PARADOX: Medical Progress

Posted on November 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.MarcinkoAssociates.com

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“Paradox of Medical Progress” is a language of medicine is loaded with misnomers, inaccuracies, and ambiguities, and is in need of reform.

Paradoxes on the other hand, deserve a different kind of attention. These seeming self-contradictions are set apart from other inconsistencies because of the truths they tell. The veracity of a paradox is at once appealing and vexing. Anyone who has tried to suppress a thought knows that trying not to think of white polar bears is a sure way to think of white polar bears!

The comic impact of a paradox was even famously explored in Joseph Heller’s Catch 22 and in Groucho Marx’s reluctance to be a member of any club that would accept him. However, the provocative nature of a paradox is its capacity to express familiar wisdom and this is particularly evident in medical science.

The more we learn, the more we learn how much we still have to learn; whereas, “what gets us into trouble is not what we don’t know, it’s what we know for sure that just ain’t so.”

On the significance of the knowledge paradox in biology, Lewis Thomas regarded ignorance as the only scientific truth of which he was confident, and discovering “the depth and scope of ignorance” as the greatest contribution of modern science.

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2024 HAPPY THANKSGIVING DAY

Posted on November 28, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Dr. David Edward Marcinko MBA

Ann Miller RN MHA

ME-P Staff Reporters

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BID/ASK SPREAD: Basis Points with Formulas

Posted on November 24, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

DEFINITIONS

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Basis Points are used in financial literature to express values that are carried out to two decimal places (hundredths of a percentage point), particularly ratios, such as yields, fees, and returns. Basis points describe values that are typically on the right side of the decimal point–one basis point equals one one-hundredth of a percentage point (0.01%). So 25 basis points equals 0.25%, and 50 basis points equals 0.50%.

Only when basis points equal or exceed 100 does the value move to the left of the decimal point–100 basis points equals 1.00%, 500 basis points equals 5.00%, etc.

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

Bid/Ask Spread (also known as bid/offer spread) is the difference between the National Best Bid and the National Best Offer, which represents the implied cost to trade a security.

As compensation for the risk taken, the market maker (or dealer) earns the bid/offer spread in exchange for facilitating the trade. Wider spreads generally indicate higher costs associated with trading the underlying assets in the ETF, hedging costs, inventory management costs, and general market risk.

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

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About iMBA Inc Expertise in Healthcare Valuation

Posted on November 23, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

iMBA Inc., and the ME-P Team

By Ann Miller RN MHA CMP™

SPONSOR: http://www.MarcinkoAssociates.com

The www.MedicalBusinessAdvisors.com is focused solely on appraising medical practices, surgery centers [ASCs], medicine, podiatry, optometry and allied healthcare businesses.

Working with our affiliated partners, like the ME-P and others, we are also available for behemoth multi-specialty medical practices, major clinics, hospitals, related healthcare organizations and networks, and PHOs, etc.

We are backed by the expertise of dedicated appraisers and valuation analysts who are trained by the foremost organizations in our industry www.CertifiedMedicalPlanner.org

Practice owners, attorneys and accountants retain us for projects including, but not limited to the following:.

There are a Myriad of Reasons for Obtaining a Medical Practice Valuation and Appraisal Engagement

Outright selling-buying
Partnership and Associate buy-in / buy-out
Mergers and Acquisitions
Organic growth tracking
Hospital integrations
Private and public reporting
Financing and Venture Capital
Estate and tax planning

Our Capability

We have the ability to provide extensive analysis of value components in healthcare practices and provide appraisals based on business, economic, and market conditions. This involves detailed examination of financials and clinical data in the context of numerous factors including medical specialty, physician supply and demand, payer mix, regulatory environment, regional dynamics, and risk premium.

Assessment

Our methods and approaches adhere to accepted standards of healthcare practice appraisal and utilize direct market data to reach justifiable conclusions. These are documented in a comprehensive report which is tailored to meet the need of the specific engagement.

BLUNDERS TO AVOID: Medical Practice Valuation Blunders[1]

SAMPLE ENGAGEMENTS: See partial engagement list below.

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

Thank you for your consideration

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MORTGAGE BACKED SECURITIES: Prepayment Risk

Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITION

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Prepayment risk is typically used in reference to mortgage-backed securities. It refers to the risk that mortgage refinancing activity might increase when market interest rates decline, which is generally not favorable for MBS investors.

For example, when homeowners refinance their mortgages, MBS investors are “prepaid,” shortening the life of their investments and forcing investors to reinvest the proceeds under lower interest rate conditions than what were most likely prevailing at the time of the original MBS investment.

Price adjustments for prepayment risk are one factor that helps explain why MBS, despite their generally high credit quality, have higher yields than comparable-maturity Treasury securities.

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The TIPPING POINT: Meanings Vary

Posted on November 22, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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A “Tipping point” has slightly varied meanings depending upon the field of study, but is frequently defined as a series of small changes in an evolutionary process that ultimately lead to a significant change or point beyond which new circumstances and conditions obtain.

For example, the point at which emerging economies go from being a long-time source of deflation to a source of inflation can be said to be an inflationary tipping point.

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The Tipping Point: How Little Things Can Make a Big Difference is the debut book by Malcolm Gladwell, first published by Litttle, Brown in 2000. Gladwell defines a tipping point as “the moment of critical mass, the threshold, the boiling point.” The book seeks to explain and describe the “mysterious” sociological changes that mark everyday life. As Gladwell stated: “Ideas and products and messages and behaviors spread like viruses do.”

Examples of such changes in his book include the rise in popularity and sales of Hush Puppies shoes in the mid-1990s and the steep drop in New York City‘s crime rate after 1990.

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INVESTMENT: Management Strategies

Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Active investment management strategies are the opposite of passive investment strategies. Active portfolio managers regularly take investment positions that clearly differ from those of the portfolio’s performance benchmark, with the objective of outperforming the benchmark over time.

Passive: https://medicalexecutivepost.com/2024/06/09/active-or-passive-investing-pursuits/

In addition to the upside potential of outperforming the benchmark, there’s also the downside possibility of under performing the benchmark. In an efficient market, there should be roughly the same magnitude of out performers and under performers for any given benchmark. But, markets are not always efficient.

