BAD MONEY MOVES of Physicians!

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

***

***

Money is a powerful tool. It can provide security, open opportunities, and help build a fulfilling life. Yet, when mismanaged, it can quickly become a source of stress and regret. Understanding the worst ways to use money is essential for anyone who wants to avoid financial pitfalls and build lasting stability.

1. Impulse Spending

One of the most damaging habits is spending without thought. Buying items on impulse—whether it’s clothes, gadgets, or luxury goods—often leads to regret and wasted resources. These purchases rarely align with long‑term goals and can drain savings meant for emergencies or investments.

2. High‑Interest Debt

Credit cards and payday loans can trap people in cycles of debt. Paying 20% or more in interest means that even small purchases balloon into massive financial burdens. Using debt irresponsibly is one of the fastest ways to erode wealth.

3. Ignoring Savings and Investments

Failing to save for the future is another critical mistake. Without an emergency fund, unexpected expenses like medical bills or car repairs can derail financial stability. Similarly, neglecting investments means missing out on compound growth that builds wealth over time.

4. Chasing Get‑Rich‑Quick Schemes

From pyramid schemes to speculative “hot tips,” chasing unrealistic returns is a recipe for disaster. These schemes prey on greed and impatience, often leaving participants with nothing but losses. Sustainable wealth comes from patience and discipline, not shortcuts.

5. Overspending on Status

Many people waste money trying to impress others—buying luxury cars, designer clothes, or extravagant experiences they cannot afford. This pursuit of status often leads to debt and financial insecurity, while providing only fleeting satisfaction.

6. Neglecting Insurance

Skipping health, auto, or home insurance to save money may seem smart in the short term, but it can be catastrophic when disaster strikes. Without protection, one accident or emergency can wipe out years of savings.

7. Failing to Budget

Living without a plan is like sailing without a map. Without a budget, it’s easy to overspend, miss bills, or fail to allocate money toward goals. Budgeting is not restrictive—it’s empowering, because it ensures money is used intentionally.

8. Ignoring Education and Skills

Spending money without investing in personal growth is another hidden mistake. Education, training, and skill development often yield lifelong returns. Neglecting these opportunities can limit earning potential and financial independence.

Conclusion

The worst things to do with money often stem from short‑term thinking, lack of discipline, or the desire for instant gratification. Impulse spending, high‑interest debt, chasing schemes, and neglecting savings all undermine financial health. By avoiding these traps and focusing on budgeting, investing wisely, and protecting against risks, money can serve as a foundation for security and freedom rather than a source of stress.

COMMENTS APPRECIATED

Like, Refer and Subscribe

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

***

***

INSURANCE AGENTS: Salary and Payment Mechanisms

By Dr. David Edward Marcinko MBA MEd CMP and Copilot A.I.

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

***

Insurance agents are primarily paid through commissions, but may also earn salaries, bonuses, and fees depending on their employment model and the types of policies they sell.

Insurance agents play a vital role in helping individuals and businesses navigate the complex world of insurance. Their compensation structures vary widely, influenced by factors such as the type of insurance they sell, whether they work independently or for a company, and the specific agreements they have with insurers. Understanding how insurance agents are paid is essential for consumers who want to make informed decisions and for aspiring agents considering a career in the industry.

The most common form of compensation for insurance agents is commission-based pay. Agents earn a percentage of the premium paid by the customer when they successfully sell a policy. These commissions can vary depending on the type of insurance. For example, first-year commissions for auto and homeowners insurance typically range from 5% to 20%, while commercial property and casualty policies may offer 10% to 15%. Life insurance policies often provide higher initial commissions, sometimes exceeding 50% of the first-year premium, followed by smaller renewal commissions in subsequent years.

There are two main types of insurance agents: captive agents and independent agents. Captive agents work exclusively for one insurance company and usually receive a combination of salary and commissions. Their compensation may also include performance bonuses and incentives tied to sales targets. Independent agents, on the other hand, represent multiple insurers and rely more heavily on commissions. They have the flexibility to offer a wider range of products, but their income is directly tied to their ability to sell policies and maintain client relationships.

***

***

In addition to commissions, some agents earn fees for services such as policy reviews, risk assessments, or consulting. These fees are more common in commercial insurance or financial planning contexts, where agents provide specialized expertise. However, fee-based compensation is less prevalent in personal lines of insurance like auto or home coverage.

Bonuses and incentives are another component of agent compensation. Insurance companies often reward agents for meeting sales quotas, retaining clients, or selling specific types of policies. These bonuses can significantly boost an agent’s income, but they may also create potential conflicts of interest if agents prioritize higher-paying products over client needs.

Some agents, particularly those employed by large firms or call centers, receive a fixed salary. This model provides stability but may limit earning potential compared to commission-based roles. Salaried agents may still receive performance bonuses or profit-sharing depending on company policy.

Ultimately, an insurance agent’s earnings depend on their business model, experience, and ability to build a loyal client base. While commissions remain the cornerstone of insurance compensation, the rise of fee-based services and hybrid models reflects a shift toward more transparent and client-focused practices.

Consumers should feel empowered to ask agents about their compensation structure to ensure they receive unbiased advice tailored to their needs.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com

Like, Refer and Subscribe

***

***

The Hidden Risk of Trusting Friends in Finance

Here’s a risk to your financial health that may surprise you!

Rick Kahler MS CFP

By Rick Kahler CFP

There are two reasons for this.

First, we tend to trust and rely on people we know.

Second, research finds that humans have a deep-seated desire to meet the needs of others, so “helping” a relative or friend get started in their financial sales career is just human nature. Unfortunately, brokerage and insurance companies know this. They train their new agents that the easiest sales to make when getting started are to relatives and friends.

Any time I find an ill-advised financial product a client has purchased from a relative or friend, I cringe, anticipating the client’s resistance to canceling it. Regardless of how bad the advice was or how outrageous the fees of an investment product may be, the deeper the relationship the more difficulty there will be in changing course.

***

***

Here’s a typical example 

Jim and Sofia, two young professionals, married at around the same time Jim’s uncle went to work for a financial services company. The uncle sold Jim a $250,000 Variable Universal Life (VUL) policy with a $500 monthly premium. Jim and Sofia were happy, thinking they had made a prudent choice to start saving for retirement and help out a relative at the same time.

When Sofia became pregnant, the couple decided to engage a fee-only financial planner. She found they were under insured to provide for a family and also that the VUL policy was incredibly expensive and ill-advised for their needs. She recommended canceling the VUL policy with its $500 monthly premium, instead paying $300 monthly for two $1 million term life insurance policies and putting $200 a month into a tax-free Roth IRA.

Sofia and Jim told this to their uncle, who was “shocked” at the planner’s “poor advice.”

He contended that any competent financial planner would know a person needs permanent insurance as a foundation to “raise their child in the case of a premature death, fund their retirement, pay estate taxes and just like a Roth, it is tax free.”
Sadly, the uncle was unwilling to admit that $250,000 of insurance wouldn’t be enough to raise their child, fund their retirement, and pay estate taxes; nor was it truly tax free. He also didn’t mention that he had a vested interest in their keeping the policy. While he probably earned 55% to 100% of the first year’s commission, it is common practice that an agent will also receive 10-15% of the annual premium from years 2-10.

***

***

Sofia and Jim agreed with the financial planner’s recommendation. They could see the sense in having $1 million of insurance on each of them instead of $250,000 on just Jim for almost half the price, plus the tax-free growth of $200 a month in the Roth IRA.

Yet they didn’t follow the planner’s advice, because they didn’t want to upset their uncle. They chose to weaken their financial health, plus risk the well-being of their family if one of them died prematurely, in order to enrich their uncle for fear of offending him.

This happens more frequently than you would think. And it isn’t limited to life insurance. I’ve seen clients invest in a variety of “opportunities,” based on advice from a family member, that were not in their best interest.

Assessment

Next time a friend or family member offers to sell you a financial product or give you some great advice, you may want to do yourself a favor and decline. If you really want to help them out, invite them over for dinner.

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

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

Contact: MarcinkoAdvisors@outlook.com

***

***

LEVEL FUNDED HEALTH CARE: A Middle Ground Solution

By Dr. David Edward Marcinko MBA MEd

***

***

Level-funded health care is an increasingly popular option for small to mid-sized businesses seeking a balance between cost control and comprehensive employee coverage. It blends features of fully insured and self-funded health plans, offering employers greater flexibility and potential savings while minimizing risk.

In a traditional fully insured plan, employers pay a fixed premium to an insurance carrier, which assumes all financial risk for employee claims. In contrast, self-funded plans allow employers to pay for claims out-of-pocket, which can lead to significant savings—but also exposes them to unpredictable costs. Level-funded plans sit between these two models, offering a structured and predictable approach to self-funding.

With level-funded health care, employers pay a fixed monthly amount that covers three components: estimated claims funding, stop-loss insurance, and administrative fees. The estimated claims portion is based on actuarial data and reflects the expected health care usage of the employee group. Stop-loss insurance protects the employer from catastrophic claims by capping their financial exposure. Administrative fees cover third-party services such as claims processing and customer support.

One of the key advantages of level-funded plans is the potential for cost savings. If actual claims fall below the estimated amount, employers may receive a refund or credit at the end of the year. This incentivizes wellness programs and preventive care, as healthier employees lead to lower claims. Additionally, level-funded plans often provide more transparency into claims data, allowing employers to better understand health trends and make informed decisions about benefits.

***

***

Another benefit is flexibility. Level-funded plans can be customized to suit the needs of a specific workforce, offering a range of coverage options and provider networks. This contrasts with the rigid structure of many fully insured plans. Employers also gain more control over plan design, which can help attract and retain talent in competitive job markets.

However, level-funded health care is not without challenges. It requires careful planning and a solid understanding of risk. Employers must be prepared for the possibility that claims may exceed projections, although stop-loss insurance helps mitigate this. Additionally, level-funded plans may not be suitable for very small groups or those with high-risk populations, as the cost of stop-loss coverage can be prohibitive.

Regulatory considerations also play a role. Level-funded plans are typically governed by federal ERISA laws rather than state insurance regulations, which can affect compliance and reporting requirements. Employers should work closely with benefits consultants or brokers to ensure they understand the legal landscape and choose a plan that aligns with their goals.

In conclusion, level-funded health care offers a compelling alternative for businesses seeking to manage costs while providing quality coverage. By combining predictability with the potential for savings and customization, it empowers employers to take a more active role in their health benefits strategy. As the health care landscape continues to evolve, level-funded plans are likely to remain a valuable option for organizations looking to strike the right balance between affordability and employee well-being.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com 

Like, Refer and Subscribe

***

***

A MODERN PRESCRIPTION SHOWDOWN: Amazon Pharmacy VS. GoodRx

By Dr. David Edward Marcinko MBA MEd

***

***

In the evolving landscape of digital health care, Amazon Pharmacy and GoodRx have emerged as two leading platforms offering consumers affordable and convenient access to prescription medications. While both aim to simplify the process of obtaining prescriptions, they differ significantly in their approach, pricing models, and user experience.

Amazon Pharmacy, launched in 2020, is a full-service online pharmacy that allows customers to order medications directly through Amazon. It offers fast, free delivery for Prime members and integrates with most insurance plans. One of its standout features is RxPass, a subscription service available to Prime members for $5 per month, which covers unlimited eligible generic medications. This model is particularly attractive to individuals who take multiple generics regularly, as it can significantly reduce out-of-pocket costs.

In contrast, GoodRx, founded in 2011, operates primarily as a price comparison and discount platform. It does not dispense medications itself but partners with local and mail-order pharmacies to help users find the lowest prices. GoodRx provides coupons that can be used at thousands of pharmacies nationwide, often resulting in substantial savings—especially for those without insurance. It also offers GoodRx Gold, a paid membership that unlocks deeper discounts and telehealth services.

***

***

When comparing the two, pricing transparency is a key differentiator. GoodRx excels in showing users a range of prices across different pharmacies, empowering them to choose the most cost-effective option. Amazon Pharmacy, while competitive, typically offers fixed prices and focuses more on convenience and integration with its broader ecosystem.

Convenience is another area where Amazon Pharmacy shines. With its streamlined ordering process, automatic refills, and integration with Amazon’s delivery network, it appeals to users who prioritize ease and speed. GoodRx, while convenient in its own right, requires users to present coupons at the pharmacy or use mail-order services, which may involve more steps.

Insurance compatibility also varies. Amazon Pharmacy accepts most major insurance plans, making it a viable option for insured individuals. GoodRx, on the other hand, is often used by those without insurance or with high deductibles, as its discounts can sometimes beat insurance copays.

However, both platforms have limitations. Amazon Pharmacy’s RxPass is restricted to generic medications and excludes certain states due to regulatory issues. GoodRx’s discounts may not apply to all medications, and prices can fluctuate depending on location and pharmacy.

In terms of user experience, Amazon offers a seamless, tech-driven interface with customer support and medication management tools. GoodRx provides educational resources, price alerts, and a mobile app that helps users track savings and prescriptions.

