BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on April 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Here’s where the major stock market benchmarks ended:
The S&P 500 index fell 61.59 points (1.2%) to 5,061.82; the Dow Jones Industrial Average lost 248.13 points (0.7%) to 37,735.11; the NASDAQ Composite® ($COMP) dropped 290.08 points (1.8%) to 15,885.02.
The 10-year Treasury note yield (TNX) surged almost 12 basis points to 4.618%.
The CBOE Volatility Index® (VIX) rose 1.92 to 19.23.
Interest-rate-sensitive sectors like real estate and utilities were among the weakest performers Monday. Technology shares were also under pressure. The small-cap Russell 2000® Index (RUT) shed 1.4% and ended at a two-month low.
In other markets, the U.S. dollar index (DXY) strengthened for the fourth consecutive trading day and hit its highest level since early November, reflecting expectations rates will stay elevated. Volatility based on the VIX jumped near 19.50, its highest level since late October.
Monday’s session also produced technical damage on the charts of benchmarks like the S&P 500, which closed under its 50-day simple moving average, currently around 5,114, for the first time since early November. The S&P 500 has dropped almost 4% from a record intraday high posted March 28th.
And, after a tough funding year for digital health startups, the first quarter of 2024 saw a flurry of deals announced—a “positive signal” that the funding landscape is looking up, according to Adriana Krasniansky, head of research at digital health strategy group and venture fund Rock Health’s advisory arm. Overall, the number of digital health funding deals (133) that closed in Q1 was the highest in six quarters, though the average deal size ($20.6 million) was smaller, according to a Rock Health report. Total funding for digital health startups was $2.7 billion, the lowest level since 2019. An increase in the frequency of deals—even if they’re smaller—is a good sign, according to Krasniansky.
Dental startup Tend aims to simplify the patient billing process via a partnership with health tech startup Cedar, the companies announced on April 11th, 2024. The US spends roughly $165 billion per year on dental services as of 2022, according to professional organization the American Dental Association—but the payment experience can be “opaque” and “confusing,” Matthew Fitzgerald, chief marketing officer at Tend, told Healthcare Brew. “From the outset, Tend has sought to innovate the dental experience by leveraging technology and hospitality to build a company around the patient,” Tend CEO Troy Bage said in a statement. “By partnering with Cedar, we’ll be able to streamline and simplify the payment process for all our members—further enhancing their overall experience with Tend, while unlocking new ways for us to elevate engagement.”
Posted on April 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Texas Governor Greg Abbott has issued a sharp warning about proposed changes to Medicaid, claiming they could “strip millions of Americans” from access to healthcare. In February 2023, the Centers for Medicare & Medicaid Services (CMS) issued a new proposed rule that would change long-standing practices for how states fund the non-federal share of Medicaid payments. In particular, the CMS is pushing for greater oversight of how states use of healthcare provider taxes to help fund their programs.
Democratic lawmakers Sen. Richard Blumenthal and Rep. Andy Kim have partnered up with RepublicanRep. Jen Kiggans to introduce legislation aiming to give army reservists and members of the National Guard that also work for the federal government options on the type of health care plans they can receive. The bill, which could impact thousands of federal employees that are also in the U.S. Army, plans to give this group of Americans the ability to decide whether they want military or civilian health care. The lawmakers said in a shared statement that their proposal will fix current regulations that limit service members who also work for the government to enroll in the cheaper Tricare Reserve Select (TRS) health plan when they also qualify for federal health plans.
Stocks tanked last Friday after the big banks reported underwhelming earnings and the sheen from the Magnificent Seven’s AI-driven surge earlier this week wore off. Meanwhile, oil prices continue to rise near six-month highs as concern grows over geopolitical tensions in the Middle East. The tech sector was highlighted in this market, particularly due to the exceptional performance of a group of mega-cap tech giants last year nicknamed the “Magnificent Seven.” This elite group includes Apple (AAPL), Amazon (AMZN), Alphabet (GOOGL), Meta Platforms (META), Microsoft (MSFT), Nvidia (NVDA) and Tesla (TSLA).
Posted on April 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Medical colleague and our financial planning for physicians textbook contributor Michael Burry MD predicted a second inflation surge, and price growth re-accelerated in March,. 2024.
The “Big Short” investor first warned of inflation in April 2020, over two years before it peaked.
Burry expected a recession, rate cuts, and stimulus spending to reignite inflation.
A growing number of drugs are in short supply around the U.S., according to pharmacists.
In the first three months of the year, there were 323 active medication shortages, surpassing the previous high of 320 shortages in 2014, according to a survey by the American Society of Health-System Pharmacists (ASHP) and Utah Drug Information Service. It also amounts to the most shortages since the trade group started keeping track in 2001. “All drug classes are vulnerable to shortages. Some of the most worrying shortages involve generic sterile injectable medications, including cancer chemotherapy drugs and emergency medications stored in hospital crash carts and procedural areas,” ASHP said in a statement.
Scheduling an appointment with a primary care doctor who belongs to a large health system might cause an increase in health care spending, according to a recent study. Such physicians tend to make more referrals to specialists, and emergency room visits and hospitalizations sometimes increase, according to the research out of Harvard T.H. Chan School of Public Health.
In short, physicians who work for health care systems like hospitals are more likely to recommend that patients use other services within those systems, compared with independent physicians. For the study — which was published in JAMA Health Forum, a journal of the American Medical Association — researchers analyzed the experiences of more than 4 million patients in Massachusetts.
UnitedHealth ChairmanStephen Hemsley and other executives sold $102 million in company stock months before a federal antitrust probe became public, Bloomberg reported.
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Small physician practices are still struggling in the wake of February’s Change Healthcare cyberattack, according to an American Medical Association (AMA) survey released Wednesday.
More than half of ~1,400 respondents (55%) reported that they’ve had to use personal funds to cover their practice’s expenses due to the cyberattack’s effects on cash flow. Practices across the country have been unable to fill prescriptions or process insurance claims as Change Healthcare systems went offline, Healthcare Brew previously reported. About two-thirds of respondents said they’ve experienced restrictions to core functions, such as suspending claim payments (36%), not being able to submit claims (32%), and not being able to obtain electronic remittance advice (39%), according to the survey.
The S&P 500 index fell 75.65 points (1.5%) to 5,123.41, down 1.6% for the week; the Dow Jones Industrial Averagelost 475.84 points (1.2%) to 37,983.24, down 2.4% for the week; the NASDAQ Composite® ($COMP) dropped 267.10 points (1.6%) to 16,175.09, down 0.5% for the week.
The 10-year Treasury note yield (TNX) fell more than 5 basis points to 4.52%, still up about 12 basis points for the week.
The CBOE Volatility Index® (VIX) rose 2.38 to 17.30.
Semiconductor shares were also among the weakest performers Friday as chip makers reversed Thursday’s sharp gains. The Philadelphia Semiconductor Index (SOX) dropped more than 3% and ended with its third straight weekly decline. Energy companies were also under pressure after crude oil prices retreated from the morning rally. Oil futures are still up 20% this year. The small-cap Russell 2000® Index (RUT) lost 1.9% and posted a 2.9% drop for the week.
In other markets, the U.S. dollar index (DXY) strengthened to a five-month high and gained 1.7% this week, reflecting beliefs the hotter-than-expected inflation readings earlier this week will keep interest rates elevated. Volatility based on the VIX jumped to its highest level since late October.
Posted on April 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
Costco started selling gold bars to its members last August, and Wells Fargo analysts believe that the product is now bringing in between $100 million and $200 million a month. The retailer doesn’t reveal the price of the 1-ounce bullion to nonmembers online, but it’s estimated to be ~2% above the spot price gold trades at, per CNBC—and that price has soared since Costco got into the gold game. The price of gold has gone up 13% this year and reached record highs as investors pile in amid inflation worries.
The big numbers from the Consumer Price Index data released on Thursday
In March, inflation rose 3.5% from the year before, up from 3.2% in February.
The “core” CPI reading, which excludes volatile food and fuel prices, came in even higher, rising 3.8% on an annual basis. That’s the same as in February, but this time it’s serious.
Half of the increases came from rising gas prices and housing.
After seeing inflation fall by 3% over the course of 2023, Fed officials believed that higher inflation readings in January and February 2024 represented a hiccup in an otherwise downward trajectory. However, with the March reading also coming in hotter than anticipated, analysts say this is more than a fluke. That means hopes for a June interest rate cut are dashed. Even the US Postal Service plans to raise the price of “forever” stamps to $0.73 in July. Get yours now. And the Mexican peso is on an absolute tear, leaving the US dollar behind.
The S&P 500® index (SPX) advanced 38.42 points (0.7%) to 5,199.06; the Dow Jones Industrial Average® ($DJI) lost 2.43 points to 38,459.08; the NASDAQ Composite gained 271.84 points (1.7%) to 16,442.20.
The 10-year Treasury note yield (TNX) rose nearly 2 basis points to 4.578%.
The CBOE Volatility Index® (VIX) fell 0.89 to 14.91.
Chip maker strength lifted the Philadelphia Semiconductor Index (SOX) more than 2% and extended the benchmark’s year-to-date gain to more than 17%. Communications services and transportation shares were also among the strongest sectors. Financial shares were mixed ahead of expected quarterly results Friday from some major banks including JPMorgan Chase (JPM), Citigroup (C), and Wells Fargo (WFC).
