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HEALTHCARE: Paradox of Choice

Posted on February 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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ORIGINAL: May 2021 | Matt Cohlmia

As the future of healthcare becomes digitized, the threat of disruption to health systems has never been greater. Despite their best intentions, the flood of new competitors and ever-proliferating modalities of care each compete for patient attention, creating the potential for a fragmented, confusing, and impersonal patient experience. At the same time, health systems possess the breadth of care, the access to data, and the patient trust to become their community’s preferred partner in care.

But to achieve success, they must leverage these resources to create easy to navigate and personalized experiences for their patients, and for the first time ever, those are within reach.

READ: https://blog.providence.org/digital-innovation-content/the-paradox-of-choice

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Filed under: Experts Invited, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, LifeStyle, mental health, Risk Management | Tagged: healthcare, Matt Cohlmia, mental health, paradox, paradox choice, paradox choice healthcare, Risk Management | Leave a comment »

DOCTORATE: Physical Therapy

Posted on February 23, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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A Doctor of Physical Therapy (DPT) helps people improve their mobility and physical functioning, manage pain, and prevent disability. After earning an undergraduate degree, a person can enroll in a DPT program, which is typically three years. The curriculum includes courses in biology, anatomy, physiology, kinesiology (movement), neurology, cardiopulmonary (heart and lung) rehabilitation, behavioral sciences, and pharmacology.

Clinical rotations are a major component of DPT education. They may perform clinical rotations in various settings including a PT clinic, hospital, nursing care facility, rehabilitation clinic, and school. At the end of their coursework and clinical rotation, a student earns a DPT degree but still must pass a state licensure exam to practice as a physical therapist.2

On average, a DPT in the U.S. makes $105,710 per year, according to 2024 statistics.

While a DPT may use the title “Dr,” they are different from an MD/DO/DPM/DDS. A DPT cannot write prescriptions or perform surgery. A DPT is also different from a PhD (Doctor of Philosophy). DPT is treatment-focused, whereas the PhD is research-focused.

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Filed under: "Doctors Only", Career Development, Glossary Terms | Tagged: DO, doctor physicial therapy, DPM, DPT, DPT salary, exercise, health, healthcare, MD, PhD, physical therapy, physicial therapist, PT, PT salary, RPt | 1 Comment »

PharmD: Doctor of Pharmacy

Posted on February 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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PharmD – Doctor of Pharmacy

A Doctor of Pharmacy [ParrmD] is the professional degree required to become a pharmacist in the US. Practicing pharmacists complete an average of six years in school—including their pre-pharmacy education—before passing required exams and completing post-graduate training.

Here’s where things often get confusing. The word “pharmacist” is sometimes used in casual conversation to refer to healthcare professionals who aren’t technically licensed to be pharmacists.

For example, pharmacy technicians assist licensed pharmacists. They work behind the counter among the medications right alongside the pharmacist. However, they don’t need a Doctor of Pharmacy to do their job. A pharmaceutical sales representative typically needs four years of a bachelor’s degree with a foundation in chemistry and biology, though this is not always a requirement. Neither of these professionals is technically a pharmacist, although laypeople may mistakenly describe them that way.

And pursuing a PharmD doesn’t always mean you’ll work in a community pharmacy. In fact, just slightly fewer than half of all PharmD recipients end up in this role. Another 15 percent practice in other healthcare settings—hospitals, nursing homes, and managed care centers, for example. Other pharmacy students pursue research roles, government regulation positions, or work in highly specialized areas like oncology or geriatric pharmacy.

A PharmD or RPH [registered pharmacist] fills the electronic or written prescriptions of a MD/DO/DPM/DDS/DMD. They generally can not prescribe drugs or write prescriptions, however.

As of February 01, 2025, the average annual pay of Doctor of Pharmacy in the United States was $196,904. While Salary.com suggests that a Doctor of Pharmacy salary in the US can go up to $236,908 or down to $149,197, most earn between $171,932 and $217,844.

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Filed under: "Doctors Only", Drugs and Pharma, Ethics, Glossary Terms, Health Insurance | Tagged: counter pharmacist, DO, Doctor of Pharmacy, DPM, health, healthcare, MD, pharmacist, pharmacy, PharmD, registered pharmacist, RPh | Leave a comment »

DAILY UPDATE: BC/BS Anti-Trust Lawsuit as Stock Markets Close Mixed

Posted on February 12, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Essays, Opinions and Curated News in Health Economics, Investing, Business, Management and Financial Planning for Physician Entrepreneurs and their Savvy Advisors and Consultants

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Blue Cross Blue Shield will soon begin paying out $2.67 billion to customers follow a years-long lawsuit alleging that the health insurance giant broke antitrust laws. The litigation began in 2013, when a class-action lawsuit was filed against more than 35 Blue Cross Blue Shield health insurance plans. The lawsuit claims the company broke antitrust laws by limiting market competition, resulting in increased premiums and reduced options for customers.

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US stocks closed mixed on Tuesday as investors assessed more tariff policy shifts from President Donald Trump and looked ahead to upcoming inflation data.

Traders also digested the start of Federal Chair Jerome Powell’s two-day testimony in Congress. In his opening remarks, Powell told lawmakers the Fed is not in a rush to adjust interest rates and reiterated the central bank’s stance of not commenting on trade policy.

The Dow Jones Industrial Average (^DJI) edged around 0.3% higher, while the benchmark S&P 500 (^GSPC) closed just above the flatline. The tech-heavy NASDAQ Composite (^IXIC) pulled back about 0.4%.

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

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My Thoughts on Artificial Intelligence [AI]

Posted on February 9, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Vitaliy Katsenelson CFA

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Article available in Spanish here.

A century ago, one fifth of the country was involved in agriculture. Due to the transformation of farming technology, only 1% of the country is now involved in farming, while our supermarkets are flooded with cheap food. I could be wrong, but I don’t see the 19% of the country who used to farm wandering around unemployed. They have retrained to do other things.

Innovation disrupts, but it also creates new jobs and improves the standard of living of society. A century ago, you could not have imagined most of the jobs we have today. I’m not just talking about social media celebrities; think about software engineers, data scientists, cybersecurity experts, etc. In fact, most white-collar jobs you see today did not exist 100 years ago. Yes, if you specialized in driving horse-powered carriages, you had to acquire new skills.

AI will displace many jobs, but it will also empower people with new productivity tools. Microsoft Excel replaced jobs that required people to add up rows of numbers with calculators, but it created many more. In the 1960s, corporations had departments filled with typists. A photocopier and then the personal computer put these hardworking folks out of a job, but they retrained to do other things.

If we have a victim mentality, AI will run us over; if we embrace it and adapt it to our lives, it may become our best friend to do the jobs we are doing, while our soon-to-be-unemployed coworkers complain about AI.

AI may have a similar impact on our lives as electricity did. Unless it becomes sentient and just like the Terminator, it turns against us (smarter people than me cannot agree on this, especially on a reasonable time frame, so I withhold my opinion on it), it will likely improve our lives significantly. One industry that immediately comes to mind is healthcare – we need major disruption in that sector.

AI may disrupt and completely reshuffle the power dynamics in some industries. Travel, for example, comes to mind; we may start looking for trips and booking tickets with the help of our AI assistant without going to the travel websites. Some companies will adapt and become winners, while others won’t and will become market-share donors.

As I am typing this, I realize (again, something I do daily now) how important management is. In our analysis, we should pay close attention to how companies are embracing AI. Are they giving it lip service or are they really adopting it and changing the business to take advantage of it?

