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The S&P 500 heads into the week at its highest level of the year after Friday’s solid jobs report suggested that the Fed could be all clear for a “soft landing”—bringing inflation back to normal without sending the economy into a recession. The S&P and Dow have posted gains for six straight weeks, their longest streak since 2019.
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But, the week’s big winner was Paramount, which spiked on reports that Shari Redstone might sell the entertainment giant.
A strong online presence is crucial for any medical or healthcare businesses, but many are struggling to figure out where to invest their marketing dollars. It is important to diversify marketing efforts and not rely solely on one channel, as changes in the industry are inevitable. Search marketing, direct marketing, and social media are three key components that healthcare organizations should incorporate in their marketing campaigns.
Search marketing has evolved over the years with changes in Google’s algorithms and the saturation of the market, requiring a focus on quality content and the expertise of an expert.
Direct marketing is becoming more popular, with lead generation companies and email marketing being effective and budget-friendly tactics. Social media is constantly evolving and increasing in price, with networks like Facebook and Twitter pushing paid advertisements.
While social media should not be the focal point of a healthcare organization’s marketing campaign, it is an integral component that can contribute to search engine rankings.
***
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Overall, a well-rounded marketing strategy that incorporates these three elements is crucial for success. A strong online presence is crucial for healthcare businesses, and diversifying marketing efforts across search marketing, direct marketing, and social media is important for success. Search marketing has changed with Google’s algorithms and increased ad costs, while direct marketing and social media have become more popular. Social media also affects search engine rankings.
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].
After grappling with high inflation for more than two years, American consumers are now seeing an economic trend that many might only dimly remember: falling prices — but only on certain types of products.
Deflation is impacting so-called durable goods, or products that are meant to last more than three years, Wall Street Journal reporter David Harrison told CBS News. As Harrison noted in his reporting, durable goods have dropped on a year-over-year basis for five straight months and dropped 2.6% in October from their September 2022 peak.
These items are products such as used cars, furniture and appliances, which saw big run-ups in prices during the pandemic. Used cars in particular were a pain point for U.S. households, with pre-owned cars seeing their prices jump more than fifty percent in the first two years of the pandemic.
Here is where the major benchmarks ended:
The S&P 500 Index was up 36.25 points (0.8%) at 4,585.59; the Dow Jones Industrial Average was up 62.95 points (0.2%) at 36,117.38; the NASDAQ Composite was up 193.28 points (1.4%) at 14,339.99.
The 10-year Treasury note yield (TNX) was up about 2 basis points at 4.144%.
The CBOE® Volatility Index (VIX) was up 0.09 at 13.06.
Tech sector strength was highlighted by the Philadelphia Semiconductor Index (SOX), which gained nearly 3%. Financial shares were also among the strongest performers, as the KBW Regional Banking Index (KRX) rose 2% and ended at a four-month high. In other markets, WTI crude oil futures (/CL) posted the market’s first gain in six days after earlier dropping to its lowest level since late June.
Apple regains a $3 trillion market cap and is on track to end the year as the world’s most valuable company for the 5th time in a row.
Today marks the 82nd anniversary of the attack on Pearl Harbor that drew the US into WWII.
Here’s where the major benchmarks ended:
The S&P 500® index (SPX) was down 17.84 points (0.4%) at 4,549.34; the Dow Jones Industrial Average® (DJI) was down 70.13 points (0.2%) at 36,054.43; the NASDAQ Composite® (COMP) was down 83.20 points (0.6%) at 14,146.71.
The 10-year Treasury note yield (TNX) was down about 5 basis points at 4.117%.
The CBOE® Volatility Index (VIX) was up 0.10 at 12.95.
Energy shares were again among the market’s weakest performers as crude oil futures extended a slump, closing below $70 per barrel for the first time since late June on concerns over slowing global demand. And, Liz Ann Sonders of Schwab said a “somewhat stealthy” rotation continued under the market’s surface, with the S&P 500® Equal Weight (SPXEW) and Russell 2000®(RUT) indexes outperforming both the S&P 500 and NASDAQ over the past month or so. She also noted a defensive tone to Wednesday’ trading, illustrated by strength in utilities and weakness in technology.
Nearly 60% of doctors who practice as employees of hospitals and other corporate entities say that non-physician practice ownership results in lower quality patient care, per a new survey commissioned by the Physicians Advocacy Institute. Loss of face time with patients and greater focus on finances negatively impact quality, they say.
Here is where the major benchmarks ended:
Here’s where the major benchmarks ended:
The S&P 500 index was down 2.60 points (0.1%) at 4,567.18; the Dow Jones Industrial Average was down 79.88 points (0.2%) at 36,124.56; the NASDAQ Composite® (COMP) was up 44.42 points (0.3%) at 14,229.91.
The 10-year Treasury note yield was down about 11 basis points at 4.18%.
The CBOE® Volatility Index (VIX) was down 0.23 at 12.85.
Energy shares were among Tuesday’s weakest performers on pressure from slumping crude oil futures, which dropped for a fourth consecutive day and hit a five-month low amid concern over global demand. Retail and transportation sectors were also soft. Technology and consumer discretionary shares were among the few gainers.
Here is where the major benchmarks ended yesterday:
The S&P 500® index (SPX) was down 24.85 points (0.5%) at 4,569.78; the Dow Jones Industrial Average® (DJI) was down 41.06 points (0.1%) at 36,204.44; the NASDAQ Composite (COMP) was down 119.54 points (0.8%) at 14,185.49.
The 10-year Treasury note yield (TNX) was up about 4 basis points at 4.264%.
The BOE® Volatility Index (VIX) was up 0.45 points at 13.08.
