DAILY UPDATE: Jobs, Chips, Banks and Tax Refunds

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

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

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

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

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

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PODCAST: Healthcare Business Start-Ups and Incubators

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Physician Owned Hospitals Myths DeBunked

BY HEALTH CAPITAL CONSULTANTS, LLC

Literature Review Debunks Claims Against Physician-Owned Hospitals


Approximately 250 hospitals across the U.S. are completely or partially physician owned. These physician-owned hospitals (POHs) can offer a variety of services, from general care to specialty services, such as cardiovascular or orthopedic care, known as “focused factories.”

Over the past several decades, healthcare providers and policymakers have claimed that POHs have a negative impact on the healthcare industry, suggesting that: (1) POHs “cherry-pick” the most profitable patients; (2) the quality of care provided at POHs is substandard; and, (3) conflicts of interest exist due to the financial incentive for physician owners to refer patients to their POHs. (Read more…) 

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DAILY UPDATE: Mixed Stock Markets with DJIA Up

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Here’s where the major benchmarks ended:

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

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🟢 What’s up

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

What’s down

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

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

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

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🟢 What’s up

What’s down

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

Here’s where the major benchmarks ended:

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

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

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

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

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Doctors Saw a 6% Boost in Pay in 2023

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

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

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

Economic Summary

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

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Consumer confidence rose for the first time in four months

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

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STOCKS UP:

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

STOCKS DOWN:

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

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UPMC: Settles Stark Law Case

By Health Capital Consultants, LLC

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On May 9th, 2024, the University of Pittsburgh Medical Center (UPMC), a large nonprofit healthcare system that owns a number of hospitals, medical practices, and other subsidiaries, announced that they would pay $38 million to settle a longstanding Stark Law case which had triggered a violation of the False Claims Act (FCA). The lawsuit claimed that several of UPMC’s surgeons ordered complex and unnecessary procedures to increase their earnings. 

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This Health Capital Topics article will discuss the UPMC settlement and the allegations underlying the case. (Read more…) 

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DAILY UPDATE: Post Memorial Day Tuesday

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US markets were closed for Memorial Day in what will be a quiet few days until the latter half of the week, when a slew of economic reports get filed. The highlights include the Fed’s Beige Book on Wednesday, initial jobless claims and Q1 GDP on Thursday, and both the April personal income & spending report and the all-important PCE read on Friday.

PCE, or the Personal Consumption Expenditures Price Index, will dictate market moves more than any of the other readings next week, since the Fed places a lot of importance on the measure—particularly core PCE, which excludes ever-changing food and gas prices. April’s CPI report was better than expected, but recent FOMC minutes revealed the Fed is still hesitant to cut interest rates without more data—which makes this PCE reading all the more significant.

And don’t forget, the US isn’t the only country fending off high inflation. Germany reports preliminary May CPI on Wednesday, while readings for France, Italy, and the entire Eurozone will be released on Friday. Tokyo CPI, economic activity, and job market data will also come out on Friday, in what is turning out to be a key day in determining where markets are heading as the second half of the year kicks off.

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  • Stock spotlight: One to watch this week is Dell, which reports its quarterly earnings on Thursday. Investors will be seeking news on its AI-server business. The company hit a record high last week as Nvidia’s red-hot revenue numbers boosted AI-related stocks.

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DAILY UPDATE: Memorial Day as Stocks Recover

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Here’s where the major stock market benchmarks ended:

  • The S&P 500 index added 36.9 points (0.7%) to 5,304.72, basically flat on the week; the Dow Jones Industrial Average gained 4.3 points (0.0%) to 39,069.59, down 2.3% for the week; the NASDAQ Composite® ($COMP) rallied 184.8 points (1.1%) to 16,920.79, up 1.4% for the week.
  • The 10-year Treasury note yield (TNX) was little changed at 4.46%, up about four basis points for the week.
  • The CBOE Volatility Index® (VIX) fell 0.86 to 11.91 and finished a roller-coaster week roughly where it started.

Some of the mega cap names saw notable strength Friday. Nvidia added another 2.6% to Thursday’s 9.3% post-earnings rally. Apple (AAPL) gained 1.7%, Meta Platforms (META) added 2.7%, and Tesla (TSLA) rose 3.2%

The small cap Russell 2000® Index (RUT) also outperformed, gaining nearly 1% Friday. However, for the week, the index lost 1.3%.

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INVITE: Professor Marcinko to Your Next Seminar or Event

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Colleagues know that I enjoy personal coaching and public speaking and give as many talks each year as possible, at a variety of medical society and financial services conferences around the country and world. All in a Corona safe environment.

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These include lectures and visiting professorships at major academic centers, keynote lectures for hospitals, economic seminars and health systems, end-note lectures at city and statewide financial coalitions, and annual lectures for a variety of internal yearly meetings.

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PODCAST: Health Insurance Denials Contradict DEI, ESG and Fairness Initiatives

By Eric Bricker MD

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DAILY UPDATE: Friday Before Memorial Day Weekend and the Stock Market Collapse

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The Friday before Memorial Day is never action packed, and this year is no exception as earnings season begins to wrap up and economic readings slow down. Two reports to watch for tomorrow: April Durable Goods Orders and University of Michigan’s May sentiment report.

Durable Goods Orders are big-ticket items with a shelf life of three or more years—think appliances and furniture for consumers, or machinery, equipment, and vehicles for businesses. More durable goods orders indicate a healthy economy, as consumers and companies alike wouldn’t spend as much if they weren’t confident they could afford it, and also provides insight into how strong the manufacturing industry is.

The University of Michigan’s consumer sentiment index is a survey of consumers via telephone to better understand how they feel about the economy, what they’re spending their money on, etc. The preliminary findings earlier this month weren’t great thanks to sticky inflation, and tomorrow’s finalized readings won’t change much. But with the latest CPI reading indicating inflation might yet be tamed, next month’s report could be much more illuminating.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 39.17 points (0.7%) to 5,267.84; the Dow Jones Industrial Average lost 605.78 points (1.5%) to 39,065.26; the NASDAQ Composite® ($COMP) shed 65.51 points (0.4%) to 16,736.03.
  • The 10-year Treasury note yield rose more than 4 basis points to 4.479%.
  • The CBOE Volatility Index® (VIX) rose 0.48 to 12.77.

Financial shares were among Thursday’s weakest performers amid ideas a “higher-for-longer” Fed rate outlook could pressure bank margins. The KBW Regional Bank Index (KRX) dropped almost 3% to a three-week low. Other interest-rate-sensitive sectors, including real estate and utilities, took pressure.

In other markets, WTI Crude Oil (/CL) futures fell for the fourth straight trading day and closed at a three-month low under $76 per barrel.

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Spot Ethereum ETFs were approved by the SEC in another big win for crypto, following the approval of spot bitcoin ETFs earlier this year.

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DAILY UPDATE: Uber Health, Lyft Healthcare, HHS Cyber Attacks as Markets Swoon

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Here’s where the major benchmarks ended:

  • The S&P 500 index lost 14.40 points (0.3%) to 5,307.01; the Dow Jones Industrial Average® ($DJI) declined 201.95 points (0.5%) to 39,671.04; the NASDAQ Composite® ($COMP) slipped 31.08 points (0.2%) to 16,801.54.
  • The 10-year Treasury note yield (TNX) rose more than 1 basis point to 4.426%.
  • The CBOE Volatility Index® (VIX) increased 0.43 to 12.29.

Retailer shares were among the market’s weakest performers after Target’s (TGT) quarterly results, released before Wednesday’s open, fell short of expectations. Target shares tumbled 8% after the company reported revenue fell 3% in the first quarter from the year-earlier period. During the company’s earnings call, Target CEO Brian Cornell noted “continued soft trends in discretionary categories” contributed to the revenue decline.

Energy companies were also under pressure after WTI Crude Oil (/CL) futures closed at a three-month low just above $77 per barrel.

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Following a series of high-profileand costlycyberattacks against the healthcare industry, the federal government is stepping in with a $50+ million initiative intended to boost hospital cybersecurity, a division of the Department of Health and Human Services (HHS) announced on May 20th.

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Uber Health will begin rolling out a new solution designed for caregivers this summer, allowing individuals to add a caregiver to their Uber profile. That caregiver can then see and spend that person’s health benefits on eligible services, request rides to doctors’ appointments or order groceries. In the coming months, Uber Health will be working with Medicare Advantage, Medicaid and commercial plans to offer the solution.


U.S. Sens. Sheldon Whitehouse and Bill Cassidy, M.D., want to reform how primary care providers get paid through Medicare, and they also want to hear from the healthcare industry about the best way to do it. Together, they introduced a bipartisan bill, the Pay PCPs Act (S. 4338), last week to better support and improve pay for high-quality primary care providers. 


