BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on July 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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What is a medical credit card?
Medical credit cards are typically offered through healthcare providers such as physicians, veterinarians, dentists, and even hospitals. Unlike major credit cards, you can’t use them for cash advances or to purchase items like groceries, gasoline, or airline tickets.
At least 5 people are dead and multiple people are injured following a shooting at the Natalie Building at St. Francis Hospital in Tulsa, Oklahoma.
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The impact of medical workplace violence became widely exposed on November 6, 2009 when 39 year old Army psychiatrist Maj. Nidal M. Hasan MD, a 1997 graduate of Virginia Tech University who received a medical doctorate in psychiatry from the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and served as an intern, resident and fellow at the Walter Reed Army Medical Center in the District of Columbia, went on a savage 100 round shooting spree and rampage that killed 13 people and injured 32 others. In April 2010 he was transferred to Bell County Jail in Belton, Texas awaiting trial.
Federal Government Guidelines
The federal government and some states have developed guidelines to assist employers with workplace violence prevention. For instance, one of the earliest sets of guidelines for a comprehensive workplace violence prevention program was published in 1993 by California OSHA. This resulted from the murder of a state employee. In 1996, Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers was published by OSHA.
OSHA Guidelines
In its guidelines, OSHA sets forth the following essential elements for developing a violence prevention program:
Management commitment — as seen by high-level management involvement and support for a written workplace violence prevention policy and its implementation.
Meaningful employee involvement — in policy development, joint management-worker violence prevention committees, post-assault counseling and debriefing, and follow-up are all critical program components.
Worksite analysis — includes regular walk-through surveys of all patient care areas and the collection and review of all reports of worker assault. A successful job hazard analysis must include strategies and policies for encouraging the reporting of all incidents of workplace violence, including verbal threats that do not result in physical injury.
Hazard prevention and control — includes the installation and maintenance of alarm systems in high-risk areas. It may also include the training and posting of security personnel in emergency departments. Adequate staffing is an essential hazard prevention measure, as is adequate lighting and control of access to staff offices and secluded work areas.
Pre-placement and periodic training and education — must include educationally appropriate information regarding the risk factors for violence in the healthcare environment and control measures available to prevent violent incidents. Training should include skills in aggressive behavior identification and management, especially for staff working in the mental health and emergency departments.
On May 17, 1999, Governor Gary Locke signed the New Workplace Violence Prevention Act for the state of Washington. This act mandates that each healthcare setting in the state implement a plan to reasonably prevent and protect employees from violence.
New Washington Workplace Violence Prevention Act
According to this act, prevention plans need to address security considerations related to:
physical attributes of the healthcare setting;
staffing, including security staffing;
personnel policies;
first aid and emergency procedures;
reporting of violent acts; and
employee education and training.
Prior to the development of an actual plan, a security and safety assessment needs to be conducted to identify existing or potential hazards. The training component of the plan must include the following topics:
general safety procedures;
personal safety procedures;
the violence escalation cycle;
violence-predicting factors;
means of obtaining a patient history form from a patient with violent behavior;
strategies to avoid physical harm;
restraining techniques;
appropriate use of medications as chemical restraints;
documenting and reporting incidents;
the process whereby employees affected by a violent act may debrief;
any resources available to employee for coping with violence; and
the healthcare setting’s workplace violence prevention plan.
Assessment
The act further mandates that any hospital operated and maintained by the State of Washington for the care of the mentally ill is required to provide violence prevention training to affected employees identified in the plan on a regular basis and prior.
Conclusion
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Instead, physician assistants (PAs) and nurse practitioners (NPs) will increasingly provide primary care services, according to a report from consulting firm Mercer.
Posted on July 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
What is anAccountable Care Organization?
DEFINITION: ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings.
Thankfully, Anish Koka is vigilant and explains the blatant obfuscations and manipulations that the central planners engage in to have their way.
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And so, In this video, Anish and colleague Michel Accad, MD, will reveal the machinations, take the culprits to task, and discuss pertinent questions regarding health care organization:
Does “capitation” reduce costs?
Do employed physicians necessarily utilize fewer resources?
What happens when a HMO and a traditional fee-for-service health system operate side-by-side in a community?
Posted on July 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants, LLC
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Because of the federal government’s preference for, and reliance on the success of, accountable care organizations (ACOs), some ACOs assume their legal status shields the organization from legal scrutiny on all issues.
However, since the 2010 advent of ACOs, the law has adapted uniquely to these organizations. This fourth installment of a five-part series on the valuation of ACOs will discuss this unique regulatory environment in which ACOs operate. (Read more…)
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 decade. 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.
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:
Frandata 1130 Connecticut Avenue, NW Washington DC 20036 202.659.8640
International Franchise Association7 1350 New York Avenue, NW Washington, DC 20005 202.628.800
Multi-Level Marketing and In-Office Dispensation
A multi-level marketing (MLM) business delivers products or services through a chain of independent distributors rather than traditional retail business outlets. Existing medical practices not only pursue income ancillary, but it is not unusual for beginning practitioners to plan for and include it in their start-up models and business plans.
The first layer is usually the distributor who must sell products/services and recruit additional members to produce a hierarchical organization with many employees. Each distributor profits from direct sales, and from a varying commission stream down-line. It may be best to investigate before you leap into these situations since some may be fraudulent pyramid schemes that sell no useful product or service, and requires only recruiting others into the scheme. Be sure to obtain a Dunn & Bradstreet or TRW credit report about any MLM company and inquire about current litigation. Most authorities agree that it take 3-5 years before serious money is made in the MLM business.
Moreover, care must be taken with this model. According to colleague Stephen Barrett MD, writing on the Mirage of Multilevel Marketing: “Many any physicians are selling health-related multi-level products to patients in their offices. The companies most involved have included Amway (now doing business as Quixtar), Body Wise, Nu Skin (Interior Design), Rexall, and Juice Plus+. Doctors are typically recruited with promises that the extra income will replace income lost to managed-care.
Back, in December 1997, the AMA Council on Ethical and Judicial Affairs (CEJA) advised against profiting from the sale of “non- health-related products” to their patients. Although CEJA’s policy statement does not mention products sold through multilevel marketing, CEJA’s chairman said the statement was triggered by the growing number of physicians who had added an Amway distributorship to their practice.”
Posted on July 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The S&P 500 index®(SPX) rose 4.13 points (0.1%) to 5,576.98; the Dow Jones Industrial Average® ($DJI) fell 52.82 points (0.1%) to 39,291.97; the NASDAQ Composite® ($COMP) climbed 25.55 points (0.1%) to 18,429.9.
The 10-year Treasury note yield increased two basis points to 4.29%.
The CBOE Volatility Index® (VIX) inched up to 12.49, still near recent lows.
What’s up
Tesla rose 3.71%, putting the company squarely in the green year to date as investors continue to celebrate the automaker’s strong delivery numbers.
Corning rose yet another 3.76%, extending the glassmaker’s gains as it quickly becomes the new hot AI stock du jour.
KymeraTherapeutics shot 23.40% higher after its partner Sanofi gave the go-ahead for further studies of its experimental skin disease treatment.
Jumia Technologies soared 29.79% after Benchmark analysts initiated coverage of the African e-commerce company with a “buy” rating.
Sony rose 4.46% on the news that it has nothing to do with the merger of Paramount and Skydance as shareholders celebrate dodging a Paramount-shaped bullet.