Technology and communications services shares were among the weakest performers Monday, with the Philadelphia Semiconductor Index (SOX) dropping 1.2%, its lowest level since mid-November.
By contrast, many smaller companies held up better. The small-cap-focused Russell 2000® Index (RUT) rose 1% and ended at a three-month high, extending a recent upswing. In other markets, gold futures (GC) plunged after earlier posting an intraday record above $2,152 an ounce.
The Internal Revenue Service (IRS) is raising the stakes for those who underpay their taxes by ratcheting up the interest penalty that will be assessed in next spring’s tax filing season. Earlier this fall, the IRS increased its interest penalty on estimated tax underpayments to 8% – a notable jump from 3% just two years ago. The IRS indicated that the interest rate penalty is determined every quarter and that for taxpayers other than corporations the assessed rate is the federal short-term rate plus three percentage points.
***
Speaking of a possible US economic “soft-landing“, the S&P 500closed at a 2023 high on Friday, the VIX (Wall Street’s “fear gauge”) has fallen to a nearly four-year low, and December has been the third-best month for the S&P since 1928. Even crypto is on a roll as bitcoin topped $40,000 for the first time since May 2022.
As we reported, the S&P 500 had its best day of the year on Friday as stocks kept their November rally rolling right into December. Pfizer, however, fell to its lowest since March 2020 after announcing that it’s pulling the plug on its experimental twice-a-day weight loss pill because it caused too many negative side effects even as pharmaceutical companies are rushing to serve the growing weight loss market.
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And, Panera Breadfiled IPO paperwork, the Financial Times reported. And it’s not the only household name that’s anticipated to hit brokerage apps next year as more companies are once again considering going public. The past two years have been an IPO stale mate as rising interest rates led to a tepid market for newcomers. Last year, Panera itself aborted a public listing it was planning via a special purpose acquisition company [SPAC] due to harsh market conditions.
But, things might be different in 2024. Fast-fashion behemoth Shein also recently filed paperwork for what could be a blockbuster IPO that raises as much as $90 billion, per Bloomberg. The publication says that more companies are rumored to be thinking about joining the potential IPO bonanza. For example:
Kim Kardashian might list her $4 billion undergarment brand, Skims.
Reddit is supposedly flirting with the idea of going public. It would be the first major social media IPO in years, and it’s been in the offing since last year, when Reddit was valued at $15 billion.
However, all IPOs have not done well:
The Birkenstock and Instacart IPOs fell short of expectations according to investment data from Dealogic
Three out of four companies that IPOed this year were trading below their offer prices as of the middle of last month.
Companies debuting on the public markets raised a meager $20 billion so far this year, a slight rebound from 2022 but a ~90% decline from 2021.
There’s almost $6 trillion of cash sitting on the sidelines in money-market funds, with the potential for some portion of it to be reallocated into “carefully selected risk assets.”
This is according to Ali Dibadj, chief executive of London-based Janus Henderson Investors, which had $308.3 billion in assets under management as of September. About $187.9 billion, or 61%, of that was in equity strategies.
***
Here’s where the major benchmarks ended:
The S&P 500 index was up 26.83 points (0.6%) at 4,594.63, up 0.8% for the week; the Dow Jones Industrial Average® (DJI) was up 294.61 points (0.8%) at 36,245.50, up 2.4% for the week; the NASDAQ Composite was up 78.81 points (0.6%) at 14,305.03, up 0.4% for the week.
The 10-year Treasury note yield was down about 14 basis points at 4.213%.
The CBOE® Volatility Index (VIX) was down 0.27 at 12.65.
Friday’s gains followed the market’s strongest month of the year, as the S&P 500 and NASDAQ surged 8.9% and 10.7% in November, respectively, their best monthly performances since July 2022. Among sectors, the KBW Regional Bank Index (KRX) jumped 5.3% Friday, and retail shares were also among the top gainers.
Shares of smaller companies extended a recent rally as the small-cap-focused Russell 2000® Index (RUT) gained 3.1% for the week and ended at a 2-1/2-month high.
The Fed’s preferred inflation measure increased 3% in October, down from 3.4% in September and getting closer to the central bank’s much-ballyhooed target of 2%. A drop in gas prices—down 4.9% from the previous month—was a major factor. Increases in core prices, which strip out food and energy costs, also slowed last month. In the last six months, core inflation has grown at a 2.5% annual rate—down significantly from 5.1% last year.
The news means the Fed will likely keep interest rates unchanged at its final 2023 meeting on December 12t and 13th.
The S&P 500 index was up 17.22 points (0.4%) at 4,567.80, up 8.9% for the month; the Dow Jones Industrial Average was up 520.47 points (1.5%) at 35,950.89, up 8.8% for the month; the NASDAQ Composite was down 32.27 points (0.2%) at 14,226.22, up 10.7% for the month.
The 10-year Treasury note yield (TNX) was up about 6 basis points at 4.33%.
CBOE® Volatility Index (VIX) was down 0.07 at 12.91.
The Dow’s gain Thursday was driven in part by Salesforce (CRM), which soared nearly 9% after the cloud software company reported stronger-than-expected quarterly results. The technology sector was otherwise soft, with the NASDAQ-100® (NDX) down 0.7% but still up 10.7% for the month. Small-cap stocks also posted a firm November, illustrated by a monthly gain of nearly 9% in the Russell 2000® Index (RUT).
And, Nathan Peterson, director of derivatives analysis at the Schwab Center for Financial Research, said the weakness in tech shares likely reflected consolidation after firm gains earlier this month. The NASDAQ Composite may also face some technical resistance around 14,350, a level where sellers stepped in back in July.
