JULY FOURTH WEEKEND READING LIST 2024

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

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CONTACT: Ann Miller RN MH

[Executive Director]

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

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

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

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Here’s where the major benchmarks ended:

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

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

What’s up

What’s down

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

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

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DAILY UPDATE: Wall Street Stocks, Dow Dogs, Commodities, Gold, the Fed, Yen and Bitcoin

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If you can believe it, Friday was the final trading day of the first half of 2024. It might be a good time to reflect on your New Year’s resolutions to see how you’re measuring up halfway through the year.

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Dogs of the Dow: The 139-year-old index has never looked more its age, with components Nike, Intel, and Boeing all down more than 30% in 2024. The Dow has gained less than 4% this year.

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But, the S&P 500 gained a sublime 15% in H1, and Nvidia alone was responsible for more than a third of that gain. The maker of AI chips surged ~150% since Jan. 1st to become the most valuable company in the USA at one point.

Going into 2024, investors were expecting the Fed to cut interest rates six times. There hasn’t been a single rate cut yet, but that hasn’t stopped the S&P from notching 31 all-time closing highs, good for the second-best tally of records this century. Stocks have overcome the Fed’s delay thanks to strong earnings, a sturdy economy, and AI fever.

Commodities soar and a currency plummets. Cocoa boomed nearly 85% over shortage concerns. Gold hit a record high last month. The Japanese yen has slumped to a 38-year low against the US dollar.

Bitcoin got a boost from new ETFs, but it’s getting boring.

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DAILY UPDATE: Stock Market Review

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The S&P 500 and NASDAQ shot to record highs last week on a solid PCE reading. But all three indexes spent Friday hovering around flat levels before they all fell into the red by the end of the trading session.

Treasury yields and gold prices alike popped higher on PCE news, with traders hoping that the Fed now has good reason to cut interest rates sooner rather than later. Despite this decline, oil wrapped up a fantastic month, with prices rising for a third straight week on higher demand this summer in the US and higher risks to supply given geopolitical turmoil between Israel and Lebanon.

But, Bitcoin continued to fall, with the crypto inching closer to the all-important $60,000 price point—a line in the sand that traders are desperate not to cross for fear of further declines.

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Are We Over-Optimizing Portfolio Asset Classes?

Too Many Other Asset Classes?

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[By Dr. David Edward Marcinko MBA MEd CMP™]Dr. David E. Marcinko MBA

Some financial analysts believe that the focus on asset classes may have gone too far as physicians and other investors have sought to “over optimize” their portfolios.

In fact, colleague David Loeper, CEO of Wealthcare Capital Management, explained this concept as follows:

“Where things have really got off track has been the insistence on breaking asset classes into sub-classes by style, market capitalization, etc. The unpredictability of all the inputs into our optimizers, even over long periods of time, has been ignored. We have attempted to take efficient portfolios of stocks, bonds and cash and make them even more efficient by breaking the unpredictable asset classes into even less predictable sub-classes. This has all been done into the pursuit of “efficiency” as the proposal was validated by the Brinson & Beebower study, which purports to find that over 90% of the investment return variance is explained by asset allocation. The risk that you produce inefficient portfolios INCREASES if you increase the number of “asset classes” for which you must forecast not only the risk and returns but also each asset class’ correlation to the others.”

Assessment

If true, and I think it is a valid point, the results of the optimizer and your resulting portfolio’s efficiency is based on the accuracy of the inputs and NOT THE NUMBER OF THE INPUTS.

Stock_Market

Or, is this like the TNTC situation in cell cultures and microbiology [Too Numerous To Count].

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

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DAILY UPDATE: Walgreens, Healthcare Fraud and Opioids as Stock Markets Hurt

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In an interview with the Wall Street Journal, CEO Tim Wentworth said the pharmacy chain Walgreens will shutter a significant share of its 8,600 locations in the US. The closures are part of a broader attempt to boost the ailing company, which also includes reducing its stake in the primary care business VillageMD. Wentworth said the company can reassign most employees instead of conducting layoffs. Shares cratered yesterday after Walgreens whiffed on Wall Street’s earnings projections due to weak consumer spending.

And, read how some counties reduced opioid overdose deaths during the pandemic. (Politico)

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What’s up

  • Oliveda International, which makes beauty products from olive oil, rose 38.33% for no apparent reason. Maybe people just really like the feel of extra virgin olive oil on their skin?
  • Infinera popped 16.38% after Nokia announced it would acquire the telecommunications hardware manufacturer for $2.3 billion.
  • Synchrony Financial rose 6.17% after a Baird analyst initiated coverage of the financial services company with an outperform rating.
  • Regional banking stocks rose on the hopes that a good PCE reading means a better chance of the Fed cutting rates soon. Regions Financial rose 3.83%, while Citizens Financial Group rose 3.16%.

What’s down

A late round of selling in the Treasury market sent yields to fresh highs as the day ended so here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) dipped 22.39 points (0.41%) to 5,460.48; the Dow Jones Industrial Average® ($DJI) fell 45.20 points (0.12%) to 39,118.86; the NASDAQ Composite® ($COMP) lost 126.08 points (0.71%) to 17,732.6.
  • The 10-year Treasury note yield climbed nine basis points to 4.38%.
  • The CBOE Volatility Index® (VIX) moved up slightly to 12.43.

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Nearly 200 people have been charged for their roles in various health care fraud schemes across the U.S. that federal authorities say amounted to over $2.7 billion in intended losses, the Justice Department announced. Attorney General Merrick Garland said charges against 193 people, including 76 doctors, nurse practitioners, and other licensed medical professionals in 32 different federal districts. The defendants were charged over a two-week sweep involving numerous law enforcement agencies nationwide, resulting in the seizure of more than “$231 million in cash, luxury vehicles, gold, and other assets,” according to Garland.

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DAILY UPDATE: Tenet, Rivian, Yen, Public Companies and the Light Stock Markets

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Stat: 40%. That’s how much Tenet Healthcare’s shares jumped in Q1. (Yahoo Finance)

Stat: 12%. This is how much the yen has weakened so far this year against the US dollar, which has people wondering whether the Japanese government will need to intervene. (Bloomberg)

Quote: “We believe the opportunity ahead is significant.”—RJ Scaringe, CEO and co-founder of Rivian, commenting on Volkswagen Group’s plans to invest as much as $5 billion in the EV company. (CNBC)

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What’s up

  • McCormick & Co rose 4.34% after the company posted spicy earnings results, absolutely crushing estimates.
  • Arista Networks rose 3.92% after Citigroup reiterated its buy rating for the cloud company but increased its price target from $330 to $385.
  • BlackBerry is still a company, and rose 10.41% after a berry good first quarter.

What’s down

  • Walgreens Boots Alliance plummeted 22.16% due to a worse-than-expected earnings report that saw the company slash its full-year guidance.
  • Hims & Hers dropped 7.19% after Hunter Growth Capital accused the company of using a shady supplier for its new weight-loss drugs.
  • Levi Strauss crashed 15.27% in a denim downfall for the ages, with second quarter earnings missing expectations after consumers spent less on blue jeans.
  • Micron Technology slid 7.12% despite beating analyst expectations in the third quarter. Unfortunately, management isn’t as bullish as analysts about the rest of the year.
  • Chewy fell 0.03% despite a tweet from Roaring Kitty of a cartoon dog—which is apparently all it takes to move markets these days.

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The U.S. government’s final gross domestic product (GDP) estimate announced early Thursday included a downward revision to quarterly consumer spending.

Treasury yields could move on the data, especially if the report is “hotter” than expected. Yields fell Thursday following mostly soft U.S. economic readings this morning.

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 4.97 points (0.1%) to 5,482.87; the Dow Jones Industrial Average® ($DJI) rose 36.26 points (0.1%) to 39,164.06; the NASDAQ Composite® ($COMP) rose 53.53 points (0.3%) to 17,858.68.
  • The 10-year Treasury note yield lost two basis points to 4.29%.
  • The CBOE Volatility Index® (VIX) fell to 12.29, its lowest close since June 13.

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DAILY UPDATE: MSFT Teams, Deloitte, HealthcCare Cyber Attacks as Markets Lift

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The EU says Microsoft violated its antitrust laws by bundling Teams with Office, potentially setting the stage for a major fine.

And, Deloitte has billions of dollars’ worth of Medicaid contracts, but the consultancy’s eligibility systems are full of errors. (KFF Health News)

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Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 8.6 points (0.16%) to 5,477.9; the Dow Jones Industrial Average® ($DJI) added 15.64 points (0.04%) to 39,127.8; the NASDAQ Composite® ($COMP) climbed 87.5 points (0.49%) to 17,805.16.
  • The 10-year Treasury note yield rose 8 points to 4.32%.
  • The CBOE Volatility Index® (VIX) eased to 12.5

What’s up

What’s down

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The disastrous ransomware attacks on Change Healthcare and Ascension this year ran up staggering costs and put a spotlight on the healthcare sector’s vulnerability. But healthcare orgs are hardly new to eye-popping bills after a major hack. Analyzing attacks on organizations in 16 countries, IBM/Ponemon Institute has shown healthcare to be the industry with the highest cost per data breach for over a decade, coming in at an average hit of $10.93 million in 2023.

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DAILY UPDATE: Gun Violence, Health & Public Companies as Technology Stocks Rebound

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The U.S. surgeon general just declared gun violence a public health crisis, driven by the fast-growing number of injuries and deaths involving firearms in the country. The advisory issued by Dr. Vivek Murthy, the nation’s top doctor, came as the U.S. grappled with another summer weekend marked by mass shootings that left dozens of people dead or wounded.

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 21.43 points (0.39%) to 5,469.30; the Dow Jones Industrial Average® ($DJI) fell 299.05 points (0.76%) to 39,112.6; the NASDAQ Composite® ($COMP) gained 220.84 points (1.26%) to 17,717.65.
  • The 10-year Treasury note yield (TNX) fell slightly to 4.24%.
  • The CBOE Volatility Index® (VIX) dropped to 12.84. 

What’s up

  • Nvidia rose 6.76% as investors realized they could buy shares of the world’s biggest semiconductor company at a discounted price.
  • Trump Media & Technology Group rose another 8.50% today on the hopes of a cash infusion, as well as hype ahead of Thursday’s presidential debate.
  • Carnival popped 8.85% after it beat analyst expectations for the second quarter, and raised its profit forecast for the rest of the year.
  • Novo Nordisk rose 3.25% after its weight-loss drug Wegovy was approved in China.
  • Enovix soared 35.05% on the news that it signed a major deal to provide VR headset batteries for an as-yet-unnamed California company.

What’s down

  • Pool Corp., maker of…pools, fell 8.04% today after cutting guidance for the year ahead.
  • SolarEdge Technologies dropped 20.60% through no fault of its own—instead, a key customer declared bankruptcy, and will be unable to pay the solar power company the $11.4 million it is owed.
  • Airbus fell 9.41% after the company announced it is cutting financial guidance for the remainder of 2024 thanks to supply chain snarls and higher costs.
  • Auto dealer stocks continue to suffer the effects of a massive cyberattack on CDK, a key supplier of dealership management software. The company says its systems will remain down until June 30, but in the meantime shares of Autonation fell 2.04%, Sonic Automotive dropped 2.56%, and Group 1 Automotive slid 2.49%.