And… digital maternal health company Babyscripts announced a partnership with Lyft Healthcare to offer sponsored rides for people who are pregnant or postpartum and face barriers to transportation. The Lyft partnership will identify transportation-insecure patients and offer free rides to in-person appointments in traditional care settings and community-based healthcare services and programs.

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PODCAST: Medicare Value Based Payments Explained

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DAILY UPDATE: Hims & Hers, MSFT-AI, Neuralink, FDIC and New Market Highs

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Microsoft unveiled new PCs with AI-powered features.

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

Hims & Hers stock soared as much as 38% on the news that it’ll provide GLP-1 injections with the same active ingredient as Ozempic or Wegovy for just $199/month—an 85% discount compared to Wegovy’s ~$1,350 monthly price tag (without insurance).

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FDIC Chair Martin Gruenberg will resign after an investigation found widespread sexual harassment at the agency. But he won’t step down until a successor is named.

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

The FDA granted Elon Musk’s neurotech company Neuralink, approval to place its brain chip into a second human test subject using a new method designed to correct issues that arose after its inaugural insertion in January, per the Wall Street Journal.

And, Optum Rx is shaking up its pharmacy model. The business says it will make drug costs more predictable and transparent for clients.

CITE: https://tinyurl.com/tj8smmes

  • All three indexes ended the day higher after Fed Governor Christopher Waller stopped by CNBC and mentioned he doesn’t think raising interest rates is in the cards, even if the Fed is waiting for more data before making cuts. The NASDAQ continued to hit new all-time highs today as investors place their bets before Nvidia’s earnings announcement tomorrow afternoon, and the S&P 500 hit yet another record.
  • Copper continued to rise as the market comes to terms with the metal’s importance, while oil fell on the news that the Biden administration will release 1 million barrels of gasoline this summer from the Northeast reserve. Meanwhile, ethereum continued to climb on the news that a new ETF may be joining the fray.

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 13.28 points (0.3%) to 5,321.41; the Dow Jones Industrial Average® ($DJI) gained 66.22 points (0.2%) to 39,872.99; the NASDAQ Composite advanced 37.75 points (0.2%) to 16,832.62.
  • The 10-year Treasury note yield (TNX) lost more than 2 basis points to 4.414%.
  • The CBOE Volatility Index® (VIX) fell 0.29 to 11.86.

Banking and consumer staples were among the market’s strongest performers Tuesday, while utility shares extended a sharp upswing over the past month. The Dow Jones Utility Average® ($DJU) added 0.5% and closed at a 12-month high. Transportation companies were among the weakest performers.

In other markets, Gold (/GC) futures slipped from Monday’s record high above $2,454 per ounce, while Silver (/SI) futures ended near a 12-year high around $32.21. Gold futures are still up 17% this year due to several factors, including reports of China’s central bank buying actual gold as well as escalating conflict in the Middle East. Gold is viewed by some as a safe-haven asset during periods of heightened geopolitical tension.

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DAILY UPDATE: Abbvie, Treasuries, Gold, Copper and the NASDAQ Rally

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The yield on the 10-year Treasury rose as investors wait for word from the FOMC on Wednesday, while oil initially rose on the news of the death of the president of Iran, though it fell back down to end the day lower after succession of the presidency was settled. But investors were clearly still feeling jittery as gold hit new highs on the back of geopolitical concerns. Copper also rose to a new all-time high.

Here’s where the major benchmarks ended:

  • The S&P 500 index gained 4.86 points (0.1%) to 5,308.13; the Dow Jones Industrial Average® ($DJI) lost 196.82 points (0.5%) to 39,806.77; the NASDAQ Composite rallied 108.91 points (0.7%) to 16,794.87.
  • The 10-year Treasury note yield (TNX) increased more than 2 basis points to 4.443%.
  • The CBOE Volatility Index® (VIX) rose 0.15 to 12.14.

Nvidia’s gain helped push the PHLX Semiconductor Index (SOX) more than 2% to a two-and-a-half-month high and just under a record close posted in early March. The small-cap Russell 2000® Index (RUT) added 0.3% and ended slightly below a six-week high posted last Wednesday. 

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JPMorgan shares fell 4.5% as investors realized that they won’t have Jamie Dimon around forever—he told shareholders at a meeting today that his 5-year timetable for leaving the company no longer applies.

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After AbbVie’s Humira, the best-selling drug in the world, lost patent exclusivity in 2023, company executives placed their bets on two other AbbVie drugs, Skyrizi and Rinvoq, to make up for an anticipated steep decline in revenue.

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DAILY UPDATE: Fiduciary Rule with Stock Market Earnings Week

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For last the week, the NASDAQ Composite (^IXIC) rose more than 2% while the S&P 500 (^GSPC) popped more than 1.5%. The Dow Jones Industrial Average (^DJI) rose more than 1%, closing above 40,000 for the first time ever on Friday.

In the week ahead, highly anticipated earnings results from Nvidia (NVDA) are expected to be the key catalyst for markets. Results from Target (TGT), Palo Alto Networks (PANW), and Lowe’s (LOW) will also be closely tracked by investors.

The week is also expected to be quieter on the economic front, with updates on activity in the manufacturing and services sectors as well as the final reading of consumer sentiment for May on tap. Minutes from the Fed’s May meeting are also expected on Wednesday afternoon.

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

The rule, finalized last month by the Labor Department, requires investment advisers to provide “prudent, loyal, honest advice free from overcharges” and avoid recommendations that favor their interests at the expense of their clients. It also updates the definition of an investment advice fiduciary under the Employee Retirement Income Security Act (ERISA) and Internal Revenue Code. 

Under the new definition, a fiduciary includes any financial services provider who offers investment advice to a retirement investor for a fee and who claims to be acting as a fiduciary or who a reasonable investor understands to be a trusted adviser acting in their best interest. The update removes the requirement that fiduciaries provide advice on a regular basis, bringing one-time advice under the rule. The Biden administration has argued that the previous definition, which was written in 1975, is outdated and has not kept pace with changes to the retirement landscape. 

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And, confidence in the U.S. dollar has waned, as forecasts suggest that a dip in inflation might allow the Federal Reserve to slash interest rates. With a notable 5% climb earlier this year, the dollar is now bracing for its first loss of 2024, triggered by a promising inflation report.

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Finally, fourteen of the world’s 20 largest stock markets have hit all-time highs recently, including England, Japan, Brazil, India, and Canada, according to Bloomberg. In the USA, the S&P 500 (also at a record) hasn’t dropped more than 2% in a trading session in 311 days, the longest streak in five years.

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PODCAST: Medicare Launched the First VBC Initiative 40 Years Ago!

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See the source image

BY DR. ERIC BRICKER MD

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Value-Based Care Happened 40 Years

Why Was Medicare Able to Bring About So Much Value-Based Payment Change in 3 Years (’83-’86) Compared to the Relatively Little Change That Has Occurred in the 11 Years Since the Affordable Care Act?

Watch the Video to Find Out.

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PODCAST: Healthcare Start-Up Accelerators and Incubators

By Dr. Eric Bricker MD

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DAILY UPDATE: Jerome Powell, DJIA, Reddit and Life Insurance

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Young adults are delaying life insurance purchases due to financial constraints and a preference for spending on immediate experiences. The insurance industry is responding with digital-first strategies and more flexible products.

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The DJIA closed above 40,000 for the first time after briefly crossing the milestone the day before and clinching its fifth winning week. Reddit shot up after announcing a partnership with OpenAI that lets the AI train on your posts and gives Reddit advertising dollars and the ability to use the tech to make new tools.

But, GameStop stock plunged after the recently reinvigorated meme stock filed to sell 45 million new shares and revealed that sales were down last quarter.

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Jerome Powell, chair of the Federal Reserve has tested positive for Covid. But the economy needn’t worry because he’s working from home.

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DAILY UPDATE: Top Causes of Death, Narcan Saves Lives but Scientific Research Fraudulent as DJIA Tops 40,000

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Walgreens has released its own brand of naloxone, a medication that reverses the effects of an opioid overdose. Available online now, Walgreens Brand Naloxone HCl Nasal Spray comes with two doses for $34.99, about $10 cheaper than the name-brand version, Narcan. The over-the-counter medication will also be available in stores by the end of May in the pain aisle, according to a press release, making the life-saving nasal spray more accessible.

