CBOE: Chicago Board Options Exchange [Volatility Indexes]

By Staff Reporters

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RELATED DEFINITIONS

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Volatility indexes are forward-looking measures of the market’s expectations of volatility (or how much a stock index’s price moves). The CBOE manages and publishes three of the most widely used volatility indexes based on three major stock indexes:

The VIX Index tracks the expected 30-day future volatility of the S&P 500 Index.

The VXN Index tracks the expected 30-day future volatility of the NASDAQ-100 Index.

The VXD Index tracks the expected 30-day future volatility of the Dow Jones Industrial Average Index.

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SECURITY ORDERS: Stop-Loss and Stop-Limit

By Dr. David Edward Marcinko MBA MEd

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A Stop order, also known as a “stop-loss order,” a stop order is an order placed with a bank or brokerage firm to either buy or sell a security after it reaches a specified price. Once the price is reached, the stop order becomes a market order, meaning there is no guarantee that an order will be completely filled at the specified stop price.

MORE: https://medicalexecutivepost.com/2024/08/30/stock-orders-positions-doctors-should-know/

A Stop-limit order is order placed with a bank or brokerage firm to buy or sell a fixed amount of an investment after it reaches a specified or better price, combining the features of a stop order and a limit order.

MORE: https://medicalexecutivepost.com/2024/08/07/about-securities-order-and-position-types/

A stop-limit order requires investors to set two price points: the first initiates the stop (the order to buy or sell) and the second sets the limit, or price beyond which the investor would not like to buy or sell. The investor also sets a time frame for which the order is valid before being cancelled. If the investor’s price cannot be met during the specified time frame, the order will be cancelled.

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DAILY UPDATE: All About the Stock Markets

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  • Stocks ended the day mixed, with the Dow sinking into the red while the S&P 500 and NASDAQ kicked off the week on a positive note thanks to gains from tech stocks.
  • Oil popped on a double-whammy of news: Long-range, US-made ballistic missiles launched from Ukraine into Russia might disrupt oil supply, while the shutdown of Norway’s Johan Sverdrup oil field due to a power outage will definitely disrupt oil supply.
  • Crypto continued its hot streak today: Bitcoin popped back above $90,000, giving other cryptocurrencies a boost.
  • Bitcoin’s boom has certainly helped MicroStrategy, which announced today that it purchased 51,780 bitcoins for approximately $4.6 billion in cash, or roughly $88,627 per bitcoin, in the last week alone.

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STOCKS UP

The new Trump Trade continues: The president-elect’s selection of Liberty Energy CEO Chris Wright to lead the Department of Energy gave Liberty a 4.85% boost today. Wright is also on the board of nuclear company Oklo, which popped 14.83%.

  • Speaking of Trump, Trump Media & Technology Group soared 16.65% on the news that it may purchase crypto trading firm Bakkt.
  • Netflix disappointed viewers with its glitchy showing of Jake Paul vs. Mike Tyson, but shareholders forgave the company after it announced record viewership of the fight. Shares climbed 2.80%.
  • CVS Health gained 5.41% on news that it struck a deal with activist investor Glenview Capital Management to add four new seats to its board.
  • Robinhood jumped 8.29% to a new all-time high thanks to an upgrade from Needham analysts giving the investing app a “buy” rating due to its crypto offerings under a pro-crypto Trump presidency.
  • Warner Bros. Discovery rose 2.71% on a Wall Street Journal report that it has settled its legal dispute with the NBA, guaranteeing broadcast rights for the next decade.

STOCKS DOWN

  • Nvidia isn’t often in this section of the newsletter, but the semiconductor leader sank 1.29% today on a report from The Information that its new Blackwell chips are prone to overheating.
  • Palantir popped after moving over to the Nasdaq last week, but the red-hot software stock dropped 6.86% as investors collected profits.
  • Redfin may help you buy a house, but the online real estate brokerage is a “sell,” according to Goldman Sachs. The Wall Street firm cited low home sales, low affordability, and low chances of success in a competitive market. Shares fell 4.42%.
  • Uber dropped 5.35% to a new 52-week low on the threat of Tesla’s robotaxis ruling the road thanks to a Trump administration that seems keen on cutting self-driving regulations.

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Here’s where the major benchmarks ended:

  •  The SPX was up 23.00 points (0.4%) to 5893.62; the Dow Jones Industrial Average® ($DJI) fell 55.39 points (0.1%) to 43,389.6; and the NASDAQ Composite® ($COMP) was up 111.69 points (0.6%) to 18,791.81.
  • The 10-year Treasury note yield fell one basis point to 4.41%.
  • The CBOE Volatility Index® (VIX) eased to 15.57.

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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: Spirit Airlines in Chapter 11 as Nvidia Rises and Target, Lowes & Walmart Highlight Stock Earnings Week

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Spirit Airlines said Monday it has filed for Chapter 11 bankruptcy protection after struggling with losses, growing debt and a failed merger during the post-pandemic travel lull. The company said in a stock market statement that it had secured a prearranged deal with bondholders that includes £300 million in financing to keep it afloat, with the business planning to end its bankruptcy in the first quarter of 2025.

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Analysts are expecting Nvidia, the world’s largest publicly traded company, to show quarterly sales of ~$33 billion, up 10% from the previous quarter and 83% year over year, but they also warn the mind-blowing growth of the chip maker could begin to slow.

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And, reports this week from Walmart, Target, Lowe’s, and other retailers will offer a peek at consumer health.

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NOVEMBER: National Alzheimer’s Awareness Month

By Dr. David Edward Marcinko MBA MEd

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The number of people living with Alzheimer’s disease is growing. The ripple effect is straining families, communities, and the healthcare system, yet talking about the disease on a personal level can be difficult.

November is Alzheimer’s Awareness Month because it can happen in any family, and because it’s worth talking about the challenges of living with or caring for someone with this disease.

You may notice splashes of teal and purple sprouting up this November, as both colors are associated with Alzheimer’s awareness. Teal is the color of the Alzheimer’s Foundation of America, chosen for its calming effect. Purple is the signature color of the Alzheimer’s Foundation, which stands for strength in the fight against Alzheimer’s disease.

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CURSE of the “Stereotype”

By Dr. David Edward Marcinko MBA MEd

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The Stereotype Curse is the negative impact of stereotypes on an individual’s performance or behavior. It’s like a self-fulfilling prophecy where being aware of a stereotype makes you more likely to conform to it.

For example, if you’re told you’re bad at math because of your gender, that stress can affect your performance. Breaking free from stereotypes requires awareness and effort.

So, next time you feel boxed in by a stereotype, remind yourself: you’re more than a cliché.

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DAILY UPDATE: 401[k] and Wamco as Stock Markets Crash!

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The Internal Revenue Service (IRS) ruled that employees at an unnamed company can designate a portion of their employer match to student debt repayments or health reimbursement accounts, in addition to their traditional 401(k).

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STOCKS UP

  • Warren Buffett’s Midas touch gave a boost to Domino’s Pizza and Pool Corp. after Berkshire Hathaway announced it has bought shares of both companies. Domino’s popped to start the day but dropped 1.27%, while Pool climbed just 0.54%.
  • Palantir is jumping ship, moving from the NYSE to the Nasdaq. Shareholders liked the move, pushing the stock up 11.14%.
  • Bloom Energy…bloomed 59.19% on the news that the renewable energy company reached an agreement to provide utility company American Electric Power with 1 gigawatt worth of fuel cells.