ChatGPT is a statistical representation of things found on the web, which will increasingly include ITS OWN output (directly and secondhand). You post something picked up from it and it will use it to reinforce its own knowledge. Progressively a self-licking lollipop.

If you want to see ChatGPT creating art, for the fun of it, spend some time on myfavoriteclassical.com, where I post music articles. Every single picture there is created by AI. I love impressionist artists, and thus I love these little AI creations. However, if you zoom in closer, you’ll find violinists playing with toothpicks, pianists with three hands and cellists with multiple arms and legs.

This self-licking lollipop is impressive, but it still has a lot to learn. (By the way, if you have not signed up to receive my classical music-only articles, you have an opportunity to do it here).

Finally, the more we rely on AI and the more content it creates, the less creative it and we become.

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Filed under: Career Development, Ethics, Experts Invited, Information Technology, Interviews, mental health | Tagged: AI, artificial intelligence, ChatGPT, healthcare, mental health, openAI, Technology, Vitaliy Katsenelson CFA | Leave a comment »

DAILY UPDATE: Pharmacy Schools and PBMs as Stocks Recover

Posted on February 6, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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One year after forming an alliance with pharmacy schools, Walgreens says it has taken steps to get more people interested in the profession and improve working conditions at the chain.

Walgreens announced the Deans Advisory Council last February, framing it as a collaboration with pharmacy schools to boost the number of students enrolling and address some of the broader issues in the industry, like burnout and declining reimbursements from pharmacy benefit managers.

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US stocks recovered from losses on Wednesday to close higher on the day. Earnings from Alphabet (GOOG, GOOGL) and AMD (AMD) fell short, but Big Tech got a boost from a jump in Nvidia (NVDA) shares.

The tech-heavy NASDAQ Composite (^IXIC) rose 0.2%, while the benchmark S&P 500 (^GSPC) added 0.4%. The Dow Jones Industrial Average (^DJI) led the gains, rising 0.7%, or more than 300 points.

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

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DAILY UPDATE: Healthcare Bankruptcies as Stock Markets Slide

Posted on February 1, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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Stat: 57. That’s how many healthcare bankruptcies there were in 2024, down from 79 in 2023. (Healthcare Dive)

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US stocks lost ground on Friday after the White House said tariffs against Mexico, Canada, and China will take effect on Saturday, reigniting fears of a coming trade war with the nation’s closest trading partners. White House Press Secretary Karoline Leavitt said the president would impose 25% tariffs on goods from Mexico and Canada, as well as a 10% tariff on goods from China.

All three major gauges fell into the red Friday. The S&P 500 (^GSPC) lost 0.5% at the closing bell, while the Dow Jones Industrial Average (^DJI) shed 0.8%. The tech-heavy NASDAQ Composite (^IXIC) gave up 0.3%, reversing earlier gains.

The dramatic tariff news pushed aside more optimistic updates from earlier in the day, which had buoyed stocks. Solid earnings from Apple (AAPL) and an inflation reading that matched expectations lifted market sentiment for much of the day.

Finally, the S&P and the Nasdaq posted losses for the week of 1% and 1.6%, respectively. The Dow, meanwhile, recorded a weekly gain of 0.3%.

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

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TRUMP ADMINISTRATION: Day-One Healthcare Moves

Posted on January 31, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Health Capital Consultants, LLC

In the first days of his second (nonconsecutive) presidential term, Donald Trump and his administration took a number of actions that will affect the healthcare industry in the near- and long-term. Further, the Trump Administration is reportedly poised to take a number of additional actions to pause, end, or otherwise change Biden-era initiatives.

Meanwhile, President Trump’s cabinet pick for the Department of Health & Human Services (HHS) hangs in the balance. This Health Capital Topics article reviews the new administration’s actions impacting the healthcare industry as of the date of publication. (Read more...)

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RN versus LPN Licenses

Posted on January 27, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

DEFINITIONS

By Staff Reporters

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Registered Nurse [RN]

RNs must complete an accredited Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) program (or, in rare cases, diploma programs). After that, they become eligible to sit the NCLEX-RN exam and apply for registered nurse licensure in their state.

As a registered nurse, duties include basic patient care but expand to more technical responsibilities like medication administration, performing diagnostic tests, and operating medical equipment. Depending on the role, one may also supervise other healthcare workers like LPNs, certified nursing assistants (CNAs), or even other RNs.

Licensed Practical Nurses [LPN]

LPNs may also be called licensed vocational nurses (LVNs), and like registered nurses, LPNs must also complete an education program before becoming eligible for licensure. LPN programs typically take around one year, and you can find them at community colleges or vocational schools.

Prospective LPNs must then take and pass the NCLEX-PN exam to become licensed. As an LPN, focus is on patient care tasks like monitoring vitals and changing bandages as part of a care team supervised by a physician or RN.

MORE: https://www.nursingprocess.org/lpn-vs-rn.html

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DAILY UPDATE: Executive Orders, ACA and the Up Markets

Posted on January 22, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Yesterday’s market performance included:

Stocks ended firmly higher on Tuesday, with the S&P 500 rising 0.88% and reclaiming the 6,000 point mark amid a pullback in Treasury yields and optimism over Donald Trump’s focus on deregulation, focused tariff strategies and the prospect of solid corporate earnings into the fourth quarter reporting season.

Tech stocks are likely to pace early gains in the Wednesday session, however, following the unveiling of a new AI joint venture called ‘Stargate’ that will include an initial $100 billion investment from SoftBank, Oracle Corp. (ORCL) and OpenAI.

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Executive Order 14009, titled “Strengthening Medicaid and the Affordable Care Act,” includes several key components designed to increase access to affordable health care and reduce the number of uninsured Americans:

Reversal of Trump administration policies: The order sought to undo measures that limited ACA provisions or made healthcare less accessible.

Longer enrollment periods: The order encouraged states to lengthen enrollment periods and provided additional federal support. As a result, many states extended their enrollment windows to ensure broader access to affordable healthcare.

Restoration of pre-existing condition protections: Reaffirmed protections for individuals with pre-existing conditions and reinforced nondiscrimination policies in healthcare.

Immediate review of agency actions: The order directed various executive departments and agencies to review existing regulations, orders, and policies to ensure they align with the goal of strengthening Medicaid and the ACA.

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xecutive Order 14070, titled “Continuing To Strengthen Americans’ Access to Affordable, Quality Health Coverage,” aimed to maintain and enhance Medicaid and the ACA. Key components included:

Enhanced marketplace subsidies: The order highlights the positive impact of the American Rescue Plan Act on access to coverage, including enhanced marketplace subsidies.

Extended postpartum Medicaid coverage: It provides options for states to extend postpartum Medicaid coverage.

New incentives for Medicaid expansion: The order includes new incentives for states to expand their Medicaid programs.

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Filed under: Alerts Sign-Up, Drugs and Pharma, Ethics, Funding Basics, Glossary Terms, Health Economics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: ACA, Affordable ACA Family Coverage, Affordable Care, DJIA, Donald Trump, DOW, executive orders, health, Health Insurance, healthcare, insurance, Marcinko, medicare, NASA, NASDAQ, oftBank, openAI, oracle, presodemt trump, S&P 500, SoftBank, stargate, Strengthening Medicaid and the Affordable Care Act, textbooks, TNX, Uncategorized, VIX, WSJ | Leave a comment »

MBBS versus MD Degree

Posted on January 19, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

POPULAR MEDICAL DEFINITIONS

By Staff Reporters

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MBBS Degree [Bachelor of Medicine, Bachelor of Surgery]

The MBBS is usually a five-year undergraduate degree that medical students complete when they want to become doctors. However, some programs take six years to complete because the institution expects you to earn a Bachelor of Science (BSc) in your training.