***

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 6.17 points (0.1%) to 5,303.27, up 1.5% for the week; the Dow Jones Industrial Average gained 134.21 points (0.3%) to 40,003.59, up 1.2% for the week; the NASDAQ Composite® ($COMP) lost 12.35 points (0.1%) to 16,685.97, up 2.1% for the week.
  • The 10-year Treasury note yield (TNX) rose more than 4 basis points to 4.42%, down about 8 basis points for the week.
  • The CBOE Volatility Index® (VIX) fell 0.43 to 11.99.

Among major companies, Nvidia (NVDA) dropped 2% Friday but still posted a 2.9% advance for the week ahead of the semiconductor leader’s quarterly earnings Wednesday. Among sectors, energy shares led gainers behind a 1% jump in WTI Crude Oil (/CL) futures. The small-cap Russell 2000® Index (RUT) ended little changed but still gained 1.7% for the week.

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Fraudulent research papers have cost scientific journal publishers millions in lost revenue. (the Wall Street Journal)

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The 10 Top Causes of Adult Death in the U.S.A.

1.  Heart disease 267.2* 2.  Cancer 142.3 3.  Unintentional injuries 64.0 4.  COVID-19 44.5 5.  Stroke 39.5 6.  Chronic lower respiratory disease 34.3 7.  Alzheimer disease 28.9 8.  Diabetes 24.1  9   Kidney disease 13.8 10. Chronic liver disease and cirrhosis 13.8 Deaths per 100,000 population.

Source: Jeffrey Bendix, Medical Economics [5/15/24]

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DAILY UPDATE: Core CPI and ERISA while Markets Remain High with Walmart Up

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Here’s where the major benchmarks ended:

America’s oldest popular stock index, the Dow Jones Industrial Average, hit a brief record high yesterday morning when it traded above 40,000, reflecting renewed hope for the market’s health after Wednesday’s promising inflation report.

  • The S&P 500® index (SPX) fell 11.05 points (0.2%) to 5,297.10; the Dow Jones Industrial Average declined 38.62 points (0.1%) to 39,869.38; the NASDAQ Composite® ($COMP) shed 44.07 points (0.3%) to 16,698.32.
  • The 10-year Treasury note yield (TNX) rose more than 2 basis points to 4.381%.
  • The CBOE Volatility Index® (VIX) dropped 0.03 to 12.42.

Walmart’s strength fueled a strong day for consumer staples shares. The S&P 500 Consumer Staples ($SP500#30), which includes Walmart as well as companies like Coca-Cola (KO) and Procter & Gamble (PG), surged 1.5% to its highest level in over two years. 

Among other companies, Applied Materials (AMAT) fell 1.6% ahead of the semiconductor industry supplier’s quarterly earnings report, which is expected after Thursday’s close.

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And, Core CPI, which tracks the price of goods and services excluding volatile food and energy prices and is closely watched as an inflation indicator, rose 3.6% from the same period last year. That’s the smallest annual increase since April 2021. On a monthly basis, core CPI rose 0.3%, marking the first time in six months that its growth slowed from the prior month. Other good signs include:

  • Grocery prices dropped 0.2% from March, the first decrease in a year.
  • Health insurance and car insurance increased more slowly in April than in March.
  • A separate report released yesterday showed consumer spending stayed steady last month.

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

Finally, Joe Manchin (D-W.Va.) and a group of Republican senators are moving to overturn a retirement investment planning rule that was finalized by the Labor Department last month. The Labor Department unveiled the new rule last month that would update the definition of an investment advice fiduciary under the Employee Retirement Income Security Act. Manchin and 15 Republican senators joined in co-sponsoring a Congressional Review Act (CRA) resolution that would overturn this new rule.

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REIMBURSEMENT: Valuation of Accountable Care Organizations

By Health Capital Consultants, LLC

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Valuation of Accountable Care Organizations: Reimbursement

The U.S. healthcare payment and delivery system is increasingly moving to a value- and quality-based system. Accountable care organizations (ACOs) are at the forefront of delivering high-quality and cost-effective care to millions of Medicare beneficiaries and privately insured patients, incentivized by substantial shared savings for those who increase quality while containing costs.

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This third installment of a five-part series on the valuation of ACOs will discuss the reimbursement environment in which ACOs participate.(Read more…) 

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DAILY UPDATE: Healthcare Monopolies, Ark Invest and the Stock Markets Mega Rally

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More people are interested in determining their “heart age” using new tests and tech tools, but some skeptics say it’s not a healthy data point to focus on. (the Wall Street Journal)

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The Cathie Wood-led Ark Invest just made some significant trades. The most prominent among them were the increased stakes in Palantir Technologies Inc (NYSE:PLTR) and the reduced holdings in Coinbase Global Inc (NASDAQ: COIN).

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 61.47 points (1.2%) to 5,308.15; the Dow Jones Industrial Average added 349.89 points (0.9%) to 39,908.00; the NASDAQ Composite rallied 231.21 points (1.4%) to 16,742.39.
  • The 10-year Treasury note yield fell almost 10 basis points to 4.348%.
  • The CBOE Volatility Index® (VIX) dropped 0.97 to 12.45.

Chipmaker shares led the way higher Wednesday, lifting the Philadelphia Semiconductor Index (SOX) almost 3% to a 10-week high. Interest-rate-sensitive sectors like real estate and utilities were also strong. The small-cap Russell 2000® Index (RUT) advanced 1.1% to a seven-week high. The U.S. Dollar Index ($DXY) slumped to its weakest level in five weeks, reflecting expectations for lower interest rates that may reduce the appeal of U.S. fixed income assets.

Among companies, Cisco Systems (CSC) surged 1.5% ahead of its quarterly results expected after Wednesday’s close. Dow member Walmart (WMT) is expected to release results Thursday morning as the unofficial retail earnings season accelerates. 

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And The U.S. Department of Justice (DOJ) announced it has established a new task force to take on healthcare monopolies and collusion. The task force, made up of prosecutors, economists, healthcare industry experts and others, will guide the division’s enforcement strategy and policy approach in healthcare, including by facilitating policy advocacy, investigations and, where warranted, civil and criminal enforcement in healthcare markets.

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DAILY UPDATE: Squarespace, Ark Invest & Hospitals as the Markets Rebound

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 25.26 points (0.5%) to 5,246.68, the highest since a record close March 28; the Dow Jones Industrial Average® ($DJI) gained 126.60 points (0.3%) to 39,558.11; the NASDAQ Composite climbed 122.94 points (0.8%) to 16,511.18.
  • The 10-year Treasury note yield (TNX) fell more than 3 basis points to 4.449%.
  • The CBOE Volatility Index® (VIX) decreased 0.18 to  13.42.

Among companies, Home Depot’s (HD) quarterly results reported earlier Tuesday kicked off the unofficial start of the retail earnings season. The home improvement retailer’s earnings topped expectations, but revenue missed forecasts, initially sending the company’s shares down sharply. 

Home Depot also reaffirmed its full-year guidance for a 1% decline in comparable-store sales and a 1% increase in total sales. The company’s shares bounced back to end with a 0.1% loss.

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And, the Cathie Wood-led Ark Invest just made some significant trades. The most prominent among them were the increased stakes in Palantir Technologies Inc (NYSE PLTR) and the reduced holdings in Coinbase Global Inc (NASDAQ: COIN).

Moreover, the website-building platform Squarespace is to go private, which it announced it’ll be doing in an all-cash deal with Permira, a private equity firm. Squarespace, which was public for nearly three years, joins a group of other smaller tech companies like Qualtrics that have recently pulled themselves off the public market. (CNBC)

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Employers and private insurers are paying hospitals more for inpatient and outpatient services than in previous years, a study from RAND Corporation finds. The American Hospital Association dismissed the report saying it offers a “skewed and incomplete picture.”


And finally … Kaiser Permanente began its 2024 earnings season with more than $2.7 billion in net income and $935 million in operating income, just months after sharing plans to lay off workers.

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Physician Electronic-Mail Bills

MY CHART”

By AMANDA SEITZ

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E-Mailing your Physician may Cost You like Your Attorneys!

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WASHINGTON (AP) — The next time you message your doctor to ask about a pesky cough or an itchy rash, you may want to check your bank account first — you could get a bill for the question.

Hospital systems around the country are rolling out fees for some messages that patients send to physicians, who they say are spending an increasing amount of time poring over online queries, some so complex that they require the level of medical expertise normally dispensed during an office visit. Patient advocates, however, worry these new fees may deter people from reaching out to their doctor and that they add another layer of complexity to the U.S. health care system’s already opaque billing process.

“This is a barrier that denies access and will result in hesitancy or fear to communicate and potentially harm patients with lower quality of care and outcomes at a much higher cost,” said Cynthia Fisher, the founder of Patient Rights Advocate, a Massachusetts-based nonprofit that pushes for hospital price transparency.