Ultimately, the choice between Amazon Pharmacy and GoodRx depends on individual needs. For those seeking a one-stop solution with predictable costs and fast delivery, Amazon Pharmacy may be ideal. For users who want to shop around for the best deal or lack insurance, GoodRx offers unmatched flexibility and savings.

As digital health continues to grow, both platforms are reshaping how Americans access medications—making prescriptions more affordable, transparent, and accessible than ever before.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com 

Like, Refer and Subscribe

***

***

MEDICAL SCHOOLS: What They Do Not Teach About Money!

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

***

WARNING! WARNING! All DOCTORS

What Medical School Didn’t Teach Doctors About Money

Medical school is designed to mold students into competent, compassionate physicians. It teaches anatomy, pathology, pharmacology, and clinical skills with precision and rigor. Yet, despite the depth of medical knowledge imparted, one critical area is often overlooked: financial literacy. For many doctors, the transition from student to professional comes with a steep learning curve—not in medicine, but in money. From managing debt to understanding taxes, investing, and retirement planning, medical school leaves a financial education gap that can have long-term consequences.

The Debt Dilemma

One of the most glaring omissions in medical education is how to manage student loan debt. The average medical student graduates with over $200,000 in debt, yet few are taught how to navigate repayment options, interest accrual, or loan forgiveness programs. Many doctors enter residency with little understanding of income-driven repayment plans or Public Service Loan Forgiveness (PSLF), missing opportunities to reduce their financial burden. Without guidance, some make costly mistakes—such as refinancing federal loans prematurely or choosing repayment plans that don’t align with their career trajectory.

Income ≠ Wealth

Medical students often assume that a high salary will automatically lead to financial security. While physicians do earn more than most professionals, income alone doesn’t guarantee wealth. Medical school rarely addresses the importance of budgeting, saving, and investing. As a result, many doctors fall into the “HENRY” trap—High Earner, Not Rich Yet. They spend lavishly, assuming their income will always cover expenses, only to find themselves living paycheck to paycheck. Without a solid financial foundation, even high earners can struggle to build net worth.

***

***

Taxes and Business Skills

Doctors are also unprepared for the complexities of taxes. Whether employed by a hospital or running a private practice, physicians face unique tax challenges. Medical school doesn’t teach how to track deductible expenses, optimize retirement contributions, or navigate self-employment taxes. For those who open their own clinics, the lack of business education is even more pronounced. Understanding profit margins, payroll, insurance billing, and compliance regulations is essential—but rarely covered in medical training.

Investing and Retirement Planning

Another blind spot is investing. Medical students are rarely taught the basics of compound interest, asset allocation, or retirement accounts. Many don’t know the difference between a Roth IRA and a traditional 401(k), or how to evaluate mutual funds and index funds. This lack of knowledge delays retirement planning and can lead to missed opportunities for long-term growth. Some doctors rely on financial advisors without understanding the fees or conflicts of interest involved, putting their wealth at risk.

Insurance and Risk Management

Medical school also fails to educate students on insurance—life, disability, malpractice, and health. Doctors need robust coverage to protect their income and assets, but many don’t know how to evaluate policies or understand terms like “own occupation” or “elimination period.” Inadequate coverage can leave physicians vulnerable to financial disaster in the event of illness, injury, or litigation.

Emotional and Behavioral Finance

Beyond technical knowledge, medical school overlooks the emotional side of money. Physicians often face pressure to maintain a certain lifestyle, especially after years of sacrifice. The desire to “catch up” can lead to impulsive spending, luxury purchases, and financial stress. Without tools to manage money mindset and behavioral habits, doctors may struggle with guilt, anxiety, or burnout related to finances.

The Case for Financial Education

Fortunately, awareness of this gap is growing. Organizations like Medics’ Money and podcasts such as “Docs Outside the Box” are working to fill the void by offering financial education tailored to physicians.

These resources cover everything from budgeting and debt management to investing and entrepreneurship. Some medical schools are beginning to incorporate financial literacy into their curricula, but progress is slow and inconsistent.

Conclusion

Medical school equips doctors to save lives, but it doesn’t prepare them to secure their own financial future. The lack of financial education leaves many physicians vulnerable to debt, poor investment decisions, and lifestyle inflation. To thrive both professionally and personally, doctors must seek out financial knowledge beyond the classroom. Whether through self-study, mentorship, or professional guidance, understanding money is as essential as understanding medicine. After all, financial health is a cornerstone of overall well-being—and every doctor deserves to master both.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

Like, Refer and Subscribe

***

***

RATE REVIEW: The 80/20 Health Insurance Rule

DEFINITIONS

By Staff Reporters

***

***

Rate Review & the 80/20 Rule

The health care law provides 2 ways to hold insurance companies accountable and help keep your costs down: Rate Review and the 80/20 rule.

Rate Review

Rate Review helps protect you from unreasonable rate increases. Insurance companies must now publicly explain any rate increase of 15% or more before raising your premium. This does not apply to grandfathered plans.

Look up your insurance plan to see its proposed and final rate increase.

80/20 Rule

The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs.

The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR. If an insurance company uses 80 cents out of every premium dollar to pay for your medical claims and activities that improve the quality of care, the company has a Medical Loss Ratio of 80%.

Insurance companies selling to large groups (usually more than 50 employees) must spend at least 85% of premiums on care and quality improvement.

If your insurance company doesn’t meet these requirements, you’ll get a rebate on part of the premium that you paid.

Will I get a rebate check from my insurance company?

If your insurance company doesn’t meet its 80/20 targets for the year, you’ll get back some of the premium that you paid.

You may see the rebate in a number of ways:

  • A rebate check in the mail
  • A lump-sum deposit into the same account that was used to pay the premium, if you paid by credit card or debit card
  • A direct reduction in your future premium
  • Your employer may also use one of the above rebate methods, or apply the rebate in a way that benefits employees

If you or your employer will get a rebate, your insurance company must notify you by August 1.

If you have an individual insurance policy, you’ll get the rebate directly from your insurance company.

For small group and large group plans, the rebate is usually paid to the employer. It may use one of the above rebate methods, or apply the rebate in a way that benefits employees.

FYI: The 80/20 rebate rules don’t apply when an insurance company has fewer than 1000 enrollees in a particular state or market.

Does this apply to my plan?

It depends.

For Rate Review: These requirements don’t apply to grandfathered plans. Check your plan’s materials or ask your employer or your benefits administrator to find out if your health plan is grandfathered.

For the 80/20 Rule: These rights apply to all individual, small group, and large group health plans, whether your plan is grandfathered or not.

COMMENTS APPRECIATED

Refer, Like and Subscribe

***

***

PHARMACY BENEFITS MANAGER: The Business Model Explained?

By A.I. and Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

***

Business Model Defined

Doctors and dentists earn money by treating patients. CPAs and Attorneys have clients, and retail stores buy items low and sell them at higher prices. This is called a business model.

More formally, a business model identifies the products or services the business plans to sell, the target market, and any anticipated expenses, in order to outline how to generate a profit. Business models are important for both new and established businesses. They help companies attract investment, recruit talent, and motivate management and staff.

Businesses should regularly update their business model, or they’ll fail to anticipate trends and challenges ahead. Business models also help investors to evaluate companies that interest them and employees to understand the future of a company they may aspire to join.

***

The Business Model of Pharmacy Benefits Managers

In the United States, health insurance providers often hire a third party to handle price negotiations, insurance claims, and distribution of prescription drugs. Providers that use such pharmacy benefit managers include commercial health plans, self-insured employer plans, Medicare Part D [drug] plans, the Federal Employees Health Benefits Program, and state government employee plans. PBMs are designed to aggregate the collective buying power of en-rollees through their client health plans, enabling plan sponsors and individuals to obtain lower prices for their prescription drugs. PBMs negotiate price discounts from retail pharmacies, rebates from pharmaceutical manufacturers, and mail-service pharmacies which home-deliver prescriptions without consulting face-to-face with a pharmacist.

PBMs DEFINED: https://medicalexecutivepost.com/2019/01/18/on-pbms-pharmacy-benefits-management/

Pharmacy benefit management companies can make revenue in several ways.

First, they collect administrative and service fees from the original insurance plan.

Then, they can also collect rebates from the manufacturer.

Traditional PBMs do not disclose the negotiated net price of the prescription drugs, allowing them to resell drugs at a public list price (also known as a sticker price), which is higher than the net price they negotiate with the manufacturer. This practice is known as “spread pricing”. The industry argues that savings are trade secrets. Pharmacies and insurance companies are often prohibited by PBMs from discussing costs and reimbursements. This leads to lack of transparency.

***

***

Therefore, states are often unaware of how much money they lose due to spread pricing, and the extent to which drug rebates are passed on to en-rollees of Medicare plans. In response, states like Ohio, West Virginia, and Louisiana have taken action to regulate PBMs within their Medicaid programs.

For instance, they have created new contracts that require all discounts and rebates to be reported to the states. In return, Medicaid pays PBMs a flat administrative fee.

PBM PODCAST: https://medicalexecutivepost.com/2023/08/26/podcast-cvs-replaces-its-pbm/

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

Like and Subscribe

***

***

DAILY UPDATE: Both ACA Premiums and Stock Markets Rise

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2025

REFER A COLLEAGUE: MarcinkoAdvisors@outlook.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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

What’s up

  • Krispy Kreme and GoPro got caught up in the new meme stock craze—the donut maker jumped 4.60%, while the wearable camera company leaped 12.41%.
  • Nintendo rose 2.36% after the company’s new Switch 2 console sold 1.6 million units in June, making it the fastest-selling console in US history.
  • GE Vernova gained 14.58% thanks to an impressive beat-and-raise earnings report for the power equipment manufacturer.
  • USANA Health Sciences soared 12.37% after the nutritional supplement maker crushed earnings estimates.
  • Cal-Maine Foods, the biggest egg producer in the country, added 13.80% after profiting from the high cost of eggs over the previous quarter.
  • Lamb Weston sizzled 16.31% higher as shareholders applauded the french fry giant’s strong earnings report and new cost-cutting program.

What’s down

  • Texas Instruments tumbled 13.34% after the semiconductor company revealed a disappointing third-quarter earnings forecast.
  • Enphase Energy plunged 14.16% thanks to weak earnings guidance, with the solar company’s management blaming tariffs for squeezing its margins.
  • SAP lost 5.03% after the enterprise software company missed Q2 revenue estimates.
  • Fiserv may have beaten analyst forecasts last quarter, but the fintech still sank 13.85% due to weaker-than-expected financial guidance.
  • Going down: Otis Worldwide dropped 12.38% after the elevator manufacturer lowered its fiscal guidance due to weak demand.

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

Insurers selling plans on ACA exchanges are expected to hike premiums next year as subsidies on them are set to expire, with the average person expected to be paying 75% more, according to an analysis from the nonpartisan research group KFF.

CITE: https://tinyurl.com/tj8smmes

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@outlook.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

DAILY UPDATE: Health Insurance Options as Bull Market Edges Upward

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2025

REFER A COLLEAGUE: MarcinkoAdvisors@outlook.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

***

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

A June 11th report from global professional services firm Alvarez & Marsal (A&M) predicts that more beneficiaries might soon ditch insurance coverage for options like short-term, limited duration plans or healthcare sharing ministries (HCSMs), which aren’t regulated like health insurance and aren’t required to comply with ACA protections like covering maternity care or pre-existing conditions.

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

🟢 What’s up

  • Nvidia extended its winning streak to five days, rising another 1.73% as the AI trade continues to recover.
  • EchoStar climbed 13.16% after the parent company of Dish TV disclosed that President Trump did in fact prod the FCC to make a deal.
  • Cyngn soared another 20.07% following a big day of gains after the company that makes self-driving tech for industrial vehicles announced a partnership with Nvidia.
  • Strong earnings from Nike (more on that later) propelled sporting goods stocks higher today. ON Holdings rose 1.74%, while Dick’s Sporting Goods climbed 3.59%.
  • Domestic power producers popped on reports that Trump is planning to issue an executive order increasing energy production to meet AI demand. Vistra gained 2.44%, GE Vernova climbed 2.54%, and Vertiv added 2.71%.

What’s down

  • Coinbase Global ended its winning streak, tumbling 5.77% after GENIUS Act hype propelled the crypto stock skyward all week long. Traders took profits in Circle as well, pushing the stablecoin stock down 15.54%.
  • Chinese EV maker Li Auto fell 1.93% on its weaker-than-expected deliveries forecast for the second quarter.
  • Fellow Chinese EV maker Xiaomi stunned markets with reports that it received 240,000 orders for its new SUV within 18 hours of its debut, but shares still sank 4%.
  • Pony.ai lost 6.31% on a report that Uber is considering helping its founder Travis Kalanick fund his acquisition of the US subsidiary of the Chinese autonomous vehicle company.
  • Gold miners tumbled while the price of the precious metal fell as investors took a risk-on stance. Newmont lost 4.11%, Barrick Mining fell 3.44%, and Kinross Gold shed 6.18%.
  • Today’s trade deal reopens the door for Chinese rare earth imports, bad news for US producers like MP Materials (down 8.59%) and USA Rare Earth (down 12.14%).