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Digital health company Sharecare has agreed to be acquired by private equity firm Altaris for $1.43 in cash per share, or about $518 million.


Nearly three months after Kaiser Permanente’s Risant Health acquired Geisinger Health, the group has now agreed to terms with Cone Health in North Carolina.


And ... UnitedHealthcare says its Surest unit improves spending and utilization across all age groups and for people with various conditions.

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DAILY UPDATE: Dental Staffing, Various Companies & the Stock Markets

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Here’s where the major benchmarks ended:

  • The S&P 500 index lost 16.75 points (0.31%) to 5,447.87; the Dow Jones Industrial Average ($DJI) gained 260.88 points (0.67%) to 39,411.21; the NASDAQ Composite ($COMP) dropped 192.54 points (1.09%) to 17,496.82.
  • The 10-year Treasury note yield (TNX) fell one basis point to 4.25%.
  • The CBOE Volatility Index® (VIX) ended slightly up at 13.47, the highest close since May 30.

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What’s up

What’s down

  • Nvidia dropped 6.68% as the semiconductor stock continues to fall, with the stock entering correction territory earlier today—a sentence we never thought we’d write.
  • Eli Lilly’s weight-loss drug Zepbound can also help people with sleep apnea, cutting into the sleep-aid market, sending shares of ResMed down 11.40% and Inspire Medical Systems down 16.45% on the news.
  • Bitcoin-connected stocks are taking a hit as the crypto selloff continues. Coinbase Global fell 6%, while MicroStrategy fell 7.52%.

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The dental industrylike other parts of healthcare—is facing significant staffing challenges. The US is in need of nearly 10,000 dental professionals and has more than 6,800 health professional shortage areas (HPSAs), which the US Department of Health and Human Services defines as “a geographic area, population, or facility with a shortage of primary care, dental, or mental health providers and services.”

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DAILY UPDATE: Genome Testing, the Stock Markets and Microsoft, Apple & Meta

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Apple and Meta are considering an AI partnership. The two tech giants are discussing integrating Meta’s generative AI model into Apple’s new AI platform, Apple Intelligence, the WSJ reports. Instead of building an in-house AI model, Apple opted for the partnership route and previously announced a deal with OpenAI to bring ChatGPT to iPhones. Apple has also reportedly held talks with AI startups Anthropic and Perplexity to fuse their AI models with Apple Intelligence and get that sweet, sweet distribution Apple provides.

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Genome testing can spot rare disease risks at birth. Newborn babies typically get blood tested for dozens of diseases, but some parents living in North Carolina and New York have recently been able to get their bundles of joy screened for hundreds of potentially life-threatening medical conditions that regular tests can’t catch thanks to a growing field called genomic medicine. Early results from two ongoing studies are very promising, the Washington Post reported, but scaling the new type of testing could be tricky: A full genome read (which covers all of your DNA) costs around $1,000 per patient. Still, research into the cost-benefit of genome sequencing has found that it can ultimately save families money on hospital care.

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Markets: Sweating the upcoming election? Investors aren’t. The S&P 500 is on track for its best first-half performance in an election year going back to 1976, per Dow Jones Market Data. And as trading begins Monday morning, Microsoft is back on the Iron Throne as the US’ most valuable company following Nvidia’s stumbles at the end of last week.

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BANKS: Eight Types; plus 1

DOCTORS NEED TO KNOW

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By Dr. David Edward Marcinko MBA MEd CMP

A general understanding of these bank types is suggested for any medical professional prior to launching a self-directed [ME, Inc] medical practice, clinic, guided investment strategy, personal financial plan or wealth building portfolio effort; etc.

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DAILY UPDATE: Reverse Aging, Credit Card Competition Act, Nvidia and a Market Re-Cap

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The de-aging biz: Time to pull back the hospital curtain and see who’s behind the booming longevity market. This article, sponsored by Timeline, lays out who’s making $$$ on “reverse aging.*

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  • The S&P 500 and NASDAQ have often outperformed the Dow in recent years thanks to their focus on tech, as well as their market-cap weighting vs the Dow’s price weighting. When tech stocks roar higher, the younger indexes rise above their older peer—but the last few days have seen a sell off of tech stocks led by NVIDIA, bringing the S&P 500 and NASDAQ lower to end the week while the Dow has continued to rise.
  • Bonds remained unchanged for most of the day, ending the trading session flat as investors parse through a week of economic data and prepare for next week’s PCE report.
  • Gold plunged after the dollar rose, making it more expensive for gold bugs to hold the precious metal.
  • As for oil, read on to learn why crude has high hopes today but may not be a smart investment tomorrow.

Nvidia faltered for the second day in a row, falling off the world’s most valuable company perch and shedding $220+ billion in market cap. But the S&P 500 has gone 377 days without a 2.05% sell-off, the longest streak since the 2008 financial crisis, per CNBC.

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The Credit Card Competition Act is proposed legislation in Congress that could fundamentally change credit card systems. If passed, it could devastate the future of cash-back and travel rewards.

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17 Math Equations that Changed the World

How many do you know?

via Ian Stewart

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[Click image to enlarge]

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Editor’s Note:

I have a bit of math background in algebra, geometry and trigonometry as well as integral and differential calculus, and parametric and non-parametric statistics.  So, this ME-P was a no-brainer. Enjoy with thanks to Ian.

So, how many equations do you know? Please tell us?

Dr. David E. Marcinko MBA MEd CMP

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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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DAILY UPDATE: Amazon Pharmacy, Healthcare Spending Boom, Companies and the Bi-Hybrid Markets

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Amazon Pharmacy announced on June 18 that, effective immediately, its RxPass medication delivery service will be available to more than 50 million Medicare beneficiaries, a move the company says could save up to $2 billion annually for the federal health insurance program.

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Here’s where the major benchmarks ended:

  • The S&P 500 index fell 8.55 points (0.2%) to 5,464.62, up 0.6% for the week; the Dow Jones Industrial Average® ($DJI) gained 15.57 points (0.04%) to 39,150.33, up 1.5% for the week; the NASDAQ Composite® ($COMP) shed 32.23 points (0.2%) to 17,689.36, little changed for the week.
  • The 10-year Treasury note yield (TNX) was little changed at 4.255%.
  • The CBOE Volatility Index® (VIX) dipped 0.06 to 13.22.

What’s up

  • Sarepta Therapeutics soared 30.14% thanks to FDA approval of Elevidys, its new Duchenne muscular dystrophy treatment.
  • Zealand Pharma rose 18.62% after Phase 1b trial results revealed its new weight-loss drug could compete with Ozempic.
  • Asana jumped 14.95% on the news that its board has approved a share repurchase program of up to $150 million of its own stock.
  • CarMax shares rose 0.37% after the company reported first-quarter earnings. The number isn’t big, but the performance is impressive considering the used car company posted a 33% decline in profits.
  • Hertz Global popped 15.95% after the company announced it was raising the size of its bond offering to $1 billion as it looks to update its fleet of rental cars.

What’s down

  • Nvidia fell another 3.22% today as the sell off continued, with investors taking profits after a record run higher.
  • Smith & Wesson Brands dropped 12.87% after the gun maker beat earnings forecasts but announced that next quarter’s sales will be lower than expected.
  • LendingTree slid 2.48% after a Bloomberg report revealed that hackers are auctioning off stolen customer data.
  • Palantir fell 6.78% after the company earned an analyst downgrade for its “gluttonous valuation,” a phrase you never want to hear as an investor.
  • Bitcoin mining stocks took a hit today, selling off after popping higher yesterday after bitcoin prices rallied. Marathon Digital Holdings dropped 7.02%, Riot Platforms fell 8.35%, and CleanSpark sank 9.81%.

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With a record number of people insured and seeking healthcare services post-pandemic, US health spend growth is outpacing GDP growth, and is expected to keep doing so through 2032, according to a June 12 report from actuaries at the Centers for Medicare and Medicaid Services (CMS). By 2032, CMS actuaries project healthcare spending will total $7.7 trillion and make up 19.7% of total US GDP, compared to $4.8 trillion and 17.6% of GDP in 2023.

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DAILY UPDATE: Bilt, Mortgage Rates, Private Equity in Behavioral Health and the Stock Markets

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Wells Fargo is losing $10 million per month on its partnership with Bilt, whose credit card offers users reward points for paying rent, and is looking to renegotiate, the WSJ reports. Apple has stopped offering its buy now, pay later program, Apple Pay Later, after partnering with outside companies, including Affirm.

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Private equity (PE) is all over healthcare, with investment firms owning more than 400 hospitals around the US. But as the country faces a mental health crisis—US Surgeon General Vivek Murthy called it the “the defining public health crisis of our time”—PE has its sights set on one of the fastest-growing areas of the industry: behavioral health care. PE has accounted for over 60% of all behavioral health deal flow since 2018, and firms like Thurston Group and Five Points Capital now own about a quarter of facilities offering behavioral health care in some states, according to a recent cross-sectional study published in JAMA Psychiatry.

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U.S. markets were closed Wednesday for the Juneteenth holiday. Here’s where the major benchmarks ended:

  • The S&P 500 index fell 13.86 points (0.3%) to 5,473.17; the Dow Jones Industrial Average® ($DJI) gained 299.90 points (0.8%) to 39,134.76; the NASDAQ Composite® ($COMP) dropped 140.64 points (0.8%) to 17,721.59.
  • The 10-year Treasury note yield (TNX) climbed about 4 basis points to 4.257%.
  • The CBOE Volatility Index® (VIX) rose 0.80 to 13.28.

What’s up

  • Gilead jumped 8.46% after clinical data revealed that its new twice-a-year shot prevents 100% of HIV cases.
  • Penn Entertainment rose 9.93% on the news that Boyd Gaming has approached its competitor with an acquisition offer.
  • Accenture rose 7.30% after the IT consulting company missed earnings estimates but more than made up for it with bullish bookings data thanks to AI.
  • Darden Restaurants rose 1.53% after a mixed earnings report. Its acquisition of Ruth’s Chris Steak House propped up earnings, while Olive Garden’s same-store sales came in flat, probably because I eat several hundred free breadsticks there every month.

What’s down

  • Trump Media & Technology Group fell 14.56% after the SEC ruled that early shareholders can resell their stock in the company, diluting new shareholders—though providing upward of $247 million in funding for the beleaguered company.
  • Nikola plummeted 31.46% after the company announced a 1-for-30 stock split in a bid to stay listed on the Nasdaq.
  • Kroger fell 3.27% despite beating analyst revenue estimates in its fiscal first quarter as investors digest the chances of the company sealing a deal to buy Albertsons.
  • Tempest Therapeutics dropped 29.47% upon the release of the latest trial data for its liver cancer treatment.
  • Jabil fell 11.45% today after the electronics supplier beat earnings estimates but warned of softer growth in the year ahead.