Active non-transparent investment management strategies are Exchange Traded Funds that are actively managed by a portfolio manager or team of managers without daily disclosure of portfolio holdings. Active transparent strategies are daily disclosures of portfolio holdings as an attribute of traditional index-based Exchange Traded Funds (ETFs). Active transparent exchange traded funds are actively managed by a portfolio manager or team of managers. As with index-based ETFs, their portfolio holdings are disclosed daily.

Di-Worsification: https://medicalexecutivepost.com/2024/04/09/what-is-financial-portfolio-di-worsification-2/

NOTE: Absolute return as an investment vehicle seeks to make positive returns by employing investment management techniques that differ from traditional mutual funds. Absolute return investment techniques include using short selling, futures, options, derivatives, arbitrage, leverage and unconventional assets.

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

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GROSSMAN-STIGLITZ: Financial Information Paradox

Posted on November 21, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The Grossman-Stiglitz Paradox was introduced by Sanford J. Grossman and Joseph Stiglitz in a joint publication in American Economic Review in 1980 that argues perfectly informationally efficient markets are an impossibility since, if prices perfectly reflected available information, there is no profit to gathering information, in which case there would be little reason to trade and markets would eventually collapse.

IOW: According to colleague Eugene Schmuckler PhD MBA CTS, the Grossman-Stiglitz paradox is the inability to recoup the cost of obtaining market information and thus implies that efficient markets cannot exist.

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PSYCHOLOGY: Retrospective Framing

Posted on November 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Ever notice how memories change over time? That’s retrospective framing.

According to Dan Ariely PhD, our brains are like movie editors, constantly tweaking the past to fit our current narrative. Recall that terrible vacation where everything went wrong? Fast forward and now it’s a hilarious adventure. This mental editing helps us make sense of our lives and learn from our experiences.

So, just remember, the past is a story we keep rewriting, and sometimes those edits can be more fiction than fact

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CHARGE MASTER: Medical Bills Paradox

Posted on November 20, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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CHARGE MASTER MEDICAL BILLS

Classic Definition: A comprehensive review of a physician, clinic, facility, medical provider or hospital’s charges to ensure Medicare billing compliance through complete and accurate HCPCS/CPT and UB-92 revenue code assignments for all items including supplies and pharmaceuticals. The charge master captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges

Modern Circumstance: A charge master quizlet (charge description master [CDM]) document that contains a computer-generated list of procedures, services, and supplies with charges for each. Charge master rates are essentially the health care market equivalent of Manufacturer’s Suggested Retail Price (MSRP) in the car buying market. Poor charge master maintenance can lead to overpayments or underpayments. It can also lead to claim rejections from insurance companies, poor patient experience, or compliance violations.

Paradox Examples:

Superbills: An encounter form that is the financial record source document used by healthcare providers and other personnel to record treated diagnoses and services rendered to the patient during the current encounter. It is also called a superbill.
Payment rates: Almost no one actually pays the publicized charge master rates. The vast majority of health care consumers are represented by a payer of some kind, such as a commercial health insurance company, Medicaid, or Medicare. Commercial insurers negotiate the actual prices they pay during the process of contracting with providers. Medicare and Medicaid establish their own payment levels independent of hospitals’ charge master lists – Medicare through the federal government and Medicaid through state governments.
Cash pay: The sad irony of the charge master is that the uninsured are the most likely to be billed charge master rates because they are not represented by a third-party payer.
Problematic features: Other items also impede the ability of payers to have a comprehensive and accurate understanding of hospitals’ financial positions. For example, nonprofit hospitals are required to report charity care, bad debt expenses, community benefit initiatives, and uncompensated care. When these expenses are reported at the charge master level, expenses can be paradoxically overstated, potentially making a hospital’s financial position look worse than it actually is.

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PARADOX: Throw Away Endowment

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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A trader can gain by throwing away some of his/her initial endowment.

SAMPLE: There is an economy with two commodities (x and y) and two traders (e.g. Alice and Bob).

In one situation, the initial endowments are (20,0) and (0,10), i.e, Alice has twenty units of commodity x and Bob has ten units of commodity y. Then, the market opens for trade. In equilibrium, Alice’s bundle is (4,2), i.e, she has four units of x and two units of y.
In the second situation, Alice decides to discard half of her initial endowment – she throws away 10 units of commodity x. Then, the market opens for trade. In equilibrium, Alice’s bundle is (5,5) – she has more of every commodity than in the first situation.

The “throw away paradox” was first described by Robert J. Aumann and B. Peleg as a note on a similar paradox by David Gale.

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CBOE: Chicago Board Options Exchange [Volatility Indexes]

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

RELATED DEFINITIONS

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Volatility indexes are forward-looking measures of the market’s expectations of volatility (or how much a stock index’s price moves). The CBOE manages and publishes three of the most widely used volatility indexes based on three major stock indexes:

The VIX Index tracks the expected 30-day future volatility of the S&P 500 Index.

The VXN Index tracks the expected 30-day future volatility of the NASDAQ-100 Index.

The VXD Index tracks the expected 30-day future volatility of the Dow Jones Industrial Average Index.

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

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Financial Planning Textbook: https://tinyurl.com/549p78u9

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SECURITY ORDERS: Stop-Loss and Stop-Limit

Posted on November 19, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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A Stop order, also known as a “stop-loss order,” a stop order is an order placed with a bank or brokerage firm to either buy or sell a security after it reaches a specified price. Once the price is reached, the stop order becomes a market order, meaning there is no guarantee that an order will be completely filled at the specified stop price.

MORE: https://medicalexecutivepost.com/2024/08/30/stock-orders-positions-doctors-should-know/

A Stop-limit order is order placed with a bank or brokerage firm to buy or sell a fixed amount of an investment after it reaches a specified or better price, combining the features of a stop order and a limit order.

