DAILY UPDATE: Healthcare Fraud Schemes Up as the Dow Dips Down

Posted on June 29, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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WASHINGTON (Reuters) -The U.S. Justice Department on Wednesday announced federal and local criminal charges targeting 78 defendants across 16 states as part of a law enforcement action involving $2.5 billion in alleged healthcare fraud schemes targeting elderly and disabled people, HIV patients and even pregnant women.

The cases range from allegations of falsely billing the federal Medicare insurance program for elderly and disabled Americans and paying illegal kickbacks, to the illicit diversion of expensive prescription medications and the improper dispensing of highly addictive opioid pain killers.

Among those facing charges include 24 doctors, nurses and other licensed medical professionals, as well as healthcare executives including the current and former CEOs of a durable medical equipment online platform accused of falsely billing $1.9 billion in fraudulent claims.

Of the $2.5 billion in alleged fraudulent claims to Medicare, state Medicaid programs that serve the poor and supplemental Medicare insurance programs offered by private insurers, about $1.1 billion was actually paid out to the fraudsters, officials said.

“The Justice Department will find and bring to justice criminals who seek to defraud Americans and steal from taxpayer-funded programs,” Attorney General Merrick Garland said in a statement.

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

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On Friday, the Labor Department will update its Personal Consumption and Expenditures (PCE) index, which is the Fed’s preferred inflation measure. The June employment report follows on July 7th.

What is the Economic CONSUMPTION FUNCTION Theory?

So, here is where the major benchmarks ended, yesterday:

The S&P 500 Index was down 1.55 points at 4,376.86; the Dow Jones Industrial Average was down 74.08 (0.2%) at 33,852.66; the NASDAQ Composite was up 36.08 points (0.3%) at 13,591.75.
The 10-year Treasury note yield (TNX) was down about 6 basis points at 3.71%.
CBOEs Volatility Index (VIX) was down 0.31 point at 13.43.

Regional banks and utilities were among the weakest sectors Wednesday, with the Philadelphia Utility Index (UTY) ending at its lowest level in nearly four weeks. Energy companies ranked among the top gainers as crude oil futures rose more than 2%.

Insurer Travelers Companies fell 2.5% to become the day’s worst-performing Dow stock.
Salesforce shares rose after Goldman Sachs said the company was poised to boost its profits.
Intel shares fell after Oracle said its software would be compatible with Ampere Computing chips in a blow to Intel’s position with data center customers.

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HEALTH SHARING AGREEMENTS: Are They Health Insurance -OR- Not?

Posted on June 24, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Health care sharing is not insurance, but the plans count as insurance under the Affordable Care Act (ACA). That means more affordable healthcare benefits while avoiding the tax penalty for going uninsured. Other pros of health care sharing over insurance include: Lower cost. Monthly costs of health sharing are usually much lower than insurance premiums, although the rules are different for what’s covered. Also, the annual “unshared amount” is much, much lower than deductibles on lower-premium or catastrophic insurance plans. Your choice of provider. There are no network requirements, and you provide your health sharing card as coverage. If a doctor won’t accept your plan and you have to pay out-of-pocket, health sharing plans reimburse your expense.s

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

Now, the caveats: Health care sharing plans aren’t required to cover pre-existing conditions, such as cancer, diabetes, or lifestyle-related conditions like smoking. Those who have them may be declined membership or won’t have the conditions fully covered for a year or more. Health care sharing also doesn’t typically cover the essential health benefits like wellness exams or mental health counseling.

Yet, at least 1.7 million Americans are involved in a health sharing agreements despite a lack of protections (KFF Health News).

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FIDUCIARY ADVICE: For Physicians, Nurses and Medical Professionals

Posted on June 24, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Ann Miller RN MHA CPHQ CMP

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INVESTMENT ADVISORY & PORTFOLIO OPINIONS, MEDICAL START-UPS, ESTABLISHED PRACTICE VALUATIONS, BUSINESS MANAGEMENT AND EXPERT WITNESS CONSULTING

“FROM CHAOS-TO-CALM”

If you’re looking at this ME-P tab, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance; looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career?

And so, we can help. From informal coaching and mentoring – to second opinions and more formal business, legal and/or financial consulting. Regardless, the need is real.

No Worries! You may have come to the right place.

A Fiduciary At Your Service

START HERE: https://davidedwardmarcinko.com/coach/

Thank You

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DAILY UPDATE: UnitedHealth Group Down as Markets Up after FOMC Pause

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

By Staff Reporters

UnitedHealth Group expects to spend more of its members’ premiums on medical care in the second quarter, driven by a rise in outpatient care for Americans 65 and older in Medicare plans, CFO John Rex said Tuesday at a Goldman Sachs investor conference. Speaking at a Goldman Sachs healthcare conference, Tim Noel, CEO of UnitedHealth’s Medicare and retirement business, pointed to elevated demand for outpatient procedures from Medicare patients, per Reuters.

“We’re seeing that more seniors are just more comfortable accessing services for things that they might have pushed off a bit like knees and hips,” Noel reportedly said at the conference. The elevated demand is expected to increase the company’s second-quarter costs and premiums look set to lag spending on claims. As a result, UnitedHealth said it expects its medical loss ratio for full-year 2023 to be in the upper end of its prior outlook.

But, following the news, RBC Capital analyst Ben Hendrix reiterated UnitedHealth with an Outperform and maintained its $592 price target. Mizuho analyst Ann Hynes also reiterated UnitedHealth with a Buy and a $600 price target.

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

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THE MARKETS

Here is where the major benchmarks ended:

The S&P 500 Index was up 3.58 points (0.1%) at 4,372.59; the Dow Jones Industrial Average (DJIA) was down 232.79 (0.7%) at 33,979.33; the NASDAQ Composite was up 53.16 (0.4%) at 13,626.48.
The 10-year Treasury note yield (TNX) was down about 4 basis points at 3.80%.
Cboe’s Volatility Index (VIX) was down 0.74 at 13.87.

Regional banks and retail were among the weakest sectors Wednesday. The KBW Regional Banking Index (KRX) tumbled from a 14-month high earlier in the day, ending down nearly 3%. Small-caps stocks also took a hit, as the Russell 2000 Index (RUT) fell 1.2%. The U.S. Dollar Index (DXY) rebounded sharply from a four-week low, boosted by the indications rates will stay higher for longer.

