NINE: Psychological Reasons We Do Dumb Things with Money [$$$$]

Yep – Even the Smart Folks!

By Lon Jefferies MBA CMP® CFP®

Dr. David Edward Marcinko MBA MEd CMP®

Lon Jeffries

In the Business Insider, Mandi Woodruff describes nine mental blocks that cause smart people to do dumb things. Review the list and itemize the factors that have negatively impacted your finances.

The Factors

  • Anchoring happens when we place too much emphasis on the first piece of information we receive regarding a given subject. For instance, when shopping for a wedding ring a salesman might tell us to spend three months’ salary. After hearing this, we may feel like we are doing something wrong if we stray from this advice, even though the guideline provided may cause us to spend more than we can afford.
  • Myopia (or nearsightedness) makes it hard for us to imagine what our lives might be like in the future. For example, because we are young, healthy, and in our prime earning years now, it may be hard for us to picture what life will be like when our health depletes and we know longer have the earnings necessary to support our standard of living. This short-sightedness makes it hard to save adequately when we are young, when saving does the most good.
  • Gambler’s fallacy occurs when we subconsciously believe we can use past events to predict the future. It is common for the hottest sector during one calendar year to attract the most investors the following year. Of course, just because an investment did well last year doesn’t mean it will continue to do well this year. In fact, it is more likely to lag the market.
  • Avoidance is simply procrastination. Even though you may only have the opportunity to adjust your health care plan through your employer once per year, researching alternative health plans is too much work and too boring for us to get around to it. Consequently, we stick with a plan that may not be best for us.
  • Confirmation bias causes us to place more emphasis on information that supports the opinion we already have. Consequently, we tend to ignore or downplay opinions that don’t mirror our own, leading us to make uninformed decisions.

NOTE: An interesting example of the confirmation bias is the case of David Rosenberg, who is one of the most well-known perpetual bears on Wall Street. In October, Mr. Rosenberg’s analysis forced him to warm to the current investment environment. His fans and followers, rather than appreciating his research and ability to adjust to new information, criticized him for changing his opinion.

As it turned out Mr. Rosenberg had fans not because of his expert analysis, but because he added intellectual heft to his followers pessimism and quasi-political desire for the system to collapse. Their view was that things were in permanent decline and his analysis, charts, and voice added respectability to their pre-existing bias. Mr. Rosenberg has now lost his fan base not because he was wrong for the last four years, but because he changed his mind.

head

  • Loss aversion affected many investors during the crash of 2008. During the crash, many people decided they couldn’t afford to lose more and sold their investments. Of course, this caused the investors to sell at market troughs and miss the quick, dramatic recovery.
  • Overconfident investing happens when we believe we can out-smart other investors via market timing or through quick, frequent trading. Data convincingly shows that people who trade most often underperform the market by a significant margin over time.
  • Mental accounting takes place when we assign different values to money depending on where we get it from. For instance, even though we may have an aggressive saving goal for the year, it is likely easier for us to save money that we worked for than money that was given to us as a gift.
  • Herd mentality makes it very hard for humans to not take action when everyone around us does. For example, we may hear stories of people making significant profits buying, fixing up, and flipping homes and have the desire to get in on the action, even though we have no experience in real estate.

Assessment

The good news is that being aware of these tendencies can help us avoid mistakes. We’ll never be perfect, but avoiding detrimental decisions based on mental prejudices can give us an advantage in our financial and retirement planning efforts.

Conclusion

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PODCAST: What is SMART BETA?

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REALLY SMART -OR- NOT REALLY

BY: DR. DAVID EDWARD MARCINKO MBA MEd CMP®

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Smart beta investment portfolios offer the benefits of passive strategies combined with some of the advantages of active ones, placing it at the intersection of efficient-market hypothesis and factor investing.

Offering a blend of active and passive styles of management, a smart beta portfolio is low cost due to the systematic nature of its core philosophy – achieving efficiency by way of tracking an underlying index (e.g., MSCI World Ex US). Combining with optimization techniques traditionally used by active managers, the strategy aims at risk/return potentials that are more attractive than a plain vanilla active or passive product.

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

Originally theorized by Harry Markowitz in his work on Modern Portfolio Theory (MPT), smart beta is a response to a question that forms the basis of MPT – how to best construct the optimally diversified portfolio. Smart beta answers this by allowing a portfolio to expand on the efficient frontier (post-cost) of active and passive. As a typical investor owns both the active and index fund, most would benefit from adding smart beta exposure to their portfolio in addition to their existing allocations.

Financial beta: https://medicalexecutivepost.com/2021/05/12/so-what-is-financial-beta-granularly/

Assessment: The smart beta approach is an arguably perfect intersection between traditional value investing and the efficient market hypothesis. But, is it worth the cost?

More: https://www.bloomberg.com/opinion/articles/2018-06-08/smart-beta-performance-isn-t-worth-the-cost

ALPHA versus BETA Podcast: https://youtu.be/dP_23vKJ3HQ

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

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

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

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

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

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DAILY UPDATE: CVS Health and AI Healthcare Chatbots as Stocks Reach New Highs

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CVS Health may be breaking up…with itself. The board of directors at CVS Health—the parent company of CVS Pharmacy, pharmacy benefit manager CVS Caremark, and insurance unit Aetna—are working with a group of bankers to review the company’s strategy, which according to Reuters, may lead to a split between its pharmacy division and Aetna.

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Stocks Up

  • Apple climbed 1.23% on a Bloomberg report that iPhone 16 demand has been shockingly strong in China.
  • Verizon Communications will purchase $1 billion worth of US Cellular’s wireless spectrum licenses. Verizon rose just 0.34%—but it’s a huge deal for US Cellular, which popped 7.22%, and Telephone and Data Systems, which owns 82% of US Cellular, and soared 15.40%.
  • Intuitive Surgical rose to a new all-time high, climbing 10.01% on strong earnings powered by sales of its da Vinci device.
  • Lamb Weston, the company behind the french fries you overindulge in every time you go out to dinner, is being pushed by activist investor Jana Partners toward exploring a sale. Shareholders rejoiced, and the stock rose 10.17%.

Stocks Down

CVS Health sank 5.23% on the news that CEO Karen Lynch will be replaced by David Joyner after three years at the helm of the struggling pharmacy/retailer. Joyner ran the company’s pharmacy service business for the last two years.

  • WD-40 seems like the staple of all consumer staples, but the company missed on both revenue and earnings estimates last quarter. Shares fell 4.79% on the news.
  • American Express dropped 3.15% after the credit card company reported a rare miss today, beating bottom-line estimates but missing revenue forecasts last quarter.
  • MGP Ingredients makes all the booze you drink under different brand names, but people aren’t drinking enough. The beverage maker issued preliminary earnings that included a 24% drop in sales. Shares tanked 24.16%.

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

Here’s where the major stock market benchmarks ended:

  • The S&P 500® index (SPX)rose 23.20 points (0.40%) to 5,864.67, a new record high close, to end the week up 0.85%; the Dow Jones Industrial Average® ($DJI) added 36.86 points (0.09%) to 43,275.91, also another record high finish, to end the week up 0.96%; and the $COMP gained 115.94 points (0.63%) to 18,489.55 to end the week up 0.80%.
  • The 10-year Treasury note yield (TNX) fell two basis points to 4.07%.
  • The CBOE Volatility Index® (VIX) fell to 18.17, the lowest since September 30.

CITE: https://tinyurl.com/tj8smmes

A new survey results may prompt health systems to second-guess some of their future plans. A recent University of Michigan survey found 74% of adults ages 50+ have “very little or no trust” in health info generated by AI. Maybe it’s not time to roll out chatbots on patient portals just yet.

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FAST FACTS: Retirement Income in the USA

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According to the National Institute on Retirement Security, almost 40 million households have no retirement savings at all. The Employee Benefit Research Institute (EBRI) estimates in its 2019 Retirement Security Projection Model that America’s current retirement savings deficit is $3.8 trillion.

What does that mean? Well, the EBRI report aggregates the savings deficit of all U.S. households headed by someone between the ages of 35 and 64, inclusive. In total, those households have $3.8 trillion fewer dollars in savings than they should have for retirement.

For more recent data, Fidelity Investments reported that in the third quarter of 2022 the average account balance for an IRA was $101,900. Employees with a 401(k) averaged $97,200, while those with a 403(b) had $87,400.

Fidelity also estimated that “an average retired couple age 65 in 2022 may need approximately $315,000 saved (after tax) to cover health care expenses in retirement.”  Keeping in mind that more Americans are also living longer than ever before, they will face more challenges to cover medical expenses in retirement.

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DAILY UPDATE: UnitedHealth, PBMs, Walgreens and Edmunds as Stock Climb

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UnitedHealth posted $6 billion in profit and $100 billion in revenue, but the company’s stock is dipping this morning.


Walgreens is closing 1,200 stores by 2027 and a net loss of $3 billion, though the company beat Wall Street’s expectations.

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

Stocks Up

  • Chip stocks recovered lost ground today thanks to a strong earnings report from TSMC (more on that below). Nvidia led the group higher, rising 0.89% to yet another new all-time high.
  • Blackstone rose 6.30% to a new record high after the world’s largest alternative asset manager reported an excellent quarter.
  • Expedia popped 4.75% after a report by the Financial Times revealed that Uber had explored an acquisition of the travel site. Expedia shareholders cheered the news, while Uber shares sank 2.45%.

Stocks Down

  • Robinhood fell 2.27% after announcing its new Legend trading platform geared specifically toward advanced traders.
  • Lucid Group plummeted 17.99% on the news that the EV automaker is offering over 262 million shares of its common stock in an attempt to raise funds.
  • CSX dropped 6.71% after missing both top- and bottom-line estimates last quarter thanks in no small part to hurricanes Helene and Milton.
  • Health insurance stocks took a beating today due to a not-great earnings report from Elevance Health (more on that below, too). Centene Corp. fell 9.09%, while Molina Healthcare tumbled 12.55%.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) slipped 1.00point (–0.02%) to 5,841.47; the $DJI added 161.35 points (0.37%) to 43,239.05; and the NASDAQ Composite®($COMP) rose 6.53 points (0.04%) to 18,373.61. 
  • The 10-year Treasury note yield (TNX) climbed eight basis points to 4.1%.
  • The CBOE Volatility Index® (VIX) sank to 18.97 by late Thursday, a two-week low.