MORE: https://medicalexecutivepost.com/2024/08/07/about-securities-order-and-position-types/

A stop-limit order requires investors to set two price points: the first initiates the stop (the order to buy or sell) and the second sets the limit, or price beyond which the investor would not like to buy or sell. The investor also sets a time frame for which the order is valid before being cancelled. If the investor’s price cannot be met during the specified time frame, the order will be cancelled.

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

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NOVEMBER: National Alzheimer’s Awareness Month

Posted on November 17, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

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The number of people living with Alzheimer’s disease is growing. The ripple effect is straining families, communities, and the healthcare system, yet talking about the disease on a personal level can be difficult.

November is Alzheimer’s Awareness Month because it can happen in any family, and because it’s worth talking about the challenges of living with or caring for someone with this disease.

You may notice splashes of teal and purple sprouting up this November, as both colors are associated with Alzheimer’s awareness. Teal is the color of the Alzheimer’s Foundation of America, chosen for its calming effect. Purple is the signature color of the Alzheimer’s Foundation, which stands for strength in the fight against Alzheimer’s disease.

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PATTERNICITY: Apophenia vs. Pareidolia

Posted on November 16, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Patternicity is our brain’s tendency to find patterns in random data. It’s why we see faces in clouds or think the stock market follows our horoscope. According to colleague Dan Ariely PhD, this quirk helped our ancestors survive by recognizing predator shapes in the bushes, but in modern times, it can lead us astray. Our brains love making connections, sometimes too much, seeing patterns where none exist.

So, when you’re convinced that your lucky socks influence your team’s performance, remind yourself: it’s just your brain’s patternicity at work.

Apophenia vs. Pareidolia

Now, “Apophenia is the general term for the human tendency to see patterns in meaningless data that may involve visual, auditory, or other senses,” according to Dr. Harold Hong, a psychiatrist from Raleigh, North Carolina. He points out that pareidolia is a specific form of apophenia that refers to seeing visual patterns in random or ambiguous visual stimuli, such as seeing a face in the clouds.

Apophenia and pareidolia are common occurrences, says Hong, and challenges often only present when someone becomes fixated on specific patterns or details that others perceive as random. “While both phenomena are natural human tendencies, they can become concerning if someone starts to fixate on specific patterns excessively,” he says, noting that apophenia may be prevalent in certain mental health conditions, such as obsessive-compulsive disorder (OCD).

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RESPONSE: Flight -OR- Fight?

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The Fight or Flight Response is our built-in alarm system, ready to spring into action at the first sign of danger. Whether it’s a charging lion or an impending deadline, our bodies react the same way – heart racing, adrenaline pumping, ready to fight or flee. This ancient survival mechanism is great for escaping predators but less helpful when dealing with modern stressors.

So, the next time you feel your heart racing over a tough email or stock market loss, remember: it’s just your caveman brain doing its thing.

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BIAS: Of “Social Proof” and Influencers

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

INVESTING DEFINITION

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Social Proof is a subtle but powerful reality that having others agree with a decision one makes, gives that person more conviction in the decision, and having others disagree decreases one’s confidence in that decision.

This bias is even more exaggerated when the other parties providing the validating/questioning opinions are perceived to be experts in a relevant field, or are authority figures, like doctors, attorneys, financial advisors, teachers and/or people on television. In many ways, the short term moves in the stock market are the ultimate expression of social proof – the price of a stock one owns going up is proof that a lot of other people agree with the decision to buy, and a dropping stock price means a stock should be sold.

According to colleague Dan Ariely PhD, when these stressors become extreme, it is of paramount importance that all participants in the financial planning and investing process have a clear understanding of what the long-term goals are, and what processes are in place to monitor the progress towards these goals.

Without these mechanisms it is very hard to resist the enormous pressure to follow the crowd; think social media and related influences.

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Convertible Securities, Bonds and Corporate Securities

Posted on November 15, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Convertible securities are those that can be converted at the investor’s choice into other investments, normally into shares of the issuer’s underlying common stock. Convertibles are typically issued as bonds or preferred stock.

Convertible bonds, which provide an ongoing stream of income, can be converted into a preset number of shares of the company’s common stock and have a maturity date. Unlike common stock, which pays a variable dividend depending on a corporation’s earnings, convertible preferred stock pays a fixed quarterly dividend. It can be converted into common stock at any time, but often are perpetual.

Corporate securities (corporate bonds and notes) are debt instruments issued by corporations, as distinct from those issued by governments, government agencies, or municipalities.

Corporate securities typically have the following features: 1) they are taxable, 2) they tend to have more credit (default) risk than government or municipal securities, so they tend to have higher yields than comparable-maturity securities in those sectors; and 3) they are traded on major exchanges, with prices published in newspapers.

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

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NOVEMBER: Lung Cancer Awareness Month

Posted on November 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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November is Lung Cancer Awareness Month, which according to the CDC, is the third most common cancer in the US. There are about one in five lung cancer deaths each year across the country, and November is dedicated to increasing screening, reducing smoking, and finding new treatments.

MORE: https://www.lung.org/

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INVESTMENT STRATEGIES: Market Neutral and Extended Equity

Posted on November 14, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Equity market neutral strategies seek to eliminate the risks of the equity market by holding up to 100% of net assets in long equity positions and up to 100% of net assets in short equity positions. These strategies attempt to exploit differences in stock prices by being long and short in stocks within the same sector, industry, market capitalization, etc. If successful, these strategies should generate returns independent of the equity market.

Equity market neutral portfolios have two key sources of return: 1) the Treasury Bill return (the interest on proceeds from short sales held in cash as collateral), and 2) the difference (the “spread”) between the return on the long positions and the return on the short positions. Stock picking, rather than broad market moves, should drive most of a market-neutral strategy’s total return (save for any return from the 100% cash position).

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

Extended Equity Strategies attempt to provide better returns than possible with long-only investments

An example of an extended equity strategy is a 130/30 portfolio, which gets its designation from taking a 130% long position and a 30% short position. In practice, this would mean $100mm invested in stocks that are viewed as attractive.

Next, the manager would borrow and sell short $30mm of unattractive stocks. Then the manager uses the proceeds from the short sale to buy an additional $30mm of attractive stocks. This results in a portfolio that has 130% long and 30% short exposure to stocks, or “extended” exposure to equities relative to a long-only, 100% stock portfolio.

