HEALTHCARE: 2021 M&A in Review

Indications for 2022

BY HEALTH CAPITAL CONSULTANTS, LLC

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2021 M&A in Review: Indications for 2022

After an understandable slowdown in 2020, due to the onset of the COVID-19 pandemic, merger & acquisition (M&A) activity in the healthcare industry accelerated in 2021, and the industry is expected to continue the high number of deals and high deal volume in 2022.

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This Health Capital Topics article will review the U.S. healthcare industry’s M&A activity in 2021, and discuss what these trends may mean for 2022. (Read more…)

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

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45% of Hospitals Have a Shortage of Primary Care Physicians

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By Staff Reporters

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A recent American College of Healthcare Executives’ survey of 310 hospital CEOs shows:

 •  94% have personnel shortages in registered nursing field
 •  85% have personnel shortages in technicians field
 •  67% have personnel shortages in therapists field
 •  45% have personnel shortages in primary care physicians field
 •  43% have personnel shortages in physician specialists field
 •  31% have personnel shortages in physician extenders and specially certified nurses field

Source: American College of Healthcare Executives, “Top Issues Confronting Hospitals in 2021, February 4, 2022

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55% of Consumers Find it Stressful Paying a Healthcare Bill

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By Staff Reporters

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An annual study of over 1,500 U.S. consumers, shows:

 •  55% of consumers find it stressful paying a healthcare bill.
 •  53% of consumers find it stressful understanding their plan’s coverage and benefits.
 •  53% of consumers find it stressful comprehending what they owe.
 •  59% of consumers find it stressful reconciling a bill issue with their payer.

Source: Cedar via GlobeNewswire, December 7, 2021

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

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COVID INFECTIONS: The Un-Vaccinated

By Staff Reporters

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33.6% of COVID Infections Were in Unvaccinated Persons

According to a recent CDC study. Among 422,966 reported SARS-CoV-2 infections in LAC residents aged ≥18 years during November 7, 2021–January 8, 2022:

 •  33.6% were in unvaccinated persons
 •  13.3% were in fully vaccinated persons with a booster
 •  53.2% were in fully vaccinated persons without a booster
 •  Unvaccinated persons were most likely to be hospitalized, representing 2.8% of COVID infections
 •  Unvaccinated persons were most likely to be admitted to an ICU, or 0.5% of COVID infections
 •  Unvaccinated persons were most likely to be require intubation for mechanical ventilation, or 0.2% of COVID infections.

Source: CDC, Morbidity and Mortality Weekly Report, February 1, 2022

Lost Vaccine Card: https://portal.ct.gov/vaccine-portal/Vaccine-Knowledge-Base/Articles/Lost-Vaccine-Card?language=en_US

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

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56% of Patients Attempted to Stretch Out a Prescription

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By Staff Reporters

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56% of Patients Attempted to Stretch Out a Prescription According tot a Recent CoverMyMeds Survey of 1,000 patients. It found: 

•  79% of patients said they’ve gone to the pharmacy only to discover a prescription cost more than they expected.
•  When faced with an affordability challenge, 56% of patients attempted to stretch out a prescription.
 •  When faced with an affordability challenge, 52% of patients skipped bills or other essential items to afford medications.
•  When faced with an affordability challenge, 51% of patients sacrificed medications to pay bills and other essentials.

Source: CoverMyMeds, “2022 Medication Access Data Guide,” February 2022

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

Rx Podcast: https://medicalexecutivepost.com/2022/02/20/podcast-how-to-write-a-medical-prescription-rx/

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PODCAST: Digital Health Market Segmentation

FOR HEALTHCARE ENTREPRENEURS

By Eric Bricker MD

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PODCAST: The “Secret” to Doctor Pay = RVUs

Relative Value Units

By Eric Bricker MD

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

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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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PODCAST: 15 Metrics for Successful Healthcare Companies

Phil Fisher Was One of the Greatest Entrepreneurial Investors of the 20th Century and a Source of Wisdom for Warren Buffett

By Eric Bricker MD

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Related: https://thehealthcareblog.com/blog/2022/02/03/after-the-crash/?utm_campaign=THCB%20Reader&utm_medium=email&utm_source=Revue%20newsletter

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Product Details

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

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Informal Money SLANG TERMS to Avoid

NOT PROFESSIONAL BUSINESS SCHOOL LINGUISTICS – BUT FAR TOO OFTEN USED

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Invite Dr. Marcinko | The Leading Business Education Network for Doctors,  Financial Advisors and Health Industry Consultants

By Dr. David Edward Marcinko MBA CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Another Word for “Money” | 100+ Different Forms of Money You Should Know •  7ESL

People really love money since it is needed to buy just about everything. In fact, we actually published a formal print dictionary on health economics and finance terms that is very popular with physician investors and medical colleagues; it is a favorite of economic students as well!