Posted on April 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST– Today’sNewsletter
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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants
“Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily“
A Partner of the Institute of Medical Business Advisors , Inc.
NEW YORK (Reuters) -The U.S. accounting watchdog on Wednesday said it has hit KPMG Netherlands with a $25 million civil penalty, a record for the regulator, in response to “egregious” and widespread exam cheating at the foreign affiliate of the major audit firm.
As millions of Americans approach age 66, they face the inevitable question, is it time to retire? The physician population is aging alongside the general population—more than 40% of physicians in the U.S. will be 65 years or older within the next decade. In the case of surgeons, there is little guidance on how to best ensure their competency throughout their career and at the same time maintain patient safety while preserving mature physician dignity.
It is a scenario playing out nationwide. From Oregon to Pennsylvania, hundreds of communities have in recent years either stopped adding fluoride to their water supplies or voted to prevent its addition. Supporters of such bans argue that people should be given the freedom of choice. The broad availability of over-the-counter dental products containing the mineral makes it no longer necessary to add to public water supplies, they say. The Centers for Disease Control and Prevention says that while store-bought products reduce tooth decay, the greatest protection comes when they are used in combination with water fluoridation.
More health systems are going to be opting out of Medicare Advantage (MA) plans, George Hill, a managing director at Deutsche Bank in Boston, predicted Monday at a “Wall Street Comes to Washington” webinar hosted by the Brookings Institution. “I think you’re going to see more large provider organizations threaten to opt out of networks, particularly as it relates to MA,” Hill said, adding that there are a number of reasons for this. “Prior authorizations are the problem, claims denials are a huge problem, delayed payments and rates are the problem — barriers in access to care in all varieties are the problem.”
The latest budget update from the nonpartisan Congressional Budget Office (CBO) found that the federal government has spent more on paying interest on the national debt than on the military in fiscal year 2024. The CBO’s budget report for March showed that the U.S. has spent $412 billion on military programs at the Department of Defense through the first half of FY-2024, according to preliminary figures from CBO and the Treasury Department.
Consumer price increases remained high last month, boosted by gas, rents, and car insurance, the government said Wednesday in a report that will likely give pause to the Federal Reserve as it weighs when and by how much to cut interest rates this year. Prices outside the volatile food and energy categories rose 0.4% from February to March, the same accelerated pace as in the previous month. Measured from a year earlier, these core prices were up 3.8%, unchanged from the year-over-year rise in February. The Fed closely tracks core prices because they tend to provide a good read of where inflation is headed.
Here’s where the major benchmarks ended:
The S&P 500® index (SPX) dropped 49.27 points (1.0%) to 5,160.64; the Dow Jones Industrial Average lost 422.16 points (1.1%) to 38,461.51; the NASDAQ Composite® ($COMP) fell 136.28 points (0.8%) to 16,170.36.
The 10-year Treasury note yield (TNX) soared more than 18 basis points to 4.548%.
The CBOE Volatility Index® (VIX) jumped 0.82 to 15.80.
Interest-rate-sensitive sectors like banks, real estate, and utilities led Wednesday’s decliners. The KBW Regional Bank Index (KRX) tumbled 5% to its lowest point since late November. The small-cap Russell 2000® Index (RUT) lost 2.5%. Energy shares were among the few gainers as WTI Crude Oil (/CL) futures rebounded after three-straight losing sessions.
In other markets, the U.S. dollar index (DXY) jumped 1% to a five-month high amid expectations interest rates will remain elevated.
Written by doctors and healthcare professionals, this textbook should be mandatory reading for all medical school students—highly recommended for both young and veteran physicians—and an eliminating factor for any financial advisor who has not read it. The book uses jargon like ‘innovative,’ ‘transformational,’ and ‘disruptive’—all rightly so! It is the type of definitive financial lifestyle planning book we often seek, but seldom find. —LeRoy Howard MA CMPTM,Candidate and Financial Advisor, Fayetteville, North Carolina I taught diagnostic radiology for over a decade. The physician-focused niche information, balanced perspectives, and insider industry transparency in this book may help save your financial life. —Dr. William P. Scherer MS, Barry University, Ft. Lauderdale, Florida This book was crafted in response to the frustration felt by doctors who dealt with top financial, brokerage, and accounting firms. These non-fiduciary behemoths often prescribed costly wholesale solutions that were applicable to all, but customized for few, despite ever-changing needs. It is a must-read to learn why brokerage sales pitches or Internet resources will never replace the knowledge and deep advice of a physician-focused financial advisor, medical consultant, or collegial Certified Medical Planner™ financial professional. —Parin Khotari MBA,Whitman School of Management, Syracuse University, New York In today’s healthcare environment, in order for providers to survive, they need to understand their current and future market trends, finances, operations, and impact of federal and state regulations. As a healthcare consulting professional for over 30 years supporting both the private and public sector, I recommend that providers understand and utilize the wealth of knowledge that is being conveyed in these chapters. Without this guidance providers will have a hard time navigating the supporting system which may impact their future revenue stream. I strongly endorse the contents of this book.—Carol S. Miller BSN MBA PMP,President, Miller Consulting Group, ACT IAC Executive Committee Vice-Chair at-Large, HIMSS NCA Board Member This is an excellent book on financial planning for physicians and health professionals. It is all inclusive yet very easy to read with much valuable information. And, I have been expanding my business knowledge with all of Dr. Marcinko’s prior books. I highly recommend this one, too. It is a fine educational tool for all doctors.—Dr. David B. Lumsden MD MS MA,Orthopedic Surgeon, Baltimore, Maryland There is no other comprehensive book like it to help doctors, nurses, and other medical providers accumulate and preserve the wealth that their years of education and hard work have earned them. —Dr. Jason Dyken MD MBA,Dyken Wealth Strategies, Gulf Shores, Alabama I plan to give a copy of this book written ‘by doctors and for doctors’ to all my prospects, physician, and nurse clients. It may be the definitive text on this important topic. —Alexander Naruska CPA,Orlando, Florida
Health professionals are small business owners who need to apply their self-discipline tactics in establishing and operating successful practices. Talented trainees are leaving the medical profession because they fail to balance the cost of attendance against a realistic business and financial plan. Principles like budgeting, saving, and living below one’s means, in order to make future investments for future growth, asset protection, and retirement possible are often lacking. This textbook guides the medical professional in his/her financial planning life journey from start to finish. It ranks a place in all medical school libraries and on each of our bookshelves. —Dr. Thomas M. DeLauro DPM,Professor and Chairman – Division of Medical Sciences, New York College of Podiatric Medicine
Physicians are notoriously excellent at diagnosing and treating medical conditions. However, they are also notoriously deficient in managing the business aspects of their medical practices. Most will earn $20-30 million in their medical lifetime, but few know how to create wealth for themselves and their families. This book will help fill the void in physicians’ financial education. I have two recommendations: 1) every physician, young and old, should read this book; and 2) read it a second time! —Dr. Neil Baum MD,Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, Louisiana
I worked with a Certified Medical Planner™ on several occasions in the past, and will do so again in the future. This book codified the vast body of knowledge that helped in all facets of my financial life and professional medical practice. —Dr. James E. Williams DABPS, Foot and Ankle Surgeon, Conyers, Georgia
This is a constantly changing field for rules, regulations, taxes, insurance, compliance, and investments. This book assists readers, and their financial advisors, in keeping up with what’s going on in the healthcare field that all doctors need to know. —Patricia Raskob CFP® EA ATA, Raskob Kambourian Financial Advisors, Tucson, Arizona I particularly enjoyed reading the specific examples in this book which pointed out the perils of risk … something with which I am too familiar and have learned (the hard way) to avoid like the Black Death. It is a pleasure to come across this kind of wisdom, in print, that other colleagues may learn before it’s too late— many, many years down the road. —Dr. Robert S. Park MD, Robert Park and Associates Insurance, Seattle, Washington
Although this book targets physicians, I was pleased to see that it also addressed the financial planning and employment benefit needs of nurses; physical, respiratory, and occupational therapists; CRNAs, hospitalists, and other members of the health care team….highly readable, practical, and understandable. —Nurse Cecelia T. Perez RN, Hospital Operating Room Manager, Ellicott City, Maryland
Personal financial success in the PP-ACA era will be more difficult to achieve than ever before. It requires the next generation of doctors to rethink frugality, delay gratification, and redefine the very definition of success and work–life balance. And, they will surely need the subject matter medical specificity and new-wave professional guidance offered in this book. This book is a ‘must-read’ for all health care professionals, and their financial advisors, who wish to take an active role in creating a new subset of informed and pioneering professionals known as Certified Medical Planners™. —Dr. Mark D. Dollard FACFAS, Private Practice, Tyson Corner, Virginia As healthcare professionals, it is our Hippocratic duty to avoid preventable harm by paying attention. On the other hand, some of us are guilty of being reckless with our own financial health—delaying serious consideration of investments, taxation, retirement income, estate planning, and inheritances until the worry keeps one awake at night. So, if you have avoided planning for the future for far too long, perhaps it is time to take that first step toward preparedness. This in-depth textbook is an excellent starting point—not only because of its readability, but because of his team’s expertise and thoroughness in addressing the intricacies of modern investments—and from the point of view of not only gifted financial experts, but as healthcare providers, as well … a rare combination. —Dr. Darrell K. Pruitt DDS, Private Practice Dentist, Fort Worth, Texas This text should be on the bookshelf of all contemporary physicians. The book is physician-focused with unique topics applicable to all medical professionals. But, it also offers helpful insights into the new tax and estate laws, fiduciary accountability for advisors and insurance agents, with investing, asset protection and risk management, and retirement planning strategies with updates for the brave new world of global payments of the Patient Protection and Affordable Care Act. Starting out by encouraging readers to examine their personal ‘money blueprint’ beliefs and habits, the book is divided into four sections offering holistic life cycle financial information and economic education directed to new, mid-career, and mature physicians.