CITE: https://tinyurl.com/tj8smmes

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@outlook.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

AD&D: Insurance Defined

Accidental Death and Dismemberment

By AI

***

***

What is AD&D insurance?

AD&D insurance combines two types of coverage: an accidental death policy that pays out if you die in an accident, and a dismemberment policy that pays out if you have a serious injury such as losing a limb or becoming paralyzed because of an accident. The beneficiary of your AD&D policy (such as your spouse) collects the money in the case of an accidental death, and you collect it if you suffer one of the injuries outlined in the policy.

NATURAL DISASTERS: https://medicalexecutivepost.com/2025/04/15/insurance-natural-disasters/

Here’s the catch: The death or injury must be the direct result of an accident. So, for example, if you have a heart attack while you’re driving and get into a fatal car crash, your beneficiaries probably won’t receive any money.

***

***

While AD&D insurance can offer financial peace of mind to you and your loved ones in the event of an accident, it won’t pay out if you die from natural causes or a terminal illness — so it’s not a replacement for life insurance. And since it doesn’t cover all injuries or disabilities, it isn’t as comprehensive as disability insurance either.

TERM INSURANCE: https://medicalexecutivepost.com/2025/02/05/insurance-term-policy/

Be aware that insurers often sell accidental death insurance without dismemberment coverage. These policies pay out only if you die and won’t cover an accident that leaves you seriously injured but alive.

AGENTS v. BROKERS: https://medicalexecutivepost.com/2025/04/27/insurance-agents-v-brokers/

COMMENTS APPRECIATED

Like and Refer

***

***

CMMI’s Evolving Strategy: Initial Indications from Recent Actions

By Health Capital Consultants, LLC

***

***

On May 13th, 2025, the CMS Center for Medicare & Medicaid Innovation (CMMI) introduced a new strategic plan for its models going forward. After ending four payment models early and canceling two not-yet-implemented models in March 2025, the agency had promised to release a new strategy. Nearly two weeks later, CMMI released that strategy, as well as a preliminary evaluation of, and changes to, one of its core payment models.

This Health Capital Topics article will review CMMI’s recent actions and what initial indications these actions provide. (Read more…) 

LTC: https://medicalexecutivepost.com/2025/06/05/cms-proposes-increasing-inpatient-long-term-care-payments-2/

COMMENTS APPRECIATED

Like and Refer

***

***

OAK STREET HEALTH: Agrees to Pay $60M to Resolve Alleged False Claims Act Liability for Paying Kickbacks to Insurance Agents in Medicare Advantage Patient Recruitment Scheme

By Staff Reporters

***

***

Oak Street Health, headquartered in Chicago and a wholly-owned subsidiary of CVS Health since 2023, has agreed to pay $60 million to resolve allegations that it violated the False Claims Act by paying kickbacks to third-party insurance agents in exchange for recruiting seniors to Oak Street Health’s primary care clinics.

Part C: https://medicalexecutivepost.com/2024/05/03/eschew-medicare-advantage-part-c-plans-now/

The Anti-Kickback Statute prohibits anyone from offering or paying, directly or indirectly, any remuneration — which includes money or any other thing of value — to induce referrals of patients or to provide recommendations of items or services covered by Medicare, Medicaid and other federally funded programs. Under the Medicare Advantage (MA) Program, also known as Part C, Medicare beneficiaries have the option to obtain their health care through privately-operated insurance plans known as MA plans. Some MA Plans contract with health care providers, including Oak Street Health, to provide their plan members with primary care services.

Medicare Advantage Rates: https://medicalexecutivepost.com/2025/04/28/medicare-advantage-plan-rates-substantially-increased-for-2026/

The United States alleged that, in 2020, Oak Street Health developed a program to increase patient membership called the Client Awareness Program. Under the Program, third-party insurance agents contacted seniors eligible for or enrolled in Medicare Advantage and delivered marketing messages designed to generate interest in Oak Street Health. Agents then referred interested seniors to an Oak Street Health employee via a three-way phone call, otherwise known as a “warm transfer,” and/or an electronic submission.

In exchange, Oak Street Health paid agents typically $200 per beneficiary referred or recommended. These payments incentivized agents to base their referrals and recommendations on the financial motivations of Oak Street Health rather than the best interests of seniors. The settlement resolves allegations that, from September 2020 through December 2022, Oak Street Health knowingly submitted, and caused the submission of, false claims to Medicare arising from kickbacks to agents that violated the Anti-Kickback Statute.

US Department of Justice: https://www.justice.gov/archives/opa/pr/oak-street-health-agrees-pay-60m-resolve-alleged-false-claims-act-liability-paying-kickbacks

COMMENTS APPRECIATED

Like and Refer

***

***

MEDICAL DEMAND: Health Care Elasticity

DEFINITION

By Staff Reporters

***

***

Classic: Despite a wide variety of empirical methods and data sources, the demand for health care is consistently found to be price inelastic

Modern: If you are sick, you will not be very price sensitive. There are exceptions to this rule (e.g., elective surgery such as plastic surgery, purchases of eyeglasses) but most studies find that patients are fairly insensitive to changes in health care prices.

Examples: For instance, the RAND Health Insurance Experiment found that the price elasticity of medical expenditures is -0.2.

***

The Medical Executive-Post is a  news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.

Refer and Like

COMMENTS APPRECIATED

***

***

MEDICINE: Emergent Care

SOME PHYSICIAN WORK FOR FREE

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

***

***

What is an Emergency Medicine Physician?

An emergency medicine physician is a medical doctor who specializes in the diagnosis, treatment, and management of acute and life-threatening medical conditions that require immediate intervention. These physicians work in hospital emergency departments, urgent care centers, and other acute care settings, where they provide rapid assessment, stabilization, and treatment to patients of all ages with a wide range of medical emergencies.

Emergency medicine physicians are trained to handle diverse medical emergencies, including trauma, cardiac emergencies, respiratory distress, severe infections, neurological emergencies, and obstetric emergencies, among others. They play a vital role in the front line management of medical emergencies, ensuring that patients receive prompt and appropriate care to improve outcomes and save lives.

***

Classic: Emergent Room or Emergency Department care is the provision of immediate medical service offering outpatient care for the treatment of acute and chronic illness and injury. It requires a broad and comprehensive fund of knowledge to provide such care. Excellence in care for patients with complex and or unusual conditions is founded on the close communication and collaboration between the urgent care medicine physician, the specialists and the primary physicians.

Modern: Urgent care does not replace your primary care physician. An urgent care center is a convenient option when someone’s regular physician is on vacation or unable to offer a timely appointment. Or, when illness strikes outside of regular office hours, urgent care offers an alternative to waiting for hours in a hospital Emergency Room.

Examples: Chest pain, bleeding that cannot be stopped and loss of consciousness; etc.

***

***

SOME ER DOCTORS WORK FOR FREE

The new president of emergency medicine for the Alberta Medical Association says Emergency Room physicians already coping with long hours, staff shortages and jammed waiting rooms are also being obligated, in some cases, to work for free. Dr. Warren Thirsk says the government has yet to follow through on a promise to reimburse emergency room doctors for so-called “good faith” payments.

“There’s been lots of excuses, but the bottom line is no one has actually received a penny for those suspended good-faith payments,” Thirsk said in an interview. “On average, every emergency physician in this province is out thousands of dollars for free work.” Good-faith payments reimburse ER doctors when they see patients who don’t have identification and can’t prove an Alberta Health Care Insurance Plan billing number.

Thirsk said the United Conservative government stopped those payments when it ripped up the master agreement with the AMA in early 2020. He said it promised to bring back those payments when the two sides agreed to a new deal in September 2022. But to date that hasn’t happened, he said.

“I’m legally and morally bound to look after you [if] you’re unidentified [as a patient],” said Thirsk, an emergency room doctor at Edmonton’s Royal Alexandra Hospital.

“I’m going to look after you because it’s the right thing to do no matter what the problem is.”

COMMENTS APPRECIATED

The Medical Executive-Post is a  news and information aggregator and social media professional network for medical and financial service professionals. Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed. Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.

Like and Refer

***

***

LONG TERM CARE INSURANCE: A Hobson’s Choice Decision?

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

***

Long Term Care Insurance [LTCI]

Some retired people live on a fixed income and many of them live right on the edge of their financial capability.  At some time in their life, they may have to make a choice regarding many purchases.  

In this case, we will illustrate “choice” using a couple’s purchase of Long-Term-Care Insurance [LTCI]. Of course, economics is the study of choice; wants, needs and scarcity, etc. In our case, if they decide to make the purchase they commit to a lifetime of premium payments. The financial tradeoff is this; if they make the commitment to purchase LTCI, they must give up something else.

EXAMPLE: In order to maintain a monthly premium of $100 ($1,200per year), an elderly patient, retired layman or couple must essentially relegate about $30,000 of financial assets to generate the $100 necessary to make an average premium payment (assumes a 7% rate of return with 4% withdrawal rate) or [4% X $30,000 = $1,200 year]. Thus, if the monthly premium cost is $500 per month, the elder must give up the use of $150,000 of retirement asset just to generate enough cash flow to pay for the LTC insurance. 

***

***

The married elder couple has to make the Hobson’s Choice decision among lifestyle (dinners, vacations, gifts to children, prescription drugs, medical care or food and shelter) versus paying an insurance premium to provide for nursing home coverage for a need, which may be very real, but will not occur until sometime in the ambiguous future. 

And so, when faced with such a tough economics Hobson’s Medicine Choice, neither of which delivers peace of mind or a respectable solution; many will simply decide that, in either case, they may already end up impoverished. Thus, many will often opt for the better lifestyle now … while they can enjoy it … together. 

Cite: Anonymous Health Insurance Agent, Norcross, Georgia

COMMENTS APPRECIATED

The Medical Executive-Post is a  news and information aggregator and social media professional network for medical and financial service professionals.

Feel free to submit education content to the site as well as links, text posts, images, opinions and videos which are then voted up or down by other members. Comments and dialog are especially welcomed.

Daily posts are organized by subject. ME-P administrators moderate the activity. Moderation may also conducted by community-specific moderators who are unpaid volunteers.

Refer, Like and Subscribe

***

***

PHANTOM: Stock Equity Plans

DEFINITIONS

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

***

Phantom equity is an increasingly popular tool within businesses, particularly startups and private companies, for incentivizing employees without diluting ownership. It allows firms to reward key personnel by linking compensation to the company’s performance, aligning employee interests with those of shareholders.

Basic Mechanisms of Phantom Equity

Phantom equity operates as a contractual agreement offering employees a simulated stake in the business without issuing actual stock. This arrangement appeals to companies aiming to maintain control over their equity structure while providing performance-based incentives. The benefits mimic stock ownership, such as dividends and capital appreciation, without the complexities of transferring actual shares.

The company establishes a phantom equity plan that defines terms such as vesting schedules, performance metrics, and payout conditions. Vesting schedules, often ranging from three to five years, encourage employee retention. Performance metrics may include revenue growth, profit margins, or other financial indicators aligned with strategic goals. Once vested, employees receive cash payments based on the value of the phantom shares, determined by the company’s valuation at payout.

Valuations, often conducted through third-party appraisals or internal financial metrics, directly affect payouts. If the company grows significantly, the value of phantom shares increases, resulting in higher payouts. Conversely, if performance declines, the value of these shares decreases, reducing compensation.

Types of Phantom Equity Plans

Phantom equity plans can be customized to suit a company’s goals, with two primary types being most common: appreciation-only arrangements and full-value arrangements.

Appreciation-Only Arrangements

Appreciation-only arrangements reward employees for the increase in the company’s value over a specified period. Employees are granted phantom shares that reflect the appreciation in the company’s valuation from the grant date to the payout date.

For instance, if phantom shares are initially valued at $10 each and the valuation rises to $15, the employee receives a payout of $5 per share. This structure ties employee rewards to company growth without affecting equity. Companies must rely on precise valuation methods, often adhering to GAAP or IFRS, to ensure fairness and compliance.

Full-Value Arrangements

Full-value arrangements provide payouts equivalent to the full value of phantom shares at vesting or payout. This includes both the initial value and any appreciation.

For example, if phantom shares are initially valued at $10 and later rise to $15, the employee receives $15 per share. While offering greater potential rewards, full-value arrangements require a larger financial commitment from the company. Careful financial planning and adherence to standards like ASC 718, which governs share-based compensation, are essential for managing these plans effectively.