CITE: https://tinyurl.com/tj8smmes

The average amount owed on “upside down” auto loans, in which the balance is more than the car is worth, hit a record high of $6,458 in the third quarter, according to Edmunds, a site that helps consumers research and buy cars

Diabetes advocates have officially joined the fight against pharmacy benefit managers (PBMs).

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OCTOBER: “Financial Planning” Month for Doctors

DR. DAVID EDWARD MARCINKO MBA MEd CMP™

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History for Us All

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History of Financial Planning Month

Financial planning as a concept has been around for a long time, but not as we know it today. When Loren Dunton set up the Society for Financial Counseling Ethics in 1969, or when the first graduating class of the College of Financial Planning graduated in 1973, financial planning was very different. It was centered around selling limited partnerships, which came to end with the Tax Reform Act of 1986.

However, financial planning re-emerged — all thanks to Richard Averitt III. The certified financial planner gave new meaning to financial planning, this time with a focus on who the client is and what their needs are. This approach was purely methodological in nature.

Soon after, financial planning picked up again. According to the Certified Financial Planner (C.F.P.) Board of Standards in Denver, today, there are more than 94,000 C.F.P.s worldwide, including over 48,000 in the U.S. Additionally, there are also organizations that have been set up for C.F.P.s, such as the Financial Planning Association (FPA), which has approximately 22,000 members.

And, don’t forget the emerging Certified Medical Planner professional fiduciary designation for physicians, dentists, nurses and allied healthcare clients.

Financial planning, as we know it now, includes investing, tax planning, retirement planning, and basically other ways to get your finances in order and create mindful budgets to ensure a safe and secure future. Getting a step ahead of your spending and finances is beneficial in the long run and Financial Planning Month in October is the perfect time to do that.

MORE: https://medicalexecutivepost.com/2022/10/27/october-national-financial-planning-month/

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PODCAST: What is “SWARM” Learning?

By Dr. David E. Marcinko MBA MEd CMP

SWARM INTELLIGENCE IN MEDICINE

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Warm Learning or Swarm Intelligence, is how swarms of bees or birds move in response to their environment.

When applied to data there is “more peer-to-peer communications, more peer-to-peer collaboration, more peer-to-peer learning and that’s the reason why swarm learning will become more and more important as … as the center of gravity shifts” from centralized to decentralized data.

DZNE : AI with Swarm Intelligence

Medicine Example:

Consider this example,  “A hospital trains their machine learning models on chest X-rays and sees a lot of tuberculosis cases, but very little of lung collapsed cases. So therefore, this neural network model, when trained, will be very sensitive to what’s detecting tuberculosis and less sensitive towards detecting lung collapse.”

“However, we get the converse of it in another hospital. So what you really want is to have these two hospitals combine their data so that the resulting neural network model can predict both situations better. But since you can’t share that data, swarm learning comes in to help reduce that bias of both the hospitals.”

And this means, “each hospital is able to predict outcomes, with accuracy and with reduced bias, as though you have collected all the patient data globally in one place and learned from it.”

Moreover, it’s not just hospital and patient data that must be kept secure. What swarm learning does is to try to avoid or reduce the sharing of data, or totally prevent the sharing of data, to [a model] where you only share the insights, or you share the learnings.

So, that’s why it is fundamentally more secure.

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DR. GOH PODCAST: https://www.technologyreview.com/2021/08/16/1031738/a-new-age-of-data-means-embracing-the-edge/?mc_cid=30af99395f&mc_eid=72aee829ad

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DICTIONARY: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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DAILY UPDATE: Goldman Sachs, Starbucks and Walgreens as Stock Markets Boost Up

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Goldman Sachs’ profit jumped 45% in monster quarter. The investment bank made $3 billion of profit on revenue of nearly $13 billion in Q3, it reported yesterday, surpassing even the rosiest of expectations. Bloomberg reported that it was the best quarter ever for Goldman’s stock trading unit, putting the group on track for a record year.

Walgreens said it will close 1,200 US stores, about one in seven locations, by 2027. The retailer will shutter 500 stores by the end of next year.

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

UP STOCKS

Trump Media & Technology Group has had a wild week, falling nearly 10% yesterday before trading of the stock was halted, then popping 15.52% today. Election hype, a Trump-sponsored cryptocurrency, and Truth+, a new streaming service, are keeping shareholders on their toes.

  • Abbott Laboratories rose 1.53% thanks to a stronger-than-expected earnings report powered by the company’s impressive medical device sales.
  • Aspen Aerogels makes insulating material for batteries, which sounds boring to everyone but the Department of Energy. The DOE signed a conditional commitment to loan the company up to $670 million, sending shares 13.24% higher.

DOWN STOCKS

  • Novavax plummeted 19.44% after the FDA put a hold on the pharma company’s flu and Covid vaccine combination.
  • ASML Holding NV dropped another 6.42% today as the semiconductor selloff continues.
  • Interactive Brokers enjoyed higher revenue and more trading from its user base last quarter, but earnings per share came in under expectations, and shares sank 4.05%.

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

Here’s where the major benchmarks ended:

  • The SPX rose27.21points (0.47%) to 5,842.47; the Dow Jones Industrial Average® ($DJI) added 337.28 points (0.79%) to 43,077.70; and the NASDAQ Composite®($COMP) increased 51.49 points (0.28%) to 18.367.08. 
  • The 10-year Treasury note yield (TNX) fell two basis points to just below 4.02%, the lowest close since October 4.
  • The CBOE Volatility Index® (VIX) dropped moderately to 19.58, still elevated considering stock market strength.

CITE: https://tinyurl.com/tj8smmes

Starbucks is reportedly pivoting from discounts and promotions to refocus on selling premium coffee and seasonal drinks

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

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

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

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

STOCKS UP

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

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

STOCKS DOWN

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

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

Here’s where the major benchmarks ended yesterday:

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

CITE: https://tinyurl.com/tj8smmes

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

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DAILY UPDATE: Life Span, Earnings Reports, Oil, Gold and Bitcoin with Closing Stock Highs

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

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  • Stocks kicked off the first full week of earnings season at full throttle. The S&P 500 rose to a new intraday record, the Dow closed above 43,000 for the first time ever, and the NASDAQ climbed steadily throughout the trading session.
  • Bitcoin soared on the news of China’s additional stimulus spending that broke this weekend. Although the Chinese government’s plans are light on details at the moment, the promise of more support for the world’s second largest economy was enough to get crypto traders hyped.

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

  • Interestingly enough, those same promises of Chinese stimulus sent oil tumbling to start the day. The selling was exacerbated by OPEC’s announcement that crude demand will fall lower than expected in 2024 and 2025.
  • Gold sank a hair today as traders weighed Chinese stimulus against a stronger dollar.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose44.82points (0.77%) to 5,859.85, a new closing high; the Dow Jones Industrial Average® ($DJI) increased 201.36 points (0.47%) to 43,065.22, also a new closing high; and the NASDAQ Composite® ($COMP) added 159.74 points (0.87%) to 18,502.69.
  • The 10-year Treasury note yield (TNX) did not trade today due to the holiday. 
  • The CBOE Volatility Index® (VIX) slipped to 19.9, its first drop below 20 since October 4.

A slate of corporate earnings reports coming from Goldman Sachs, Bank of America, and Citigroup in the financial sector, along with healthcare giants Johnson & Johnson, Walgreens, and UnitedHealth. And throughout the week: Morgan Stanley will report on Wednesday, Netflix reports on Thursday, and Procter & Gamble and American Express drop their financials on Friday. It’ll pose a big test for the stock market’s $8 trillion rally this year.

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MARCINKO & ASSOCIATES: Financial Planning and Business Management Education for Physicians

By Dr. David Edward Marcinko MBA MEd CMP

CONSULTING ADVICE – NOT SALES

“AT YOUR SERVICE”

E-mail: MarcinkoAdvisors@msn.com

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Marcinko & Associates is financial guide. We help answer your questions in an empowering way. We educate and guide medical colleagues to understand their financial picture and to make better financial decisions. We strive to simplify everything, clear up confusion, and address specific needs and goals.

Simply put, we’re a financial services company on a mission to empower financial freedom for all healthcare professionals; only. We work with doctors, nurses, medical providers, individuals and all sizes of organizations to offer investment, wealth management and retirement solutions so everyone can have a clear and simple understanding of where their finances and career is today and where it is headed tomorrow.

Whatever your financial situation, we do not shame, criticize, or sell. We enrich, educate and empower. We work only with medical colleagues at every stage of their financial journey [students, interns, residents, practitioners, mid-career and mature physicians], through big life personal changes to annual employment reviews, in order to help them understand, invest, and protect their money and lifestyle.

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For example, the following are current issues of review need for each Fall and Winter:

  • Financial planning reviews: 401-k, insurance, budget plans, investing, debt and savings, etc
  • Assess, develop, and align financial retirement and estate planning goals
  • Risk Management: Malpractice, home, life, medical, auto and personal indemnity
  • Life Insurance Need Reviews: whole, universal and term  
  • Business, operations, HR, employment negotiations and medical practice management
  • Annuity Need Reviews: Indexed and Fixed [Pros and Cons].

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At Marcinko & Associates we discuss specific needs and answer specific questions. We educate and make personalized recommendations that you are free to use, incorporate or disregard. Referrals to trusted specialists and strategic alliance partners then occur if – and as – needed [pro re nata].

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STOCK MARKET: A Zero Sum Bias?

By Staff Reporters

FINANCIAL / INVESTMENT ADVISORS & STOCK BROKERS

SPONSOR: http://www.MarcinkoAssociates.com

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According to colleague Dan Ariely PhD, a Zero Sum Bias [ZSB] is the mistaken belief that one person’s gain is another’s loss. It’s like thinking the world is a giant pie with only so many slices. This mindset fuels competition and jealousy, making us forget that collaboration can create more pie. It’s why we sometimes root against others instead of working together.