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VALUATION: Medicare Advantage [Part C] Plans

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

By Health Capital Consultants, LLC

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Valuation of MA Plans: Regulatory Environment

Healthcare provider organizations, including Medicare Advantage organizations (MAOs), face a range of federal and state legal and regulatory constraints, which affect their formation, operation, procedural coding and billing, and transactions.

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

This final installment of the three-part series on the valuation of Medicare Advantage (MA) plans will review the regulatory environment in which these plans operate. (Read more…)

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CPI REPORT: May Round-Up 2023

Posted on June 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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DEFINITION: A consumer price index (CPI) is a price index, the price of a weighted average market basket of consumer goods and services purchased by households. Changes in measured CPI track changes in prices over time.

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

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4 Key Points from the Report

1. Energy is doing a lot of the work. Cheaper energy played a major role in pulling inflation down to 4% last month from 4.9% in April, per Axios. Gas prices plunged almost 20% from last year, when Russia’s invasion of Ukraine sent fuel costs to the moon, while broader energy prices fell nearly 12%.

2. “Revenge spending” is down. Once COVID pandemic lock downs lifted, Americans splurged on vacations, leisure, and recreation (new pickle ball paddles!) in what economists dubbed “revenge spending.” Now that everyone has taken their week long trip to Italy, there are signs that revenge spending is waning: Airfare prices dropped 13% annually in May and, according to the US Travel Association, hotel demand is below 2019 levels. Bad for your Instagram, but good for inflation.

3. Food prices are up. The cost of food ticked up 0.2% in May from April after staying flat in the previous two months, showing how inflation has persisted on grocery store shelves. But not all aisles are created equal—the price of eggs dropped nearly 14% from April (the biggest one-month drop since 1951), while fruit and veggie prices rose 1.3%.

4. More than anything else, rent is propping up inflation. Shelter costs are the largest category in the CPI report, and they’re still on the upward march, climbing 8.7% from a year earlier. The good news: Economists say this government data doesn’t reflect on-the-ground information, such as reports of softening rent by Zillow and Apartment List. Shelter costs in the CPI are expected to decline during the second half of the year.

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BRAIN AWARENESS MONTH: I’m Supporting “Adaptive Miami Beach Days” in June and Beyond

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

DR. KENT MERCADO JD

U.S. CONGRESS 11th DISTRICT – ILLINOIS

http://www.ElectDrKent.com

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As a doctor and attorney, it is only logical for me to be the medical guardian for my adult learning and physically challenged cousin. So, I am here in Miami, Florida nearly every month for his physician appointments as well as social service visits. But, we also make sure we attend exciting and fun activities, as well!

In fact, last weekend was no exception as we went to the Sabrina Cohen Foundation for their Adaptive Beach Days event during Brain Awareness Month every June.

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The Cohen Foundation provides adaptive services for physically impaired people to participate in water activities, particularly in the ocean and beach activities. Miss Cohen was injured 19 years ago in a terrible accident and had a spinal cord injury. Instead of feeling sorry for herself, she created a foundation where she helps others enjoy life and activities outdoors. She received a 2 1/2 million dollar grant from the city of Miami and has a permanent site on the Beach in Miami. And, she provides services and activities for many people and is trying to take her foundation nationwide.

LEARN MORE: http://www.sabrinacohenfoundation.org

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ME-P NOTE: The Illinois’s 11th Congressional District is in the state of Illinois. It includes parts of Cook, DuPage, Kendall, Kane and Will counties, as well some suburbs of Chicago and rural areas. So, please drop us a line and consider learning about and supporting Dr. Kent, regardless of your congressional district, affiliation and/or U.S. state. He is a political centrist and surely a rising new national star.

DR KENT MERCADO JD FOR CONGRESS

VISIT: http://www.ElectDrKent.com

DONATE: https://tinyurl.com/yckrppn8

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KAISER PERMANENTE: Acquires Geisinger Health

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

By Health Capital Consultants, LLC

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On April 26, 2023, the California-based healthcare giant Kaiser Permanente announced a $5 billion “mega deal” to acquire Pennsylvania health system Geisinger Health. Kaiser also announced the formation of a new nonprofit health system, to be called Risant Health. Geisinger Health will be the first health system under the umbrella of Risant Health, although Kaiser aims to add approximately five more systems to the entity.

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

This Health Capital Topics article will review this mega deal and discuss what this transaction may mean for hospitals and health systems. (Read more…)

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Hospital Capital Structure

Posted on June 10, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the Cost of Capital

[By Calvin W. Wiese; MBA, CPA]

[By David Edward Marcinko MBA]

[Staff Writers]

It is critical to understand and to measure the total cost of capital. Lack of understanding and appreciation of the total cost of capital is widespread, particularly among not-for-profit hospital executives.

Capital Structure Defined

The capital structure includes long-term debt and equity; total capital is the sum of these two. Each of these components has cost associated with it. For the long-term debt portion, this cost is explicit: it is the interest rate plus associated costs of placement and servicing. For the equity portion, the cost is not explicit and is widely misunderstood.

Capital Structure of Hospitals

In many cases, hospital capital structures include significant amounts of equity that has accumulated over many years of favorable operations. Too many physician and healthcare executives wrongly attribute zero cost to the equity portion of their capital structure. Although it is correct that generally accepted accounting principles continue to assign a zero cost to equity, there is opportunity cost associated with equity that needs to be considered. This cost is the opportunity available to utilize that capital in alternative ways.

Cost of Capital

In general, the cost attributed to equity is the return expected by the equity markets on hospital equity. This can be observed by evaluating the equity prices of hospital companies whose equity is traded on public stock exchanges. Usually the equity prices will imply cost of equity in the range of 10% to 14%; at least prior to the recent Wall Street meltdown.

Cost of Equity Exceeds Long-Term Debt

Almost always, the cost of equity implied by hospital equity prices traded on public stock exchanges will substantially exceed the cost of long-term debt. Thus, while many hospital executives will view the cost of equity to be substantially less than the cost of debt (i.e., to be zero), in nearly all cases, the appropriate cost of equity will be substantially greater than the cost of debt.

Weighted Average Cost of Capital

Hospitals need to measure their weighted average cost of capital. WACC is the cost of long-term debt multiplied by the ratio of long-term debt to total capital plus the cost of equity multiplied by the ratio of equity to total capital (where total capital is the sum of long-term debt and equity).