What’s down
Albemarle dropped 8.76% after Baird analysts warned that lower lithium demand will translate to lower profits for the miner in its upcoming second quarter.
BP sank 4.80% after management warned of lower-than-expected profits and a writedown of its German refining facility to the tune of up to $2 billion.
Helios Technologies fell 10.94% on the news that the CEO of the industrial manufacturer had been placed on paid leave for potentially violating the company’s code of ethics.
OpenAI’s venture fund and Arianna Huffington’s Thrive Global are jointly funding a new startup that aims to build an AI health coach to promote healthier lifestyles.
Function Health, a health tech company focused on preventive medicine, recently closed a series A round led by Andreessen Horowitz (a16z) Bio + Health along with a slew of celebrity investors.
“…small businesses with fewer than 1,000 employees are four times more likely to be impacted by attackers than medium and large businesses.” That’s us, Doc. (You might not get this kind of news from the American Dental Association).
EDITOR’S NOTE: I first met Rich in B-school, when I was a student, back in the day. He was the Founder and CEO of Superior Consultant Holdings Corp. Rich graciously wrote the Foreword to one of my first textbooks on financial planning for physicians and healthcare professionals. Today, Rich is a successful entrepreneur in the technology, health and finance space.
Posted on July 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By NIHCM
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Private equity acquisition of physician practices continues to grow nationwide. New research focused on specialists in dermatology, gastroenterology, and ophthalmology shows the impact of the trend.
Novel evidence by NIHCM grantee Jane Zhu, MD, and her team, reveals shifts in workforce composition and hiring patterns after private equity firms obtain physician practices. The researchers’ findings are particularly important for policymakers and practices considering selling to private equity firms. Highlights include:
A significant yearly increase in the number of advanced practice providers at private equity-acquired practices, specifically nurse practitioners and physician assistants.
In acquired practices, entering clinicians replaced exiting clinicians at a higher rate than at non-private equity-acquired practices.
This work adds to the research team’s previous findings, including the geographic variations in private equity ownership across six medical specialties, and the impact of private equity on health care costs and utilization.
Posted on July 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST –TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The CBOE Volatility Index® (VIX) climbed slightly to 12.37.
The S&P 500 index®(SPX) rose 5.66points (0.1%) to 5,572.85; the Dow Jones Industrial Average® ($DJI) dropped 31.08 points (0.1%) to 39,344.79; the NASDAQ Composite® ($COMP) gained 50.98 points (0.3%) to 18,403.74.
The 10-year Treasury note yield (TNX) was roughly flat at 4.27%.
Intel popped 6.15% after an analyst at Melius Research declared the company could be one of the big AI winners in the second half of this year.
Morphic Holding skyrocketed 75.06% on the news that Eli Lilly will acquire the drugmaker for $3.2 billion in cash.
SolarEdge climbed 9.26% thanks to an upgrade from “underperform” to “neutral” by Bank of America analysts, who see big upside and few downside risks ahead.
Lucid rose 7.85% on the news that its deliveries rose 70% in the second quarter.
What’s down
ServiceNow dipped 5.04% after Guggenheim analysts downgraded the cloud computing company to “sell,” citing growing risks in the second half of this year.
Stat: 27. That’s a tally of some of the hospital mergers, acquisitions, joint ventures, affiliations, and partnerships that have been canceled since January 2022. (Becker’s Hospital Review)
Read: Health insurers received $50 billion from Medicare for diseases that doctors did not treat over three years, according to a recent analysis. (Wall Street Journal)
Posted on July 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Health Capital Consultants LLC
In February 2023, Novant Health, a 19-hospital, non-profit health system operating throughout the Carolinas, agreed to acquire two North Carolina hospitals – Davis Regional Medical Center and Lake Norman Regional Medical Center – from Community Health System (CHS), a publicly-traded mega-system operating in 15 states.
After the $320 million deal was announced, the Federal Trade Commission (FTC) began an extensive review of the acquisition, and concluded that: (1) the transaction may substantially reduce competition; (2) create a monopoly; and (3) constitute an unfair method of competition. (Read more…)
Posted on July 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Wall Street is counting down the hours until Friday, which is when Q2 earnings season kicks off. Investors are hoping anyone besides Big Tech will post impressive results to keep the rally going. Although the stock market has set record after record this year, it’s mostly been the work of tech giants. As of Tuesday, about 40% of S&P 500 companies were in the red for 2024.
Federal Reserve Chair Jerome Powell will give updates on the economy to Congress on Tuesday and Wednesday, where he’ll likely be asked about the prospect of interest rate cuts. Those plans could become clearer on Thursday, when the consumer price index inflation report drops.
Boeing will plead guilty to a criminal fraud charge stemming from two fatal crashes of 737 Max planes and pay an additional $243.6 million fine, allowing it to avoid a criminal trial sought by victims’ families. More here.
Posted on July 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
ADVERSE SELECTION
By staff reporters
The tendency of people who are less than standard health insurance risks to seek or continue insurance to a greater extent than other individuals. This so called “selection against the insurer”, or “anti-selection”, is a form of stacking the deck and is also found in the tendency of policy owners to take advantage of favorable options in health insurance or managed care contracts.
Or, a particular health plan, whether indemnity or managed care, is selected against by the enrollee, and thus an inequitable proportion of enrollees requiring more medical services are found in that plan.
Example: Low enrollee out-of-pocket costs might lure those individuals requiring more health services into an HMO rather than an indemnity-plan because the former does not have a deductible.
Therefore, the HMO would have a greater proportion of less-healthy enrollees, thereby driving up costs and increasing financial risks. Also occurs with one of the following:
When a premium doesn’t cover costs. Some populations, perhaps due to age or health status, have a great potential for high utilization.
Some population parameter such as age (e.g., a much greater number of 65-year-olds or older to young population) that increases the potential for higher utilization and often increases costs above those covered by a payer’s capitation rate.
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COMMENTS?
Thank You
“DICTIONARY OF TERMS FOR THE BUSINESS OF MEDICINE”
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Posted on July 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
As home hospital programs continue to grow—employment in the home health industry is projected to increase by nearly 30% by 2029—so does the concern that home healthcare professionals are increasingly vulnerable to assault and harassment.
The S&P 500 index® (SPX)rose 30.17 points (0.54%) to 5,567.19; the Dow Jones Industrial Average® ($DJI) rose 67.87 points (0.17%) to 39,375.87; the NASDAQ Composite® ($COMP) climbed 164.46 points (0.9%) to 18,352.76.
The 10-year Treasury note yield (TNX) dropped nearly seven basis points to just below 4.28%.
The CBOE Volatility Index® (VIX) increased slightly to 12.45.
What’s up
Meta Platforms rose 5.88% a day after CEO Mark Zuckerberg posted a video of himself wearing a tux, holding an American flag and a beer, and wakeboarding. Shareholders apparently approve of such an absolute stud running the company.
Koss Corp. rose another 25.68% as the latest meme stock continues to rally for no reason at all.
Macy’s popped 9.48% after bidders looking to acquire the beleaguered retailer raised their offer from $6.6 billion to $6.9 billion.
Southwest sank 5.67% on the first full trading day after the company adopted a “poison pill” to fend off activist investor Elliott Management.
Budget airline companies took a blow after a Raymond James analyst downgraded the industry due to a “clear as mud” outlook for the third quarter. Frontier Group fell 6.79%, while Spirit Airlines dropped 8.70%.