Question: Is the stock market a zero-sum game? You frequently hear media refer to games and markets as zero-sum games.

Answer: Well, yes, we define the stock market as a zero-sum game, both in the short and in the long term, although it technically is incorrect. A zero-sum game is where one person’s gain is another person’s loss – thus there is no wealth created and the overall benefit is zero. This doesn’t apply to stocks, but it’s a zero-sum game in relation to a stock market benchmark.

For example, short-term trading in stocks is theoretically not a zero-sum game, and neither is long-term investing. But short-term trading is close to a zero-sum game, and long-term investing is a zero-sum game if we use a broad index as a benchmark.

Essentially, in other words, the stock market functions as an expansive network of zero-sum transactions; each trade engages a buyer and a seller–their perspectives on a security’s future value contrasting. These opposing views propel market prices: they mirror not only risk transfer but also potential reward—a dynamic process indeed! Traders and investors must grasp the crucial zero-sum aspect; it underscores trading’s inherent competitiveness. Effectively anticipating market trends and actions from other participants: therein lies success in this environment. 

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So, next time you feel like someone else’s success diminishes your own, remember: there’s more than enough pie to go around.

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ORTHOPEDIC & PODIATRIC SURGERY: Ambulatory Surgery Centers

AVERAGE REVENUE PER CASE

By Staff Reporters

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Podiatry is 3rd in Average Revenue Per Case in ASCs

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Ambulatory Surgery Centers: Creating Value through Outpatient Surgery

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Orthopedic surgery topped the pack for ASC revenue per case, according to VMG Health’s “Multi-Specialty ASC Benchmarking Study” for 2022.

The specialty was only the fourth most-represented among ASC cases, however. Nationally, gastroenterology was the most-represented specialty among ASCs, with 32 percent of all cases, followed by ophthalmology, with 26 percent, and pain management and orthopedics, with 22 and 21 percent, respectively.

Average revenue per case:

1. Orthopedics — $3,791

2. Gynecology — $3,117

3. Podiatry — $2,990

4. Urology — $2,724

5. Otolaryngology — $2,617

6. General surgery — $2,508

7. Plastic surgery — $2,264

8. Ophthalmology — $1,487

9. Pain management — $1,273

10. Gastroenterology — $1,079

Source: Marcus Robertson, Becker’s ASC [2/15/22]

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DAILY UPDATE: Boeing, Nobel Peace Prize, Tesla, JPMorgan and Wells Fargo

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Yom Kippur. Wishing a meaningful and easy fast to our readers who observe.

Boeing plans to lay off 10% of its workforce, or ~17,000 people, to cut costs as its factory workers’ strike continues.

The Nobel Peace Prize was awarded to Nihon Hidankyo, a Japanese organization of survivors of the atomic bombings of Hiroshima and Nagasaki, that advocates against nuclear weapons.

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  • Markets: After big banks—which are often viewed as a proxy for the economy’s health—kicked off earnings season strong, the S&P 500 and the Dow hit new records, capping off stocks’ fifth winning week in a row.

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Stock spotlight: Elon Musk’s presentation of Tesla’s long-awaited Robocab didn’t go as badly as that time the Cybertruck’s “unbreakable” window got smashed on stage, but investors were unimpressed by its lack of key details.

Hailing the news were Uber and Lyft, which rose after Tesla failed to present a looming threat.

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JPMorgan says the soft landing is here. Reporting its first quarterly earnings since the Fed’s big interest rate cut, America’s biggest bank earned more than expected from loans and boosted what it forecasts it’ll earn for the year.

In other banking news, Wells Fargo also beat earnings expectations.

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DAILY UPDATE: Ikea & Fidelity Investments with SPX Bank at New High

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Ikea’s revenue fell for the first time in four years after it lowered prices to spark an increase in orders.

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Stocks up

Stocks down

  • Stellantis continued to tumble today, falling another 2.22% after the carmaker announced its CEO will step down in early 2026.
  • A.O. Smith probably doesn’t ring a bell, but there’s a good chance they made the water heater in your basement. Unfortunately, they’re not selling too many these days, and shares sank 6.25% after the company cut its full-year outlook.

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

Here’s where the major benchmarks ended:

  • The SPX rose 34.98 points (0.61%) to 5,815.03 to end the week up 1.11%; the $DJI added 409.74 points (0.97%) to 42,863.86 to end the week up 1.21%; and the $COMP gained 60.88 points (0.33%) to 18,342.94 to end the week up 1.13%.
  • The 10-year Treasury note yield (TNX) fell two basis points to 4.07% but rose nine basis points this week.
  • The CBOE Volatility Index® (VIX) slipped to 20.41, still up slightly for the week.

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Fidelity Investments has notified 77,099 people that their personal information was stolen in an August data breach. he mega asset manager has not disclosed what data the digital crooks nabbed, but assured customers that the security snafu “did not involve any access to your Fidelity account(s).” But hey, no worries, the firm claimed no evidence of data misuse.

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UNITEDHEALTHGROUP: Recent Pros and Cons of UNH

By Staff Reporters

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A class action lawsuit has been filed in Minnesota against UnitedHealth Group (NYSE:UNH) over allegations that the health insurer and its subsidiary, NaviHealth, used a faulty algorithm to deny rehabilitation care for Medicare Advantage beneficiaries. California-based Clarkson Law Firm filed the lawsuit in the U.S. District Court of Minnesota on Tuesday following an investigative report published by the health-focused news site Stat.

It alleges that UnitedHealth and its subsidiary, NaviHealth, used the computer algorithm named nH Predict to “systematically deny claims” of patients recovering from debilitating illnesses in nursing homes. According to the lawsuit, despite its 90% error rate, the company used the algorithm to deny claims, knowing that only 0.2% would appeal its decision. According to Stat, Humana (HUM), the nation’s second-largest player in the Medicare Advantage market behind UnitedHealth (UNH), also uses nH Predict. UnitedHealth (UNH) denied it used the NaviHealth predict tool to arrive at coverage decisions.

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Ironically, UnitedHealth’s (NYSE:UNH) Optum Rx unit announced plans to move eight insulin products to “preferred” status on formularies to further expand the number of patients benefiting from $35 or less monthly out-of-pocket costs for the lifesaving therapy.

Optum Rx, UNH’s pharmacy benefit manager (PBM), said that effective January 1, 2024, all short- and rapid-acting insulins will move to Tier 1 in commercial formularies, a list of drugs the company maintains to indicate coverage for insured patients.

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DAILY UPDATE: Wegovy, Home Health Medicare, Federal Budget Deficit and Organ Transplants as Stock Markets Set New Highs

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Kamala Harris announced a plan to broaden Medicare to cover home healthcare for the first time in an effort to help the “sandwich generation” of Americans who are taking care of both their children and their parents.

WeightWatchers said it will offer cheaper copycat versions of Novo Nordisk’s weight loss drug, Wegovy.

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

Stocks up

  • Reddit gained 0.31% thanks to Jefferies analysts, who debuted their coverage of the social media stock with a “buy” rating, praising the company’s AI potential.
  • Biogen climbed 1.90% after the FDA gave its treatment for kidney transplant patients a special Breakthrough Therapy Designation.
  • Cruise stocks sailed higher today, in spite of the oncoming hurricane in the Gulf of Mexico. Norwegian Cruise Line, Carnival, and Royal Caribbean popped 10.91%, 7.05%, and 5.26%, respectively, on upgrades from Citi analysts.
  • Astera Labs jumped 15.60% after it debuted a new family of data center switches built specifically for AI.
  • Helen of Troy soared 17.88% thanks to a stronger-than-expected earnings report from the struggling consumer goods manufacturer.
  • Arcadium Lithium continued to rocket higher today after mining behemoth Rio Tinto announced it’s buying the lithium miner for $5.85 per share. Arcadium shares rose 30.90%.

Stocks down

  • Boeing just can’t catch a break: Talks with striking machinists broke down and the airplane manufacturer withdrew its recent contract offer. Shares sank 3.41% on the news.
  • US-traded shares of German life sciences company Bayer dropped 6.96% after a US court decided it will hear arguments that products from Bayer brand Monsanto allegedly harmed people.
  • Trump Media & Technology Group finally settled down after a wild rally following a wild rally in Pennsylvania featuring Elon Musk, falling 5.64% today.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 40.91 points (0.71%) to 5,792.04, a new record-high close; the Dow Jones Industrial Average® ($DJI) added 431.63 points (1.03%) to 42,512.00, also a new closing high; and the NASDAQ Composite® ($COMP) increased 108.70 points (0.60%) to 18,291.62.
  • The 10-year Treasury note yield (TNX) climbed three basis points to 4.06%, the highest since late July.
  • The CBOE Volatility Index® (VIX) eased to 20.8.

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In 2023, about 36% of Hispanic or Latino candidates waiting for a transplant received one, compared to 58% of non-Hispanic white candidates, according to the US Department of Health and Human Services Office of Minority Health.

Stat: $1.8 trillion. That eye-watering number is the federal budget deficit as of September 30th, according to the Congressional Budget Office. Higher interest rates, and increases in Social Security and Medicare, are driving the budget gap. (the Wall Street Journal)

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OPINIONS: Secure Unbiased Financial Planning -or- Economic Practice Management Advice

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Certified Medical Planner®

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FINANCIAL PLANNING

CAREER DEVELOPMENT

MEDICAL PRACTICE BUY IN / OUT

INVESTMENT ANALYSIS

PORTFOLIO MANAGEMENT

MERGERS AND ACQUISITIONS

PRACTICE APPRAISALS AND VALUATIONS

RETIREMENT PLANNING

FEE-ONLY

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The DUPONT Decomposition Equation for ROI [Collections Rules for Hospitals]

D.D.E. FOR HOSPITALS AND HEALTHCARE ORGANIZATIONS

DEM blue

By Dr. David E. Marcinko MBA MEd CMP

[Editor-in-Chief] http://www.CertifiedMedicalPlanner.org

According to the Dupont Decomposition Equation – which involves the conglomeration of net operating income, revenues, expenses and average operating assets – ROI and economic profit is increased in three prioritized ways:

  1. Cost and expense reductions.
  2. Revenue increases [Rev]
  3. Reduced average operating assets [AOO]

Note: ROI = NOI / Rev X Rev / AOO

Cost and expense reductions

Although many hospitals have reduced expenses, postponed projects and put clinical or information technology projects on hold because of the current healthcare conundrum, this may be unwise and quality may suffer. And, mental health care programs are almost always the first cost center to be reduced in tough times.