STOCKS DOWN

  • What Buffett giveth, Buffett taketh away: Apple sank on the news that Berkshire Hathaway has sold shares of the company, and almost completely eliminated its position in Ulta Beauty. Apple fell 1.41%, while Ulta Beauty dropped 4.60%.
  • Shareholders were expecting the worst from Chinese online retailer Alibaba, and although the company actually beat earnings forecasts, it wasn’t enough—shares still sank 2.20%.
  • Applied Materials tumbled 9.20% after beating both top and bottom line expectations, but shareholders balked at the slowdown in several key businesses.
  • AST SpaceMobile plummeted 9.59% after reporting bigger losses and smaller sales than Wall Street wanted to see.

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Here’s where the major stock market benchmarks ended:

  • The SPX fell 78.55 points (–1.32%) to 5,870.62 to end the week down 2.08%; the Dow Jones Industrial Average® ($DJI) lost 305.87 points (–0.70%) to 43,444.99 to end the week down 1.24%; and the NASDAQ Composite® ($COMP) decreased 427.52 points (–2.24%) to 18,680.12 to end the week down 3.15%.
  • The 10-year Treasury note yield rose one basis point to 4.43% but added 12 basis points for the week. Shorter-term yields rose less.
  • The CBOE Volatility Index® (VIX) climbed sharply to 16.11 as stocks fell.

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The problems at storied bond manager Western Asset Management keep growing. Clients have pulled about $55 billion from Wamco, as the division is known, since mid-August, representing about 15% of its assets. Franklin Templeton, its 77-year-old parent company and one of the largest asset managers in the U.S., recently reported its steepest quarterly outflows on record.

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

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BIAS: Of “Social Proof” and Influencers

INVESTING DEFINITION

By Dr. David Edward Marcinko MBA MEd

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Social Proof is a subtle but powerful reality that having others agree with a decision one makes, gives that person more conviction in the decision, and having others disagree decreases one’s confidence in that decision. 

This bias is even more exaggerated when the other parties providing the validating/questioning opinions are perceived to be experts in a relevant field, or are authority figures, like doctors, attorneys, financial advisors, teachers and/or people on television.  In many ways, the short term moves in the stock market are the ultimate expression of social proof – the price of a stock one owns going up is proof that a lot of other people agree with the decision to buy, and a dropping stock price means a stock should be sold. 

According to colleague Dan Ariely PhD, when these stressors become extreme, it is of paramount importance that all participants in the financial planning and investing process have a clear understanding of what the long-term goals are, and what processes are in place to monitor the progress towards these goals. 

Without these mechanisms it is very hard to resist the enormous pressure to follow the crowd; think social media and related influences.

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FATAL: Narcissism

BY DR. DAVID EDWARD MARCINKO MBA MEd

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Imagine if Narcissus had a social media account. Fatal narcissism is what happens when self-love goes off the rails. It’s not just about admiring your reflection; it’s an all-consuming need for admiration and validation. Think endless selfies and humblebrags.

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While a bit of narcissism is normal, fatal narcissism is like a black hole – it sucks in all attention and gives nothing back.

So, if my Instagram looks like a shrine to my own greatness, you might be witnessing fatal narcissism in action.

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Convertible Securities, Bonds and Corporate Securities

By Dr. David Edward Marcinko MBA MEd

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Convertible securities are those that can be converted at the investor’s choice into other investments, normally into shares of the issuer’s underlying common stock. Convertibles are typically issued as bonds or preferred stock.

Convertible bonds, which provide an ongoing stream of income, can be converted into a preset number of shares of the company’s common stock and have a maturity date. Unlike common stock, which pays a variable dividend depending on a corporation’s earnings, convertible preferred stock pays a fixed quarterly dividend. It can be converted into common stock at any time, but often are perpetual.

Corporate securities (corporate bonds and notes) are debt instruments issued by corporations, as distinct from those issued by governments, government agencies, or municipalities.

Corporate securities typically have the following features: 1) they are taxable, 2) they tend to have more credit (default) risk than government or municipal securities, so they tend to have higher yields than comparable-maturity securities in those sectors; and 3) they are traded on major exchanges, with prices published in newspapers.

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DAILY UPDATE: Healthcare Private Equity Prominent as Stocks Go Down

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Private equity (PE) dollars have become prominent in the US healthcare industry in recent decades, with PE firms now owning roughly 8% of all private hospitals in the country, according to nonprofit Private Equity Stakeholder Project. But studies have illustrated the financial model’s potential adverse effects, such one published in JAMA in December 2023 that found PE-owned hospitals are 25.4% more likely to report patient complications. Others have found that PE-owned healthcare companies represented more than one-fifth of healthcare company bankruptcies in 2023 and that PE-owned hospitals see their assets drop an average of 24% following an acquisition.

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STOCKS UP

Tapestry, parent company of luxury brands like Coach and Kate Spade, and Capri, parent company of luxury brands like Versace and Jimmy Choo, have announced they will mutually terminate their planned merger. Tapestry popped 12.80%, while Capri rose 4.43%.

  • Speaking of luxury brands, Burberry soared 18.04% after its CEO announced a turnaround plan designed to halt the company’s recent decline.
  • Semiconductor maker ASML plummeted last month on a profit warning, but rose 2.90% today on reassurances that it’s still on track to meet its 2030 revenue forecasts.

STOCKS DOWN

  • Super Micro Computer fell yet another 11.41% as it nears the November 16 deadline to report fiscal year earnings or be delisted from the Nasdaq.
  • Trump Media & Technology Group dropped 6.71% as investors digested news that company insiders are shedding shares, as well as in reaction to a number of President-elect Trump’s cabinet appointments.
  • Hims & Hers Health tumbled 24.46% on the news that Amazon is getting into the telehealth game, offering Prime members fixed prices on treatments for hair loss and erectile dysfunction.
  • Ibotta is a cashback rewards company, but its shareholders may want their cash back. The company beat on top and bottom line estimates last quarter, but the win wasn’t good enough, and shares sank 12.55%.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 36.21 points (–0.60%) to 5,949.17; the Dow Jones Industrial Average® ($DJI) lost 207.33 points (–0.47%) to 43,750.86; and the NASDAQ Composite® ($COMP) dropped 123.07 points (–0.64%) to 19,107.65. 
  • The 10-year Treasury note yield fell three basis points to 4.42%.
  • The CBOE Volatility Index® (VIX) edged up to 14.17.

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INVESTMENT STRATEGIES: Market Neutral and Extended Equity

By Staff Reporters

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Equity market neutral strategies seek to eliminate the risks of the equity market by holding up to 100% of net assets in long equity positions and up to 100% of net assets in short equity positions. These strategies attempt to exploit differences in stock prices by being long and short in stocks within the same sector, industry, market capitalization, etc. If successful, these strategies should generate returns independent of the equity market.

Equity market neutral portfolios have two key sources of return: 1) the Treasury Bill return (the interest on proceeds from short sales held in cash as collateral), and 2) the difference (the “spread”) between the return on the long positions and the return on the short positions. Stock picking, rather than broad market moves, should drive most of a market-neutral strategy’s total return (save for any return from the 100% cash position).

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Extended Equity Strategies attempt to provide better returns than possible with long-only investments

An example of an extended equity strategy is a 130/30 portfolio, which gets its designation from taking a 130% long position and a 30% short position. In practice, this would mean $100mm invested in stocks that are viewed as attractive.

Next, the manager would borrow and sell short $30mm of unattractive stocks. Then the manager uses the proceeds from the short sale to buy an additional $30mm of attractive stocks. This results in a portfolio that has 130% long and 30% short exposure to stocks, or “extended” exposure to equities relative to a long-only, 100% stock portfolio.

Note: It’s important to point out that here is the risk of theoretical unlimited amount of loss with short selling, (i.e. the price of the short-sold stocks increases; the long position can only go down to $0).