Product Details

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

And, money is by far one of those words that has more slang or terms for it than any others. This proves that cash or money, does not have be boring when speaking about it. Just keep in mind that these slang synonyms are in plural form. They are also words mostly used for US currency.

Perhaps the fact that money is so important may help to explain why there are so many different ways to say it. These 95 slang words for money and their meanings are really worth taking a look at. This list not only contains the countless ways to speak, write or say the word money, but also what are the meanings behind each phrase or term.

LINK: https://blog.online-spellcheck.com/english/95-slang-words-money-meanings/

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ASSESSMENT: Lastly, remember to never use any of these slang terms for money if you are doing formal writing or publishing; especially for me!

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What Really is an Economic PUBLIC GOOD?

By Staff Reporters

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According to Tejvan Pettinger, a public good has two characteristics:

  1. Non-rivalry: This means that when a good is consumed, it doesn’t reduce the amount available for others.
    – E.g. benefiting from a street light doesn’t reduce the light available for others but eating an apple would.
  2. Non-excludability: This occurs when it is not possible to provide a good without it being possible for others to enjoy. For example, if you erect a dam to stop flooding – you protect everyone in the area (whether they contributed to flooding defenses or not.
See the source image

A public good is often (though not always) under-provided in a free market because its characteristics of non-rivalry and non-excludability mean there is an incentive not to pay. In a free market, firms may not provide the good as they have difficulty charging people for their use.

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

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QUERY: Is Health and Medical Care a Public Good?

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PODCAST: Medicare Re-Admission Penalty Explained

As part of the Affordable Care Act of 2010

CMS changed its hospital readmission penalty methodology

BY ERIC BRICKER MD

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

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

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J.B. SAY: The “Law of Markets” Podcast

What it Is – How it Works

By Staff Reporters

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DEFINITION: In classical economics, Say’s law, or the law of markets, is the claim that the production of a product creates demand for another product by providing something of value which can be exchanged for that other product. Thus, production is the source of demand.

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

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Say's Law of Markets - Overview, How It Works, Criticism

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PODCAST: https://www.youtube.com/watch?v=eGGy06xbjd8

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Average Annual Healthcare Growth Rates of Spending, Utilization and Price

By Staff Reporters

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Average Annual Growth Rates of Spending, Utilization, and Prices

 •  Spending per person: commercial insurers (3.2% per year); Medicare fee for service (1.8% per year)
 •  Utilization per person: commercial insurers (0.4% per year); Medicare fee for service (0.5% per year)
 •  Prices paid to providers: commercial insurers (2.7% per year); Medicare fee for service (1.3% per year).

Notes: For hospitals and physicians’ services, 2013-2018
Source: Congressional Budget Office – January 2022

“The Prices That Commercial Health Insurers and Medicare Pay for Hospitals’ and Physicians’ Services”
 

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PODCAST: Medicare Provider Payment Changes

By Eric Bricker MD

The Centers for Medicare and Medicaid Services (CMS) Announce Changes to Doctor and Healthcare Provider Payments

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

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PODCAST Related Medical Payments: https://medicalexecutivepost.com/2021/10/01/podcast-on-medicare-payments-to-doctors/

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CMS: MSSP ACO Growth 2012-2022

By Staff Reporters

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DEFINITION: An accountable care organization is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation.

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

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See the source image

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CMS MSSP ACO Growth 2012-2022

Performance YearACOsAssigned Beneficiaries
202248311.0 million
202147710.7 million
202051711.2 million
201948710.4 million
201856110.5 million
20174809.0 million
20164337.7 million
20154047.3 million
20143384.9 million
2012+20132203.2 million

Source: CMS 2022 Shared Savings Program Fast Facts – As of January 1, 202

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FRANCHISE Healthcare Opportunities?