Tax Implications: https://eqvista.com/phantom-stock/phantom-stock-plans-taxation/

COMMENTS APPRECIATED

Like and Review

***

***

The DOCTOR EFFECT

Dr. David Edward Marcinko; MBA MEd CMP™

Medical Colleagues Beware the Advisors

***

***

SPONSOR: http://www.MarcinkoAssociates.com

Several years ago a group of highly trusted and deeply  experienced financial advisors, insurance service professionals and estate planners noted that far too many of their mature retiring physician clients, using traditional stock brokers, management consultants and financial advisors, seemed to be less successful than those who went it alone. These Do-it-Yourselfers [DIYs] had setbacks and made mistakes, for sure. But, the ME Inc doctors seemed to learn from their mistakes and did not incur the high management and service fees demanded from general or retail one-size-fits-all “advisors.”

In fact, an informal inverse related relationship was noted, and dubbed the Doctor Effect.” In others words, the more consultants an individual doctor retained; the less well they did in all disciplines of the financial planning and medical practice management, continuum.

Of course, the reason for this discrepancy eluded many of them as Wall Street brokerages and wire-houses flooded the media with messages, infomercials, print, radio, TV, texts, tweets, dinners and internet ads to the contrary. Rather than self-learn the basics, the prevailing sentiment seemed to purse the holy grail of finding the “perfect financial advisor.”  This realization confirmed the industry culture which seemed to be:

Bread for the advisor – Crumbs for the client!

And so, Marcinko Associates formed a cadre’ of technology focused and highly educated multi-degreed doctors, nurses, financial advisors, attorneys, accountants, psychologists and educational visionaries who decided there must be a better way for their healthcare colleagues to receive financial planning advice, products and related advisory services within a culture of fiduciary responsibility.

We trust you agree with this specific niche knowledge, and collegial consulting philosophy, as illustrated thru our firm and these two books.

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: MarcinkoAdvisors@outlook.com 

COMMENTS APPRECIATED

Like, Refer and Subscribe

***

***

***

AOMB: Assignment of Medical Benefits

By Staff Reporters

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

 
Classic: An arrangement by which a patient requests that their health benefit payments be made directly to a designated person or facility, such as a physician or hospital. It is a legally binding agreement between patient and Insurance company asking them to send your reimbursement checks directly to your doctor.
 
Modern: To accept assignment means that the provider agrees to accept what ever the insurance company allows or approves as payment in full for the claim. The patient signs paperwork requiring his health insurance provider to pay his physician or hospital directly.
 
EXAMPLES:
 
CMS: The approved amount, also known as the Medicare-approved amount, is the fee that Medicare sets as how much a provider or supplier should be paid for a particular service or item. Original Medicare calls this “assignment.”
 
Tardiness: When a medical office accepts an assignment of benefits, the insured patients may have to wait several months for their insurance reimbursement to arrive.

 COMMENTS APPRECIATED

Refer and Like

***

***

INSURANCE: Natural Disasters

By Staff Reporters

***

***

Natural Disaster Insurance

Protecting accumulated assets by insuring them against the wrath of Mother Nature

Most homeowners’ insurance policies do not cover damages arising from floods or earthquakes.  If a home, or any other real property like a vacation home or beach condo, is in an area subject to floods or earthquakes, consider the value of purchasing insurance that covers such catastrophes.

Take the time to review your homeowners’ policy, making sure that it will repair or replace your roof if damaged by hail, and will apply in the event of high winds, rather than only in tornadoes. The key to the maintenance of any type of insurance is to anticipate all of the possible calamities, and then to decide whether you can afford to lose the assets exposed to those calamities.

COMMENTS APPRECIATED

Read, Refer, Like and Subscribe

***

***

OBTAIN: An Unbiased Second Financial Planning Opinion

By Ann Miller RN MHA CPHQ CMP

***

***

Finally … Fiduciary second investing and financial planning opinions right here!

Telephonic or electronic advice for medical professionals that is:

  • Objective, affordable, medically focused and financially personalized
  • Rendered by a pre-screened financial consultant for doctors and medical professionals
  • Offered on a pay-as-you-go basis, by phone or secure e-mail transmission

The iMBA Discussion Forum™ is a physician-to-financial advisor telephone or e-mail portal that connects independent financial professionals to doctors, nurses or healthcare executives desiring affordable and unbiased financial planning advice.

Medical professionals and healthcare executives can now receive direct access to pre-screened iMBA professionals in the areas of Investing, Financial Planning, Asset Allocation, Portfolio Management, Insurance, Mortgage and Lending, Human Resources, Retirement Planning and Employee Benefits. To assist our medical professional and healthcare executive members, we can be contracted with per-minute or per-project fees, and contacted by client phone, email or secure instant messaging.

***

http://www.MARCINKOASSOCIATES.com

E-mail CONTACT: MarcinkoAdvisors@outlook.com

***

***

Thank You

WORKER’S COMPENSATION: Physician Insurance

By Staff Reporters

***

***

While some medical practitioners and facilities can operate without Professional Liability Insurance coverage, one business related insurance that cannot / should not be avoided is Worker’s Compensation.  Employers in all but seven states – so-called “monopolistic” states because they have their own state funds, are under statutory obligation to provide coverage for their employees.  Historically, Worker’s Compensation pre-dates Social Security entitlements and well before the emergence of employer sponsored group benefits.

The coverage under worker’s compensation provides for lost income due to on-the-job accidents or work-related disability or death and the amount of benefits vary by state.  In some instances, the coverage will reimburse the employee for medical expenses incurred with the accident. 

The four general benefits covered under Worker’s Compensation are:

Medical Care – for expenses incurred usually without limitations on amount or period of care.

Disability Income – payable for both total and partial disability and is usually based on 66 2/3 percent of their wage base.

Death Benefits – generally fall into two categories; one a flat amount for “burial” insurance; and two, survivor benefits.  Though varying by state, these benefits are similar to the disability payment (a percentage of weekly base wages) but may be capped as to total benefit, such as $50,000 or a period, such as 10 years

Rehabilitation Benefits – includes not only medical rehabilitation, but vocational rehabilitation, vocational counseling, retraining or educational benefits, and job placement

Traditionally, the secondary purpose of Worker’s Compensation was to reduce potential litigation because employees accepting the benefits from a Worker’s Compensation claim generally waived their right to sue their employer. 

***

***

However, in our litigious society, this “protective shelter” has been severely tested and is crumbling.

Employers may provide their Worker’s Compensation three ways:

  • Private commercial insurance
  • State government funds
  • Self-insurance

Very few factors drive the premium structure – the occupation of the workers is the single most important determinant of premiums.  An office worker may have premiums as low as $.10 per hundred of wages and a coal miner may exceed $50.00 per hundred of wages.  Generally speaking, however, Worker’s Compensation premiums for the medical profession or healthcare worker are among the lowest available.

Therefore, for the medical practice, some physicians may consider self-insurance because the weekly benefits are typically below $500, thus making this decision attractive. 

Alternatively, because officers and owners can elect not to be covered by Worker’s Compensation, the decision to purchase coverage from a private insurance company may afford inexpensive assurance that the benefits will be conveniently provided, and administered, by a private insurance company for their employees.

COMMENTS APPRECIATED

Read, Refer, Like and Subscribe

***

***

LIFE INSURANCE: Split Dollar Plans

By Staff Reporters

***

***

Split-Dollar Life Insurance: An arrangement under which a life insurance policy’s premium, cash values, and death benefit are split between two parties—usually a corporation and a key employee or executive. Under such an arrangement an employer may own the policy and pay the premiums and give a key employee or executive the right to name the recipient of the death benefit.

***

***

Several factors will affect the cost and availability of life insurance, including age, health, and the type and amount of insurance purchased. Life insurance policies have expenses, including mortality and other charges. If a policy is surrendered prematurely, the policy holder also may pay surrender charges and have income tax implications. You should consider determining whether you are insurable before implementing a strategy involving life insurance.

Any guarantees associated with a policy are dependent on the ability of the issuing insurance company to continue making claim payments.

COMMENTS APPRECIATED

Refer and Subscribe

***

***

HEALTH ACTUARY: Medical Professions

By Dr. David Edward Marcinko MBA MEd CMP®

***

***

SPONSOR: http://www.MarcinkoAssociates.com

THE MEDICAL AND HEALTHCARE ACTUARY

Health actuaries analyze potential risks, profits and trends that will affect their employers, which are often in the health insurance, government health services and medical provider industries. They advise companies on issuing policies to consumers based on risks, calculated premiums and upcoming changes in health-care costs.

It’s common for an actuary to have a bachelor’s degree or higher in actuary studies, mathematics or statistics. Coursework on medical terminology and hierarchy of the medical field is also beneficial. In addition to academic education, certification is also necessary to reach “professional status,” which is required by most employers.

***

***

The professional organization, Society of Actuaries, certifies actuaries in the health and medical field. Their statistical work is commonly done with predictive tables, probability tables and life tables that are created on customized statistical analysis software such as Stata or XLSTAT.

The actuary field as a whole is growing faster than other fields, according to the Bureau of Labor Statistics [BLS]. In 2020, it expanded by 27 percent. The average annual salary for an actuary in 2010 was $87,650. More specifically, in the health insurance field, the salary was slightly higher at $91,000.

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

COMMENTS APPRECIATED

Subscribe, Refer and Like

***

***

MEDICAL LABORATORY RESULTS: Direct Patient Access?

PROS and CONS

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP®

***

***

SPONSOR: http://www.MarcinkoAssociates.com

§ DIRECT PATIENT ACCESS TO LABORATORY RESULTS

According to Patricia Salber MD [personal communication], there are a number of reasons why direct patient access to laboratory medical results is a good idea:

  • Between 8 and 26% of abnormal test results, including those suspicious for cancer, are not followed up in a timely manner.  Direct access could help reduce the number of times this occurs
  • Self-management, particularly of chronic illness has known benefits.  Just like the QS people, many folks with chronic illness obtain and manage to self-acquired lab results every day via gluco-meters, home pulmonary function tests, blood pressure measurements, and so forth.  Direct access to laboratory-acquired data, one could argue is a continuation of that personal responsibility
  • Patients want to be notified about their results in what they perceive as a timely fashion.  In one study, patients who received direct notification of their bone density tests results were more likely to perceive they had timely notification compared to usual care even though there was no measurable effect on actual treatment received after three months
  • Being more responsible for test results could encourage consumers to try to learn more about the meaning of the test results, conceivably increasing their health literacy. 

But, the arguments against direct access discussed include the following:

  • Patients prefer their physicians contact them directly when they have abnormal test results, although the major studies published in 2005 and 2009, preceded the extraordinary use of the internet to access health information that exists today.
  • There is concern over whether patients will know what to do when they receive the results – will they make erroneous interpretations or fail to contact their docs?  This could be, but the intent of the proposed rule is shared access to the results.  We suspect if the rule become law, docs will develop better notification mechanisms so that they reach the patient before the patient directly accesses the results or lab companies will design better lab test notifications with easy-to-understand interpretations or a whole new industry will appear that can provide instantly available individualized lab interpretation…or maybe all three of these would happen and that would be a very good thing.
  • Unknown impact of dual notification (doctors and patients) of lab test results on physician behavior…would docs simply shift responsibility for initiating follow-up care from themselves to their patients?
  • Would direct access of life-changing lab tests, such as HIV or malignancy, lead to unnecessary patient anxiety – or worse?  (Conversely, is there less anxiety, desperation, or suicidal ideation if the bad news is delivered face to face? 
  • Individuals likely may contact their physicians immediately after getting the lab results asking for a telephonic or face-to-face interpretation … it is not known how this would impact physician workload and/or potential for reimbursement [personal communication, Richard Hudson DO, Atlanta, GA].

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

COMMENTS APPRECIATED

Subscribe, Refer and Like

***

***

QUALIFIED EXCHANGE: 1035 Life Insurance Policy

DEFINITION

By Staff Reporters

***

***

1035 Exchange

DEFINITION: A method of exchanging insurance-related assets without triggering a taxable event. Cash-value life insurance policies and annuity contracts are two products that may qualify for a 1035 exchange.

***

A 1035 exchange is a feature in the tax code that permits individuals to transfer funds from an existing life insurance endowment, or annuity policy to a new one without tax consequences.

The IRS permits these like-kind trades under Internal Revenue Code section 1035, where this process takes its name from.

These transactions are not subject to tax deductions or tax credits but rather tax deferrals, meaning that individuals would only pay taxes on any earnings once they receive money from the policy later.

Without this provision, policyholders would have to close their previous accounts and be subjected to both taxes and surrender charges before they could open a new account.

Cite: https://www.annuity.org/annuities/1035-exchange/

COMMENTS APPRECIATED

Subscribe and Refer

***

***

INSURANCE: How To Get Results On Homeowner Claims

By Rick Kahler; CFP®

http://www.KahlerFinancial.com

***

***

If you have ever filed a homeowners insurance claim, you know it can feel more like an endurance test than a straightforward process. While insurers are legally required to honor valid claims, they have strong financial incentives to delay, underpay, or deny them whenever possible.

Over the years, I’ve learned this the hard way. The most recent lesson started when a hailstorm hit my home in June 2023. I promptly filed an insurance claim. I also made up a story that leaving someone more qualified than me in charge would free me from a part-time job as a contractor, so I relied on a roofing contractor to handle the whole claim, including the gutter and siding damage. That was my first mistake.