Mortgage rates fell below 7% last week to their lowest level since March, but this didn’t spur much extra demand.

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What is Your Academic Teaching Philosophy?

 Here is My Teaching Philosophy

[By Dr. David Edward Marcinko MBA, MEd]

Although any learner-centered teaching philosophy, or Boyer Model of scholarship, is constantly in flux, the mission of a public or private educator is: [1] to promote positive learning; [2] to motivate students, staff and graduates; [3] to provide a strong foundation for lifelong learning; and in modernity [4] to enhance career and life-work opportunities; to [5] improve bottom-line financial metrics, and [6] to collaborate on a national and global basis.

However, because we are specifically operating in the rapidly changing healthcare, business management, investing, finance, economics and education milieu, even deeper experiential insight is needed.

Developing NEW Teaching AND Education Skills FOR Business and Healthcare 2.0

Medicine and healthcare business today is different than a generation ago, and all educators and healthcare professionals need new skills to be successful.

Traditionally, the physician – like the classroom professor – was viewed as the “captain of the ship”. Today, their role may be more akin to a ship’s navigator, utilizing clinical, teaching skills and knowledge to chart the patient’s, or student’s, course through a confusing morass of requirements, choices, rules and regulations to achieve the best attainable clinical or didactic outcomes.

This new teaching paradigm includes many classic business school principles, now modified to fit the PP-ACA, the era of health reform, and modern technical connectivity. Thus, a Professor, Chair or Dean must be a subtle guide on the side; not bombastic sage on the stage.

These, newer teaching philosophies must include:

  • Negotiation – working to optimize appropriate curricula, services and materials;
  • Team play – working in concert with others to coordinate education delivery within a clinically appropriate and cost-effective framework;
  • Working within the limits of competence – avoiding the pitfalls of the generalist teacher versus the subject matter expert that may restrict access to professors, texts and facilities by clearly acknowledging when a higher degree of didactic service is needed on behalf of the student;
  • Respecting different cultures and values – inherent in the support of the academic Principle of Autonomy is the acceptance of values that may differ from one’s own. As the US becomes more culturally heterogeneous, educators and medical providers are called upon to work within, and respect, the socio-cultural and/or spiritual framework of patients, students and their families; 
  • Seeking clarity on what constitutes marginal education – within a system of finite resources; providers and professors are called upon to openly communicate with students and patients regarding access to marginal education and/or treatments.
  • Supporting evidence-based practice – educators, like healthcare providers, should utilize outcomes data to reduce variation in treatments and curriculum to achieve higher academic efficiencies and improved care delivery;
  • Fostering transparency and openness in communications – teachers and healthcare professionals should be willing, and prepared, to discuss all aspects of care and academic andragogy; especially when disclosing problems or issues that arise;
  • Exercising decision-making flexibility – treatment algorithms, templates and teaching pathways are useful tools when used within their scope; but providers and professors must have the authority to adjust the plan if circumstances warrant;
  • Becoming skilled in the art of listening and interpretingIn her ground-breaking book, Narrative Ethics: Honoring the Stories of Illness, Rita Charon, MD PhD, a professor at Columbia University, writes of the extraordinary value of using the patient’s personal story in the treatment plan. She notes that, “medicine practiced with narrative competence will more ably recognize patients and diseases; convey knowledge and regard, join humbly with colleagues, and accompany patients and their families through ordeals of illness.” In many ways, attention to narrative returns medicine full circle to the compassionate and caring foundations of the patient-physician relationship. The educational analog to this book is, The Ethics of Teaching [A Casebook], co-edited by my teacher and colleague Deborah Ware Balogh PhD of the University of Indianapolis.

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Assessment

Finally, these thoughts represent only a handful of examples to illustrate the myriad of new skills that tomorrow’s healthcare professionals, and modern educators, must master in order to meet their timeless professional obligations of compassionate patient care and contemporary teaching effectiveness.

Dr. Marcinko Teaching Philosophy

CHAIR: Chair 3.0 Philosophy Dr. Marcinko

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Product DetailsProduct Details

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DAILY UPDATE: Nvidia, Golden Goose and the Summer Solstice

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HAPPY SUMMER SOLSTICE

Today is the first day of summer in the Northern Hemisphere, aka summer solstice. It’s also the longest day of the year.

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The markets were closed yesterday for Juneteenth, but they’ll be back today to see if they can keep their hot streak going.

But, the company known for selling shoes that look like they’ve been dragged through mud postponed its IPO, putting a pause on what has been a big year for European companies going public. Golden Goose announced Tuesday it wouldn’t go public in Milan on Friday as planned due to fraught market conditions in Europe stemming from parliamentary elections across the Continent.

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Nvidia is now the most valuable company in the world. The chipmaker passed Microsoft to become the world’s most valuable public company, topping $3.3 trillion in market cap. Earlier this month, it reached the $3 trillion mark for the first time, flying past Apple for second place. The AI boom has propelled Nvidia—which owns about 80% of the industry’s data center chip market—to new heights, enriching investors and CEO Jensen Huang along the way. Huang has added nearly $100 billion to his net worth in less than two years, making him the 13th richest person in the world as of June.

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VENTURE CAPITAL FUNDING: Digital Health Space

Investment Banking

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Venture capital funding in the digital health space cooled a bit in 2022 following a red-hot 2021. Overall, digital health companies raised $15.3 billion last year, down from the $29.1 billion raised in 2021—but still above the $14.1 billion raised in 2020, according to Rock Health a seed fund that supports digital health startups.

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Nevertheless, analysts predict VC investors and IBs will still put a good amount of money into digital health in 2024 and 2025, especially in alternative care, drug development, health information technology, artificial intelligence, EMRs and software that reduces physician workload.

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Of course. an essential first part of attracting VC interest and IB money is the crafting and presentation of your formal business plan [“pitch”] ; as well as the needed technical and managerial experience. This is crucial for success and exactly where we can assist.

READ MORE: investment-banking

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DAILY UPDATE: Wells Fargo, Public Companies as Stock Markets Extend Rally

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Wells Fargo is losing $10 million per month on its partnership with Bilt, whose credit card offers users reward points for paying rent, and is looking to renegotiate, the WSJ reports. Apple has stopped offering its buy now, pay later program, Apple Pay Later, after partnering with outside companies, including Affirm.

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Here’s where the major benchmarks ended:

  • The S&P 500 index gained 13.80 points (0.3%) to 5,487.03; the Dow Jones Industrial Average® ($DJI) added 56.76 points (0.2%) to 38,834.86; the NASDAQ Composite® ($COMP) rose 5.21 points (0.03%) to 17,862.23, a record close for the seventh day in a row.
  • The 10-year Treasury note yield (TNX) dipped more than 6 basis points to 4.215%.
  • The CBOE Volatility Index® (VIX) fell 0.45 to 12.30.

What’s up

What’s down

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And … precision medicine company Tempus AI is going public, raising $410.7 million through its initial public offering.

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DAILY UPDATE: Microsoft & Google Cyber Security Discounts as Stock Markets Rally

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  • Microsoft. According to a same-day announcement on its site, the company will give “nonprofit pricing and discounts for its security products optimized for smaller organizations, providing up to a 75% discount,” along with free cybersecurity training, assessments, and—for at least one year, the company says—Windows 10 security updates.
  • Google. The White House said that Google will “provide endpoint security advice to rural hospitals and nonprofit organizations at no cost,” as well as a pilot program designed to help rural facilities “develop a packaging of security capabilities that fit these hospitals’ unique needs.”

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What’s up

What’s down

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Here’s where the major benchmarks ended:

  • The S&P 500 index gained 41.63 points (0.8%) to 5,473.23; the Dow Jones Industrial Average® ($DJI) added 188.94 points (0.5%) to 38,778.10; the NASDAQ Composite advanced 168.14 points (1.0%) to 17,857.02.
  • The 10-year Treasury note yield (TNX) rose more than 6 basis points to 4.279%.
  • The CBOE Volatility Index® (VIX) increased 0.10 to 12.76.

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DAILY UPDATE: Done Global TeleHealth

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The NASDAQ nabbed its fifth-straight record close last week, and the S&P 500 snapped its four-day streak. Both were up for the week as investors digested data that showed inflation cooling. Adobe became the latest company to soar thanks to AI, spiking after delivering better-than-expected earnings and forecasts.

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Those who rely on ADHD medication got some bad news last week when the CDC issued a health advisory alerting patients that there may be possible “increased risks for injury and overdose,” after two executives at Done Global, a telehealth company, were arrested for fraud linked to allegedly selling Adderall over the internet. The CDC warned that as many as 30,000 to 50,000 adult patients could be affected. https://tinyurl.com/3rf5py6c

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DAILY UPDATE: Father’s Day, Medical Debt and USAA

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HAPPY FATHER’S DAY

News 4 in San Antonio Texas organized a video call with several USAA members who lost funds due to fraud — and have been left with little to no recourse. Some of them also belong to the Facebook group, USAA Fraud and Victims, which has 2,900 members. A few USAA members even reported being asked by the institution to cover the negative balances on their accounts after their money was stolen.

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The race to a $3 trillion market cap seemed like it would always be between Apple and Microsoft. But over the last twelve months, Nvidia has come roaring to the front of the pack, neck and neck with the big tech incumbents. In the last two weeks alone it has replaced Apple in the #2 spot, only to be supplanted earlier this week when Apple’s AI plans propelled it back ahead. Now, it’s anybody’s race to the next big benchmark: a $4 trillion market cap.

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In a move that could be good for patients but bad for hospitals, the Consumer Financial Protection Bureau (CFPB) on Tuesday proposed regulation that would wipe medical debt from many consumers’ credit reports. The rule is meant to help the 15 million people in the US who creditors say still have a combined $49 billion of medical debt that negatively affects their credit scores, Rohit Chopra, director of the CFPB, said during a June 11 press briefing. About 100 million people in the US have some amount of medical debt, which totals roughly $220 billion, according to data from the Peterson-KFF Health System Tracker. The proposed regulation comes after three credit-reporting conglomeratesEquifax, Experian, and TransUnion—removed paid-off medical debt and medical debts under $500 from credit reports in 2022 and 2023, respectively.

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DAILY UPDATE: Sat Healthcare Private Equity, Elder Abuse Awareness Day

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Quote: “​​When private equity gets hold of healthcare systems, it is literally a matter of life and death, so if you drive a hospital like Steward into bankruptcy, putting patients and communities at risk, you should face real consequences.”—Sen. Elizabeth Warren on a proposed federal bill to impose jail time on executives who “loot” health systems, leading to patient harm (Fierce Healthcare)

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Here’s where the major benchmarks ended:

  • The S&P 500 index fell 2.14 points (0.04%) to 5,431.60, up 1.6% for the week; the Dow Jones Industrial Average® ($DJI) lost 57.94 points (0.2%) to 38,589.16, down 0.5% for the week; the NASDAQ Composite gained 21.32 points (0.1%) to 17,688.88, up 3.2% for the week.
  • The 10-year Treasury note yield (TNX) fell more than 2 basis points to 4.215%, after earlier dropping under 4.19%, its lowest since late March.
  • The CBOE Volatility Index® (VIX) rose 0.72 to 12.66.