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dave-2

BY DR. DAVID E. MARCINKO MBA CMP®

CMP logo

SPONSOR: http://www.CertifiedMedicalPlanner.org

Healthcare Business and Medical Franchises

The International Franchise Association (IFA) estimates that that about $1 trillion in sales, or 40% of all retail sales, were made through franchised establishment last year.  On the positive side, franchises offer a branded practice concept with management training and access to proprietary methods, marketing and advertising campaigns and a host of support.

Moreover, there are franchises available for virtually every healthcare product or service, including: diet, weight loss and fitness; vein care and laser surgery; vitamins, nutriceuticals and pharmaceuticals; plastic and cosmetic surgery; dermatology, tanning and skin care; home healthcare and extended, etc. Some well know established healthcare and medical franchises are:  Doctors Express, Being There Senior Care, Home Care Assistance, Personal Training Institute, Inches-A-Weigh, Remedy Intelligent Staffing, Visiting Angels, Unlimited MedSearch, prnYourHealth and Any Lab Test Now, etc.

On the downside, franchises incur high start-up costs, rules and obligations, payment of franchise percentages and many contractual obligations. Questions to consider when contemplating this business entity include:

  • Franchise stability, track record, licensing and costs.
  • Training, support and proximity of other franchises.
  • Independence, ownership laws, contracts and dispute resolutions,
  • Screening methods, market size and potential market share.
  • Replacement cost and transferability?

For more information on Uniform Franchise Offerings Circulars (UFOCs) contact www.FranChoice.com or:

Frandata

1130 Connecticut Avenue, NW

Washington DC 20036

202.659.8640

http://www.frandata.com

International Franchise Association

1350 New York Avenue, NW

Washington, DC 20005

202.628.800

http://www.franchise.org


Also visit:
www.aafd.org; www.franNet.com

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-

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Health Consumption Expenditures Per Capita

By Staff Reporters

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KFF: Health Consumption Expenditures Per Capita

 •  United States: $11,946
 •  Switzerland: $7,138
 •  Germany: $6,731
 •  Netherlands: $6,299
 •  Austria: $5,899
 •  Sweden: $5,754
 •  France: $5,564
 •  Belgium: $5,458
 •  Canada: $5,370
 •  United Kingdom: $5,268
 •  Australia: $4,919
 •  Japan: $4,691

Notes: U.S. value obtained from National Health Expenditure data. Data from Australia, Belgium, Canada, Japan and Switzerland are from 2019. Data for Australia, France, and Japan are estimated. Data for Austria, Canada, Germany, Netherlands, and Sweden are provisional. Health consumption does not include investments in structures, equipment, or research. Data for 2020 except as noted.
Source: KFF analysis of National Health Expenditure (NHE) and OECD data, January 21, 2022

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

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PODCAST: Health Insurance Costs Have Risen 55% in the Last Decade

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By Eric Bricker MD

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Health Insurance Cost Has Risen 55% in the last 10 Years. The Annual Health Insurance Cost for Family Coverage is Now $21,000 Per Year

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Dysfunctional Employee Benefits Article in Journal of the American Medical Association

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

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PODCASTS: Medicare Cost Reports Explained

By Eric Bricker MD

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PODCAST: Medicare Bad Debt Reimbursement: https://www.youtube.com/watch?v=LMa4at0wlRU

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PODCAST: If You Pay Doctors More, Will They Work More or Less?

Income and Substitution Effects in Healthcare Economics

By Erice Bricker MD

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

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Comprehensive Financial Planning and Risk Management Strategies for Doctors and their Advisors

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Best Practices from Leading Consultants and Certified Medical Planners

SPONSOR: http://www.CertifiedMedicalPlanner.org

CMP logo

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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™

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

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PODCAST: Healthcare Challenges Post Pandemic?

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By Richard Helppie

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We’re posting this episode of The Common Bridge, with Henry Ford Health System President and CEO, Wright Lassiter, III complete with written transcript, along with the podcast and video links because there were technical difficulties with Mr. Lassiter’s audio. This way, you can read along, or refer back to us.

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PODCAST: https://www.youtube.com/watch?v=bKC5k7qrfDk

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IRS Advanced Child Tax Credit Payments Letter 6419

By Staff Reporters

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See the source image

The IRS Tax Letter 6419 has been sent out to families who received the Child Tax Credit in 2021 and it explains how the advance tax credit will affect your filing this year. This may be of special importance to young physicians, nurses and all younger medical professionals.