About 15 months later, my roof and gutters were replaced, but the siding repairs and painting remained undone. Every time the insurance company reassigned my claim to a new adjuster, I had to start over. When I called the contractor after a period of inactivity, they said the adjuster had ghosted them, so they’d given up—and I still owed them the full roofing bill.

At that point, I had two choices: pay out of pocket for the unfinished work or escalate. I chose the latter. I filed a complaint with the state insurance division, contacted my agent, reached out to the last adjuster, hired my own painter, and withheld final payment to the contractor. I also made it clear that I was prepared to take legal action if necessary. That was not a bluff.

Within a week, things started moving. Seven days later, the insurance company reinspected my home and sent a check covering all but $3,000 of the painting costs. After nearly two years of delays and excuses, progress finally happened when I took matters into my own hands.

Delay is a common insurer tactic. They’ll repeatedly ask for more documentation, take months to respond, or swap adjusters to force you to restart the process—all in hopes that you’ll give up or accept a lower payout.

Another common tactic is the lowball offer. Insurers often rely on software that underestimates damages or send adjusters unfamiliar with actual repair costs. Accepting their first offer without question can be a costly mistake. It’s wise to get independent repair estimates or even hire a public adjuster who works for you rather than the insurance company.

Insurers also deny claims based on fine print, arguing that damage was pre-existing, caused by poor maintenance, or excluded under some obscure clause. Knowing your policy inside out and keeping pre-loss photos can help you counter these claims.

Another trick? Steering homeowners toward “preferred” contractors who work at discounted rates and may prioritize the insurer’s interests over yours. Getting independent estimates ensures repairs are done properly.

For homeowners stuck in an insurance battle, persistence is key. Withholding final payment until work is complete, filing a complaint with the state insurance division, and even considering small claims court can help push a claim forward. If the dispute is within your state’s small claims limit—often between $10,000 and $25,000—filing may push the insurer to settle.

Assuming my contractor would handle everything was my biggest mistake, and it cost me nearly two years of frustration. Even though progress happened quickly once I took control, my claim isn’t over. I suspect I will be filing legal action in small claims court against the insurance company, contractor, and insurance agent.

If you need to navigate an insurance claim, be persistent and attentive. Keeping records, pushing back on delays, and escalating when necessary can mean the difference between being shortchanged and getting the settlement you deserve.

COMMENTS APPRECIATED

Subscribe, Refer and Like

***

***

AMAZON: Healthcare Pivot

By Health Capital Consultants, LLC

***

***

Amazon’s Healthcare Pivot

During the January 2025 J.P. Morgan Healthcare Conference, Teladoc’s executives announced the company has partnered with Amazon Health Services, joining its Health Benefits Connector program. The program was rolled out in January 2024 and connects Amazon customers with virtual care benefits covered by their insurance plan or employer; if eligible, customers are able to apply to join the program(s).

Teladoc is the fifth company to join Amazon’s Health Benefits Connector program (formerly known as Health Conditions Programs), along with digital physical therapy company Hinge Health; chronic condition management company Omada; online therapy and mental health firm Rula; and behavioral healthcare provider Talkspace. (Read more…) 

COMMENTS APPRECIATED

Refer and Subscribe

***

***

ABBREVIATIONS GLOSSARY: Risk Management, Insurance and Asset Protection for Physicians

By Staff Reporters

SPONSOR: http://www.HealthDictionarySeries.org

***

***

RISK MANAGEMENT, LIABILITY INSURANCE AND ASSET PROTECTION ABBREVIATIONS

[Glossary of Important Acronyms]

Much has been written and much has been opined on the topic of medical risk management, insurance, asset protection and professional liability for physicians and healthcare providers in this textbook; and elsewhere.

But occasionally, we all still get lost in a wide array of abbreviations, acronyms, and initialisms that are constantly changing in this ecosystem.

And so, this glossary serves as a ready reference for those who want to know about these medical risk management definitions in a quick and ready fashion.

Acronyms and Abbreviations

AAASC             American Association of Ambulatory Surgery Centers

AAHP                American Association of Health Plans

ABN                  advance beneficiary notice

ABQAUR          American Board of Quality Assurance and Utilization Review

ACE                   acute care episode

ACHCE             American College of Health Care Executives

ACS                   American College of Surgeons

ADA                  Americans with Disabilities Act

ADC                  average daily census

ADL                  activities of daily living

ADT                  Admission/Discharge/Transfer

AHA                  American Hospital Association

AHIMA             American Health Information Management Association

AHRQ               Agency for Healthcare Research and Quality

AI                      average inventory

AIMR                Association for Investment Management and Research

AIR                    assumed interest rate

ALE                   annualized loss expectancy

ALF                   assisted living facility

ALOS                average length of stay

AMA                 American Medical Association

AMBAC            AMBAC Indemnity Corporation

AMGA               American Medical Group Association

ANSI                 American National Standards Institute

AP                     accounts payable

APA                  American Psychiatric Association

APC                   ambulatory payment classification

APG                   ambulatory payment group

APR                   annual percentage rate

AR                     accounts receivable

ASA                   American Society of Appraisers

ASC                   ambulatory surgery centers; also Accredited Standards Committee

ASHA                American Surgical Hospital Association

ASO                   administrative services only

ASTC                 ancillary service technical component

ATM                  asynchronous transfer mode

AVG                  ambulatory visit group

BANTA             best alternative to negotiated agreement

BBA                  Balanced Budget Act of 1997

BBRA                Balanced Budget Refinement Act [1999]

BCP                   business continuity planning

BEA                   break-even analysis

BEP                   break-even point

BIPA                 Benefits Improvement and Protection Act [2000]

BLS                   Bureau of Labor Statistics

BPD                   border protection device

BS                      balance sheet

BSA                   Bank Secrecy Act

BVS                   business valuation standard

CA                     certificate authority

CAC                  Carrier Advisory Committee

CAS                   cost accounting standards

CASB                Cost Accounting Standards Board

CC                     common criteria [for IT Security Evaluation —ISO/IEC 15408];
complication or comorbidity [for MS-DRGs]

CCA                  certified cost accountant

CCC                   cash conversion cycle

CCEVS              common criteria evaluation and validation scheme

CCHIT               Certification Commission for Healthcare Information Technology

CCU                  critical care unit

CDC                  Centers for Disease Control and Prevention

CDH                  consumer-directed healthcare

CDHP                consumer-directed healthcare plan

CDPM               Clinical Data Project Manager

CDSS                 clinical decision support system

CEO                   Chief Executive Officer

CF                      conversion factor

CFA                   Chartered Financial Analyst

CFO                   Chief Financial Officer

CFR                   Code of Federal Regulations

CHAMP             Children’s Health and Medicare Protection Act of 2007

CHAMPUS        Civilian Health and Medical Program of the Uniformed Services

CHE                   Certified Healthcare Executive

CHIPS               Center for Healthcare Industry Performance Studies

CIA                    Corporate Integrity Agreement

CIO                    Chief Information Officer

CIP                    Customer Identification Program

CIS                    computer information systems

CLIA                 Clinical Laboratory Improvement Act

CLT                   capitation liability theory

CME                  continuing medical education

CMI                   case mix index

CMIO                Chief Medical Information Officer

CMIS                 contribution margin income statement

CMN                  Certificate of Medical Necessity

CMP                  Certified Medical Planner ™

CMS                  Centers for Medicare and Medicaid Services [formerly HCFA]

COD                  cash on delivery

COGME             Council of Graduate Medical Education

COH                  cash on hand

COLA                cost of living allowance

CON                  Certificate of Need

COO                  Chief Operating Officer

COSO                Committee of Sponsoring Organizations

COTS                 commercial off-the-shelf

CPHQ                Certified Physician in Healthcare Quality

CPIM                 Certificate in Production and Inventory Management

CPI-U                Consumer Price Index—urban

CPM                  critical (clinical) path method

CPOE                computerized physician order entry [system]

CPR                   computer-based patient record

CPT                   current procedural terminology

CQI                    continuous quality improvement

CRL                   Certification Revocation List

CRM                  customer relationship management

CRVS                California Relative Value Studies

CSO                   Chief Security Officer

CT scan              computed tomography scan [also called CAT scan]

CUSIP               Committee on Uniform Security Identification Procedures

CVE                   common vulnerabilities and exposures

CVPA                cost-volume-profit analysis

CY                     calendar year

DAC                  discretionary access control

DBMS                database management system

DCF                   discounted [net] cash flow

DEA                  Drug Enforcement Agency

DHHS                Department of Health and Human Services

DHMR               Designated Healthcare Management Representative

DIO                   days inventory outstanding

DLH                  doctor labor hours

DME                  durable medical equipment

DNFB                discharged, not finally billed

D&O                  directors and officers

DO                     Doctor of Osteopathy

DOA                  dead on arrival

DoD                   Department of Defense

DOJ                   Department of Justice

DOT                  Department of Transportation

DPH                  Department of Public Health

DPM                  Doctor of Podiatric Medicine

DPO                  days payable outstanding

DPP                   direct participation program

DRA                  Deficit Reduction Act of 2005

DRG                  diagnosis-related group

DES                   disease-specific care

DSH                   disproportionate share hospital [adjustment]

DSO                   days sales outstanding

DSS                   decision support system

DVP                  delivery versus payment

DWC                 days working capital

EAP                   Employee Assistance Program

EBDIT               earnings before depreciation, interest and taxes

EBM                  evidence-based medicine

ECP                   Exposure Control Plan

ED                     emergency department

EDI                    Electronic Data Interchange

EDSS                 Executive Decision Support System

EEOC                Equal Employment Opportunity Commission

EHCR                Efficient Healthcare Consumer Response Report

EHO                  emerging healthcare organization

EHR                   electronic health record

EIN                    employer identification number

E&M                  evaluation and management

EMR                  electronic medical record(s)

EMTALA           Emergency Medical Treatment and Active Labor Act

EOB                   explanation of benefits

EOMB               Explanation of Medicare Benefits

EOQ                  economic order quantity

EOQC                economic order quantity cost [analysis]

EPA                   Environmental Protection Agency

ePHI                  electronic personal health information

EPO                   exclusive provider organization

EPR                   electronic patient record

EPRI                  Emergency Preparedness Resource Inventory

ERISA               Employee Retirement Income Security Act

ERP                   enterprise resource planning

FACT Act          Fair and Accurate Credit Transactions Act of 2003

FAR                   federal acquisition regulation

FASB                 Financial Accounting Standards Board

FBCA                Federal Bridge Certification Authority

FC                      fixed cost

FCA                   False Claims Act

FDA                   Food and Drug Administration

FEHBP              federal employees health benefits program

FF&E                 furniture, fixtures and equipment

FFS                    fee-for-service

FGIC                  Financial Guaranty Insurance Company

FHA                   Federal Housing Administration

FIFO                  first in first out

FIPS                   Federal Information Processing Standard

FMAP                Federal Medical Assistance Percentage

FMLA                Family Medical Leave Act

FMV                  fair market value                                                                                                                                                                                                                    

FTP                    file transfer protocol

FV                     fair value

  • FY                     fiscal year

GAAP                generally accepted accounting principles

GAO                  [U.S.] Government Accountability Office (name changed in 2004 from General Accounting Office)

GDP                   gross domestic product

GIGO                 garbage in, garbage out

GMC                  guaranteed mortgage certificate

GNMA               Government National Mortgage Association

GNP                   gross national product

GPWW              Group Practice Without Walls

GSA                   General Services Administration

HARA               Healthcare Accounts Receivable Analysis [report]

HCCM               Hierarchical Condition Category Management

HCFA                [former] Health Care Financing Administration

HCFAC              Healthcare Fraud and Abuse Control [program]

HCFMA             Health Care Financial Management Association

HCPCS              healthcare common procedure coding system

HCSS                 Health Care Staffing Services

HD-HCP            high deductible healthcare plan

HEDIS               Health Plan Employer Data and Information Set

HFMA               Healthcare Financial Management Association

HH                     home health

HHA                  home health agency

HHCA               home healthcare agency

HHRG                home health resource group

[D]HHS             [Department of] Health and Human Services

HIM                   health information management

HIMSS               Health Information and Management Systems Society

HIPAA              Health Insurance Portability and Accountability Act [of 1996]

HIPDB               Healthcare Integrity and Protection Data Bank

HIPPS                health insurance prospective payment system

HIS                    hospital information system

HISAC               Healthcare Information Sharing and Analysis Center

HIT                    healthcare information technology

HMMIS              hospital materials management information system

HMO                 health maintenance organization

HOPPS              hospital outpatient prospective payment system

HR                     Human Resources

HSA                   health systems agency; also health savings account

HSG                   hospital service group

HSRV                hospital-specific relative value

I&A                   identification and authentication

IBA                    Institute of Business Appraisers

IBNR                 incurred but not reported [expenses]

ICD-9-CM          International Classification of Diseases, Ninth Revision, Clinical Modification [10-CM]