What’s up

  • Adobe soared 14.51% today after crushing analyst expectations when it announced earnings late yesterday.
  • Shopify rose 4.59% after it received yet another analyst upgrade. JPMorgan analysts gave the stock an overweight rating on June 11, while today Evercore analysts upgraded the company to outperform.
  • Hasbro popped 6% after the toy maker earned an upgrade to “buy” from Bank of America predicated on the company’s digital gaming strategy.

What’s down

  • Cruise stocks took a major blow today after a Bank of America report revealed that there was softer-than-expected pricing across the industry in May. Carnival fell 7.09%, Norwegian Cruise Line dropped 7.43%, and Royal Caribbean fell 4.35%.
  • RH plummeted 17% after the furniture maker reported a larger-than-expected loss in the previous quarter.
  • Stellantis fell 4.08% after the company’s CEO announced it will cut costs to compete with Chinese EV makers.
  • Penn Entertainment sank 8.66% on the news that competitor Boyd Gaming has voted in an M&A expert to its board of directors, which, combined with activist investors pushing Penn to put itself up for sale, could indicate an acquisition ahead.

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June 15th marks an important day on our calendar – Elder Abuse Awareness Day. It is a day for communities worldwide to unite in bringing attention to the challenges and difficulties faced by elders and our collective responsibility to protect and support them.

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DAILY UPDATE: Flag Day, KKR, Wells Fargo and the S&P 500

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HAPPY FLAG DAY

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Wells Fargo found that some of its employees were pretending to work — and sent them packing. More than a dozen employees in the bank’s wealth and investment management divisions were discharged last month “after review of allegations involving simulation of keyboard activity creating impression of active work,” Bloomberg reported citing disclosures filed with the Financial Industry Regulatory Authority (FINRA).

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Here’s where the major benchmarks ended:

  • The S&P 500 index gained 12.71 points (0.2%) to 5,433.74; the Dow Jones Industrial Average lost 65.11 points (0.2%) to 38,647.10; the NASDAQ Composite rose 59.12 points (0.3%) to 17,66756.
  • The 10-year Treasury note yield (TNX) fell about 5 basis points to 4.246%.
  • The CBOE Volatility Index® (VIX) declined 0.10 to 11.94.

What’s up

What’s down

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On Monday, private equity giant KKR jumped 12% after S&P Dow Jones Indices announced the company would be joining the index yesterday, along with CrowdStrike and GoDaddy, which saw their stocks jump 9% and 2%, respectively. The additions will be incorporated June 24.

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DAILY UPDATE: Moody, CME Fedwatch and Ever Rising Stock Markets

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On Monday, private equity giant KKR jumped 12% after S&P Dow Jones Indices announced the company would be joining the index on Friday, along with CrowdStrike and GoDaddy, which saw their stocks jump 9% and 2%, respectively. The additions will be incorporated June 24.

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Stat: 99.4%. That’s the likelihood that interest rates will stay the same after the Fed’s meeting, according to the CME Fedwatch Tool. So it looks to be more “hurry up and wait” for interest rates to start coming down. 🫤 (Business Insider)

Quote: “It’s hard to think of a time when the US economy has diverged so fundamentally from its peers.”—Mark Zandi, chief economist at Moody’s Analytics, on the strength of the US economy compared to the weakness of other major economies. The US economy is continuing to grow while economies like Germany, Japan, and Canada are falling into recession. (The Atlantic)

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 45.71 points (0.9%) to 5,421.03; the Dow Jones Industrial Average  lost 35.21 points (0.1%) to 38,712.21; the NASDAQ Composite gained 264.89 points (1.5%) to 17,608.44.
  • The 10-year Treasury note yield (TNX) fell more than 7 basis points to 4.326%.
  • The CBOE Volatility Index® (VIX) declined 0.81 to  12.04.

What’s up

What’s down

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DAILY UPDATE: Apple AI, Addus HomeCare, Waystar and the Rising Markets

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Here’s where the major benchmarks ended:

  • The S&P 500 index rose 14.53 points (0.3%) to 5,375.32; the Dow Jones Industrial Average® ($DJI) declined 120.62 points (0.3%) to 38,747.42; the NASDAQ Composite gained 151.02 points (0.9%) to 17,343.55.
  • The 10-year Treasury note yield (TNX) fell about 7 basis points to 4.398%.
  • The CBOE Volatility Index® (VIX) rose 0.13 to 12.87.

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

What’s up

  • Apple shares rose 7.26%, hitting a new all-time high on hopes that the company’s AI innovations can make up for lost ground. Today’s surge reaffirmed its position as the second-largest publicly traded company in the US, retaking the #2 spot from Nvidia.
  • Affirm popped 11.04% as Apple’s newest partner, with its buy-now-pay-later loans to be embedded in Apple Pay.
  • FMC Corp rose 4% on the news that its president and CEO has stepped down. It can’t feel good when your company’s stock rises after you announce you’re leaving.
  • Calavo Growers was up 8.24% after the avocado producer announced strong second quarter results thanks to high avocado prices. Those darn millennials eating their avocado toast strike again!

What’s down

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The “A” in AI stands for Apple, the techies attending Apple’s annual Worldwide Developers Conference (WWDC) were told yesterday. CEO Tim Cook and Co. unveiled Apple Intelligence, a host of AI-powered features that will debut on iPhones, iPads, and Macs this fall.

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Addus HomeCare is making a major move to expand its business with plans to buy Gentiva’s personal care business for $350 million.


Healthcare payment software maker Waystar debuted on the public market Friday, raising $967.5 million, and marking the biggest health tech IPO since 2022. The company plans on paying off existing debt.

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DAILY UPDATE: Tele-Health, Fortune 500, Companies and the Stocks Markets

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The end has come for the Covid-19-era federal Affordable Connectivity Program, which some critics say will make telehealth access challenging for millions in rural and tribal areas. (NPR/KFF Health News)

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Here’s where the major benchmarks ended yesterday:

  • The S&P 500 index rose 13.80 points (0.3%) to 5,360.79; the Dow Jones Industrial Average® ($DJI) gained 69.05 points (0.2%) to 38,868.04; the NASDAQ Composite added 59.40 points (0.4%) to 17,192.53.
  • The 10-year Treasury note yield (TNX) rose almost 4 basis points to 4.467%.
  • The CBOE Volatility Index® (VIX) rose 0.52 to 12.74.

What’s up

  • Diamond Offshore Drilling rose 10.91% after fellow offshore drilling company Noble Corp. announced it would acquire Diamond in a cash and stock deal worth $1.6 billion total. Noble shares rose 6.08% on the news as well.
  • Crowdstrike, GoDaddy, and KKR will be added to the S&P 500 when the index rebalances at the end of the quarter. Crowdstrike rose 7.29%, GoDaddy rose 1.94%, and KKR was up 11.22% on the news.
  • Texas Pacific Land Corporation shares also rose 24.57% on the news that the company will be inducted into the S&P MidCap 400.

What’s down

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Stat: 42. That’s how many healthcare industry companies were named on the latest Fortune 500, which lists the largest corporations in the US based on revenue for fiscal year 2023. (Advisory Board)

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MUTUAL FUNDS: Terms and Definitions for Physicians

A “Need-to-Know” Glossary for all Medical Professionals

http://www.HealthDictionarySeries.org

HDS

[ME-P Staff Writers] 

ADV: A two-part form filed by investment advisors who register with the Securities and Exchange Commission (SEC), as required under the Investment Advisers Act. ADV Part II information must be provided to potential investors and made available to current investors.

Alpha: A measure of the amount of a portfolio’s expected return that is not related to the portfolio’s sensitivity to market volatility. A benchmark that uses beta as a measure of risk, a benchmark and a risk free rate of return (usually T-bills) to compare actual performance with expected performance.

For example, a fund with a beta of .80 in a market that rises 10% is expected to rise 8%.

If the risk-free return is 3%, the alpha would be –.6%, calculated as follows: (Fund return – Risk-free return) – (Beta x Excess return) = Alpha   (8% – 3%) – [.8 × (10% – 3%)] = (–) .6%   

Note: A positive alpha indicates out-performance while a negative alpha means underperformance. 

Asset allocation: Strategic asset allocation refers to the long-term targets for allocation of a percentage of a portfolio among different asset classes. In contrast, tactical asset allocation refers to short-term targets.

Average maturity: The average weighted maturity of the bonds in a portfolio providing an indication of interest rate risk.

Benchmark: An index, managed portfolio, or fund used to compare performance characteristics with the targeted portfolio or fund.

Beta: A statistically computed measure of the portfolio’s relationship to changes in market value. If, compared to the S&P 500, a fund has a beta of .80; it is expected to under perform a rising market by 20% and outperform a falling market by 20%. 

Bond: Publicly traded debt instruments that are issued by governments and corporations. The issuer agrees to pay a fixed amount of interest over a specified time period and to repay the principal at maturity.

Closed-end mutual fund: An investment company that registers shares in accordance with SEC regulations and is traded in securities markets at prices determined by investments. 

Diversification: Buying a number of different investment vehicles to protect against default of a single vehicle, thereby reducing the risk of the portfolio.

Duration: A more technical calculation of interest rate risk exposure that uses the present value of expected cash flows to be returned to the bond holder over the term of the bond. 

Fundamental analysis: An analysis of a company’s stock that focuses on the economic environment, the industry the company is in, and the company’s financial situation and operating results.

Mutual fund: A regulated investment company that manages a portfolio of securities for its shareholders.

Net asset value (NAV): The value of fund assets fewer liabilities divided by outstanding shares. 

Open-end mutual fund: An investment company that invests money in accordance with specific objectives on behalf of investors. Fund assets expand or contract based on investment performance, new investments and redemptions.

Portfolio manager: The person(s) who is/are responsible for managing the portfolio in accordance with the objectives dictated by an investor or a fund’s prospectus.

Prospectus: A disclosure document filed with the SEC and made available to prospective and current investors. The prospectus covers sales charges, expenses, investment objectives and restrictions, management fees, financial highlights, and other information. 

R-squared (R2): Relationship of a fund or portfolio’s performance to a benchmark index.

For example, a fund R-squared of .5 means only 50% of its return is explained by the index. Other factors are responsible for the balance of performance. 

SEC yield: A standardized calculation of yield over a 30-day period, sometimes quoted as the “30-day yield.” It takes into account yield-to-maturity rather than current dividends. 

Standard deviation: A statistic that looks at a series of returns and expresses the average deviation from the mean return.

Statement of additional information: A disclosure document filed with the SEC that supplements the prospectus. It is made available to investors upon request. 

Technical analysis: An analysis that focuses on trends in financial markets generally.

For example, a technical analyst may view an entire industry’s group of stocks to be declining. Although the analyst may be correct about the group of stocks as a whole, there may be exceptions represented by specific, individual companies.

Total return: The combination of investment return from income, such as dividends and interest, and appreciation or depreciation in the value of the investment (Income returns plus capital return.) 