Upgrades today, especially with concurrent marketing and advertising promotions, may well be considered a strategic competitive advantage, and at bargain basement prices for those with cash or credit. This cost reduction is easy because it gives the biggest buck-bang in the ROI equation, and is the first line of ROI augmentation by savvy administrators and CEOs. It is also intuitive and wholly “wrung-out” in the marketplace, to date.

Revenue increases

On the other hand, revenues can usually be only incrementally increased by improving services like emergency care, urgent care, wellness, out-patient and/or surgical departments. This is the more difficult part of the equation and yields a positive, but lesser return in the ROI equation.

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

DuPont Formula: Learn More At Accounting Play

Three Modern Collections Rules for Hospitals

The following medical practice procedures will markedly increase upfront office collections:  

  • Train staff to handle exceptions. What is your policy if the patient payment is significant? Will you allow 25% payments—one today and three over the next three months? Communicate your policy to all staff. What will you do if a patient shows up without an insurance card? There will be other exceptions. Train employees to call the appropriate practice-management contact when an exception does not fit in the categories you provide and make sure those managers are responsive.
  • Understand that not everyone will shine in collections. The value of this new front-desk function should be reflected in job descriptions and wages. Track staff performance and hold employees accountable for collection goals. The most successful practices collect in the 90% range.
  • Provide professional signage that states your basic policy. “Payments are due at time of service.” Avoid typewritten, lengthy explanations taped to walls or desks that look like clutter.

Reduced average operating assets

Finally, any delay in updating facilities – while easy and may reduce operating assets – there is little ROI advantage and profit potential. Of course, facility asset upgrades mean borrowing funds through tax-exempt bonds – the main source of debt for most hospitals – and is currently difficult or impossible in this climate. Loans from banks, private investors, angels, venture capitalists or other financial institutions are similarly difficult to obtain. Thus, this part of the equation may often be neglected; as is the case now.

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DAILY UPDATE: Pfizer Down While Stock Markets Ignite

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Activist investor takes $1 billion stake in Pfizer. The firm Starboard Value has amassed a stake in the pharma giant, which has struggled after reaching new heights during the pandemic, in hopes of turning the company around.

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What’s up

  • If you can’t beat ‘em, join ‘em: WW International, aka WeightWatchers, soared 46.95% after the company announced it will begin offering GLP-1 weight-loss drugs.
  • Nvidia rose 4.05% after the Foxconn CEO told CNBC that AI demand is still incredibly strong.
  • Trump Technology & Media Group soared 18.54% after Tesla CEO Elon Musk appeared alongside the former president at a rally in Pennsylvania over the weekend.
  • Palantir popped 6.58% after the CTO of the data analytics firm appeared on CNBC and told everyone that his company is making mad money.
  • Welcome to the club: S&P Global announced that DocuSign is replacing MDU Resources Group in the S&P MidCap 400 index, while MDU is moving to the S&P SmallCap 600 index. Docusign rose 6.55% on the news, while MDU gained 2.44%.
  • Humana finally caught a break when a Bernstein analyst upgraded the stock today, writing that the health insurer has been hurt enough. Shares rose 2.92%.

What’s down

  • What goes up must come down: Chinese stocks, which have enjoyed an impressive rally recently, came tumbling back to Earth today after the country’s state planner didn’t announce any new stimulus measures. Bilibili fell 12.93%, JD.com lost 7.52%, Alibaba sold off 6.67%, and Nio dropped 8.10%.
  • Today’s oil selloff pummeled energy stocks: Valero Energy lost 5.31%, while Marathon Petroleum stumbled 7.66%.
  • Sphere Entertainment dropped 2.84% on the news that its CFO is leaving the company.
  • Super Micro Computer gave back 5.01% after its rally yesterday as investors pocketed their profits.

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

Here’s where the major benchmarks ended:

  • The SPX rose 55.19 points (0.97%) to 5,751.15; the Dow Jones Industrial Average® ($DJI) added 126.13 points (0.30%) to 42,080.37; and the NASDAQ Composite® ($COMP) gained 259.01 points (1.45%) to 18,182.92.
  • The 10-year Treasury note yield (TNX) rose one basis point to 4.03%.
  • The CBOE Volatility Index® (VIX) sank to 21.24, still above its long-term average.

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DAILY UPDATE: Obesity, Three Mile Island and Medical Records as Stocks Crash

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In a public health milestone, the US adult obesity rate stopped its long climb and dropped by roughly two percentage points between 2020 and 2023, according to new data from the National Health and Nutrition Examination Survey.

In 2024, about 62% of clinicians reported that “excessive documentation requirements” is a leading cause of burnout, according to Athenahealth, a health tech and electronic health record (EHR) company. The American Medical Association reported in January that primary care physicians, for example, can spend up to 45.7 minutes on medical record documentation for every 30-minute appointment.

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

What’s up

  • Scholar Rock shares quadrupled (yes, you read that right) 361.99% after its spinal muscular atrophy drug apitegromab provided a dramatic improvement for patients in a late-stage clinical trial.
  • Super Micro Computer surged 15.79% after the semiconductor company announced it shipped over 100,000 GPUs last quarter, highlighting strong data center demand.
  • Generac Holdings makes generators, so it’s no wonder that the stock popped 8.54% thanks to huge demand for back-up power from areas hit by Hurricane Helene and places preparing to deal with Hurricane Milton.
  • Arcadium Lithium skyrocketed 35.39% after it announced that Rio Tinto has approached the lithium miner about an acquisition.
  • Air Products and Chemicals rose 9.53% after CNBC reported that activist investor Mantle Ridge has taken a $1 billion stake in the industrial gas supplier. Activist investors are clearly getting more active these days.

What’s down

  • Netflix sank 2.47% thanks to a downgrade from Barclays analysts worried that the streaming service’s revenues will slow in the coming months. That outweighed an upgrade from Piper Sandler analysts, who think the streamer’s high valuation is warranted.
  • In another big tech downgrade, Wells Fargo analysts downgraded Amazon due to multiple headwinds like competition from Walmart and lower advertising revenue. Shares sank 3.06%.
  • Back-to-back hurricanes hitting the South are pummeling insurance stocks like Universal Insurance (down 19.60%), Allstate (down 4.90%) Travelers Companies (down 4.34%) and Chubb (down 4.61%).
  • Garmin tumbled 4.06% on a downgrade from Morgan Stanley analysts, who think the device-maker’s revenue will decline and margins will shrink in the coming quarters.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 55.13 points (–0.96%) to 5,695.94;the Dow Jones Industrial Average® ($DJI) dropped 398.51 points (–0.94%) to 41,954.24; and the NASDAQ Composite® ($COMP) lost 213.94 points (–1.18%) to 17,923.90.
  • The 10-year Treasury note yield (TNX) rose five basis points to 4.03%, near two-month highs.
  • The CBOE Volatility Index® (VIX) climbed to 22.77, the highest in a month.

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Stat: $1.6 billion. That’s the size of the federal loan guarantee that the operators of Three Mile Island are seeking from the Energy Department. Constellation Energy plans to restart the infamous plant to sell electricity to Microsoft data centers (Washington Post)

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DAILY UPDATE: FluMist, Neural Data and the Jobs Report

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The FDA just approved FluMist from AstraZeneca for self- or caregiver administration for the prevention of influenza virus subtypes A and B.

Plus, August’s revised jobs report showed the US actually created 159,000 jobs, up from 142,000 initially reported last month.

People in CA will have explicit rights to their own “neural data”—covering anything a person thinks or physically/emotionally feels—which is designed to prevent companies from gathering and selling that type of personal info

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DAILY UPDATE: PayPal, IRS, Flood Insurance and the US Hiring Pace as Stocks Roar Ahead

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PayPal completed its first transaction using its proprietary stablecoin to pay an invoice to Ernst & Young. It’s a milestone for the payments company’s advance into cryptocurrency.

The free IRS tax filing software, which was piloted in 12 states for the 2024 tax season, will be available in 24 states for 2025.

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Stocks Up

  • Your loss is our gain: Shares of airline stocks popped on the news of Spirit’s problems. Delta Air Lines ascended 3.84%, United Airlines climbed 6.47%, and Frontier Group Holdings soared 16.43%.
  • Albemarle popped 8.25% on the rumor that mining behemoth Rio Tinto may try to make an acquisition of the lithium miner. Other potential takeover targets rose as well, including Arcadium (up 10%) and SQM (up 3%).
  • Abercrombie & Fitch rose 9.10% thanks to an upgrade from JP Morgan analysts, who are bullish about the fashion retailer’s recent momentum.
  • Ubisoft Entertainment skyrocketed 29.87% on the news that the video game maker’s parent company and founders are considering a buyout.

Stocks down

  • Rivian Automotive tumbled 3.15% after the EV startup cut its 2024 production forecast and missed on Q3 deliveries.
  • Homebuilder stocks sank on today’s strong jobs report, which propelled treasury yields higher, which means that mortgage rates aren’t getting any lower. D.R. Horton dropped 2.91%, Lennar fell 2.52%, and Toll Brothers lost 2.57%.
  • Transportation stocks fell thanks to an agreement between port owners and longshoremen to put the recent strike on pause. Moller-Maersk lost 5.37%, while Zim Integrated Shipping Services stumbled 12.55%.