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

The explosion of telehealth over the last three years — driven by the COVID-19 outbreak and relaxed federal regulations for online care — prompted many doctors to adopt more robust telecommunication with their patients. Consultations that once happened in an office were converted to computer or smart phone visits. And health care systems invited patients to use new online portals to message their doctors with a question at any time, American Medical Association president Jack Resneck Jr. told The Associated Press.

“When people figured out this is cool and could improve care, you saw hospitals and practice groups saying to patients, welcome to your portal … you can ping your physician with questions if you want,” Resneck said. “We found ourselves as physicians getting dozens and dozens of these a day and not having time built in to do that work.”

The charges vary for each patient and hospital system, with messages costing as little as $3 for Medicare patients to as much $160 for the uninsured. In some cases, the final bill depends on how much time the doctor spends responding.

READ HERE: https://my.clevelandclinic.org/online-services/mychart/messaging#msdynttrid=bAU8cKe-602S6wFIwSYop1KQswRcT2b2F5mRJ-92OEc

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PODCAST: Hospital Price Transparency Website

BILLY EATS MEDICAL BILLS

By Eric Bricker MD

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DAILY UPDATE: Moderna Down with Mixed Markets

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 1.26 points (0.02%) to 5,221.42; the Dow Jones Industrial Average lost 81.33 points (0.2%) to 39,431.51; the NASDAQ Composite® ($COMP) gained 47.37 points (0.3%) to 16,388.24.
  • The 10-year Treasury note yield (TNX) dropped almost 2 basis points to 4.487%.
  • The CBOE Volatility Index® (VIX) surged 1.05 to 13.60.

Biotechnology and food and beverage shares were among the market’s strongest sectors Monday, while communication services stocks were among the biggest laggards. Energy shares took pressure despite a jump of 1.2% in WTI Crude Oil (/CL) futures, which ended above $79 per barrel after slumping last week to two-month lows.

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Moderna is “bleeding money” as its forthcoming RSV vaccine doesn’t appear to deliver better results than other RSV shots already on the market. (Bloomberg)

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It’s ChatGPT-4o’s time to shine. The “o” stands for omni, and it’s the latest iteration of OpenAI’s signature chatbot. According to the company, it’s much faster with enhanced “capabilities across text, vision, and audio.”

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23% is the average portion of the bill hospitals collected from patients before treatment in Q1 of this year, up 3% YoY. (the Wall Street Journal)

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About Tombstone Securities Advertising and the “New Issue” Propsectus

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A Primer for Physician Investors and Medical Professionals

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

[Editor-in-Chief]

[PART 2 OF 8]

BU Dr. Marcinko

NOTE: This is an eight part ME-P series based on a weekend lecture I gave more than a decade ago to an interested group of graduate, business and medical school students. The material is a bit dated and some facts and specifics may have changed since then. But, the overall thought-leadership information of the essay remains interesting and informative. We trust you will enjoy it.

Introduction

Despite the SEC restrictions, noted in Part I of this series, some idea of potential demand for a new security issue can be gauged and have a bearing on  pricing decisions.

For example, as CEO of a medical instrument company, or interested investor, would you rather see a great deal of interest in a potential new issue or not very much interest?  There is however, one kind of advertisement that the underwriter can publish during the cooling off period. It’s known as a tombstone ad.  The ad makes it clear that it is only an announcement and does not constitute an offer to sell or  solicit the issue, and that such an offering can only be made by  prospectus.  SEC Rule 134 of the 1933 Act  itself, refers to a tombstone ad as “communication not deemed a prospectus”  because it makes reference to the prospectus in the ad. Tombstones have received their name because of the sparse nature of details found in them.

However, the most popular use of the tombstone ad is to announce the effectiveness of a new issue, after it has been successfully issued. This promotes the success of  both he underwriter, as well as the company.

Since distributing securities involves potential liability to the investment bank, it will do everything possible to protect itself.  So, near the end of the cooling off period, a meeting is held between the underwriter and the corporation. It is known as a due diligence meeting. At this meeting they both discuss amendments that are going to be necessary to make the registration statement complete and accurate. The corporate officers, and the underwriters sign, the final registration statement. They have civil liability for damages that result from omissions of material facts or

Mis-statements of fact. They also have criminal liability if the distribution is done by use of fraudulent, manipulative, or deceptive means. Due diligence takes on a whole new meaning when  incarceration from a half-hearted effort underwriting efforts can occur. The investment bank strives to ensure that there have been no material changes to the issuer or the terms of the issue since the registration statement was filed.

Again, as a physician, how would you feel if you were an investment banker raising capital for a new pharmaceutical company that had developed a drug product that was highly marketable. But, on the day after the issue was effective, there was a major news story indicating that the company was being sued for patent infringement? What effect do you think that would have on the market price of this new issue? It would probably plunge. How could this situation have been prevented? The due diligence meeting is more than a cocktail party or a gathering in a smoke filled room. Otherwise, the company would require specially trained people, to do a patent search lessening the likelihood of this scenario. At the due diligence meeting, work is done on the preparation of the final prospectus, but the investment bank does not set the public offering price or the effective date at this meeting. The SEC will eventually set the effective date for the registration and it is on that date that the final offering price will be determined.

Once the SEC sets the effective date, sales may be executed and money can be accepted by the investment bank. It is at this time that the final prospectus, similar to the red herring but without the red ink and with the missing numbers, is issued. A prospectus is an abbreviated form of the registration statement, distributed to purchasers, on and after the effective date of  the registration. It is not the same as the registration statement. A typical registration statement consists of papers that stand more than a foot high; rarely does a prospectus go beyond 40 or 50 pages. All purchasers will receive a final prospectus and then it becomes permissible for the underwriter to provide sales literature.

In addition to the requirement that a prospectus must be delivered to a purchaser of new issues no later than with confirmation of the trade, there are two other requirements that healthcare executives investors should know.

90-day: When an issuer has an initial public offering (IPO), there is generally a lack of publicly available material relating to the operations of that issuer.  Because of this, the SEC requires that all members of the underwriting group make available a prospectus on an IPO for a period of 90 days after the effective date.

4O-day: Once an issuer has gone public, there are a number of routine filings that must be made with the SEC so there is publicly available information regarding the financial condition of that issuer. Since additional information is now available, the SEC requires that, on all issues other than IPOs, any member of the underwriting group must make available a prospectus for a period of 40 days after the effective date.

In the event that the investment bankers misgauged the marketplace, and the issue moves quite slowly, it is possible that information contained in the prospectus would be rendered obsolete by the SEC. Specifically, the SEC requires that any prospectus used more than 9 months after the effective date, may not have any financial information more than 16 months old. It can however, be amended or stickered, with updated information, as needed.

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Syndication Among Underwriters

Because the investment banking firm may be underwriting (distributing) a rather large dollar amount of securities, to spread its risk exposure, it may form a group made up of other investment bankers or underwriters, known as a syndicate. The syndicate is headed by a syndicate manager, or lead underwriter, and it is his job to decide whether to participate in the offering. If so, the managing underwriter will sign a non-binding agreement called a letter of intent. .

If all has gone well and the market place is sufficiently interested in the security, and the SEC has been satisfied with respect to the registration statement, it is time for all parties to the offering to formalize their relationships with a contract including the basic understandings reflected in the letter of intent. Three principal underwriting contracts are involved in the usual public offering, each serving a distinct purpose. These are the: Agreement among Underwriters, Underwriting Agreement, and the Dealer Agreement.

In the Agreement Among Underwriters (AAU), the underwriters committing to a portion of the issue, enter into an agreement establishing the nature and terms of their relationship with each other. It designates the syndicate manager to act on their behalf, particularly to enter into an Underwriting Agreement with the issuer, and to conduct the offering on behalf of each  of them. The AAU will designate the managing underwriter’s compensation (management fee) for managing the offering.

The authority to manage the offering includes the authority to: agree with the issuer as to the public offering price; decide when to commence the offering; modify the offering price and selling commission; control all advertising; and, control the timing and effectiveness of the registration statement by quickly responding to deficiency letters. Each underwriter agrees to purchase a portion of the underwritten securities, which is known as each under-writer’s allotment (allocation).  It is normally signed severally, but not jointly, meaning each underwriter is obligated to sell his allocation but bears no financial obligation for any unsold allotment of another underwriter. This is referred to as a divided account or a Western account. Much less frequently, an undivided or Eastern account, will be used. Each underwriter is responsible for unsold allotments of others, based upon a  proportionate share of the offering.