Turnover: Under SEC rules, a figure computed that indicates how often securities in the portfolio are bought and sold. For example, if turnover is 100% over a one-year period, the securities (on average) were replaced once. 

12b-1 fee: The maximum annual fee payable from fund assets for distribution and sales costs as allowed by the SEC. 

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DAILY UPDATE: Markets, Cue Health Down, Blue Kansas Part C and the FOMC

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Markets: Stocks dropped ever so slightly to end last week as investors tried to make sense of the big jobs report. Lots of jobs = good, but lots of jobs also = interest rates likely staying the same for awhile longer (more below). AMC had a rough day, tumbling 15% as the latest meme stock craze started to fizzle.

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Blue Kansas City Exiting MA Market by 2025 Due to ‘Regulatory Demands’

Blue Cross and Blue Shield of Kansas City (Blue KC) is leaving the Medicare Advantage (MA) market at the end of 2024, the insurer announced recently. The company blamed “heightened regulatory demands and rising market and financial pressures” for the decision but said it is still focused on employer-sponsored health plans, and Medicare supplement and Affordable Care Act plans in the state.

“We explored every alternative path for our MA members and are disappointed we must exit this line of business,” said Erin Stucky, Blue KC President and CEO, in a statement. “We value our MA members and are committed to providing uninterrupted, quality service to our current MA membership through the end of 2024.”

Source: Noah Tong, Fierce Healthcare [6/3/24]

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Cue Health, founded in 2010, started with great hopes as it promised a way to accurately test for Covid-19 without needing a lab. “We designed and developed a new molecular testing platform bringing lab complexity to an easy-to-use, portable device. Now you can get the best of lab molecular testing — speed, accuracy, and versatility – at home, the office, or on the go,” the company shared on its website. The company went public (with the ticker  (HLTH) ) in 2021 at $16 and rose to $20.55 and carried that massive $2.3 billion valuation. Through 2023 and into this year, Cue unsuccessfully tried to shore up operations, get new products to market, and find new capital.

In May, however, the FDA advised customers not to use two of its products at all because they did not deliver accurate results. Finally, its board and executives threw in the towel. On May 28th, the company announced it was ceasing operations and filed for bankruptcy in Delaware’s U.S. Bankruptcy Court. The company’s assets will be sold off at an undetermined date, and the proceeds will be distributed to creditors.       

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Inflation data from the Fed meeting on Wednesday: Inflation data for May arrives in the morning, and it’s expected to show price growth held steady at 3.4% annually. In the afternoon, the FOMC will wrap up its meeting with a Jerome Powell press conference. The Fed is pretty much a lock to hold interest rates at their current level.

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DAILY UPDATE: Payroll Jobs and Longevity Up

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People whose job it is to watch the economy are shocked at how many jobs the economy added last month: Payrolls added 272,000 more jobs in May, according to employer stats the government dropped yesterday, vastly exceeding the 190,000 increase that analysts predicted.

  • The biggest job gains were in healthcare (68k jobs), government (43k), and hospitality (42k).
  • The average hourly pay increased by 0.4% from the previous month and 4.1% over the year, also exceeding analysts’ predictions.

The surprisingly strong employment gains are prompting some head-scratching since they come amid slowing economic growth as consumers pull back on spending. The job market’s resilience has dashed hopes among investors and anyone planning to take out a loan that the Fed will lower interest rates soon. For example:

  • The unemployment rate ticked up to 4% from 3.9% in April, breaking its historic streak of 27 months under 4%.
  • A survey of households revealed that the number of Americans working dropped by 408,000 from April to May.

Some economists claim the household survey fails to properly account for immigrant workers, who have been the main driver of working population growth in recent years. But others say it checks out given the general cool-down vibes in the labor market: Job openings were at a three-year low in April, and many recent college grads have struggled to find work.

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While some companies would be thrilled if everyone started living to 120, it could spell trouble for the rest of us. Experts believe that centenarians becoming anything more than an anomaly would put the world in an economic pickle and require a societal overhaul to adapt. Even without futuristic tech that enables ultra-longevity, many developed countries are already in an economic bind due to aging populations and declining birth rates. The US Census Bureau projects that people older than 64 will reach 23% of the population by 2060 (compared to 17% in 2020), which means higher retirement and healthcare costs with fewer workers to offset them.

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DAILY UPDATE: Companies and Stocks Dip as Job Growth Rises

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Bank of America analysts recently looked back at the last 100 years of stock market data, searching for asset bubbles and what indicated their approach. The nine historical bubbles they found all had one thing in common ahead of their bursting: rising volatility. But, right now the Volatility Index, or VIX, is nowhere near the highs seen before the dot-com bubble burst, which should soothe investor concerns.

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What’s up

  • Jazz Pharmaceuticals rose 5.39% today thanks to RBC Capital reiterating its outperform rating of the stock, highlighting the potential of the company’s forthcoming essential tremor treatment.
  • CarGurus popped 4.05% after receiving a shiny new outperform rating from JMP Securities, which likes the company’s online marketplace business model.
  • Las Vegas Sands rose 3.11% today on no particular news, as did Cedar Fair, which rose 3.27%. Both are beneficiaries of the vacation season, and likely enjoyed a boost today due to nothing more than the fact that it was a sunny summer Friday.

What’s down

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Here’s where the major benchmarks ended:

  • The S&P 500 index declined 5.97 points (0.1%) to 5,346.99, up 1.3% for the week; the Dow Jones Industrial Average® ($DJI) lost 87.18 points (0.2%) to 38,798.99, up 0.3% for the week; the NASDAQ Composite® ($COMP) shed 39.99 points (0.2%) to 17,133.13, up 2.4% for the week.
  • The 10-year Treasury note yield (TNX) jumped about 15 basis points to 4.432%.
  • The CBOE Volatility Index® (VIX) fell 0.36 to 12.22.

Interest-rate-sensitive sectors including banking, real estate, and utilities were among this week’s poorest performers amid expectations the Fed is unlikely to lower rates from historically high levels. The Dow Jones Utility Average ($DJU) dropped 2.8% this week. Retailers also posted a down week. Semiconductors still clocked a firm week despite declines the past two days. The PHLX Semiconductor Index (SOX) advanced 3.2% for the week. 

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STOCK SPLITS: A Vital Equity Investing Concept for Physicians and all Investors

By Dr. David Edward Marcinko MBA MEd CMP™

SPONSOR: http://www.CertifiedMedicalPlanner.org

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One important equity concept that medical professionals should be aware of is the idea of stock splits.

In a stock split, a corporation issues a set number of shares in exchange for each share held by share holders. Typically, a stock split increases the number of shares owned by a shareholder.

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For example, XYZ Corp. may declare a 2-for-1 split, which means that share holders will receive two shares for each share that they own. However, corporations can also declare a reverse stock split, such as a 1-for-2 split where shareholders would receive 1 share for every two shares that they own.


While stock splits can either increase or decrease the number of shares that a share holder owns, the most important thing to understand about stock splits is that they have no impact on the aggregate value of the shareholder’s position in the company.

Using the XYZ Corp. example above, if the stock is trading at $10 per share, an investor owning 100 shares has a 24 total position of $1,000. After the 2-for-1 split occurs the investor will now own 200 shares, but the value of the stock will adjust downward from $10 per share to $5 per share.

Thus, the investor still owns $1,000 of XYZ stock. While stock splits are often interpreted as signals from management that conditions in the company are strong, there is no intrinsic reason that a stock split will result in subsequent stock appreciation.

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Walking Doctors Through a Stock Exchange Trade

Understanding the Traditional Process

By Dr. David Edward Marcinko MBA MEd CMP

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To see how the transactions are actually handled on the floor of an exchange, let us assume that an order to buy 100 shares of General Electric has been given by a doctor customer to the registered representative (stock broker), of a member firm in Atlanta. The order is a market order (an order to buy at the lowest possible price at the time the order reaches the floor of the exchange). This order is telephoned by direct wire, or computer, to the New York office of the member firm, which in turn telephones its order to its clerk on the floor of the exchange.

Each member firm has at least one member of the exchange representing them making trades on the floor. Each one of these members is assigned a number for identification. When the floor clerk receives the order to purchase the General Electric, he causes his member’s call number to appear on 3 large boards situated so that one is always in view. These boards are constantly watched brokers so that they will know when wanted at the phone, since there’s too much noise on the floor to use a paging system. Seeing his number on the board, the broker hurries to his telephone station or cell phone and receives the order to buy 100 shares of G.E. “at the market”. Acting as a commission broker, he immediately goes to the post where G.E. is traded and asks “how’s G.E”, of the specialist?

Order and Position Types

At this point, it is important to understand the different types of orders and positions that can be used to buy and sell securities from the specialist.

Market Order:

A market order is an order to be executed at the best possible price at the time the order reaches the floor. Market orders are the most common of all orders. The greatest advantage of the market order is speed. The doctor specifies no price in this type of order, he merely orders his broker to sell or buy at the best possible price, regardless of what it may be. The best possible price on a buy is the lowest possible price. The best possible price on a sell is the highest possible price. In other words, if a medical professional customer is buying, he logically wants to pay as little as possible, but he is not going to quibble over price. He wants the stock now, whatever it takes to get it. If he’s a seller, the doctor client wants to receive as much as possible, but will not quibble, he wants out, and will take what he can get, right now. No other type of order can be executed so rapidly. Some market orders are executed in less than one minute from the time the broker phones in the order. Because the investor has specified no price, a market order will always be executed. The doctor is literally saying, “I will pay whatever it takes, or accept whatever is offered”.

Limit Order:

The chief characteristic of a limit order is that the doctor decides in advance on a price at which he decides to trade. He believes that his price is one that will be reached in the market in reasonable time. He is willing to wait to do business until he has obtained his price even at the risk his order may not be executed either in the near future or at all. In the execution of a limit order, the broker is to execute it at the limit price or better. Better, means that a limit order to buy is executed at the customer’s price limit or lower, in a limit order to sell, at price limit or higher. If the broker can obtain a more favorable price for his doctor customer than the one specified, he is required to do so.

Order Length:

Now, even though the doctor has given his price limit, we need to know the length of effectiveness of the order. Is the order good for today only? If so, it is a day order, it automatically expires at the end of the day.  Alternatively, the doctor may enter an open or, “good until canceled” order. This type of order is used when the doctor believes that the fluctuations in the market price of the stock in which he’s interested will be large enough in the future that they will cause the market price to either fall to, or rise to, his desired price, i.e. his limit price. He is reasonably sure of his judgment and is in no hurry to have/his order executed. He knows what he wants to pay or receive and is willing to wait for an indefinite period.

Years ago, such orders were carried for long periods of time without being reconfirmed. This was very unsatisfactory for all parties concerned.  A doctor would frequently forget his order existed and, if the price ever reached his limit and the order was executed, the resulting trade might not be one he wished to make. To avoid the problem, open (GTC) orders must be reconfirmed by the doctor customer each six months. Does that mean six months after the order is entered? … No! The exchange has appointed the last business day of April and the last business day of October as the two dates per year when all open orders must be reconfirmed.