Assessment

WACC is then used as the basis for capital charges associated with all capital investments. Capital investments should be expected to generate positive returns after applying this capital charge based on the WACC.

Conclusion

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Congress Mulling Medicare Site-Neutral Payment Policy

Posted on June 10, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

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Congress Mulling Medicare Site-Neutral Payment Policy

Congress is actively considering several bills related to site-neutral payment that has hospitals across the U.S. significantly concerned. The proposed legislation would lower the price that Medicare pays hospitals for common outpatient services, such as x-rays and general checkups, and match what it pays outpatient facilities such as physician offices. Facilities that are owned by hospitals (known as hospital outpatient departments, or HOPDs) earn more than twice what an independent outpatient facility earns for providing the same services.

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

This Health Capital Topics article will review the changes that are being considered by Congress, as well as the responses from stakeholders. (Read more…)

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PHYSICIAN COMPENSATION: Rising but NOT with Inflation!

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

By Staff Reporters and MGMA Survey

Physician Compensation is Rising but Not Keeping Pace with Inflation

Despite physician and advanced practice provider productivity continuing its post-pandemic recovery, compensation gains are being outstripped by the most severe inflationary growth in decades, according to a new report. Provider compensation increased across the board, with primary care physicians (PCPs) receiving the biggest increase last year. Growth in median total compensation for primary care doctors doubled from 2021 to 2022—from pay growth of 2.13% to 4.41%. But these gains were eclipsed by the rate of inflation at 7% and 6.5%, respectively.

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

Surgical and non-surgical specialists saw their change in median total compensation cool slightly in 2022, dropping from 3.89% for surgical specialists in 2021 to 2.54% in 2022, and from 3.12% for non-surgical physicians in 2021 to 2.36% in 2022, according to the Medical Group Management Association’s 2023 provider compensation and production report.

Source: Heather Landi, Fierce Healthcare [6/6/23]

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DAILY UPDATE: UHC, Merck and the Boring Markets

Posted on June 7, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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UnitedHealthcare’s stunning advance notification change to it’s colonoscopy coverage roils physicians and patients, alike.

LINK: https://www.uhcprovider.com/content/dam/provider/docs/public/prior-auth/Prior-Auth-Gastroenterology-FAQ.pdf?utm_campaign=hcb&utm_medium=newsletter&utm_source=morning_brew

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The Biden administration is confident it will succeed in the courts against Merck & Co’s lawsuit filed on Tuesday, the White House said, defending the Medicare health insurance program’s authority to seek deals on medicine prices. “We are confident we will succeed in the courts: there is nothing in the Constitution that prevents Medicare from negotiating lower drug prices,” White House spokeswoman Karine Jean-Pierre said in a statement.

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

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Behind negative returns for shares of UnitedHealth and Merck, as noted above, UnitedHealth’s shares were off $14.28, or 2.9%, while those of Merck have dropped $3.23, or 2.9%. A $1 move in any one of the 30 components of the Dow results in a 6.59-point swing. In summary:

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Here is where the major benchmarks ended yesterday:

The S&P 500^® Index was up 10.04 points (0.2%) at 4283.84; the Dow Jones industrial average was up 10.48 at 33,573.34; the NASDAQ Composite was up about 47 points (0.36%) at 13,276.42.
The 10-year Treasury yield was little changed at 3.687%.
CBOE’s Volatility Index was down 0.70 at 14.03.

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PODCAST: Hospital Out Patient Pricing Explained

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

By Eric Bricker MD

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DAILY UPDATE: Worker Health Insurance Value and Major Market Benchmarks

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

By Staff Reporters

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Workers appear to value paid time off even more than having employer-funded health insurance, a recent study found. The Pew Research Center report called “How Americans view their jobs” found 62% of the 5,900 people surveyed felt it’s “extremely” important to have paid time off for vacations or minor illness, with a further 27% saying it’s “very” important. That’s higher than the 51% who said employer-funded health insurance was extremely important, with 28% saying it’s very important.

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

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And, here is where the major market benchmarks ended yesterday:

The S&P 500 Index was up 0.07 point at 4205.52; the Dow Jones industrial average was down 50.56 (0.2%) at 33,042.78; the NASDAQ Composite was up 41.74 (0.32%) at 13,017.43.
The 10-year Treasury yield was down about 13 basis points at 3.694%.
CBOE’s Volatility Index was little changed at 17.46.

Oilfield services companies and others in energy were among the weakest performers as crude oil futures dropped more than 4% to less than $70 a barrel, reflecting ample supply.

Consumer staples and health care were also weak. The U.S. dollar index was down slightly after rising earlier to its highest level since mid-March.

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ENVISION HEALTHCARE : KKR Backed and Bankrupt!

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

A”Surprise Billing” Maven

By Staff Reporters

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Envision, a $10 billion physician and ambulatory surgery firm owned by private equity giant Kohlberg Kravis Roberts, filed for Chapter 11 bankruptcy on May 15th 2023. It was the largest healthcare bankruptcy in US history.

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

Envision claimed to employ 25 thousand clinicians- emergency physicians, anesthesiologists, hospitalists, intensivists, and advanced practice nurses and contracted with 780 hospitals. Envision’s ER physicians delivered 12 million visits in 2021, not quite 10% of the US total hospital ED visits.

READ: https://www.advisory.com/daily-briefing/2023/05/19/envision-bankruptcy#:~:text=On%20Monday%2C%20Envision%20Healthcare%20filed%20for%20Chapter%2011,%E2%80%94%20will%20be%20cancelled%2C%20totaling%20around%20%245.6%20billion.

MORE: https://www.brookings.edu/wp-content/uploads/2021/10/Private-Equity-Investment-As-A-Divining-Rod-For-Market-Failure-14.pdf

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RE-PODCAST: Financial Implications of Ozempic, Wegovy and Mounjaro

Posted on May 28, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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PODCAST: Venture Capital in Healthcare VS. Boot Strapping

Posted on May 27, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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PODCAST: Physician’s Mental Health

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

Doctor Burnout According to Specialty

By Eric Bricker MD

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MEDICARE: Part “C” Plans = Double Standard

Posted on May 24, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Anonymous

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The HHS OIG Fall 2022 report was recently released to Congress. On page 20, there are many referrals to seven inappropriate payments to a variety of Medicare “Advantage” Plans. Topping the list is Humana. The OIG claims that Humana in the time period studied falsified records to receive $34.4M worth of payments they received from CMS for risk diagnosis code risk assessments. If even half this amount is true, it is unconscionable that Humana is not severely fined, their executives terminated and subjected to criminal proceedings, and they should be banned from the Medicare program for ten years. This is no different from how other healthcare providers are criminalized, so the question is, why is the insurance industry treated different and preferentially when they commit fraud?