A ransomware attack has caused a health care chain, which operates 30 hospitals in six states, to move patients from some of its emergency rooms to other hospitals, while putting certain procedures on pause, the company announced.
According to a statement from Ardent Health Services, the attack happened on November 23rd. The company said as a result of the attack, it took its network offline and suspended user access to its information technology applications, including the software used to document patient care.
***
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Here is where the major benchmarks ended:
Here’s where the major benchmarks ended:
The S&P 500® index was down 4.31 points (0.1%) at 4,550.58; the Dow Jones Industrial Average was up 13.44 points at 35,430.42; the NASDAQ Composite ® was down 23.27 points (0.2%) at 14,258.49.
The 10-year Treasury note yield (TNX) was down about 8 basis points at 4.261%.
CBOE ® Volatility Index (VIX) was up 0.29 at 12.98.
At Marcinko & Associates our clients traditionally includephysicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.
The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].
Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.
***
But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.
***
Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.
Apple is pulling the plug on its credit card partnership with Goldman Sachs Group, the Wall Street Journal reported on Tuesday. The tech giant recently sent a proposal to the Wall Street bank to exit the contract in the next 12 to 15 months, the report said, citing people briefed on the matter.
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Senators Elizabeth Warren (Democrat) and Mike Braun (Republican) sent a letter to the US Department of Health and Human Services last week, asking it to investigate whether large insurance companies are hiking prescription drug prices at pharmacies they own
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Here is where the major benchmarks ended:
Here’s where the major benchmarks ended:
The S&P 500® index (SPX) was up 4.46 points (0.1%) at 4,554.89; the Dow Jones Industrial Average was up 83.51 points (0.2%) at 35,416.98; the NASDAQ Composite® (COMP) was up 40.73 points (0.3%) at 14,281.76.
The 10-year Treasury yield was down about 6 basis points at 4.33%.
The CBOE® Volatility Index (VIX) was little-changed at 12.69.
Semiconductor and transportation shares were among the weakest performers Tuesday, and regional banks were also under pressure. Small cap stocks also lagged. The Russell 2000® Index (RUT) fell about 0.4% for its lowest close in a week.
Retailers and utilities were among the firmest sectors. In other markets, the U.S. Dollar Index (DXY) weakened to its lowest level since mid-August, reflecting expectations that U.S. interest rates have peaked.
Posted on November 28, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
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By Staff Reporters
Giving uesday is a Movement that Unleashes the Power of Radical Generosity Around the World
Giving Tuesday re-imagines a world built upon shared humanity and generosity.
***
A global network collaborates year-round to inspire generosity around the world, with a common mission to build a world where generosity is part of everyday life.
Whether it’s making someone smile, helping a neighbor or stranger out, showing up for an issue or people we care about, or giving some of what we have to those who need our help, every act of generosity counts, and everyone has something to give.
Wall Street is gearing up for rate cuts. Yep! Twenty months after the Federal Reserve began a historic campaign against inflation, investors now believe there is a much greater chance that the central bank will cut rates in just four months than raise them again in the foreseeable future.
Interest-rate futures indicated last week a roughly 60% chance the Fed will lower rates by a quarter-of-a-percentage point by its May 2024 policy meeting, up from 29% at the end of October, according to CME Group data. The same data has pointed to four cuts by the end of the year. And, investors, battered by the Fed’s efforts to slow the economy, have reacted by driving the S&P 500 up nearly 9% this month. That is despite the wagers reflecting different possible paths for the economy, not all of them favorable for stocks.
Of course, investors look ahead to the release this week of key US inflation data that could provide a guide for the Federal Reserve’s plans for interest rates going into the new year.
The S&P 500 Index was down 8.91 points (0.2%) at 4,550.43; theDow Jones Industrial Average® (DJI) was down 56.68 points (0.2%) at 35,333.47; the NASDAQ Composite® was down 9.83 points (0.1%) at 14,241.02.
The 10-year Treasury note yield (TNX) was down about 10 basis points at 4.387%.
CBOE Volatility Index® (VIX) was up 0.23 at 12.69.
Transportation shares were among the weakest performers Monday, and energy was also soft behind a drop in crude oil futures. Weakness in many retail stocks suggested some concern over consumer spending given high interest rates and slower job growth. The S&P Retail Select Index (SPSIRE) fell 0.6% but is still up 8.2% for the month. Consumer discretionary and real estate shares were among the few gainers.
Many wanted to discount Black Friday this year, but discounts only made it stronger. Despite analysts’ tepid outlook, the shopping holiday generated a record $9.8 billion in online sales in the US, a 7.5% increase over a year ago, according to Adobe Analytics
Here is where the major benchmarks ended the month:
The S&P 500 has had a sensational month—up nearly 8.7%. It’s one of the best Novembers on record. Since 1928, the S&P has gained more than 8% in November fewer than 10 times, per Bloomberg.
And, don’t expect things to slow today—Adobe predicts a record $12 billion in sales on Cyber Monday, a 5.4% increase over last year and the biggest online shopping day in US history. Retailers are set to cut prices by 30% on electronics, one of the biggest sales drivers over the past week.
Shopping data reveals that Q4 isn’t as important as one might expect. For example, the holiday quarter in 2022 accounted for 26.8% of the year’s sales, just a hair over the 25% mark if sales were evenly spread across the year, per the US Census Bureau. Of course, some types of retailers depend on the holiday quarter far more than others. Discretionary retailers (which sell the things you want, but don’t need…aka gifts) rely on Q4 for up to 40% of their yearly sales, according to McKinsey. For department stores, clothing stores, and toy stores, the holiday season really is make-or-break. GameStop, for instance, recorded 37% of its annual revenue last year in the last three months of 2022.