Crypto-related stocks tumbled after bitcoin fell below $54,000 at one point today, though they recovered alongside the cryptocurrency later in the trading session. Coinbase Global fell 0.56%, Robinhood Markets dropped 0.98%, and MicroStrategy fell 1.56%.
This will authorize the Department of Public Health to conduct a pilot program that will provide visits to at-risk and under served rural communities during pregnancy and early childhood.
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HB591– The bill relates to mental health and it authorizes marriage and family therapists to perform certain acts that physicians and psychologists are authorized to perform regarding emergency exams for involuntary evaluation and treatment for mental illness, alcohol or drug abuse.
HB548 – The bill provides reasonable access to records concerning reports of child abuse to the Administrative Office of the Courts.
HB128– This bill enacts Gracie’s Law, which prohibits providers from discriminating against potential organ transplant recipients due to physical or mental disabilities.
Posted on July 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The S&P 500 broke above 5,500 yesterday and stayed there for the first time in market history, notching yet another all-time high for the index—its 32nd this year alone. With so much bullishness it’s understandable that investors may be wondering if we’re at the top yet, but chartists suggests gains tend to beget gains. The bulls have too much momentum to stop now—and if/when the FOMC cuts rates later this year, it seems likely that we’ll see more all-time highs in 2024? Any thoughts.
The Biden administration has awarded $206.3 million of funding to clinician training programs across 42 universities and provider organizations to bolster the nation’s geriatrics care workforce. Programs will be able to integrate geriatrics training into primary care and will work to educate older adults’ families on their care needs. Health and Human Services, in its announcement, noted that primary care providers are a crucial source of care for much of the aging population.
As Walmart shutters its primary care clinics, the retail giant inked a deal to sell its MeMD telehealth business to health tech startup Fabric. Fabric provides a telemedicine platform for a range of customers, including provider groups, with the goal of improving the clinician and patient experience, as well as operational efficiency. The acquisition will expand its provider network, add virtual behavioral health to the company’s services and build on Fabric’s employer and payer solutions.
And…The U.S. Supreme Court has overturned the Chevron deference, stripping power from federal agencies to interpret and enforce regulations. Courts no longerhave to defer to reasonable agency interpretations. One healthcare attorney told Fierce Healthcare he predicts the Centers for Medicare & Medicaid Services will be under a microscope from the courts going forward, and there will be more scrutiny towards provider reimbursement cuts, drug pricing regulation and the Inflation Reduction Act.
The S&P 500 index®(SPX)rose 28.01 points (0.51%) to 5,537.02; the Dow Jones Industrial Average® ($DJI) fell 23.85 points (-0.1%) to 39,308.00; the NASDAQ Composite® ($COMP) gained 159.54 points (0.9%) to 18,188.30.
The 10-year Treasury note yield (TNX) dropped seven basis points to 4.36%.
The CBOE Volatility Index® (VIX) held steady at 12.09.
What’s up
Tesla rose yet another 6.54% as investors continue to celebrate stronger-than-expected delivery numbers. Much like the company’s self-driving mode, this stock can’t stop.
Nvidia rose 4.57%, with the bulls seemingly beating profit-taking bears heading into the holiday.
MGM Resorts popped 2.24% after BTIG analysts gave the company a “buy” rating and a price target 20% higher than shares trade for today.
Quest Diagnostics rose 3.11% after announcing it will acquire fellow laboratory service provider LifeLabs for $985 million.
What’s down
First Foundation plummeted 23.81% after the bank announced it will raise $225 million to shore up a balance sheet burdened by commercial real estate loans.
Constellation Brands fell 3.76% after the alcoholic beverage maker reported stronger than expected earnings but missed Wall Street’s expectations on revenue.
Simulations Plus slid 14.87% after it reported strong third-quarter earnings but announced it’s cutting its dividend.
CureVac popped then dropped 6.59% after GSKbought the rights to the smaller pharma company’s Covid-19 and flu vaccines for $1.6 billion.
Posted on July 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
SCOTUS: Two technology company cases involving Texas and Florida laws challenging social-media companies’ content moderation were sent to lower courts. SCOTUS thus effectively granted the companies a victory. The Supreme Court isn’t willing to blow up the internet just yet.
PitchBook released its analysis of digital health venture capital deals done in the first quarter. The first quarter saw downturns in telehealth and digital therapeutics, but opportunities exist in mental health chatbots and care search platforms.
Amedisys, a large home health provider, plans to divest a number of care centers to an affiliate of VitalCaring Group in advance of its planned merger with UnitedHealth Group later this year.
Paramount Global rose 5.97% on a report from the New York Times that Barry Diller’s IAC may be exploring an acquisition of the embattled entertainment company. IAC fell just 0.26%.
Archer Aviation popped 8.92% after the air taxi manufacturer received a $55 million investment from Stellantis.
Oliveda International is up 19.81% today after the olive oil company announced massive quarterly revenue growth at a key subsidiary.
Pure Storage plunged 4.15% after UBS analysts downgraded the stock to “sell,” citing its high valuation and overhyped AI potential.
Homebuilders took a beating after Citi analysts downgraded Lennar and D.R. Horton from “neutral” to “sell,” noting the housing market will remain soft in the second half of the year. Lennar dropped 1.61%, and D.R. Horton fell 1.35%.
Here’s where the major benchmarks ended:
The S&P 500 index rose 33.92 points (0.62%) to 5,509.01; the Dow Jones Industrial Average® ($DJI) climbed 162.33 points (0.41%) to 39,331.85; the NASDAQ Composite® ($COMP) rallied 149.46 points (0.84%) to 18,028.76.
The 10-year Treasury note yield (TNX) dipped four basis points to 4.43%.
The CBOE Volatility Index® (VIX) dropped to 12.03 after earlier trading at its lowest intraday level since late May.
SCOTUS: Health policy leaders say patients, providers, and health systems should brace for more uncertainty and less stability in the healthcare system. Even routine government functions such as deciding the rate to pay doctors for treating Medicare beneficiaries could become embroiled in long legal battles that disrupt patient care or strain providers to adapt.
Posted on July 2, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Private equity gets a big accounting firm yet. The March story about private equity firm New Market Capital buying a $2.8 billion stake in accounting firm Grant Thorton was a big story. Private equity is gobbling up accounting firms, signaling a potential sea change in how accounting firms will operate in the future, with “more than half” of the top 20 accounting firms in talks with private equity.
The S&P 500® index (SPX) rose 14.61 points (0.27%) to 5,475.09; the Dow Jones Industrial Average® ($DJI) climbed 50.66 points (0.13%) to 39,169.52; the NASDAQ Composite® ($COMP) added 146.70 points (0.83%) to 17,879.30.
The 10-year Treasury note yield (TNX) rose 12 basis points to 4.47%, the highest level since May 30 and back above its 50-day moving average, a technically important move.
The CBOE Volatility Index® (VIX) slipped to 12.19.
Crude oil is up sharply over the last month amid rising Middle East tensions.
Spirit AeroSystems Holdings rose 3.35% on the news that Boeing plans to acquire the airplane parts supplier. Boeing shares rose a tepid 2.58%.
Birkenstock climbed 1.78% after UBS analysts rated the stock a “buy” and increased their price target 63% due to the company’s expansion plans.
French stocks rose on snap election results that showed the far-right National Rally may be unable to form a majority after the next round of elections on July 7.
