DAILY UPDATE: Nurses & AI, Private Equity & CPAs, Public Companies and the Hot July Stock Markets

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

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Private equity gets a big accounting firm yet. The March story about private equity firm New Market Capital buying a $2.8 billion stake in accounting firm Grant Thorton was a big story. Private equity is gobbling up accounting firms, signaling a potential sea change in how accounting firms will operate in the future, with “more than half” of the top 20 accounting firms in talks with private equity.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 14.61 points (0.27%) to 5,475.09; the Dow Jones Industrial Average® ($DJI) climbed 50.66 points (0.13%) to 39,169.52; the NASDAQ Composite® ($COMP) added 146.70 points (0.83%) to 17,879.30.
  • The 10-year Treasury note yield (TNX) rose 12 basis points to 4.47%, the highest level since May 30 and back above its 50-day moving average, a technically important move.
  • The CBOE Volatility Index® (VIX) slipped to 12.19.

Crude oil is up sharply over the last month amid rising Middle East tensions.

What’s up

What’s down

  • Chewy stock popped then dropped 6.63% after Roaring Kitty revealed a 6.6% stake in the pet products company.
  • GameStop shares fell 5.35% after CEO Ryan Cohen posted on Twitter/X for the first time in months to advertise a job opening.
  • Uber fell 2.17% and Lyft fell 0.92% on the news that Massachusetts now requires both companies to pay rideshare drivers $32.50 an hour, plus benefits.
  • Cruise stocks sank on the news that Hurricane Beryl is stronger than expected and will disrupt service throughout the Caribbean. Norwegian Cruise Line fell 5.86%, Carnival fell 5.40%, and Royal Caribbean fell 1.86%.

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The largest nursing union in the US, National Nurses United (NNU), is sounding the alarm about the use of artificial intelligence (AI) in healthcare. In April, the union’s affiliate California Nurses Association (CNA) protested an AI conference helmed by managed care consortium Kaiser Permanente. Like workers in other sectors who are worried about AI encroachment, the nurses fear that the tech is contributing to the devaluation of their skills amid what they say is already a “chronic” understaffing crisis, nurses reported in an NNU survey of 2,300 registered nurses and members in early 2024.

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DAILY UPDATE: Squarespace, Ark Invest & Hospitals as the Markets Rebound

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

MEDICAL EXECUTIVE-POST – TODAY’S NEWSLETTER BRIEFING

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

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 25.26 points (0.5%) to 5,246.68, the highest since a record close March 28; the Dow Jones Industrial Average® ($DJI) gained 126.60 points (0.3%) to 39,558.11; the NASDAQ Composite climbed 122.94 points (0.8%) to 16,511.18.
  • The 10-year Treasury note yield (TNX) fell more than 3 basis points to 4.449%.
  • The CBOE Volatility Index® (VIX) decreased 0.18 to  13.42.

Among companies, Home Depot’s (HD) quarterly results reported earlier Tuesday kicked off the unofficial start of the retail earnings season. The home improvement retailer’s earnings topped expectations, but revenue missed forecasts, initially sending the company’s shares down sharply. 

Home Depot also reaffirmed its full-year guidance for a 1% decline in comparable-store sales and a 1% increase in total sales. The company’s shares bounced back to end with a 0.1% loss.

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And, the Cathie Wood-led Ark Invest just made some significant trades. The most prominent among them were the increased stakes in Palantir Technologies Inc (NYSE PLTR) and the reduced holdings in Coinbase Global Inc (NASDAQ: COIN).

Moreover, the website-building platform Squarespace is to go private, which it announced it’ll be doing in an all-cash deal with Permira, a private equity firm. Squarespace, which was public for nearly three years, joins a group of other smaller tech companies like Qualtrics that have recently pulled themselves off the public market. (CNBC)

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Employers and private insurers are paying hospitals more for inpatient and outpatient services than in previous years, a study from RAND Corporation finds. The American Hospital Association dismissed the report saying it offers a “skewed and incomplete picture.”

And finally … Kaiser Permanente began its 2024 earnings season with more than $2.7 billion in net income and $935 million in operating income, just months after sharing plans to lay off workers.

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HEALTHCARE: Business News

Posted on November 8, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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House Democrats want CMS to better monitor Medicare Advantage plans’ use of AI tools to ensure they don’t allow an unusually high level of restrictive and repeated denials.