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

These OIG studies are great reads, but up until now, they have done nothing to stop the insurance industry’s abusive practices of denying “clean claims”, denying claims after prior authorization, ignoring CCI edits, “losing” charts sent for review and then claiming higher error rates to Congress, paying providers often less than 50% of Medicare, and this the last draw… falsifying data so they can be paid more from CMS. When will this madness stop? When will providers have the gumption to actually act out the famous quote, “I’m mad as hell and I’m not going take it anymore!” (from the movie Network), and Peter Finch it!

***

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

***

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RIGHTS: Mental Health in America [Georgia]

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

MENTAL HEATH AMERICA

By Staff Reporters

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MENTAL HEALTH PARITY ACT

Atlanta, GA – Governor Brian P. Kemp, joined by First Lady Marty Kemp and their three daughters, Lt. Governor Geoff Duncan, Speaker David Ralston, members of the House and Senate, and mental health advocates, to sign the Mental Health Parity Act (HB1013) into law.

You may view his remarks from the bill signing ceremony below, and you can watch the full ceremony here.

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Mental Health Rights

People living with mental health conditions are people. They have people they love, activities they enjoy, and dreams for their lives. As people, they deserve to be treated with dignity, and under the law they have rights and protections.

GA MENTAL HEALTH PARITY LAW: https://gov.georgia.gov/press-releases/2022-04-04/gov-kemp-provides-remarks-and-signs-mental-health-parity-act

Unfortunately, it has long been the case that individuals with mental health conditions are among the most abused and discriminated against in our country. From leaving people to languish in overcrowded state hospitals to lobotomies and forced sterilization, the treatment of those with mental health conditions is a dark stain on our history as a nation.

While we have come a long way, abuse and discrimination continue to be serious problems today. The shackling or restraining of children, keeping people out of work, and denying access to services are just a few examples of the way we continue to fail the 1 in 5 Americans that has a diagnosable mental health disorder.

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

This is not just a small issue for a small group of people: half of all Americans will experience a diagnosable mental health condition in their lifetime. If it is not us being directly impacted, it is likely that it will be our family members, friends, or loved ones– whether we know it or not. Beyond struggles in education or employment, we see the loss of human dignity and even human life for the people we love and care about when we do not work to address abuses in the system.

For Mental Health America, the fight against abuse and discrimination is essential to our history and continues to guide our work. MHA’s symbol, which sits in our national office, is the Bell of Hope cast from the chains and shackles that were used to restrain individuals in old state hospitals. As an organization, MHA is committed to the principles of human and civil rights inherent to the concept of equal justice under the law.

PROVIDERS: https://medicalexecutivepost.com/2022/10/05/a-review-of-mental-healthcare-provider-types/

***

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DAILY UPDATE: The Markets and Other Items

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

By Staff Reporters

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Here is where the major benchmarks ended yesterday:

The S&P 500^® Index was up 0.65 point at 4192.63; the Dow Jones industrial average was down 140.05 (0.4%) at 33,286.58; the NASDAQ Composite was up 62.88 (0.5%) at 12,720.78.
The 10-year Treasury yield was up about 3 basis points at 3.721%.
CBOE’s Volatility Index was up 0.38 at 17.19.

The NASDAQ-100 Index ended at a 13-month high, driven by gains in large tech companies. Lenders were also particularly strong, with the KBW Regional Banking Index up nearly 3%. Oilfield services companies also rose as crude oil futures ticked higher. Consumer staples was among the weaker sectors.

***

Debt ceiling negotiations could result in less funding for state and local health officials to combat STDs. Remote work is making it easier for some family caregivers to fill care gaps. An RSV vaccine for pregnant women is another step closer to approval. Congress will question CIGNA over its practice of rejecting medical claims by the hundreds of thousands every month.

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

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

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DAILY UPDATE: FTC Blocks Amgen, CME Fed Watch and the Markets

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

By Staff Reporters

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The Federal Trade Commission said on Tuesday [yesterday] it will try to block an effort by bio-pharmaceutical leader Amgen Inc. from purchasing Horizon Therapeutics for $28.3 billion, charging the move could force insurance companies to favor their products. The FTC said the coupling of Amgen and Horizon could have allowed Amgen to leverage its portfolio of top-selling drugs to entrench a monopoly position in treatments for thyroid eye disease and chronic refractory gout. The watchdog agency said Amgen could force insurance companies and pharmacy benefit managers, or PBMs, into favoring Horizon’s two monopoly products. It said Tepezza is used to treat thyroid eye disease, while Krystexxa is used to treat chronic refractory gout. The agency said neither of the treatments has competition in the pharmaceutical marketplace.

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

***

And, the CME FedWatch Tool shows an 82% probability of the Fed leaving rates where they are, versus an 18% chance of another rate hike. As for rate cuts, Liz Ann Sonders of Schwab said they remain unlikely “unless the banking crisis significantly worsens and/or the economy or labor market sinks notably.” “Otherwise, the most likely outcome is for the Fed to pause and hold,” she added.

***

So, here is where the major benchmarks ended yesterday:

The S&P 500^® Index was down 26.38 points (0.64%) at 4,109.90; the Dow Jones Industrial Average was down 336.46 (1.01%) at 33,012.14; the NASDAQ Composite was down 22.16 (0.18%) at 12,343.05.
The 10-year Treasury yield was up about 4 basis points at 3.541%.
CBOE’s Volatility Index was up 90 basis points at 18.02.

The energy sector was one of the weakest performers Tuesday, as WTI Crude Oil futures dipped. The Dow Jones U.S. Oil & Gas Total Stock Market Index was down more than 2%, while the S&P Global Oil Index shed 2.5%. Real estate and utilities also lagged. Communication services and tech were the strongest performers.

***

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

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

***

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What is the “Good-Rx” Business Model?