What’s down
Chewy stock popped then dropped 6.63% after Roaring Kitty revealed a 6.6% stake in the pet products company.
GameStop shares fell 5.35% after CEO Ryan Cohen posted on Twitter/X for the first time in months to advertise a job opening.
Uber fell 2.17% and Lyft fell 0.92% on the news that Massachusetts now requires both companies to pay rideshare drivers $32.50 an hour, plus benefits.
Cruise stocks sank on the news that Hurricane Beryl is stronger than expected and will disrupt service throughout the Caribbean. Norwegian Cruise Line fell 5.86%, Carnival fell 5.40%, and Royal Caribbean fell 1.86%.
The largest nursing union in the US, National Nurses United (NNU), is sounding the alarm about the use of artificial intelligence (AI) in healthcare. In April, the union’s affiliate California Nurses Association (CNA) protested an AI conference helmed by managed care consortium Kaiser Permanente. Like workers in other sectors who are worried about AI encroachment, the nurses fear that the tech is contributing to the devaluation of their skills amid what they say is already a “chronic” understaffing crisis, nurses reported in an NNU survey of 2,300 registered nurses and members in early 2024.
Posted on July 1, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
If you can believe it, Friday was the final trading day of the first half of 2024. It might be a good time to reflect on your New Year’s resolutions to see how you’re measuring up halfway through the year.
Dogs of the Dow: The 139-year-old index has never looked more its age, with components Nike, Intel, and Boeing all down more than 30% in 2024. The Dow has gained less than 4% this year.
But, the S&P 500 gained a sublime 15% in H1, and Nvidia alone was responsible for more than a third of that gain. The maker of AI chips surged ~150% since Jan. 1st to become the most valuable company in the USA at one point.
Going into 2024, investors were expecting the Fed to cut interest rates six times. There hasn’t been a single rate cut yet, but that hasn’t stopped the S&P from notching 31 all-time closing highs, good for the second-best tally of records this century. Stocks have overcome the Fed’s delay thanks to strong earnings, a sturdy economy, and AI fever.
Commodities soar and a currency plummets. Cocoa boomed nearly 85% over shortage concerns. Gold hit a record high last month. The Japanese yen has slumped to a 38-year low against the US dollar.
Bitcoin got a boost from new ETFs, but it’s getting boring.
Posted on June 29, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
In an interview with the Wall Street Journal, CEO Tim Wentworth said the pharmacy chain Walgreens will shutter a significant share of its 8,600 locations in the US. The closures are part of a broader attempt to boost the ailing company, which also includes reducing its stake in the primary care business VillageMD. Wentworth said the company can reassign most employees instead of conducting layoffs. Shares cratered yesterday after Walgreens whiffed on Wall Street’s earnings projections due to weak consumer spending.
And, read how some counties reduced opioid overdose deaths during the pandemic. (Politico)
Oliveda International, which makes beauty products from olive oil, rose 38.33% for no apparent reason. Maybe people just really like the feel of extra virgin olive oil on their skin?
Infinera popped 16.38% after Nokia announced it would acquire the telecommunications hardware manufacturer for $2.3 billion.
Synchrony Financial rose 6.17% after a Baird analyst initiated coverage of the financial services company with an outperform rating.
Regional banking stocks rose on the hopes that a good PCE reading means a better chance of the Fed cutting rates soon. RegionsFinancial rose 3.83%, while CitizensFinancialGroup rose 3.16%.
What’s down
Trump Media & Technology Group fell 18.09%, despite initially popping this morning after the first presidential debate.
Accolade bombed 44.29% after the health tech company reported decent earnings but revealed lower guidance for the year ahead than Wall Street expected.
Kura Sushi USA, which is in fact a publicly traded sushi company, plummeted 24.04% due to worse-than-expected earnings, as well as poor full-year guidance.
A late round of selling in the Treasury market sent yields to fresh highs as the day ended so here’s where the major benchmarks ended:
The S&P 500® index (SPX) dipped 22.39 points (0.41%) to 5,460.48; the Dow Jones Industrial Average® ($DJI) fell 45.20 points (0.12%) to 39,118.86; the NASDAQ Composite® ($COMP) lost 126.08 points (0.71%) to 17,732.6.
The 10-year Treasury note yield climbed nine basis points to 4.38%.
The CBOE Volatility Index® (VIX) moved up slightly to 12.43.
Nearly 200 people have been charged for their roles in various health care fraud schemes across the U.S. that federal authorities say amounted to over $2.7 billion in intended losses, the Justice Department announced. Attorney General Merrick Garland said charges against 193 people, including 76 doctors, nurse practitioners, and other licensed medical professionals in 32 different federal districts. The defendants were charged over a two-week sweep involving numerous law enforcement agencies nationwide, resulting in the seizure of more than “$231 million in cash, luxury vehicles, gold, and other assets,” according to Garland.
Posted on June 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Stat: 40%. That’s how much Tenet Healthcare’s shares jumped in Q1. (Yahoo Finance)
Stat: 12%. This is how much the yen has weakened so far this year against the US dollar, which has people wondering whether the Japanese government will need to intervene. (Bloomberg)
Quote: “We believe the opportunity ahead is significant.”—RJ Scaringe, CEO and co-founder of Rivian, commenting on Volkswagen Group’s plans to invest as much as $5 billion in the EV company. (CNBC)
Walgreens Boots Alliance plummeted 22.16% due to a worse-than-expected earnings report that saw the company slash its full-year guidance.
Hims & Hers dropped 7.19% after Hunter Growth Capital accused the company of using a shady supplier for its new weight-loss drugs.
Levi Strauss crashed 15.27% in a denim downfall for the ages, with second quarter earnings missing expectations after consumers spent less on blue jeans.
Micron Technology slid 7.12% despite beating analyst expectations in the third quarter. Unfortunately, management isn’t as bullish as analysts about the rest of the year.
Chewy fell 0.03% despite a tweet from Roaring Kitty of a cartoon dog—which is apparently all it takes to move markets these days.
The U.S. government’s final gross domestic product (GDP) estimate announced early Thursday included a downward revision to quarterly consumer spending.
Treasury yields could move on the data, especially if the report is “hotter” than expected. Yields fell Thursday following mostly soft U.S. economic readings this morning.
Here’s where the major benchmarks ended:
The S&P 500® index (SPX) rose 4.97 points (0.1%) to 5,482.87; the Dow Jones Industrial Average® ($DJI) rose 36.26 points (0.1%) to 39,164.06; the NASDAQ Composite® ($COMP) rose 53.53 points (0.3%) to 17,858.68.
The 10-year Treasury note yield lost two basis points to 4.29%.
The CBOE Volatility Index® (VIX) fell to 12.29, its lowest close since June 13.
Posted on June 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The S&P 500® index (SPX) rose 8.6 points (0.16%) to 5,477.9; the Dow Jones Industrial Average® ($DJI) added 15.64 points (0.04%) to 39,127.8; the NASDAQ Composite® ($COMP) climbed 87.5 points (0.49%) to 17,805.16.
The 10-year Treasury note yield rose 8 points to 4.32%.
The CBOE Volatility Index® (VIX) eased to 12.5
What’s up
FedEx shipped 15.52% directly to your portfolio after beating fourth-quarter earnings expectations and guiding for higher-than-expected earnings in the coming fiscal year.