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Here’s where the major stock benchmarks ended:

  • The S&P 500® index (SPX) climbed 51.13 points (0.9%) to 5,751.07 up 0.22% for the week;the Dow Jones Industrial Average® ($DJI) added 341.16 points (0.81%) to 42,352.75, up 0.09% for the week; and the NASDAQ Composite® ($COMP) rose 219.37 points (1.22%) to 18,137.85, up 0.1% for the week. 
  • The 10-year Treasury note yield (TNX) soared 13 basis points to 3.98%, finishing the week up 23 basis points. The 2-year yield rose 37 basis points this week.
  • The CBOE Volatility Index® (VIX)fell to 18.58 but remains elevated from last month’s lows, likely on geopolitical concerns.

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Only 2% of the homes hit by Hurricane Helene in Georgia, North Carolina, and South Carolina had a policy protecting them against catastrophic flooding, according to an analysis by Politico and E&E News.

The US Hiring Pace picked up strongly in September and the unemployment rate ticked down to 4.1%, signs the U.S. economy had continued momentum in a month the Federal Reserve delivered its first interest-rate cut in four years. U.S. employers added 254,000 jobs last month, the Labor Department said Friday.

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DAILY UPDATE: Costco Gold, US Dock Workers & OpenAI Funding as Stocks Close Lower

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Costco, which found success selling gold bars, will now sell platinum ones, too.

US dock workers agreed to return to work after port operators sweetened their contract offer, ending a three-day strike that threatened to disrupt the American economy. The breakthrough Thursday came after port employers offered a 62% increase in wages over six years, according to people familiar with the matter.

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Stocks up

  • Nvidia gained 3.32% after CEO Jensen Huang said in an interview that demand for the company’s new Blackwell chips is “insane.”
  • EVgo soared 60.81% after the EV charging company received both a $1.05 billion loan from the Department of Energy and an upgrade from JP Morgan analysts.
  • Utility stocks soared in the third quarter thanks to higher electricity demand for AI, and it isn’t stopping anytime soon. Both Vistra Corp. and Constellation Energy surged 5.62% and 4.52%, respectively, on comments from Google CEO Sundar Pichai that the tech titan may utilize nuclear energy in the coming years.

Stocks down

  • Levi Strauss sank 7.69% after releasing subpar earnings, cutting its full-year sales forecast , and announcing it may sell its Dockers brand.
  • Tesla fell 3.35% after announcing a recall of over 27,000 Cybertrucks due to issues with their rearview camera.
  • Hims & Hers Health dropped 9.60% on the announcement that Eli Lilly’s weight-loss drugs are no longer on the FDA’s shortage list.
  • Joby Aviation tumbled 8.63%, giving up a portion of yesterday’s gains after the aviation startup received $500 million in additional funding from Toyota.
  • Stellantis, makers of Jeep, Dodge, and Chrysler vehicles, sank 4.11% to a new 52-week low today as a combination of terrible sales forecasts and a downgrade from Barclays analysts kicked the automaker while it’s already down.
  • Constellation Brands had strong beer sales but terrible wine and spirits sales last quarter, leading to a mixed earnings report that has shareholders worried about what the future holds. Shares sank 4.70%.

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Here’s where the major stock benchmarks ended:

  • The S&P 500® index (SPX)fell 10 points (–0.17%) to 5,699.96; the Dow Jones Industrial Average ($DJI) dropped 185 points (–0.44%) to 42,011.59; the  NASDAQ Composite® ($COMP) shed 7 points (–0.04%) to 17,918.48.
  • The 10-year Treasury note yield (TNX) added 7 basis points to 3.85%. 
  • The CBOE Volatility Index® (VIX) rose 1.7 points to 20.59.

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Microsoft, NVIDIA, and Apple were rumored to be among the investors to participate in OpenAI’s latest funding round, pushing its market cap well beyond $150 billion. However, Apple dropped out of the exercise at the eleventh hour for unclear reasons as OpenAI was about to close the funding round.

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DAILY UPDATE: MSFT, J&J and CVS as Stock Markets Lag

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Rosh Hashanah, the Jewish New Year, begins tonight and ends on Friday. Shana Tova to those celebrating.

Microsoft overhauled its Copilot AI assistant, adding voice and vision capabilities to make it more personalized.


A new report from Deloitte reveals improving health equity could increase the country’s GDP by $2.8 trillion by 2040 and increase U.S.-based corporate profits by $763 billion.


And … Johnson & Johnson’s is not moving forward with implementation of its proposed rebate model after HRSA push-back.  

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What’s up stocks

  • Caesars Entertainment popped 5.27% after it announced it will buy back $500 million in common shares while also offering $1 billion in senior notes to raise money.
  • Joby Aviation surged 27.92% on the news that Toyota will invest another $500 million in the aviation startup as it attempts to build a flying electric taxi.
  • Lamb Weston Holdings rose 2.62% thanks to a strong earnings report and a comprehensive restructuring plan for the french fry titan.
  • Novavax soared 19.16% following a glowing report from Jefferies analysts citing the pharma company’s strong vaccine sales.

What’s down stocks

  • Tesla sank 3.49% after revealing that auto deliveries for the third quarter came in lower than analysts expected.
  • Ford fell 2.51% for pretty much the same reason, reporting disappointing sales growth in the third quarter.
  • It’s never a good thing when a company pulls its guidance, and that was certainly true for Nike today. Shares dropped 6.77% after the company postponed its investor day and reported a 10% year over year decline in sales.
  • Nike’s report was so bad that shares of Foot Locker and Dick’s Sporting Goods fell 2.97% and 0.23%, respectively.
  • Humana plummeted 11.79% on the news that membership in its 4 star-rated Medicare Advantage plans plunged 94%.
  • Conagra Brands dropped 8.07% after the packaged food giant missed on both sales and earnings estimates last quarter.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX)was little changed at 5,709.54; the Dow Jones Industrial Average ($DJI) rose 39.55 points (0.09%) to 42,196.52; the NASDAQ Composite® ($COMP) gained 14.76 points (0.08%) to 17,925.12.
  • The 10-year Treasury note yield (TNX) added 5 basis points to 3.78%. 
  • The CBOE Volatility Index® (VIX) edged 0.4 points lower to 18.86.

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CVS is laying off nearly 3,000. The healthcare giant is conducting a strategic review as its stock has fallen more than 20% this year, the Wall Street Journal reported

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DAILY UPDATE: Health Plan Costs Up and Stock Markets Upbeat

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Despite inflation cooling down, employer health plan costs are heating up, according to a September analysis from consulting firm consulting firm Mercer.

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STOCKS UP

STOCKS DOWN

Stellantis, the European company behind Chrysler, Dodge, and Jeep sank 12.49% after it warned that sales in the second half of its fiscal year will come in lower than expected. The bad news pulled down shares of competitors Aston Martin (which fell 24.51%), Ford (a 2% drop), and GM (3.53% lower today).

  • Carnival beat top and bottom line estimates last quarter, and posted record revenue for the third quarter. But shares stumbled 0.32% on management’s forecast that earnings in the fourth quarter will disappoint. Rival cruise companies all dropped in sympathy: Royal Caribbean fell 0.10%, while Norwegian Cruise Line Holdings tumbled 2.10%.
  • Crypto stocks took a beating today after bitcoin’s latest rally fizzled out. Coinbase fell 6.83%, while MicroStrategy lost 4.32%.

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Here’s where the major stock market benchmarks ended:

  • The SPX gained 24.26 points (0.42%) to 5,762.48; the Dow Jones Industrial Average® ($DJI) rose 17.15 points (0.04%) to 42,330.15; the NASDAQ Composite® ($COMP) added 69.58 points (0.38%) to 18,189.17.
  • The 10-year Treasury note yield (TNX) climbed five basis points to 3.8%, near the high of its recent range.
  • The CBOE Volatility Index® (VIX) eased to 16.66 after climbing above 17 earlier today but remains up from a week ago.

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Big Data and Health Economics: S.W.O.Ts.

By Brendan Collins

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DAILY UPDATE: The Stock Markets and Meta

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  • Markets: It’s been a September to remember for the stock market after the S&P 500 and Dow Jones hit fresh highs last week. Thursday was the 42nd record-high close for the S&P 500 this year, and on Friday, the Dow notched its 32nd record-high close, per CNN Business. Recent data indicates that all the ingredients are coming together for a “soft landing”: The economy is staying strong while inflation has continued to fall. And more rate cuts are on their way.

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Stock spotlight: Meta’s rally this year has been fruitful for its CEO’s bank account. The net worth of Mark Zuckerberg, who owns a 13% stake in his company, climbed above $200 billion for the first time, per Bloomberg. He’s now the fourth-richest person in the world.

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

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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.

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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.

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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.

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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.

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

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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)

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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%.

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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.

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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.

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MICRO-CERTIFICATIONS: Financial Advisors Seeking Physician-Client Niche Success?

Micro-Credentials on the Rise

KNOWLEDGE RICHES IN NICHES

DR. DAVID EDWARD MARCINKO MBA MEd CMP

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Do you ever wish you could acquire specific information for your career activities without having to complete a university Master’s Degree or finish our entire Certified Medical Planner™ professional designation program? Well, Micro-Certifications from the Institute of Medical Business Advisors, Inc., might be the answer. Read on to learn how our three Micro-Certifications offer new opportunities for professional growth in the medical practice, business management, health economics and financial planning, investing and advisory space for physicians, nurses and healthcare professionals.

Micro-Certification Basics

Stock-Brokers, Financial Advisors, Investment Advisors, Accountants, Consultants, Financial Analyists and Financial Planners need to enhance their knowledge skills to better serve the changing and challenging healthcare professional ecosystem. But, it can be difficult to learn and demonstrate mastery of these new skills to employers, clients, physicians or medical prospects. This makes professional advancement difficult. That’s where Micro-Certification and Micro-Credentialing enters the online educational space. It is the process of earning a Micro-Certification, which is like a mini-degree or mini-credential, in a very specific topical area.