Note: It’s important to point out that here is the risk of theoretical unlimited amount of loss with short selling, (i.e. the price of the short-sold stocks increases; the long position can only go down to $0).

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

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MEDICAL TESTS: The Surprise Paradox

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MARCINKOASSOCIATES.com

THE SURPRISE MEDICAL TEST PARADOX

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Classic Definition: A doctor announces to her hospitalized patient that there will be a painful medical test sometime during the following week. The patient begins to speculate about when it might occur, until another patient announces that there is no reason to worry because a medical surprise test is impossible.

The test cannot be given on Friday, because by the end of the day on Thursday we would know that the test must be given the next day. Nor can the test be given on Thursday, because, given that we know that the test cannot be given on Friday, by the end of the day on Wednesday we would know that the test must be given the next day. And likewise for Wednesday, Tuesday, and Monday!

Modern Circumstance: The patient spends a restful weekend not worrying about the test, yet is very surprised when it is given on Wednesday. How could this happen?

Paradox Example: There are various versions of this paradox; one of them, called the Hangman, concerns a condemned prisoner who is clever but ultimately overconfident. The implications of the paradox are as yet unclear, and there is virtually no agreement about how it should be solved.

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FINANCIAL YIELDS: All About Fixed Income Securities

Posted on November 13, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

SPONSOR: http://www.CertifiedMedicalPlanner.org

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Yield: For bonds and other fixed-income securities, yield is a rate of return on those securities. There are several types of yields and yield calculations. “Yield to maturity” is a common calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity.

Yield curve: A line graph showing the yields of fixed income securities from a single sector (such as Treasuries or municipals), but from a range of different maturities (typically three months to 30 years), at a single point in time (often at month-, quarter- or year-end). Maturities are plotted on the x-axis of the graph, and yields are plotted on the y-axis. The resulting line is a key bond market benchmark and a leading economic indicator.

Yield to maturity [real yield to maturity]: Yield to maturity is a common performance calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity. Real yield to maturity is simply yield to maturity minus any “inflation premium” that had been added/priced in. (See Real yield.)

Yield ratio: A ratio of one yield divided by another. Most often used as a relative value measurement.

Yield spread: A “spread,” in fixed income parlance, is simply a difference. Yield spreads measure yield differences, typically between debt securities with high credit ratings (which typically have lower yields) and those with lower ratings (which typically have higher yields). Yield spreads can also be measured between debt securities with different maturities (shorter-maturity securities typically have lower yields and longer-maturity securities typically have higher yields).

Yield trap: An investment that can lure investors with an attractive yield that may not be fundamentally sustainable, or that may lead to undesired price volatility. Yield traps can lurk in both the equity and fixed income markets. They have a tendency to prey on those who can least afford them, including retirement investors looking for increased relative income and stability, who may have been too focused on their income goals and not enough on stability.

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

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PHYSICIAN: Pay Cuts in 2025

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Doctors, Facing Another Pay Cut, Call for Permanent Medicare Payment Reform

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. CMS has finalized the calendar year 2025 Medicare Physician Fee Schedule rule that sets payment rates for next year and also outlines new policies focused on primary care, preserved telehealth flexibilities, and a strengthened Medicare Shared Savings Program (MSSP).

But, provider groups were quick to condemn CMS’ decision to go ahead with the pay cut, which was proposed in the draft rule released in July. In a statement, Bruce Scott, MD, president of the American Medical Association (AMA), pointed out that that while physicians are receiving a 2.8% payment cut next year, medical practice costs for physicians will increase by 3.5% in 2025. After adjusted for inflation, Medicare reimbursement to physicians has decreased 29% since 2001, the AMA says.

Source: Heather Landi, Fierce Healthcare [11/2/24]

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Take the Physician-Focused FINANCIAL PLAN “Challenge”

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Do You Have “What it Takes”?

Book Marcinko

DEM 2

By Professor David E. Marcinko MBBS DPM MBA MEd CMP®

Institute of Medical Business Advisors, Inc.

mba

www.CertifiedMedicalPlanner.org

cmp-logo16

My History

More than 20 years ago I crafted a comprehensive holistic financial plan for a young doctor colleague who was born in 1959. In fact, he was not even a medical student at the time; so “canned off-the-shelf plans”, computer generated software or generic spread sheets were not a viable creation option. It was all a granular, detailed, specific and cognitive work-product. Today, he is a board-certified internist.

So, in 2023, it is right and just to take a look back and see how well, or poorly, we’ve fared.

Now, I appreciate more than most how financial planning is a “process”; and not an isolated event. Yet, all sorts of “advisors” and “consultants” create and charge hefty fees for same, and on-going monitoring, every day.

The ME-P Challenge

Nevertheless, I challenge all you mid-career or senior financial planners /advisors to this competition; regardless of degree, certification or designation.

“Show me your financial plan” – AND – “I’ll show you my financial plan”

Here Comes the Judge

Then, our community of ME-P readers, subscribers, visitors and “judges” will decide the winner.

The contest is open to any financial advisor, planner, consultant, wealth manager, CFP®, CFA, insurance agent, CPA or CLU, ChFC, or stock-broker, etc., who is not afraid of transparency in his or her work product and purported expertise.

Of Financial Certifications and Designations

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Assessment

So, just send in a copy of any “blinded” physician-focused financial plan that is about 21 years old. We will post for all to see and review …. warts and all … including my own; three part mega-plan!

The winner will receive bragging rights, academic swagger, and expert promotion to our entire ME-P ecosystem and network of medical, business, law and graduate school communities; as well as physicians, nurses, healthcare executives and allied health care professionals.

An informed sought-after and lucrative sector – indeed!

IOW: Free publicity and positive “new-wave” PR – PRICELESS!