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DAILY UPDATE: United Health, Cigna and Inflation as Stock Markets Flatten

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UnitedHealth Group posted nearly $6.1 billion in profit last quarter, edging out Elevance Health with $5.6 billion. Paige Minemyer has more takeaways from third quarter earnings results.


Cigna told investors the company is no longer pursuing a merger with Humana, opting to avoid tricky questions from federal regulators.

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STOCKS UP

  • EV startup Rivian popped 13.71% after announcing a new $5.8 billion joint venture with Volkswagen to collaborate on a new line of vehicles that will begin rolling off the assembly line in 2027.
  • Rocket Lab…rocketed 28.44% to a new all-time high after increasing revenue 55% last quarter and announcing the first launch deal for its new Neutron rocket.
  • Charter Communications will purchase Liberty Broadband in an all-stock deal. Charter shares rose 3.63% on the news, while Liberty shares sank 5.05%.
  • Cava reported strong earnings today, including impressive same-store sales growth of 18%. Shares soared on the open, though ended the day up just 1.57%.
  • Flutter Entertainment, parent company of sports betting app FanDuel, rose 6.89% to hit an all-time high thanks to incredibly strong betting on the NFL last quarter.

STOCKS DOWN

  • The problems continue at Super Micro Computer, which announced it will need EVEN MORE time to submit its quarterly 10-Q form to the SEC. That’s on top of the delayed filing of its annual 10-K filing from back in June—and if it doesn’t file that by November 16, the stock will be delisted from the Nasdaq. Shares sank 6.31%.
  • Spirit Airlines really may go bankrupt this time. The beleaguered airline has lost hope of merging with Frontier Airlines, so shares plunged 59.32%.
  • Maplebear, which is the parent company of Instacart, delivered bad news for shareholders: Next quarter will be worse than expected. Shares fell 11.01%.
  • SoundHound AI reported record revenue last quarter, but shares plummeted 17.06% after the voice recognition stock also revealed much lower margins.

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 1.39 points (0.02%) to 5,985.38; the Dow Jones Industrial Average® ($DJI) added 47.21 points (0.11%) to 43,958.19; and the NASDAQ Composite® ($COMP) fell 50.66 points (–0.26%) to 19,230.74. 
  • The 10-year Treasury note yield added two basis points to 4.45%, just below last week’s four-month high.
  • The CBOE Volatility Index® (VIX) slid to 14.03, down sharply from above 20 early last week.

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The Labor Department on Wednesday reported that consumer prices in October rose 2.6% from a year earlier. That marks a pickup in the pace of inflation from September, when prices were up 2.4% on the year.

A digital token inspired by a Shiba Inu dog meme is now worth more than the company that pioneered the assembly line. Yesterday, dogecoin continued its post-election surge to become more valuable than 121-year-old Ford.

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

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MEDICAL TESTS: The Surprise Paradox

By Staff Reporters

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THE SURPRISE MEDICAL TEST PARADOX

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Classic Definition:  A doctor announces to her hospitalized patient that there will be a painful medical test sometime during the following week. The patient begins to speculate about when it might occur, until another patient announces that there is no reason to worry because a medical surprise test is impossible.

The test cannot be given on Friday, because by the end of the day on Thursday we would know that the test must be given the next day. Nor can the test be given on Thursday, because, given that we know that the test cannot be given on Friday, by the end of the day on Wednesday we would know that the test must be given the next day. And likewise for Wednesday, Tuesday, and Monday!

Modern Circumstance: The patient spends a restful weekend not worrying about the test, yet is very surprised when it is given on Wednesday. How could this happen?

Paradox Example: There are various versions of this paradox; one of them, called the Hangman, concerns a condemned prisoner who is clever but ultimately overconfident. The implications of the paradox are as yet unclear, and there is virtually no agreement about how it should be solved.

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FINANCIAL YIELDS: All About Fixed Income Securities

By Dr. David Edward Marcinko MBA MEd CMP™

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Yield: For bonds and other fixed-income securities, yield is a rate of return on those securities. There are several types of yields and yield calculations. “Yield to maturity” is a common calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity.

Yield curve: A line graph showing the yields of fixed income securities from a single sector (such as Treasuries or municipals), but from a range of different maturities (typically three months to 30 years), at a single point in time (often at month-, quarter- or year-end). Maturities are plotted on the x-axis of the graph, and yields are plotted on the y-axis. The resulting line is a key bond market benchmark and a leading economic indicator.

Yield to maturity [real yield to maturity]: Yield to maturity is a common performance calculation for fixed-income securities, which takes into account total annual interest payments, the purchase price, the redemption value, and the amount of time remaining until maturity. Real yield to maturity is simply yield to maturity minus any “inflation premium” that had been added/priced in. (See Real yield.)

Yield ratio: A ratio of one yield divided by another. Most often used as a relative value measurement.

Yield spread: A “spread,” in fixed income parlance, is simply a difference. Yield spreads measure yield differences, typically between debt securities with high credit ratings (which typically have lower yields) and those with lower ratings (which typically have higher yields). Yield spreads can also be measured between debt securities with different maturities (shorter-maturity securities typically have lower yields and longer-maturity securities typically have higher yields).

Yield trap: An investment that can lure investors with an attractive yield that may not be fundamentally sustainable, or that may lead to undesired price volatility. Yield traps can lurk in both the equity and fixed income markets. They have a tendency to prey on those who can least afford them, including retirement investors looking for increased relative income and stability, who may have been too focused on their income goals and not enough on stability.

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CELEBRATE: World Kindness Day

November 13th, 2024

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World Kindness Day is an international holiday first introduced in 1998 by the World Kindness Movement.

The holiday is devoted to promoting kindness throughout the world, understanding the positive potential of large and small acts of kindness, and unifying together as human beings.

WKD: https://worldkindness.org/

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DAILY UPDATE: Bitcoin Fog as Chegg the DJIA and NASDAQ Drop

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

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The operator of the longest-running money laundering machine in dark web history, Bitcoin Fog, has been sentenced to 12 years and six months in US prison. Roman Sterlingov, 36, a Russian-Swedish national, was also ordered to repay more than half a billion dollars accrued from the cryptocurrency mixing service that he ran for a decade between 2011 and 2021.

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

Stocks Up

  • r Elliott Investment Management is at it again, this time with a $5 billion stake in industrial conglomerate Honeywell. Shares gained 3.87% on the news.
  • Shopify announced its ninth consecutive quarter of beating analyst revenue expectations, pushing shares up 21.04%.
  • Bad news is good news: 40% of the workforce at 23andMe is getting laid off to cut costs. Shareholders cheered, and shares climbed 2.17%.
  • Where’s the beef? Tyson Foods popped 6.55% after announcing strong earnings thanks to higher beef and chicken prices last quarter.
  • Sentinel One climbed 2.01% after Deutsche Bank analysts upgraded the cybersecurity stock from “hold” to “buy,” noting it should profit from CrowdStrike’s outage earlier this year.

Stocks Down

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 17.36 points (–0.29%) to 5,983.99; the Dow Jones Industrial Average® ($DJI) lost 382.15 points (–0.86%) to 43,910.98; and the NASDAQ Composite® ($COMP) decreased 17.36 points (–0.09%) to 19,281.40.
  • The 10-year Treasury note yield added 12 basis points to 4.43%.
  • The CBOE Volatility Index® (VIX) fell to 14.81, unusual on a day when stocks lost ground.

CITE: https://tinyurl.com/tj8smmes

Chegg is on the verge of collapse. Its stock is down 99% since 2021, the Wall Street Journal reported, wiping out nearly $15 billion in market value.

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

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Take the Physician-Focused FINANCIAL PLAN “Challenge”

Do You Have “What it Takes”?