The above comments referred to firm commitment underwriting. Another type of underwriting commitment  however, is known as best efforts underwriting. Under the terms of  best efforts underwriting, the underwriters make no commitment to buy or sell the issue, they simply do the best they can, acting as an agent for the issuer, and having no liability to the issuer if none of the securities are sold. There is no syndicate formed with a best efforts underwriting. The investment bankers form a selling group, with each member doing his best to sell his allotment. Two variations of a best efforts underwriting are: the all-or-none, and the mini-max (part-or-none) underwriting. Under the provisions of an all-or-none offering, unless all of the shares can be distributed within a specified period of time, the offering will terminate and no subscriptions or orders will be accepted or filled. Under mini-max, unless a set minimum amount is sold, the offering will be terminated.

SEC Rule 15c2-4 requires the underwriter to set up an escrow account for any money received before the closing date, in the event that it is necessary to return the money to prospective purchasers. If the “minimum”, or the “all” contingencies are met, the monies in escrow go to the issuer with the underwriters retaining their appropriate compensation. In order to make sure that investors are properly protected, the escrow account must be maintained at a bank for the benefit of the investors until every appropriate event or contingency has occurred. Then, the funds are properly returned to the investors. If the money is to be placed into an interest bearing account, it must have a maturity date no later than the closing date of the offering, or the account must be redeemable at face with no prepayment penalty as regards principal.

Underwriter Compensation Hierarchy

As we have seen, in a firm commitment the underwriter buys the entire issue from the issuer and then attempts to resell it to the public. The price at which the syndicate offers the securities to the public is known as the public offering price. It is the price printed on the front page of the prospectus.

However, the managing underwriter pays the issuer a lower price than this for the securities. The difference between that lower price and the public offering price is known as the spread or underwriting discount. Everyone involved in the sale of a new issue is compensated by receiving part of the spread. The amount of the spread is the subject of negotiations between the issuer and the managing underwriter, but usually is within a range established by similar transactions between comparable issuers and underwriters. The spread is also subject to NASD [now FINRA] review and approval before sales may commence. The spread is broken down by the underwriters so that a portion of it is paid to the managing underwriter for finding and packaging the issue and managing the offering (usually called the manager’s fee); and a portion is retained by each underwriter (called the underwriting or syndicate allowance) to compensate the syndicate members for their expenses, use of money, and assuming the risk of the underwriting. The remaining portion is allocated to the selling group and is called selling concession. It is often useful to remember the compensation hierarchy pecking order in the following way:

  • Spread (syndicate manager).
  • Underwriters allowance (syndicate members)
  • Selling concession (selling group members)
  • Re-allowance (any other firm)

While the above deal with corporate equity, the only other significant item with respect to corporate debt is the Trust Indenture Act of 1939. This Federal law applies to public issues of debt securities in excess of $5,000,000. The thrust of this act is to require an indenture with an independent trustee (usually a bank or trust company) who will report to the holders of the debt securities on a regular basis.

Successful marketing of a new issue is a marriage between somewhat alien factors: compliance and numerous Federal, state, and self-regulatory rules and statutes; along with finely honed and profit-motivated sales techniques. It’s not too hard to see that there could be a real, or apparent, conflict of interest here. Most successful investment bankers have built their excellent reputations upon their ability to properly balance these two objectives consistently, year after year.

PART ONE:

Understanding investment banking rules, securities markets, brokerage accounts, margin and debt

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DAILY UPDATE: Ark Invest, Dell and “Buy Now-Pay Later”

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While Buy Now-Pay Later (BNPL) reduces friction when purchasing, it’s giving some economy watchers unease. As Americans’ budgets buckle under the weight of inflation and higher interest payments, some worry BNPL is more of an invisible burden than a boon, Bloomberg reports. Beware the “phantom debt,” a Wells Fargo economist recently warned, referring to the BNPL industry’s short-term loans, which go largely unaccounted for by those tracking Americans’ debt load. That’s because, unlike credit cards and auto loan providers, Afterpay, Affirm, Klarna, and other BNPL providers don’t usually report transactions to credit scoring agencies.

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The Cathie Wood-led Ark Invest just made some significant trades. The most prominent among them were the increased stakes in Palantir Technologies Inc (NYSE: PLTR) and her reduced holdings in Coinbase Global Inc (NASDAQ: COIN).

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Dell has recently seen a decline in its revenue. In its most recent earnings report, it revealed that its net revenue shrunk by 11% year-over-year during its fiscal 2024 fourth quarter. For full year 2023, the company’s revenue was down by 14% to $88.4 billion. Partly that was due to a weak personal-computer market and the costs associated with more than 6,000 layoffs. But investors are excited by Dell’s growth potential for its server and computer businesses because of artificial intelligence, the Motley Fool reported.

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DAILY UPDATE: National Nurses Week, Multiplan Lawsuit, Rite Aid and Fatburger Down

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HAPPY MOTHER’S DAY 2024

Fat Brands is the parent company of Fatburger, Johnny Rockets, and a few other restaurant chains. Last year, former CEO Andy Wiederhorn stepped down after the Los Angeles Times reported that the federal government was investigating him for fraud. He has since stayed on as the company’s chairman, but on Friday the Justice Department charged him with perpetuating a $47 million fraud against his own shareholders.

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In a recent Becker’s Health Care Newsletter, it is reported that a large multi-state hospital system is suing Multiplan for illegal price fixing and automatic significant price reductions, in particular, for out-of-network providers. The story states that Multiplan, by bombarding healthcare providers with automatic reductions in pricing, has made it impossible for providers to deliver healthcare.

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National Nurses Week, which ends today on May 12th, Florence Nightingale’s birthday

Rite Aid has announced that 39 stores are set to close their doors for good, this follows the decision to declare Chapter 11 bankruptcy back in October, 2023.    

The strategy? Reduce the total number of stores to 1,600 nationwide. 

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PRISONER’S DILEMMA: In Health Economics

DEM white shirt

By Dr. David Edward Marcinko MBA MEd CMP

Understanding the Prisoner’s Dilemma

[From Wikipedia, the free encyclopedia]

As all economists and psychologists know, the prisoner’s dilemma is a standard example of a game analyzed in game theory that shows why two completely “rational” individuals might not cooperate, even if it appears that it is in their best interests to do so. It was originally framed by Merrill Flood and Melvin Dresher working at RAND in 1950. Albert W. Tucker formalized the game with prison sentence rewards and named it, “prisoner’s dilemma” (Poundstone, 1992), presenting it as follows:

Two members of a criminal gang are arrested and imprisoned. Each prisoner is in solitary confinement with no means of communicating with the other. The prosecutors lack sufficient evidence to convict the pair on the principal charge. They hope to get both sentenced to a year in prison on a lesser charge.

Simultaneously, the prosecutors offer each prisoner a bargain. Each prisoner is given the opportunity either to: betray the other by testifying that the other committed the crime, or to cooperate with the other by remaining silent.

The offer is:

  • If A and B each betray the other, each of them serves 2 years in prison
  • If A betrays B but B remains silent, A will be set free and B will serve 3 years in prison (and vice versa)
  • If A and B both remain silent, both of them will only serve 1 year in prison (on the lesser charge)

It is implied that the prisoners will have no opportunity to reward or punish their partner other than the prison sentences they get, and that their decision will not affect their reputation in the future. Because betraying a partner offers a greater reward than cooperating with him, all purely rational self-interested prisoners would betray the other, and so the only possible outcome for two purely rational prisoners is for them to betray each other.

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thats-outrageous-prisoners-rights-to-free-medical-care-af

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The interesting part of this result is that pursuing individual reward logically leads both of the prisoners to betray, when they would get a better reward if they both kept silent.

In reality, humans display a systemic bias towards cooperative behavior in this and similar games, much more so than predicted by simple models of “rational” self-interested action. A model based on a different kind of rationality, where people forecast how the game would be played if they formed coalitions and then they maximize their forecasts, has been shown to make better predictions of the rate of cooperation in this and similar games given only the payoffs of the game.

An extended “iterated” version of the game also exists, where the classic game is played repeatedly between the same prisoners, and consequently, both prisoners continuously have an opportunity to penalize the other for previous decisions. If the number of times the game will be played is known to the players, then (by backward induction) two classically rational players will betray each other repeatedly, for the same reasons as the single shot variant. In an infinite or unknown length game there is no fixed optimum strategy, and Prisoner’s Dilemma tournaments have been held to compete and test algorithms.

In Health Economics

Advertising is sometimes cited as a real-example of the prisoner’s dilemma.