This structure permits one to dip into the book based on personal need to find relief, rather than to overwhelm. Given the complexity of modern domestic healthcare, and the daunting challenges faced by physicians who try to stay abreast of clinical medicine and the ever-evolving laws of personal finance, this textbook could not have come at a better time. —Dr. Philippa Kennealy MD MPH, The Entrepreneurial MD, Los Angeles, California Physicians have economic concerns unmatched by any other profession, arriving ten years late to the start of their earning years. This textbook goes to the core of how to level the playing field quickly, and efficaciously, by a new breed of dedicated Certified Medical Planners™. With physician-focused financial advice, each chapter is a building block to your financial fortress. —Thomas McKeon, MBA, Pharmaceutical Representative, Philadelphia, Pennsylvania An excellent resource … this textbook is written in a manner that provides physician practice owners with a comprehensive guide to financial planning and related topics for their professional practice in a way that is easily comprehended. The style in which it breaks down the intricacies of the current physician practice landscape makes it a ‘must-read’ for those physicians (and their advisors) practicing in the volatile era of healthcare reform. —Robert James Cimasi, MHA ASA FRICS MCBA CVA CM&AA CMP™, CEO-Health Capital Consultants, LLC, St. Louis, Missouri Rarely can one find a full compendium of information within a single source or text, but this book communicates the new financial realities we are forced to confront; it is full of opportunities for minimizing tax liability and maximizing income potential. We’re recommending it to all our medical practice management clients across the entire healthcare spectrum. —Alan Guinn, The Guinn Consultancy Group, Inc., Cookeville, Tennessee Dr. David Edward Marcinko MBA CMP™ and his team take a seemingly endless stream of disparate concepts and integrate them into a simple, straightforward, and understandable path to success. And, he codifies them all into a step-by-step algorithm to more efficient investing, risk management, taxation, and enhanced retirement planning for doctors and nurses. His text is a vital read—and must execute—book for all healthcare professionals and physician-focused financial advisors. —Dr. O. Kent Mercado, JD, Private Practitioner and Attorney, Naperville, Illinois
Kudos. The editors and contributing authors have compiled the most comprehensive reference book for the medical community that has ever been attempted. As you review the chapters of interest and hone in on the most important concerns you may have, realize that the best minds have been harvested for you to plan well… Live well. —Martha J. Schilling; AAMS® CRPC® ETSC CSA, Shilling Group Advisors, LLC, Philadelphia, Pennsylvania I recommend this book to any physician or medical professional that desires an honest no-sales approach to understanding the financial planning and investing world. It is worthwhile to any financial advisor interested in this space, as well. —David K. Luke, MIM MS-PFP CMP™, Net Worth Advisory Group, Sandy, Utah Although not a substitute for a formal business education, this book will help physicians navigate effectively through the hurdles of day-to-day financial decisions with the help of an accountant, financial and legal advisor. I highly recommend it and commend Dr. Marcinko and the Institute of Medical Business Advisors, Inc. on a job well done. —Ken Yeung MBA CMP™, Tseung Kwan O Hospital, Hong Kong I’ve seen many ghost-written handbooks, paperbacks, and vanity-published manuals on this topic throughout my career in mental healthcare. Most were poorly written, opinionated, and cheaply produced self-aggrandizing marketing drivel for those agents selling commission-based financial products and expensive advisory services. So, I was pleasantly surprised with this comprehensive peer-reviewed academic textbook, complete with citations, case examples, and real-life integrated strategies by and for medical professionals. Although a bit late for my career, I recommend it highly to all my younger colleagues … It’s credibility and specificity stand alone. —Dr. Clarice Montgomery PhD MA,Retired Clinical Psychologist In an industry known for one-size-fits-all templates and massively customized books, products, advice, and services, the extreme healthcare specificity of this text is both refreshing and comprehensive. —Dr. James Joseph Bartley, Columbus, Georgia
My brother was my office administrator and accountant. We both feel this is the most comprehensive textbook available on financial planning for healthcare providers. —Dr. Anthony Robert Naruska DC,Winter Park, Florida
Posted on April 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
THE AMA A.U.I. REPORT
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By Staff Reporters
Doctors are excited—yet cautious—about the role augmented intelligence (AUI) could play in the future of healthcare. That’s the takeaway from an American Medical Association (AMA) survey released last month.
About two-thirds (65%) of 1,000+ physicians that the AMA surveyed in August 2023 agreed that there was at least some advantage to using AUI-powered tools, particularly when it comes to diagnostic ability (72%), work efficiency (69%), and clinical outcomes (61%). More than half (56%) of doctors said AUI tools could best help address administrative burdens.
Private equity and venture capital investments typically involve ownership of shares in a company and represent title to a portion of the company’s future earnings. However, private equity is an equity interest in a company or venture whose stock is not yet traded on a stock exchange.
Venture capital is typically a special case of private equity in which the investment is in a company or venture that has little financial history or is embarking on a high risk/high potential reward business strategy.
Like real estate, private equity and venture capital investments generally share a general lack of liquidity and a lack of comparability across different individual investments. The lack of liquidity comes from the fact that private equity and venture capital investments are typically not tradable on a stock exchange until the company has an IPO.
The lack of comparability is due to the fact that most private equity and venture capital investments are the result of direct negotiation between the investor/venture capitalist and the existing owners of the company /venture.
With widely divergent terms and provisions across different investments, it is difficult to make general claims regarding the characteristics of private equity and venture capital investments.
It’s never a source of pride stepping out of a dirty car or truck, especially for image conscious doctors. But, keeping your vehicle looking like new, for the doctor’s parking lot, is tough work. Sure, you may take it through the drive-thru car wash every now and then, but that isn’t the deep cleaning that your car deserves.
All in the Details
Detailing, on the other hand, is promised to give your beloved vehicle that ‘new-car’ feeling all over again. It isn’t easy work, but the results are amazing. While you could detail your car at home, is it really worth it? Let’s take a look at why letting the pros detail your vehicle is the way to go – or – not!
Working at the Car Wash
When you wash your vehicle at a drive-thru car wash, you may be doing more harm than good. If the car wash has brushes or pieces of cloth that scrub your vehicle as it goes through, these components can easily scratch your car’s finish. All of the bits of dirt from cars before can be trapped in the cloth and brushes, and as they scrub your vehicle, they act as sandpaper, permanently marring your paint.
One step better is hand washing your car at home, but even then, you must be careful to not just become a humanized version of the car wash. Using two buckets is a good start, with one bucket being a rinse bucket to remove the dirt from your sponge, and the other containing the soap.
SOAP Suds – Not SOAP Notes
Also, be careful of the type of soaps and car care products being used. The interior and exterior cleaners found at the local parts store are often of decent quality, but they aren’t always the best, and they must be used properly. Even then, for a normal car owner, detailing a car can become an all-day task, sometimes with less than perfect results.
Don’t forget to use a clay bar or brick followed by your favorite Carnuba wax, too.
The Pros
So, why should you let the pros handle your detailing needs? They should know exactly what specialty products are right for your vehicle to get the perfect results every time. And, they know the techniques that will yield showroom-finish results while you don’t have to even touch your car.
And, while you won’t want to clean out all the dried soda, coffee stains, or leftover cheeseburger wrappers from under your seat, they will gladly do it for you – for a price.
Imagine
Just picture getting into a blindingly shiny, clean vehicle with an interior that looks equally as pristine. No more purchasing all kinds of car care products that don’t deliver results. No more spending hours in the driveway getting soaked and frustrated. No more wasted time. Pros know what it takes to detail your vehicle to concourse standards.
But then, it is just a job for them. It is a labor of love for me. Am I neurotic or compulsive?
My near showroom and mint conditioned 2000 Jaguar XJ-V8-L is a full-size luxury sedan, offers sporting drive characteristics, mixed with a classic style and interior comfort. It was available in multiple trims which all came very well equipped with upscale amenities.
And, this extended wheelbase version offers much more rear seat leg room for long and winding Georgia road trips. The standard steel engine [not nikasil] in this XJ is a 4.0L V8 which produces 290 hp. The upper and lower timing chain tensioners are original, second generation metal, not plastic.
There is also a supercharged version of this vehicle which bumps output to an impressive 370 hp. Even with all of its power and weight, my XJ-8-L is still rated at over 20 mpg on the highway. Ammenities and upgrades include a mobile phone, Magellan GPS, LoJack theft recovery system, CD and MP-3 players, with internal and external cable antenna for satellite radio.