Posted on May 16, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Anonymous

GoodRx Holdings, Inc. is an American healthcare company that operates a telemedicine platform and a free-to-use website and mobile app that track prescription drug prices in the United States and provide free drug coupons for discounts on medications. GoodRx checks more than 75,000 pharmacies in the United States

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Good Rx makes money by perpetuating the, artificially set, high sticker prices of medications and receiving a portion of Pharmacy Benefits Manager [PBM] fees.

How it Works

GoodRx taps into PBM network for their “discounts” off of sticker price (e.g. Express Scripts, Optum Rx, Navitus … etc)

Consumer pays the newly “discounted” drug price.

Pharmacy pays PBM fee.

PBM pays GoodRx portion of the fee.

Good Rx adjusted EBITDA in 2019: $160 Million

Good Rx 2020 revenue is up 48% first half of 2020 – $257M

IPO: https://mobile-reuters-com.cdn.ampproject.org/c/s/mobile.reuters.com/article/amp/idUSKBN24Y0N6

Opinion:

This is not market value.

This is another hand in the cookie jar keeping healthcare prices artificially high.

The consumer is the one ultimately harmed.

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Mental Health Entrepreneurial Start-Up Companies

Posted on May 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

Top Ten [10] Venture Capital Backed

By Dr. David Edward Marcinko MBA

By Carol Miller RN MBA

By http://www.MCOL.com

***

Mental Health White Paper:

FILE: https://medicalexecutivepost.com/wp-content/uploads/2019/05/mental-health-dr.-marcinko.pdf

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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™

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

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PODCAST: Healthcare Entrepreneur Playbook

Posted on May 14, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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Happy Birthday Florence Nightingale [203rd]

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

By Staff Reporters

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Happy 203rd birthday to Florence Nightingale, the founder of modern nursing. She rose to fame during the Crimean War, when her hygiene standards substantially reduced the mortality rate at army hospitals. The healthcare industry still relies on some of her ideas, such as using data as a tool to improve hospital care. The “lady with the lamp” is still lighting the path forward.

***

Other Health Care Stories

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PUBLIC HEALTH EMERGENCY: Ends May 11th, 2023

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

By Health Capital Consultants, LLC

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On January 30th, 2023, President Joseph Biden announced that the public health emergency (PHE) and national emergency declaration related to the COVID-19 pandemic will finally end on May 11, 2023, after being in place for over three years.

And so, this Health Capital Topics article will discuss the changes that will take place after both declarations cease, and the implications for stakeholders. (Read more…)

***

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DAILY UPDATE: Inflation, Public Health and the Markets

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

By Staff Reporters

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Because the inflation data came in roughly as expected, Wall Street sees the door still open for the Federal Reserve to leave interest rates alone at its next meeting in June. That would be the first time it hasn’t raised rates at a meeting in more than a year, and a pause would offer some breathing room for the economy and financial markets.

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

***

Today is the last day of the US Covid-19 public health emergency, which has been in place since Jan. 31st, 2020. With it comes the end of certain Covid-era rules, though some telehealth protections have been extended through the end of 2024. Here’s to all the medical professionals who got us through, and a remembrance for the millions who lost their lives to Covid.

***

Brightline, a California-based mental health startup, laid off 20% of its staff this week following a data breach.
North Carolina is the latest state to consider changes to the prior authorization process that advocates say delays care.
A board member at Geisinger claims that consolidation prompted the healthcare provider to sell to Kaiser Permanente.
Texas Gov. Greg Abbott said the state should address mental health issues in the wake of a shopping mall mass shooting, but did not call for gun control reform.

Pharma companies lean on AI for better innovation, efficiency AstraZeneca has big R&D goals to mitigate future declines in Covid-related sales Say goodbye to trypanophobia—this biotech is trying to turn injectable drugs into pills

***

Finally, here is where the major benchmarks ended yesterday:

The S&P 500 Index was up 18.47 points (0.5%) at 4137.64; the Dow Jones industrial average was down 30.48 (0.1%) at 33,531.33; the NASDAQ Composite was up 126.89 (1.0%) at 12,306.44.
The 10-year Treasury yield was down about 8 basis points at 3.441%.
CBOE’s Volatility Index was down 0.80 at 16.91.

Oilfield services providers and other energy companies were among the laggards Wednesday, pressured by a more-than 1% drop in WTI crude oil futures.

Financial sector stocks struggling to escape the effects of the bank volatility earlier this spring helped push the KWB Regional Bank Index back near a 2½-year low reached last week.

***

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

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

***

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PODCAST: Hospital CEO Compensation

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

By Eric Bricker MD

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UnitedHealth Group’s Physician Acquisition Efforts Accelerate

Posted on May 10, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, Inc

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On February 22, 2023, UnitedHealth Group’s (UHG’s) Optum division, the health insurance giant’s care delivery arm, acquired Crystal Run Healthcare, a New York based physician group of almost 400 physicians, nurse practitioners, and other providers

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

This significant move is just the latest in UHG’s concerted effort over the past few years to acquire outpatient providers, surgery centers, and physician groups. This Health Capital Topics article will briefly survey some of the insurer’s recent acquisitions and initiatives to expand their physician services network. (Read more…)

***

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PODCAST: Financially Hospitals Must Survive

Posted on May 9, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

HOW TO SURVIVE?

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Whatever Happened to the Invisible Hand of Capitalism?

Posted on May 6, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

The Invisible Hand of Capitalism?

By Vitaliy Katsenelson CFA

Just as the well-meaning economist of the Soviet Union didn’t know the correct price of sugar, nor do the good-intentioned economists of our global central banks know where interest rates should be.

***

Assessment

Even more important, they can’t predict the consequences of their actions.

Here’s why?

http://contrarianedge.com/2016/03/16/whatever-happened-to-the-invisible-hand-of-capitalism/

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

***

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

Posted on May 6, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Ann Miller RN MHA CMP™

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

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

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

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

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

e-Books Save Money

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

Payable thru PayPal [3% courtesy surcharge applies].

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

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Social Determinants of Health from Inside the Hospital System

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

SDOH

By Staff Reporters

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READ: Social determinants of health aren’t just for patients. Health systems looking to promote health equity within their communities can start internally, by looking at their own workforce; according to HealthcareBrew.

***

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DAILY UPDATE: Big Pharma Earnings, Covid, RSV Vaccine, FOMC and the Markets

Posted on May 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

MAY THE FOURTH BE WITH YOU

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Many pharma companies reported earnings in the last week, and the common thread is crashing Covid-related sales.