Of course, as an educator and professor of health economics and finance, we are pleased to present you with the deep medical business knowledge and detailed financial,managerial and accounting techniques used, with some real-life “tips and pearls” developed over the last two decades of R&D, right here:

MORE: Comprehensive Financial Planning Strategies for Doctors …[Best Practices from Leading Consultants and Certified Medical Planners™]

MORE: Risk Management Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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

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PART 1: My Sample Financial Plan I [Data gathering, goals and objectives]

PART 2: My Sample Financial Plan II [Data Analytics, Creation and Crafting]

PART 3: Request here: MarcinkoAdvisors@msn.com [Stress Testing and Completion]

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← Back

Thank you for your response. ✨

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BONDS: Zero Coupon [Pros & Cons]

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITIONS

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Zero-coupon securities (aka zeros) are debt securities [bonds] that, unlike most of their debt security counterparts, make no periodic interest payments to investors. Instead, they are sold at a deep discount (with an imputed interest rate priced into the discount), then redeemed for their full face value at maturity.

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

When held to maturity, a zero’s entire return comes from the difference between its purchase price and its value at maturity.

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ANGUS DEATON’S: Paradox

Posted on November 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Angus Deaton’s 1980s studies, including one called “Why is consumption so smooth?” gave birth to a concept called the Deaton Paradox — in short, sharp shocks to income didn’t seem to cause similarly large shocks to consumption.

IOW: Consumption varies surprisingly smoothly despite sharp variations in income.

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

According to David Henderson, this was an important development in understanding the actions of consumers, causing economists to rethink the “permanent income hypothesis” developed by Milton Friedman, which suggested that people spend based on their lifetime income.

And, Mike Bird wrote a good article on Deaton the highlighted the Nobel Prize in Economics Committee.

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ECONOMIC: Paradoxes all Financial Advisors Should Know

Posted on November 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

SPONSOR: http://www.CertifiedMedicalPlanner.org

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A paradox is a logic and self-contradictory statement or a statement that runs contrary to one’s expectation. It is a statement that, despite apparently valid reasoning from true or apparently true premises, leads to a seemingly self-contradictory or a logically unacceptable conclusion. A paradox usually involves contradictory-yet-interrelated elements that exist simultaneously and persist over time. They result in “persistent contradiction between interdependent elements” leading to a lasting “unity of opposites”.

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And so, as we plan for our financial future thru a New Year Resolution for 2025, it’s helpful to be cognizant of these paradoxes. While there’s nothing we can do to control or change them, there is great value in being aware of them, so we can approach them with the right tools and the right mindset.

According to Adam Grossman, here are seven [7] of the paradoxes that can bedevil financial decision-making, clients and financial advisors, alike:

There’s the paradox that all of the greatest fortunes—Carnegie, Rockefeller, Buffett, Gates—have been made by owning just one stock. And yet the best advice for individual investors is to do the opposite: to own broadly diversified index funds. More: https://tinyurl.com/285vftx4
There’s the paradox that the stock market may appear over valued and yet it could become even more overvalued before it eventually declines. And when it does decline, it may be to a level that is even higher than where it is today.
There’s the paradox that we make plans based on our understanding of the rules—and yet Congress can change the rules on us at any time, as the recent 2024 election results attest.
There’s the paradox that we base our plans on historical averages—average stock market returns, average interest rates, average inflation rates and so on—and yet we only lead one life, so none of us will experience the average.
There’s the paradox that we continue to be attracted to the prestige of high-cost colleges, even though rational analysis that looks at return on investment tells us that lower-cost state schools are usually the better bet.
There’s the paradox that early retirement seems so appealing—and has even turned into a movement—and yet the reality of early retirement suggests that we might be better off staying at our desks.
There’s the paradox that retirees’ worst fear is outliving their money and yet few choose the financial product that is purpose-built to solve that problem: the single-premium immediate annuity.

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

How should you respond to these paradoxes? As you plan for your financial future, embrace the concept of “loosely held views.”

In other words, make financial plans, but continuously update your views, question your assumptions and rethink your priorities.

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PRIMARY MEDICAL CARE: The Paradox

Posted on November 11, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP™

Sponsor: http://www.CertifiedMedicalPlanner.org

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Classic Definition: Despite rising costs, health care often is of poor quality. Evidence from a classic medical improvement outcomes study assessed care of patients with several chronic diseases. This study found that patients’ functional health status outcomes are similar to care rendered by specialists and generalists but that generalists use far fewer resources. Similar outcome at lower cost represents higher value.

Modern Circumstance: Current solutions to improving care quality may do more harm than good if they focus more on diseases than on people. Efforts to improve the parts (evidence-based care of specific diseases) may not necessarily improve the whole (the health of people and populations).

Expanding access to specialty care, for example, has been proposed as both a source of and a solution for deficiencies in quality of care. Primary care is touted as an essential building block of a high-value health care system even as it is undermined by systems attempting to improve the quality, effectiveness, and value of their health care..

Paradox Example: The above contradictions plague improvement efforts in health care systems around the world, particularly the United States The paradox is that compared with specialty care or with systems dominated by specialty medical care, primary care is associated with the following: (1) poorer quality care for individual diseases, yet (2) similar functional health status at lower cost for people with chronic disease, and (3) better quality, better health, greater health equity and lower costs for whole peoples and populations.

And so, this contradiction plagues improvement efforts in health care systems around the world, particularly the United States.

Cite: Kurt Stange MD PhD and Robert Ferrer MD MPH

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BRICS: Economics Defined

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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BRIC is an acronym for the economies of Brazil, Russia, India, China and South Africa,combined.

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

These are considered to be large developing economies that are part of a global, twenty-first century shift in economic power and influence away from the more established, traditional developed economies of the twentieth century.

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SORTINO: A Financial Risk Ratio

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINED

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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The Sortino Ratio is similar to the Sharpe Ratio, it is a measure of risk-adjusted performance which looks at returns through the lens of the risk taken to achieve that performance, but instead of volatility of return, it uses downside variance as its measure of risk.

SHARP RATIO: https://medicalexecutivepost.com/2021/11/08/introducing-the-sharp-index/

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MEMORY: Fallibility

Posted on November 10, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Memory is Fallible. Think you have a great memory? Think again.