What a Cat? She is my third favorite female after my intelligent and beautiful wife, and smart and lovely daughter.
Conclusion
Are you a DIYer, like me? Nothing says you care more than doing it yourself.
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
TERMS & DEFINITIONS FOR PHYSICIANSAND ALL INVESTORS:
PRUDENT BUYER: The efficient purchaser of market balance between value and cost.
PRUDENT MAN RULE: An 1830 court case stating that a person in a fiduciary capacity (a trustee, executor, custodian, etc) must conduct him/herself faithfully and exercise sound judgment when investing monies under care. “He is to observe how men of prudence, discretion and intelligence manage their own affairs, not in regard to speculation, but in regard to the permanent distribution of their funds, considering the probable income as well as the probable safety of the capital to be invested.” Allows for mutual funds and variable annuities.
PRUDENT INVESTOR RULE: A fiduciary is required to conduct him/herself faithfully and exercise sound judgment when investing monies and take measured and reasonable investment risks in return for potential future rewards. Allows for mutual funds, stocks, bonds, variable annuities asset allocation & Modern Portfolio Theory.
EDITOR’SNOTE: We interviewed noted authority Ben Aikin AIF® on this topic more than a decade ago. He was ahead of his time regarding fiduciary accountability and we appreciate his insights.
Managerial and medical cost accounting is not governed by generally accepted accounting principles (GAAP) as promoted by the Financial Accounting Standards Board (FASB) for CPAs. Rather, a healthcare organization costing expert may be a Certified Cost Accountant (CCA) or Certified Managerial Accountant (CMA) designated by the Cost Accounting Standards Board (CASB), an independent board within the Office of Management and Budget’s (OMB) Office of Federal Procurement Policy (OFPP).
The Cost Accounting Standards Board
CASB consists of five members, including the OFPP Administrator who serves as chairman and four members with experience in government contract cost accounting (two from the federal government, one from industry, and one from the accounting profession). The Board has the exclusive authority to make, promulgate, and amend cost accounting standards and interpretations designed to achieve uniformity and consistency in the cost accounting practices governing the measurement, assignment, and allocation of costs to contracts with the United States.
Codified at 48 CFR
CASB’s regulations are codified at 48 CFR, Chapter 99. The standards are mandatory for use by all executive agencies and by contractors and subcontractors in estimating, accumulating, and reporting costs in connection with pricing and administration of, and settlement of disputes concerning, all negotiated prime contract and subcontract procurement with the United States in excess of $500,000. The rules and regulations of the CASB appear in the federal acquisition regulations.
North American Industry Classification System (NAICS) codes are used to categorize data for the federal government. In acquisition they are particularly critical for size standards. The NAICS codes are revised every five years by the Census Bureau. As of October 1, 2007, the federal acquisition community began using the 2007 version of the NAICS codes at www.census.gov/epcd/www/naics.html
Cost Accounting Standards
Healthcare organizations and consultants are obligated to comply with the following cost accounting standards (CAS) promulgated by federal agencies:
CAS 501 requires consistency in estimating, accumulating, and reporting costs.
CAS 502 requires consistency in allocating costs incurred for the same purpose.
CAS 505 requires proper treatment of unallowable costs.
CAS 506 requires consistency in the periods used for cost accounting.
The requirements of these standards are different from those of traditional financial accounting, which are concerned with providing static historical information to creditors, shareholders, and those outside the public or private healthcare organization.
Assessment
Functionally, most healthcare organizations also contain cost centers, which have no revenue budgets or mission to earn revenues for the organization. Examples include human resources, administration, housekeeping, nursing, and the like. These are known as responsibility centers with budgeting constraints but no earnings. Furthermore, shadow cost centers include certain non-cash or cash expenses, such as amortization, depreciation and utilities, and rent. These non-centralized shadow centers are cost allocated for budgeting purposes and must be treated as costs http://www.CertifiedMedicalPlanner.org
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
(“Informed Voice of a New Generation of Fiduciary Advisors for Healthcare”)
For most lay folks, personal financial planning typically involves creating a personal budget, planning for taxes, setting up a savings account and developing a debt management, retirement and insurance recovery plan. Medicare, Social Security and Required Minimal Distribution [RMD] analysis is typical for lay retirement. Of course, we can assist in all of these activities, but lay individuals can also create and establish their own financial plan to reach short and long-term savings and investment goals.
But, as fellow doctors, we understand better than most the more complex financial challenges doctors can face when it comes to their financial planning. Of course, most physicians ultimately make a good income, but it is the saving, asset and risk management tolerance and investing part that many of our colleagues’ struggle with. Far too often physicians receive terrible guidance, have no time to properly manage their own investments and set goals for that day when they no longer wish to practice medicine.
For the average doctor or healthcare professional, the feelings of pride and achievement at finally graduating are typically paired with the heavy burden of hundreds of thousands of dollars in student loan debt.
You dedicated countless hours to learning, studying, and training in your field. You missed birthdays and holidays, time with your families, and sacrificed vacations to provide compassionate and excellent care for your patients. Amidst all of that, there was no time to give your finances even a second thought.
Between undergraduate, medical school, and then internship and residency, most young physicians do not begin saving for retirement until late into their 20s, if not their 30s. You’ve missed an entire decade or more of allowing your money and investments to compound and work for you. When it comes to addressing your financial health and security, there’s no time to waste.
ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.
When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings it achieves for the Medicare program.
Now, suppose that in a new Accountable Care Organization [ACO] contract, a certain medical practice was awarded a new global payment or capitation styled contract that increased revenues by $100,000 for the next fiscal year. The practice had a gross margin of 35% that was not expected to change because of the new business. However, $10,000 was added to medical overhead expenses for another assistant and all Account’s Receivable (AR) are paid at the end of the year, upon completion of the contract.
Cost of Medical Services Provided (COMSP):
The Costs of Medical Services Provided (COMSP) for the ACO business contract represents the amount of money needed to service the patients provided by the contract. Since gross margin is 35% of revenues, the COMSP is 65% or $65,000. Adding the extra overhead results in $75,000 of new spending money (cash flow) needed to treat the patients. Therefore, divide the $75,000 total by the number of days the contract extends (one year) and realize the new contract requires about $ 205.50 per day of free cash flows.
Assumptions
Financial cash flow forecasting from operating activities allows a reasonable projection of future cash needs and enables the doctor to err on the side of fiscal prudence. It is an inexact science, by definition, and entails the following assumptions:
All income tax, salaries and Accounts Payable (AP) are paid at once.
Durable medical equipment inventory and pre-paid advertising remain constant.
Gains/losses on sale of equipment and depreciation expenses remain stable.
Gross margins remain constant.
The office is efficient so major new marginal costs will not be incurred.
Physician Reactions:
Since many physicians are still not entirely comfortable with global reimbursement, fixed payments, capitation or ACO reimbursement contracts; practices may be loath to turn away short-term business in the ACA era. Physician-executives must then determine other methods to generate the additional cash, which include the following general suggestions:
1. Extend Account’s Payable
Discuss your cash flow difficulties with vendors and emphasize their short-term nature. A doctor and her practice still has considerable cache’ value, especially in local communities, and many vendors are willing to work them to retain their business
2. Reduce Accounts Receivable
According to most cost surveys, about 30% of multi-specialty group’s accounts receivable (ARs) are unpaid at 120 days. In addition, multi-specialty groups are able to collect on only about 69% of charges. The rest was written off as bad debt expenses or as a result of discounted payments from Medicare and other managed care companies. In a study by Wisconsin based Zimmerman and Associates, the percentages of ARs unpaid at more than 90 days is now at an all time high of more than 40%. Therefore, multi-specialty groups should aim to keep the percentage of ARs unpaid for more than 120 days, down to less than 20% of the total practice. The safest place to be for a single specialty physician is probably in the 30-35% range as anything over that is just not affordable.
The slowest paid specialties (ARs greater than 120 days) are: multi-specialty group practices; family practices; cardiology groups; anesthesiology groups; and gastroenterologists, respectively. So work hard to get your money, faster. Factoring, or selling the ARs to a third party for an immediate discounted amount is not usually recommended.
3. Borrow with Short-Term Bridge Loans
Obtain a line of credit from your local bank, credit union or other private sources, if possible in an economically constrained environment. Beware the time value of money, personal loan guarantees, and onerous usury rates. Also, beware that lenders can reduce or eliminate credit lines to a medical practice, often at the most inopportune time.
4. Cut Expenses
While this is often possible, it has to be done without demoralizing the practice’s staff.
5. Reduce Supply Inventories
If prudently possible; remember things like minimal shipping fees, loss of revenue if you run short, etc.
6. Taxes
Do not stop paying withholding taxes in favor of cash flow because it is illegal.
Hyper-Growth Model:
Now, let us again suppose that the practice has attracted nine more similar medical contracts. If we multiple the above example tenfold, the serious nature of potential cash flow problem becomes apparent. In other words, the practice has increased revenues to one million dollars, with the same 35% margin, 65% COMSP and $100,000 increase in operating overhead expenses. Using identical mathematical calculations, we determine that $750,000 / 365days equals $2,055.00 per day of needed new free cash flows! Hence, indiscriminate growth without careful contract evaluation and cash flow analysis is a prescription for potential financial disaster.