For example, AstraZeneca’s Covid medication sales dropped $1.5b in Q1, Merck’s Covid antiviral sales fell 88% from the same quarter in 2022, and Roche’s diagnostics division sales fell 28% from Q1 2022, thanks to low Covid-test demand. Clearly, pharma companies have to figure out how to pivot their strategies in a post-Covid world.

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

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The CDC will not continue to track Covid-19 community spread as the country enters the endemic stage of the pandemic.

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The Food and Drug Administration approved Wednesday the first-ever vaccine to combat severe respiratory syncytial virus, or RSV. Arexvy, the new vaccine developed by GlaxoSmithKline, was approved for adults 60 and older and was 82% effective at preventing lower respiratory tract illness caused by RSV, according to trial data. It was also 94% effective in those who had at least one underlying medical condition.

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The Federal Reserve voted unanimously to raise interest rates by a quarter point yesterday, the tenth rate hike since the central bank started its battle against inflation last March. The move comes amid ongoing fragility in the banking sector triggered partly by higher interest rates, and following the collapse of three regional banks. Markets had anticipated the rate hike, and remained fairly muted after the Fed’s announcement.

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Finally, here’s where the major indexes ended up:

The S&P 500^® Index was down 28.83 points at 4090.75; the Dow Jones industrial average was down 270.29 (0.8%) at 33,414.24; the NASDAQ Composite was down 55.18 (0.5%) at 12,025.33.
The 10-year Treasury yield was down about 7 basis points at 3.367%.
CBOE’s Volatility Index was up 0.52 at 18.30.

Energy companies were among the market’s weakest performers as crude oil continued a recent decline, with WTI crude futures falling more than 4% under $70 a barrel—a nearly six-week low.

Semiconductor and financial shares were also weak. The U.S. dollar index dropped sharply in the wake of the Fed announcement before rebounding.

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

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

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BUSINESS PLAN CONSTRUCTION: For Health Industry Modernity

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

FOR MEDICAL AND HEALTHCARE ENTREPRENEURS AND INNOVATORS

By Dr. David Edward Marcinko MBA MEd CMP®

I was asked by business schools and medical colleagues – and their bankers, CPAs and advisors – to speak about this topic several times last year before the pandemic.

Now, with the specter of M-4-A etc; it certainly is a vital concern to all young entrepreneurs, doctors & medical professionals whether live, audio recorded or in podcast form. And so, here is a written transcript of a recent presentation for your review.

Now, with the specter of tele-health, tele-medicine, M-4-A etc; it certainly is a vital concern to all young doctors & medical professionals whether live, audio recorded or in podcast form. And so, here is a written transcript of a recent presentation for your review.

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New Product Business Plan Sample [2021 Updated] | OGScapital

***

READ: https://medicalexecutivepost.com/wp-content/uploads/2017/08/mba-business-plan-capstone-outline.pdf

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PODCAST: Confessions of a Hospital CFO

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

CHIEF FINANCIAL OFFICER

By Eric Bricker MD

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

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DAILY UPDATE: Eli Lilly and MIT’s Vaccine Printer

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

By Staff Reporters

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Eli Lilly (NYSE: LLY) investors continued to be in a good mood about their stock on Friday. Following the estimates-beating first quarter reported by the big pharmaceutical company the previous morning, they traded the shares up by 1.4% on the final trading day of the week. That eclipsed the 0.8% gain of the S&P 500 index.

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

***

Researchers at MIT have created a new type of tabletop printer that spits out vaccine doses on demand in the form of thumbnail-size microneedle patches. Once scaled, this mobile technology could produce hundreds of doses per day, revolutionizing pandemic response. And in a boon for warmer or more remote parts of the world, the vaccine patches can be stored at room temperature for months before they’re slapped on—no refrigeration or professional administering required.

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Filed under: "Ask-an-Advisor", Alerts Sign-Up, Drugs and Pharma, Financial Planning, Funding Basics, Health Economics, iMBA, Inc., Investing | Tagged: CBOE, DOW, Eli Lilly, gas, gold, LLY, markets, MIT, oil, S&P 500.DJIA, stock markets, Treasury yields, vaccine, VIX | Leave a comment »

DAILY UPDATE: Alphabet, Microsoft, Big Pharma and the Markets

Posted on April 27, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The two tech giants posted earnings that showed they’re both on solid footing, despite investors’ concerns that growth would slow to a trickle. For Alphabet, Google search advertising revenue grew again after a quarter in the red. And Microsoft’s all-important cloud division posted better-than-expected sales. Both companies stated AI could impact their businesses, but they differed in their predictions: Microsoft characterized AI as a much more disruptive force than Google did.

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

Get ready for earnings calls from pharmaceutical companies: Eli Lilly, AstraZeneca, AbbVie, and more quarterly calls this week. Investors will watch AbbVie’s sales numbers, as Amgen introduced the first biosimilar version of AbbVie’s blockbuster arthritis drug, Humira, in January. In its last call, AbbVie executives said they expected to lose $7.9 billion in Humira sales in 2023

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

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Here’s where the indexes ended yesterday.

The S&P 500 Index was down 15.64 points (0.4%) at 4055.99; the Dow Jones industrial average was down 228.96 (0.7%) at 33,301.87; the NASDAQ Composite was up 55.19 (0.5%) at 11,854.35.
The 10-year Treasury yield was up about 4 basis points at 3.439%.
CBOE’s Volatility Index was up 0.17 at 18.84.

***

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Filed under: "Advisors Only", "Doctors Only", Alerts Sign-Up, Drugs and Pharma, Ethics, Experts Invited, Health Economics, Health Insurance, Investing, LifeStyle | Tagged: AbbVie, AMGEN, CBOE, crude, DJIA, DOW, Eli Lilly, gold, humira, NASDAQ, oil, S&P 500, Treasury yields, VIX | Leave a comment »

PODCAST: Physicians Need to Be Trained as Entrepreneurs and Encouraged to Innovate!

Posted on April 27, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

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By Kevin Pho MD

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“Teaching medical students entrepreneurial and business skills is invaluable as the need for leadership in medicine grows in every single sector. Many physicians already engage in managerial and entrepreneurial-like practices without labeling these skills. By formalizing these skills into medical education, physicians will be able to take their ambitions and ideas about how to best run existing health care institutions and translate them into innovations for the future of the field.”