Book Marcinko

DEM 2

By Professor David E. Marcinko MBBS DPM MBA MEd CMP®

Institute of Medical Business Advisors, Inc.

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www.CertifiedMedicalPlanner.org

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My History

More than 20 years ago I crafted a comprehensive holistic financial plan for a young doctor colleague who was born in 1959. In fact, he was not even a medical student at the time; so “canned off-the-shelf plans”, computer generated software or generic spread sheets were not a viable creation option. It was all a granular, detailed, specific and cognitive work-product. Today, he is a board-certified internist.

So, in 2023, it is right and just to take a look back and see how well, or poorly, we’ve fared.

Now, I appreciate more than most how financial planning is a “process”; and not an isolated event. Yet, all sorts of “advisors” and “consultants” create and charge hefty fees for same, and on-going monitoring, every day.

The ME-P Challenge

Nevertheless, I challenge all you mid-career or senior financial planners /advisors to this competition; regardless of degree, certification or designation.

“Show me your financial plan” – AND – “I’ll show you my financial plan”

Here Comes the Judge

Then, our community of ME-P readers, subscribers, visitors and “judges” will decide the winner.

The contest is open to any financial advisor, planner, consultant, wealth manager, CFP®, CFA, insurance agent, CPA or CLU, ChFC, or stock-broker, etc., who is not afraid of transparency in his or her work product and purported expertise.

Of Financial Certifications and Designations

*** [Creating and Evaluating a physician focused financial plan]

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Assessment

So, just send in a copy of any “blinded” physician-focused financial plan that is about 21 years old. We will post for all to see and review …. warts and all … including my own; three part mega-plan!

The winner will receive bragging rights, academic swagger, and expert promotion to our entire ME-P ecosystem and network of medical, business, law and graduate school communities; as well as physicians, nurses, healthcare executives and allied health care professionals.

An informed sought-after and lucrative sector – indeed!

IOW: Free publicity and positive “new-wave” PR – PRICELESS!

Of course, as an educator and professor of health economics and finance, we are pleased to present you with the deep medical business knowledge and detailed financial,managerial and accounting techniques used, with some real-life “tips and pearls” developed over the last two decades of R&D, right here:

MORE: Comprehensive Financial Planning Strategies for Doctors[Best Practices from Leading Consultants and Certified Medical Planners™]

MORE: Risk Management Liability Insurance, and Asset Protection Strategies for Doctors and Advisors [Best Practices from Leading Consultants and Certified Medical Planners™]

Conclusion

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

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

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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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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PART 1: My Sample Financial Plan I [Data gathering, goals and objectives]

PART 2: My Sample Financial Plan II [Data Analytics, Creation and Crafting]

PART 3: Request here: MarcinkoAdvisors@msn.com [Stress Testing and Completion]

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Thank you for your response. ✨

BONDS: Zero Coupon [Pros & Cons]

DEFINITIONS

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Zero-coupon securities (aka zeros) are debt securities [bonds] that, unlike most of their debt security counterparts, make no periodic interest payments to investors. Instead, they are sold at a deep discount (with an imputed interest rate priced into the discount), then redeemed for their full face value at maturity.

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

When held to maturity, a zero’s entire return comes from the difference between its purchase price and its value at maturity.

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DAILY UPDATE: About the Markets

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

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The S&P 500 closed above 6,000 for the first time. Chips fell on China trade tension. The US dollar rose. Treasuries were closed.

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

Here’s where the major benchmarks ended:

  •  The SPX rose 5.81 points (0.10%) to 6,001.35; the Dow Jones Industrial Average® ($DJI) added 304.14 points (0.69%) to 44,293.13, a new all-time closing high; and the NASDAQ Composite® ($COMP) gained 11.99 points (0.06%) to 19,298.76.
  • The 10-year Treasury note yield (TNX) didn’t trade today due to the Veterans Day holiday.
  • The CBOE Volatility Index® (VIX) inched up to 15.05. 

CITE: https://tinyurl.com/tj8smmes

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

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PRIMARY MEDICAL CARE: The Paradox

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP

Sponsor: http://www.CertifiedMedicalPlanner.org

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Classic Definition: Despite rising costs, health care often is of poor quality. Evidence from a classic medical improvement outcomes study assessed care of patients with several chronic diseases. This study found that patients’ functional health status outcomes are similar to care rendered by specialists and generalists but that generalists use far fewer resources. Similar outcome at lower cost represents higher value.

Modern Circumstance: Current solutions to improving care quality may do more harm than good if they focus more on diseases than on people. Efforts to improve the parts (evidence-based care of specific diseases) may not necessarily improve the whole (the health of people and populations).

Expanding access to specialty care, for example, has been proposed as both a source of and a solution for deficiencies in quality of care. Primary care is touted as an essential building block of a high-value health care system even as it is undermined by systems attempting to improve the quality, effectiveness, and value of their health care..

Paradox Example: The above contradictions plague improvement efforts in health care systems around the world, particularly the United States The paradox is that compared with specialty care or with systems dominated by specialty medical care, primary care is associated with the following: (1) poorer quality care for individual diseases, yet (2) similar functional health status at lower cost for people with chronic disease, and (3) better quality, better health, greater health  equity and lower costs for whole peoples and populations.

And so, this contradiction plagues improvement efforts in health care systems around the world, particularly the United States.

Cite: Kurt Stange MD PhD and Robert Ferrer MD MPH

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SORTINO: A Financial Risk Ratio

DEFINED

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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The Sortino Ratio is similar to the Sharpe Ratio, it is a measure of risk-adjusted performance which looks at returns through the lens of the risk taken to achieve that performance, but instead of volatility of return, it uses downside variance as its measure of risk.

SHARP RATIO: https://medicalexecutivepost.com/2021/11/08/introducing-the-sharp-index/

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DAILY UPDATE: Election Week Wrap-Up

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

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  • Stocks ended a record-breaking election week by breaking records: The Dow rose above 44,000 for the first time ever, the S&P 500 rose above 6,000 for the first time ever, and the NASDAQ hit its own all-time high.
  • Tesla in particular had an excellent week, rising to a market cap of $1 trillion on a post-election surge.
  • Treasury yields fell and ended the week lower than where they began as investors hedged their bets and bought bonds.

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

  • Oil rose a bit this week on fears that Hurricane Rafael would disrupt supply in the Gulf Coast, but new projections show the storm losing steam, which meant oil did as well.
  • One investment that didn’t go down this week: bitcoin. The crypto king soared to a new all-time high as traders bought into a friendlier regulatory environment under Donald Trump.

CITE: https://tinyurl.com/tj8smmes

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

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FINANCIAL Derivatives

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Derivatives are securities whose performance and/or structure is derived from the performance and/or structure of other assets, interest rates, or indexes. If used moderately and in appropriate situations, derivatives can help stabilize portfolios and/or enhance returns. However, if used in excess and/or in inappropriate circumstances, they can be harmful, potentially causing portfolio instability and/or losses. Derivatives are similar to medicine in their behavior–usually safe when used as directed, potentially toxic when abused.

There are many different types of derivative securities and many different ways to use them. Some derivative securities, such as mortgage-related and other asset-backed securities, are in many respects like any other investment, although they may be more volatile or less liquid than more traditional debt securities.

Futures and options are commonly used for traditional hedging purposes to attempt to protect portfolios from exposure to changing interest rates, securities prices or currency exchange rates, and for cash management purposes as a low-cost method of gaining exposure to a particular securities market without investing directly in those securities.

Certain other derivative securities may be described as structured investments. A structured investment is a security whose value or performance is linked to an underlying index or other security or asset class. Structured investments include collateralized mortgage obligations (CMOs). Structured investments also include securities backed by other types of collateral.