When cigarette advertising was legal in the United States, competing cigarette manufacturers had to decide how much money to spend on advertising. The effectiveness of Firm A’s advertising was partially determined by the advertising conducted by Firm B. Likewise, the profit derived from advertising for Firm B is affected by the advertising conducted by Firm A. If both Firm A and Firm B chose to advertise during a given period, then the advertising cancels out, receipts remain constant, and expenses increase due to the cost of advertising. Both firms would benefit from a reduction in advertising.

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cigarette+smoke

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However, should Firm B choose not to advertise, Firm A could benefit greatly by advertising. Nevertheless, the optimal amount of advertising by one firm depends on how much advertising the other undertakes. As the best strategy is dependent on what the other firm chooses there is no dominant strategy, which makes it slightly different from a prisoner’s dilemma. The outcome is similar, though, in that both firms would be better off were they to advertise less than in the equilibrium. Sometimes cooperative behaviors do emerge in business situations.

For instance, cigarette manufacturers endorsed the making of laws banning cigarette advertising, understanding that this would reduce costs and increase profits across the industry. This analysis is likely to be pertinent in many other business situations involving advertising

Without enforceable agreements, members of a cartel are also involved in a (multi-player) prisoners’ dilemma. ‘Cooperating’ typically means keeping prices at a pre-agreed minimum level. ‘Defecting’ means selling under this minimum level, instantly taking business (and profits) from other cartel members. Anti-trust authorities want potential cartel members to mutually defect, ensuring the lowest possible prices for consumers.

More Healthcare Examples:

Assessment

The prisoner’s dilemma game can be used as a model for many real world situations involving cooperative behavior. In casual usage, the label “prisoner’s dilemma” may be applied to situations not strictly matching the formal criteria of the classic or iterative games: for instance, those in which two entities could gain important benefits from cooperating or suffer from the failure to do so, but find it merely difficult or expensive, not necessarily impossible, to coordinate their activities to achieve cooperation.

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DAILY UPDATE: Mortgage Rates, Ascension Healthcare Network Security Event with Mixed Markets

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Novavax, the Covid vaccine-maker’s value doubled after it announced a $1.2 billion deal to develop new shots with Sanofi.

And, Mortgage rates fell for the first time since March, to just over 7%.

Here’s where the major stock market benchmarks ended:

  • The S&P 500 index rose 8.60 points (0.2%) to 5,222.68, up 1.9% for the week; the Dow Jones Industrial Average® ($DJI) advanced 125.08 points (0.3%) to 39,512.84, up 2.2% for the week and its eighth straight daily gain; the NASDAQ Composite® ($COMP) fell 5.40 points (0.03%) to 16,340.87, up 1.1% for the week.
  • The 10-year Treasury note yield (TNX) increased more than 5 basis points to 4.50%.
  • The CBOE Volatility Index® (VIX) fell 0.14 to 12.55.

Chip makers ranked among top gainers Friday after Taiwan Semiconductor Manufacturing (TSM) shares surged 4.5% after the company said its April revenue soared 60% behind AI-driven demand. The Philadelphia Semiconductor Index (SOX) climbed 1% and posted a 1.9% gain for the week. Consumer staples and transportation shares were also strong. Energy shares slipped behind a 1.2% drop in WTI Crude Oil (/CL) futures, though oil still ended slightly higher for the week.

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National hospital operator Ascension said a “cyber security event” has disrupted some of its clinical operations, according to a news release. Ascension, a St. Louis-based nonprofit and Catholic healthcare network, announced it had detected “unusual activity” on some of its systems. In response, the company kicked off an investigation and remediation efforts—including turning to outside cybersecurity firm Mandiant for help, as well as notifying the “appropriate authorities,” per the release.

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Planet Fitness to raise membership price for the first time since 1998. It’s going to take more than $10/month to join a gym once Planet Fitness raises the price of a basic membership for new members to $15 per month this summer. The $10 amount, which has held steady for 26 years, was considered a sweet spot where people were happy to sign up and wouldn’t bother to cancel once they gave up on their fitness goals. But after posting weaker-than-expected Q1 results, the gym chain decided it’s time to change, even though execs acknowledged that customers are looking to save rather than spend.

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What is Knightian Uncertainty in Economics?

About Frank Knight PhD

[By staff reporters]

In economics, Knightian uncertainty is a lack of any quantifiable knowledge about some possible occurrence, as opposed to the presence of quantifiable risk (e.g., that in statistical noise or a parameter’s confidence interval). The concept acknowledges some fundamental degree of ignorance, a limit to knowledge, and an essential unpredictability of future events.

Knightian uncertainty is named after University of Chicago economist Frank Knight (1885–1972), who distinguished risk and uncertainty in his work Risk, Uncertainty, and Profit:[1]

“Uncertainty must be taken in a sense radically distinct from the familiar notion of Risk, from which it has never been properly separated…. The essential fact is that ‘risk’ means in some cases a quantity susceptible of measurement, while at other times it is something distinctly not of this character; and there are far-reaching and crucial differences in the bearings of the phenomena depending on which of the two is really present and operating…. It will appear that a measurable uncertainty, or ‘risk’ proper, as we shall use the term, is so far different from an unmeasurable one that it is not in effect an uncertainty at all.”

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PODCAST: History Applied to Health Economics

Divining the Future?

By Eric Bricker MD

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PODCAST: BUDGET MISTAKES: Kill Employee Health Plans

By Eric Bricker MD

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DAILY UPDATE: Medicaid & CHIPS Unwind, Steward Health System Bankrupts as the Markets are Mixed

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It’s the first anniversary of the Medicaid unwinding for many states, a process that kicked off when federal rules that had kept people on Medicaid and the Children’s Health Insurance Program (CHIP) through the pandemic expired. And while states could redetermine eligibility again, things have “unwound” more than some experts predicted. Children were kicked off the rolls at higher rates than adults, according to a new study the Urban Institute released May 2. Twelve states—Montana, Iowa, South Dakota, Alabama, Idaho, Georgia, Texas, Arkansas, Oklahoma, Florida, Mississippi, Colorado—exceeded 100% of their total projections for disenrolling children.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) was little changed at 5,187.67; the Dow Jones Industrial Average gained 172.13 points (0.4%) to 39,056.39; the NASDAQ Composite® ($COMP) declined 29.80 points (0.2%) to 16,302.76.
  • The 10-year Treasury note yield (TNX) rose more than 3 basis points to 4.496%.
  • The CBOE Volatility Index® (VIX) fell 0.23 to 13.00.

Retail and real estate shares were among the weakest areas Wednesday, while banks and utilities were firm. Utility shares extended a nearly month-long rally, which may in part reflect greater expectations for Fed rate cuts. Lower interest rates can make utility shares with high dividend yields relative to Treasuries more appealing. The Dow Jones Utility Average ($DJU) rose 0.5% to end at its highest level since late July and is up 12% from a mid-April low.

And, Shopify’s value plunged by nearly $20 billion after the online payments company released a gloomy forecast for this quarter. It’s the latest pandemic darling to stumble: According to the Financial Times, the firms that skyrocketed during lockdowns have lost a collective $1.5 trillion in value since the end of 2020.

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Steward Health Care System, the largest U.S. physician-owned hospital operator, is expected to file for chapter 11 bankruptcy as soon as Sunday, according to a WSJ report, which cited people familiar with the matter. Steward Health Care is the largest tenant of Medical Properties Trust (NYSE: MPW). Steward Health Care hired restructuring advisers to improve its liquidity and restore its balance sheet in January 2024.  

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DAILY UPDATE: Robinhood’s SEC Enforcement with Mixed Stock Markets

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Here’s where the major stock market benchmarks ended:

  • The S&P 500 index rose 6.96 points (0.1%) to 5,187.70; the Dow Jones Industrial Average gained 31.99 points (0.1%) to 38,884.26; the NASDAQ Composite® ($COMP) eased 16.70 points (0.1%) to 16,332.56.
  • The 10-year Treasury note yield dropped more than 3 basis points to 4.457%.
  • The CBOE Volatility Index® (VIX) fell 0.26 to 13.23.

Interest-rate-sensitive sectors, such as real estate and utilities, were among the market’s strongest performers Tuesday. The Philadelphia Utility Index (UTY) rose 1.3%, its fifth straight daily gain, and hit its highest level in almost a year. The recent strength may in part reflect heightened expectations for lower interest rates, which may make utility shares with relatively high dividend yields compared to Treasuries more appealing. The utilities sector is also coming off a strong April, during which it was the only S&P 500 sector with a positive return, with chart patterns suggesting a bullish long-term momentum shift.

The semiconductor sector was among the weakest sectors Tuesday, partly behind a 1.7% drop in Nvidia (NVDA). The shares fell after billionaire investor Stanley Druckenmiller told CNBC he reduced his stake in the chipmaker in late March, saying that artificial intelligence may be a “little overhyped” for the short term.

