BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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PCE or the Personal Consumption Expenditures (“PCE”) price deflator—comes from the Bureau of Economic Analysis’ quarterly report on U.S. gross domestic product—and is based on a survey of businesses and is intended to capture the price changes in all final goods, no matter the purchaser.
Because of its broader scope and certain differences in the methodology used to calculate the PCE price index, the Federal Reserve (“the Fed”) holds the PCE deflator as its preferred, consistent measure of inflation over time.
Posted on April 30, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
LAWSUIT
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Humana Used AI Tool from UnitedHealth to Deny Medicare Advantage Claims
Humana used an artificial intelligence tool owned by UnitedHealth Group to wrongfully deny Medicare Advantage [Part C] members’ medical claims, according to a class-action complaint filed on Dec. 12th. The lawsuit was filed in the U.S. District Court for the Western District of Kentucky and is the latest legal action against major insurers such as UnitedHealthcare and Cigna for allegedly using automated data tools to wrongfully deny members’ claims.
The complaint against Humana, the country’s second-largest Medicare Advantage insurer, accuses the company of using an AI tool called nH Predict to determine how long a patient will need to remain in post-acute care and overrides physicians’ determinations for the patient. The plaintiffs claim Humana set a goal to keep post-acute facility stay lengths for MA members within 1% of nH Predict’s estimations. Employees who deviate from the algorithm’s estimates are “disciplined and terminated, regardless of whether a patient requires more care,” the lawsuit alleges. When decisions made by the algorithm are appealed, they are allegedly overturned 90% of the time.
Source: Jakob Emerson Becker’s Payer Issues [12/13/23]
Posted on April 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
MEDICAL EXECUTIVE-POST–TODAY’SNEWSLETTERBRIEFING
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Costco started selling gold bars to its members last August, and Wells Fargo analysts believe that the product is now bringing in between $100 million and $200 million a month. The retailer doesn’t reveal the price of the 1-ounce bullion to nonmembers online, but it’s estimated to be ~2% above the spot price gold trades at, per CNBC—and that price has soared since Costco got into the gold game. The price of gold has gone up 13% this year and reached record highs as investors pile in amid inflation worries.
The big numbers from the Consumer Price Index data released on Thursday
In March, inflation rose 3.5% from the year before, up from 3.2% in February.
The “core” CPI reading, which excludes volatile food and fuel prices, came in even higher, rising 3.8% on an annual basis. That’s the same as in February, but this time it’s serious.
Half of the increases came from rising gas prices and housing.
After seeing inflation fall by 3% over the course of 2023, Fed officials believed that higher inflation readings in January and February 2024 represented a hiccup in an otherwise downward trajectory. However, with the March reading also coming in hotter than anticipated, analysts say this is more than a fluke. That means hopes for a June interest rate cut are dashed. Even the US Postal Service plans to raise the price of “forever” stamps to $0.73 in July. Get yours now. And the Mexican peso is on an absolute tear, leaving the US dollar behind.
The S&P 500® index (SPX) advanced 38.42 points (0.7%) to 5,199.06; the Dow Jones Industrial Average® ($DJI) lost 2.43 points to 38,459.08; the NASDAQ Composite gained 271.84 points (1.7%) to 16,442.20.
The 10-year Treasury note yield (TNX) rose nearly 2 basis points to 4.578%.
The CBOE Volatility Index® (VIX) fell 0.89 to 14.91.
Chip maker strength lifted the Philadelphia Semiconductor Index (SOX) more than 2% and extended the benchmark’s year-to-date gain to more than 17%. Communications services and transportation shares were also among the strongest sectors. Financial shares were mixed ahead of expected quarterly results Friday from some major banks including JPMorgan Chase (JPM), Citigroup (C), and Wells Fargo (WFC).
Posted on January 12, 2024 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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JPMorgan Chase’s profit fell in the fourth quarter as the lender set aside nearly $3 billion to help refill a government deposit insurance fund. JPMorgan and several major banks are required to pay a bulk of the $16 billion to replenish the Federal Deposit Insurance Corporation’s deposit insurance fund (DIF), which was drained after Silicon Valley Bank and Signature Bank failed last year.
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Bank of America’s fourth-quarter profit shrank as the lender took $3.7 billion in combined charges to refill a government deposit insurance fund and phase out a loan index. Its net interest income (NII) – the difference between what banks earn from loans and pay to depositors – fell 5% to $13.9 billion as the company spent more to keep customer deposits and demand for loans stayed subdued amid high interest rates.
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Wells Fargo press release (NYSE:WFC): Q4 Non-GAAP EPS of $1.29 beats by $0.20. Revenue of $20.48B (+2.2% Y/Y) beats by $100M. Shares -1% PM. Fourth quarter 2023 results included: ◦ $(1.9) billion, or ($0.40) per share, of expense from an FDIC special assessment ◦ $(969) million, or ($0.20) per share, of severance expense for planned actions ◦ $621 million or $0.17 per share, of discrete tax benefits related to the resolution of prior period tax matters ◦ Provision for credit losses in fourth quarter 2023 included an increase in the allowance for credit losses driven by credit card and commercial real estate loans, partially offset by a lower allowance for auto loans. The change in allowance for credit losses also included higher net loan charge-offs for commercial real estate office and credit card loans
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Citigroup (C) is in the middle of a complicated restructuring. It made it clear Wednesday that its fourth quarter earnings report Friday will be complicated, too.
The giant New York-based bank said in a regulatory document it will take more than $3 billion in one-time reserves and expenses as part of those fourth quarter results. They include everything from a $1.3 billion reserve build for currency exposure in Argentina and Russia to $780 million in charges related to severance costs and other aspects of a wide-ranging restructuring of the bank led by CEO Jane Fraser.
Twenty-eight healthcare companies, including CVS Health , are signing U.S. President Joe Biden’s voluntary commitments aimed at ensuring the safe development of artificial intelligence (AI), a White House official said yesterday. The commitments by healthcare providers and payers follow those of 15 leading AI companies, including Google, OpenAI and OpenAI partner Microsoft to develop AI healthcare models responsibly.
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Health insurance company Humana is being accused of allegedly wrongfully denying care to elderly patients, who are enrolled in Medicare Advantage Plans, using an augmented intelligence model “to override” physicians’ orders on “necessary care patients require,” according to a new lawsuit.
The lawsuit, filed by two Humana Medicare Advantage Plan customers on December th 12 in Kentucky, claims that Humana uses an AI model called nH Predict, and it allegedly has a high error rate. And allegedly, despite knowing that it’s inaccurate, the company still uses it.
The S&P 500 index was up 12.46 points (0.3%) at 4,719.55; the Dow Jones Industrial Average was up 158.11 points (0.4%) at 37,248.35; the NASDAQ Composite® (COMP) was up 27.59 points (0.2%) at 14,761.56.
The 10-year Treasury note yield (TNX) was down about 11 basis points at 3.923%, falling under 4% for the first time since early August.
The CBOE® Volatility Index (VIX) was up 0.25 at 12.44.
Financial shares remained among the market’s strongest post-FOMC gainers, reflecting ideas that lower interest rates will boost profit margins for banks. Goldman Sachs (GS) rallied nearly 6%, the second-best gain among Dow companies, and hit a 23-month high. The KBW Bank Index (BKX), which includes major companies like Bank of America (BAC) and Citigroup (C) as well as several regional lenders, surged 5% to a nine-month high.
Also, the small-cap Russell 2000® Index (RUT) continued to outgain large-cap counterparts, rising 2.7% to a 4 ½-month high.
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