ICP                    inventory conversion period

ICSI                   Institute for Clinical Systems Improvement

IDS                    integrated delivery system; also intrusion detection system

IDTF                  independent diagnostic testing facilities

IHS                    Indian Health Services

IME                   indirect medical education [adjustment]

IOM                   Institute of Medicine

IPA                    Independent Physician Association; also Independent Practice Association

IPPS                  [Medicare] inpatient prospective payment system

IRB                    Institutional Review Boards

IRC                    Internal Revenue Code

IRR                    internal rate of return

IRS                    Internal Revenue Service

ISAC                  Information Sharing and Analysis Center

ISMS                  information security management system

ISO                    International Standards Organization

ISP                     Internet service provider

I-SPY Act          Internet Spyware Prevention Act

IT                       information technology

ITL                    Information Technology Laboratory

ITR                    inventory turnover ratio

JAMA                 Journal of the American Medical Association

JCAHO              [former] Joint Commission on Accreditation of Healthcare Organizations

[now known as the The Joint Commission-TJC]

JIT                     just-in-time

[inventory management]

LAN                  local area network

LCC                   life-cycle cost

LEP                   limited English proficiency

LIFO                  last in, first out

LIS                     Laboratory Information Systems

LISW                 Licensed Independent Social Worker

LLC                   Limited Liability Company

LLP                   Limited Liability Partnership

LMFT                Licensed Marriage and Family Therapist

LPCC                 Licensed Professional Clinical [Mental Health] Counselor

LOS                   length of stay

LVN                  licensed vocational nurse

LPN                   licensed practical nurse

LRAC                long-range average cost

LRRA                Liability Risk Retention Act

LSP                    limited service provider

LTCPP               long-term care pharmacy provider

MABC               medical activity-based costing

MAC                  monitored anesthesia care; also mandatory access control

MB                    marginal benefit

MBT                  Mechanical Biological Treatment [organization]

MC                    marginal cost

MCC                  major complication or co-morbidity

MCM                 mixed cost method

MCO                  managed care organization

MCS                  Monte Carlo Simulation

MD                    medical doctor

MDC                  major diagnostic category

MEC                  modified endowment contract

MedPAC            Medicare Payment Advisory Commission

MGMA              Medical Group Management Association

MI                      Medical Informatics

MIS                    management information services

MLIC                 malpractice liability insurance component

MMA                 Medicare Prescription Drug, Modernization, and Improvement Act of 2003

MMCO              Medicare Managed Care Organizations

MOE                  maximum office efficiency

MPCA               medical practice cost analysis

MPT                  Modern Portfolio Theory

MR                    medical records, marginal revenue

MSA                  medical savings account

MSCI                 Metals Service Center Institute

MS-DRG            Medicare Severity DRG

MSDS                material safety data sheet

MSO                  management services organization

MUD                 medically unnecessary days

MVO                 mean variance optimization

NACVA             National Association of Certified Valuation Analysts

NAICS               North American Industry Classification System

NAIP                 National Association of Inpatient Physicians

NAHC               National Association of Healthcare Consultants

NASD                National Association of Securities Dealers

NASDAQ          National Association of Securities Dealers Automated Quotations

NAT                  network address translation

NAV                  net asset value

NBER                National Bureau of Economic Research

NCFFR              National Commission on Fraudulent Financial Reporting

NCPDP              National Council for Prescription Drug Programs

NCQA               National Committee for Quality Assurance

NCUA               National Credit Union Administration

NCVHS             National Committee on Vital and Health Statistics

NDC                  National Drug Code

NEJM                New England Journal of Medicine

NGC                  National Guideline Clearinghouse

NIAP                 National Information Assurance Partnership

NIC                    net interest cost

NIOSH               National Institute of Occupational Safety and Health

NIS                    net income statement

NISAC               National Infrastructure Simulation and Analysis Center

NIST                  National Institute of Standards and Technology

NOW account     negotiable order of withdrawal account

NPDB                National Practitioner Data Bank

NPI                    National Provider Identification [number]

NPP                   Notice of Privacy Practices

NPS                   national provider system

NPV                  net present value

NQF                   National Quality Forum

NRC                  National Research Council

NRV                  net-realized accounts receivable value

NSA                   National Security Agency

NTFS                 new technology file system

NTPA                net target profit analysis

NYSE                New York Stock Exchange

OBO                  order book official

OBRA                Omnibus Budget Reconciliation Act [of 1989]

OCC                  Option Clearing Corporation

OCR                  optical character recognition; also Office of Civil Rights

OFAC                Office of Foreign Assets Control

OFPP                 Office of Federal Procurement Policy

OID                   original issue discount

OIG                    Office of the Inspector General [U.S. Department of Health and Human Services]

OMB                  Office of Management and Budget

OPHC                Office of Prepaid Health Care

OPIM                 other potentially infectious material

OPPS                 outpatient prospective payment system

OS                     operating system

OSI                    open systems interconnect

OR                     operating room

OSHA                Occupational Safety and Health Administration

OSJ                    Office of Supervisory Jurisdiction

OTC                   over-the-counter

P4P                    pay-for-performance

P/E                     price to earnings [ratio]

P/R                    price to revenue [ratio]

PAC                   planned amortization certificate

PAY                  post-acquisition year

PC                     [mortgage] participation certificate; also personal computer

PCC                   project cost of capital

PCMCIA            Personal Computer Memory Card International Association

PCP                   primary care physician

PDA                  personal digital assistant

PDX                   Patient Data Exchange

PE[C]                 practice expense [component]

PEO                   professional employer organization

PFS                    patient financial services

PG                     purchasing group

PHA                  public housing authority

PHI                    protected health information

PHN                  Private Health Network

PHO                  physician-hospital organization

PHR                   patient health record

PIN                    personal identification number

PIO                    public information office

PKI                    public/private key informatics/infrastructure

PKIX                 public key infrastructure for X.509 certificates

PLIC                  [mal]practice liability insurance component

PMG                  primary medical group

PM/PM              per member per month

PO                     purchase order

POC                   point-of-care

POL                   physician office laboratory

POS                   point-of-service

POSP                 point of service plan

PP                      projection profile

PP&E                property, plant, and equipment

PPE                   personal protective equipment

PPMC                physician practice management company

PPO                   preferred provider organization

PPS                    [Medicare] prospective payment system

PR                     pregnancy and related conditions

PROM               programmable read-only memory

PSI                     patient safety indicator

PSN                   provider-sponsored network

PSO                   provider-sponsored organization

Pt                       patient

PTO                   paid time off

PWC                  physician work component

PY                     projected year

QA                     quality assurance

QI                      quality improvement

RA                     registration authority

RADIUS            remote authentication dial-in user service

RAN                  Revenue Anticipation Note

RBAC                role-based access control

RBRVG             resource-based relative value group

RBRVS              resource-based relative value scale

RBRVU             resource-based relative value unit

RDBMS             regional database management system

REIT                  real estate investment trust

RERVU             resource-based relative value unit

REV/PP             revenue per patient

RFI                    request for information

RFID                  radio frequency identification device [scanner]

RFP                   request for payment

RHIO                 Regional Health Information Organization

RN                     Registered Nurse

RNANS             Registered Nurses Association of Nova Scotia

ROE                   return on equity

ROI                    return on investment

ROM                  read-only memory

ROP                   re-order point

RRG                   risk-retention group

RSNA                Radiological Society of North America

RUG-III             resource utilization group III

RVS                   relative value scale

RVUm               relative value unit – malpractice

RVUpe               relative value unit – practice expenses

RVUw               relative value unit – work

rWACC              relative weighted average cost of capital

S&P                   Standard and Poor’s

SaaS                   Software-as-a-Service

SAMHSA           Substance Abuse and Mental Health Services Administration

SAN                   storage area network

SARS                 Sever Acute Respiratory Syndrome

SBBI                  Stocks, Bonds, Bills and Inflation [Yearbook]

SCIM                 supply chain inventory management

SCF                    statement of cash flows

SCM                  supply chain management

SCP                   standard cost profile

SD                     standard deviation

SDLC                 system development life cycle

SDN                   specially designated nationals

SDO                   standards development organization

SEC                   Securities and Exchange Commission

SERP                 supplemental extended reporting policy

SESIP                sharps with engineered sharps injury protection

SHM                  Society of Hospital Medicine

SIC                    Standard Industrial Code

SIPC                  Securities Investor Protection Corporation

SLA                   service level agreement

SMA                  special miscellaneous account

SMD                  Society of Medical Dental Management Consultants

SMS                   socioeconomic monitoring system

SMTP                simple mail transfer protocol

SNF                   skilled nursing facility

SNMP                simple network management protocol

SP                      special publication

SSH                   single-specialty hospitals

SSL                    secure socket layer

STP                    standard treatment protocol

SVPN                secure virtual private network

TEL                   Terror Exclusion List

TFC                   total fixed cost

TIC                    true interest cost

TIN                    tax identification number

TLS                    transport layer security

TPA                   third party administrator

TQIM                 total quality and improvement management

TQM                  total quality management

UCC                  Uniform Commercial Code

UCSF                 University of California at San Francisco

UDP                  user datagram protocol

UFS                   unix file system

UIIRC                University of Iowa Injury Prevention Research Center

UM                    utilization management

UPIN                 Unique Provider Identification Number

UR                     utilization review

USPAP              Uniform Standards of Professional Appraisal Practices

v                        variance

VA                     Veterans Affairs

VAR                  value at risk

VC                     variable cost

VOC                  volatile organic chemicals

VPN                  virtual private network

WACC               weighted average cost of capital

WAN                 wide area network

WHO                 World Health Organization

WIA                   weighted industry average

WORM              wrote once-read many

READINGS

  • Marcinko, DE and Hetico, RN: Dictionary of Health Insurance and Managed Care. Springer Publishing, New York, NY 2007
  • Marcinko, DE and Hetico, RN: Dictionary of Health Information Technology and Security. Springer Publishing, New York, NY 2009
  • Marcinko, DE and Hetico, RN: Dictionary of Health Economics and Finance. Springer Publishing, New York, NY 2008

EDUCATION: Books

HEALTHCARE ADMINISTRATION BLOGS 

  • Candid CIO: Will Weider, CIO of Ministry Health Care and Affinity Health System, offers his perspectives on administration issues in this blog.
  • Christina’s Considerations: Christina Thielst is a hospital and healthcare administrator and entrepreneur with a deep desire for continually improving the health of the community being served. This is her blog.
  • Healing Hospitals — Formerly Ask a Hospital President: F. Nicholas “Nick” Jacobs has more than 20 years experience in hospital management, with an acknowledged reputation for innovation and consumer-centered leadership.
  • Hospital Impact: Part of the Fierce network of health sites, this site is becoming popular among healthcare administrators for its news updates, tips and opinions on health care matters.
  • Leading the Way to Medical Excellence: the president of McLeod Health non-profit institutions provides weekly insights into his facilities and health care in general.
  • Let’s Talk Health Care: Bruce Bullen, Interim Chief Executive Officer at Harvard Pilgrim in Massachusetts, provides and open and ongoing conversation about health care administration.
  • Life as a Healthcare CIO: Dr. John Halamka records his experiences with infrastructure, applications, policies, management, and governance as he supports 3,000 doctors, 18,000 faculty and about three million patients.
  • Managed Care Matters: Joe Paduda shares his knowledge on managed care for group health, health policy, health research, and medical news for insurers, employers, and healthcare providers.
  • More than Medicine: Tom Quinn, president and CEO of Community General Hospital in Syracuse, New York, began his career as a hospital kitchen worker. His perspective on administration reflects his knowledge on how hospitals work from every angle.
  • Regis University Health Services Administration Blog: Learn more about a college health service through the blog provided by its health administrator, Michael Jackson.
  • Running a Hospital: A CEO of a large Boston hospital shares thoughts on hospitals, medicine and health care issues.
  • St. Joseph Medical Center: Chief Executive Officer at St. Joseph Medical Center in Missouri, Mr. Kashman, provides personal insight into administrative matters and general topics.
  • Todd’s Perspective: Todd Linden, president and CEO of Grinnell Regional Medical Center, offers insights into medical administration and guest bloggers provide insight into various departments.
  • Wachter’s World: This blog focuses on hospitals, hospitalists, quality, safety, policy and much more from Robert M. Wachter, MD, Professor and Associate Chairman of the Department of Medicine at the University of California, San Francisco.