Kaiser Permanente continues to rebound from a rough 2022 and pulled in $239 million in net income in Q3. That marks a dramatic turnaround from the $1.5 billion net loss the integrated system had seen a year prior.

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And … during the Milken Institute’s Future of Health Summit Monday, former HHS Secretary Alex Azar and current department chief Xavier Becerra sparred over the Biden administration’s approach to negotiating Medicare drug prices.

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Finally, family physicians utilizing value-based payment (VBP) models reported burnout relief in a study from EHR company Elation Health and the American Academy of Family Physicians. Burnout among providers decreased once practices passed a threshold of 75% financial investment in VBP models.

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Filed under: "Doctors Only", Accounting, Breaking News, Drugs and Pharma, Ethics, Health Insurance, Health Law & Policy, Healthcare Finance, Information Technology, Insurance Matters, Managed Care, Risk Management, Taxation | Tagged: , , , , , , , , , , , , , | Leave a comment »

STRIKE: Kaiser Permanente Strikes

Posted on October 4, 2023 by Dr. David Edward Marcinko MBA MEd CMP™

By Staff Reporters

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More than 75,000 workers employed by Kaiser Permanente, one of the largest nonprofit healthcare providers in the US, plan to walk off the job for three days—starting today.

Healthcare workers across the industry are experiencing challenges, which Kaiser acknowledged in response to the looming strike. According to a statement by the company, up to two-thirds of healthcare staff everywhere are burnt out. That’s exacerbated by the issues Kaiser employee unions say they’re striking over, including:

  • Acute staffing shortages: Short-staffing is a common problem in healthcare, but union members say that it has worsened between the pandemic and the Great Resignation—and patient safety is in danger.
  • Wage increases: The union wants what it describes as competitive compensation that accounts for the increased cost of living: a $25/hour wage floor and increases between 6.25% and 7% over the next four years.

Kaiser insists it pays a decent and denied claims of being short-staffed, saying it hired 22,000 people already this year.

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PODCAST: Medical Unions in Healthcare

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Physicians, hospitals, and emergency rooms will not be impacted, but some facilities will have reduced staff for nursing and support roles.

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PODCAST: Unique Kaiser Permanente Success Factors

Posted on November 11, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

A VERTICAL INTEGRATED HEALTH PLAN AND HOSPITAL SYSTEM

BY ERIC BRICKER MD

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PODCAST: Why Kaiser Permanente Health Insurance Has Not Spread?

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KP STRIKE: https://www.msn.com/en-us/money/other/some-32000-workers-at-kaiser-permanente-ready-to-strike-on-november-15/vi-AAQvYi5

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PODCAST: Why Kaiser Permanente Health Insurance Has Not Spread?

Posted on October 6, 2021 by Dr. David Edward Marcinko MBA MEd CMP™

ACROSS TO MORE OF AMERICA

By Eric Bricker MD

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KAISER VACCINE MANDATE: https://www.msn.com/en-us/news/us/almost-5000-kaiser-permanente-health-care-employees-suspended-for-refusing-vaccine/ar-AAPaVF0?ocid=BingNewsSearch

KP: https://www.msn.com/en-us/news/politics/kaiser-permanente-puts-2000-workers-on-unpaid-leave-over-vaccine-mandate/ar-AAPcwNo?li=BBnb7Kz

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Paper Medical Records Keep Good Dentists [and Physicians] Honest

Posted on June 15, 2011 by Dr. David Edward Marcinko MBA MEd CMP™

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Good Fences Keep Good Neighbors

[By D Kellus Pruitt DDS]

“Changes to an EHR (electronic health record) can go unnoticed and can be harder to trace than changes made to paper records”

Sen. Mark Leno [D-San Francisco, the author of SB 850]

Yesterday, Kendall Taggart posted “Bill would require ‘track changes’ on electronic medical records” on California Watch.com.

http://www.chron.com/disp/story.mpl/deadbymistake/ca/6555170.html

It seems there is a growing problem with providers in California who cannot be held accountable for altering patients’ digital health records to protect themselves rather than their patients. With paper records on the other hand, erasures, ink and even handwriting can be scrutinized should a court of law need reliable evidence. What’s more, Sen. Leno’s feel-good law will not make EDRs any cheaper. Meanwhile, the multifaceted safety of paper dental records is not only proven by a very long track record, but it is irrefutable and free. Hard evidence is the innocent dentist’s friend. Otherwise it’s “he said, she said” and an unpredictable jury that might not like dentists anyway.