According to psychologist and colleague Dan Ariely PhD, memory is more like a game of telephone than a recording device. Each time you recall an event, your brain makes tiny edits, adding some flair or skipping the boring parts. It’s why you can’t remember where you left your keys but can vividly recall an embarrassing moment from high school.

So, the next time someone says, “I remember it like it was yesterday,” know that yesterday might be a heavily edited rerun.

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REO versus REIT

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Real Estate Operating Company (REOC)

A company that invests in real estate and whose shares trade on a public exchange.

Real Estate Investment Trust (REIT)

A real estate operating company (REOC) is similar to a real estate investment trust (REIT), except that an REOC will reinvest its earnings into the business, rather than distributing them to unit holders like REITs do.

Also, REOCs are more flexible than REITs in terms of what types of real estate investments they can make.

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

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FINANCIAL Derivatives

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Derivatives are securities whose performance and/or structure is derived from the performance and/or structure of other assets, interest rates, or indexes. If used moderately and in appropriate situations, derivatives can help stabilize portfolios and/or enhance returns. However, if used in excess and/or in inappropriate circumstances, they can be harmful, potentially causing portfolio instability and/or losses. Derivatives are similar to medicine in their behavior–usually safe when used as directed, potentially toxic when abused.

There are many different types of derivative securities and many different ways to use them. Some derivative securities, such as mortgage-related and other asset-backed securities, are in many respects like any other investment, although they may be more volatile or less liquid than more traditional debt securities.

Futures and options are commonly used for traditional hedging purposes to attempt to protect portfolios from exposure to changing interest rates, securities prices or currency exchange rates, and for cash management purposes as a low-cost method of gaining exposure to a particular securities market without investing directly in those securities.

Certain other derivative securities may be described as structured investments. A structured investment is a security whose value or performance is linked to an underlying index or other security or asset class. Structured investments include collateralized mortgage obligations (CMOs). Structured investments also include securities backed by other types of collateral.

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

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FINANCIAL PLANNING AND ECONOMIC: Mental Health Blocks

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

Filed under: iMBA, Inc. | Tagged: anxiety, finance, health, Investing, mental health | Comments Off on FINANCIAL PLANNING AND ECONOMIC: Mental Health Blocks

KENNETH ARROW: Information Paradox

Posted on November 9, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

To sell information you need to give it away before the sale

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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THE FATHER OF HEALTH ECONOMICS

According to Wikipedia, a fundamental tenet of the paradox is that the customer, i.e. the potential purchaser of the information describing a technology (or other information having some value, such as facts), wants to know the technology and what it does in sufficient detail as to understand its capabilities or have information about the facts or products to decide whether or not to buy it. Once the customer has this detailed knowledge, however, the seller has in effect transferred the technology to the customer without any compensation. This has been argued to show the need for patent protection [HIPPA].

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

If the buyer trusts the seller or is protected via contract, then they only need to know the results that the technology will provide, along with any caveats for its usage in a given context. A problem is that sellers lie, they may be mistaken, one or both sides overlook side consequences for usage in a given context, or some unknown-unknown affects the actual outcome.

MORE :https://www.nobelprize.org/prizes/economic-sciences/1972/arrow/facts/

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ARTIFICIAL Scarcity

Posted on November 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Artificial Scarcity refers to the intentional limitation of the availability of a product or resource to create a sense of rarity, which often drives up its perceived value and price.

Think: surge pricing

And, circumstances with insufficient competition can lead to suppliers exercising enough market power to constrict supply. The clearest example is a monopoly, where a single producer has complete control over supply and can extract a additional price.

By creating a temporary shortage, sellers or producers can increase demand and capitalize on consumers’ fear of missing out, thereby influencing market dynamics to their advantage. This strategy is frequently used in marketing, particularly for limited-edition items or high-demand products.

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RECIPROCITY: Science “Sales” in Action

Posted on November 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

FREE SAMPLES

The Art of Giving – And Receiving – Value!

By Staff Reporters

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Imagine you’re at a party, and someone hands you a drink. Your first instinct? Find something to give back. This is [sales] reciprocity in action – our built-in psychological urge to repay kindness.

According to colleague Dan Ariely PhD, it’s like a cosmic balance sheet in our brains, ensuring we don’t owe anyone a favor. This is why companies give out free samples. They’re not just being nice; they know you’ll feel a pang of guilt if you walk away without buying something.

THINK: Free financial planning dinner seminar and prospecting event. That’s you – the Sales Prospect!

So, next time someone does you a favor, remember: it’s not just seller kindness, it’s science!

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CURRENCY OPTIONS: Hedging and Overlays

Posted on November 8, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Currency Hedging is a risk-management strategy, as part of a foreign investment strategy, currency hedging is designed to reduce the impact from changes in the relative values of currencies involved in the foreign investment strategy.

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

In any foreign investment strategy, a significant part of the potential risk and return comes from exposure to relative currency value fluctuations. If exposure to those currency fluctuations is minimized, investors can experience more of a “pure play” exposure to the foreign investments. There is a variety of possible currency hedging strategies, ranging from swaps, options, and spot contracts to simply buying foreign currencies.

Currency Overlay is a financial trading strategy used to separate the management of currency risk from other portfolio strategies. A currency overlay manager can seek to hedge the risk from adverse movements in exchange rates, and/or attempt to profit from tactical currency views.

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

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INVESTING NEWS: Stocks, Bonds, Oil, Gold, Bitcoin and Sectors Review Post Election

Posted on November 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

BREAKING NEWS!

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Stocks surged and stayed higher all yesterday day on news of Donald Trump’s presidential victory. The Dow rocketed over 1,350 points as soon as markets opened, and all three indexes ended the day at record highs.
Treasury yields have paralleled Trump’s chances of taking the White House for the last few weeks, and his election sent them soaring to over 4.46% at one point today.
Oil and gold both fell as the dollar rose after Trump’s win. The greenback popped on the promise of Trump’s protectionist tariff policies and the lower likelihood of the Fed cutting interest rates as fast as previously expected.
Bitcoin surged as traders celebrated the beginning of the new, friendlier regulatory environment that Trump promised during his campaign.