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

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KENNETH ARROW: Information Paradox

To sell information you need to give it away before the sale

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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THE FATHER OF HEALTH ECONOMICS

According to Wikipedia, a fundamental tenet of the paradox is that the customer, i.e. the potential purchaser of the information describing a technology (or other information having some value, such as facts), wants to know the technology and what it does in sufficient detail as to understand its capabilities or have information about the facts or products to decide whether or not to buy it. Once the customer has this detailed knowledge, however, the seller has in effect transferred the technology to the customer without any compensation. This has been argued to show the need for patent protection [HIPPA].

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

If the buyer trusts the seller or is protected via contract, then they only need to know the results that the technology will provide, along with any caveats for its usage in a given context. A problem is that sellers lie, they may be mistaken, one or both sides overlook side consequences for usage in a given context, or some unknown-unknown affects the actual outcome.

MORE :https://www.nobelprize.org/prizes/economic-sciences/1972/arrow/facts/

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DAILY UPDATE: SPX Ends Just Short of 6,000

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

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

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Stocks up

  • In another daily double-digit swing, Trump Media & Technology Group jumped 15.22% after President-elect Trump announced he has no plans to sell shares of his social media company.
  • Toast isn’t just for breakfast anymore—it’s also a restaurant software company that’s making money hand over fist. Shares popped 14.93% on strong earnings news.
  • Axon Enterprise climbed 28.68% to a new all-time high thanks to an impressive quarter for the law enforcement technology company.
  • Upstart started up and stayed there, soaring 46.02% after the AI lending marketplace beat-and-raised analyst estimates last quarter.
  • Unless you’re a medical professional, you’ve probably never heard of digital platform Doximity, but doctors love it. Shares surged 34.06% on a stronger-than-expected quarter.

Stocks down

  • Pinterest plummeted after the social media site announced slowing user growth combined with lower ad pricing, a one-two combo that sent shares tumbling 14%.
  • Airbnb may have beaten revenue expectations, but shareholders punished it for missing on earnings estimates last quarter. Shares fell 8.66%.
  • Sweetgreen sank 6.01% after the fast casual eatery fell short of analyst estimates last quarter and Goldman Sachs lowered its rating from “buy” to “neutral.”
  • Redfin plunged 15.62% after it announced lower earnings than analysts expected, cut its forecasts, and revealed it’s losing ground to competitors.

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

Here’s where the major benchmarks ended:

  • The SPX rose 22.44 points (0.38%) to 5,995.54 to end the week up 4.66%; the Dow Jones Industrial Average® ($DJI) added 259.65 points (0.59%) to 43,988.99 to end the week up 4.61%; and the NASDAQ Composite®($COMP) climbed 17.31 points (0.09%) to 19,286.78 to end the week up 5.74%.
  • The 10-year Treasury note yield (TNX) fell four basis points to 4.31%, but the 2-year yield added three basis points to 4.25%. Shorter-term yields, which are more closely connected to near-term rate policy, gained on longer-term ones this week.
  • The CBOE Volatility Index® (VIX) fell to 14.99, near a two-month low.

CITE: https://tinyurl.com/tj8smmes

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

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RECIPROCITY: Science “Sales” in Action

FREE SAMPLES

The Art of Giving – And Receiving – Value!

By Staff Reporters

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Imagine you’re at a party, and someone hands you a drink. Your first instinct? Find something to give back. This is [sales] reciprocity in action – our built-in psychological urge to repay kindness.

According to colleague Dan Ariely PhD, it’s like a cosmic balance sheet in our brains, ensuring we don’t owe anyone a favor. This is why companies give out free samples. They’re not just being nice; they know you’ll feel a pang of guilt if you walk away without buying something.

THINK: Free financial planning dinner seminar and prospecting event. That’s you – the Sales Prospect!

So, next time someone does you a favor, remember: it’s not just seller kindness, it’s science!

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CURRENCY OPTIONS: Hedging and Overlays

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Currency Hedging is a risk-management strategy, as part of a foreign investment strategy, currency hedging is designed to reduce the impact from changes in the relative values of currencies involved in the foreign investment strategy.

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

In any foreign investment strategy, a significant part of the potential risk and return comes from exposure to relative currency value fluctuations. If exposure to those currency fluctuations is minimized, investors can experience more of a “pure play” exposure to the foreign investments. There is a variety of possible currency hedging strategies, ranging from swaps, options, and spot contracts to simply buying foreign currencies.

Currency Overlay is a financial trading strategy used to separate the management of currency risk from other portfolio strategies. A currency overlay manager can seek to hedge the risk from adverse movements in exchange rates, and/or attempt to profit from tactical currency views.

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

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DAILY UPDATE: FOMC Cuts Interest Rates as Stock Markets Rise

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

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

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The Federal Reserve cut interest rates by 0.25 percentage points Thursday, the second consecutive cut after a two-year rate-hike run to curb post-pandemic inflation.

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

What’s up

  • Lyft announced impressive earnings results thanks to more commuters using the ride-hailing service, as well as upbeat guidance for the future. Shares rose 22.92%.
  • Shareholders worried about a housing market slowdown hurting Zillow had nothing to fear: The real estate website crushed earnings estimates, and shares popped 23.77%.
  • Warner Bros. Discovery enjoyed its biggest single-quarter surge in subscribers ever thanks to streaming service Max, which sent shares soaring 11.81%.
  • Under Armour rocketed 23.33% higher after its cost-savings plan paid off last quarter and management guided for a strong quarter ahead.
  • Planet Fitness surprised shareholders with a solid quarter for the gym giant, as well as forecasts of more growth ahead. Shares climbed 11.26%.
  • Prison operators GEO Group and CoreCivic both surged on Trump’s election, and their rally continued today—in-spite of very different paths forward for each stock. GEO Group gained 13.63%, while CoreCivic rose 25.60%.

What’s down

  • Trump Media & Technology Group was one of the biggest winners on election night, and although the stock soared over the last few days, investors decided to take profits today. Shares sank 22.97%.
  • Wolfspeed plummeted 39.24% after announcing larger-than-expected losses last quarter, poor forecasts for next quarter, and layoffs to cut costs.
  • Match Group shareholders were heartbroken to hear that Tinder’s revenue fell last quarter, though strong revenue growth from Hinge helped ease the pain. Shares dropped 17.87%.
  • Virgin Galactic isn’t just a mean nickname from your high school years—it’s also a space stock that can’t make money to save its life. Shares fell 11.87%.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 44.06 points (0.74%) to 5,973.10; the Dow Jones Industrial Average® ($DJI) fell 0.59 points (0.00%) to 43,729.34; and the NASDAQ Composite® ($COMP) gained 285.99 points (1.51%) to 19,269.46.
  • The 10-year Treasury note yield (TNX) fell nine basis points to 4.34%, with most of the drop coming long before the Fed decision.
  • The CBOE Volatility Index® (VIX) continued its post-election plunge to 15.21.

CITE: https://tinyurl.com/tj8smmes

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

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INVESTING NEWS: Stocks, Bonds, Oil, Gold, Bitcoin and Sectors Review Post Election

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

BREAKING NEWS!

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  • Stocks surged and stayed higher all yesterday day on news of Donald Trump’s presidential victory. The Dow rocketed over 1,350 points as soon as markets opened, and all three indexes ended the day at record highs.
  • Treasury yields have paralleled Trump’s chances of taking the White House for the last few weeks, and his election sent them soaring to over 4.46% at one point today.
  • Oil and gold both fell as the dollar rose after Trump’s win. The greenback popped on the promise of Trump’s protectionist tariff policies and the lower likelihood of the Fed cutting interest rates as fast as previously expected.
  • Bitcoin surged as traders celebrated the beginning of the new, friendlier regulatory environment that Trump promised during his campaign.