Sofia Yunez is a medical student.

She shares her story and discusses her KevinMD article, “To be effective leaders, physicians need to be trained as entrepreneurs and encouraged to innovate.”

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PODCAST: https://kevinmd.libsyn.com/physicians-need-to-be-trained-as-entrepreneurs-and-encouraged-to-innovate

***

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?s=books&ie=UTF8&qid=1287563112&sr=1-9

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Filed under: "Doctors Only", Career Development, Health Economics, Interviews, Investing, Videos | Tagged: Entrepreneurs, kevin pho, KevinMD, Physicians Need to Be Trained as Entrepreneurs and Encouraged to Innovate, Sofia Yunez | Leave a comment »

PODCAST: Future of Healthcare Profit Opportunities

Posted on April 27, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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Filed under: "Doctors Only", Career Development, Drugs and Pharma, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Videos | Tagged: Eric Bricker MD, health care profit, healthcare profit, healthcare profits, medical profit, medical profits | Leave a comment »

SVB: Grew from the Business Start-Up Ecosystem

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

By Staff Reporters

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DEFINITION: Startups are young companies or ventures that are founded to develop a unique or innovative product, service, or platform, and bring it to market. They are typically in the early stages of their development and face high uncertainty and failure rates. They are usually self-funded by the founders or seek external funding from investors or loans. They aim to grow large beyond the solo founder and disrupt existing industries or create new one.

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

SVB rooted in the startup ecosystem

SVB was relatively small—it had 40,000 customers compared to JPMorgan Chase’s 66 million—but it claimed to bank nearly half of all US tech and life sciences startups last year, including household names like Etsy, Roblox, and Roku. The cultural cachet of having a relationship with SVB as a venture-backed startup was like sporting a New Yorker tote at Whole Foods.

But the reason its loss will leave such a gaping hole in the startup community isn’t that it was cool to name-drop at a networking event. Because the bank was created in 1983 specifically to cater to venture-backed startups, it helped them in ways that most banks can’t—or won’t.

SVB chill loans: According to the MorningBrew, SVB would offer loans to startups more readily than large banks, basing the loans on a company’s ability to raise venture capital funds, not to turn a profit. SVB was also known for being flexible—even if startups breached their loan terms. “They were the easiest money for an unprofitable, early stage to mid-stage tech company,” Irving Investors founder Jeremy Abelson told The Information. And, even small startups received hand-holding services, such as guidance on how to set up their financial infrastructure. Its bankers personally called startups when they secured their first rounds of funding, according to The Information.

Startups now have to deal with big banks

Several founders who previously banked with SVB told Bloomberg that they’re moving their money to Chase and Bank of America, banks considered “too big to fail.”

Startups’ experience at big banks won’t be like their time at SVB. Not only is Jamie Dimon unlikely to call a startup to congratulate them on their Series A, but big banks are also expected to be more tight-fisted with their loans. The Office of the Comptroller of the Currency, a regulator that oversees large US banks, disapproves of loans to companies that are further out than one year from profitability, according to Crunchbase.

The loss of SVB is therefore expected to have a chilling effect on loans to venture-backed startups, aka “venture debt,” which SVB handed out more of than any other bank.

***

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

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Filed under: "Ask-an-Advisor", Alternative Investments, Ethics, Health Economics, Investing, LifeStyle, Risk Management | Tagged: Bank America, Chase, crunch base, Etsy, fed, FOMC, JPMorgan, Morniong Brew, Roblox, Roku, Silicon Valley Bank, SVB, Venture Capital, venture debt | Leave a comment »

Financial-Tech [Entrepreneurial Start-Ups] Falling

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

By Staff Reporters

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DEFINITION: Financial technology (abbreviated fintech or FinTech) is the technology and innovation that aims to compete with traditional financial methods in the delivery of financial services. Artificial intelligence, Blockchain, Cloud computing, and big Data are regarded as the “ABCD” (four key areas) of FinTech. The Fintech industry is an emerging industry that uses technology to improve activities in finance. The use of smartphones for mobile banking, investing, borrowing services,and cryptocurrency are examples of technologies aiming to make financial services more accessible to the general public.

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Financial technology companies consist of both startups and established financial institutions and technology companies trying to replace or enhance the usage of financial services provided by existing financial companies.

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

A subset of fintech companies that focus on the insurance industry are collectively known as insurtech or insuretech

READ: https://tinyurl.com/yrx2kxy4

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

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Filed under: Accounting, Glossary Terms, Health Economics, Investing | Tagged: AI, block chain, ChatGPT, Entrepreneurial Start-Ups, fin-tech, financial technology., Financial-Tech [Entrepreneurial Start-Ups] Falling, start-up, Venture Capital | Leave a comment »

Gifts that Violate the FCA Anti-kickback Statute

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

THE EIGHT [8] GIFTS

By Staff Reporters

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Much like the False Claims Act, the Anti-Kickback Statute (AKS) remains a frequent tool used by the Department of Justice to investigate the healthcare industry. Unlike the False Claims Act, the AKS imposes criminal penalties on violators.

FCA: https://medicalexecutivepost.com/2022/03/28/doj-recoveries-for-false-claims-act-cases-doubled-in-2021/

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

The leaders of a physicians’ practice may be held liable for what others in the practice do, even if the leader did not know precisely what was going on. It has been called the “crime of doing nothing.”

1. Providing free dinners or lunches to physicians

2. Travel expenses paid to physicians

3. Entering into consulting or research agreements with physicians under which payments are made but minimal (or zero) work is done in return

4. Other gifts, such as electronics or tickets to sporting events

5. Laboratory pays a specimen processing fee to physicians above the fair value for those fees

6. Physician retention or recruitment agreements, when those agreements provide for payments above fair market value or are made with the intent to induce Medicare referrals

7. Agreements for speaking or teaching where the payments are above fair market value or made with the intent to induce referrals

8. Discount schemes that do not meet the safe harbor requirements

Source: Sara Kropf and Logan Lutton, Physicans Practice

STARK LAWS: https://medicalexecutivepost.com/2023/04/18/podcast-the-anti-kickback-and-stark-laws-for-doctors-and-hospitals-explained/

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

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Filed under: "Doctors Only", Accounting, Ethics, Health Economics, Health Insurance, iMBA, Inc., Risk Management | Tagged: AKS, anti-kickback, false claims act, FCA, Stark laws | Leave a comment »

MEDICARE / MEDICAID: Physician Acceptance Down

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

By Staff Reporters

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Physicians Who Accept Medicare, Medicaid at All-time Low of 65%

Reduced Medicare and Medicaid payments are having more physicians considering reducing those patient bases, according to Medscape’s “Physician Compensation Report” for 2023. Sixty-five percent of physicians surveyed said they would continue treating current Medicare or Medicaid patients and take on new ones, according to the report. Medscape said it is the lowest percentage it has seen in its annual compensation reports. Five years ago, 71 percent of physicians said they would continue treating current Medicare or Medicaid patients and take on new ones.