Tagggart writes: “A bill working its way through the state Legislature would make it more difficult for health care providers [including dentists] to modify or delete electronic medical records and leave no record of the change … The bill would require providers to automatically record any change or deletion of electronically stored medical information and identify who made the change. Furthermore, the bill would make it possible for patients to see the changes if they requested their medical records.” Do Democrats from California ever consider the price tag of their ideas? Is there any wonder why healthcare costs continue to rise?

Kaiser Responds 

Teresa Stark of Kaiser Permanente responds: “Our system can’t do that, and we’re not aware of any system that can. Given the level of investment required to bring our EHR up to that level, is this really what we want to be spending our money on?”

Regulatory expenses in healthcare are like tsunamis to dentists. Big boats like Kaiser in deep water might hardly notice the swell that will overwhelm our inflatable water wings in the shallows.

And, if it is too expensive for Kaiser – one of the largest healthcare systems in the nation with thousands of staff – imagine how expensive and time-consuming the new law will make electronic dental records? Since California often leads the nation in swell regulatory ideas, will California dentists be the first to flee to paper records should the costs of digital keep rising?

Even before California’s latest regulatory patch is slapped on EDRs, they offer no return on investment. That means paperless practices are more expensive to maintain than paper practices, and ultimately, patients will pay an increased price for paperless dentistry.

Assessment 

Micromanagement of small practices is expensive even if performed using the EDRs dentists themselves purchase. Swell ideas from well-meaning lawmakers are pricing miracle discoveries from safely interconnected EDRs out of reach. Why is HIT incompatible with common sense?

Conclusion

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As the Health Care Vote Passes

Posted on March 28, 2010 by Dr. David Edward Marcinko MBA MEd CMP™

Another Troubling Insurance Story

By Marian Wang, ProPublica – March 17, 2010 2:03 pm EDT

[picapp align=”none” wrap=”false” link=”term=health+insurance&iid=8337843″ src=”c/e/5/3/President_Obama_signs_baf7.JPG?adImageId=11734822&imageId=8337843″ width=”380″ height=”484″ /]

Reuters filed a stunning report [1] recently about a health insurance company that targeted policyholders with HIV to drop their coverage. It opens with the case of Jerome Mitchell:

Patient Jerome Mitchell

Previously undisclosed records from Mitchell’s case reveal that [health insurance company Fortis [now known as Assurant Health] had a company policy of targeting policyholders with HIV. A computer program and algorithm targeted every policyholder recently diagnosed with HIV for an automatic fraud investigation, as the company searched for any pretext to revoke their policy. As was the case with Mitchell, their insurance policies often were canceled on erroneous information, the flimsiest of evidence, or for no good reason at all, according to the court documents and interviews with state and federal investigators ….

Insurance companies have long engaged in the practice of “rescission,” whereby they investigate policyholders shortly after they’ve been diagnosed with life-threatening illnesses. But, government regulators and investigators who have overseen the actions of Assurant and other health insurance companies say it is unprecedented for a company to single out people with HIV.

The Three Minute Rule

A South Carolina judge who ruled on the case noted that in the meeting in which the rescission committee [2] reviewed Mitchell’s case and decided to cancel his policy, there were more than 40 other customers whose cases were up for review, and “an average of three minutes or less” was spent per customer. Assurant Health told Reuters [1] it doesn’t comment on individual customer claims, while a spokesman added the company disagreed with “certain of the court’s characterizations of Assurant Health’s policies and procedures.” 

Link: http://www.propublica.org/ion/blog/item/as-health-care-vote-nears-another-troubling-insurance-story

Assessment

As the story notes, it’s not just this one insurance company that has been engaging in aggressive rescission. In California, state regulators fined five major health insurance providers—Health Net, Anthem Blue Cross, Blue Shield of California, PacifiCare and Kaiser Permanente—for dropping more than 6,000 sick policyholders. The terms of those settlements, reached in 2008 and 2009 [3], have yet to be implemented in most cases, according to news reports [3] from last week.

Industry Indignation Index: 39

Conclusion

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