                 Legal Matters

  • Drug and Device Law: This blog contains an attorney’s personal views (and those of several other Dechert attorneys) on topics that arise in the defense of pharmaceutical and medical device product liability litigation.
  • Drug Injury Watch: Learn more about drug injury lawsuits from an attorney who represents patients and their families.
  • FDA Law Blog: Hyman, Phelps & McNamara, P.C. is the largest dedicated food and drug law firm in the country. Their knowledge about laws and regulations governing drugs, medical devices, foods, dietary supplements, and cosmetics is helpful to anyone interested in these topics.
  • Health Care Law Blog: Bob Coffield’s expertise lies in helping businesses and health care providers weave through a variety of state and federal health care regulations and assisting them in business transactions.
  • Health Plan Law: This site contains information about group health plans, claims administration and related ERISA fiduciary issues. This site also contains tutorials.
  • HealthBlawg: this is David Harlow’s popular health care law blog, offering expert insights and easy-to-understand analysis.
  • Healthcare Law Blog: Holland & Hart’s healthcare practice provides insight into this arena, including HIPAA, Stark law, the Anti-kickback Statute and more.
  • HIPAA Blog: Join in on this discussion of medical privacy issues often buried in “political arcana.”
  • HIPAA, HiTech & HIT: This updated blog brings insight into legal issues, developments and other pertinent information that relates to the creation, use and exchange of electronic health records.
  • HIT Blawg: This blog is focused on national health information technology legal trends and current news on this topic.
  • Home Care Law Blog: Learn more about legal and policy issues in the home health care, private duty and hospice industries from Gilliland & Markette LLP.
  • Med Law Blog: This law blog focuses on topics that range from compliance to contracts and from employee benefits to HIPAA and HIT.
  • Physician Law: This blog provides and easy way to stay on top of current news, updates and useful tips relating to legal issues that affect physicians and non-institutional providers.

                 eHealth and Health IT

  • Chilmark Research: This blog provides perspectives on key IT trends in the healthcare sector.
  • davidrothman.net: David is the Information Services Specialist at the Community General Hospital Medical Library, but he also provides great ideas for 2.0 tools and tips for healthcare industry professionals on this blog.
  • e-CareManagement blog: Vince Kuraitis, owner of Better Health Technologies, LLC, has a passion for disease management and care coordination that dates back to 1995.
  • e-HealthExpert: A non-profit organization provides a free and open forum to support the development of expertise in the field of eHealth, Healthcare Information Systems, and Health IT (Clinical IT).
  • eHealth: John Sharp is an IT Manager for a major medical center in Northeast Ohio, with a focus on ehealth, personal health records, Web 2.0 technologies, Windows Sharepoint Services and project management.
  • Found In Cache: If you would prefer a professional’s take on social media matters, Web sites and all things technological, then follow Ed Bennett, a technology expert for a Maryland medical care system.
  • Future Health IT: A health IT and EPR advocate from the UK provides a format to discuss the future of health care and IT.
  • Informaticopia: This UK blogger provides eclectic news and views on health informatics and elearning.
  • MedGadget: Stay ahead of the gadget curve with this site, which offers information about the newest health care gadgets on the market as well as emerging medical technologies.
  • Neil Versel’s Healthcare IT Blog: A healthcare journalist’s provides his views on the major segment of the industry he covers — and, he provides a ton of links to other sites as well.
  • Schwartz Healthcare IT Blog: A variety of authors from Schwartz Communications provide insights into ways to use IT effectively within healthcare facilities.
  • The Health IT Channel: For a different perspective on IT and EHR as well as other health care issues, watch a few videos at this site.
  • The Healthcare IT Guy: The CEO of Netspective, a Java/.NET consultancy that specializes in healthcare IT with an emphasis on e-health, EMRs, data integration, and legacy modernization, supplies tips and information for physicians and healthcare administration.

ACKNOWLEDGEMENTS: To Mackenzie H. Marcinko PhD of iMBA Inc., Perry D’Alessio CPA CMP™ [Hon] New York, NY; and Daniel B.  Moisand CFP®, Principal for Moisand Fitzgerald Tamayo, Melbourne, FL.

COMMENTS APPRECIATED

Refer, Like and Subscribe

***

***

***

***

INSURANCE: Variable Universal Life

DEFINITION

By Staff Reporters

***

***

Variable Universal Life Insurance: Permanent life insurance that allows the policyholder to vary the amount and timing of premiums and, by extension, the death benefit. Universal life insurance policies accumulate cash value which grows tax deferred. Within certain limits, policyholders can direct how this cash value will be allocated among sub-accounts offered within the policy.

Several factors will affect the cost and availability of life insurance, including age, health, and the type and amount of insurance purchased. Life insurance policies have expenses, including mortality and other charges. If a policy is surrendered prematurely, the policyholder also may pay surrender charges and have income tax implications. You should consider determining whether you are insurable before implementing a strategy involving life insurance.

Any guarantees associated with a policy are dependent on the ability of the issuing insurance company to continue making claim payments.

COMMENTS APPRECIATED

Refer and Subscribe

***

***

INSURANCE TERMS: All Doctors Should Know

By Staff Reporters

***

***

DEFINITION BAR SLIDES LEFT TO RIGHT

Understanding Insurance Jargon

1. Premiums

When you purchase an insurance policy, you'll be required to make regular payments, known as premiums. These payments are typically made monthly or annually and are the cost of maintaining your insurance coverage.

2. Deductible

Think of a deductible as the money you have to shell out from your own pocket before your insurance kicks in to help cover your expenses. It's like the upfront cost you need to cover before your insurance really starts working for you.For example, if you have a $500 deductible and make a claim for $1,000, you'll need to pay $500, and your insurer will cover the remaining $500.

3. Policyholder

The policyholder is the person who owns an insurance policy. This individual is responsible for paying premiums and making claims under the policy.

4. Coverage Limit

Every insurance policy has a coverage limit, which is the maximum amount your insurer will pay out for a covered claim. It's crucial to understand your policy's limits to ensure you have adequate coverage.

5. Underwriting

Underwriting is the process insurers use to assess the risk of providing coverage to an individual or entity. It involves evaluating factors such as age, health, and driving record to determine premium rates and eligibility.

Types of Insurance

6. Auto Insurance

Auto insurance provides financial protection in case of accidents, theft, or damage to your vehicle. It's a legal requirement in many places and typically includes liability, collision, and comprehensive coverage.

7. Health Insurance

Health insurance covers medical expenses, including doctor visits, hospital stays, and prescription medications. It can be provided by employers or purchased individually.

8. Homeowners Insurance

Homeowners insurance is like a safety net for your home and stuff. It steps in to help if your place or belongings get damaged or stolen. Plus, it's got your back with liability coverage in case someone gets hurt while on your property.

9. Life Insurance

Life insurance pays out a death benefit to beneficiaries when the policyholder passes away. It can provide financial security to loved ones and cover funeral expenses.

10. Liability Insurance

Liability insurance covers you in case you're responsible for injuring someone or damaging their property. It's often included in auto and homeowners insurance policies.

Navigating Insurance Policies

11. Exclusions

Exclusions are specific events or circumstances that your insurance policy doesn't cover. It's essential to review these carefully to understand what situations won't be reimbursed.

12. Riders

Riders are add-ons to insurance policies that provide additional coverage for specific situations. For example, you can add a rider to your homeowners policy to cover expensive jewelry.

13. Claim

A claim is a formal request to your insurance company for coverage or reimbursement for a loss or damage. It's essential to follow the claims process outlined in your policy.

14. Grace Period

The grace period is the amount of time you have to pay your premium after the due date without your coverage lapsing. Be aware of your policy's grace period to avoid a lapse in coverage.

15. No-Claims Discount

Many insurance companies offer a no-claims discount to policyholders who haven't filed any claims within a specified period. This can lead to lower premiums over time.

Specialized Insurance Terms

16. Subrogation

Subrogation is the process by which an insurance company seeks reimbursement from a third party for a claim it has already paid out. This often occurs in auto accidents when your insurer goes after the at-fault driver's insurance company.

17. Actuary

An actuary is a professional who uses mathematics and statistics to assess risk and set premium rates for insurance policies. They play a crucial role in the insurance industry's financial stability.

18. Adjuster

An insurance adjuster is responsible for investigating claims, evaluating damage, and determining how much the insurance company should pay. They work to ensure fair settlements for policyholders.

19. Premium Credit

Premium credit is a discount offered by insurers to policyholders who meet specific criteria, such as having a good driving record or installing safety features in their home.

20. Salvage Value

When an insured item is damaged or totaled, it may still have some value. Salvage value refers to the amount the insurer can recover by selling the damaged item.

Protecting Your Financial Future

21. Risk Management

Effective risk management involves identifying potential risks and taking steps to minimize or mitigate them. Insurance is one tool in your risk management toolkit.

22. Beneficiary

A beneficiary is the person or entity designated to receive the proceeds of a life insurance policy when the policyholder passes away. It's essential to keep this information up to date.

23. Policy Term

The policy term is the duration for which your insurance policy is valid. It's crucial to renew your policy before it expires to maintain coverage.

24. Umbrella Policy

An umbrella policy provides additional liability coverage beyond the limits of your primary insurance policies. It can protect your assets in the event of a costly lawsuit.

25. Coinsurance

Coinsurance is the percentage of costs that you and your insurance company share after you've met your deductible. It's often seen in health insurance policies.

Insurance in Practice

26. Premium Increase

Your insurance premium may increase due to factors such as claims history, changes in coverage, or external economic conditions. It's essential to shop around for the best rates.

27. Depreciation

Depreciation is the decrease in the value of an asset over time. Insurance policies may account for depreciation when settling claims for damaged property.

28. Reinstatement

If your insurance policy lapses due to non-payment, you may have the option to reinstate it by paying any outstanding premiums and fees.

29. Excess

Excess, also known as a deductible, is the portion of a claim that you're responsible for paying. It's designed to prevent small, frequent claims.

30. Pre-Existing Condition

In health insurance, a pre-existing condition is a medical condition you had before obtaining coverage. Within the framework of the Affordable Care Act, insurance providers are prohibited from refusing coverage or imposing elevated premiums due to pre-existing medical conditions.

Insurance Regulations

31. State Insurance Department

Each state in the United States has a department or commission responsible for regulating insurance within its borders. They oversee insurers' operations and protect consumers.

32. Consumer Reports

Consumer reports provide information on insurance companies' financial strength, customer satisfaction, and claims-handling. They can help you choose a reputable insurer.

33. Guaranteed Renewal

Guaranteed renewal is a provision in some insurance policies that ensures the insurer cannot refuse to renew your policy as long as you pay your premiums.

34. Non-Cancelable Policy

A non-cancelable policy is one that the insurer cannot cancel or change the terms of as long as you pay your premiums. This provides certainty in coverage.

35. Market Conduct Examination

Insurance regulators conduct market conduct examinations to assess insurers' business practices and ensure they comply with laws and regulations.
Insurance for Businesses

36. Business Interruption Insurance

Business interruption insurance provides coverage for lost income and expenses when a covered event, such as a fire or natural disaster, forces your business to close temporarily.

37. Workers’ Compensation

Workers' compensation insurance covers medical expenses and lost wages for employees who are injured on the job. It's typically required by law for businesses with employees.

38. Professional Liability Insurance

Professional liability insurance, often called errors and omissions insurance, protects professionals from liability claims resulting from errors or negligence in their work.

39. Business Owner’s Policy (BOP)

A business owner's policy bundles essential coverages, such as property and liability insurance, into a single policy designed for small businesses. It's a cost-effective option.

40. D&O Insurance

Directors and officers (D&O) insurance protects the personal assets of company leaders in case they are sued for alleged wrongful acts while managing the business.

Advanced Insurance Concepts

41. Aggregate Limit

The aggregate limit is the maximum amount an insurance policy will pay out during a policy term, regardless of the number of claims made.

42. Risk Pooling

Insurance works on the principle of risk pooling, where policyholders collectively share the financial burden of covered losses.

43. Loss Ratio

The loss ratio is a measure of an insurance company's claims payouts compared to its earned premiums. A high loss ratio may indicate financial instability.

44. Surplus Lines Insurance

Surplus lines insurance covers risks that standard insurers won't or can't cover. It's often used for unique or high-risk situations.

45. Rescission

Rescission is the cancellation of an insurance policy retroactively, often due to misrepresentation or fraud on the policyholder's part.

Future of Insurance

46. Insurtech

Insurtech refers to the use of technology, such as artificial intelligence and data analytics, to streamline and improve the insurance industry's processes.

47. Telematics

Telematics devices track driving behavior and can lead to personalized auto insurance rates based on individual habits.

48. Microinsurance

Microinsurance provides affordable coverage to low-income individuals and communities, helping them mitigate risks and protect their assets.

49. Blockchain in Insurance

Blockchain technology can enhance transparency and security in insurance by creating immutable records of policies and claims.

50. Climate Change and Insurance

Climate change poses significant challenges to the insurance industry as it leads to more frequent and severe weather events. Insurers must adapt to these changing risk landscapes.
Insurance is a complex field with a language of its own, but understanding these 50 common insurance terms can help you navigate the world of insurance with confidence. Whether you're looking for auto, health, home, or any other type of insurance, being informed about these terms and concepts is essential to making informed decisions about your coverage.

COMMENTS APPRECIATED

Subscribe and Refer

***

***

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

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2025

REFER A COLLEAGUE: MarcinkoAdvisors@outlook.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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

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.

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

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%.