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

Sector check-up

  • Financials were the biggest sector mover Wednesday, up 6.16%, hitting a new high.
  • Industrials were up 3.93% Wednesday, hitting a new high.
  • Energy was up 3.54% in the session. It’s now 4.28% from the April high.
  • Real Estate fell 2.64% during trading. It’s now 5.6% from the high. 
  • Consumer Staples fell 1.5%. The sector is 5.76% from the September high.
  • Utilities fell 1%. It’s now 5.72% from the mid-October high.
  • Duke Energy was flat over the past three months, and it is 6.3% from the October high.

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PHYSICIAN PERSONAL COACHING: Financial Planning and Retirement Consulting

SPONSORED BY: http://www.MarcinkoAssociates.com

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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.

LEARN MORE: https://tinyurl.com/y3j2t3ab

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DAILY UPDATE: Record Stock Market Blast Off Post Trump Presidential Election

MEDICAL EXECUTIVE-POST TODAY’S NEWSLETTER BRIEFING

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

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

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

http://www.MedicalBusinessAdvisors.com

SPONSORED BY: Marcinko & Associates, Inc.

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Stocks Up

  • One more group of stocks that soared on a Trump election: Big Tech companies with antitrust problems. Another Trump presidency should go a long way toward clearing up the regulatory hurdles many companies have faced recently, which is why Alphabet popped 3.99% and Amazon rose 3.8%.
  • CVS Health surged 11.33% after meeting revenue forecasts but missing earnings expectations. However, the miss was due to a one-time charge, so shareholders quickly forgave the healthcare retailer.
  • Planet Fitness gained 6.09% on a surprise bid for bankrupt fitness chain Blink Holdings in an attempt to bolster its own gym business.

Stocks Down

  • Super Micro Computer had a chance to show the world it wasn’t committing the fraud it has recently been accused of. Instead, the company announced it is still unable to determine when it will file the quarterly report due August 29. Shares crashed 18.05%.
  • Home builder stocks sank on fears that a Trump presidency will slow the rate of Fed rate cuts, keeping mortgage rates higher for longer. DR Horton fell 3.8%, Lennar dropped 4.84%, Pulte Group lost 3.09%, and Toll Brothers tumbled 1.46%.
  • Cannabis stocks were betting big on a ballot measure in Florida to allow the sale of recreational marijuana. The initiative’s failure sent shares of Curaleaf plummeting 29.17%, Trulieve Cannabis plunged 38.8%, and Ayr Wellness sank 55.87%.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 146.28 points (2.53%) to 5,929.04; the Dow Jones Industrial Average® ($DJI) added 1,508.05 points (3.57%) to 43,729.93; and the NASDAQ Composite® ($COMP) gained 544.29 points (2.95%) to 18,983.47—a new closing high. 
  • The 10-year Treasury note yield (TNX) surged 14 basis points to 4.43%, its highest level since July.
  • The CBOE Volatility Index® (VIX) fell sharply to 16.3 as election-related uncertainty diminished.

CITE: https://tinyurl.com/tj8smmes

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

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HINDSIGHT BIAS: The “Curse of Knowledge”

By Staff Reporters

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The Curse of Knowledge and Hindsight Bias

Similar in ways to the availability heuristic (Tversky & Kahneman, 1974) and to some extent, the false consensus effect, once you (truly) understand a new piece of information, that piece of information is now available to you and often becomes seemingly obvious. It might be easy to forget that there was ever a time you didn’t know this information and so, you assume that others, like yourself, also know this information: the curse of knowledge.

Cite: https://medicalexecutivepost.com/2022/11/18/what-is-the-dunning-kruger-effect/

However, according to colleague Dan Ariely PhD, it is often an unfair assumption that others share the same knowledge. The hindsight bias is similar to the curse of knowledge in that once we have information about an event, it then seems obvious that it was going to happen all along.

I should have seen it [divorce, stock market crash/soar my smoking & lung cancer, unemployment, etc] coming!

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STOCK MARKETS: Roaring and Soaring!

BREAKING FINANCIAL NEWS

By Staff Reporters

SPONSOR: http://www.MarcinkoAssociates.com

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Stocks just roared out of the gate this Wednesday morning following news that former President Donald Trump has secured a second term in the White House and Republicans won a majority in the Senate.

The Dow Jones Industrial Average rose 1,341 points, or about 3.1 percent, as the market opened, reaching a record high. It was the first time it has jumped more than 1,000 points in a single day since November 2022.

The S&P 500 also gained 1.9 percent, and the NASDAQ climbed 1.8 percent.

Despite concern from big business about Trump’s plan to impose blanket tariffs on imports to the U.S., Wall Street is anticipating tax cuts and deregulation during a second Trump presidency.

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INVESTING RISKS: Retained Earnings, Weighted Assets and Sequence of Return

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Retained Earnings Risk: Profits generated by a company that are not distributed to stockholders as dividends. Instead, they are either reinvested in the business or kept as a reserve for specific objectives, such as paying off debt or purchasing equipment. Retained earnings risks are also called “undistributed profits,” “undistributed earnings,” or “earned surplus.”

Risk-Weighted (or risk-adjusted) Assets: Within the context of measuring the financial stability of banks and other financial institutions, the risk-weighted assets figure is an aggregate of a financial institution’s assets (usually loans to its customers) after the loans have been individually adjusted for their risk. This involves multiplying each loan by a factor that reflects its risk. Low-risk loans are multiplied by a low number, high-risk by high. The aggregate number can then be used to calculate the financial institution’s capital ratio. Lower risk-weighted assets typically result in higher capital ratios, and higher risk-weighted assets usually translate to lower capital ratios.

Sequence-of-Returns Risk: The risk of market conditions impacting the overall returns of an investment portfolio during the period when a retiree is first starting to withdrawal money from investments as income. For example, if a retiree has to withdrawal income from his or her portfolio when market prices are depressed, the portfolio may lose out on the potential returns that income could have made once market prices recovered.

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DAILY UPDATE: Home Buyers and Jeff Bezos as Stock Markets Soar!

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

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

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

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First-time homebuyers in 2024 had a median income of $97,000, and their median age was 38. ​​OpenAI and Jeff Bezos invested in Physical Intelligence, a robot startup with the aim of “bringing general-purpose AI into the physical world.”

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

Stocks Up

  • Cybersecurity darling Palantir soared 23.38% to a record high thanks to strong earnings, high AI demand, and big spending from the Department of Defense.
  • Astera Labs skyrocketed 37.70% after the semiconductor parts maker (and one of Nvidia’s key suppliers) announced strong earnings.
  • Crypto stocks had a great day thanks to a widespread cryptocurrency rally. Coinbase rose 4.13%, MicroStrategy gained 2.16%, and Riot Platforms jumped 8.13%.

Stocks Down

Trump Media & Technology Group arrested its recent downturn and popped 12% at one point today, but gave all those gains up and ended the day down 1.16%.

  • You’d think the end of a multi-week labor dispute costing billions of dollars would be a relief for shareholders, but Boeing still sank 2.62% on news that it’s reached an agreement with striking machinists.
  • It’s a me, lower revenue forecasts! Nintendo fell 1.68% after announcing that sales of its Switch console are starting to sag.
  • Wynn Resorts sagged 9.34% thanks to misses on both top and bottom line expectations last quarter.
  • Some of the smaller semiconductor stocks on the market took a beating today. NXP Semiconductor dropped 5.17% after announcing weaker-than-expected Q4 guidance, Lattice Semiconductor tumbled 1.37% after missing on sales forecasts and announcing job cuts, and while Cirrus Logic beat expectations this quarter, it still fell 7.09% on lower forecasts.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 70.07 points (1.23%) to 5,782.76; the Dow Jones Industrial Average® ($DJI) added 427.28 points (1.02%) to 42,221.88; and the NASDAQ Composite® ($COMP) increased 259.19 points (1.43%) to 18,439.17.
  • The 10-year Treasury note yield (TNX) dropped two basis points to 4.29%.
  • The CBOE Volatility Index® (VIX) slipped to 20.72.