By the time a student applies to a medical program, they have likely taken several foundational science courses as part of their high school (or secondary) education. For example, medical applicants in the United Kingdom are often expected to show high scores on their General Certificate of Secondary Education (GCSE) and A-levels.

Earning an MBBS means that students are certified to care for patients as junior physicians without specialized training. Graduates are expected to complete two years of additional training, which rotates them through different specialties. Once they identify a specialty they like, they can apply for additional training, which can take anywhere between three and eight years.

MD Degree [Doctor of Medicine]

The acronym “MD” stands for the Latin term “Medicinae Doctor,” which translates to “Doctor of Medicine” in English.

It refers to the title that students from the United States of America obtain after finishing medical school. Some countries consider the “MD” title a postgraduate doctoral degree that MBBS graduates can obtain with additional years of training.

MORE: https://medicalschoolexpert.co.uk/medical-degrees-explained/

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Filed under: "Doctors Only", Career Development, Drugs and Pharma, Glossary Terms, Health Law & Policy, iMBA, iMBA, Inc., Marcinko Associates | Tagged: Bachelor of Medicine, Bachelor of Surgery, doctor of medicine, education, health, healthcare, Marcinko, mbbs, MD, medical degrees, medical doctor, medical education, medical school, Medicinae Doctor, medicine | Leave a comment »

DAILY UPDATE: PBM Mark-Ups as Stocks Waiver

Posted on January 17, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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The FTC’s second interim staff report on consolidated pharmacy benefit managers (PBMs) found that the three largest of these middlemen—CVS Health’s Caremark Rx, Cigna Group’s Express Scripts, and UnitedHealth Group’s OptumRx—”marked up two specialty generic cancer drugs by thousands of percent and then paid their affiliated pharmacies hundreds of millions of dollars of dispensing revenue in excess of estimated acquisition costs for each drug annually.”

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The S&P 500 fell 0.2%. The NASDAQ 100 lost 0.7%. The Dow Jones Industrial Average slid 0.2%. A gauge of the “Magnificent Seven” megacaps slipped 1.9%. The Russell 2000 added 0.2%. The KBW Bank Index declined 0.2%.

The yield on 10-year Treasuries declined four basis points to 4.61%. The Bloomberg Dollar Spot Index rose 0.1%.

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

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Filed under: Drugs and Pharma, Ethics, Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: Caremark Rx, Cigna, Cigna Express Scripts, DJIA, DOW, drug mark ups, FTC, generic drugs, healthcare, Marcinko, NASA, NASDAQ, OptumRx, PBM, PBMs, S&P 500, textbooks, TNX, UnitedHealth, VIX, WSJ | Leave a comment »

DAILY UPDATE: Capital One, CPI and Medicare as Wall Street Blasts Off

Posted on January 16, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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The U.S. Department of Labor reported a 0.4% increase in the monthly CPI after seasonal adjustment, overshooting the forecast of 0.3% and the previous value of 0.3%. On an annual basis, inflation climbed to 2.9%, up from 2.7% in November, the highest rate since July 2024.

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US stocks ripped higher on Wednesday as high hopes for bank earnings paid off and a crucial consumer inflation update showed key prices increased less than expected in December.

The benchmark S&P 500 (^GSPC) popped more than 1.8%, while the Dow Jones Industrial Average (^DJI) rose more than 1.6%, or over 700 points. Meanwhile, the tech-heavy NASDAQ Composite (^IXIC) soared 2.5%.

Stocks took a leg higher after the Consumer Price Index (CPI) showed progress toward the Fed’s 2% inflation target in December. Prices climbed 0.2% month-on-month on a “core” basis, which strips out the more volatile costs of food and gas, an easing from November’s 0.3% gain. Over last year, core CPI rose 3.2%.

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Capital One is being sued by the US government’s consumer watchdog agency for “cheating millions of consumers” and not paying more than $2 billion in interest to holders of its high-interest savings accounts.

CITE: https://tinyurl.com/tj8smmes

As of January 1st 2025, beneficiaries enrolled in Part D prescription drug plans will have their out-of-pocket spending capped at $2,000 for the year. This new policy was part of President Joe Biden’s 2022 Inflation Reduction Act (IRA), which included other drug pricing measures such as capping the cost of insulin at $35 per month for seniors.

But only a small share of Medicare enrollees will benefit from the cap, according to an analysis from nonprofit organization AARP’s Public Policy Institute, as most don’t spend more than $2,000 annually on their medications after hitting their deductible (which is up to $590 for standard plans in 2025). Beneficiaries spent an average of $400 to $500 per year as of 2022, the Hill reported, citing data from the US Department of Health and Human Services (HHS).

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DAILY UPDATE: Medicare Advantage Bonus Payments as Stocks Rise and Technology Pops

Posted on January 7, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Health plans made billions in Medicare Advantage bonus payments. A yearlong investigation reveals how. (the Wall Street Journal)

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The 10-year Treasury note yield ($TNX) is higher by ~3 basis points to 4.63%.

The U.S. Dollar Index ($DXY) is lower by 0.69 to 108.26.

WTI Crude Oil (/CL) is trading higher by 0.68% to $74.46 per barrel.

Gold prices have traded in a range of $2,624.60 to $2,663.80 and were last seen trading lower by 0.39% to $2,644.40/oz.

Natural Gas prices have traded in a range of $3.502-3.726 and were last seen trading higher by 7.30% to $3.599/MMBtu.

Bitcoin (/BTC) is trading higher by 3.83% to $102,114.50 today.

CITE: https://tinyurl.com/tj8smmes

US stocks largely rose on Monday as chip names popped and investors awaited the release of key monthly jobs data later this week.

The S&P 500 (^GSPC) was up about 0.5%, while the Dow Jones Industrial Average (^DJI) fell about 0.1% after being higher for most of the session. The tech-heavy NASDAQ Composite (^IXIC) led the gains, adding about 1.2%, after a tech-led rally on Friday.

Chip stocks rallied after a record revenue and a strong sales forecast from Nvidia (NVDA) server partner Foxconn (2317.TW, HNHPF), which boosted optimism for AI-fueled growth. Shares of Nvidia climbed more than 3%, as the stock closed at a record high. Meanwhile peer Micron Technology (MU) rose over 10%.

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ANTHEM Splits with SCRIPPS Health

Posted on January 2, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Anthem Blue Cross and Scripps Health will part ways impacting thousands of patients.

Scripps Health and Anthem Blue Cross officially just parted ways on January 1st, 2025, leaving about 125,000 patients uncertain of what their healthcare and insurance will look like in 2025.

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DAILY UPDATE: Veterans Scammed as 3 Major Markets Drop

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Read: Health insurers reportedly took billions of dollars from Medicare to cover veterans who didn’t use services. (the Wall Street Journal)

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US stocks closed the holiday week on a downbeat note as Wall Street slogged to the finish of a largely triumphant year.

The S&P 500 (^GSPC) lost 1.1%, while the tech-heavy NASDAQ Composite (^IXIC) shed 1.5% Friday at the close. The Dow Jones Industrial Average (^DJI) gave up 0.8%. Meanwhile, the 10-year Treasury yield (^TNX) hovered near seven-month highs around 4.6%.

After stacking impressive gains this year, some of the biggest names in tech lost ground as investors took profits, rebalance portfolios, or reassessed their lofty valuations. Tesla (TSLA) lost 5%. Nvidia (NVDA) gave up c2%, while Amazon (AMZN) decreased by 1%.