But for other retailers, Q4 isn’t such a big deal. People apparently read throughout the year because book stores only depend on the fourth quarter for 27.4% of sales. People also need to eat food all year long: Q4 accounted for 26.3% of sales for grocery stores.
Meanwhile, gas stations, car dealerships, and building material companies perform worse in the holiday quarter than at other times of the year.
The S&P 500 Index was 2.72 up points (0.1%) at 4,559.34, up 1% for the week; the Dow Jones Industrial Average®(DJI) was up 117.12 points (0.3%) at 35,390.15, up 1.3% for the week; the NASDAQ Composite was down 15.00 points (0.1%) at 14,250.85, up 0.9% for the week.
The 10-year Treasury note yield (TNX) was up about 5 basis points at 4.47%.
CBOE Volatility Index (VIX) was down 0.34 at 12.46.
Nvidia reported another quarter of record sales and gave a strong revenue outlook, pointing to red-hot demand for chips that underpin the artificial-intelligence boom. Huge investments in AI by tech giants from Microsoft to Amazon.com and by other large corporations have helped propel Nvidia’s sales to unprecedented levels in recent quarters.
***
The chief executive of Binance, the largest global cryptocurrency exchange, plans to step down and plead guilty to violating criminal U.S. anti-money-laundering requirements, in a deal that may preserve the company’s ability to continue operating, according to people familiar with the matter. And, the U.S. Department of Justice has just brought criminal charges against Binance and its billionaire founder and CEO, Changpeng Zhao.
Here is where the major benchmarks ended:
The S&P 500 Index was down 9.19 points (0.2%) at 4,538.19; the Dow Jones Industrial Average® (DJI) was down 62.75 points (0.2%) at 35,088.29; the NASDAQ Composite was down 84.55 points (0.6%) at 14,199.98.
The 10-year Treasury note yield (TNX) was down about 2 basis points at 4.404%.
The CBOE Volatility Index® (VIX) was down 0.06 at 13.35.
Financial and technology shares were among the weakest sectors Tuesday, with the KBW Regional Banking Index (KRX) dropping 2.1%. Small-cap stocks also gave back some of a recent rally, as the Russell 2000® Index(RUT) fell 1.3% after touching a two-month high Monday. Health care, materials and utilities were among the few sectors to post gains.
At Marcinko & Associates our clients traditionally includephysicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.
The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].
Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.
***
But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.
***
Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.
Why Your Medical Internet Marketing Campaign Isn’t Effective
A strong online presence is crucial for healthcare businesses, but many are struggling to figure out where to invest their marketing dollars. It is important to diversify marketing efforts and not rely solely on one channel, as changes in the industry are inevitable.
Search marketing, direct marketing, and social media are three key components that healthcare organizations should incorporate in their marketing campaigns. Search marketing has evolved over the years with changes in Google’s algorithms and the saturation of the market, requiring a focus on quality content and the expertise of a PPC expert.
Direct marketing is becoming more popular, with lead generation companies and email marketing being effective and budget-friendly tactics. Social media is constantly evolving and increasing in price, with networks like Facebook and Twitter pushing paid advertisements. While social media should not be the focal point of a healthcare organization’s marketing campaign, it is an integral component that can contribute to search engine rankings.
Overall, a well-rounded marketing strategy that incorporates these three elements is crucial for success. A strong online presence is crucial for healthcare businesses, and diversifying marketing efforts across search marketing, direct marketing, and social media is important for success. Search marketing has changed with Google’s algorithms and increased ad costs, while direct marketing and social media have become more popular. Social media also affects search engine rankings.
Stocks started the short trading week by ticking upward yesterday. Microsoft climbed to its highest in a year after appearing to be the winner in OpenAI’s Sam Altman drama.
Read: Recommendations on books, classes, and music from Bill Gates. (GatesNotes)
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Here is where the major US stock market benchmarks ended:
The S&P 500 Index was up 33.36 points (0.7%) at 4,547.38; the Dow Jones® Industrial Average (DJI) was up 203.76 points (0.6%) at 35,151.04; the NASDAQ Composite®was up 159.05 points (1.1%) at 14,284.53.
The 10-year Treasury note yield (TNX) was down about 2 basis points at 4.42%.
CBOE Volatility Index® (VIX) was down 0.39 at 13.41.
Strength in technology was illustrated by the Philadelphia Semiconductor Index (SOX), which jumped almost 2% and neared a four-month high. Communications services shares were also strong, as were energy companies, helped by a second-straight day of sharp gains in crude oil futures.
The small-cap focused Russell 2000 Index (RUT) rose 0.5% to a two-month high, following last week’s 5.4% rally that outpaced its large-cap counterparts.
And, Bayer’s stock had its worst day ever, dropping the company’s value by ~$8 billion, after a US jury ordered it to pay $1.56 billion over claims its Roundup weedkiller caused cancer and the company had to stop the trial for its top drug candidate because it wasn’t working.
News last week that inflation eased more than expected in October solidified the view that the Federal Reserve is done with its most aggressive rate-hike campaign in four decades. And that could be a boon for the stock market and your 401(k).
Over the last 10 rate hike cycles dating to 1974, the S&P 500 index rose an average 14.3% in the 12 months following the Fed’s final rate increase, according to an analysis by Ryan Detrick, chief market strategist at Carson Group.
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Stocksclimbed to reach their third positive week in a row for the first time since summer, boosted by data showing inflation is on its way down. And, the Gap soared as the retailer reported strong sales last quarter at both Old Navy and its namesake stores.