CITE: https://tinyurl.com/tj8smmes

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@outlook.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

INSURANCE: Permanent Life

By Staff Reporters

***

***

Permanent Life Insurance: A class of life insurance policies that do not expire—as long as premiums are kept current—and which combine a death benefit with a savings component. This savings portion can accumulate a cash value against which the policy owner may be able to borrow funds.

Several factors will affect the cost and availability of life insurance, including age, health and the type and amount of insurance purchased. Life insurance policies have expenses, including mortality and other charges. If a policy is surrendered prematurely, the policyholder also may pay surrender charges and have income tax implications. So, you should consider determining whether you are insurable before implementing a strategy involving life insurance.

Finally, any guarantees associated with a policy are dependent on the ability of the issuing insurance company to continue making claim payments.

COMMENTS APPRECIATED

Refer and Subscribe

***

***

INSURANCE: Term Policy

By Staff Reporters

***

***

Term Insurance: Life insurance that provides coverage for a specific period. If the policyholder dies during that time, his or her beneficiaries receive the benefit from the policy. If the policyholder outlives the term of the policy, it is no longer in effect. Several factors will affect the cost and availability of life insurance, including age, health, and the type and amount of insurance purchased.

Life insurance policies have expenses, including mortality and other charges. If a policy is surrendered prematurely, the policyholder also may pay surrender charges and have income tax implications.

And, you should consider determining whether you are insurable before implementing a strategy involving life insurance. Any guarantees associated with a policy are dependent on the ability of the issuing insurance company to continue making claim payments.

COMMENTS APPRECIATED

Refer and Subscribe

***

***

***

DAILY UPDATE: Healthcare Bankruptcies as Stock Markets Slide

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2025

REFER A COLLEAGUE: MarcinkoAdvisors@outlook.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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

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

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

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%.

CITE: https://tinyurl.com/tj8smmes

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@outlook.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

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

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@outlook.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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.

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

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%.

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

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).

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@outlook.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

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

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@outlook.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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

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

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

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%.

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@outlook.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

DAILY UPDATE: Veterans Scammed as 3 Major Markets Drop

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@outlook.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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

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

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

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.

CITE: https://tinyurl.com/tj8smmes

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@outlook.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

MARCINKO ASSOCIATES: Physician Wealth Advisors and Practice Management Consultants

FIDUCIARY MEDICAL COLLEAGUES – FEE ONLY – NO PRODUCT OR SALES COMMISSIONS

SPONSOR: http://www.MarcinkoAssociates.com

***

***

DEAR MEDICAL COLLEAGUES

Achieving your financial, wealth and medical practice management goals is important, but handling everything on your own can be overwhelming. That’s where we come in. At D. E. Marcinko & Associates, our team of dual degree experienced physician advisors and medical consultants is here to guide you every step of the way. We believe in providing unbiased, high-quality financial and business advice.

For example, we offer a one-time written financial plan with oral evaluation for a flat fee with no ongoing sales or assets under management fees or commissions. Together, we can create a personalized financial plan tailored to your unique goals, empowering you to make confident, informed decisions as you navigate your financial future.

Other Services Include:

  • Estate Planning We have a network of qualified legal professionals that we can refer you to for state specific estate planning needs.
  • Tax Strategy We can work alongside your CPA for tax planning purposes. If needed, we can refer you to a qualified tax professional.
  • Investment Analysis If you have investments, we review your accounts to make sure they are aligned with your long-term goals.
  • 401-k Allocations We evaluate your 401(k) allocations and provide recommendations that align with your goals.
  • Education Savings We help you explore the various ways to plan and save for education expenses.
  • Insurance & Risk Management We assess your insurance coverage to ensure it adequately protects you against potential risks; as well as evaluate and provide expert litigation witnesses, as needed.
  • Medical Practice Management We evaluate your current or potential medical practice to determine value and/or private equity offers or physician practice management formats [PPMC] for new, mid-career or retiring physicians, nurses and dentists.   

D. E. Marcinko & Associates is unique and fully committed to all phases of a medical professionals personal and business life cycle. We are at your service 24/7: Email MarcinkoAdvisors@outlook.com

ANN MILLER RN MHA CMP

***

Thank You

***

***

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

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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

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

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-

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

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.

CITE: https://tinyurl.com/tj8smmes

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@msn.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

2025 MEDICARE: Agent & Broker Pay Day Changes

How insurance agents will be compensated for helping seniors?

By Staff Reporters

***

***

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.

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

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

COMMENTS APPRECIATED

Subscribe and Refer!

Thank You

***

***

INSURANCE: Long Term Care Economics

LTC

By Anonymous Insurance Agent

***

***

Some retired people live on a fixed income and many of them live right on the edge of their financial capability.  At some time in their life, they may have to make a choice regarding many purchases.  In this case, we will illustrate “choice” using a couple’s purchase of Long-Term-Care Insurance [LTCI].

Of course, economics is the study of choice; wants, needs and scarcity, etc. In our case, if they decide to make the purchase they commit to a lifetime of premium payments. The financial tradeoff is this; if they make the commitment to purchase LTCI, they must give up something else.

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

Example: In order to maintain a monthly premium of $100 ($1,200per year), an elderly patient, retired layman or couple must essentially relegate about $30,000 of financial assets to generate the $100 necessary to make an average premium payment (assumes a 7% rate of return with 4% withdrawal rate) or [4% X $30,000 = $1,200 year]. Thus, if the monthly premium cost is $500 per month, the elder must give up the use of $150,000 of retirement asset just to generate enough cash flow to pay for the LTC insurance. 

The married elder couple has to make the decision among lifestyle (dinners, vacations, gifts to children, prescription drugs, medical care or food and shelter) versus paying an insurance premium to provide for nursing home coverage for a need, which may be very real, but will not occur until sometime in the ambiguous future. 

And so, when faced with such a tough economics, neither of which delivers peace of mind or a respectable solution; many will simply decide that, in either case, they may already end up impoverished. 

Thus, many will often opt for the better lifestyle now … while they can enjoy it … together. 

COMMENTS APPRECIATED

Subscribe Today!

***

HEALTH INSURANCE: https://tinyurl.com/4cf6rat9

***

AMA: 41 Senators Sign Letter to Stop Medicare Cuts

By Staff Reporters

***

***

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

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

COMMENTS APPRECIATED

Subscribe Today!

***

***

DAILY UPDATE: Health Insurance Affordability as Stock Markets Broadly Rise

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

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.

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

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.

CITE: https://tinyurl.com/tj8smmes

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@msn.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

IN & OUT OF NETWORK: Medical Care

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

***

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.

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

***

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.

COMMENTS APPRECIATED

Subscribe Today!

***

***

EMPLOYER’S: Pay for Health Insurance Paradox

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

***

***

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!

COMMENTS APPRECIATED

Thank You

***

***

DAILY UPDATE: MyChart, Meta, Zelle and Acadia as the DJIA Rises

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

Stat: 150. That’s how many health systems use AI to help draft replies on MyChart, sometimes without disclosing this to patients. (the New York Times)

Contained in a roughly 200-page quarterly filing from JPMorgan Chase last month were eight words that underscore how contentious the bank’s relationship with the government has become. The lender disclosed that the Consumer Financial Protection Bureau could punish JPMorgan for its role in Zelle, the giant peer-to-peer digital payments network. The bank is accused of failing to kick criminal accounts off its platform and failing to compensate some scam victims.

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

Stocks Up

Bristol-Myers Squibb rose 1.56% after the FDA approved its new drug for schizophrenia, the first new treatment of its kind in decades. Some analysts expect the drug, Cobenfy, to bring in $6 billion in peak annual revenue.

  • Trump Media gained 5.58% despite a co-founder of its Truth Social platform cashing out nearly all of his shares—worth about $100 million at current prices.
  • Chinese EV maker Nio added another 12.80% to bring its weekly gains to nearly 25%. It’s benefiting from the overall euphoria around Chinese stocks and anticipation over its quarterly delivery numbers due next week.
  • Speaking of the Chinese government’s stimulus measures, investors are wagering that the Macau locations of Las Vegas Sands Corp. (up 5.59%) and Wynn Resorts (up 7.24%) will see more visitors.
  • IonQ, a quantum computing company based in College Park, MD (go Terps), shot up 20.47% after inking a contract with the US Air Force Research Lab.

Stocks down

  • Nvidia dropped 2.17%. Bloomberg reported that the Chinese government is ramping up the pressure on local tech companies to move away from using Nvidia AI chips and lean more on domestic suppliers.
  • WeightWatchers, whose shares are down more than 90% this year, booted its CEO Sima Sistani, who pivoted the company to weight-loss drugs. Investors aren’t betting a change at the top will lead to a turnaround, sending shares 2.11% lower on the day.
  • Globe Life sank 4.74% after the US Equal Employment Opportunity Commission found that the life insurance company tolerated a “pervasive pattern of harassing conduct” at one of its top sales agencies, per Business Insider.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) lost 7.20 points (–0.13%) to 5,738.17 to end the week up 0.62%; the Dow Jones Industrial Average® ($DJI) added 137.89 points (0.33%) to 42,313.00 to end the week up 0.59%; the NASDAQ Composite® ($COMP) fell 70.70 points (–0.39%) to 18,119.59 to end the week up 0.95%.
  • The 10-year Treasury note yield (TNX) fell four basis points to 3.75%, up two basis points for the week.
  • The CBOE Volatility Index® (VIX) jumped to 16.64.

CITE: https://tinyurl.com/tj8smmes

Meta is facing a fine of $102 million for storing some users’ passwords in “plaintext”. The social media giant has admitted to poor password management.

Acadia and the Department of Justice just reached a ~$20M agreement to settle accusations that the company billed Medicare, Medicaid, and TRICARE for medically unnecessary inpatient mental health services. Acadia found itself under pressure after a New York Times investigation published earlier in September allegedly found that the company kept patients in facilities against their will to maximize insurance payments.

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@msn.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***

DAILY UPDATE: State Farm & Berkshire Hathaway as ESG Retreats and Markets Rise

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

***

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

Serving Almost One Million Doctors, Financial Advisors and Medical Management Consultants Daily

A Partner of the Institute of Medical Business Advisors , Inc.

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

***

http://www.MarcinkoAssociates.com

Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
© Copyright Institute of Medical Business Advisors, Inc. All rights reserved. 2024

REFER A COLLEAGUE: MarcinkoAdvisors@msn.com

SPONSORSHIPS AVAILABLE: https://medicalexecutivepost.com/sponsors/

ADVERTISE ON THE ME-P: https://tinyurl.com/ytb5955z

Your Referral Count -0-

Stat: Over 90%. That’s the percentage of the insurance industry’s uptick in fossil fuel securities investment coming from just two firms, State Farm and Berkshire Hathaway. (The Wall Street Journal)

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

Stocks up

  • Southwest Airlines ascended 5.42% after the company laid out its growth plans in an attempt to fend off an activist investor attack.
  • Starbucks climbed 1.93% thanks to an upgrade from Bernstein analysts who foresee a “grande comeback” for the coffee chain.
  • CarMax revved 5% higher after posting strong second-quarter earnings, beating both top and bottom line forecasts.
  • Jabil jumped 11.65% after the electronics parts manufacturer announced impressive earnings and revealed plans to cut costs.
  • Bilibili, which sounds like you’re trying to get your friend William’s attention, popped 15.44% after Goldman Sachs analysts upgraded the Chinese internet company.

Stocks down

  • Super Micro Computer plunged 12.17% on the news that the Department of Justice is launching a probe into the tech company, a few weeks after note short seller Hindenburg Research published a report alleging “accounting manipulation.”
  • Sonos, makers of your favorite subwoofer, sank 4.45% after a rare “double downgrade” by Morgan Stanley analysts, who demoted the stock from a positive “overweight” all the way to a negative “underweight.”
  • Oil stocks took a big hit today after Saudi Arabia announced it will increase its oil production next month. Diamondback Energy fell 6.46%, Shell dropped 3.91%, and ConocoPhillips lost 3.23%.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 23.11 points (0.40%) to 5,745.37; the Dow Jones Industrial Average® ($DJI) added 260.36 points (0.62%) to 42,175.11; the NASDAQ Composite® ($COMP) increased 108.08 points (0.60%) to 18,190.29.
  • The 10-year Treasury note yield (TNX) climbed one basis point to 3.79%.
  • The CBOE Volatility Index® (VIX) was steady at 15.57.

CITE: https://tinyurl.com/tj8smmes

A retreat from ESG is due to backlash from conservatives who are critical of the idea that fund managers should be considering any other factor but a company’s shareholders in their investment decisions. Accusations of “greenwashing” have also plagued many ESG funds, which is when an asset management firm charges higher fees for a specific thematic fund without actually delivering a unique investment strategy.

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

COMMENTS APPRECIATED

PLEASE SUBSCRIBE: MarcinkoAdvisors@msn.com

Thank You

***

***

***

***

EDUCATIONAL TEXTBOOKS: https://tinyurl.com/4zdxuuwf

***