CITE: https://tinyurl.com/tj8smmes

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

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METAVERSE MEDICINE: A Paradigm Shift?

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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In what some are calling the next iteration of the internet, the metaverse is an unfamiliar digital world where you could be an avatar navigating computer-generated places and interacting with others in real time. In this space, the constraints of our physical, bricks and mortar world and travel habits fade. And new opportunities and challenges emerge.

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

For example:

  • Google in healthcare: The search giant has repeatedly successfully transferred its in-depth knowledge of algorithms in the field of medicine, particularly since it acquired DeepMind.
  • Apple in healthcare: Apple will keep on working on expanding the health features of its devices, Apple Watch and iPhones included.
  • Microsoft in healthcare: Microsoft’s cloud solutions provide integrated capabilities that make it easier to improve the healthcare experience.
  • Amazon in healthcare: Amazon will make further use of its vast knowledge of online shopping trends and behavior and will keep on providing what people need, from medicine to wearables.
  • IBM in healthcare: IBM has a lot to offer in federated learning, blockchain, and quantum computing.
  • Nvidia in healthcare: NVIDIA seems incredibly focused on its approach to healthcare. We can expect NVIDIA to be a leader in the use of artificial intelligence in healthcare.
  • Facebook in healthcare: The Metaverse developed by Facebook/Meta has incredible potential to revolutionize healthcare.

All this technology has huge potential because it uses both virtual reality (VR) and augmented reality (AR) technology to work in virtual spaces: All signs point to the metaverse being widely used as a disruptive change in healthcare, from better surgical precision to therapeutic uses to social-distance accommodations and more.

But along with these improvements come new problems that will change what we know about modern healthcare. The metaverse is a paradigm shift in healthcare that everyone involved needs to be aware of. This is because it changes how medical infrastructure is built, how startup costs are covered, and how data security and privacy are handled.

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

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GDP: Private Domestic Health Care Investments

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.MarcinkoAssociates.com

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SPONSOR: http://www.CertifiedMedicalPlanner.org

GROSS PRIVATE DOMESTIC HEALTH CARE INVESTMENTS

Classic:  Investment purchases and private expenditures of healthcare firms, the value of related construction, and the change in inventory during the year.

Modern: Gross Revenue Per Day is the average amount charged by a hospital for one day of inpatient care (gross inpatient revenue divided by patient-census days).

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

Examples:

  • Gross Revenue Per Discharge: The average amount charged by a hospital to treat an inpatient from admission to discharge (gross inpatient revenue divided by discharges).
  • Gross Revenue Per Visit: The average amount charged by a hospital for an outpatient visit (gross outpatient revenue divided by outpatient visits).

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DAILY UPDATE: CVS Splits as Stocks Down in Slow Session

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Among consideration for CVS is splitting up its assets: CVS Pharmacy, pharmacy benefit manager CVS Caremark, and insurance arm Aetna. The company has reportedly been in talks with bankers about the move, Reuters reported early this month.

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STOCKS UP

  • Just as Nvidia will replace Intel, Sherwin Williams will replace Dow Inc. on the Dow (how embarrassing, getting kicked off an index you share a name with). Sherwin Williams popped 4.59%, while Dow Inc. fell 2.08%.
  • Chewy is also getting added to an index, replacing Stericycle on the MidCap 400. Shares rose 6.34%.
  • Peloton pedaled 3.59% higher on a double upgrade from Bank of America analysts, who like the bike company’s higher profit outlook and hiring of new CEO Peter Stern from Ford.
  • Yum! China, the company that operates Pizza Hut and KFC restaurants in China, climbed 7.12% after announcing that new store openings translated into better-than-expected revenue and earnings last quarter.

STOCKS DOWN

Nuclear energy stocks took a big hit today after the Federal Energy Regulatory Commission ruled that Talen Energy could not increase the amount of energy its nuclear plant in Susquehanna, PA, produces in order to power an Amazon data center. Talen fell 2.23%, Vistra Corp sank 3.18%, and Constellation Energy plummeted 12.46%.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) dipped 16.11 points (–0.28%) to 5,712.69; the $DJI dropped 257.59 points (–0.61%) to 41,794.60; and the $COMP lost 59.93 points (–0.33%) to 18,179.98.
  • The 10-year Treasury note yield (TNX) fell five basis points to 4.31%.
  • The CBOE Volatility Index® (VIX)edged up to 22.11, still below last week’s peaks.

CITE: https://tinyurl.com/tj8smmes

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

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ECONOMICS: John B. Taylor’s Rule

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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Named for a U.S. economist, the JB Taylor Rule is a mathematical monetary-policy formula that recommends how much a central bank should change its nominal short-term interest rate target (such as the U.S. Federal Reserve’s federal funds rate target) in response to changes in economic conditions, particularly inflation and economic growth. It’s typically viewed as guideline for raising short-term interest rates as inflation and potentially inflationary pressures increase. The rule recommends a relatively high interest rate (“tight” monetary policy) when inflation is above its target or when the economy is above its full employment level, and a relatively low interest rate (“easy” monetary policy) under the opposite conditions.

To illustrate, the monetary policy of the FOMC, changed throughout the 20th century. The period between the 1960s and the 1970s is evaluated by Taylor and others as a period of poor monetary policy; the later years typically characterized as stagflation. The inflation rate was high and increasing, while interest rates were kept low. Since the mid-1970s monetary targets have been used in many countries as a means to target inflation.

However, in the 2000s the actual interest rate in advanced economics, notably in the US, was kept below the value suggested by the Taylor rule.

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

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

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

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

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

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

CITE: https://tinyurl.com/tj8smmes

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

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

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

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PHYSICIANS: Career Change Conundrum

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: https://marcinkoassociates.com/process-what-we-do/

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Half of Physicians Plan to Change Career Paths

The Physicians Foundation conducted a survey on physician practice patterns and perspectives a few years ago. Here are some key findings from the report:

• 31% of physicians identify as independent practice owners or partners.
• Almost half (47%) of physicians plan to change career paths.
• 78% of physicians sometimes, often or always experience feelings of burnout.
• Nearly a quarter of physician time is spent on non-clinical paperwork.

This result is not good for Medicine.

Cite: The Physicians Foundation, September 2018

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HFRI: Fund of Funds Composite Index

By Dr. David Edward Marcinko MBA MEd

SPONSOR: http://www.MarcinkoAssociates.com

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HFRI: Fund of Funds invests with multiple managers through funds or managed accounts. The strategy designs a diversified portfolio of managers with the objective of significantly lowering the risk (volatility) of investing with an individual manager.

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

The Fund of Funds manager may allocate funds to numerous managers within a single strategy, or with numerous managers in multiple strategies. The investor has the advantage of diversification among managers and styles with significantly less capital than investing with separate managers.

HFRI: https://hfr-wp-s3.s3.amazonaws.com/wp-content/uploads/2024/03/05142042/HFRI_formulaic_methodology.pdf

The HFRI Fund of Funds Index is not included in the HFRI Fund Weighted Composite Index.

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IN & OUT OF NETWORK: Medical Care

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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What does in-network mean?