Vista Outdoor rose 9.09% after MNC Capital raised its bid to acquire the ammunition maker to $3.2 billion.
What’s down
General Mills dipped 4.58% thanks to a poor quarterly earnings report, with lower sales due to lower demand from consumers.
Paychex fell 6.11% despite beating earnings estimates this quarter. The problem is slower growth ahead due to small and mid-sized businesses struggling with high inflation.
Aptiv dropped 7.93% after news of the Rivian-Volkswagen deal prompted Piper Sandler analysts to downgrade the stock and lower their price target.
The disastrous ransomware attacks on Change Healthcare and Ascension this year ran up staggering costs and put a spotlight on the healthcare sector’s vulnerability. But healthcare orgs are hardly new to eye-popping bills after a major hack. Analyzing attacks on organizations in 16 countries, IBM/Ponemon Institute has shown healthcare to be the industry with the highest cost per data breach for over a decade, coming in at an average hit of $10.93 million in 2023.
Posted on June 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The U.S. surgeon general just declared gun violence a public health crisis, driven by the fast-growing number of injuries and deaths involving firearms in the country. The advisory issued by Dr. Vivek Murthy, the nation’s top doctor, came as the U.S. grappled with another summer weekend marked by mass shootings that left dozens of people dead or wounded.
The S&P 500 index rose 21.43 points (0.39%) to 5,469.30; the Dow Jones Industrial Average® ($DJI) fell 299.05 points (0.76%) to 39,112.6; the NASDAQ Composite® ($COMP) gained 220.84 points (1.26%) to 17,717.65.
The 10-year Treasury note yield (TNX) fell slightly to 4.24%.
The CBOE Volatility Index® (VIX) dropped to 12.84.
What’s up
Nvidia rose 6.76% as investors realized they could buy shares of the world’s biggest semiconductor company at a discounted price.
Trump Media & Technology Group rose another 8.50% today on the hopes of a cash infusion, as well as hype ahead of Thursday’s presidential debate.
Carnival popped 8.85% after it beat analyst expectations for the second quarter, and raised its profit forecast for the rest of the year.
Novo Nordisk rose 3.25% after its weight-loss drug Wegovy was approved in China.
Enovix soared 35.05% on the news that it signed a major deal to provide VR headset batteries for an as-yet-unnamed California company.
SolarEdge Technologies dropped 20.60% through no fault of its own—instead, a key customer declared bankruptcy, and will be unable to pay the solar power company the $11.4 million it is owed.
Airbus fell 9.41% after the company announced it is cutting financial guidance for the remainder of 2024 thanks to supply chain snarls and higher costs.
Auto dealer stocks continue to suffer the effects of a massive cyberattack on CDK, a key supplier of dealership management software. The company says its systems will remain down until June 30, but in the meantime shares of Autonation fell 2.04%, Sonic Automotive dropped 2.56%, and Group 1 Automotive slid 2.49%.
Digital health company Sharecare has agreed to be acquired by private equity firm Altaris for $1.43 in cash per share, or about $518 million.
Nearly three months after Kaiser Permanente’s Risant Health acquired Geisinger Health, the group has now agreed to terms with Cone Health in North Carolina.
Posted on June 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The S&P 500 index lost 16.75 points (0.31%) to 5,447.87; the Dow Jones Industrial Average ($DJI) gained 260.88 points (0.67%) to 39,411.21; the NASDAQ Composite ($COMP) dropped 192.54 points (1.09%) to 17,496.82.
The 10-year Treasury note yield (TNX) fell one basis point to 4.25%.
The CBOE Volatility Index® (VIX) ended slightly up at 13.47, the highest close since May 30.
Trump Media & Technology Group soared 36.15% today after the company announced it expects to receive over $69.4 million from recently exercised stock warrants.
Target rose 2.44% on the news that it has teamed up with Shopify to allow vendors to sell on Target’s third-party website, Target Plus. Shopify shares fell 1.11%.
Alnylam Pharma popped 34.52% after trial results revealed its new drug to treat a rare form of heart disease cuts the risk of death and cardiovascular events by up to 33%.
Nvidia dropped 6.68% as the semiconductor stock continues to fall, with the stock entering correction territory earlier today—a sentence we never thought we’d write.
Eli Lilly’s weight-loss drug Zepbound can also help people with sleep apnea, cutting into the sleep-aid market, sending shares of ResMed down 11.40% and Inspire Medical Systems down 16.45% on the news.
Bitcoin-connected stocks are taking a hit as the crypto selloff continues. Coinbase Global fell 6%, while MicroStrategy fell 7.52%.
The dental industry—like other parts of healthcare—is facing significant staffing challenges. The US is in need of nearly 10,000 dental professionals and has more than 6,800 health professional shortage areas (HPSAs), which the US Department of Health and Human Services defines as “a geographic area, population, or facility with a shortage of primary care, dental, or mental health providers and services.”
Posted on June 24, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Apple and Meta are considering an AI partnership. The two tech giants are discussing integrating Meta’s generative AI model into Apple’s new AI platform, Apple Intelligence, the WSJ reports. Instead of building an in-house AI model, Apple opted for the partnership route and previously announced a deal with OpenAI to bring ChatGPT to iPhones. Apple has also reportedly held talks with AI startups Anthropic and Perplexity to fuse their AI models with Apple Intelligence and get that sweet, sweet distribution Apple provides.
Genome testing can spot rare disease risks at birth. Newborn babies typically get blood tested for dozens of diseases, but some parents living in North Carolina and New York have recently been able to get their bundles of joy screened for hundreds of potentially life-threatening medical conditions that regular tests can’t catch thanks to a growing field called genomic medicine. Early results from two ongoing studies are very promising, the Washington Post reported, but scaling the new type of testing could be tricky: A full genome read (which covers all of your DNA) costs around $1,000 per patient. Still, research into the cost-benefit of genome sequencing has found that it can ultimately save families money on hospital care.
Markets: Sweating the upcoming election? Investors aren’t. The S&P 500 is on track for its best first-half performance in an election year going back to 1976, per Dow Jones Market Data. And as trading begins Monday morning, Microsoft is back on the Iron Throne as the US’ most valuable company following Nvidia’s stumbles at the end of last week.
Posted on June 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The de-aging biz: Time to pull back the hospital curtain and see who’s behind the booming longevity market. This article, sponsored by Timeline, lays out who’s making $$$ on “reverse aging.*
The S&P 500 and NASDAQ have often outperformed the Dow in recent years thanks to their focus on tech, as well as their market-cap weighting vs the Dow’s price weighting. When tech stocks roar higher, the younger indexes rise above their older peer—but the last few days have seen a sell off of tech stocks led by NVIDIA, bringing the S&P 500 and NASDAQ lower to end the week while the Dow has continued to rise.
Bonds remained unchanged for most of the day, ending the trading session flat as investors parse through a week of economic data and prepare for next week’s PCE report.
Gold plunged after the dollar rose, making it more expensive for gold bugs to hold the precious metal.
As for oil, read on to learn why crude has high hopes today but may not be a smart investment tomorrow.
Nvidia faltered for the second day in a row, falling off the world’s most valuable company perch and shedding $220+ billion in market cap. But the S&P 500 has gone 377 days without a 2.05% sell-off, the longest streak since the 2008 financial crisis, per CNBC.
The Credit Card Competition Act is proposed legislation in Congress that could fundamentally change credit card systems. If passed, it could devastate the future of cash-back and travel rewards.