Wall Street has just three trading days remaining in a 2024 full of big gains, but markets have been unable to mount a “Santa Claus” rally into the end of the year.

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DAILY UPDATE: Medicare Tele-Health Out as DJIA Finishes Up a Tad

Posted on December 27, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Absent Congressional action, beginning January 1sy, 2025, the statutory limitations that were in place for Medicare telehealth services prior to the COVID-19 PHE will retake effect for most telehealth services.

This means most telehealth visits will not be covered by Medicare in 2025, unless Congress acts by the end of December 2024.

***

(Reuters) -The Dow Jones Industrial Average closed fractionally higher on Thursday, stretching its winning streak to five sessions despite light trading volumes and rising U.S. Treasury yields weighing on some of the dominant technology megacaps.

While the NASDAQ Composite and the S&P 500 were broadly unchanged, the indexes both finished slightly in negative territory. This snapped the NASDAQ’s four-session run of higher closes, and ended the S&P 500’s own run at three sessions.

On a day of few catalysts, investors responded to yields on U.S. government bonds inching higher, including the yield on the benchmark 10-year Treasury note hitting its highest since early May at 4.64% earlier in the session. And, a strong auction of seven-year notes early in the afternoon though helped yields come off slightly, with the 10-year note at 4.58% in late-afternoon trade.

Higher yields are traditionally seen as negative for growth stocks, as it raises the cost of their borrowing to fund expansion. With markets increasingly dominated by the megacap technology stocks known as the Magnificent Seven, crimping their performance – especially in lieu of other market catalysts – will put downward pressure on benchmark indexes.

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The S&P 500 slipped 2.45 points, or 0.04%, to 6,037.59 points, while the NASDAQ Composite lost 10.77 points, or 0.05%, to 20,020.36. The Dow Jones Industrial Average rose 28.77 points, or 0.07%, to 43,325.80.

Six of the megacaps fell, with Tesla leading decliners with a 1.8% fall. The outlier was Apple, rising 0.3% and continuing to edge closer to becoming the first company in the world to hit a market value of $4 trillion.

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DAILY UPDATE: PBMs and Healthcare A.I. as All Major Market Indexes Drop

Posted on December 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Stat: 97%. That’s how many healthcare leaders think A.I. will become important in healthcare over the next five years.

***

Pharmacy benefit managers (PBMs) are once again under pressure from federal leaders. A group of Democratic and Republican congresspeople proposed legislation that would attempt to prevent pharmacies from also owning PBMs. The three largest PBMs—CVS Health’s Caremark, Cigna’s Express Scripts, and UnitedHealth Group’s Optum Rx—currently operate pharmacies and administer more than 80% of the prescriptions in the US, and officials have linked this practice to drug price increases.

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US stocks fell across the board on Tuesday, with the Dow logging its biggest losing streak in 46 years. The Dow Jones Industrial Average (^DJI) finished the session down roughly 0.6%, registering its ninth straight day of losses. The last 9-day losing streak for the Dow was Feb. 1978. Prior to that, the index suffered an 11-day losing streak in 1974 and another in 1971.

The other major indexes dropped in tandem on Tuesday, with the benchmark S&P 500 (^GSPC) falling around 0.4% and the NASDAQ Composite (^IXIC) losing about 0.3% after the tech-heavy index closed at a record high on Monday.

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DAILY UPDATE: Medicare Open Enrollment Ends as Stock Market Weekly Gains

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Medicare Open enrollment ended December 7th, 2024. New Plans commence January 1st, 2025.

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Potential Market-Moving Catalysts:

Economic:

Monday (12/9): Wholesale Inventories
Tuesday (12/10): Productivity-Revised, Unit Labor Costs-Revised
Wednesday (12/11): Consumer Price Index (CPI), EIA Crude Oil Inventories, MBA Mortgage Applications Index, Treasury Budget
Thursday (12/12): Producer Price Index (PPI), EIA Natural Gas Inventories, Initial Claims, Continuing Claims
Friday (12/13): Export Prices ex-ag, Import Prices ex-oil

Earnings:

Monday (12/9): Oracle Group (ORCL), MongoDB Inc. (MDB), Toll Brothers Inc. (TOL), Casey’s General Stores Inc. (CASY), Vail Resorts Inc. (MTN)
Tuesday (12/10): AutoZone Inc. (AZN), Ferguson Enterprises Inc. (FERG), Academy Sports and Outdoors Inc. (ASO), GameStop Corp. (GME)
Wednesday (12/11): Adobe Inc. (ADBE), Nordson Corp. (NDSN), REV Group Inc. (REVG)
Thursday (12/12): Ciena Corp. (CIEN), Broadcom Inc. (AVGO), Costco Wholesale Corp. (COST)
Friday (12/13): -no reports-

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U.S. stocks closed mostly higher Friday, with the S&P 500 and NASDAQ Composite each notching fresh record peaks after the latest employment report showed jobs growth bounced back in November. The S&P 500 rose 15.16 points, or 0.2%, to end at 6,090.27. The NASDAQ climbed 159.05 points, or 0.8%, to close at 19,859.77. The Dow Jones Industrial Average fell 123.19 points, or 0.3%, to end at 44,642.52.

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2025 MEDICARE: Agent & Broker Pay Day Changes

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

How insurance agents will be compensated for helping seniors?

By Staff Reporters

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Health insurance agents offering support to seniors signing up for healthcare coverage will be compensated differently starting in 2025. For example:

The government will pay $100 more per enrollment to agents who sign seniors up for Medicare Advantage Plans or Medicare Part D for the first time — a significant increase from the proposed $31 pay increase for agents.

And, Medicare is ending sales incentives for agents who currently receive bonuses, including volume-based bonuses, for signing people up for Medicare Advantage Plans, Medigap Supplement Plans or Part D. Medicare is also putting a stop to agents and brokers collecting “administrative fees” above the fixed compensation cap the government has put in place.

The hope is that providing agents with fair initial compensation will no longer incentivize them to steer seniors towards plans that may not be a good fit.

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PS: Medicare open enrollment ended December 7th, 2024. New plans commence January 1st, 2025

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AMA: 41 Senators Sign Letter to Stop Medicare Cuts

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

By Staff Reporters

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In a sign of legislative momentum, 41 senators are supporting efforts to prevent a pending 2.8 percent cut in Medicare physician payments that will go into effect January 1st. The bipartisan letter led by Sens. John Boozman, R-Ark., and Peter Welch, D-Vt., to Senate leaders says the cuts would interfere with the ability of physicians to provide high-quality care. “These continued payment cuts undermine the ability of independent clinical practices – especially in rural and under served areas – to care for their communities,” the letter said.

The Senate letter follows one from the American Medical Association (AMA) and 127 other state medical associations and national medical societies asking Congress to use these last few congressional days to prevent the scheduled cuts. The letter to congressional leaders also urges Congress to provide a positive payment update for 2025. All 50 state medical societies – and DC— as well as 77 national medical societies signed.

Source: AMA

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DAILY UPDATE: Health Insurance Affordability as Stock Markets Broadly Rise

Posted on November 26, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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The Commonwealth Fund’s 2024 biennial health insurance survey, released November 21, found that though 79% of US adults had continuous health insurance for 12 months, 23% were under insured, meaning they have health insurance and still can’t afford care. About 56% of those surveyed had adequate insurance coverage all year.