In a shocking move, the OpenAI’s board of directors pushed out CEO Sam Altman, one of the world’s most prominent tech executives. The company said that Altman “was not consistently candid in his communications with the board,” and thus the board lost its confidence in Altman’s ability to lead.
OpenAI, and Altman, became household names this year after the company’s ChatGPT chatbot sparked a frenzy around the field of generative artificial intelligence. OpenAI, which has received $13 billion in investment from Microsoft, is reportedly valued at $86 billion. CTO Mira Murati will keep the CEO seat warm for now.
Here is where the major benchmarks ended on Friday:
The S&P 500 Index (SPX) was up 5.78 points (0.1%) at 4,514.02, up 2.2% for the week; the Dow Jones Industrial Average (DJI) was up 1.81 points at 34,947.28, up 1.9% for the week; the NASDAQ Composite was up 11.81 points (0.1%) at 14,125.48, up 2.4% for the week.
The 10-year Treasury note yield was down about 1 basis point at 4.439%.
CBOE’s Volatility Index (VIX) was down 0.54 at 13.78.
Retail shares were among Friday’s strongest sectors, helped by a nearly 30% surge by Gap (GPS) after the apparel company stronger-than-expected quarterly results. Energy companies were also higher thanks to a nearly 4% rise in WTI Crude Oil futures (/CL). Oil prices are still down 20% from a 2023 peak of more than $95 posted in late September.
In other markets, the U.S. dollar index dropped 1.8% for the week to touch its weakest level since September 1st, reflecting stepped-up expectations that interest rates have peaked.
Over the course of the last few weeks, Cathie Wood of ARKK has been offloading the firm’s holdings in Roku, Inc. (NASDAQ:ROKU). Across all of her firm’s funds, Wood has sold stock in the streaming company totaling over $56 million. The move comes after Roku released its financials for q3.
Here is where the major benchmarks ended:
The S&P 500 Index was up 5.36 points (0.1%) at 4,508.24; the Dow Jones Industrial Average was down 45.74 points (0.1%) at 34,945.47; the NASDAQ Composite was up 9.84 points (0.1%) at 14,113.67.
The 10-year Treasury note yield (TNX) was uabout 9 basis points at 4.445%.
Cboe’s Volatility Index (VIX) was up 0.14 at 14.32.
Walmart’s commentary weighed on the retail sector. Energy was also a laggard, as crude oil futures fell 5% to a four-month low of less than $73 a barrel, in part because record U.S. crude production has boosted supply.
Senate leaders voted Wednesday night in favor of the short-term government funding bill the House passed Tuesday night ahead of Friday’s shutdown deadline. House Speaker Mike Johnsonpitched a two-step plan that he described as a “laddered CR” — or continuing resolution — that will keep the government funded at 2023 levels. The bill extends government funding until January 19th for the Veterans Affairs, Transportation, Housing and Urban Development and Energy departments, as well as for military construction. The rest of the government is funded until February 2nd, 2024.
Here is where the major benchmarks ended:
The S&P 500® Index (SPX) was up 7.18 points (0.2%) at 4,502.88; the Dow Jones Industrial Average was up 163.51 points (0.5%) at 34,991.21; the NASDAQ Composite was up 9.45 points (0.1%) at 14,103.84.
The 10-year Treasury note yield (TNX) was up about 10 basis points at 4.541%.
CBOE’s Volatility Index (VIX) was up 0.02 at 14.18.
Retail and financial shares were among Wednesday’s strongest performers. The KBW Regional Banking Index (KRX) rose 1.3% to a 2½-month high. Transportation and consumer staples were also higher. Energy shares were one of the few laggards as crude oil futures sank more than 2% after the Energy Department reported a larger-than-expected increase in U.S. crude inventories.
US Economic leaders are looking to the past for some inspiration on how to deal with the present—the only issue is, no one seems to be able to agree which past era they should be studying. But, predictions diverge, for example.
Meanwhile economists at the White House say the inflationary period after World War II acts as a better guide because pent-up demand from the pandemic will eventually fade away.
UBS disagrees with both, saying the 1990s more closely resembles the economic climate world leaders are currently attempting to navigate. A note from the UBS Chief Investment Office, led by Jason Draho, questioned whether the 2020s would act as “another roaring 20s” seen a century before. During this period, technological advances led to a rapid increase in productivity, while major industries like automotive, film and chemicals took off. The data suggests today’s economy has officially entered a new regime, UBS outlined: “A regime is defined by its growth, inflation, and rate attributes. These are all at their highest levels since prior to the global financial crisis (GFC).”
Here is where the major benchmarks ended:
The S&P 500 Index was up 84.15 points (1.9%) at 4,495.70; the Dow Jones Industrial Average (DJI) was up 489.83 points (1.4%) at 34,827.70; the NASDAQ Composite (COMP) was up 326.64 points (2.4%) at 14,094.38.
The 10-year Treasury note yield (TNX) was down about 18 basis points at 4.453%.
CBOE’s Volatility Index (VIX) was down 0.60 at 14.16.
The small-cap focused Russell 2000 Index (RUT), which has lagged large-cap benchmarks for most of the year, jumped more than 5% Tuesday. Small-caps are often seen as being more exposed to the economic cycle and had suffered because of concerns that high interest rates could push the economy into recession.
Other interest rate-sensitive sectors, such as real estate, materials, and utilities, also saw outsize gains.
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].
World Kindness Day, an international holiday that was formed in 1998, to promote kindness throughout the world and is observed annually on November 13th as part of the World Kindness Movement. It is observed in many countries including the United States, Canada, Japan, Australia and the U.A.E. World Kindness Day presents us with the opportunity to reflect upon one of the most important and unifying human principles. On a day devoted to the positive potential of both large and small acts of kindness, try to promote and diffuse this crucial quality that brings people of every kind together.