READ: https://www.irs.gov/individuals/understanding-your-letter-6419

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

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PODCAST: Data Science and Statistics in Healthcare

HYPOTHESIS TESTING

BY ERIC BRICKER MD

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RELATED PODCAST: https://www.youtube.com/watch?v=MSnJ-q1pTQk

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CORRELATION / CAUSATION: https://medicalexecutivepost.com/2021/02/05/correlation-is-not-causation/

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ORACLE Buys CERNER Electronic Medical Records

By Staff Reporters

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According to reporter Neal Freyman, Tech giant Oracle said it’s paying $28.3 billion to buy electronic medical records company Cerner, because anything that makes paperwork less excruciating seems like a savvy business play.

Oracle is known for being aggressive with acquisitions (it even rallied a group to try and buy TikTok last year), but Cerner is Oracle’s biggest purchase in its history. The deal is further evidence that health care is “on par with banking in terms of the importance to our future,” as cofounder Larry Ellison told analysts earlier this month.

  • In Cerner, Oracle will get the Klay Thompson of the electronic medical records market—a very influential player, but in second place behind Epic, which owns a 31% market share.

Bottom line: Big tech companies see a golden opportunity in bringing the health care industry to the cloud, given its size (health care spending accounts for almost 20% of US GDP), and its old-school record-keeping process. A Mayo Clinic study cited by Oracle showed that doctors and nurses spend an average of 1–2 hours on desk work for every hour they take to see patients.

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EMR PODCAST: https://medicalexecutivepost.com/2021/08/29/podcast-on-electronic-medical-records/

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

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HIT: 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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PODCAST: Ochsner Value Based Care Saves $100-M

BY ERIC BRICKER MD

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Ochsner Health in New Orleans and Its EVP of Value-Based Care, Dr. David Carmouche, Have Had REAL Success with REAL Value-Based Care.

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

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PODCAST: The Mark Cuban Cost Plus Drug Co (MCCPDC)

By Staff Reporters

Mark Cuban, not Congress, will give Americans cheaper prescription drugs

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When universal health care fails to pass in Congress, there’s always Mark Cuban to fall back on. The billionaire and Dallas Mavericks owner launched an online pharmacy this week in order to combat the price gouging of prescription drugs by large pharmaceutical companies.

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

The Mark Cuban Cost Plus Drug Co. (MCCPDC) will offer more than 100 generic drugs that will be purchased directly from the manufacturers and sold online with a 15 percent markup across the board and a small pharmacist fee. For context, pharmaceutical companies generally mark prices up at least 100 percent and up to 1000 percent in some cases.

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PBM Forum Wrap Up: Greater Transparency, Further Congressional Review  Needed to Lower Drug Prices - United States House Committee on Oversight  and Government Reform

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READ: https://www.msn.com/en-us/money/other/its-quite-a-country-when-mark-cuban-not-congress-will-give-americans-cheaper-prescription-drugs/ar-AAT2KJ3?li=BBnb7Kz

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UPDATE: Markets and the Economy

By Staff Reporters

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PODCAST: How to Read Healthcare Insurance Reports

BY ERIC BRICKER MD

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

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

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

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PODCAST: Hospital Innovation Will Happen

By Eric Bricker MD

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1. 18% of Healthcare Workers have left their job since 2020.

2. 66% of ICU and Acute Care Nurses have considered leaving.

3. ICUs are so short staffed that they have had to run at 4:1 patient to nurse ratios… the normal is 2:1.

4. A Florida hospital spent $24 Million in 2021 on temporary workers to cover for labor shortages… normally they spend $1 Million per year.

5. Nurses average age is 52 and 19% of nurses are over 65 … the nursing workforce is older because younger people do not want the job.

Why?

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What is the Economic CONSUMPTION FUNCTION Theory?

WE ARE NOT CONSUMING AND THE MARKETS ARE DOWN

By Staff Reporters

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A Theory of the Consumption Function

One of Milton Friedman’s most popular works, A Theory of the Consumption Function, challenged traditional Keynesian viewpoints about the household. This work was originally published in 1957 by Princeton University Press, and it reanalyzed the relationship displayed “between aggregate consumption or aggregate savings and aggregate income.”