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Peloton is reportedly being circled by private equity firms for a potential buyout of the enfeebled fitness company.

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The SEC is preparing to sue over Robinhood’s crypto business. Robinhood just revealed that it’s been notified that the SEC plans to bring an enforcement action against its crypto unit for alleged securities violations. But the online brokerage said it’s not sweating: “We firmly believe that the assets listed on our platform are not securities and we look forward to engaging with the SEC to make clear just how weak any case against Robinhood Crypto would be on both the facts and the law,” Dan Gallagher, Robinhood’s chief legal, compliance, and corporate affairs officer, wrote in a blog post. Such a notice doesn’t always mean a suit will follow, but crypto companies and the agency have been sparring for years over whether crypto tokens count as securities.

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The Biden administration were quick to praise a new report that extends the lifespan of the Hospital Insurance Trust Fund, but the report renewed calls for increasing physician payments.


Amwell, a telehealth company, continues to struggle in the stock market, and both its bottom- and top-line results in the first quarter missed Street analysts’ estimates.


And … between the Change Healthcare cyberattack and Medicare Advantage headwinds, major insurers faced unique challenges in the first quarter.

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Stat: 8.7%. That’s the level to which US consumers can expect the 30-year mortgage rate to rise over the next year, which marks a series high, according to a New York Federal Reserve survey (MarketWatch)

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DAILY UPDATE: FQHCs Down and Healthcare Bankruptcies Up as the Markets Extend Gains

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Low-income communities often struggle to access healthcare services, but a new analysis of federally qualified health centers (FQHCs)—which provide quality care to patients regardless of ability to pay—has helped nail down one reason. When it comes to screening for certain cancers, these nonprofit community health centers have fallen far behind the national average, according to a study led by cancer center researchers at the University of Texas MD Anderson and the University of New Mexico.

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Healthcare bankruptcies surged in 2023, and it turns out many of the companies that went under had one thing in common: private equity (PE) ownership. At least 21% of the 80 healthcare companies that filed for bankruptcy last year were PE-owned, according to a report from the nonprofit Private Equity Stakeholder Project (PESP).

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Warren Buffett on contemplated his own mortality at Berkshire’s meeting. Succession was the topic du jour at the Berkshire Hathaway shareholder meeting in Omaha last week. After his longtime business partner Charlie Munger died last year at 99, CEO Warren Buffett—who turns 94 in August—revealed his heir apparent, Greg Abel, will have the final say on investment decisions in his absence. Buffett ended his Q&A portion with the quip, “I not only hope you come next year. I hope I come next year.” Adding to the ominous vibes, Buffett said AI is a genie that “scares the hell out of me.”

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Here’s where the major benchmarks ended:

  • The S&P 500 index climbed 52.95 points (1.0%) to 5,180.74; the Dow Jones Industrial Average gained 176.59 points (0.5%) to 38,852.27; the NASDAQ Composite advanced 192.92 points (1.2%) to 16,349.25.
  • The 10-year Treasury note yield (TNX) fell about 1 basis  point to 4.491%.
  • The CBOE Volatility Index® (VIX) was little changed at 13.48.

Semiconductors were among the strongest performers Monday behind Micron Technology (MU), whose shares rallied 4.7% after Robert W. Baird upgraded the chipmaker to “outperform” from “neutral.” Micron Technology was the top gainer in the Philadelphia Semiconductor Index (SOX), which advanced 2.2% to near a four-week high.

Small-cap stocks also got out of the gate strong this week. The Russell 2000® Index (RUT) gained 1.2% to end at a four-week high but is still up just 1.7% for the year, while the S&P 500 has gained 8.6%.

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FINANCIAL AND HEALTH ECONOMICS BENCH MARKING

Understanding the operational and financial status of your organization or practice

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

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Dr. DEMFinancial benchmarking can assist healthcare managers and professional financial advisors in understanding the operational and financial status of their organization or practice.

The general process of financial benchmarking analysis may include three elements: (1) Historical subject benchmarking; (2) Benchmarking to industry norms; and, (3) Financial ratio analysis.

History

Historical subject benchmarking compares a healthcare organization’s most recent performance with its reported performance in the past in order to: examine performance over time; identify changes in performance within the organization (e.g., extraordinary and non-recurring events); and, to predict future performance.

As a form of internal benchmarking, historical subject benchmarking avoids issues such as: differences in data collection and use of measurement tools; and, benchmarking metrics that often cause problems in comparing two different organizations.

However, it is necessary to common size data in order to account for company differences over time that may skew results.

Benchmarking

Benchmarking to industry norms, analogous to Fong and colleagues’ concept of industry benchmarking,   involves comparing internal company-specific data to survey data from other organizations within the same industry. This method of benchmarking provides the basis for comparing the subject entity to similar entities, with the purpose of identifying its relative strengths, weaknesses, and related measures of risk.

***

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Financial Ratio Analysis

The process of benchmarking against industry averages or norms will typically involve the following steps:

  1. Identification and selection of appropriate surveys to use as a benchmark, i.e., to compare with data from the organization of interest. This involves answering the question, “In which survey would this organization most likely be included?”;
  2. If appropriate, re-categorization and adjustment of the organization’s revenue and expense accounts to optimize data compatibility with the selected survey’s structure and definitions (e.g., common sizing); and,
  3. Calculation and articulation of observed differences of organization from the industry averages and norms, expressed either in terms of variance in ratio, dollar unit amounts, or percentages of variation.

Trends

Financial ratio analysis typically involves the calculation of ratios that are financial and operational measures representative of the financial status of an enterprise.  These ratios are evaluated in terms of their relative comparison to generally established industry norms, which may be expressed as positive or negative trends for that industry sector. The ratios selected may function as several different measures of operating performance or financial condition of the subject entity.

The Selected Ratios

Common types of financial indicators that are measured by ratio analysis include:

  1. Liquidity. Liquidity ratios measure the ability of an organization to meet cash obligations as they become due, i.e., to support operational goals. Ratios above the industry mean generally indicate that the organization is in an advantageous position to better support immediate goals. The current ratio, which quantifies the relationship between assets and liabilities, is an indicator of an organization’s ability to meet short-term obligations. Managers use this measure to determine how quickly assets are converted into cash.
  2. Activity. Activity ratios, also called efficiency ratios, indicate how efficiently the organization utilizes its resources or assets, including cash, accounts receivable, salaries, inventory, property, plant, and equipment. Lower ratios may indicate an inefficient use of those assets.
  3. Leverage. Leverage ratios, measured as the ratio of long-term debt to net fixed assets, are used to illustrate the proportion of funds, or capital, provided by shareholders (owners) and creditors to aid analysts in assessing the appropriateness of an organization’s current level of debt. When this ratio falls equal to or below the industry norm, the organization is typically not considered to be at significant risk.
  4. Profitability. Indicates the overall net effect of managerial efficiency of the enterprise. To determine the profitability of the enterprise for benchmarking purposes, the analyst should first review and make adjustments to the owner(s) compensation, if appropriate. Adjustments for the market value of the “replacement cost” of the professional services provided by the owner are particularly important in the valuation of professional medical practices for the purpose of arriving at an ”economic level” of profit.

Data Homogeneity

The selection of financial ratios for analysis and comparison to the organization’s performance requires careful attention to the homogeneity of data. Benchmarking of intra-organizational data (i.e., internal benchmarking) typically proves to be less variable across several different measurement periods.

However, the use of data from external facilities for comparison may introduce variation in measurement methodology and procedure. In the latter case, use of a standard chart of accounts for the organization or recasting the organization’s data to a standard format can effectively facilitate an appropriate comparison of the organization’s operating performance and financial status data to survey results.

***Financial Planning MDs 2015

BOOK: Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

Operational Performance Benchmarking

Operational benchmarking is used to target non-central work or business processes for improvement.  It is conceptually similar to both process and performance benchmarking, but is generally classified by the application of the results, as opposed to what is being compared.  Operational benchmarking studies tend to be smaller in scope than other types of benchmarking, but, like many other types of benchmarking, are limited by the degree to which the definitions and performance measures used by comparing entities differ.  Common sizing is a technique used to reduce the variations in measures caused by differences (e.g., definition issues) between the organizations or processes being compared.

Common Sizing

Common sizing is a technique used to alter financial operating data prior to certain types of benchmarking analysis and may be useful for any type of benchmarking that requires the comparison of entities that differ on some level (e.g., scope of respective benchmarking measurements, definitions, business processes).  This is done by expressing the data for differing entities in relative (i.e., comparable) terms.