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

Sector check-up

Financials were the biggest sector mover Wednesday, up 6.16%, hitting a new high.
Industrials were up 3.93% Wednesday, hitting a new high.
Energy was up 3.54% in the session. It’s now 4.28% from the April high.
Real Estate fell 2.64% during trading. It’s now 5.6% from the high.
Consumer Staples fell 1.5%. The sector is 5.76% from the September high.
Utilities fell 1%. It’s now 5.72% from the mid-October high.
Duke Energy was flat over the past three months, and it is 6.3% from the October high.

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COCKTAIL: Party Effect

Posted on November 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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The cocktail party effect is the ability of the human hearing and auditory system to focus one’s listening attention on a particular speaker in a noisy environment, such as a crowded party. This allows people to focus on a specific conversation while filtering out other nearby conversations and background noise.

Consider that you’re at a crowded party, noise everywhere, but you hear your name mentioned across the room. How? Welcome to the Cocktail Party Effect.

Your brain is like a highly trained butler, filtering out the background chatter to catch something personally relevant. It’s not just your name, either; it could be juicy gossip or a mention of free pizza or an exciting new stock tip you’ve been considering; or even an IPO.

So, according to psychologist colleague Dan Ariely PhD, this selective attention keeps us sane in a noisy world, helping us focus on the things that matter – like whether that person just said “free drinks” or “freeloading, or “free-stock trading.”

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DAILY UPDATE: Record Stock Market Blast Off Post Trump Presidential Election

Posted on November 7, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Stocks Up

One more group of stocks that soared on a Trump election: Big Tech companies with antitrust problems. Another Trump presidency should go a long way toward clearing up the regulatory hurdles many companies have faced recently, which is why Alphabet popped 3.99% and Amazon rose 3.8%.
CVS Health surged 11.33% after meeting revenue forecasts but missing earnings expectations. However, the miss was due to a one-time charge, so shareholders quickly forgave the healthcare retailer.
Planet Fitness gained 6.09% on a surprise bid for bankrupt fitness chain Blink Holdings in an attempt to bolster its own gym business.

Stocks Down

Super Micro Computer had a chance to show the world it wasn’t committing the fraud it has recently been accused of. Instead, the company announced it is still unable to determine when it will file the quarterly report due August 29. Shares crashed 18.05%.
Home builder stocks sank on fears that a Trump presidency will slow the rate of Fed rate cuts, keeping mortgage rates higher for longer. DR Horton fell 3.8%, Lennar dropped 4.84%, Pulte Group lost 3.09%, and Toll Brothers tumbled 1.46%.
Cannabis stocks were betting big on a ballot measure in Florida to allow the sale of recreational marijuana. The initiative’s failure sent shares of Curaleaf plummeting 29.17%, Trulieve Cannabis plunged 38.8%, and Ayr Wellness sank 55.87%.

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

Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) rose 146.28 points (2.53%) to 5,929.04; the Dow Jones Industrial Average^® ($DJI) added 1,508.05 points (3.57%) to 43,729.93; and the NASDAQ Composite^® ($COMP) gained 544.29 points (2.95%) to 18,983.47—a new closing high.
The 10-year Treasury note yield (TNX) surged 14 basis points to 4.43%, its highest level since July.
The CBOE Volatility Index^® (VIX) fell sharply to 16.3 as election-related uncertainty diminished.

CITE: https://tinyurl.com/tj8smmes

Visualize: How private equity tangled banks in a web of debt, from the Financial Times.

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HINDSIGHT BIAS: The “Curse of Knowledge”

Posted on November 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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The Curse of Knowledge and Hindsight Bias

Similar in ways to the availability heuristic (Tversky & Kahneman, 1974) and to some extent, the false consensus effect, once you (truly) understand a new piece of information, that piece of information is now available to you and often becomes seemingly obvious. It might be easy to forget that there was ever a time you didn’t know this information and so, you assume that others, like yourself, also know this information: the curse of knowledge.

Cite: https://medicalexecutivepost.com/2022/11/18/what-is-the-dunning-kruger-effect/

However, according to colleague Dan Ariely PhD, it is often an unfair assumption that others share the same knowledge. The hindsight bias is similar to the curse of knowledge in that once we have information about an event, it then seems obvious that it was going to happen all along.

I should have seen it [divorce, stock market crash/soar my smoking & lung cancer, unemployment, etc] coming!

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STOCK MARKETS: Roaring and Soaring!

Posted on November 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BREAKING FINANCIAL NEWS

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Stocks just roared out of the gate this Wednesday morning following news that former President Donald Trump has secured a second term in the White House and Republicans won a majority in the Senate.

The Dow Jones Industrial Average rose 1,341 points, or about 3.1 percent, as the market opened, reaching a record high. It was the first time it has jumped more than 1,000 points in a single day since November 2022.

The S&P 500 also gained 1.9 percent, and the NASDAQ climbed 1.8 percent.

Despite concern from big business about Trump’s plan to impose blanket tariffs on imports to the U.S., Wall Street is anticipating tax cuts and deregulation during a second Trump presidency.

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INVESTING RISKS: Retained Earnings, Weighted Assets and Sequence of Return

Posted on November 6, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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Retained Earnings Risk: Profits generated by a company that are not distributed to stockholders as dividends. Instead, they are either reinvested in the business or kept as a reserve for specific objectives, such as paying off debt or purchasing equipment. Retained earnings risks are also called “undistributed profits,” “undistributed earnings,” or “earned surplus.”

Risk-Weighted (or risk-adjusted) Assets: Within the context of measuring the financial stability of banks and other financial institutions, the risk-weighted assets figure is an aggregate of a financial institution’s assets (usually loans to its customers) after the loans have been individually adjusted for their risk. This involves multiplying each loan by a factor that reflects its risk. Low-risk loans are multiplied by a low number, high-risk by high. The aggregate number can then be used to calculate the financial institution’s capital ratio. Lower risk-weighted assets typically result in higher capital ratios, and higher risk-weighted assets usually translate to lower capital ratios.