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

Keynes: https://medicalexecutivepost.com/2016/05/25/keynesian-versus-austrian-economics/

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Consumption Function Definition

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Now, according to Wikipedia, Friedman’s counterpart Keynes believed people would modify their household consumption expenditures to relate to their existing income levels. Friedman’s research introduced the term “permanent income” to the world, which was the average of a household’s expected income over several years, and he also developed the permanent income hypothesis. Friedman thought income consisted of several components, namely transitory and permanent. He established the formula y = y p + y t {\displaystyle y=y_{p}+y_{t}} {\displaystyle y=y_{p}+y_{t}} in order to calculate income, with p representing the permanent component, and t representing the transitory component.

A model of the Permanent Income Hypothesis

Milton Friedman’s research changed how economists interpreted the consumption function, and his work pushed the idea that current income was not the only factor affecting people’s adjustment household consumption expenditures. Instead, expected income levels also affected how households would change their consumption expenditures. Friedman’s contributions strongly influenced research on consumer behavior, and he further defined how to predict consumption smoothing, which contradicts Keynes’ marginal propensity to consume. Although this work presented many controversial points of view which differed from existing viewpoints established by Keynes, A Theory of the Consumption Function helped Friedman gain respect in the field of economics. His work on the Permanent Income Hypothesis is among the many contributions which were listed as reasons for his Sveriges-Riskbank Prize in Economic Sciences. His work was later expanded on by Christopher D. Carroll, especially in regards to the absence of liquidity constraints.

READ MORE HERE:

Of course, the Permanent Income Hypothesis faced some criticism, mainly from Keynesian economists. The primary criticism of the hypothesis is based on a lack of liquidity constraints.

HAYEK: https://medicalexecutivepost.com/2011/05/06/john-maynard-keynes-v-s-fa-hayek/

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Your comments are appreciated.

QUERY: What is the CF for Healthcare?

MORE: https://medicalexecutivepost.com/2018/09/18/are-doctors-practitioners-of-conspicuous-consumption/

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Healthcare NOT a Part of the US Inflation Surge!

WHO KNEW?

By Staff Reporters

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According to Wikipedia, in economics, inflation refers to a general progressive increase in prices of goods and services in an economy.[1] When the general price level rises, each unit of currency buys fewer goods and services; consequently, inflation corresponds to a reduction in the purchasing power of money.[2][3] The opposite of inflation is deflation, a sustained decrease in the general price level of goods and services. The common measure of inflation is the inflation rate, the annualised percentage change in a general price index.[4]

READ MORE: https://en.wikipedia.org/wiki/Inflation

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

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Health Care Price Changes and Per Capita Growth in Medicare | Mercatus  Center

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Healthcare Not a Part of the US Inflation Surge: Who Knew?

However, according to Jeff Goldsmith, overall health spending has only risen by 4.4% since January of 2020, and the percentage of GDP devoted to health has fallen by more than half a percent, from 18.1% pre-pandemic to 17.5% in October.   This is despite four surges of COVID hospitalizations, overflowing ICUs and ERs, labor shortages, and other COVID-related stresses.  Health system staffing levels are still nearly a half-million lower than they were pre-pandemic.  Had the federal government not stepped in through the CARES Act, FEMA funding, and temporary suspensions of Medicare rate cuts, the nations’ hospitals would have been seriously damaged by COVID-related financial stresses, which are far from being over.  

ESSAY: https://thehealthcareblog.com/blog/2021/11/19/healthcare-not-a-part-of-the-us-inflation-surge-who-knew/

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UPDATE: Stock Market and Retail Banks

BY STAFF REPORTERS

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Stock Markets: Stocks ticked higher as investors zeroed in on Senate testimony from Fed Chair Jerome Powell, who is up for a second term. Powell said the Fed would do what’s necessary to get inflation back to normal levels.

Banks: Bank of America decided to make life a little less difficult for account holders without piles of cash. The bank—America’s second largest—announced on Tuesday that it would reduce overdraft fees by around 70%, from $35 to $10. BofA is also scrapping a $12 non-sufficient funds fee (for bouncing a check or making an automated overdraft) and will eliminate transfer fees for its overdraft protection service.The decision comes on the recently shined heels of similar moves by other large banks.

  • Capital One announced last month that it was eliminating overdraft fees altogether.
  • In August, JPMorgan increased its charge-incurring overdraft amount to $50 (it was previously $5).
  • PNC Bank introduced a 24-hour grace period on overdraft penalties.

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