Micro-Certification Requirements

Once you’ve completed all of the requirements for our Micro-Certification, you will be awarded proof that you’ve earned it. This might take the form of a paper or digital certificate, which may be a hard document or electronic image, transcript, file, or other official evidence that you’ve completed the necessary work.

Uses of Micro-Certifications

Micro-Certifications may be used to demonstrate to physicians prospective medical clients that you’ve mastered a certain knowledge set. Because of this, Micro-Certifications are useful for those financial service professionals seeking medical clients, employment or career advancement opportunities.

Examples of iMBA, Inc., Micro-Certifications

Here are the three most popular Micro-Certification course from the Institute of Medical Business Advisors, Inc:

  • 1. Health Insurance and Managed Care: To keep up with the ever-changing field of health care physician advice, you must learn new medical practice business models in order to attract and assist physicians and nurse clients. By bringing together the most up-to-date business and medical prctice models [Medicare, Medicaid, PP-ACA, POSs, EPOs, HMOs, PPOs, IPA’s, PPMCs, Accountable Care Organizations, Concierge Medicine, Value Based Care, Physician Pay-for-Performance Initiatives, Hospitalists, Retail and Whole-Sale Medicine, Health Savings Accounts and Medical Unions, etc], this iMBA Inc., Mini-Certification offers a wealth of essential information that will help you understand the ever-changing practices in the next generation of health insurance and managed medical care.
  • 2. Health Economics and Finance: Medical economics, finance, managerial and cost accounting is an integral component of the health care industrial complex. It is broad-based and covers many other industries: insurance, mathematics and statistics, public and population health, provider recruitment and retention, health policy, forecasting, aging and long-term care, and Venture Capital are all commingled arenas. It is essential knowledge that all financial services professionals seeking to serve in the healthcare advisory niche space should possess.
  • 3. Health Information Technology and Security: There is a myth that all physician focused financial advisors understand Health Information Technology [HIT]. In truth, it is often economically misused or financially misunderstood. Moreover, an emerging national HIT architecture often puts the financial advisor or financial planner in a position of maximum uncertainty and minimum productivity regarding issues like: Electronic Medical Records [EMRs] or Electronic Health Records [EHRs], mobile health, tele-health or tele-medicine, Artificial Intelligence [AI], benefits managers and human resource professionals.

Other Topics include: economics, finance, investing, marketing, advertising, sales, start-ups, business plan creation, financial planning and entrepreneurship, etc.

How to Start Learning and Earning Recognition for Your Knowledge

Now that you’re familiar with Micro-Credentialing, you might consider earning a Micro-Certification with us. We offer 3 official Micro-Certificates by completing a one month online course, with a live instructor consisting of twelve asynchronous lessons/online classes [3/wk X 4/weeks = 12 classes]. The earned official completion certificate can be used to demonstrate mastery of a specific skill set and shared with current or future employers, current clients or medical niche financial advisory prospects.

Mini-Certification Tuition, Books and Related Fees

The tuition for each Mini-Certification live online course is $1,250 with the purchase of one required dictionary handbook. Other additional guides, white-papers, videos, files and e-content are all supplied without charge. Alternative courses may be developed in the future subject to demand and may change without notice.

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Contact: For more information, or to speak with an academic representative, please contact Ann Miller RN MHA CMP™ at: MarcinkoAdvisors@msn.com [24/7].

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DAILY UPDATE: Visa, Coca-Cola, Cardinal & Advocate Health and Obesity as Markets Fall

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Cardinal Health has agreed in principle to acquire Integrated Oncology Network for more than $1.1 billion.


And … Advocate Health announced it will wipe clean more than 11,500 judgment liens on patients’ homes and real estate.

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What’s up

  • Flutter Entertainment, parent company of betting app FanDuel, popped 5.06% after it revealed its impressive growth plans.
  • Hewlett Packard Enterprise rose 5.05% thanks to an upgrade from Barclays analysts who think that rising AI demand will increase the company’s server revenue.
  • Trump Media & Technology Group gained 10.48% after shareholders panicked that the end of its lockup period would mean big selling by insiders, fears that haven’t materialized.
  • Progress Software climbed 11.85% after a strong beat-and-raise earnings report.

What’s down

  • Southwest Airlines stumbled 4.57% after announcing it will cut service to and from Atlanta, a major hub for air travel, as it looks to save money ahead of a showdown with activist investor Elliott Investment Management.
  • Bank of America fell just 0.51% on the revelation that Warren Buffett can’t stop selling the stock.
  • KB Home sank 5.35% after the homebuilder beat revenue estimates but missed on earnings. It also issued a downbeat forecast for the rest of its fiscal year.
  • Global Payments dropped 6.37% thanks to a downgrade from BTIG analysts who were unimpressed by the payment provider’s near-term growth plans.

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

  • The S&P 500® index (SPX) fell 10.68 points (–0.19%) to 5,722.25; the Dow Jones Industrial Average® ($DJI) dropped 293.47 points (–0.70%) to 41,914.75; the NASDAQ Composite® ($COMP) added 7.68 points (0.04%) to 18,082.21.
  • The 10-year Treasury note yield (TNX) climbed five basis points to 3.78% and seems stuck in a range between 3.7% and 3.8%.
  • The CBOE Volatility Index® (VIX) rose slightly to 15.51, still near its September lows.

CITE: https://tinyurl.com/tj8smmes

Coca-Cola pulled its new flavor, Spiced, from shelves after just six months because of dis-interest in it.

Visa was sued by the Justice Department for antitrust violations. The DOJ alleged in a complaint filed in Manhattan federal court that the payments giant is illegally monopolizing the debit card market by penalizing merchants who try to use alternatives, Bloomberg reported.

For the first time in more than a decade, the nationwide number of people with obesity hasn’t gone up, according to new CDC data showing that the condition appears in about 40% of US adults.

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

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

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

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What’s up

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

What’s down

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

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

Here’s where the major benchmarks ended:

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

CITE: https://tinyurl.com/tj8smmes

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

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

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

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DAILY UPDATE: Apollo, Constellation Energy & the US Health System as S&P 500 Hits New High

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Private equity giant Apollo has offered an investment of up to $5 billion in Intel, a sign of support for its comeback efforts, according to Bloomberg.

Stat: 9 out of 10. That’s where the US healthcare system ranked on efficiency among 10 high-income countries. (Axios)

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

What’s up

  • Intel is suddenly looking like the belle of the ball. Shares rose 3.30% after Apollo Global Management reportedly offered to make an investment of up to $5 billion, even as Qualcomm hints it wants to acquire the old school tech giant.
  • Palantir surged 2.02% during its first day of trading on the S&P 500, in spite of a downgrade from a Raymond James analyst.
  • Southwest Airlines ascended 2.03% after management told employees that “tough decisions” lie ahead, implying forthcoming job cuts as the company focuses on profitability.
  • Boeing popped 1.96% on hopes that a labor dispute will be over soon after the company issued its “final” offer to striking machinists, including a 30% raise over the next four years.
  • Tesla revved 4.93% higher thanks to an analyst upgrade from Barclays focused on higher delivery expectations and near-term catalysts like the upcoming Robotaxi event.

What’s down

  • General Motors sank 1.70% after receiving an analyst downgrade from Bernstein citing “earnings headwinds.”
  • Ulta Beauty fell 2.03% thanks to an analyst downgrade from the folks at TD Cowen, who don’t like the rising costs the makeup company will have to pay to stay competitive.
  • Trump Media & Technology Group tumbled to a new all-time low, falling 10.33% as worries arise that former President Donald Trump will sell a portion of his stake in the social media company.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) added 16.02 points (0.28%) to 5,718.57; the Dow Jones Industrial Average® ($DJI) increased 61.29 points (0.15%) to 42,124.65; the NASDAQ Composite® ($COMP) rose 25.94 points (0.14%) to 17,974.27.
  • The 10-year Treasury note yield (TNX)added one basis point to 3.74%.
  • The CBOE Volatility Index® (VIX) fell to 15.82, closing at another new low for September.

CITE: https://tinyurl.com/tj8smmes

Stat: $1.6 billion. That’s how much Constellation Energy is investing in reopening facilities at nuclear power plant Three Mile Island. The company is restarting the infamous plant to sell power to Microsoft data centers. (CNBC)

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

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DAILY UPDATE: FTC Insulin Prices, Open AI Funding, Disney Slack Hack and Private Equity Banks

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The Federal Trade Commission hit the three largest companies that negotiate drug prices with a lawsuit claiming they’ve artificially inflated the cost of insulin for patients. The companies—UnitedHealth Group’s Optum Rx, CVS Health’s Caremark, and Cigna’s Express Scripts—together administer ~80% of all US prescriptions, the agency said. The suit alleges they increased profits by steering patients toward higher-priced insulin with bigger rebates so they could pocket the cash that drug companies gave back.

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OpenAI has so many interested investors it’ll have to turn some away from an expected $6.5 billion funding round that values the company at $150 billion.

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Disney employees will have to stop using Slack in the wake of a hack that leaked the company’s chat logs.

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

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DAILY UPDATE: Nike CEO Out, Cancer and Drug Deaths Down as Stock Markets Pause

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Overdose deaths in the US are plummeting. According to new public health data, drug-related deaths fell more than 10% in the 12 months ending in April, a massive improvement from double-digit increases seen in recent years, NPR just reported.

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What’s up

  • Nike popped 6.84% once CEO John Donahoe announced he will step down after four years on the job. Turns out when they say “Just do it,” “it” means resigning in disgrace after tarnishing an iconic brand.
  • Intel rose 3.31% on the news that Qualcomm approached the company with a buyout offer. Qualcomm sank 2.87% on the revelation.
  • Constellation Energy are the geniuses behind turning Three Mile Island back on, which shareholders love—the stock soared 22.29% today.
  • Vistra jumped 16.60% on the news that the Texas-based utilities provider is acquiring the remaining 15% stake of its subsidiary Vistra Vision that it doesn’t already own.