Posted on January 29, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Tech giants highlight busiest earnings week of the season: Five of the Magnificent Seven—Apple, Microsoft, Amazon, Meta, and Alphabet—will deliver their Q4 results, and we advise you against taking a shot every time AI is mentioned. On Wednesday, Boeing is scheduled to give an update on how the 737 Max 9 debacle will impact its 2024 forecasts. In all, 106 S&P 500 companies will report this week, including Starbucks, Pfizer, GM, and Big Oil.
Fed meeting and jobs report: As if those earnings won’t keep Wall Street on its toes, the Fed will wrap up its first meeting of the year on Wednesday and the January jobs report will drop on Friday. Chair Jerome Powell will almost certainly keep interest rates unchanged for now, but investors are keen to hear whether he predicts a rate cut in March. On the jobs front, US employers are expected to have continued hiring briskly in January, despite the wave of high-profile layoff announcements.
Posted on January 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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American Medical Association (AMA) leaders lauded the Medicare Payment Advisory Commission (MedPAC) this month for backing increased physician payment rates for 2025.
AMA President Jesse Ehrenfeld praised MedPAC, a nonpartisan independent legislative agency that advises Congress on the Medicare program, for endorsing a draft recommendation that urges lawmakers to increase physician payment rates to reflect inflation. He cast the move as “a critical first step toward the necessary work of reforming the broken Medicare payment system.”
“Long-term reforms from Congress are overdue to close the unsustainable gap between what Medicare pays physicians and the actual costs of delivering high-quality care. When adjusted for inflation in practice costs, Medicare physician pay declined 26% from 2001 to 2023,” he said in a statement.
Posted on January 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Four U.S. banks warned of lower interest income for this year on Friday, capping a week of dour commentary from the industry that has been under pressure from high deposit costs. After more than a year of booking strong profits on the back of the high interest they were able to charge on loans, banks are contending with a string of challenges heading into 2024, including weaker loan growth and potentially tougher capital rules.
Markets: Investors saw the S&P 500 and the Dow finished Friday at all-time highs. Soaring tech stocks helped the S&P blow past both intra-day and closing records set in January 2022.
Stock spotlight: Spirit Airlines had a bumpy ride this week. After falling for days, the budget carrier took off when it raised its forecast and said it still believes in the deal for JetBlue to buy it that a judge has blocked. Spirit and JetBlue also filed an appeal to try to save the merger.
Posted on January 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Drugmakers kicked off 2024 by raising the list prices for Ozempic, Mounjaro and dozens of other widely used medicines. Companies including Novo Nordisk, the maker of Ozempic, and Eli Lilly, which sells Mounjaro, raised list prices on 775 brand-name drugs during the first half of January 2024, according to an analysis for The Wall Street Journal by 46brooklyn Research, a nonprofit drug-pricing analytics group.
The drugmakers raised prices of their medicines by a median 4.5%, though the prices of some drugs rose by around 10% or higher, according to the research group. The median increase is higher than the rate of inflation, which ticked up to 3.4% in December.
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Reddit’s IPO is reportedly due in March. According to Reuters, the social media platform’s long-awaited initial public offering will launch by the end of March after it makes its public filing in late February. It’ll be the first big social media IPO since 2019, when Pinterest went public. All eyes will fall on Reddit’s own users, who are known to fuel meme stock rallies—namely AMC and GameStop—and could help prop up the company’s debut on the stock market. Valued at about $10 billion as of 2021, Reddit reportedly will sell 10% of its shares as it competes with TikTok and Facebook for attention and ad dollars.
Here’s where the major benchmarks ended:
The S&P 500 index rose 58.87 points (1.2%) to 4,839.81, up 1.2% for the week; the Dow Jones Industrial Average gained 395.19 points (1.1%) to 37,863.80, up 0.7% for the week; the NASDAQ Composite® (COMP) increased 255.32 points (1.7%) to a two-year high of 15,310.97, up 2.3% for the week.
The 10-year Treasury note yield (TNX) fell about 1 basis point to 4.132%.
The CBOE Volatility Index® (VIX) fell 0.83 to 13.30.
Strength in Nvidia and other chipmakers like Advance Micro Devices (AMD), which surged 6%, lifted the Philadelphia Semiconductor Index (SOX) 4% to a record high close. Regional banks were also among the market’s strongest performers, as the KBW Regional Banking Index (KRX) added nearly 2%. Food and beverage companies and utilities were among the weakest performers.
Posted on January 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Statistic 187,000: That’s how many first time unemployment claims were filed last week, a surprise decline and the lowest since September 2022. The resilient labor market is continuing to chug along as companies continue to hold on to the workers they have.
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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 Thursday, after Humana 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.”
In response, three largest sponsors of Medicare Advantage plans, UnitedHealth Group, CVS Health, and Humana, have seen their shares fall 3.2%, 7.5%, and 14.3% so far this year, respectively, as of midday Thursday. The S&P 500 is down 0.6% over the same period, while Cigna Group—which is reportedly near a deal to sell its relatively small Medicare Advantage business—is up 1%.
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Here’s where the major benchmarks ended:
The S&P 500 index rose 41.73 points (0.9%) to 4,780.94; the Dow Jones Industrial Average® (DJI) gained 201.94 points (0.5%) to 37,468.61; the NASDAQ Composite increased 200.03 points (1.4%) to 15,055.65.
The 10-year Treasury note yield (TNX) rose nearly 4 basis points to 4.142%.
The CBOE Volatility Index® (VIX) fell 0.66 to 14.13.
Gains in Taiwan Semiconductor and its industry counterparts sent the Philadelphia Semiconductor Index (SOX) up 3.4% to a three-week high. In a further illustration of tech sector strength, the Nasdaq-100® (NXD), which includes the NASDAQ’s largest non-financial companies, rose 1.5% to a record closing high. Banking and utility shares were among the market’s weakest performers.
DEFINITION: Venture capital (VC) is a form of private equity and a type of financing that investors provide to start-up companies and small businesses that are believed to have long term growth potential. Venture capital generally comes from well-off investors, investment banks, and any other financial institutions. Venture capital doesn’t always have to be money. In fact, it often comes as technical or managerial expertise. VC is typically allocated to small companies with exceptional growth potential or to those that grow quickly and appear poised to continue to expand.
DEFINITION:Disruptive innovation is a business that creates a new market or value network, or enters at the bottom of an existing market and eventually displaces established market-leading firms, products, and alliances. The term, “disruptive innovation” was popularized by the American academic Clayton Christensen and his collaborators beginning in 1995, but the concept had been previously described in Richard N. Foster‘s book “Innovation: The Attacker’s Advantage” and in the paper Strategic Responses to Technological Threats.
Start-Ups and industry disruptors: Here are just a few of the recent collapses, as per the New York Times:
WeWork, which raised over $11 billion as a private startup, went bankrupt earlier this fall.
Hopin, the virtual events startup that rode a Covid Virus wave to a $7.6 billion valuation, sold its primary business units for $15 million.
The e-scooter company Bird, which became the fastest startup ever to land a $1 billion valuation, was de-listed from the NYSE and is now worth $7 million.
Overall, more than 3,200 private venture-capital backed US startups that have collectively raised $27.2 billion have gone out of business this year, according to the New York Times and PitchBook. So, why are the disruptors doing down?
Well, the Federal Reserve raised interest rates to a 22-year high. The cost of capital has become far more expensive, and investments that are less risky have gotten more attractive. This year has been particularly bad.
It’s a sad and instantaneous end to the golden Venture Capital years fueled by low interest rates and the growth of the mobile interne. Investment in US startups jumped by 8x between 2012 and 2022 to $344 billion dollars.
Posted on January 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Walgreens doled out some tough medicine to its investors this week when it cut its quarterly dividend to shareholders nearly in half, in a move to conserve cash and strengthen its long-term financial position, according to CEO Tim Wentworth.
Illinois-based Walgreens Boots Alliance Inc (WBA), which operates one of the largest US drugstore chains, on Thursday declared a quarterly dividend of 25 cents per share, a reduction from 48 cents per share the previous quarter. The dividend will be payable on March 12th.
The move will allow Walgreens to increase cash flow and free up capital “to invest in sustainable growth initiatives in our pharmacy and healthcare businesses, which we believe will ultimately improve shareholder value,” Wentworth said in a statement.
On behalf of [Name of medical practice or clinic] (hereinafter called the “practice”), this letter sets out a proposed agreement for your initial employment in Dr. [Name of physician]’s medical practice. After both you and Dr. [Name of physician] have agreed upon all issues related to your employment, a formal physician employment agreement will be prepared for your review and signature.
1. Term: You will be an employee of the practice for an initial [Duration]-month period starting [Month, Date, Year]. Should you and the practice want to proceed past this initial employment period, an offer of co-ownership may be made to you as described in item nine below.