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

What does out-of-network mean?

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

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

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OUT OF NETWORK [OON] MEDICAL CARE

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

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

THINK: Medicare Advantage {Part C] Plans

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

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STRIPES: Separate Trading of Registered Interest and Principal of Securities)

By Staff Reporters

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DEFINITIONS

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STRIPS (Separate Trading of Registered Interest and Principal of Securities) is an acronym that describes both a government bond issuance program and the securities issued by the program. STRIPS are a form of zero-coupon security (defined below) created under the U.S. Treasury’s STRIPS program.

Originally, zero-coupon securities were created by broker-dealers who bought Treasury bonds and deposited these securities with a custodian bank. The broker-dealers then sold receipts representing ownership interests in the coupons or principal portions of the bonds.

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

Some examples of zero-coupon securities sold through custodial receipt programs are CATS (Certificates of Accrual on Treasury Securities), TIGRs (Treasury Investment Growth Receipts) and generic TRs (Treasury Receipts). The U.S. Treasury subsequently introduced a program called Separate Trading of Registered Interest and Principal of Securities (STRIPS), through which it exchanges eligible securities for their component parts and then allows the component parts to trade in book-entry form.

STRIPS are direct obligations of the U.S. government and have the same credit risks as other U.S. Treasury securities. STRIPS are generally considered the most liquid (easily bought and sold) zero-coupon securities.

GOVERNMENT: https://www.treasurydirect.gov/marketable-securities/strips/

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DAILY UPDATE: Ford, Peloton and Starbucks as Stocks Climb

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

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

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

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SPONSORED BY: Marcinko & Associates, Inc.

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Ford paused production of its F-150 Lightning electric truck from mid-November to early January as demand for the once-coveted EV dwindles.

Peloton named Peter Stern, the co-founder of Apple Fitness+, as its next CEO.

Starbucks is bringing back Sharpied names on cups for the first time in four years as new CEO Brian Niccol tries to shake up the struggling coffee chain.

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

STOCKS UP

  • Boeing offered striking machinists yet another new contract offer, including a 38% pay raise over the next four years. The union will vote on the contract on Monday. Shares climbed 3.54%.
  • Avis Budget motored 10.92% higher despite missing forecasts on both earnings and revenue. Shareholders celebrated the rental car company’s strong growth expectations from management and took advantage of a cheap valuation.
  • Globalstar rocketed 32.38% after the satellite communications company announced an expanded deal with Apple.
  • Charter Communications soared 11.87% after losing fewer subscribers than expected, which is like a back-handed compliment in the investing world.

STOCKS DOWN

  • Trump Media & Technology Group remains on the roller coaster, falling another 13.53% today as early exit polls show Vice President Kamala Harris with a lead in several key states.
  • Wayfair may have met earnings expectations last quarter, but the online home goods retailer also lost customers and fulfilled fewer orders. Shares fell 6.26%.
  • Super Micro Computer continued to sell off after the resignation of its financial auditor, an almost-sure sign of fraud. Shares sank another 10.51%.

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

  • The S&P 500® index (SPX) rose 23.35 (0.41%) to 5,728.80 to end the week down 1.37%; the Dow Jones Industrial Average® ($DJI) added 288.73 points (0.69%) to 42,052.19 to end the week down 0.15%; and the NASDAQ Composite®($COMP) gained 144.76 points (0.80%) to 18,239.92 to end the week down 1.50%.
  • The 10-year Treasury note yield (TNX) climbed eight points to 4.36%, the highest since early July.
  • The CBOE Volatility Index® (VIX)remained elevated at 21.88.

CITE: https://tinyurl.com/tj8smmes

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

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EMPLOYER’S: Pay for Health Insurance Paradox

By Dr. David Edward Marcinko MBA MEd CMP

SPONSOR: http://www.CertifiedMedicalPlanner.org

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

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

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

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

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

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

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CREDIT: All About Contractual Agreements

By Staff Reporters

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DEFINITIONS

What Is CREDIT? Credit is a contractual agreement in which a borrower receives a sum of money or something else of value and commits to repaying the lender later, typically with interest. Credit is also the creditworthiness or credit history of an individual or a company. Good credit tells lenders you have a history of reliably repaying what you owe on loans. Establishing good credit is essential to getting a loan.

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Credit Analysis is a form of financial analysis used primarily to determine the financial strength of the issuer of a security, and the ability of that issuer to provide timely payment of interest and principal to investors in the issuer’s debt securities. Credit analysis is typically an important component of security analysis and selection in credit-sensitive bond sectors such as the corporate bond market and the municipal bond market.

Credit Default Swap Index (CDX) is a credit derivative, based on a basket of CDS, which can be used to hedge credit risk or speculate on changes in credit quality.

Credit Default Swaps (CDS) are credit derivative contracts between two counter parties that can be used to hedge credit risk or speculate on changes in the credit quality of a corporation or government entity.

Credit Quality reflects the financial strength of the issuer of a security, and the ability of that issuer to provide timely payment of interest and principal to investors in the issuer’s securities. Common measurements of credit quality include the credit ratings provided by credit rating agencies such as Standard & Poor’s and Moody’s. Credit quality and credit quality perceptions are a key component of the daily market pricing of fixed-income securities, along with maturity, inflation expectations and interest rate levels.

Credit Rating Agency (CRA) is a company that assigns credit ratings for issuers of certain types of debt obligations as well as the debt instruments themselves. In the United States, the Securities and Exchange Commission (SEC) permits investment banks and broker-dealers to use credit ratings from “Nationally Recognized Statistical Rating Organizations” (NRSRO) for similar purposes. As of January 2012, nine organizations were designated as NRSROs, including the “Big Three” which are Standard and Poor’s, Moody’s Investor Services and Fitch Ratings.

A Credit Rating Downgrade by a credit rating agency (such as Standard & Poor’s, Moody’s or Fitch), of reducing its credit rating for a debt issuer and/or security. This is based on the agency’s evaluation, indicating, to the agency, a decline in the issuer’s financial stability, increasing the possibility of default (defined below). A downgrade should not to be confused with a default; a debt security can be downgraded without defaulting. (And, conversely, a debt issuer can suddenly default without being downgraded first–credit ratings and credit rating agencies are not infallible.)

Credit Ratings are measurements of credit quality provided by credit rating agencies). Those provided by Standard & Poor’s typically are the most widely quoted and distributed, and range from AAA (highest quality; perceived as least likely to default) down to D (in default). Securities and issuers rated AAA to BBB are considered/perceived to be “investment-grade”; those below BBB are considered/perceived to be non-investment-grade or more speculative.

Credit Risk is the risk that the inability or perceived inability of the issuers of debt securities to make interest and principal payments will cause the value of those securities to decrease. Changes in the credit ratings of debt securities could have a similar effect.

Credit Risk Transfer Securities (CRTS) are the unsecured obligations of the GSEs (Government Sponsored Enterprises). Although cash flows are linked to prepays and defaults of the reference mortgage loans, the securities are unsecured loans, backed by general credit rather than by specified assets.

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

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EARNINGS REPORTS: Magnificent Seven Stocks

By Staff Reporters

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  • Investors waited for the Magnificent 7 stock reports to begin rolling last evening. The NASDAQ rose to a new high on optimism while the Dow Jones fell, and the S&P 500 split the difference.
  • Alphabet announced earnings after the bell yesterday, Microsoft and Meta Platforms reveal their latest quarters today, Amazon and Apple on Thursday afternoon.
  • The 10-year Treasury yield hit a 4-month high this afternoon before paring back a bit as traders struggle to find a signal in all the market noise.
  • Oil rebounded a bit from yesterday’s terrible day, though it still ended the trading session lower.

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

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