Example: Dr. Smith wants to buy 100 shares of XYZ. The price has been fluctuating between 50 and 55. He places a limit order to buy at 51, although the current market price is 54. Limit orders to buy (buy limit orders) are always placed below the current market. To do otherwise makes no sense. It is possible that, within a reasonable time, the price will drop to 51 and his broker can purchase the stock for him at that price. If the broker can purchase the stock at less that 51, that would certainly be fine with the doctor customer since he wants to pay no more than 51. A sell limit order works in reverse and is always placed above the current market price.

Example: Dr. Smith wants to sell 100 shares of XYZ stock. The order is 54. A sell limit order is place at 56. Sell limit orders are always placed above the market price. As soon as the pride rises to 56, if it ever does, the broker will execute it at 56 or higher. In no case will it be executed at less than 56.

The advantage of the limit order is that the doctor has a chance to buy at less or to sell at more than the current market price prevailing when he placed the order. He assumes that the market price will become more favorable in the future than it is at the time the order is placed. The word” chance ” is important. There is also the “chance” that the order will not be executed at all. The doctor just mentioned, who wanted to buy at 51, may never get his order filled since the price may not fall that low.  If he wanted to sell at 56, the order may also not ever be executed since it might not rise that high during the time period the order is in effect.

Stop Orders:

A very important type of order is the stop order, frequently called a stop-loss order. There are two distinct types of stop orders. One is the stop order to sell, called a sell stop, and the other is a stop order to buy, called a buy stop. Either type might be thought of as a suspended market order; it goes into effect only if the stock reaches or passes through a certain price.

The fact that the market price reaches or goes through the specified stop price does not mean the broker will obtain execution at the exact stop price. It merely means that the order becomes a market order and will be executed at the best possible price thereafter. The price specified on a stop order bears a relationship to the current market price exactly opposite to that on a limit order. Whereas a sell limit is placed at a price above the current market, a sell stop is placed at a price below the current market. Similarly, while a buy limit is placed at a price below the current market, a buy stop is placed at a price above the current market. Why would a doctor investor use a stop order?

There are two established uses for stop orders. One of them might be called protective; the other might be called preventive.

Protective: This order protects a doctors’ existing profit on a stock currently owned.

For example, a doctor purchases a stock at 60. It rises to 70. He has made a paper profit of $10 per share. He realizes that the market may reverse itself. He therefore gives his broker a stop order to sell at 67. If the reversal does occur and the price drops to 67 or less, the order immediately becomes a market order. The stock is disposed of at the best possible price. This may be exactly 67, or it may be slightly above or below that figure. Why? …Because what happened at 67 was that his order became a market order; the price he actually received was dependent upon the next activity in the market. Let us suppose that the sale was made at 66 1/2. The doctor customer made a gross profit of 6 1/2 points per share on his original purchase. Without the stop order, the stock may have dropped considerably below that before the customer could have placed a market order and his profit might have been less or, in fact, he might have even sold at a loss.

Preventive:

A doctor purchases 100 shares of a stock at 30. He obviously anticipates that the price of the stock will rise in the near future (why else would he buy?). However, he realizes that his judgment may be faulty. He therefore, at the time of purchase, places a sell stop order at a price somewhat below his purchase price, for example, at 28. As yet, he has made neither profit nor loss; he’s merely acting to prevent a loss that might follow if he made the wrong bet and the stock does fall in price. If the stock does drop, the doctor knows that once it gets as low as 28, a market order will be turned in for him and, therefore, he will lose only 2 points or thereabout. It might have been much more had he not used the sell stop.

Miscellaneous Orders and Positions

Beside market, limit and stop orders, there are some other miscellaneous orders to know.

A stop limit order is a stop order that, once triggered or activated, becomes a limit order. Realize that it is possible for a stop limit to be triggered and not executed, as the limit price specified by the doctor may not be available.

In addition, there are all or none and fill or kill orders, and even though both require the entire order to be filled, there are distinct differences. An all or none (AON) is an order in which the broker is directed to fill the entire order or none of it. A fill or kill (FOK) is an order either to buy or to sell a security in which the broker is directed to attempt to fill the entire”‘ amount of the order immediately and in full, or that it be canceled.

The difference between an all or none and a fill or kill order is that with an all or none order, immediate execution is not required, while immediate execution is a critical component of the fill or kill. Be cause of the immediacy requirement, FOK orders are never found on the specialist’s book. Another difference is that AON orders are only permitted for bonds, not stocks, while FOK orders may be used for either.

Also, there exists an immediate or cancel order (IOC), which is an order to buy or sell a security in which the broker is directed to attempt to fill immediately as much of the order as possible and cancel any part remaining. This type of order differs from a fill or kill order which requires the entire order to be filled. An IOC order will permit a partial fill. Because of the immediacy requirement, IOC and FOK orders are never found on the specialist’s book.

Long and Short Positions

A long buy position means that shares are for sale from a market makers inventory, or owned by the medical investor, outright. Market makers take long positions when customers and other firms wish to sell, and they take short positions when customers and other firms want to buy in quantities larger than the market maker’s inventory. By always being ready, willing, and able to handle orders in this way, market makers assure the investing public of a ready market in the securities in which they are interested. When a security can be bought and sold at firm prices very quickly and easily, the security is said to have a high degree of liquidity, also known as marketability.

A short position investor seeks to make a profit by participating in the decline in the market price of a security.

Now, let’s see how these terms, long and short, apply to transactions by medical investors, rather than market makers, in the securities markets.

When a doctor buys any security, he is said to be taking a long position in that security. This means the investor is an owner of the security. Why does a doctor take a long position in a security? Besides – receiving dividend income, to make a profit from an increase in the market price. Once the security has risen sufficiently in price to satisfy the investor’s profit needs, the investor will liquidate his long position, or sell his stock. This would officially be known as a long sale of stock, though few people in the securities business use the label “long sale”. This is the manner in which the above investor had made a profit is the traditional method used; buy low, sell high.

Let’s look at an actual investment in General Motors to investigate this principle further. A medical investor has taken a long position in 100 shares of General Motors stock at a price of $70 per share. This means that the manner in which he can do that is by placing a market order which will be executed at the best “available market price at the time, or by the / placing of a buy limit order with a limit price of $70 per share. The investor firmly believes, on the basis of reports that he has read about the automobile industry and General Motors specifically, that at $70 a share, General Motors is a real bargain. He believes that based on its current level of performance, it should be selling for a price of between $80 and $85 per share. But, the doctor investor has a dilemma. He feels certain that the price is going to rise but he cannot watch his computer, or call his broker, every hour of every day. The reason he can’t watch is because patients have to be seen in the office. The only people who watch a computer screen all day are those in the offices of brokerage firms (stock broker registered representatives), and doctor day traders, among others.

In the above example, with a sell limit order, if the doctor investor was willing to settle for a profit of $12 per share, what order would he place at this time? If you said, “sell at $82 good ’til canceled”, you are correct. Why GTC rather than a day order? Because our doctor investor knows that General Motors is probably not going to rise from $70 to $82 in one day. If he had placed an order to sell at $82 without the GTC qualification, his order would have been canceled at the end of this trading day. He would have had to re-enter the order each morning until he got an execution at 82. Marking the order GTC (or open) relieves him of any need to replace the order every morning. Several weeks later, when General Motors has reached $82 per share in the market, his order to sell at 82 is executed. The medical investor has bought at 70 and sold at 82 and realized a $12 per share profit for his efforts.

Let’s suppose that the medical investor, who has just established a $12 per share profit, has evaluated the performance of General Motors common stock by looking at the market performance over a period of many years. Let’s further assume that the investor has found by evaluating the market price statistics of General Motors is that the pattern of movement of General Motors is cyclical. By cyclical, we mean that it moves up and down according to a regular pattern of behavior. Let’s say the investor has observed that in the past, General Motors had repeated a pattern of moving from prices in the $60 per share range as a low, to a high of approximately $90 per share. Further, our investor has observed that this pattern of performance takes approximately 10 to l2 months to do a full cycle; that is, it moves from about 60 to about 90 and back to about 60 within a period of roughly l2 months. If this pattern repeats itself continually, the investor would be well advised to buy the stock at prices in the low to mid 60’s hold onto it until it moves well into the 80’s, and then sell his long position at a profit. However, what this means is that our investor is going to be invested in General Motors only 6 months of each year. That is, he will invest when the price is low and, usually within half a year, it will reach its high before turning around and going back to its low again. How can the doctor investor make a profit not only on the rise in price of General Motors in the first 6 months of the cycle, but on the fall in price of General Motors in the second half of the cycle? One technique that is available is the use of the short sale.

The Short Sale

If a doctor investor feels that GM is at its peak of $ 90 per share, he may borrow 100 shares from his brokerage firm and sell the 100 shares of borrowed GM at $ 90. This is selling stock that is not owned and is known as a short sale. The transaction ends when the doctor returns the borrowed securities at a lower price and pockets the difference as a profit. In this case, the doctor investor has sold high, and bought low.

Odd Lots

Most of the thousands of buy and sell orders executed on a typical day on the NYSE are in 100 share or multi-100 share lots. These are called round lots. Some of the inactive stocks traded at post 30, the non-horseshoe shaped post in the northwest corner of the exchange, are traded in 70 share round lots due to their inactivity. So, while a round lot is normally 700 shares, there are cases where it could be 10 shares. Any trade for less than a round lot is known as an odd lot. The execution of odd lot orders is somewhat different than round lots and needs explanation.

When a stock broker receives an odd lot order from one of his doctor customers, the order is processed in the same manner as any other order. However, when it gets to the floor, the commission broker knows that this is an order that will not be part of the regular auction market. He takes the order to the specialist in that stock and leaves the order with the specialist. One of the clerks assisting the specialist records the order and waits for the next auction to occur in that particular stock. As soon as a round lot trade occurs in that particular stock as a result of an auction at the post, which may occur seconds later, minutes later, or maybe not until the next day, the clerk makes a record of the trade price.

Every odd lot order that has been received since the last round lot trade, whether an order to buy or sell, is then executed at the just noted round lot price, the price at which the next round lot traded after receipt of the customer’s odd lot order, plus or minus the specialist’s “cut “.  Just like everything else he does, the specialist doesn’t work for nothing. Generally, he will add 1/8 of a point to the price per share of every odd lot buy order and reduce the proceeds of each odd lot sale order by 1/8 per share. This is the compensation he earns for the effort of breaking round lots into odd lots. Remember, odd lots are never auctioned but, there can be no odd lot trade unless a round lot trades after receipt of the odd lot order.

Conclusion

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Hurdle Rates V. Highwater Marks V. Claw Back Provisions

More on Hedge Funds and Fees

dem-2By Dr. David Edward Marcinko MBA MEd CMP®

SPONSOR: http://www.CertifiedMedicalPlanner.org

Many physicians and other investors — even those that meet net worth guidelines — are surprised to learn that there exists a $500 – 999 billion, or more, alternative investment industry that is not generally marketed to the public. Such alternative investments have also been known as hedge funds or private investment funds.

Unlike mutual funds, these alternative investments can be structured in a wide variety of ways. Because of the very same regulations discussed above, these funds cannot be advertised, but they are far from illegal or illicit.