Example:

For example, common sizing is often used to compare financial statements of the same company over different periods of time (e.g., historical subject benchmarking), or of several companies of differing sizes (e.g., benchmarking to industry norms). The latter type may be used for benchmarking an organization to another in its industry, to industry averages, or to the best performing agency in its industry.  Some examples of common size measures utilized in healthcare include:

  1. Percent of revenue or per unit produced, e.g., relative value unit (RVU);
  2. Per provider, e.g., physician;
  3. Per capacity measurement, e.g., per square foot; or,
  4. Other standard units of comparison.

Assessment

As with any data, differences in how data is collected, stored, and analyzed over time or between different organizations may complicate the use of it at a later time.  Accordingly, appropriate adjustments must be made to account for such differences and provide an accurate and reliable dataset for benchmarking.

Conclusion

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

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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DAILY UPDATE: Cooling Labor Markets with Unemployment Rate Uptick

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A cooling labor market raises hopes for a rate cut in the summer. The latest Labor Department data shows the US added 175,000 jobs in April, but much less than the 300,000 added in March and also less than economists expected. Meanwhile, the unemployment rate ticked up to 3.9% from 3.8% in March, and wages rose less than anticipated. All that bad news for us was music to the ears of investors who are holding out hope that the Federal Reserve might still cut interest rates this summer despite most recent economic data showing that inflation is sticking around.

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Rate cuts appear to be back on the 2024 menu following Friday’s softer-than-expected jobs report, fueling gains for all three major stock indexes last week. With the report calming worries that inflation is ticking back up, investors now project a 50% likelihood that the Federal Reserve will reduce rates in September.

Coinbase is benefiting from the hype around new bitcoin ETFs. The crypto exchange reported a $1.2 billion quarterly profit last week, and net revenue rose by 115%.

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PODCAST: Doctor Hospital Co-Owned Ambulatory Surgery Centers (ASC)

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PODCASTS: Hospital Posts Laboratory Prices to Physician EMRs

Doctors Order Less Laboratory Tests

By Eric Bricker MD

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FDA: Regulation of Laboratory Tests

By Staff Reporters

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The Food and Drug Administration wants to make sure that if someone is analyzing your blood and urine, it’s worth your time, so the agency just finalized regulations to govern the $10 billion lab test industry. Tests designed by laboratories have long gone without government scrutiny, but the FDA said the time has come to ensure these tests are accurate—though the new standards will be phased in over several years.

There are currently about 80,000 medical tests available from ~1,200 labs, per the FDA, and those will mostly be grandfathered in. Still, the industry has pushed back, saying the regulations will inhibit innovation, and could sue to block the rules from taking effect.

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DAILY UPDATE: Stock Markets Rally

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MAY THE FOURTH BE WITH YOU

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 63.59 points (1.3%) to 5,127.79, up 0.6% for the week; the Dow Jones Industrial Average® ($DJI) gained 450.02 points (1.2%) to 38,675.68, up 1.1% for the week; the NASDAQ Composite surged 315.37 points (2.0%) to 16,156.33, up 1.4% for the week.
  • The 10-year Treasury note yield (TNX) fell about 7 basis points to 4.50%, down about 16 basis points for the week.
  • The CBOE Volatility Index® (VIX) fell 1.19 to 13.49.

Technology shares were among the strongest performers Friday behind a 6% rally in shares of Apple (AAPL), which late Thursday reported stronger-than-expected quarterly results and said it will repurchase $110 billion in shares. Amgen (AMGN) soared nearly 12%, leading Dow gainers after the biotechnology company beat earnings expectations.

In other markets, WTI Crude Oil futures (/CL) extended a week-long slump to end just above $78 per barrel, the lowest since mid-March. Crude futures dropped almost 7% this week, partly reflecting rising U.S. supplies and signs of slower fuel demand.

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PODCAST: “All OR Nothing” Hospital Contracts

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DAILY UPDATE: Stock Markets Up Beat!

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Yesterday, sales of Wegovy more than doubled last quarter, and at least 25,000 people are starting to take it in the US per week. It also posted a $3.65 billion net profit and increased its sales outlook for 2024. But its stock Novo Nordisk still dropped yesterday.

***

iPhone sales are down but Apple share buybacks are up. Apple managed to keep investors happy, sending its stock shooting up after-hours yesterday, despite selling fewer iPhones last quarter. Sales of the signature phone dipped 10% year over year, and revenue fell 4.3% to $90.8 billion. But Apple also announced $110 billion in share buybacks, the largest in the company’s history, per CNBC. And sales in China, which has been a sore spot, came in at $16.4 billion, less than a year earlier but more than analysts had predicted.

***

Stocks rose yesterday as investors digested Jerome Powell’s recent comments and decided they only had to fear fear itself—and not interest rate hikes. Investors changed into the fast lane to buy Carvana after the used car sales site reported its best earnings ever Wednesday evening.

***

Stat: 16%. That’s the percentage by which CVS stocks plummeted Wednesday after the company reported earnings below expectations and cut its annual outlook, according to (CNBC).

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But Here’s where the major stock market benchmarks ended Thursday:

  • The S&P 500® index (SPX) rose 45.81 points (0.9%) to 5,064.20; the Dow Jones Industrial Average® ($DJI) added 322.37 points (0.9%) to 38,225.66; the NASDAQ Composite® ($COMP) surged 235.48 points (1.5%) to 15,840.96.
  • The 10-year Treasury note yield (TNX) dropped about 1 basis point to 4.583%.
  • The CBOE Volatility Index® (VIX) fell 0.71 to 14.68.

Transportation shares helped lead the market higher after C.H. Robinson (CHRW) reported stronger-than-expected quarterly results, sending the freight logistics and trucking company’s stock up 12%. The Dow Jones Transportation Average ($DJT) jumped 2.5%. Semiconductors were also strong after Qualcomm (QCOM) advanced 9.7% in the wake of the chip maker’s better-than-expected earnings.

Apple (AAPL) shares advanced 2.2% ahead of the company’s quarterly earnings report scheduled after Thursday’s close.

In other markets, WTI Crude Oil (/CL) futures bounced back to end with a slight gain after earlier dropping to a seven-week low under $78.50 per barrel.

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ESCHEW “C”: Medicare Advantage [Part C] Plans Now?

By Dr. David Edward Marcinko MBA MEd CMP

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Medicare [Dis] Advantage Plans [Medicare Part C] commenced in 2003 or so and I have railed against them since then. First, for their low physician payments. And then as a patient advocate for the last decade. And, today, for both reasons. As a doctor and independent health insurance agent myself, believe me when I speak thusly.

READ: https://medicalexecutivepost.com/2023/11/07/proposed-changes-medicare-advantage/

***

Now, while Medicare Advantage plans are undoubtedly not the right choice for everyone, insurance companies still say there are some folks who will get exactly what they need from the plans and at a moderate price.

Nevertheless, Ernesto Jaboneta, the IT Director of California-based Medicare insurance agency Agent Pitstop, acknowledged there are many predatory salespeople who will jump to have you join a plan that doesn’t end up helping you in the long run. Still, there are precautions you can take to make falling into this trap less likely.

“The first thing anyone can do is invite along a family member or trusted friend to any appointments with an insurance agent,” Jaboneta told Newsweek. “Don’t feel pressured to decide right away.”

Before you commit to anything, you should compare plans and find out if your doctors will remain in your network. And if you’re unsure about some of the information you received from an insurance agent, you can also call 1-800-MEDICARE for more assistance.

Jaboneta also said there’s a big difference between captive insurance agents and independent agents, as well, and seniors should take note of this.

“A captive agent is an insurance agent who works directly for an insurance carrier,” Jaboneta said. “They have no incentive to compare options outside their own company, which is different than an independent agent who can compare all the options available. In many cases, when a beneficiary calls into an insurance company to find information, they will be talked into enrolling.”

The open enrollment period lasts from October 15th to December 8th, but there’s another enrollment period from January 1st to March 31st for anyone unhappy with their Medicare Advantage plan who wants to switch or revert to Medicare.

MORE: https://medicalexecutivepost.com/2023/12/24/medicare-part-c-humana-used-a-i-tool-from-unitedhealth-to-deny-medicare-advantage-claims/

INVESTING UPDATE: Managed-care companies are reporting that seniors on Medicare Advantage Part C plans used far more medical services than expected in the final months of 2023. The announcements have sparked two separate selloffs over the past week: The first came January 12th, when UnitedHealth Group announced its fourth-quarter earnings. The second came after Humana just laid out preliminary fourth-quarter results, and said the high utilization trends would have a material impact on its 2024 performance “if current trends continue.”

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

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