Your employment with the practice will essentially be “at will,” since you or the practice may voluntarily terminate it at any time upon 30 days’ written notice to the other. However, the following are conditions under which the practice may terminate your employment immediately: (a) upon your death or disability for three (3) consecutive months; (b) upon the suspension, revocation, or cancellation of your right to practice medicine in the State of [State]; (c) if you should lose privileges at any hospital at which the practice regularly maintains admission privileges; (d) should you fail or refuse to follow reasonable policies and directives established by the practice; (e) should you commit an act amounting to gross negligence or willful misconduct to the detriment of the practice or its patients; (f) if you are convicted of a crime involving moral turpitude, including fraud, theft, or embezzlement; and (g) if you breach any of the terms of your employment contract.
2. Compensation: Your salary for the initial 12-month period will be $[dollar value] and $[dollar value] in the second 12-month period, each year payable in monthly installments. You will also be entitled to an incentive bonus calculated as follows: [Percentage] % of your collected production when such collections exceeds $[dollar value] in the first year and $[dollar value] in the second year. The bonus each year will be calculated and paid on a semiannual basis. You will also be entitled to receive a one-time signing bonus of $[dollar value] if you sign your employment contract before [Month, Date, Year].
A portion of your compensation may be paid for by proceeds received from [Name of hospital] under the terms and conditions of a hospital recruitment agreement. The parties to this agreement will be the hospital and the practice only. However, forgiveness of any advances made by the hospital will be directly contingent upon the length of time you remain with the practice. Therefore, should your employment terminate for any reason, the practice will require you to repay to it any amounts the practice repays the hospital, in no matter what form, per the terms and conditions in the hospital recruitment agreement. [Note: Use this if the practice signs a hospital recruitment agreement with the hospital.]
3. Benefits: In addition to your base compensation and incentive bonus, the practice will pay for the following: (a) health insurance, (b) malpractice insurance, (c) continuing medical education (CME) costs, (d) medical license fee, (e) board certification exam fee, (f) reasonable cellular phone costs, and (g) a pager. You will also be entitled to a moving cost allowance for relocating to [Location.] You will be entitled to two weeks of paid vacation, 10 working days as paid sick leave, and four days paid time off for CME or the board certification exam.
4. Disability Leave: In case of absence because of your illness or injury, your base salary will continue for a period not exceeding 30 days per calendar year, plus any unused vacation time and sick leave. You will be entitled to any incentive bonus payments that may be due to you as collections are received on your prior production. Absence in excess of 30 days would be without pay. Unused sick leave cannot be carried over to succeeding years, nor will it be paid for at any time.
5. Exclusive Employment: As an employee, you will be involved full-time in the practice and you may not take any outside employment during the term of your employment agreement without the practice’s written approval. However, you will be entitled to keep compensation from honorariums, royalties, and copyrights if approved by the practice in writing. If the practice does not give approval, then the income from such activities shall remain the property of the practice.
6. Termination Compensation: Should your employment terminate for any reason, you will be entitled to accrued but unpaid base compensation, earned but unpaid incentive bonus, and unused vacation leave.
7.Non-Solicitation: During the course of your employment, the practice will introduce and make available to you its contacts and referring physician relationships, ongoing patient flow, general hospital sources, business and professional relationships, and the like. Since you have not been in private practice in the area previously, you acknowledge that you currently have no established patients following you. If there should be a termination, the practice will not restrict your ability to practice medicine in the area; however, it will require you to enter into a nonsolicitation agreement in which you agree not to solicit the employees of the practice nor its patients to follow you into your new medical practice. [Note: Insert Covenant Not to Compete here, if applicable.]
8. Employee-Only Status: During the term of your employment, you will not be required to contribute any money toward the practice’s equipment or operations, but likewise your work will give you no financial interest in the assets of the practice. However, the practice intends to offer you the opportunity to buy into the ownership of the practice as set forth in item 9 below.
9. Ownership Opportunity: At the end of your employment period, the practice will evaluate your relationship and may offer you the opportunity to become a co-owner in the practice (or enter into an office-sharing relationship). This offer is not mandatory and is at the total discretion of the practice. Should an offer not be tendered for some reason, the practice will wait until the end of your next 12-month employment period to decide whether to tender an offer of co-ownership. If an offer of co-ownership is made, Dr. [Name of physician] will discuss with you the following: (a) what percentage of the practice you will be allowed to acquire, (b) how best to value such interest, and (c) how you will pay for the acquisition of such interest. The practice hopes to achieve mutually agreeable solutions to these ownership issues.
We hope this offer meets with your approval. If so, please contact Dr. [Name of physician] as soon as possible. This letter is not intended to be a legally binding agreement; it is, rather, a tool to be used to prepare your formal physician employment agreement. If you should have any questions, please do not hesitate to contact myself or Dr. [Name of physician] at your convenience.
DEFINITION: According to the Food and Drug Administration [FDA], the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, tele-health and tele-medicine, and personalized medicine. From mobile medical apps and software that support the clinical decisions doctors make every day to artificial intelligence and machine learning, digital technology has been driving a revolution in health care. Digital health tools have the vast potential to improve our ability to accurately diagnose and treat disease and to enhance the delivery of health care for the individual. Digital health technologies use computing platforms, connectivity, software, and sensors for health care and related uses. These technologies span a wide range of uses, from applications in general wellness to applications as a medical device. They include technologies intended for use as a medical product, in a medical product, as companion diagnostics, or as an adjunct to other medical products (devices, drugs, and biologics). They may also be used to develop or study medical products.
As many investors predicted, digital health funding took a dive in 2023, according to Rock Health’s year-end funding report. Startups got creative to stay afloat but many digital health founders will have to “face the music” in 2024, the VC firm’s analysts say.
Editor’s Note: I am on the Advisory Board of Medblob™a start-up based in Boston, MA. The digital mission of Medblob™ is to improve community and national health by allowing patients to better manage their health, providers to better treat their patients, and researchers to have the best information to discover cures to the most prevalent and pernicious diseases.
Posted on January 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The S&P 500® index (SPX) was down 7.04 points (0.2%) at 4,756.50; the Dow Jones Industrial Average® (DJI) was down 157.85 points (0.4%) at 37,525.16; the NASDAQ Composite was up 13.94 points (0.1%) at 14,857.71.
The 10-year Treasury note yield (TNX)was up about 2 basis points at 4.019%.
The CBOE® Volatility Index (VIX) was down 0.32 at 12.76.
Energy shares were among the market’s weakest performers Tuesday despite a rally of nearly 2% in crude oil futures. The Philadelphia Oil Service Index (OSX) sank 2.4% to a four-week low. Banking and materials were also notably soft. Small-cap stocks remained under pressure, sending the Russell 2000® Index (RUT) down 1.1%.
Despite the market’s weak start to the year, excessively bullish sentiment “remains a risk” to the recent rally, according to Kevin Gordon, senior investment strategist at Schwab. But he also noted that market “breadth,” the number of advancing shares versus declining shares, is “healthier” than it was for much of 2023. Sentiment “is still quite stretched, which means that the market remains vulnerable to a correction,” Gordon said. “However, the backdrop—whether it’s the number of stocks trading above their 200-day moving average, outperforming their respective benchmark, or in an uptrend—is relatively healthy. That keeps the broader uptrend in place, albeit not perfectly or smoothly.”
Posted on December 23, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
Follow these 5 Tips to be sure you cruise safely into the new year!
By Dr. David Edward Marcinko MBA
I am not an auto mechanic but I did cover the local hospital ER for more than a decade.
So, here are some holiday driving tips and pearls for Christmas, Holiday motoring safety and the New Year 2024.
1. Get a Pre-holiday Vehicle Check-up
A general pre-holiday vehicle check-up at your dealership can reduce your risk of having problems on the road. You’ll want to pay close attention to your vehicle’s tire pressure. Temperature fluctuations can affect pressure and a little destabilization can create unsafe driving conditions. Be sure to check yours and when you need to add air to those tires.
2. Raise ‘Em High – to Not Drinking and Driving
Sounds obvious but it bears repeating. Whether it’s at the company Christmas party, New Year’s Eve or just catching up with friends for a festive drink, drinking and driving is just not worth it. Designate a driver or enjoy a mock-tail instead.
3. Slow the Rein-Deer Down and Pay Attention
Not only are drivers distracted today by all their electronic devices, pedestrians are too. Be aware and pay attention to everyone. Speed is another one of the leading causes of car accidents (plus sudden acceleration is a major gas guzzler). Yes, rushing around can make you feel like you can make up some time on the road. But we promise you that your friends and family would rather have you arrive safely even if you are 10 minutes late.
4. Buckle Up
Another pretty obvious tip…but, you don’t want to wrinkle your new party dress! That dress is not going to impress the Emergency Room Doctor! According to the National Highway Traffic Safety Administration, in 2015, seat belts saved an estimated 13,941 lives among passenger vehicle occupants age 5 and older. An estimated 266 lives of children under age 5 were saved by their use of restraints and an estimated 2,573 lives were saved by frontal air bags. You definitely want to be part of that statistic in the event of an accident.
5. Rest Up Before Your Trip
Be sure to stay alert and be well rested before heading out. Late night holiday gatherings or long trips to visit family can lead to drowsiness. Sharing the driving responsibilities can help. You can stretch and walk around to help wake your body up. Be sure to take additional breaks as needed. If you are feeling tired and fatigued, pull over to get coffee, water and a snack.
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.
Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.