Posted on June 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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President Joe Biden is cracking down on what the White House calls “junk” health insurance plans – namely, less-robust and short-term coverage that the Trump administration expanded as a cheaper alternative to Obamacare AHA plans.
Biden announced a draft regulation which, once finalized, would limit temporary plans to four months instead of the current three-year maximum. It would also require more disclosure on coverage limits.
“This rule would help make these plans fairer and help ensure that consumers know what they’re getting when they sign up for insurance,” said White House domestic policy advisor Neera Tanden. “When they don’t know what they’re getting and get these gigantic bills, they can feel like it’s a scam.”
The president also announced new guidance on medical billing stemming from 2020’s No Surprises Act. The guidance would limit the ability of insurers that contract with hospitals to claim provided care was not in network and have customers pay more money. Health plans also would need to disclose facility fees that are increasingly charged to patients and can surface as an unexpected cost in a medical bill.
Posted on June 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By American Journal of Public Health
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Public health is now part of the political conversation but everyone doesn’t understand it in the same way. Hence the idea of interviewing Governor John Kasich, former governor of Ohio, who has been promoting a greater attention to public health, about what is public health for him.
Posted on June 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Amazon Pharmacy announced on June 18 that, effective immediately, its RxPass medication delivery service will be available to more than 50 million Medicare beneficiaries, a move the company says could save up to $2 billion annually for the federal health insurance program.
The S&P 500 index fell 8.55 points (0.2%) to 5,464.62, up 0.6% for the week; the Dow Jones Industrial Average® ($DJI) gained 15.57 points (0.04%) to 39,150.33, up 1.5% for the week; the NASDAQ Composite® ($COMP) shed 32.23 points (0.2%) to 17,689.36, little changed for the week.
The 10-year Treasury note yield (TNX) was little changed at 4.255%.
The CBOE Volatility Index® (VIX) dipped 0.06 to 13.22.
What’s up
Sarepta Therapeutics soared 30.14% thanks to FDA approval of Elevidys, its new Duchenne muscular dystrophy treatment.
Zealand Pharma rose 18.62% after Phase 1b trial results revealed its new weight-loss drug could compete with Ozempic.
Asana jumped 14.95% on the news that its board has approved a share repurchase program of up to $150 million of its own stock.
CarMax shares rose 0.37% after the company reported first-quarter earnings. The number isn’t big, but the performance is impressive considering the used car company posted a 33% decline in profits.
Hertz Global popped 15.95% after the company announced it was raising the size of its bond offering to $1 billion as it looks to update its fleet of rental cars.
What’s down
Nvidia fell another 3.22% today as the sell off continued, with investors taking profits after a record run higher.
Smith & Wesson Brands dropped 12.87% after the gun maker beat earnings forecasts but announced that next quarter’s sales will be lower than expected.
LendingTree slid 2.48% after a Bloomberg report revealed that hackers are auctioning off stolen customer data.
Palantir fell 6.78% after the company earned an analyst downgrade for its “gluttonous valuation,” a phrase you never want to hear as an investor.
Bitcoin mining stocks took a hit today, selling off after popping higher yesterday after bitcoin prices rallied. Marathon Digital Holdings dropped 7.02%, Riot Platforms fell 8.35%, and CleanSpark sank 9.81%.
With a record number of people insured and seeking healthcare services post-pandemic, US health spend growth is outpacing GDP growth, and is expected to keep doing so through 2032, according to a June 12 report from actuaries at the Centers for Medicare and Medicaid Services (CMS). By 2032, CMS actuaries project healthcare spending will total $7.7 trillion and make up 19.7% of total US GDP, compared to $4.8 trillion and 17.6% of GDP in 2023.
Posted on June 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Wells Fargo is losing $10 million per month on its partnership with Bilt, whose credit card offers users reward points for paying rent, and is looking to renegotiate, the WSJ reports. Apple has stopped offering its buy now, pay later program, Apple Pay Later, after partnering with outside companies, including Affirm.
Private equity (PE) is all over healthcare, with investment firms owning more than 400 hospitals around the US. But as the country faces a mental health crisis—US Surgeon General Vivek Murthy called it the “the defining public health crisis of our time”—PE has its sights set on one of the fastest-growing areas of the industry: behavioral health care. PE has accounted for over 60% of all behavioral health deal flow since 2018, and firms like Thurston Group and Five Points Capital now own about a quarter of facilities offering behavioral health care in some states, according to a recent cross-sectional study published in JAMA Psychiatry.
U.S. markets were closed Wednesday for the Juneteenth holiday. Here’s where the major benchmarks ended:
The S&P 500 index fell 13.86 points (0.3%) to 5,473.17; the Dow Jones Industrial Average® ($DJI) gained 299.90 points (0.8%) to 39,134.76; the NASDAQ Composite® ($COMP) dropped 140.64 points (0.8%) to 17,721.59.
The 10-year Treasury note yield (TNX) climbed about 4 basis points to 4.257%.
The CBOE Volatility Index® (VIX) rose 0.80 to 13.28.
What’s up
Gilead jumped 8.46% after clinical data revealed that its new twice-a-year shot prevents 100% of HIV cases.
Penn Entertainment rose 9.93% on the news that Boyd Gaming has approached its competitor with an acquisition offer.
Accenture rose 7.30% after the IT consulting company missed earnings estimates but more than made up for it with bullish bookings data thanks to AI.
Darden Restaurants rose 1.53% after a mixed earnings report. Its acquisition of Ruth’s Chris Steak House propped up earnings, while Olive Garden’s same-store sales came in flat, probably because I eat several hundred free breadsticks there every month.
What’s down
Trump Media & Technology Group fell 14.56% after the SEC ruled that early shareholders can resell their stock in the company, diluting new shareholders—though providing upward of $247 million in funding for the beleaguered company.
Nikola plummeted 31.46% after the company announced a 1-for-30 stock split in a bid to stay listed on the Nasdaq.
Kroger fell 3.27% despite beating analyst revenue estimates in its fiscal first quarter as investors digest the chances of the company sealing a deal to buy Albertsons.
TempestTherapeutics dropped 29.47% upon the release of the latest trial data for its liver cancer treatment.
Jabil fell 11.45% today after the electronics supplier beat earnings estimates but warned of softer growth in the year ahead.
Mortgage rates fell below 7% last week to their lowest level since March, but this didn’t spur much extra demand.
Posted on June 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The top health official in the US is urging Congress to pass legislation that would stamp social media apps with a surgeon general’s warning “stating that social media is associated with significant mental health harms for adolescents,” he wrote in an op-ed for the New York Times recently.
Surgeon General Dr. Vivek Murthy’s push for a warning label follows years of alarm-sounding with his strongest appeal to lawmakers yet.
In his statement, Murthy referenced a 2019 study that found risks of depression doubled among teens who scroll for more than three hours per day, and a 2023 Gallup poll showing that US teens log a daily average of 4.8 hours on social media.
If you do not have a market niche; you are not deeply informed If you are not deeply informed; you can’t different yourself If you can’t differentiate yourself; you can’t differentiate price If you can’t differentiate price; you have no market power If you have no market power; you have no unique knowledge If you have no unique knowledge; you have fewer profits
If you have fewer profits; you are not likely a CMP™
Posted on June 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Wells Fargo is losing $10 million per month on its partnership with Bilt, whose credit card offers users reward points for paying rent, and is looking to renegotiate, the WSJ reports. Apple has stopped offering its buy now, pay later program, Apple Pay Later, after partnering with outside companies, including Affirm.