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STOCKS UP

Rocket Lab rocketed (sorry) 3.44% to a new record high after launching not one, but two different rockets in two different hemispheres in a single day.
Bath & Body Works soared 16.51% on a strong beat-and-raise quarter.
Robinhood jumped 3.27% after Morgan Stanley analysts doubled their price target for the investing app.
Super Micro Computer surged yet another 15.87%, more than doubling in the last seven days, and shareholders cheered its comeback.
Hims & Hers Health climbed 23.77% on the news that the new head of the FDA may be an ally.
Flying taxi company Vertical Aerospace popped 45.51% after announcing an additional $50 million in funding from one of its biggest shareholders.

STOCKS DOWN

Defense contractor stocks got a double whammy today: Hopes of a ceasefire between Israel and Hezbollah, combined with Elon Musk’s declaration on X that buying manned military aircraft is wasteful. Lockheed Martin fell 3.76%, Northrop Grumman dropped 2.39%, and Raytheon Technologies parent company RTX Corp. fell 1.74%.
Speaking of Musk, Tesla sank 3.96% after California announced it may exclude the automaker from incentives that encourage drivers to buy EVs in the state.
Pipeline operator Oneok lost 4.72% on the news that it will acquire the remaining portion of EnLink Midstream that it doesn’t already own.
After rallying last week thanks to its inclusion in the S&P 500, Texas Pacific Land sank 6.71% today as investors took profits.

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

Here’s where the major benchmarks ended:

The SPX rose 18.03 points (0.30%) to 5,987.37; the $DJI added 440.06 points (0.99%) to 44,736.57; and the NASDAQ Composite^® ($COMP) gained 51.18 points (0.27%) to 19,054.84.
The 10-year Treasury note yield fell 15 basis points to 4.27%.
The CBOE Volatility Index^®(VIX)dropped to 14.74, the lowest since November 14.

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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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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™

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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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California Passes Bill Regulating Private Equity Deals

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

By Health Capital Consultants, LLC

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On September 28th, 2024, California Governor Gavin Newsom vetoed Assembly Bill (AB) 3129, which sought to regulate private equity (PE) transactions involving healthcare organizations by requiring certain transactions to be reviewed by, and to receive approval from, the California Attorney General (AG).

In his veto message, Governor Newsom stated that the state’s Office of Health Care Affordability (OHCA), established in 2022, has the power to review and evaluate healthcare transactions (including the ones at issue in AB 3129). While OHCA does not have the power to block proposed transactions, as the AG would have had under AB 3129, it can refer transactions to the AG for further examination. Put simply, the governor’s veto seems to stem from concern that taking power away from the newly-created OHCA could muddy the waters in healthcare transaction regulation.

While there is a possibility that the California legislature could override Governor Newsom’s veto, it appears unlikely as of the publication of this Alert. However, the overall popularity of this bill in the legislature (as evidenced by the fairly wide margins with which it passed) indicates that PE groups looking to transact in the healthcare space – both in California and across the U.S. – should be on high alert, as regulators are increasingly turning their focus on the role of PE in healthcare.

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

For more information on AB 3129, as well as the status of state and federal regulation of PE, see the September 2024 Health Capital Topics article entitled, “California Passes Bill Regulating Private Equity Deals.”

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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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SPONSOR: http://www.CertifiedMedicalPlanner.org

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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DAILY UPDATE: Nvidia, Intel, Oil, Bitcoin, Treasury Yields, CMS and Physician Pay

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Nvidia is replacing Intel on the Dow Jones Industrial Average, a shakeup to the blue-chip index that replaces a flagging semiconductor company with the primary vendor of GPUs for AI.

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Despite selling off last week, stocks spent Friday comfortably in the green thanks to strong earnings from big tech.
Treasury yields rose back above 4.3% as bonds sold off and investors poured money into risk assets.
Oil rose a bit on reports that Iran may retaliate against Israel sometime soon.
Bitcoin was unable to hold the line and continued to fall today as crypto volatility continues to escalate ahead of the election.

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Bipartisan Legislation Aims to Stop Medicare Cuts & Boost Physician Pay in 2025

Physicians and other healthcare practitioners may get a pay boost in 2025 through a bipartisan bill recently introduced in Congress. The proposed bill seeks to block planned Medicare pay cuts next year and would provide the first inflationary update to physician pay in years. The Medicare Patient Access and Practice Stabilization Act would counteract the 2.8% cut to the conversion factor proposed by the Centers for Medicare and Medicaid Services (CMS) in the draft CY-2025 Physician Fee Schedule. A stop-gap pay fix is usually enacted by Congress at the end of the year.

Source: Emma Beavins, Fierce Healthcare [10/30/24].

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IN & OUT OF NETWORK: Medical Care

Posted on November 2, 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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What does in-network mean?

In-network refers to a health care provider that has a contract with your health plan to provide health care services to its plan members at a pre-negotiated rate. Because of this relationship, you pay a lower cost-sharing when you receive services from an in-network doctor.

What does out-of-network mean?

Out-of-network refers to a health care provider who does not have a contract with your health insurance plan. If you use an out-of-network provider, health care services could cost more since the provider doesn’t have a pre-negotiated rate with your health plan. Or, depending on your health plan, the health care services may not be covered at all.

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OUT OF NETWORK [OON] MEDICAL CARE

Classic: Any medical provider, supplier or facility that is in-network is one that has contracted with your health insurer to provide services;as above.

Modern: Depending on your plan, if you visit an out-of-network provider, it may not be covered or might be only partially covered. When making appointments with various doctors and service providers, you may notice some are listed as “in-network” while others are “out-of-network.”

THINK: Medicare Advantage {Part C] Plans

Example: You can expect a higher deductible and out-of-pocket limit at out-of-network providers. Your coinsurance and co-payment may also be higher for out-of-network providers.

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EMPLOYER’S: Pay for Health Insurance Paradox

Posted on November 1, 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: Employers write checks that cover most health insurance premiums for employees and their dependents. But as the late Princeton health economist Uwe Reinhardt PhD once explained, employer-sponsored insurance is like a pickpocket taking money out of your wallet at a bar and buying you a drink. You appreciate the cocktail until you realize you paid for it yourself.

Modern Circumstance: With health coverage, employers write the check to the insurer, but employees bear the cost of the premium — the entire premium, not just the portion listed as their contribution on their pay stub. The premium money that goes to the insurance company is cash that employers would otherwise deposit in employees’ accounts like the rest of their salary.

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

Paradox Example: The fallacy paradox is in thinking an employer’s contribution comes out of profits. In fact, higher health insurance premiums mean lower wages for workers. Since 1999, health insurance premiums have increased 147 percent and employer profits have increased 148 percent. But in that time, average wages have hardly moved, increasing just 7 percent. Clearly workers’ wages, not corporate profits, have been paying for higher health insurance premiums. Health care costs are one — though not the only — reason wages have stagnated over the last few decades. With health insurance costs rising faster than growth in the economy, more labor costs go to benefits like health insurance and less to take-home pay. Yet the paradox that employees don’t pay for their own health insurance is widespread:

The first reason is that individuals cannot be sure what causes their wages to change or remain stagnant for decades.
The second reason is that employers want Americans to believe that they pay for their workers’ health insurance.
The third reason is that there are those who profit from the employment-based system: drug companies, device manufacturers, specialty physicians and high-income individuals.

And so, they all want you to believe companies are being magnanimous in giving you insurance, but they are not!

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PARADOX: Value Based Care

Posted on October 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

BY DR. DAVID EDWARD MARCINKO MBA MED CMP™

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A young clinician representative advising to consider the cost versus value of medicine. Health care concept for economic cost-effectiveness analysis, driving down medical costs, improved access.