Sequence-of-Returns Risk: The risk of market conditions impacting the overall returns of an investment portfolio during the period when a retiree is first starting to withdrawal money from investments as income. For example, if a retiree has to withdrawal income from his or her portfolio when market prices are depressed, the portfolio may lose out on the potential returns that income could have made once market prices recovered.

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METAVERSE MEDICINE: A Paradigm Shift?

Posted on November 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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In what some are calling the next iteration of the internet, the metaverse is an unfamiliar digital world where you could be an avatar navigating computer-generated places and interacting with others in real time. In this space, the constraints of our physical, bricks and mortar world and travel habits fade. And new opportunities and challenges emerge.

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

For example:

Google in healthcare: The search giant has repeatedly successfully transferred its in-depth knowledge of algorithms in the field of medicine, particularly since it acquired DeepMind.

Apple in healthcare: Apple will keep on working on expanding the health features of its devices, Apple Watch and iPhones included.

Microsoft in healthcare: Microsoft’s cloud solutions provide integrated capabilities that make it easier to improve the healthcare experience.

Amazon in healthcare: Amazon will make further use of its vast knowledge of online shopping trends and behavior and will keep on providing what people need, from medicine to wearables.

IBM in healthcare: IBM has a lot to offer in federated learning, blockchain, and quantum computing.

Nvidia in healthcare: NVIDIA seems incredibly focused on its approach to healthcare. We can expect NVIDIA to be a leader in the use of artificial intelligence in healthcare.

Facebook in healthcare: The Metaverse developed by Facebook/Meta has incredible potential to revolutionize healthcare.

All this technology has huge potential because it uses both virtual reality (VR) and augmented reality (AR) technology to work in virtual spaces: All signs point to the metaverse being widely used as a disruptive change in healthcare, from better surgical precision to therapeutic uses to social-distance accommodations and more.

But along with these improvements come new problems that will change what we know about modern healthcare. The metaverse is a paradigm shift in healthcare that everyone involved needs to be aware of. This is because it changes how medical infrastructure is built, how startup costs are covered, and how data security and privacy are handled.

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

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GDP: Private Domestic Health Care Investments

Posted on November 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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GROSS PRIVATE DOMESTIC HEALTH CARE INVESTMENTS

Classic: Investment purchases and private expenditures of healthcare firms, the value of related construction, and the change in inventory during the year.

Modern: Gross Revenue Per Day is the average amount charged by a hospital for one day of inpatient care (gross inpatient revenue divided by patient-census days).

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

Examples:

Gross Revenue Per Discharge: The average amount charged by a hospital to treat an inpatient from admission to discharge (gross inpatient revenue divided by discharges).
Gross Revenue Per Visit: The average amount charged by a hospital for an outpatient visit (gross outpatient revenue divided by outpatient visits).

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ARTIFICIAL INTELLIGENCE: Big Technology Stocks

Posted on November 5, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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After its AI-related earnings disappointed Wall Street last quarter, Big Tech doubled down in the latest period:

Amazon spent $22.6 billion on property and equipment like data centers and chips. That’s an 81% spike from the same time last year.
Meta raised its low-end guidance for capex (capital expenditures), which could reach $40 billion by the end of the year. It beat earnings estimates, even with AR glasses subsidiary Reality Labs costing $4.4 billion in operating losses.
Apple is still betting on Apple Intelligence to boost sales. Most revenue came from the new iPhone 16, Apple Watch, and AirPods, but Apple services like TV+ and iCloud also grew massively to account for a quarter of the business.
Google crushed earnings estimates and revealed that more than 25% of all new code it writes is generated by AI (and reviewed by engineers).

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ECONOMICS: John B. Taylor’s Rule

Posted on November 4, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Named for a U.S. economist, the JB Taylor Rule is a mathematical monetary-policy formula that recommends how much a central bank should change its nominal short-term interest rate target (such as the U.S. Federal Reserve’s federal funds rate target) in response to changes in economic conditions, particularly inflation and economic growth. It’s typically viewed as guideline for raising short-term interest rates as inflation and potentially inflationary pressures increase. The rule recommends a relatively high interest rate (“tight” monetary policy) when inflation is above its target or when the economy is above its full employment level, and a relatively low interest rate (“easy” monetary policy) under the opposite conditions.

To illustrate, the monetary policy of the FOMC, changed throughout the 20th century. The period between the 1960s and the 1970s is evaluated by Taylor and others as a period of poor monetary policy; the later years typically characterized as stagflation. The inflation rate was high and increasing, while interest rates were kept low. Since the mid-1970s monetary targets have been used in many countries as a means to target inflation.

However, in the 2000s the actual interest rate in advanced economics, notably in the US, was kept below the value suggested by the Taylor rule.

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“R-Squared” [Coefficient of Determination] Defined

Posted on November 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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R-squared is an investment portfolio performance and risk measure that indicates how much of a portfolio’s performance fluctuations were attributable to movements in the portfolio’s benchmark index. R-squared can range from 0-100%.

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

IOW: R Squared, also known as the coefficient of determination, is a statistical measure used in the context of regression analysis. It represents the proportion of the variance in the dependent variable that is predictable from the independent variable(s). Essentially, it provides a measure of how well the observed outcomes are replicated by the model, based on the proportion of total variation of outcomes explained by the mode

For example, an R-squared of 100% indicates that all portfolio performance movements were attributable to movements in the benchmark index—they correlate perfectly to the benchmark.

Conversely, an r-squared of 0% indicates that there is no correlation between the performance movements of the portfolio and the benchmark.

Cite: http://www.CertifiedMedicalPlanner.org

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PHYSICIANS: Career Change Conundrum

Posted on November 3, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: https://marcinkoassociates.com/process-what-we-do/

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Half of Physicians Plan to Change Career Paths

The Physicians Foundation conducted a survey on physician practice patterns and perspectives a few years ago. Here are some key findings from the report:

• 31% of physicians identify as independent practice owners or partners.
• Almost half (47%) of physicians plan to change career paths.
• 78% of physicians sometimes, often or always experience feelings of burnout.
• Nearly a quarter of physician time is spent on non-clinical paperwork.

This result is not good for Medicine.

Cite: The Physicians Foundation, September 2018

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