What’s down

  • UPS sank 2.67% after FedEx announced poor quarterly results and cut its earnings forecast.
  • Lennar fell 5.33% in spite of beating earnings estimates last quarter. The problem is that shareholders don’t like the homebuilder’s forecast of no growth next quarter.
  • Chewy tumbled 4.34% on the news that the pet products retailer will kick off an underwritten offering of $500 million of shares from a private equity partner, and buy back $300 million in shares—effectively reducing the company’s private equity ownership stake.
  • Novo Nordisk dipped 5.46% after the pharmaceutical giant announced mixed results from the latest trial of a new weight-loss drug.
  • ASML declined 3.97% thanks to a downgrade by Morgan Stanley analysts citing a slowdown in demand across the semiconductor industry.
  • Trump Media & Technology Group continued to fall today, dropping another 7.82% now that the early investor lockup period has concluded.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) slipped 11.09 points (–0.19%) to 5,702.53, ending the week 1.36% higher; the Dow Jones Industrial Average® ($DJI) added 38.17 points (0.09%) to 42,063.36, ending the week 1.60% higher; the Nasdaq Composite® ($COMP) lost 65.66 points (–0.36%) to 17,948.32, ending the week 1.60% higher.
  • The 10-year Treasury note yield (TNX) slipped one basis point to 3.73% but finished the week up eight basis points and outgained the 2-year yield by four basis points.
  • The Cboe Volatility Index® (VIX) ended at 16.1, its lowest close this month.

CITE: https://tinyurl.com/tj8smmes

Nike CEO John Donahoe will retire on October 13th and be replaced by longtime executive Elliott Hill, the company announced yesterday.

Stat: 33%. That’s how much the US cancer death rate fell from 1991 to 2021, equaling about 4.1 million lives saved, according to the latest Cancer Progress Report. (CBS News).

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DAILY UPDATE: Microsoft and Intuitive Machines as the Stock Markets Rocket Upward!

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Microsoft will buy back up to $60 billion in shares and is boosting its dividend by about 10% (from 75 cents per share to 83 cents).

Stat: 60%. That’s how much Intuitive Machines’ stock jumped in early trading yesterday after NASA awarded the company a contract to “build moon data satellites.” (CNBC)

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

What’s up

  • Lower interest rates mean it’s cheaper to afford a car, a realization that helped propel Tesla up 7.36% today.
  • Darden Restaurants rose 8.25% as shareholders cheered a new deal between the Olive Garden parent company and Uber, whose shares rose 2.42% as well.
  • Airbnb gained 5.17% after CEO Brian Chesky noted that the company is working to expand long-term rental offerings of over 28 days.
  • MobilEye Global popped 14.99% after Intel announced it has no plans to sell any of its 88% stake in the autonomous driving company. Intel shares rose 1.78% as well.

What’s down

  • Trump Media & Technology Group fell 5.89% as the lockup period, during which early investors like the former president can’t sell their stake in the company, is about to end.
  • Progyny plummeted 32.65% after the health insurance benefits company announced it is losing a key customer that accounts for 12% of Progyny’s revenue.
  • Five Below sank 2.22% after JP Morgan analysts downgraded the stock, though they also boosted their price target.

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

Here’s where the major benchmarks ended:

  • The SPX rose 95.38 points (1.70%) to 5,713.64; the $DJI added 522.09 points (1.26%) to 42,025.19; the NASDAQ Composite® ($COMP) added 440.68 points (2.51%) to 18,013.98.
  • The 10-year Treasury note yield (TNX) climbed five basis points to 3.74%, while the 2-year note yield was unchanged.
  • The CBOE Volatility Index® (VIX) slid to 16.33, registering its lowest close so far this month.

CITE: https://tinyurl.com/tj8smmes

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

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DAILY UPDATE: Walgreens, Mental Health, M&As, Pfizer and Eli Lilly as the Markets Tank

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Stat: $106.8 million. That’s how much Walgreens agreed to pay the federal government to settle claims that the company fraudulently billed government programs for prescriptions that were never dispensed. (the Wall Street Journal)

Quote: “We put a Band-Aid on a chronic situation and that Band-Aid isn’t going to last.”—Roland Behm, co-founder of the Georgia Mental Health Policy Partnership advocacy group, on the shortage of mental health care services following the Apalachee High School shooting (KFF Health News)

EY’s latest monthly M&A report found that in August, the total value of large deals (worth $100+ million) reached $1.1 trillion, a 26% YoY jump. This was thanks in part to a 44% YoY increase in deal value last month, to $137 billion, according to the report.

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

What’s up

  • US Steel gained 1.57% as the battle over the future of the legacy steelmaker continues.
  • Intuitive Machines skyrocketed 38.33% thanks to a deal between the space communications company and NASA worth over $4.8 billion.
  • Victoria’s Secret popped 3.63% after Barclays analysts upgraded shares from “Underweight” to “Equal Weight.”
  • Barclays analysts were active today, boosting VF Corp. 3.89% by upgrading the shoewear company from “Equal Weight” to “Overweight.”
  • Duolingo rose 3.20% to a new all-time high, and though there was no news propelling the multilingual app higher, shares have continued to rise ever since its strong earnings announcement in early August.

What’s down

  • ResMed tumbled 5.12% thanks to a downgrade from Wolfe Research due to concerns that a new drug from Eli Lilly may eat into the med tech company’s share of the CPAP machine market.
  • eBay sank 2.64% after its CFO sold over $1.9 million in company stock.
  • Cencora fell 2.58% on the news that the drug distributor paid hackers $75 million in ransom over the course of three bitcoin installments, the largest cyberattack extortion payment ever.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 16.32 points (–0.29%) to 5,618.26; the Dow Jones Industrial Average® ($DJI) lost 103.08 points (–0.25%) to 41,503.10; the NASDAQ Composite® ($COMP) decreased 54.76 points (–0.31%) to 17,573.30.
  • The 10-year Treasury note yield rose four basis points to 3.69%.
  • The CBOE Volatility Index® (VIX) climbed to 18.23, the highest since September 10.

CITE: https://tinyurl.com/tj8smmes.

At the end of August, pharmaceutical giant Pfizer announced a new website called PfizerForAll, which provides information on common health issues like migraines or the flu and connects patients to tele-health services and prescription delivery services so they can get treatments and diagnostic tests delivered to their homes. Pfizer promotes some of its own therapies, including Paxlovid for Covid-19 and Nurtec for migraines, on the site.

And, that move came after rival pharmaceutical company Eli Lilly started LillyDirect in January, through which the company delivers prescriptions straight to patients. Eli Lilly also partnered with Amazon Pharmacy in March to deliver some of its medications to consumers’ doorsteps, including Ozempic competitor Zepbound, a GLP-1 weight loss drug.

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DAILY UPDATE: Larry Ellison, Estate Planning, Female VCs, Health Costs as Markets Finish Flat

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Oracle Chairman Larry Ellison became the world’s second-richest person yesterday, pulling past Amazon founder Jeff Bezos as the software company’s stock surged. Elon Musk still sits at No. 1, per Forbes.

Read: Estate planning lawyers are sleeping easy. Read about how rich Americans are prepping for potential estate tax changes ahead of the election. (the Wall Street Journal)

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What’s up

  • Intel can’t stop, won’t stop: It rose 2.68% after announcing it will break its foundry business into a separate entity, which should go a long way to helping out the struggling chip maker.
  • Microsoft rose a tepid 0.88%, in spite of positive news: The company is raising its dividend and kicking off a new share repurchasing program.
  • Hewlett Packard Enterprise rounded out the old-school tech giants breaking to the upside, rising 5.69% after Bank of America analysts upgraded the stock from “Neutral” to “Buy.”
  • Flutter Entertainment, parent company of sports bettor FanDuel, popped 3.32% on the news that it’s buying Italian gambling company Snaitech S.A.
  • Gannett Co. soared 18.74% thanks to an upgrade of the newspaper company from “Sell” to “Neutral” by Citi analysts.

What’s down

  • Philip Morris International tumbled 2.14% after the tobacco titan sold its asthma inhaler maker Vectura Group for $198 million.
  • Accenture sank 4.85% on the news that it will push promotions back from June all the way to December, implying cash flow problems for the consulting giant.
  • Cigna fell 2.86% after Express Scripts, the healthcare giant’s pharmacy-benefits unit, sued the FTC over a recent drug pricing report.
  • Trump Media & Technology Group dropped 6.60% after a judge ruled that the company must award one of its investors a large chunk of the stock in exchange for helping it go public.

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Here’s where the major benchmarks ended:

  • The SPX added 1.49 points (0.03%) to 5,634.58; the Dow Jones Industrial Average® ($DJI) fell 15.90 points (–0.04%) to 41,606.18; the NASDAQ Composite® ($COMP) rose 35.93 points (0.20%) to 17,628.06.
  • The 10-year Treasury note yield (TNX) rose two basis points to 3.64%, near the lower end of its recent range.
  • The CBOE Volatility Index® (VIX) climbed to 17.74, its highest in nearly a week.

CITE: https://tinyurl.com/tj8smmes

Health benefit costs are soaring for employers, with over half of respondents saying they will need to make cost-cutting changes for next year: what employers are expecting.


Rethink Impact, a venture capital firm investing in female-led tech companies, has raised $250 million.


Employer Direct Healthcare is rebranding as Lantern and making a play in the infusion care space. The company also bolstered its clinical team, nabbing former execs at Teladoc and Hinge Health.

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Employer Healthcare Cost Management Techniques

On Medical Cost Containment

By http://www.MCOL.com

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Conclusion

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DAILY UPDATE: PwC, Birth Rate, Social Media, NHS and the Mixed Markets

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It’s going to be a gloomy October for some 1,800 PwC employees. The Big Four firm has announced it’ll be laying off around 2.5% of its US unit’s workforce next month, the Wall Street Journal reported. About half of the job cuts will take place offshore. The cuts will occur mainly in PwC’s US advisory, products, and technology operations functions.