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Value Based Care Classic Definition: Value-based care is a type of payment model that pays doctors and hospitals for treating patients in the right place, at the right time and with just the right amount of care. You can look at it as a financial incentive to motivate healthcare providers to meet specific performance measures related to the quality and efficiency of the process. The same way, it penalizes weaker experiences, such as medical errors. The concept is often counter-intuitive.

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

Modern Circumstance: As healthcare costs continue to rise, value-based care has been growing in popularity compared to the traditional fee-for-service method.

Think: HMOs, PPOs, capitation payments and Medicare Advantage [Part C].

Paradox Examples:

Payment: A physician paid through fee-for-service compensation might like to see a packed medical office waiting room. More patients and services equate to higher pay. But, the same doctor paid through a VBC contract might wish to see an emptier waiting room as s/he will get the exact same daily pay for seeing fewer patients and working much less.
Prospectivity: Traditional Fee-for-Service medicine treats sick patients. VBC medicine seeks to keep patients healthy and out of the doctor’s office.

Nursing Capitation: https://medicalexecutivepost.com/2024/07/07/on-nursing-capitation-reimbursement/

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DAILY UPDATE: Stock Markets, Netflix and Medicare Part C as CVS Closes Stores

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Markets: The S&P 500 hit an all-time high yesterday, closing out its sixth consecutive week of gains for its longest streak of 2024. The Dow and NASDAQ also closed in the green.

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The largest Medicare Advantage insurers have prioritized profits over patient care by increasing the use of prior authorization in recent years to frequently deny post-acute care services to older adults, according to a report published Oct. 17th by the Senate Permanent Subcommittee on Investigations.

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The drugstore chain CVS is in the process of shuttering “roughly 300” locations across the country in 2024, a spokesperson confirmed to Good Housekeeping. That includes the dozens of pharmacies in Target stores.

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Stock spotlight: Netflix stock jumped on Friday, a day after its earnings report beat expectations.

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Do Doctors Use ChatGPT in Clinical Decisions?

Posted on October 18, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Are doctors using publicly available tools like ChatGPT? The answer, Fierce Healthcare finds, is yes. In the first in-depth look of its kind into physician use of public genAI tools, Fierce Healthcare spoke with nearly two dozen doctors, students, AI experts and regulators, and helped conduct a survey of more than 100 physicians. The reporting confirms that some doctors are turning to tools intended for non-clinical uses to make clinical decisions.

More: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2804309

A collaborative survey between Fierce Healthcare and physician social network Sermo found that 76% of respondents reported using general-purpose LLMs in clinical decision-making. With no standardized guidelines, lagging physician training and regulators racing to try to keep up with rapidly changing technology, guardrails to protect patients appear to be years behind current rates of utilization.

Source: Fierce Healthcare [10/8/24]

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DAILY UPDATE: Maximum Lifespan as Medicare Part C is Down and Stocks Markets Decline

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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Maximum lifespans. The upper limit of human life expectancy is leveling out, according to a new study published in the journal Nature Aging. Back in 1990, life-extending tech and health measures were increasing the average global lifespan by about 2.5 years per decade, but that dropped to 1.5 years per decade in the 2010s and closer to zero in the US, where there are more drug overdoses, shootings, and medical care inequities.

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STOCKS UP

Sphere Entertainment popped 6.33% on the news that a second Sphere will be built in Abu Dhabi. London was originally supposed to be the location of a second venue, but they’ve already got the Eye, and didn’t need more circular tourist attractions.

Oklo, a Sam Altman-backed nuclear energy startup, rose another 16.04% on the news that Google will purchase nuclear power to turbocharge its AI infrastructure.
Charles Schwab climbed 6.10% after the bank announced a top and bottom line beat last quarter, as well as higher revenue projections for the full fiscal year.
Boeing somehow gained 2.26% after announcing it is raising $35 billion to support its struggling finances as the machinist union strike enters its second month.
Wolfspeed, which sounds like a super power in a YA novel, soared 21.27% on the news that the US government will provide the chipmaker with up to $750 million in government grants.

STOCKS DOWN

Semiconductor stocks got a double whammy in the last 48 hours. First, Bloomberg revealed that US officials are considering limiting the sale of AI chips outside the country. Then, ASML missed its Q3 sales estimates (more on that below). Nvidia shares slid 4.52%, AMD fell 5.22%, and Intel dropped 3.33%.
Citigroup beat earnings estimates this quarter, but shareholders punished the bank for setting aside more money in case of higher loan losses ahead. Shares dropped 5.11%.
Coty, parent company of numerous beauty brands like CoverGirl, fell 10.74% to a new 52-week low after it warned of a sales slowdown in the coming quarters.
Enphase Energy tumbled 9.29% after RBC analysts downgraded the solar power stock, citing growing competition from the likes of Tesla as well as slowing demand for solar batteries.
Speaking of energy, oil stocks plummeted on news of Israel’s targeting of Iranian military assets rather than crude production facilities. Exxon Mobil fell 3.01%, Chevron dropped 2.67%, and Valero Energy sank 4.62%.

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Here’s where the major benchmarks ended yesterday:

The S&P 500^® index (SPX) fell 44.59 points (–0.76%) to 5,815.26; the Dow Jones Industrial Average^® ($DJI) dropped 324.80 points (–0.75%) to 42,740.42; and the NASDAQ Composite^® ($COMP) lost 187.09 points (–1.01%) to 18,315.59.
The 10-year Treasury note yield (TNX) fell three basis points to 4.04%, the lowest close in a week.
The CBOE Volatility Index^®(VIX) climbed to 20.72, an elevated level.

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Millions of seniors will lose access to their Medicare Advantage plans after major insurer cuts in the aftermath of the Inflation Reduction Act. Experts spoke with Newsweek about what’s going on and what steps seniors can take to get the coverage they need.

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MEDICARE: Open Enrollment Period Commences

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

By Staff Reporters & The Medicare Team

Medicare open enrollment—which runs from October 15th through December 7th this year—is your chance to check in on your Medicare plan and, if needed, change it.

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Mark your calendars — Medicare Open Enrollment starts October 15th! Did you know new benefits are coming to Medicare drug coverage next year?

Starting in 2025, all Medicare plans will include a $2,000 cap on what you pay out-of-pocket for prescription drugs covered by your plan. So, it’s more important than ever to make sure your drugs are covered.

Also starting next year, you can choose to participate in a program that spreads your out-of-pocket drug costs across the calendar year, instead of paying all at once at the pharmacy. It’s called the Medicare Prescription Payment Plan — and you can opt in with your plan throughout the 2025 plan year. Contact your plan for more details.

Preview Coverage Options

Remember, Medicare plans can change from one year to the next, and so can your health needs. Preview and compare all your health and drug options and see if you can save!

The Medicare Team

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DAILY UPDATE: CPI, PepsiCo and Health Insurance Premiums as Stocks Drift Off Recent Highs

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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The Consumer Price Index rose 2.4% in the 12-month period that ended in September, while a gauge that strips out food and energy prices was 3.3%, the government said yesterday.

Stat: 7%. That’s how much employer health insurance premiums increased this year, after rising by the same margin last year. Family coverage this year costs roughly $25,500 for employers and employees. (the Wall Street Journal)

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Stocks up

Celsius Holdings, makers of those disgusting energy drinks your 12-year-old cousin chugs, soared 14.42% after analysts from Stifel and Piper Sandler gave it a vote of confidence.
Crowdstrike enjoyed a rare bump 5.56% higher today after RBC Capital analysts named the company one of the top software stocks of 2025. Speaking of, Delta Air Lines announced it took a $380 billion hit last quarter due to the Crowdstrike outage. Shares of the airline sank 1.16% after earnings.
CVS Health rose 1.35% after an upgrade from Barclays analysts who think the company’s Medicare business should recover nicely.
GXO Logistics, a supply-chain management company, popped 14.11% on a report from Bloomberg that the company is exploring a potential sale.