The S&P 500 index gained 13.80 points (0.3%) to 5,487.03; the Dow Jones Industrial Average® ($DJI) added 56.76 points (0.2%) to 38,834.86; the NASDAQ Composite® ($COMP) rose 5.21 points (0.03%) to 17,862.23, a record close for the seventh day in a row.
The 10-year Treasury note yield (TNX) dipped more than 6 basis points to 4.215%.
The CBOE Volatility Index® (VIX) fell 0.45 to 12.30.
What’s up
La-Z-Boy, your dad’s favorite recliner/stock, rose 19.39% after beating analyst expectations in the fourth quarter and issuing upbeat guidance for the year.
Dell rose 5.13% a day after Morgan Stanley analysts named the company one of their top stock picks thanks to its focus on servers powering AI.
Aerovate Therapeutics dropped another 14.55% today, a day after the company announced a failure in the phase 2 trial of its new blood pressure medication.
Lennar sank 4.96% after announcing lower-than-expected home deliveries last quarter in yet another sign that the housing market is in the dumps.
Posted on June 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Microsoft. According to a same-day announcement on its site, the company will give “nonprofit pricing and discounts for its security products optimized for smaller organizations, providing up to a 75% discount,” along with free cybersecurity training, assessments, and—for at least one year, the company says—Windows 10 security updates.
Google. The White House said that Google will “provide endpoint security advice to rural hospitals and nonprofit organizations at no cost,” as well as a pilot program designed to help rural facilities “develop a packaging of security capabilities that fit these hospitals’ unique needs.”
Broadcom rose yet another 5.41% today, continuing its blistering rally higher thanks to one analyst’s declaration that the stock should replace Tesla in the Magnificent 7.
Micron Technology rose 4.58% after getting upgraded by Cantor Fitzgerald for its exposure to the AI trade.
AMC Networks plummeted 35.14% after the company announced it’s issuing $125 million in new debt.
Louisiana Pacific dropped 3.46% after Goldman Sachs analysts downgraded the stock to “sell” and reduced their price target to $81.
GameStop fell 12.13% almost as soon as the company’s annual shareholder meeting began this afternoon, and no amount of “hodling” could halt the decline.
The S&P 500 index gained 41.63 points (0.8%) to 5,473.23; the Dow Jones Industrial Average® ($DJI) added 188.94 points (0.5%) to 38,778.10; the NASDAQ Composite advanced 168.14 points (1.0%) to 17,857.02.
The 10-year Treasury note yield (TNX) rose more than 6 basis points to 4.279%.
The CBOE Volatility Index® (VIX) increased 0.10 to 12.76.
The Care Continuum Alliance, an alliance of stakeholders across the continuum of care, is working precisely toward the goal of improving the health of populations. They espouse a detailed set of principles and a model of “population health management.” It can be summed up, in the broadest sense, as the care provider community, in partnership with patients and their families, conducting proactive and collective monitoring of the patient’s healthcare quality, adherence, access, and outcomes with the goal of improving the health of an entire patient population.
As such, population health management stresses wellness and prevention through lifestyle and disease management and complex case management to remove the gap between zero care and costly chronic or emergency care. It emphasizes the full spectrum of needs from prevention and wellness to keeping healthy people and at-risk people healthy, to better manage the care of those with chronic conditions, and to still be ready to provide emergent or acute care services. In most cases, it also includes the involved providers taking on accountability for the financial risk and quality of care provided.
We have been working with administrative and physician leaders across the country to grapple with what it will mean to actually foster valuable population health management in the different communities they serve. It is clear that this is a whole new paradigm and that the years of experience and training that have brought them to where they are today may not have sufficiently prepared them for what is to come. It requires a well-coordinated and complete continuum of care, with new metrics and advanced analytics. As one might expect,while clusters of resistance to the idea remain, most have flung themselves into learning mode and are beginning to “act their way into new thinking.”
However, we also see a big risk in powering ahead without revisiting the role of a key stakeholder group—patients and their families, whose experience and perspective are often left behind, but whose actions will have a profound effect on the future success of population health management efforts.
Posted on June 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The NASDAQ nabbed its fifth-straight record close last week, and the S&P 500 snapped its four-day streak. Both were up for the week as investors digested data that showed inflation cooling. Adobe became the latest company to soar thanks to AI, spiking after delivering better-than-expected earnings and forecasts.
Those who rely on ADHD medication got some bad news last week when the CDC issued a health advisory alerting patients that there may be possible “increased risks for injury and overdose,” after two executives at Done Global, a telehealth company, were arrested for fraud linked to allegedly selling Adderall over the internet. The CDC warned that as many as 30,000 to 50,000 adult patients could be affected. https://tinyurl.com/3rf5py6c
Posted on June 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
News 4 in San Antonio Texas organized a video call with several USAA members who lost funds due to fraud — and have been left with little to no recourse. Some of them also belong to the Facebook group, USAA Fraud and Victims, which has 2,900 members. A few USAA members even reported being asked by the institution to cover the negative balances on their accounts after their money was stolen.
The race to a $3 trillion market cap seemed like it would always be between Apple and Microsoft. But over the last twelve months, Nvidia has come roaring to the front of the pack, neck and neck with the big tech incumbents. In the last two weeks alone it has replaced Apple in the #2 spot, only to be supplanted earlier this week when Apple’s AI plans propelled it back ahead. Now, it’s anybody’s race to the next big benchmark: a $4 trillion market cap.
In a move that could be good for patients but bad for hospitals, the Consumer Financial Protection Bureau (CFPB) on Tuesday proposed regulation that would wipe medical debt from many consumers’ credit reports. The rule is meant to help the 15 million people in the US who creditors say still have a combined $49 billion of medical debt that negatively affects their credit scores, Rohit Chopra, director of the CFPB, said during a June 11 press briefing. About 100 million people in the US have some amount of medical debt, which totals roughly $220 billion, according to data from the Peterson-KFF Health System Tracker. The proposed regulation comes after three credit-reporting conglomerates—Equifax, Experian, and TransUnion—removed paid-off medical debt and medical debts under $500 from credit reports in 2022 and 2023, respectively.
Posted on June 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Quote: “When private equity gets hold of healthcare systems, it is literally a matter of life and death, so if you drive a hospital like Steward into bankruptcy, putting patients and communities at risk, you should face real consequences.”—Sen. Elizabeth Warren on a proposed federal bill to impose jail time on executives who “loot” health systems, leading to patient harm (Fierce Healthcare)
The S&P 500 index fell 2.14 points (0.04%) to 5,431.60, up 1.6% for the week; the Dow Jones Industrial Average® ($DJI) lost 57.94 points (0.2%) to 38,589.16, down 0.5% for the week; the NASDAQ Composite gained 21.32 points (0.1%) to 17,688.88, up 3.2% for the week.
The 10-year Treasury note yield (TNX) fell more than 2 basis points to 4.215%, after earlier dropping under 4.19%, its lowest since late March.
The CBOE Volatility Index® (VIX) rose 0.72 to 12.66.
Shopify rose 4.59% after it received yet another analyst upgrade. JPMorgan analysts gave the stock an overweight rating on June 11, while today Evercore analysts upgraded the company to outperform.