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And, stocks markets are on a roll with almost too many trophies to hand out. The NASDAQ had its best day since May on Friday, while the S&P 500 has gained for nine of the last 10 sessions, rising 7.2% in that period. Falling bond yields have investors thinking the market is poised for a rally to close out 2023.
Carried interest, or carry, in finance, is a share of the profits of an investment paid to the investment manager in excess of the amount that the manager contributes to the partnership, specifically in alternative investments (private equity and hedge funds).
In small businesses that are not blind pools, such as single property real estate, the investment manager often funds the business prior to the formation of the partnership. It is a performance fee, rewarding the manager for enhancing performance. The structure also takes advantage of favorable tax treatment in the United States.
However, critics of carried interest want it to be reclassified as ordinary income – not capital gains – to be taxed at the ordinary income tax rate. Private equity advocates argue that the increased tax will subdue the incentive to take the kind of risk that is necessary to invest in and manage companies to profitability.
Regardless of the technology infra-structure, there are generally four types of fees that an online investment platforms charge:
Trading Fees: Any fixed charge attached to each trade that you make. This will typically be either a flat fee or what’s known as the “spread,” when your broker charges you based on the difference between the buying and the selling price of an asset.
Trading Commissions: This is when a broker will charge you for each trade you make based on a percentage of the volume or value of each trade.
Inactivity Fees: Any fees that the broker charges you for not trading, such as for keeping money in a brokerage account.
Non-Trading/Other Fees: Any form of fee for using this platform not covered above. For example, a brokerage might charge you for making deposits into your account, taking money out of it or signing up for additional services.
Posted on November 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
The Institute of Medical Business Advisors is a leading national scope provider of healthcare economics, finance, investing, managerial accounting, policy, management and business administration education and medical practice management textbooks, reports, hand-books, dictionaries, journals, white-papers, fair-market valuations [FMV] and legal advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution. iMBA helps the nation’s financial, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.A virtuous “win-win” situation for all concerned.
The firm serves universities, medical, business, graduate and nursing schools; physicians, dentists, attorneys and legal societies – accountants, financial service providers, stock brokers, RIAs, wealth and hedge fund managers – emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related academic entities.
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 November 11, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
Today is Veterans Day, when Americans honor all who have served our country in the armed forces. It’s celebrated on November 11th each year because on that morning in 1918 (at the 11th hour of the 11th day of the 11th month), the Allied nations and Germany signed an armistice that ended the fighting in World War I.
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SPONSOR: MarcinkoAssociates.com
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Moody’s credit rating agency downgraded its outlook on the US government from ‘stable’ to ‘negative’, citing the risks to the nation’s fiscal strength and the political polarization in Congress. The agency has maintained the US’s current top-grade AAA rating, but has raised the possibility that it may be cut in the future. While the move does not automatically mean it will downgrade America’s creditworthiness, it increases the chances. Even the prospect of a US downgrade could hurt Americans’ investment portfolios, make it even more expensive for them to borrow money, and make it more costly for the government to pay off its debts.
These effects would likely be even more painful if Moody’s does eventually downgrade the US debt. The nation’s diminished fiscal strength, undone by extreme partisanship in Washington, was a key driver of the action, according to a statement from Moody’s.
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YET: Here is where the major benchmarks ended on Friday:
The S&P 500 Index was up 67.89 points (1.6%) at 4,415.24, up 1.3% for the week; the Dow Jones Industrial Average was up 391.16 points (1.2%) at 34,283.10, up 0.7% for the week; the NASDAQ Composite was up 276.66 points (2.1%) at 13,798.11, up 2.4% for the week.
The 10-year Treasury note yield was down about 1 basis point at 4.622%.
CBOE’s Volatility Index (VIX) was down 0.11 at 14.20.
Nearly every market sector gained Friday, with semiconductors and other tech shares leading the pack. The Philadelphia Semiconductor Index (SOX) jumped more than 4% to its highest level in more than two months. Consumer discretionary and energy companies were also strong, the latter thanks to a nearly-2% gain in crude oil futures.
But small-caps continued to lag their bigger counterparts, with the Russell 2000 Index (RUT) rising 1.1% Friday, though it was still down 3.1% for the week.
As fellow doctors, we understand better than most the more complex financial challenges physicians 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.
And you may be misled by unscrupulous “advisors”.
For example:
Question: Do you know the difference between a “Fee-Only” and a “Fee-Based financial advisor? Not knowing may cost you tens of thousands of dollars, or more, in excessive advisory fees.
There are only three possibilities if you want to go into practice for yourself; buy a practice; franchise a business, or start one. However, if you have an existing practice, merging it to form a larger entity can be a satisfying experience. The pace of practice mergers is accelerating, but it is often difficult to make an informed judgment about synergy. Mergers make sense only if the resulting value is more than additive to the original; not duplicative.
Unfortunately, far too many mergers fail to create, or actually destroy existing value. So, look for complimentary processes, personalities and ideas. In a merger of two existing practices, there is no substitute for personal interaction between employees and physician-management. This creates cross-pollination and new ideas in everything from service-lines and the patient production process, to marketing and finance, and to proprietary and intellectual rights. Most importantly, it allows diversity of ideas.
And so, the following are questions to consider when contemplating a medical practice merger:
What are the risks of this transaction and how are they mitigated? Will talented employees be retained on both sides and can an exodus be prevented? Are the specific liabilities of each practice known? Remember, the farther outside your area of specialty or expertise, the greater the risk of being wrong. Will I appraise each practice independently, and correctly? Where will employee allegiance rest? What is the name, and logo, of the new entity? Who will be the CEO?