Stocks down

10X Genomics, which sounds like the bad guys that accidentally release a military-grade virus in a zombie movie, fell 24.70% after it announced preliminary results that disappointed shareholders.
Toronto-Dominion Bank dropped 5.29% on the news that not only will the Canadian bank pay US regulators $3 billion in penalties, but its retail business growth will be limited in the US. All that for failing to stop drug cartels from laundering money.
First Solar sank 9.29% after Jefferies analysts cut their price target on the solar power panel maker, citing production delays hurting the company’s bottom line. The report sent shares of competitors Enphase Energy and SolarEdge Technologies tumbling 5.82% and 4.32%, respectively.
PayPal lost 3.27% thanks to a report from Bernstein analysts who downgraded the stock on fears that Venmo could lose market share to competitors.

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Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) lost 11.99 points (–0.21%) to 5,780.05; the Dow Jones Industrial Average^® ($DJI) fell 57.88 points (–0.14%) to 42,454.12; and the NASDAQ Composite^® ($COMP) dropped 9.56 points (–0.05%) to 18,282.05.
The 10-year Treasury note yield (TNX) rose three basis points to 4.1%, the highest since July 31 and closing in on the 100-day moving average.
The CBOE Volatility Index^®(VIX) was flat at 20.87.

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PepsiCo cut its full-year organic revenue guidance as consumers reduced their spending on drinks and snacks, and the company posted “its second straight quarter of weaker-than-expected sales,” CNBC reported.

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MARKETS: Humana, General Motors, Nike & the Middle East

Posted on October 2, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Humana, the country’s second largest Medicare Advantage insurer, is aggressively culling its plan offerings after several quarters of spending more than expected on its members’ medical care, and getting hammered on Wall Street for it. The company will scrap Medicare Advantage plans in 2025 that currently cover about 560,000 members.

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Markets: Stocks embraced the start of spooky season by falling yesterday, ending a hot streak as investors mulled the rising tensions in the Middle East.

General Motors: Reported slightly better-than-expected sales during the third quarter, thanks in part to increased sales of small crossovers and electric vehicles. The automaker reported a 2.2% decrease in sales, compared with a year earlier, an improvement over auto industry forecasts that projected a decline of more than 3% in the quarter.

Meanwhile: Nike’s beleaguered stock was up a bit ahead of its first earnings report since the company announced a CEO change. It withdrew its full-year guidance and postponed its investor day as longtime company veteran Elliott Hill prepares to take the top job at the sneaker giant. Instead, executives said Nike will provide quarterly guidance for the rest of the year. Shares of Nike fell about 7% in early trading Wednesday.

Cite: https://tinyurl.com/bdfjyxhf

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DAILY UPDATE: Exxon Mobil, Medicare Part C, Boeing and UniCredit as Stocks Rise

Posted on September 25, 2024 by Dr. David Edward Marcinko MBA MEd CMP™

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California state officials filed a lawsuit against one of the world’s top oil giants accusing Exxon Mobil of driving global pollution by running a “decades-long campaign of deception” that dramatically overstated the effectiveness of plastic recycling. The suit seeks “multiple billions of dollars” in civil damages from Exxon Mobil—a main producer of the petrochemicals used to make single-use plastics—California Attorney General Rob Bonta said.

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What’s up

Smartsheet popped 6.47% on the news that Blackstone and Vista Equity Partners will pay $8.4 billion in cash to take the software maker private.
Freeport-McMoRan gained 7.95% after the Chinese government announced stimulus plans. Shareholders are hopeful that more economic activity means more business for the copper miner.
Liberty Broadband soared 25.92% thanks to its counterproposal to Charter Communications, asking for a higher payout before an acquisition takes place. Charter shares fell 2.49%.
Thor Industries rose 6.18% after the RV company announced stronger-than-expected earnings.

What’s down

Visa fell 5.36% as the US government sued it over an alleged debit card monopoly.
Regeneron Pharmaceuticals dropped 4.21% due to a federal judge’s ruling that it cannot block a new product from rival pharma company Amgen that mimics its eye-care drug Eylea.

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

Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) added 14.36 points (0.25%) to 5,732.93; the Dow Jones Industrial Average^® ($DJI) rose 83.57 points (0.20%) to 42,208.22; the NASDAQ Composite^® ($COMP) gained 100.25 points (0.56%) to 18,074.52.
The 10-year Treasury note yield (TNX) finished unchanged at 3.74%.
The CBOE Volatility Index^®(VIX) keeps setting new lows for September, dropping to 15.49.

CITE: https://tinyurl.com/tj8smmes

Boeing offers 30% raise in attempt to end strike. With 30,000 factory workers on strike and 737 production halted for a second week, the embattled aviation company offered to hike wages for union members higher than the original 25% increase over four years they voted to reject.

Seniors could see large increases to their Medicare Advantage costs in 2025 as major changes are underway for prescription plans.

German Chancellor Olaf Scholz warned Italian bank UniCredit against “unfriendly” acts after the bank upped its stake in Germany’s Commerzbank, eclipsing the country as its largest shareholder.

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Filed under: Information Technology, Investing, Marcinko Associates, Recommended Books, Sponsors | Tagged: Boeing, DJIA, DOW, Exxon Mobil, healthcare, Marcinko, medicare, Medicare Advantage, NASA, NASDAQ, Part C, retirement, S&P 500, SPX, textbooks, TNX, UniCredit, VIX, WSJ | Leave a comment »

PODCAST: Accounting for Healthcare Professionals

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

By Eric Bricker MD

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PODCAST: Economic Cycles in Healthcare

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

By Eric Bricker MD

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The Market Technicians

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Filed under: "Doctors Only", Accounting, Career Development, Experts Invited, Health Economics, Healthcare Finance, Videos | Tagged: economic cycles, economic cycles healthcare, Eric Bricker MD, healthcare, healthcare inflation, healthcarecost inflation, inflation cost inflation, medical cost inflation | Leave a comment »

RESOURCES: Financial and Economic Essays for Doctors and Healthcare Professionals

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

https://marcinkoassociates.com

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Informational essays of most current interest to healthcare professionals. Check back periodically for practical updates. Our catalogue library of major books, texts, case models and dictionaries is suggested for additional financial, economic, business and medical practice management information and education.

READ HERE: https://marcinkoassociates.com/articles-essays/

UPDATE: Prior ME-P Topics:

1-The number of balance billing disputes reaching arbitration is far higher than federal projections suggested.

2-Experts worry ACOs could face lasting financial difficulties due to an alleged $2 billion Medicare urinary catheter fraud scheme.

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PODCAST: Impact of Education on Employee Health Care

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

HEALTH INSURANCE DEMOGRAPHICS

By Eric Bricker MD

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DAILY UPDATE: Second Apple Downgrade with Mixed Markets as Investors Await Payroll Data and Lilly Sells Medications Directly to Patients

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

By Staff Reporters

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Here’s where the major benchmarks ended:

The S&P 500^® index (SPX) was down 16.13 points (0.3%) at 4,688.68; the Dow Jones Industrial Average^® (DJI) was up 10.15 points at 37,440.34; the NASDAQ Composite was down 81.91 points (0.6%) at 14,510.30.
The 10-year Treasury note yield (TNX) was up about 9 basis points at 3.997%.
The CBOE^® Volatility Index (VIX) was up 0.08 at 14.12.