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History

In fact, physicians were among the most significant early investors in one of the last century’s most successful hedge funds. Mr. Warren Buffett, Chairman of Berkshire Hathaway, Inc. and a legendary investor got his start in 1957 running the Buffett Partnership, an alternative investment fund not open to the general public. Mr. Buffett’s first public appearance as a money manager was before a group of physicians in Omaha, Nebraska. Eleven decided to put some money with him. A few of these original investors followed him into Berkshire Hathaway, now among the most highly valued companies in the world.

The alternative investment, or hedge, funds of today are similar to the original Buffett Partnership in many ways. So, we will discuss several unique terms which potential investors should be aware.

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Hurdle Rate

Hedge funds may feature a hurdle rate as part of the calculation of the fund manager’s performance incentive compensation. Also known as a “benchmark,” the hurdle rate is the amount, expressed in percentage points, an investor’s capital account must appreciate before the account becomes subject to a performance incentive fee. Potential medical investors should view the hurdle rate as a form of protection in context with other features of the fee arrangement.

The hurdle rate, which benchmarks a single year’s performance, may be considered mutually exclusive of any other year, or the hurdle rate may compound each year. The former case is more common. In the latter case, a portfolio manager failing to attain a hurdle rate in the first year will find the effective hurdle rate considerably higher during the second year.

Once a fund manager attains the hurdle rate for an investor, the medical investor’s capital account may be charged a performance incentive fee only on the performance above and beyond the hurdle rate. Alternatively, the account may be charged a performance fee for the entire level of performance, including the performance required to attain the hurdle rate. Other variations on the use of the hurdle rate exist, and are limited only by the contract signed between the fund manager and the investor. The hurdle rate is not generally a negotiating point, however.

Example:

A fund charges a performance fee with a 6 percent hurdle rate, calculated in mutually exclusive manner. Dr. Lanouettea, a radiologist investor places $100,000 with the fund. The first year’s performance is 5 percent. The investor therefore owes no performance fee during the first year because the portfolio manager did not attain the hurdle rate. During year two, the portfolio manager guides the fund to a 7 percent return. Because the hurdle rate is mutually exclusive of any other year, the portfolio manager has attained the 6 percent hurdle rate and is entitled to a performance fee.

Highwater Mark

Some funds feature a highwater mark provision, also known as a ”loss-carryforward” provision. As with the hurdle rate, potential investors should consider the highwater mark a form of protection. A high water mark is an amount equal to the greatest value of an investor’s capital account, adjusted for contributions and withdrawals. The high water mark ensures that the hedge fund manager charges a performance incentive fee only on the amount of appreciation over and above the highwater mark set at the time the performance fee was last charged. The current trend is for newer funds to feature this highwater mark, while older, larger funds may not feature it.

Example:

A fund charges a 20 percent performance fee with a highwater mark but no hurdle rate. Dr. Butalak, a dentist investor contributes $100,000 to the fund. During the first year, the hedge fund manager grows that capital account to $110,000 and charges a 20 percent performance fee, or $2,000. The ending capital account balance and highwater mark is therefore $108,000. During year two, the account falls back to $100,000, but the highwater mark remains $108,000. During year three, in order for the manager to charge a performance fee, the manager must grow the capital account to a level above $108,000.

Clawback Provision

Rarely, a fund may provide investors with a clawback provision. This term, borrowed from the venture capital fund world, such provisions result in a refund to the investor of all or part of a previously charged performance fee if a certain level of performance is not attained in subsequent years. Such refunds in the face of poor or inadequate performance may not be legal in some states or under certain authorities.

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.

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DAILY UPDATE: +/- Stocks and Dull Market Reviews

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What’s up

What’s down

  • Victoria’s Secret shares dropped 6.37% even though the company met both earnings and revenue estimates this quarter. It’s still mid-turnaround, however, and high debt remains a concern for investors.
  • Big Lots shares tanked 18.32% after the company announced abysmal earnings thanks to core customers cutting back their spending.
  • Canopy Growth shares dropped 8.45% after the marijuana producer announced plans to sell more shares in order to keep the company afloat.
  • Five Below shares fell 10.60% after announcing unimpressive earnings as low-income customers get squeezed by inflation.
  • Nio shares dropped 6.92% after the EV maker announced slower earnings than anticipated thanks to the ongoing decline in EV sales.

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Here’s where the major benchmarks ended:

  • The S&P 500 index fell 1.07 points (0.02%) to 5,352.96; the Dow Jones Industrial Average® ($DJI) gained 78.84 points (0.2%) to 38,886.17; the NASDAQ Composite eased 14.78 points (0.1%) to 17,173.12.
  • The 10-year Treasury note yield (TNX) fell slightly to 4.285%.
  • The CBOE Volatility Index® (VIX) declined 0.05 to  12.58.

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PODCAST: What is an “Entrepreneur” According to Austrian Eonomists

The Methodology of Thinking on Your Own

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By Dr. David E. Marcinko MBA MEd CMP

The Austrian school of Economics uses the logic of a priori thinking—something a person can think on their own without relying on the outside world—to discover economic laws of universal application.

The other mainstream schools of economics, like the neoclassical school, the new Keynesians and others, make use of data and mathematical models to prove their point objectively.

In this respect, the Austrian school can be more specifically contrasted with the German historical school that rejects the universal application of any economic theorem.

PODCAST: https://www.youtube.com/watch?v=MxK8FKU3BPs

And so, colleague Peter Quinones Free Man Beyond The Wall – welcomes Per in this podcast presentation. Per talks about the role of the entrepreneur, not only in society, but according to the Austrian School of Economics!

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PODCAST: http://freemanbeyondthewall.libsyn.com/episode-312

Assessment: Your thoughts and comments are appreciated.

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CAREER DEVELOPMENT

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As CEO and favorite on the lecture circuit, medical and entrepreneurial futurist Dr. David Edward Marcinko MBA MEd CMP™ enjoys public speaking and gives many talks each year to a variety of conferences around the country, Asia and Europe. He is often quoted in the media, with speaking engagements to more than 135 financial, educational and state medical societies and business groups in an entertaining and witty fashion.

These include seminar speaking engagements and interviews for TV, radio, news and trade magazines, podcasts, blogs and vlogs, and Key-note speeches for colleges, universities, hospitals, business schools or commencement exercises; End-note lectures at city, state, regional or national coalitions on capitalism and free-markets; and annual Break-out sessions for a variety of public and population healthcare policy, management and administration colloquia and meetings.

Past sponsors include Medical Pharmaceutical Companies [Pfizer, Glaxo, Smith-Klein-Fujisawa, Novartis, Shering, Terumo, Sunoviom, Schering-Plough, Sepracor and Aventis, etc]; and Financial Services Corporations [First Global Financial Advisors, Merrill Lynch, Sun-Trust, The Principal, and Pacific Life Insurance Company, etc].

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CONTACT: Ann Miller RN MHA for public speaking and interview information, professional fees and related engagement details: MarcinkoAdvisors@msn.com

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DAILY UPDATE: D-Day, Digital Health, Stock Companies as Markets Zoom Up!

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Today is the 80th anniversary of D-Day: More than 60 World War II veterans flew to Paris over the weekend to take part in what organizers believe could be the final major WWII commemoration involving living veterans. American veterans will be joined by President Joe Biden and other heads of state in Normandy.

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

The digital health market has had a tough year, with no IPOs in all of 2023. Comparatively, the industry saw roughly 20 public exits in 2021. The recent slowdown in the broader IPO market is linked to several trends, including high interest rates and some high-profile bankruptcies, according to Adriana Krasniansky, head of research at digital health strategy group and venture fund Rock Health’s advisory arm.

Here’s where the major benchmarks ended:

  • The S&P 500 index rose 62.69 points (1.2%) to 5,354.03; the Dow Jones Industrial Average® ($DJI) gained 96.04 points (0.3%) to 38,807.33; the NASDAQ Composite rallied 330.86 points (2.0%) to 17,187.90.
  • The 10-year Treasury note yield (TNX) fell more than 5 basis points to 4.283%, its lowest level since April 1.
  • The CBOE Volatility Index® (VIX) declined 0.53 to 12.63.

What’s up

  • Nvidia only rose 5.16% today, but it was enough to surpass Apple’s market cap, making the high-flying semiconductor stock the second most valuable public company in the US.
  • Crowdstrike rose 11.98% today after reporting better than expected fiscal first quarter earnings yesterday afternoon.
  • Guidewire Software rose 17.63% today after its beat & raise quarterly report late yesterday.
  • Stitch Fix rose 29.40% after a red-hot earnings report, completely turning around the stock’s slow slide downward this year.
  • SweetGreen popped 12.76% this afternoon after revealing that its new automated kitchens can actually save on costs and cut time for orders in the long run.

What’s down

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

In case you needed more proof that we’re living in the strangest timeline: Morgan Stanley, which owns E*Trade, is contemplating kicking stock influencer Roaring Kitty off the platform. It’s concerned he manipulated GameStop stocks by…posting a meme on X. (the Wall Street Journal)

CITE: https://tinyurl.com/tj8smmes

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What Kind of [Physician] Entrepreneur Are You?

More Doctors are Joining the Ranks

http://www.MarcinkoAssociates.com

Marcnko & Associates

[Medical] entrepreneurs, doctors and nurses, clinics and small-to-medium size healthcare business are on the forefront of  job creation in the United States because of the Affordable Care Act [ACA] of 2010.

And so, we now preview this infographic to celebrate the entrepreneur, their styles, and to investigate the data behind startup growth. Hopefully, it will encourage the next generation of physician-entrepreneurs.

Who knows, there just may be the next Steve Jobs MD out there!

Source: BizSugar

Conclusion

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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

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DAILY UPDATE: The Peso, Health Company News with Firmer Stock Markets

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

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Sword Health, a virtual provider of musculoskeletal care, banked a financing round of $130 million after nearly tripling its revenue in the past year.


Blue Cross and Blue Shield of Kansas City is leaving the Medicare Advantage market, citing increased regulatory demands and a relatively small MA membership.


And … Cigna laid off 261 employees from its Evernorth Care Group division in Arizona. Keep up to date with all workforce updates with Fierce Healthcare’s ongoing layoff tracker.

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

On Monday, the largest U.S.-traded, Mexico-focused fund — the iShares MSCI Mexico ETF which has more than $2 billion under management — slid 10.7% to book its largest daily percentage decrease since March 16th, 2020. Meanwhile, the Franklin FTSE Mexico ETF was off 10%, also logging its worst day in over four years, according to Dow Jones Market Data. The two funds, which traded at $57.93 and $28.78, respectively, on Monday afternoon, closed at their lowest levels since early November, according to Dow Jones Market Data. 

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

June got off to a rough start on Monday when a glitch at the NYSE incorrectly made it appear that some stocks suffered steep plunges—including a 99% dip in Berkshire Hathaway. Trading in the affected stocks was quickly halted and the errors were fixed.