Hasbro popped 6% after the toy maker earned an upgrade to “buy” from Bank of America predicated on the company’s digital gaming strategy.
What’s down
Cruise stocks took a major blow today after a Bank of America report revealed that there was softer-than-expected pricing across the industry in May. Carnival fell 7.09%, Norwegian Cruise Line dropped 7.43%, and RoyalCaribbean fell 4.35%.
RH plummeted 17% after the furniture maker reported a larger-than-expected loss in the previous quarter.
Penn Entertainment sank 8.66% on the news that competitor Boyd Gaming has voted in an M&A expert to its board of directors, which, combined with activist investors pushing Penn to put itself up for sale, could indicate an acquisition ahead.
June 15th marks an important day on our calendar – Elder Abuse Awareness Day. It is a day for communities worldwide to unite in bringing attention to the challenges and difficulties faced by elders and our collective responsibility to protect and support them.
Posted on June 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Wells Fargo found that some of its employees were pretending to work — and sent them packing. More than a dozen employees in the bank’s wealth and investment management divisions were discharged last month “after review of allegations involving simulation of keyboard activity creating impression of active work,” Bloomberg reported citing disclosures filed with the Financial Industry Regulatory Authority (FINRA).
The S&P 500 index gained 12.71 points (0.2%) to 5,433.74; the Dow Jones Industrial Average lost 65.11 points (0.2%) to 38,647.10; the NASDAQ Composite rose 59.12 points (0.3%) to 17,66756.
The 10-year Treasury note yield (TNX) fell about 5 basis points to 4.246%.
The CBOE Volatility Index® (VIX) declined 0.10 to 11.94.
GameStop rose 14.18% after Keith Gill, aka Roaring Kitty, seemingly closed out a large chunk of his options position in the stock. Oh, and the company’s servers crashed during its shareholder meeting today due to overwhelming interest.
John Wiley & Sons rose 12.11% after the publisher of the beloved For Dummies book series announced it’s using its content to train AI models. Is there nothing AI can’t do???
What’s down
Virgin Galactic fell 14.28% after the company announced a 1-for-20 reverse stock split, a necessary evil in order to remain listed on the NYSE.
On Monday, private equity giant KKR jumped 12% after S&P Dow Jones Indices announced the company would be joining the index yesterday, along with CrowdStrike and GoDaddy, which saw their stocks jump 9% and 2%, respectively. The additions will be incorporated June 24.
That’s a huge range in percentages, but even if we split it right down the middle, that means at least 50% of medical bills are wrong—50% of the medical bills that are coming into your house and mine—and most healthcare consumers don’t even realize it.
Robin Milcowitz, a Florida woman who found herself enrolled in an AccessOne loan at a Tampa hospital in 2018 after having a hysterectomy for ovarian cancer, said she was appalled by the financing arrangements.“Hospitals have found yet another way to monetize our illnesses and our need for medical help,” said Milcowitz, a graphic designer.
She was charged 11.5% interest — almost three times what she paid for a separate bank loan. “It’s immoral,” she said.
Posted on June 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
On Monday, private equity giant KKR jumped 12% after S&P Dow Jones Indices announced the company would be joining the index on Friday, along with CrowdStrike and GoDaddy, which saw their stocks jump 9% and 2%, respectively. The additions will be incorporated June 24.
Stat: 99.4%. That’s the likelihood that interest rates will stay the same after the Fed’s meeting, according to the CME Fedwatch Tool. So it looks to be more “hurry up and wait” for interest rates to start coming down. 🫤 (Business Insider)
Quote: “It’s hard to think of a time when the US economy has diverged so fundamentally from its peers.”—Mark Zandi, chief economist at Moody’s Analytics, on the strength of the US economy compared to the weakness of other major economies. The US economy is continuing to grow while economies like Germany, Japan, and Canada are falling into recession. (The Atlantic)
The S&P 500 index rose 45.71 points (0.9%) to 5,421.03; the Dow Jones Industrial Average lost 35.21 points (0.1%) to 38,712.21; the NASDAQ Composite gained 264.89 points (1.5%) to 17,608.44.
The 10-year Treasury note yield (TNX) fell more than 7 basis points to 4.326%.
The CBOE Volatility Index® (VIX) declined 0.81 to 12.04.
Builders FirstSource rose 5.35% on investor hopes of interest rate cuts coming sooner rather than later, which would heat up the housing market and help the building materials supplier’s business. PulteGroup rose 4.01% for the same reasons.
These Laws Were Put Into Place So That Doctors Would Not Put Shareholders Before Patients and So That Corporations Would Not Interfere with Doctor Judgement.
Corporate Practice of Medicine Laws are at the State Level, NOT the Federal Level.
Each State Has Its Own Exceptions Such as 1) Doctors Can Work for Companies That Are Owned by Other Doctors and 2) Doctors Can Work for Hospitals.
Accordingly, Private Equity Firms Have Been on a Physician Practice Buying Binge.
Two of the Largest Purchases Were KKR’s Purchase of Envision’s 25,000 Doctors for Almost $10 Billion and Blackstone’s Purchase of Team Health’s 20,000 Doctors for $6 Billion.
If Corporate Practice of Medicine Laws Say that Doctors Cannot Work for a Corporation, How are Private Equity Purchases of Physician Practices Legal?
Posted on June 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
The S&P 500 index rose 14.53 points (0.3%) to 5,375.32; the Dow Jones Industrial Average® ($DJI) declined 120.62 points (0.3%) to 38,747.42; the NASDAQ Composite gained 151.02 points (0.9%) to 17,343.55.
The 10-year Treasury note yield (TNX) fell about 7 basis points to 4.398%.
The CBOE Volatility Index® (VIX) rose 0.13 to 12.87.
Apple shares rose 7.26%, hitting a new all-time high on hopes that the company’s AI innovations can make up for lost ground. Today’s surge reaffirmed its position as the second-largest publicly traded company in the US, retaking the #2 spot from Nvidia.
Affirm popped 11.04% as Apple’s newest partner, with its buy-now-pay-later loans to be embedded in Apple Pay.
FMC Corp rose 4% on the news that its president and CEO has stepped down. It can’t feel good when your company’s stock rises after you announce you’re leaving.
Calavo Growers was up 8.24% after the avocado producer announced strong second quarter results thanks to high avocado prices. Those darn millennials eating their avocado toast strike again!
What’s down
Paramount Global plummeted 7.85% after National Amusements and Skydance failed to reach a deal.
CoreCivic sank 19.75% after the US government announced it will end its contract with the prison company when it closes a detention facility near the southern border of Texas. Shares of TargetHospitality, which maintains the facility, fell 31.48% as well on the news.
FuelCell Energy fell 5.84%, reversing yesterday’s gains after the company announced lower-than-expected quarterly losses. Shares are now under $1, which means the stock could be delisted from the Nasdaq.
The “A” in AI stands for Apple, the techies attending Apple’s annual Worldwide Developers Conference (WWDC) were told yesterday. CEO Tim Cook and Co. unveiled Apple Intelligence, a host of AI-powered features that will debut on iPhones, iPads, and Macs this fall.
Addus HomeCare is making a major move to expand its business with plans to buy Gentiva’s personal care business for $350 million.
Healthcare payment software maker Waystar debuted on the public market Friday, raising $967.5 million, and marking the biggest health tech IPO since 2022. The company plans on paying off existing debt.
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