Oilfield services and consumer discretionary shares were also among the market’s weakest performers Thursday. Banking and health care were among the strongest sectors, illustrating renewed investor interest in stocks that lagged the broader market last year.

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

And, Eli Lilly is poised to sell medicine directly to consumers — with an emphasis on newly popular weight-loss drugs — in a move toward cutting out the controversial middle players in drug distribution.

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Filed under: Alternative Investments, Financial Planning, Funding Basics, Glossary Terms, Investing, Touring with Marcinko | Tagged: Apple, banking, banks, CPI, DJIAm, Eli Lilly, energy, gold, healthcare, inflation, investors, Lilly, Marcinko, markets, metals, NASDAQ, oil, payrolls, real-estate, Russell Index 2000, RUT, S&P 500, stock markets, TNX, utilities | Leave a comment »

EDITOR’S CORNER: Fierce Health-Care’s 10 Most-Read Stories of 2023

Posted on December 25, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Heather Landi

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READ HERE: http://tinyurl.com/484773vm

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U.S. ECONOMY: Perhaps a “Soft Landing” After All?

Posted on December 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

YET- HEALTH CARE IS GROWING!

By Staff Reporters

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The US economy is looking like it could avoid a downturn and achieve a soft landing after all. US employers added a more-than-expected 199,000 workers to their payrolls last month, the Bureau of Labor Statistics said recently. The solid result calmed many analysts’ fears that a steeper economic slowdown is imminent due to the Federal Reserve’s earlier interest rate hikes. And, it brings us closer to the coveted “soft landing” scenario, in which the Fed tames inflation on the economy. For example:

The unemployment rate unexpectedly ticked down for the first time since July, to 3.7%.
Average hourly pay increased by 0.4% and is now up 4% for the year, beating the projected pace of annual price growth.
But the job market isn’t quite what it used to be

Last month’s 199-k jobs created were below the average of 240,000 added in the preceding 12 months. Plus, November hiring was confined to just a handful of industries:

Healthcare and the government were responsible for two-thirds of the headcount growth, adding 77,000 and 49,000 jobs, respectively.
The manufacturing sector gained 28,000 workers—but that was largely due to folks returning to work after striking against the Big Three automakers.
CITE: https://www.r2library.com/Resource/Title/082610254

Finally, in another sign that employers might be pulling back from on-boarding new people, the Labor Department reported earlier this week that job openings in late October were at their lowest since March 2021.

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Filed under: "Ask-an-Advisor", Financial Planning, Funding Basics, Glossary Terms, Health Economics, Healthcare Finance, Investing | Tagged: automakers, BLS, Bureau Labor Statistics, fed, Federal Reserve, FOMC, health care, healthcare, job markets, labor, soft landing, US economy | Leave a comment »

DAILY UPDATE: Health Care, FOMC and the Tepid Markets

Posted on December 12, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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In healthcare, legislators could vote next week on a major health reform package that includes a ban on spread pricing in Medicaid and a push toward site-neutral payments.

In more news from the Hill, a bipartisan bill was introduced that seeks to cancel a 3.4% Medicare pay cut to docs, which has drawn plenty of ire from the industry.

***

The final FOMC meeting of the year will take place this week, and like most work meetings in mid-December, not a whole lot is going to happen. Chair Jerome Powell is widely expected to leave interest rates unchanged as inflation continues its descent to a 2% target. But 2024 planning is in full swing, and investors are desperate to learn when the Federal Reserve thinks it will need to cut rates next year.

***

Here is where the major stock index benchmarks ended:

The S&P 500 index was up 18.07 points (0.4%) at 4,622.44; the Dow Jones Industrial Average® (DJI) was up 157.06 points (0.4%) at 36,404.93; the NASDAQ Composite was up 28.51 points (0.2%) at 14,432.49.
The 10-year Treasury note yield (TNX) was little-changed at 4.239%.
The CBOE® Volatility Index (VIX) was up 0.28 at 12.63.

In addition to retailers, semiconductor company shares also posted outsized gains Monday, boosted in part by a jump of nearly 10% in Broadcom (AVGO). The Philadelphia Semiconductor Index (SOX) gained more than 3% and ended near a two-year high. Transportation companies were also strong.

In other markets, Natural Gas futures (/NG) plunged more than 6% to a six-month low, reflecting warmer-than-normal U.S. temperatures and excess supplies.

Finally, the so-called Magnificent Seven stocks of Apple, Microsoft, Alphabet, Amazon.com, Nvidia, Tesla and Meta Platforms each fell at least 0.8%. Meta led the declines, dropping 2.2%. But only one out of 11 S&P 500 sectors fell. Even the information technology sub-index ticked higher, reflecting gains outside of the largest companies in the sector.

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Filed under: Financial Planning, Funding Basics, Glossary Terms, Health Economics, Health Insurance, Healthcare Finance, Investing, Touring with Marcinko | Tagged: /NG, Alaphabet, Amazon, Apple, banks, DJIA, DJIAm, energy, FOMC, gold, google, healthcare, inflation, interest rates, IRS, Marcinko, markets, Medicaid, medicare, Meta, metals, MSFT, NASDAQ, Nvidia, oil, Powell, real-estate, Russell Index 2000, RUT, S&P 500, SOX, stock markets, Tesla, TNX, utilities | Leave a comment »

CASE MODELS: Healthcare Business Entities

Posted on November 6, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

MARCINKO ASSOCIATES, Inc.

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The Marcinko & Associates case study and white-paper compendium is a teaching vehicle that presents potential clients with a critical management issue that serves as a spring board to lively debate in which participants present and defend their analysis and prescriptions. The average case is 2 to 100 pages long (prose, tables, graphs, charts, spread sheets and figures, etc).

CASE MODEL Sample Privatization: https://tinyurl.com/3af5nf7s

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CASE MODELS: Healthcare Business Entities

Posted on October 30, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

MARCINKO ASSOCIATES, Inc.

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AMAZON in Healthcare

Posted on October 27, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By The Medical Futurist

Amazon In Healthcare: Disruption, Data Nightmares And Digital Health Dreams

Amazon’s healthcare ventures present a double-edged sword. On one hand, there’s undeniable promise, but the flip side paints a cautionary tale.

READ: https://tinyurl.com/ydtbvahx

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DAILY UPDATE: Major Stock Markets

Posted on September 30, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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Here is where the major benchmarks ended today:

The S&P 500 Index was down 11.65 points (0.3%) at 4,288.05, down 0.7% for the week; the Dow Jones Industrial Average (DJIA) was down 158.84 points (0.5%) at 33,507.50, down 1.3% for the week; the NASDAQ Composite (COMP) was up 18.05 points (0.1%) at 13,219.32, up slightly for the week but down 5.8% for the month.
The 10-year Treasury note yield (TNX) was down about 1 basis point at 4.583%.
CBOE’s Volatility Index (VIX) was up 0.18 at 17.52.

Energy stocks were among the market’s weakest performers as crude oil futures extended a pullback from a rally earlier in the week that sent prices to 13-month highs above $93 a barrel.

Health care and financial sectors were also soft. Regional banks, retailers, and consumer discretionary shares were among the strongest performers.

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

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Filed under: "Ask-an-Advisor", Alerts Sign-Up, Financial Planning, Funding Basics, iMBA, Inc., Investing | Tagged: CBOE, DJIA, DOW, Energy stocks, financial stocks, healthcare, healthcare stocks, NASDAQ, S&P 500, VIX | Leave a comment »

PODCAST: Poverty in Healthcare Explained

Posted on September 1, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Eric Bricker MD

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