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.”
Merck reported $640 million in sales for its Covid-19 drug, Lagevrio, in Q3 earnings, blowing past analyst expectations of $140.8 million. Covid drug sales have dropped for most big pharma companies this year, with Pfizer lowering its total expected 2023 earnings by about $9 billion due mostly to declining Paxlovid sales. Merck attributed the boost to increasing demand for Lagevrio in Japan.
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California’s largest health system agreed to a $200 million settlement on October 12th following an investigation that found the system has failed to provide timely behavioral health appointments for patients and has canceled more than 100,000 appointments.
Kaiser Permanente, which also runs a health plan, will “undertake a systemic overhaul” of its behavioral health services, Mary Watanabe, director of the Department of Managed Health Care (DMHC), the regulatory body that oversees managed care plans in California, said in a statement. The DMHC began investigating Kaiser in May 2022 after the Oakland-based health system saw a 20% increase in behavioral health patient complaints in 2021, the DMHC said in a statement.
President President Biden spoke Tuesday afternoon on what the White House has called a crackdown on “junk fees” in retirement planning. Such fees chip away at account balances over time, leading to lifetime savings that are up to 20% less than if advisors were held to the highest standards, according to a White House statement.
Under current regulations, advisors who provide advice to workers rolling their 401(k) or related plan into an individual retirement account are generally not considered a fiduciary—that is, a professional who must put clients’ interests ahead of their own. This means that an advisor could steer an investor into, say, an annuity that pays the advisor a big commission, even if it’s not the best option for the investor. In some cases, commission costs and other fees are baked into the product, as opposed to paid outright, and investors don’t realize that they are silently eating into returns over time.
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The Federal Reserve left interest rates unchanged Wednesday as it continues to track inflation and the health of the economy. The central bank voted unanimously to leave its primary interest rate in the range of 5.25% to 5.50%. U.S. interest rates are the highest they’ve been in 23 years. That means interest rates on loans such as mortgages have gone up sharply, and so have payments on Treasury bonds and interest-bearing accounts.
Here is where the major benchmarks ended:
The S&P 500 Index was up 44.06 points (1.1%) at 4,237.86; the Dow Jones Industrial Average (DJI) was up 221.71 points (0.7%) at 33,274.58; the NASDAQ Composite was up 210.23 points (1.6%) at 13,061.47.
The 10-year Treasury note yield (TNX) was down about 11 basis points at 4.761%.
CBOE’s Volatility Index (VIX) was down 1.30 at 16.84.
In addition to technology, communication services and utilities were among the strongest sectors Wednesday. Energy shares were under pressure as crude oil futures extended this week’s slump and ended at a two-month low. The U.S. dollar index (DXY) tumbled from an earlier rally to a one-month high, potentially reflecting expectations that domestic interest rates may be near a peak.
The average cost of a health insurance plan offered through an employer rose 7% this year, to $23,968 for family plans and $8,435 for individuals, according to a new survey from the private health foundation KFF.
The jump—the highest since 2011—was driven by inflation, as well as higher wages for healthcare workers and hospital system mergers, health policy experts say. Here’s what it means for employers and the 150+ million Americans who get insurance through work:
The increase amounted to ~$500 more out of pocket for family plan-holders, and $75 more for solo riders—further squeezing consumer spending power, which is already constrained by wages that haven’t caught up to high inflation.
Employers often bear the brunt of increased health spending because, in the interest of staying competitive, they’re wary of offloading too much of the rising costs onto their workers. That’s likely why deductibles haven’t grown much in the past five years.
Last month, the FTC and DOJ jointly released a draft of new guidelines they will use to evaluate potential mergers and acquisitions (M&As).
The guidelines include 13 principles the agencies will follow when scrutinizing deals. The principles stipulate that mergers may not “entrench or extend a dominant position,” eliminate competition between firms, increase concentration in an already concentrated market, or prevent new players from entering a market. The guidelines will be finalized following a 60-day public comment period.
The proposed rules reflect a return to pre-2010 guidelines on concentration, the Wall Street Journal reported, noting that they’d apply to deals that resulted in firms having a market share of 30% or more. The new guidance may give the FTC and DOJ, which have filed numerous antitrust actions, more leeway to go after deals.
At D.E. Marcinko & Associates our clients traditionally includephysicians [MD, MBBS and DO], dentists [DDS and DMD], podiatrists [DPM], Registered Nurses [RNs], Certified Registered Nurse Anesthetists [CRNA], Physician Assistants [PA] and Nurse Practitioners [NP]. A growing cohort of clients include medical technologists, physical, speech and occupational therapists, etc.
The above are naturally segregated into three career tranches: 1. New practitioners, 2] Mid-Career practitioners and 3] Mature practitioners. We serve them all and are fully prepared for any special needs situation that may arise in any tranche [death, divorce, adverse risk event and/or bankruptcy, etc].
D.E.Marcinko & Associates understands the complexity of financial and non-financial deal terms because we are also doctors. Our “hard” knowledge of your business comes from being actual healthcare facility owners, operators and medical practitioners [with additional professional licenses and expertise] enabling us to effectively analyze your business, take corrective measures and present your healthcare entity in the best possible and accurate light.
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But, if you’re looking at this website, chances are you are fed up, burned out, seeking practice management techniques or a better work-life balance. Or, you are looking for a new non-clinical career, thinking of finance, investing, retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical or professional career? This is known as “soft” psychology, coaching, personal consulting or fraternal advice.