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

For the report, Medscape collected responses from 10,011 physicians across more than 29 specialties. The data was collected between Oct. 7, 2022, and Jan. 17, 2023. Eight percent of physicians surveyed said they would not take on new Medicare patients, and 5 percent said they would not take new Medicaid patients. Four percent said they will stop treating some or all of their current Medicare patients and will not take on new ones, and 3 percent said the same about Medicaid patients. Twenty-two percent said they have not yet decided how they will move forward regarding Medicare and Medicaid patients, according to the report.

Source: Andrew Cass, Becker’s Payer Issues [4/18/23]

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Filed under: "Doctors Only", Accounting, Career Development, Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, iMBA, Inc., Managed Care, Risk Management, Taxation | Tagged: doctor compensation, doctor pay, doctor salary, medacape, Medicaid, medicare, Medscape.physician compensation, physician compensation | Leave a comment »

PODCAST: US Hospital Bond Debt Explained

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

Do Patients Come First or Creditors?

By Eric Bricker MD

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

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Filed under: Experts Invited, Health Economics, Healthcare Finance, Investing, Videos | Tagged: AHA, bond ratings, Eric Bricker MD, Hospital Bonds, hospital capital finance, hospital debt, MOODY | Leave a comment »

WOMEN: Gaining Economic Earnings Influence

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

Physician Salary Pay Gap Comparisons

By Staff Reporters

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Physician Salary Pay Gap Follow-Up: https://medicalexecutivepost.com/2023/04/14/physician-salary-pay-gap/

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Women earn as much as or more than their husbands in just under half of US opposite-sex marriages, a significant advancement for economic equality from past decades, according to a new Pew Research study.

Sixteen percent of wives in opposite-sex marriages are the sole or primary breadwinners in their home (“primary” meaning they make more than 60% of the household’s income). This share is triple the 5% of women breadwinners from 50 years ago.
In 29% of marriages, both spouses bring home about the same income.

But, according to MorningBrew, in marriages where both partners have the same income, women spend about four-and-a-half more hours per week on chores and care giving than men.

And when women become the house’s primary income earner, little really changes about how much time either partner spends on chores, Pew found. But in this scenario, men report almost five more hours of leisure time per week than men in egalitarian households

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

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Filed under: Accounting, Career Development, Ethics, Experts Invited, Health Economics, Investing, LifeStyle, Taxation | Tagged: MorningBrew, pay gap, Pew Research, physician salary, wives economic influence, women, women earnings | Leave a comment »

DAILY UPDATE: Meta & Disney Cut More Jobs While the Stock Markets Bobble

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

By Staff Reporters

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Meta Platforms, the billionaire’s social media empire, will reportedly cut thousands more jobs. And the bloodbath is not over, according to the latest reports. Meta plans to eliminate thousands more jobs. According to Bloomberg News, an internal memo has been sent to managers, asking them to prepare for tough new announcements. The job cuts, which total 4,000, are expected to affect Facebook, WhatsApp and Instagram. They would also affect Reality Labs, the division that houses the group’s Metaverse projects — Quest virtual-reality headsets. In 2021 and 2022, Reality Labs, which is supposed to build the company’s next big thing, recorded a cumulative loss of nearly $24 billion, including $13.7 billion just last year.

And, Walt Disney Company plans to cut thousands of jobs next week, in another lay-off round that includes about 15% of the staff in its entertainment division, according to people familiar with the plans. Disney Entertainment will bear a significant chunk of the job cuts – with approximately 15% of the division’s staffers set to exit next week, according to a report. Disney has more than 200,000 employees across its various businesses.

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And now, the Markets:

The S&P 500 Index fell 0.35 point to 4154.52; the Dow Jones industrial average was down 79.62 (0.2%) at 33,897.01; the NASDAQ Composite was up 3.81 at 12,157.23.
The 10-year Treasury yield was up about 2 basis points at 3.60%.
CBOE’s Volatility Index was down 0.37 at 16.46.

Transportation was one of the top gainers among S&P 500 sectors yesterday, thanks in part to strength in United Airlines (UAL) and other top carriers. Real estate and financials were also higher, while oilfield services stocks were among the weakest performers due to a sharp drop in crude oil prices. WTI futures fell below $80, their lowest level in nearly three weeks.

Oil prices rallied at the start of this month after members of OPEC+ announced a production cut.

***

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

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Filed under: "Ask-an-Advisor", Alerts Sign-Up, Alternative Investments, Career Development, Experts Invited, Health Economics, Information Technology, Investing, LifeStyle | Tagged: Bloomberg, Disney, DJIA, DOW, Facebook, FB, gas, Instagram, Meta, metaverse, NASDQA, oil, Quest, Quest VR, real estate, S&P 500, stock markets, Treasury yields, UAL, VR, walt, WTI | Leave a comment »

PODCAST: Investing in Digital Health Sales and Marketing

Posted on April 19, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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

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Filed under: "Doctors Only", Drugs and Pharma, Experts Invited, Glossary Terms, Health Economics, Health Insurance, Investing, Videos | Tagged: Digital Health, digital health marketing, digital health sales, Eric Bricker MD, investing in digital health, PODCAST: Investing in Digital Health Sales and Marketing | 1 Comment »

PODCAST: The Anti-Kickback and Stark Laws for Doctors and Hospitals Explained

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

By Eric BrickerMD

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

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Filed under: "Doctors Only", CMP Program, Ethics, Experts Invited, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Industry Indignation Index, Insurance Matters, Interviews, Risk Management, Videos | Tagged: anti kick-back laws, anti-kickback, Eric Bricker, Eric Bricker MD, Stark, Stark laws | 1 Comment »

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