Posted on December 20, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Supermarket chain Kroger is moving into primary care for seniors. The company is partnering with Better Health Group to test out a value-based, primary care model at eight of its in-store clinics in Atlanta.
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As the Artificial Intelligence race heats up, Google unveiled this week new AI models called MedLM purpose-built for healthcare use cases like summarizing patient-doctor interactions. HCA Healthcare is already testing out the technology.
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And … Cigna is attracting plenty of interest for the rumored sale of its Medicare Advantage business, Bloomberg reported, here: who’s competing to scoop up the MA segment.
Finally, more than two dozen healthcare payers and providers are making voluntary safety, security and transparency commitments to the White House regarding the use of artificial intelligence.
Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.
Micro-Certification Basics
Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.
Micro-Certification Requirements
Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.
Uses of Micro-Certifications
Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.
Examples of iMBA, Inc., Micro-Certifications
Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:
1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.
Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.
How to Start Learning and Earning Recognition for Your Knowledge
Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.
Mini-Certification Tuition, Books and Related Fees
The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.
***
Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at: MarcinkoAdvisors@msn.com [24/7] -OR- 770-448-0769[9:00 – 5:00 EST].
Posted on December 16, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
***
INFLUENCERS
Reach Industry Pros, Executives and Decision-Makers with Ease!
Thank you for your interest in advertising on, or sponsoring the ME-P, the web’s only site integrating medical practice management with personal financial planning for all industry professionals.
Why should your company sponsor or advertise on the ME-P?
• Reader loyalty. Not only does the ME-P receive a mind-boggling number of page views and visits each month, its readers are loyal. • Reader stature. ME-P readers are experienced industry pros, executives and decision-makers. • Selective advertising. The ME-P is a free read that’s off the radar of the big-ad companies. Your ad here stands out as personal and different. • Supporting the ME-P makes a big difference and costs only a fraction of other online publications with far fewer readers. • Cost. CPM is reasonable and low compared to other sites.
E-mail us for a full packet, but give a look to these results from the ME-P’s annual reader survey:
* 89% of readers said the ME-P influences their perception of products and companies * 34% said that ME-P sponsorship alone give them a higher interest or appreciation for those companies * 754% said the ME-P has some, a good bit, or a lot of industry influence
Contact me and I’ll e-mail you a rate card. Your support makes a difference!
The bond market just finished its best month since 1985, according to the Financial Times, with investor optimism creating a surge in bond prices and a plunge in yields (reminder: they move in opposite directions). The yield on the benchmark 10-year US Treasury note dipped below 4.3% for the first time since September. And other economic measures are looking good:
The bond rally spilled over to stocks, where the S&P 500 and Dow just clinched their best months since July 2022 and October 2022, respectively.
Mortgage rates dropped for the fifth consecutive week, to 7.22%.
Traders are optimistic that the FOMC may be done hiking interest rates. With recent data showing both consumer spending and the job market cooling down—but not too much—economists see the once-aspirational economic soft landing as achievable, which is great news for Wall Street and to avoid a recession).
Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.
Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.
CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].
Posted on December 1, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Online therapy company Talkspace will provide free virtual mental health services to more than 400,000 adolescents and teens in New York City after inking a deal with the city. The new program, dubbed TeenSpace, will connect teens to a licensed therapist through phone, video and text.
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The Patient-Centered Outcomes Research Institute (PCORI) has announced funding awards of $80.5 million to support four new studies focused on disparities in maternal health. They will take into account clinical and social factors that contribute to inequities and will compare interventions in various settings.
And … Ayble Health, a digital health platform for patients with chronic gastrointestinal conditions, is working with the Mayo Clinic Complex Care Program to offer a hybrid care model that matches patients with the appropriate virtual and in-person care based on acuity and need.
General Motors plans to sharply increase cash return to shareholders, as Chief Executive Mary Barra seeks to reassure investors about the health of GM’s core car-making business after setbacks in fledgling pursuits such as electric and driver-less vehicles.
The company just announced it will work to offset higher labor expenses from its new contract with the United Auto Workers and unionized employees in Canada. The contracts will add a total of $9.3 billion in costs over about four years, including $1.5 billion next year, higher than analysts had estimated.
Barra is trying to jump-start GM’s flailing shares while also refocusing investors on the underlying strength of its main business: selling gas- and diesel-powered trucks and SUVs. It marks a shift in the message from recent years, during which the CEO sought to recast GM as a tech company poised to transcend the messy world of car manufacturing.
GM said it would log strong profits this year despite a six-week strike that shaved $1.1 billion from its bottom line in the third and fourth quarters. The company expects full-year operating profit of $11.7 billion to $12.7 billion, after withdrawing its guidance last month during the strike
Posted on November 16, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
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Nurse Practitioner Week takes place annually in the second week of November to recognize these incredible healthcare providers and raise awareness of the powerful role they play in ensuring general health and well-being.
Can you believe that the nurse practitioner profession has been in existence for 56 years now? Nurse practitioners are highly educated and trained medical professionals who are almost like doctors. In addition to their fundamental roles as registered nurses, they can provide primary care, counseling, diagnosis, offer health education, and write prescriptions.
Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.
Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.
CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].
Experts estimate that it can cost more than $1 million to recruit and train a replacement for a doctor who leaves the profession because of burnout. But, as no broad calculation of burnout costs exists, Dr. Tait Shanafelt [Mayo Clinic researcher and Stanford Medicine’s first Chief Physician Wellness Officer] said Stanford, Harvard Business School, Mayo Clinic and the American Medical Association (AMA) are further cost estimating the issue. Nevertheless, Shanafelt and other researchers have shown that burnout erodes job performance, increases medical errors, and leads doctors to leave a profession they once loved.
Fortunately, we can help. From formal coaching to second career opinions, mentoring and advising, we can help with our remediation executive career programs. Regardless of what is happening in your life, it is wonderful to have a non-partial, confidential and informed career coach and sounding board on your side.
CITE: JAMA Internal Medicine [Effect of a Professional Coaching Intervention on the Well-Being and Distress of Physicians].
The Marcinko & Associates case study and white-paper compendium is a teaching vehicle that presents potential clients with a critical management issue that serves as a spring board to lively debate in which participants present and defend their analysis and prescriptions. The average case is 2 to 100 pages long (prose, tables, graphs, charts, spread sheets and figures, etc).
Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.
Micro-Certification Basics
Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.
Micro-Certification Requirements
Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.
Uses of Micro-Certifications
Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.
Examples of iMBA, Inc., Micro-Certifications
Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:
1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.
Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.
How to Start Learning and Earning Recognition for Your Knowledge
Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.
Mini-Certification Tuition, Books and Related Fees
The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.
***
Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at: MarcinkoAdvisors@msn.com [24/7] -OR- 770-448-0769[9:00 – 5:00 EST].
Posted on November 5, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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“The Medicare physician payment schedule released today is an unfortunate continuation of a two-decade march in making Medicare unsustainable for patients and physicians.
For 2024, the new rule indicates there will be another downward adjustment of 3.4 percent, on top of the 2 percent payment reduction in 2023. At the same time, the payment schedule confirms the Medicare Economic Index (MEI) increase at 4.6 percent, the highest this century and on top of last year’s 3.8 percent. MEI is the government measure of inflation in medical practice costs. “
“When adjusted for inflation, Medicare physician payment already has effectively declined 26% from 2001 to 2023 before additional inflation and these cuts are factored in.”
Posted on November 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The IRS has increased the 401(k) plan contribution limits for 2024, allowing employees to defer up to $23,000 into workplace plans, up from $22,500 in 2023. The agency boosted contributions for individual retirement accounts to $7,000 for 2024, up from $6,500. The employee contribution limit for 401(k) plans is also increasing to $23,000 in 2024, up from $22,500 in 2023, and catch-up contributions for savers age 50 and older will remain unchanged at $7,500. The new amounts also apply to 403(b) plans, most 457 plans and Thrift Savings Plans.
IBM just informed its US workers that starting on January 1st, 2024, the corporation will no longer match employee contributions to their 401(k) retirement plans. Instead, it will offer a new benefit called a Retirement Benefit Account (RBA).
“Each eligible employee’s RBA will be credited monthly with an amount equal to five percent of their eligible pay – no employee contribution required,” a leaked internal memo reads, the content of which was confirmed by The Register’s sourcing. “IBMers will also receive a one-time salary increase to offset the difference between the IBM contributions they are currently eligible to receive in the 401(k) plan and the new five percent RBA pay credit. This is separate from the annual salary plan later in the year.”
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A jury on Thursday convicted FTX co-founder Sam Bankman-Fried of fraud, conspiracy and money laundering, the culmination of a month-long trial that saw the former crypto mogul take the stand in his own defense after his inner circle of friends-turned-deputies provided damning testimony against him.
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Here is where the major benchmarks ended:
The S&P 500 Index was up 79.92 points (1.9%) at 4,317.78; the Dow Jones Industrial Average (DJI) was up 564.50 points (1.7%) at 33,839.08; the NASDAQ Composite was up 232.72 points (1.8%) at 13,294.19.
The 10-year Treasury note yield was down about 13 basis points at 4.663%.
CBOE’s Volatility Index (VIX) was down 1.21 at 15.66.