CITE: https://tinyurl.com/tj8smmes

What’s up

What’s down

  • Stanley Black & Decker fell 3.69% after it was downgraded at Barclays. A slowdown in consumer spending plus a slow housing market means not many people are buying fancy drills at the moment.
  • Bath & Body Works fell 12.60% after beating analyst expectations this quarter but announcing that next quarter will bring lower lower earnings.
  • Designer Brands fell 20.27% after it beat revenue expectations but missed on earnings as its turnaround continues.

Here’s where the major benchmarks ended:

  • The S&P 500 index gained 7.94 points (0.2%) to 5,291.34; the Dow Jones Industrial Average® ($DJI) added 140.26 points (0.4%) to 38,711.29; the NASDAQ Composite® ($COMP) rose 28.38 points (0.2%) to 16,857.05.
  • The 10-year Treasury note yield (TNX) fell more than 7 basis points to 4.328%.
  • The CBOE Volatility Index® (VIX) rose 0.05 to 13.16.

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DAILY UPDATE: Cyber Health Hacks, DocGo, Public Companies and Mixed Stock Markets

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.

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Dollar General has ended a pilot program with mobile care provider DocGo, becoming the latest retailer to wind down primary care operations, spokespeople from both companies confirmed to Healthcare Brew on May 31st. The retail giant—the largest in the US by number of stores—began the healthcare partnership in 2023 after announcing ambitions to establish itself as a “health destination” two years prior. DocGo and Dollar General offered mobile health clinics with basic, preventive, and urgent care services at three stores in Tennessee. Dollar General executives previously said in a June 2023 press release that they would expand the DocGo pilot program to more stores.

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

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) rose 5.89 points (0.1%) to 5,283.40; the Dow Jones Industrial Average® ($DJI) lost 115.29 points (0.3%) to 38,571.03; the NASDAQ Composite® ($COMP) advanced 93.65 points (0.6%) to 16,828.67.
  • The 10-year Treasury note yield (TNX) declined more than 11 basis points to 4.40%, near a two-week low.
  • The CBOE Volatility Index® (VIX) rose 0.19 to 13.11.

🟢 What’s up?

What’s down?

  • GSK dropped 8.65% on the news that a Delaware court will allow scientific evidence to be heard in a series of lawsuits regarding the discontinued heartburn drug Zantac.
  • Boston Beer fell 3.25% after shareholders decided to take their winnings and run following Friday’s big pop after news of its apparent acquisition by Suntory.
  • Tractor Supply shares toppled 6.21%, likely on poor manufacturing news from the ISM Index, while Halliburton shares fell 5.34%, likely on poor oil news from OPEC+.
  • Dozens of Mexican stocks and ETFs tumbled today on the election of a new president. The steepest decline was seen by Grupo Financiero Banorte, SAB, which fell 11.38%.

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

Cyberattacks around the country are wreaking havoc on the ground at targeted hospitals, but a new study shows that security breaches hurt surrounding providers, too. The research published in JAMA on May 29 found that cyberattacks led to a decrease in emergency department (ED) visits at attacked hospitals and an increase in ED patients at nearby hospitals.

CITE: https://tinyurl.com/tj8smmes

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PODCAST: What is a Quality-Adjusted Life Year?

NOT A Generic Obscure Measure

By Dr. David E. Marcinko MBA MEd CMP

http://www.CertifiedMedicalPlanner.org

The quality-adjusted life year or quality-adjusted life-year (QALY) is a generic measure of disease burden, including both the quality and the quantity of life lived.

It is used in economic evaluation to assess the value for money of medical interventions. One QALY equates to one year in perfect health. If an individual’s health is below this maximum, QALYs are accrued at a rate of less than 1 per year.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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ASSESSMENT: To be dead is associated with 0 QALYs. QALYs can be used to inform personal decisions, to evaluate programs, and to set priorities for future programs

VIDEO: https://www.youtube.com/watch?v=OTmXnv2RAHw

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

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DAILY UPDATE: Jobs, Chips, Banks and Tax Refunds

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.

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Stat: 4.6%. That’s how much the average income tax refund increased YoY, from $2,878 in April 2023 to $3,011 as of April 5th. (Axios)

Quote: “Wall Street has never been known for high character and high values. Is there a willingness to support Trump if it looks like he’s on the right track? Yes. I’m not proud of that, and I’m not part of that either.”—Dan Lufkin, co-founder of investment bank Donaldson, Lufkin & Jenrette (Bloomberg)

Read: Bank of America’s CEO sees an overall cautiousness on display in the current spending choices of consumers and businesses. (CNBC)

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

The May jobs report will drop on Friday: Little change is expected from April, when the unemployment rate ticked up to 3.9% and fewer jobs were added than expected (175,000). This jobs report will be one of the final pieces of economic data to drop before the Fed meets on June 11th and 12th. The central bank is unlikely to announce an interest rate cut.

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

Software is no longer eating the world. For the first time, chip stocks now account for the heaviest weighting in the S&P 500, taking the top spot away from software companies last week. Salesforce and other enterprise software giants are getting crushed as companies prioritize generative AI investments (chips and servers) over SaaS products.

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PODCAST: What is Epistemic Ambivalence?

Epistemic Ambivalence!

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

[By staff reporters]

Epistemic Ambivalence is almost the opposite idea of what ambivalence means because to be epistemic means you know, you are sure.

Epistemic ambivalence is when you may know the truth of a situation but cannot say which truth it is, because there is more than one option.

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MORE: Schrödinger’s cat is a thought experiment, sometimes described as a paradox, devised by Austrian physicist Erwin Schrödinger in 1935. It illustrates what he saw as the problem of the Copenhagen interpretation of quantum mechanics applied to everyday objects. The scenario presents a hypothetical cat that may be simultaneously both alive and dead, a state known as a quantum superposition, as a result of being linked to a random subatomic event that may or may not occur. The thought experiment is also often featured in theoretical discussions of the interpretations of quantum mechanics. Schrödinger coined the term Verschränkung (entanglement) in the course of developing the thought experiment.
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Assessment: Your thoughts are appreciated.
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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)
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Invite Dr. Marcinko

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What is “COMPASSION FADE?”

A Cognitive Bias of the Post Corona Virus Pandemic Era

Courtesy: www.CertifiedMedicalPlanner.org

By Dr. David E. Marcinko MBA MEd CMP

Compassion Fade is a cognitive bias that predisposes people to behave more compassionately towards a small number of identifiable victims than to a large number of anonymous ones.

LINK: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

It is the psychological explanation to the known phenomenon alluded to by Joseph Stalin in his famous quote “The death of one man is a tragedy; the death of millions is a statistic”.

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LINK: https://www.publichealthpost.org/research/compassion-fade/

Assessment: Your thoughts and comments are appreciated.

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BUSINESS, FINANCE, INVESTING AND INSURANCE TEXTS FOR DOCTORS:

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DAILY UPDATE: Mixed Stock Markets with DJIA Up

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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Here’s where the major benchmarks ended:

  • The S&P 500 index added 42.03 points (0.8%) to 5,277.51, down 0.5% for the week; the Dow Jones Industrial Average® ($DJI) gained 574.84 points (1.5%) to 38,686.32, down 1.0% for the week; the NASDAQ Composite® ($COMP) declined 2.06 points (0.01%) to 16,735.02, down 1.1% for the week. 
  • The 10-year Treasury note yield (TNX) fell more than 6 basis points to 4.491%.
  • The CBOE Volatility Index® (VIX) declined 1.55 to 12.92.

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

🟢 What’s up

  • Gap popped 27% after the retail conglomerate raised its guidance for the year and sales for all four of its brands beat earnings expectations.
  • Caesars jumped 12% because of the Carl Icahn effect: The investor reportedly acquired a “sizeable stake” in the casino company, per Bloomberg.
  • The Boston Beer Company shares gained 21% on reports that the company may sell itself to Suntory.
  • Ambarella leapt 20% after better-than-expected earnings for the semiconductor company.
  • PENN Entertainment jumped 20% today after an activist investor called for a sale of the company.

What’s down

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

Private equity and consolidation are leading to a rise in hospital costs for patients. (the Wall Street Journal)

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DAILY UPDATE: Hospital Charges, Cannabis and Stocks as Markets Slump

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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Daily Update Provided By Staff Reporters Since 2007.
How May We Serve You?
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The prices hospitals charge for their services have long been opaque, but thanks to a 2021 hospital price transparency law, the picture is starting to come slightly into focus. And it turns out, there are some huge disparities in the prices hospitals charge that can’t be attributed to quality of care, according to a recent study from research institute Rand Corporation.

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

🟢 What’s up

What’s down

  • Salesforce is down 19.73% after the cloud computing company missed revenue estimates for the first time since 2006 and projected slower sales in the coming quarter. Turns out not even commercials featuring hunky Matthew McConaughey could save the company’s quarter.
  • UIPath shares plummeted 34.06% after announcing disappointing results and lower forward guidance, and to add insult to injury got hit with an analyst downgrade from Bank of America.
  • Build-A-Bear Workshop got the stuffing knocked out of it, dropping 13.92% after it missed estimates on both the top and bottom lines.
  • Hormel sank 9.69% after missing earnings thanks to slower retail sales offsetting higher meat prices, leaving shareholders stuck eating bologna sandwiches for lunch.
  • Kohl’s dropped 22.88% in its worst day ever after the company announced a terrible quarter and forecast more issues ahead due to customers contending with inflation.

Here’s where the major benchmarks ended:

  • The S&P 500® index (SPX) fell 31.47 points (0.6%) to 5,235.48; the Dow Jones Industrial Averagedropped 330.06 points (0.9%) to 38,111.48; the NASDAQ Composite® ($COMP) declined 183.50 points (1.1%) to 16,737.08.
  • The 10-year Treasury note yield (TNX) lost more than 7 basis points to 4.548%.
  • The CBOE Volatility Index® (VIX) rose 0.19 to 14.47.

Interest-rate-sensitive sectors including banks and utilities were among the stronger performers Thursday, boosted by a pullback in Treasury yields from four-week highs posted earlier in the week. Stocks are still heading for a down week, with the S&P 500 on track for its first weekly decline out of the past six.

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

Legal cannabis is a booming industry: An estimated $38.4 billion in medical and recreational cannabis was sold in the US in 2023, and that figure is projected to rise to $56.9 billion by 2028. The industry has grown an average of 29.1% per year between 2018 and 2023, according to IBISWorld.

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What is the “DeMark” Investing Indicator?

A TECHNICAL ANALYSIS STOCK TRADING SIGNAL?

By Dr. David Edward Marcinko MBA, MEd CMP

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DEFINITION: The DeMark indicator (DeM) is a technical analysis oscillator that compares the most recent and previous prices of an asset to measure the demand and the directional trend of the market. It is based on principles promoted by technical analyst Thomas DeMark, who developed it over his nearly 50-year career. It aims to identify potential price reversals and inflection points before the market responds. It can be applied to any asset class, region, time interval, and data set.

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

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See the source image

READ: https://www.tradingview.com/scripts/demark/

TECHNICAL ANALYSIS: https://medicalexecutivepost.com/2007/12/03/the-technicians/

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