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

What’s up

  • Intel gained 6.36% on the news that it has secured $3.5 billion in grants from the Pentagon.
  • Oracle rose yet another 5.12%, making co-founder Larry Ellison the second-richest person in the world thanks to its recent surge.
  • Alcoa climbed 6.09% on the news that it will sell its stake in a joint venture with Saudi Arabia Mining Co. to the tune of $1.1 billion in stock and cash.
  • Bausch + Lomb Corp popped 14.66% on a report from the Financial Times that the eyewear company is considering selling itself to get out from under a massive debt load.
  • Nuvalent soared 28.27% on impressive results from Phase 1 trials of its new cancer treatments.

What’s down

  • Apple fell 2.78% just a few days before its big iPhone 16 launch on Friday thanks to reports that demand for the new phone may be lower than anticipated.
  • Walgreens Boots Alliance sank 2.06% after it agreed to pay $106.8 million for charging the US government for prescriptions it never filled.
  • Yelp tumbled 3.03% thanks to Bank of America analysts initiating their coverage of the reviews website with a bearish “underperform” rating.
  • Trump Media & Technology Group gave up some of its recent gains, falling 3.84% only a few days after soaring on the news that former President Donald Trump won’t sell his shares of the company.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) added 7.07 points (0.13%) to 5,633.09; the Dow Jones Industrial Average® ($DJI) rose 228.30 points (0.55%) to 41,622.08; the NASDAQ Composite® ($COMP) dropped 91.84 points (–0.52%) to 17,592.13.
  • The 10-year Treasury note yield (TNX) fell about three basis points to 3.62%, a new 15-month closing low.
  • The BOE Volatility Index® (VIX) inched up to 16.99.

CITE: https://tinyurl.com/tj8smmes

Stat: 2%. That’s how much the birth rate declined from 2022 to 2023. (CDC)

Quote: “Every year they choose not to act, they will be complicit.”—Christine McComas, a mother from Maryland whose daughter died after she was cyberbullied, on members of the House attempting to pass a bill to regulate social media for children (Politico)

Read: UK Prime Minister Keir Starmer said the National Health Service must “reform or die,” and laid out a 10-year plan to fix it. (Reuters)

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MEDICAL PRACTICE MANAGEMENT: Consulting & Advice

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DE MARCINKO & ASSOCIATES: Financial, Business & Management Education and Advisory Opinions for Physicians

By Dr. David Edward Marcinko MBA MEd CMP

“AT YOUR SERVICE”

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Marcinko & Associates is financial guide. We help answer your questions in an empowering way. We educate and guide medical colleagues to understand their financial picture and to make better financial decisions. We strive to simplify everything, clear up confusion, and address specific needs and goals.

Simply put, we’re a financial services company on a mission to empower financial freedom for all healthcare professionals; only. We work with doctors, nurses, medical providers, individuals and all sizes of organizations to offer investment, wealth management and retirement solutions so everyone can have a clear and simple understanding of where their finances and career is today and where it is headed tomorrow.

Whatever your financial situation, we do not shame, criticize, or sell. We enrich, educate and empower. We work only with medical colleagues at every stage of their financial journey [students, interns, residents, practitioners, mid-career and mature physicians], through big life personal changes to annual employment reviews, in order to help them understand, invest, and protect their money and lifestyle.

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For example, the following are current issues of review need for each Fall and Winter:

  • Financial planning reviews: 401-k, insurance, budget plans, investing, debt and savings, etc
  • Assess, develop, and align financial retirement and estate planning goals
  • Risk Management: Malpractice, home, life, medical, auto and personal indemnity
  • Life Insurance Need Reviews: whole, universal and term  
  • Business, operations, HR, employment negotiations and medical practice management
  • Annuity Need Reviews: Indexed and Fixed [Pros and Cons].

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At Marcinko & Associates we discuss specific needs and answer specific questions. We educate and make personalized recommendations that you are free to use, incorporate or disregard. Referrals to trusted specialists and strategic alliance partners then occur if – and as – needed [pro re nata].

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DAILY UPDATE: Rite Aid, Stock Markets, Gold, Oil Bitcoin, Uber & Waymo

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Nearly a year after filing for Chapter 11, Rite Aid announced on September 3 that the company has exited the bankruptcy process and will move forward as a private company. The retail pharmacy chain filed for bankruptcy in October 2023 as it struggled to keep up with competitors CVS and Walgreens, in addition to mounting debt, falling revenue, and multimillion-dollar opioid settlements.

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Stocks wrapped up a comeback last week, with all three major indexes ending the trading session on a high note. Both the S&P 500 and the NASDAQ enjoyed five straight winning days, and both indexes had their best week of the year. Gold continued to break records today, as the double whammy of forthcoming rate cuts and a declining dollar sent the precious metal soaring. Oil rose a bit today after Hurricane Francine passed over the Gulf of Mexico and output began to normalize. Bitcoin staged a late afternoon rally to end the week over 9% higher than where it started, as investors embraced risk and optimism swept through markets.

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Uber riders will be able to flag Waymo robotaxis in Austin and Atlanta in 2025 as the companies expand their partnership.

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DAILY UPDATE: Physician Burnout

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Healthcare comes with its share of mental challenges, especially considering that clinicians often care for patients when they’re in difficult and sometimes tragic situations. New research shows that even the path to getting into the workforce can be a challenge, with some physicians burning out before they make it to graduation.

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  • The national debt is growing to an unwieldy size ($35.5 trillion) and now we’re beginning to feel its effects: The interest payment on the US debt topped $1 trillion for the first time ever.
  • Consumer sentiment hit a five-month high as Americans look ahead to lower inflation and interest rates, but sentiment remains well below its 2021 peak.
  • The yield curve un-inverted, but there’s always another recession indicator out there warning of a downturn ahead.
  • The cryptocurrency Wild West is still alive and well: Americans lost $5.6 billion in crypto scams last year, according to the FBI.
  • Credit card debt hit 10.9%, its highest level in 12 years, according to Deloitte.

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Most doctors report feeling overworked and are considering a change in career, according to a new poll.

Doximity, a virtual network for physicians, found that 81% doctors surveyed last fall said they felt overworked—a slight decline from 86% who reported burnout in 2022 but still up from 73% in 2021. Meanwhile, about three in five doctors said they were considering early retirement (30%), looking for another employer (15%), or leaving the profession altogether (14%), the poll found.

The findings, released last year, come amid reports of rising rates of physician burnout and dissatisfaction since after the Covid-19 pandemic.

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DAILY UPDATE: JPMorgan Chase, Bank of America, OpenAI and MSFT as Markets Continue Stock Rally

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OpenAI says its new model can reason like a person. The ChatGPT-maker released a preview of a new artificial intelligence model that’s officially called o1 named by its internal code name, Strawberry—a reference to AI’s inability to determine the correct number of r’s in the word.

Microsoft plans to lay off 650 people in its Xbox unit.

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

What’s up

  • Campbell Soup Company climbed 2.63% on the news that, after 155 years, it will change its name to The Campbell’s Company. No soup for you!
  • Wells Fargo somehow gained 2.37% after a US banking regulator declared its safeguards against money laundering weren’t strong enough.
  • Lululemon Athletica popped 2.54% after CEO Calvin McDonald bought more shares of the company, signaling confidence in the struggling retailer.
  • Uber drove 6.45% higher thanks to a deal with Alphabet’s Waymo to offer driverless taxi rides in Austin and Atlanta starting next year.
  • RH rose 25.46% a day after announcing shockingly strong earnings for the home-furnishing retailer.
  • Trump Media & Technology Group soared 11.79% on the former president’s announcement that he’s “not selling” his shares of the company.

What’s down

  • Adobe dropped 8.47% after beating top and bottom line forecasts last quarter but projecting weaker than expected earnings next quarter.
  • Garmin tumbled 5.12% after Barclays analysts downgraded the stock and cut their price target, citing the device-maker’s weak sales and low profit margin.
  • US-listed shares of Chinese retailers like Alibaba and PDD dropped 0.93% and 2.40%, respectively, on the news that President Biden announced the US will crack down on cheap goods from China. Etsy, which competes with these retailers, popped 7.56% on the news.
  • ViaSat sank 14.58% thanks to a deal between United Airlines and SpaceX to use Starlink satellites to provide free in-flight WiFi instead of ViaSat’s products.

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

Here’s where the major benchmarks ended:

  • The SPX advanced 30 points (0.5%) to 5,626.02 and was up 4% for the week; the Dow Jones Industrial Average® ($DJI) gained 297 points (0.7%) to 41,393.78 and added 2.6% for the week; the NASDAQ Composite® ($COMP) rose 114 points (0.7%) to 17,683.98 and was 6% higher for the week.
  • The 10-year Treasury note yield (TNX) edged 2 basis points lower to 3.66%.
  • The CBOE Volatility Index® (VIX) fell 0.6 points to 16.48.

CITE: https://tinyurl.com/tj8smmes

JPMorgan Chase and Bank of America are pledging to put in more safeguards to prevent what their industry is infamous for: overworking junior employees, the Wall Street Journal reported this week.

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

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iMBA Inc = Supporting Doctors and their Consulting Advisors

The Medical Executive-Post Educational Resource

[By Ann Miller RN MHA]

We are an emerging online and onground community that connects medical professionals with financial advisors and management consultants. We participate in a variety of insightful educational seminars, teaching conferences and national workshops. We produce journals, textbooks and handbooks, white-papers, CDs and award-winning dictionaries. And, our didactic heritage includes innovative R&D, litigation support, opinions for engaged private clients and media sourcing in the sectors we passionately serve.

Through the balanced collaboration of this rich-media sharing and ranking forum, we have become a leading network at the intersection of healthcare administration, practice management, medical economics, business strategy and financial planning for doctors and their consulting advisors. Even if not seeking our products or services, we hope this knowledge silo is useful to you. Our content creation—including speaking topics, articles and course development—is client-driven.

In the Health 2.0 era of political reform, our goal is to: “bridge the gap between practice mission and financial solidarity for all medical professionals.”  

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

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Am I over-insured and thus wasting money? Am I under-insured and thus at risk for a liability or other disaster? I never really had the means of answering these questions; until now.

LLOYD M. KRIEGER; MD, MBA

[Rodeo Drive Plastic Surgery – Beverly Hills, CA]