to 16,103.45.
The 10-year Treasury note yield rose nearly four basis points to 4.34%.
The CBOE Volatility Index® (VIX) dipped 0.08 to 14.33.
All but two S&P 500 sectors finished in the green, with communications, information technology, consumer discretionary, and consumer staples leading the advance. Health care and real estate finished modestly lower.
Crude oil prices rose to multi-month highs on the heels of stronger-than-expected industrial production data from China and concerns over potential supply disruptions.
According to Reuters, a Ukrainian strike sparked a fire at the Slavyansk refinery in Krasnodar on Saturday and ongoing attacks have now idled around 7% of Russia’s refining capacity so far this year. Brent Crude Oil (/BZ) futures, the global benchmark, gained 2% Monday.
Posted on March 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Salesforce just announced new AI solutions for health-care workers that could help automate some of the manual administrative tasks that are driving physician burnout. READ MORE
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On Friday, National Association of Realtors (NAR) agreed to pay $418 million over the next four years to settle several lawsuits alleging it artificially inflated realtor commissions. Included in the deal is a policy change that will likely obliterate agents’ 5%–6% commissions.
Posted on March 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Stocks fell yesterday after another round of hotter-than-expected inflation data chilled investors. But it was a tremendous Thursday for sporting goods store Dick’s, as it soared 15% after posting its largest sales quarter in history in Q4, thanks in part to consumers buying more expensive items.
Here’s where the major stock benchmarks ended:
The S&P 500 index fell 14.83 points (0.3%) to 5,150.48; the Dow Jones Industrial Average® ($DJI) declined 137.66 points (0.4%) to 38,905.66; the NASDAQ Composite shed 49.24 points (0.3%) to 16,128.53.
The 10-year Treasury note yield (TNX) rose about 10 basis points to 4.292%.
The CBOE Volatility Index® (VIX) rose 0.65 to 14.40.
Technology shares remained under pressure, as a pullback in Nvidia (NVDA) and other chip makers sent the Philadelphia Semiconductor Index (SOX) down almost 2% to its lowest close of the month. Nvidia fell 3.2% Thursday and has dropped nearly 10% from a record intraday high of $974 last Friday. Banks and small-cap stocks were also among the market’s weakest performers.
“Tech shares appear to be going through a corrective phase following last Friday’s key reversal day in Nvidia. The question remains whether a potential correction in tech will spill over into the broader market or whether money will rotate into other areas of the market.”
In other markets, WTI crude oil futures (/CL) extended this week’s rally with a gain of 1.7% and ended slightly above $81 per barrel, its highest level since early November. Oil’s strength has been driven by an unexpected drop in U.S. inventories and concerns over supply disruptions after Ukrainian strikes on oil refineries in Russia.
Posted on March 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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On December 26, 2023, a study published in the Journal of the American Medical Association (JAMA) found concerning changes in patient outcomes and hospital adverse events associated with private equity (PE) acquisition and ownership of hospitals. Over the past ten years, PE firms have set their sights on hospitals as a lucrative investment opportunity, spending nearly $1 trillion to finance healthcare acquisitions, and purchasing more than 200 hospitals from non-PE owners.
Posted on March 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Each Pi Day, we recall Akira Haraguchi, who in 2016 set the unofficial world record for reciting the most digits of pi: 100,000 over more than 16 hours. He did it by mentally linking each digit with a syllable and creating a collection of epic stories from the words those syllables formed.
Posted on March 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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DEFINITION: Creeping, or mild, inflation occurs when prices rise slowly. According to the Federal Reserve, when prices increase by 2% or less, it benefits economic growth. This kind of mild inflation makes consumers expect that prices will keep going up, which boosts demand.
And so, inflation was a bit warmer last month as consumer prices rose 3.2% in February, the Labor Department just reported, up from the 3.1% that economists expected. That marks the second straight month that inflation came in higher than forecast. The data reinforces the Fed’s position to wait until inflation is tamed before cutting interest rates. Still, the central bank is widely expected to cut rates sometime later this year despite yesterday’s less-than-ideal report. It will meet next week to continue deliberations on a potential rate reduction.
The S&P 500® index (SPX) fell 9.96 points (0.2%) to 5,165.31; the Dow Jones Industrial Average gained 37.83 points (0.1%) to 39,043.32; the NASDAQ Composite® (COMP) declined 87.87 points (0.5%) to 16,177.77.