Nearly every sector participated in Thursday’s rally, with banks and other financial companies leading gainers. The KBW Regional Banking Index (KRX) surged more than 5%. Energy and retail shares were also strong. Small-cap stocks outpaced their larger counterparts, with the Russell 2000 Index (RUT) jumping 2.5%.
The Marcinko & Associates case study and white-paper compendium is a teaching vehicle that presents potential clients with a critical management issue that serves as a spring board to lively debate in which participants present and defend their analysis and prescriptions. The average case is 2 to 100 pages long (prose, tables, graphs, charts, spread sheets and figures, etc).
Posted on October 21, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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The U.S. government on Friday posted a $1.695 trillion budget deficit in fiscal 2023, a 23% jump from the prior year as revenues fell and outlays for Social Security, Medicare and interest costs on the federal debt rose significantly.
The Treasury Department said the deficit was the largest since a COVID-fueled $2.78 trillion gap in 2021 and marks a major return to ballooning deficits after back-to-back declines during President Joe Biden’s first two years in office. The deficit comes as Biden is asking Congress for $100 billion in new foreign aid and security spending, including $60 billion for Ukraine and $14 billion for Israel, along with funding for U.S. border security and the Indo-Pacific region.
The S&P 500® Index was down 53.84 points (1.3%) at 4,224.16, down 2.4% for the week; the Dow Jones Industrial Average (DJI) was down 286.89 points (0.9%) at 33,127.28, down 1.6% for the week; the NASDAQ Composite was down 202.37 points (1.5%) at 12,983.81, down 3.2% for the week.
The 10-year Treasury note yield was up about 8 basis points at 4.907%.
CBOE’s Volatility Index (VIX) was up 0.26 at 21.71.
Small-cap stocks, which are considered to be more exposed to economic uncertainty, were also soft, as the Russell 2000 Index (RUT) dropped to a 12-month low and was 2.2% lower for the week.
Gold futures rose 2.3% for the week and ended near a three-month high, as the fighting in the Middle East fueled demand for assets considered to be safe havens. Volatility based on the VIX spiked to its highest level since March.
Posted on October 19, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Though high interest rates have consumers and businesses feeling the pinch, they’ve been a boon to the US’s largest banks. JPMorgan Chase, Citigroup, and Wells Fargo all had stronger-than-expected third-quarter results. In total, the banks earned $22 billion in profit, more than a third higher than in Q3 2022, the Wall Street Journal reported. Their combined revenue was $81 billion, or 14% higher than last year.
Bank stocks dipped last month following the Fed’s meeting, where it held interest rates steady. But though high rates have hurt some smaller banks, they’ve helped keep the large banks’ net interest margins healthy according to CNBC. JPMorgan’s Net Interest Income (NII) was up 30% year over year, rising to $22.9 billion. Wells Fargo’s declined slightly from last quarter, but was still 8% higher than it was last year.
The US economy remains strong, but shows some signs of slowing, bank executives said during recent earnings calls. JPMorgan and Citi took note of consumer spending, with JPMorgan CFO Jeremy Barnum saying, “we are coming on off a very low base. And so there’s a hope and an expectation that we are on the path to normalization and improvement.”
The average cost for a family health insurance plan offered through an employer jumped 7% this year to $23,968 − the highest rate increase in a decade, according to the annual employer health benefits survey released yesterday by KFF, a nonprofit health policy organization. Prices are far higher than they were a year ago, when premiums increased by 1%.
***
Here is where the major benchmarks ended:
The S&P 500 Index was down 58.60 points (1.3%) at 4,314.60; the Dow Jones Industrial Average (DJI) was down 332.57 points (1.0%) at 33,665.08; the NASDAQ Composite was down 219.44 points (1.6%) at 13,314.30.The 10-year Treasury note yield was up about 6 basis points at 4.906%.CBOE’s Volatility Index (VIX) was up 1.42 at 19.30.
Weaker-than-expected quarterly results from some airlines and shipping companies weighed on the transport sector, with the Dow Jones Transportation Average (DJT) sinking 3.4% to end near a four-month low. Financial shares were also lower, with the KBW Regional Banking Index (KRX) dropping nearly 3%. Energy was one of the few areas of strength after WTI Crude Oil futures (CLZ3) jumped above $87 a barrel to a two-week high following a larger-than-expected drop in U.S. supplies. Gold futures rose 1.4% near a two-month high.
Posted on October 18, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
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INFLUENCERS
Reach Industry Pros, Executives and Decision-Makers with Ease!
Thank you for your interest in advertising on, or sponsoring the ME-P, the web’s only site integrating medical practice management with personal financial planning for all industry professionals.
Why should your company sponsor or advertise on the ME-P?
• Reader loyalty. Not only does the ME-P receive a mind-boggling number of page views and visits each month, its readers are loyal. • Reader stature. ME-P readers are experienced industry pros, executives and decision-makers. • Selective advertising. The ME-P is a free read that’s off the radar of the big-ad companies. Your ad here stands out as personal and different. • Supporting the ME-P makes a big difference and costs only a fraction of other online publications with far fewer readers. • Cost. CPM is reasonable and low compared to other sites.
E-mail us for a full packet, but give a look to these results from the ME-P’s annual reader survey:
* 89% of readers said the ME-P influences their perception of products and companies * 34% said that ME-P sponsorship alone give them a higher interest or appreciation for those companies * 754% said the ME-P has some, a good bit, or a lot of industry influence
Contact me and I’ll e-mail you a rate card. Your support makes a difference!
Posted on October 17, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Neuberger Berman is submitting a shareholder proposal to Lions Gate Entertainment Corp., advocating for an end to the dual-class voting structure at the company ahead of a spinoff of its studio business.
The investment manager owns 0.02% of the company’s class A shares and 4.4% of the non-voting class B shares, according to a statement and Bloomberg calculations. Neuberger Berman, which has been a shareholder since 2016, submitted a proposal after having sent a letter to Lions Gate’s board last month.
Neuberger Berman said “one share, one vote” is a foundational principle of corporate governance and that dual-class structures are inconsistent with market practice with a 7% adoption among S&P 500 companies. It also said the structure may impair value and increase risk as it complicates capital structure and gives certain shareholder outsized influence.
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Treasury Secretary Janet Yellen said higher interest rates may persist, while insisting the US economy is “in a good place.” The interest on US debt, which stands at 98% of economic output, “remains manageable,” Yellen said on Monday in an interview with Sky News. “Higher interest rates may persist although that’s not clear,” she said. “Our fiscal situation is by no means unsolvable. We have to be attentive to it.”
LinkedIn said Monday it is laying off hundreds of employees amounting to about 3% of the social media company’s workforce. The Microsoft-owned career network is cutting about 668 roles across its engineering, product, talent and finance teams. “Talent changes are a difficult, but necessary and regular part of managing our business,” the company said in a statement.
***
Here is where the major benchmarks ended:
The S&P 500 Index was up 45.85 points (1.1%) at 4,373.63; the Dow Jones Industrial Average was up 314.25 points (0.9%) at 33,984.54; the NASDAQ Composite (COMP) was up 160.75 points (1.2%) at 13,567.98.
The 10-year Treasury note yield (TNX) was up about 8 basis points at 4.71%.
CBOE’s Volatility Index (VIX) was down 2.06 at 17.26.
All 11 S&P 500 sectors posted gains in Monday’s broad-based upswing, led by the S&P Retail Select Industry Index (SPSIRE), which surged 2.7%.
Regional banks and transportation shares were also among the strongest performers. Energy stocks held firm even as WTI crude oil futures slipped over 1%.
The markets are down again and stocks continued their September slump with tech companies getting hit especially hard as investors fretted about another possible Fed rate hike because of data showing prices for manufacturing and services trending upward. It was a mixed bag for the meme stock faithful, with AMC hitting an all-time low after releasing a plan to sell new shares and GameStop rising after-hours thanks to better-than-expected sales last quarter.
This all may demonstrate that private companies looking to fund growth in this high-interest rate environment are facing a tough time raising capital amidst falling valuations, according to a new Deloitte survey.
The problem is particularly acute for smaller companies. Many of the companies challenged by capital raising saw themselves putting out the “For Sale” sign within the next six months, which could lead to an M&A boom later this year.
“The No. 1 largest factor that people saw as a challenge or a barrier was a decrease in valuations of their business,” Wolfe Tone, vice chair and US and Global Deloitte Private leader, told CFO Brew. “Clearly, increasing interest rates and pricing was closely behind that. Liquidity challenges not far behind that.”
Private companies have been looking to raise capital to fund a range of growth initiatives; meeting talent needs and expanding tech capabilities are at the top of the list, Tone said. Not far behind was “increasing productivity and improving cost structures.”
Support our online development, and advance our onground research initiatives in free market economics, as we seek to showcase the brightest Next-Gen minds.
THE ME-P DISCLAIMER: Posts, comments and opinions do not necessarily represent iMBA, Inc., but become our property after submission. Copyright © 2006 to-date. iMBA, Inc allows colleges, universities, medical and financial professionals and related clinics, hospitals and non-profit healthcare organizations to distribute our proprietary essays, photos, videos, audios and other documents; etc. However, please review copyright and usage information for each individual asset before submission to us, and/or placement on your publication or web site. Attestation references, citations and/or back-links are required. All other assets are property of the individual copyright holder.
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