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Regardless, of your “soft” personal or “hard” corporate needs, our transparent Fees for Service [FFS] model is moderated for all colleagues based on the acuity and urgency of their engagements. Reduced rates and/or limited charity work may also be possible.
If you’re looking at this tab, chances are you are fed up, burned out, seeking better work-life balance, looking for a new non-clinical career, thinking of retirement, or all of the above. Perhaps you are just looking to regain the joy and meaning in your medical career.
The average net worth of someone younger than 35 years old is $76,300, as of 2019. From there, average net worth steadily rises within each age bracket. Between 35 to 44, the average net worth is $436,200, while between 45 to 54 that number increases to $833,200. Average net worth cracks the $1 million mark between 55 to 64, reaching $1,175,900.
Average net worth again rises for those ages 65 to 74, to $1,217,700, before falling to $977,600 for someone over age 75.
Posted on October 9, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
The Institute of Medical Business Advisors is a leading national scope provider of healthcare economics, finance, investing, managerial accounting, policy, management and business administration education and medical practice management textbooks, reports, hand-books, dictionaries, journals, white-papers, fair-market valuations [FMV] and legal advisory opinions using multi-platform and traditional seminars and channels of knowledge distribution. iMBA helps the nation’s financial, healthcare and education professionals make decisive improvements in their direction and performance by empowering them through unbiased information, consultants and proprietary tools, books, templates and B-school styled case models.A virtuous “win-win” situation for all concerned.
The firm serves universities, medical, business, graduate and nursing schools; physicians, dentists, attorneys and legal societies – accountants, financial service providers, stock brokers, RIAs, wealth and hedge fund managers – emerging entities, hospitals, clinics, outpatient centers, CXOs and their BODs – the press, media and related academic entities.
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].
As a new physician investor, it’s important to know the distinctions between like measurements because the market allows firms to advertise their numbers in ways not otherwise regulated. Often companies will publicize their numbers using either GAAP or non-GAAP measures. GAAP, or generally accepted accounting principles, outlines rules and conventions for reporting financial information. It is a means to standardize financial statements and ensure consistency in reporting.
When a company publicizes its earnings and includes non-GAAP figures, it means it wants to provide investors with an arguably more accurate depiction of the company’s health (for instance, by removing one-time items to smooth out earnings). However, the further a company deviates from GAAP standards, the more room is allocated for some creative accounting and manipulation.
When looking at a company that is publishing non-GAAP numbers, new physician investors should be wary of these pro forma statements, because they may differ greatly from what GAAP deems acceptable.
GAAP is set forth in 10 primary principles, as follows:
Principle of consistency: This principle ensures that consistent standards are followed in financial reporting from period to period.
Principle of permanent methods: Closely related to the previous principle is that of consistent procedures and practices being applied in accounting and financial reporting to allow comparison.
Principle of non-compensation: This principle states that all aspects of an organization’s performance, whether positive or negative, are to be reported. In other words, it should not compensate (offset) a debt with an asset.
Principle of prudence: All reporting of financial data is to be factual, reasonable, and not speculative.
Principle of regularity: This principle means that all accountants are to consistently abide by the GAAP.
Principle of sincerity: Accountants should perform and report with basic honesty and accuracy.
Principle of good faith: Similar to the previous principle, this principle asserts that anyone involved in financial reporting is expected to be acting honestly and in good faith.
Principle of materiality: All financial reporting should clearly disclose the organization’s genuine financial position.
Principle of continuity: This principle states that all asset valuations in financial reporting are based on the assumption that the business or other entity will continue to operate going forward.
Principle of periodicity: This principle refers to entities abiding by commonly accepted financial reporting periods, such as quarterly or annually.
Posted on October 3, 2023 by Dr. David Edward Marcinko MBA MEd CMP™
Hospitals are Dropping Medicare Advantage [Part C] Plans – Left and Right
By Dr. David Edward Marcinko MBA
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Hospitals SayBye-Bye?
Medicare Advantage provides health coverage to more than half of the nation’s seniors, but a growing number of hospitals and health systems nationwide are pushing back and dropping the private plans altogether. Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.
“It’s become a game of delay, deny and not pay,” Chris Van Gorder, president and CEO of San Diego-based Scripps Health, told Becker’s. “Providers are going to have to get out of full-risk capitation because it just doesn’t work — we’re the bottom of the food chain, and the food chain is not being fed.” Van Gorder said the health system is facing a loss of $75 million this year on the MA contracts, which will end December 31st for patients covered by UnitedHealthcare, Anthem Blue Cross, Blue Shield of California, Centene’s Health Net and a few more smaller carriers.
Source: Becker’s Hospital Review [9/27/23]
COMMENTS APPRECIATED
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Cigna to Pay $172M Over Alleged Medicare Advantage Fraud
The Cigna Group will pay $172.3 million to resolve allegations that it violated the False Claims Act by submitting incorrect Medicare Advantage patient data to CMS to receive higher payments from the agency. The U.S. Attorney’s Office for the Eastern District of Pennsylvania alleged Sept. 30 that Cigna also falsely certified that the submitted data was accurate, failed to withdraw the “untruthful” data, and did not repay CMS.
Cigna will use $135.3 million from the settlement to resolve the allegations from the Justice Department. The remaining $37 million will resolve allegations related to unsupported diagnoses for Medicare Advantage enrollees that received in-home services from Cigna. As part of the settlement, Cigna has entered into a five-year accountability and auditing agreement with HHS’ Office of Inspector General, which will require company executives and board members to certify Cigna’s compliance moving forward. The payer must also conduct annual risk assessments and submit to independent risk adjustment audits.
Source: Jakob Emerson, Becker’s Payer Issues [10/2/23]
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