The 10-year Treasury note yield (TNX) rose almost 4 basis points to 4.192%.
The CBOE Volatility Index® (VIX) fell slightly to 13.75.
Energy shares were among the market’s strongest performers Wednesday behind gains in crude oil prices. Brent crude futures (/BZ), the global benchmark, rose above $84 to end at their highest level since early November after Ukrainian strikes on oil refineries in Russia stirred concern over supply disruptions. The S&P Energy Index ($SP500#10) jumped 1.5% and reached its highest level since late October, while the S&P 500 Materials Index ($SP500#15) rose almost 1% and ended at a record high.
Posted on March 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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As tax season kicks off, the Internal Revenue Service is warning taxpayers and administrators of health spending plans that personal expenses for general health and wellness are not legally considered medical expenses, as it fears some may be misled.
In a press release published Wednesday, the IRS reminded individuals filing their taxes that medical expenses for areas such as weight loss are not deductible or reimbursable under health flexible spending arrangements, health savings accounts, health reimbursement arrangements or medical savings accounts, and that they should beware of companies suggesting otherwise.
“Legitimate medical expenses have an important place in the tax law that allows for reimbursements,” said Danny Werfel, the IRS commissioner, in a statement. “But taxpayers should be careful to follow the rules amid some aggressive marketing that suggests personal expenditures on things like food for weight loss qualify for reimbursement when they don’t qualify as medical expenses.”
According to the IRS, while some companies claim that a doctor’s note based on self-reported health information is enough to qualify a non-medical nutritional, wellness or exercise program as a reimbursable medical expense, that’s not the case. Legally, such a note does not back a targeted diagnosis-specific activity or treatment that would qualify as a medical expense, but simply a personal expense. Cite: Newsweek Giulia Carbonaro
Did you know that the American Medical Association is calling on medical schools and residency programs to include specific information about healthcare economics and financing in their curricula.
But, is health economics heterodoxic, or not? And; what about demand-derived economics in medicine?
Posted on March 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Pharmaceutical companies have filed a slew of suits around the country to get federal judges to invalidate a government program aimed at lowering drug costs for seniors by allowing Medicare to negotiate prices, as is the norm in many other countries, according to the Washington Post. The companies argue it’s unconstitutional and would inhibit their ability to develop new treatments.
The Federal Reserve is looking for steady, reliable signs that inflation is simmering down before it cuts interest rates this year. So far, 2024 has not delivered. Data released by the Bureau of Labor Statistics on Tuesday showed prices rose 3.2 percent over last year, slightly outpacing forecasts of 3.1 percent. Prices also rose 0.4 percent in February over the previous month — in line with expectations, but still hotter than economists would like to discern.
Stocks swung up on Tuesday as investors shrugged off a middling inflation report and looked ahead to next week’s Fed meeting. Meanwhile, Oracle went sky-high, posting its best day since 2021 after demand for AI prompted a huge increase in sales for its cloud computing business.
Here’s where the major benchmarks ended:
The S&P 500® index (SPX) gained 57.33 points (1.1%) to 5,175.27; the Dow Jones Industrial Average® ($DJI) added 235.83 points (0.6%) to 39,005.49; the NASDAQ Composite® (COMP) climbed 246.36 points (1.5%) to 16,265.64.
The 10-year Treasury note yield (TNX) rose about 5 basis points to 4.155%.
The CBOE Volatility Index® (VIX) fell 1.38 to 13.84.
Chip makers’ bounce-back helped boost the Philadelphia Semiconductor Index (SOX) more than 2%, as it recovered part of a 5% drop the previous two trading days. Industry leader Nvidia (NVDA) jumped over 7%. Consumer discretionary and communications services shares were also among the strongest areas. Regional banks and real estate were among the weakest sectors as the CPI data spurred an upturn in Treasury yields.
Posted on March 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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On January 29, 2024, the Centers for Medicare and Medicaid Services (CMS) announced that Performance Year 2024 participation increased in their various accountable care organization (ACO) initiatives. Specifically, 50 new ACOs joined the Medicare Shared Savings Program (MSSP), and 71 ACOs renewed their contracts, bringing the total participation in the MSSP to 480 ACOs.
Additionally, 245 organizations chose to continue participation in two other CMS models – the ACO Realizing Equity, Access, and Community Health (REACH) Model and the Kidney Care Choice (KCC) Model.
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